Abstract Number: Esoc2026a85 a Public Health Challenge: Stroke Symptom Recognition and Emergency Response in Brazil - A Systematic Review and Meta-Analysis

Abstract Background and aims Stroke remains a major public health challenge in Brazil. In 2012, the Ministry of Health implemented the Stroke Care Line (Resolution 665/2012), emphasizing public education and prevention as key elements of effective management. Despite these initiatives, the population’s ability to recognize stroke and respond appropriately remains uncertain. We aimed to evaluate stroke awareness among the Brazilian general population. Methods PubMed, Embase, SciELO, LILACS, and the Cochrane Register were searched for observational studies. Primary outcome was general stroke recognition. Secondary outcomes included recognition of components of the Brazilian stroke mnemonic SAMU (Sorria–smile, Abrace–hug, Música–song, Urgente–urgent). Random-effects meta-analyses estimated pooled prevalences with 95% confidence (CI). Meta-regression assessed associations with educational level using odds ratio (OR). Results Sixteen studies (n=17,569) were included. The pooled prevalence of stroke recognition was 72.2% (95%CI:65.0-78.5). Recognition of warning signs was 55.6% (95%CI:42.3-68.0) for mouth dropping, 51.4% (95%CI:37.2-65.4) for weakness, 53.9% (95%CI:38.3-68.9) for speech difficulty, and 44.7% (95%CI:37.6-52.0) for calling emergency medical service. Higher educational level was significantly associated with better recognition (OR=5.65; 95%CI:1.002-31.86;p0.05). No significant changes were observed for S, A, and M components before versus after Resolution 665/2012, whereas intention to call Emergency Medical Service (EMS) improved significantly. Conclusions Major gaps remain in Brazil in identifying warning signs and activating EMS, even after implementation of Resolution 665/2012. Culturally adapted, school- and community-based educational strategies emphasizing SAMU should be prioritized and evaluated in future prospective studies. Conflict of interest There is no conflict of interest to declare.