Sudanese physicians’ insights on managing stroke during Sudan’s war 2024

Abstract

BACKGROUND: Stroke is a major public health burden, with high mortality and long-term disability, particularly in low-resource and conflict-affected settings. In Sudan, the ongoing armed conflict since April 2023 has critically impacted healthcare delivery, yet its effects on stroke care remain underexplored. METHODS: A descriptive cross-sectional survey was conducted among 431 physicians managing stroke cases during the 2024 Sudan conflict. Data were collected through a self-administered questionnaire distributed via medical networks. Descriptive statistics summarized the findings, and Kruskal-Wallis tests assessed associations. RESULTS: Most respondents were general practitioners (49.2%), with over 80% having ≤ 5 years' experience and working in public hospitals. Nearly 49% reported significantly worsened stroke outcomes since the war, and 58% noted increases in both incidence and severity. Key barriers included delayed hospital arrival (38.5%), lack of neuroimaging (28.8%), and financial constraints. Over 70% cited shortages in supplies; rehabilitation was disrupted by facility loss, displacement, and inadequate follow-up. Complications such as recurrent strokes (57.5%) and infections (53.4%) were common. No significant associations were found between demographic factors and responses patterns to stroke management services. CONCLUSION: The war has led to a systemic collapse in stroke management in Sudan. A coordinated response is urgently needed to address diagnostic limitations, security risks, and rehabilitation gaps. Strengthening training, infrastructure, and resource delivery must be prioritized in future recovery strategies.