Czynniki warunkujące dostęp do opieki nad guzami mózgu w Angoli: Przegląd systematyczny

Abstract Background. Brain tumors require an exceptionally demanding continuum of care because clinical outcomes depend on timely recognition, neuroimaging, neurosurgical decision-making, pathology, oncology, radiotherapy, supportive treatment, and longitudinal follow-up. In low- and middle-income settings, this pathway is commonly disrupted by delays, out-of-pocket costs, urban concentration of services, and weak referral systems. Objective. To map the determinants of access to brain tumor care in Angola and to situate the Angolan context within the broader sub-Saharan African literature, with emphasis on clinical recognition, access to computed tomography (CT) and magnetic resonance imaging (MRI), neurosurgery, pathology, oncology, radiotherapy, financing, geography, continuity of care, and clinical governance. Methods. We conducted an exploratory scoping review of published and documentary sources, guided by PRISMA-ScR and Joanna Briggs Institute recommendations. Indexed literature, African regional sources, clinical guidance documents, and institutional materials with analytic relevance to Angola were synthesized narratively according to major domains of access. Results. International and regional evidence indicates that brain tumor care is vulnerable to serial bottlenecks, including delayed presentation, initially nonspecific symptoms, diagnostic confusion with stroke, central nervous system infection, or epilepsy, inconsistent access to CT and MRI, specialist shortages, delayed surgery, limited pathology capacity, inadequate radiotherapy availability, and loss to follow-up. In Angola, disease-specific published evidence remains scarce, and the exact patient profile and care timelines are still insufficiently documented. Nevertheless, regional African literature and the minimum requirements of neuro-oncology suggest that access in Angola depends less on any single technical intervention than on the coordinated functioning of the entire diagnostic and therapeutic pathway. Conclusions. Access to brain tumor treatment in Angola should be framed as a systemic neuro-oncology challenge. Priority actions include strengthening clinical suspicion and referral pathways, ensuring functional CT and MRI access, protecting neurosurgical and anesthetic capacity, improving reliable pathology, integrating care with oncology and radiotherapy, expanding financial protection, and creating clinical registries capable of measuring delays, treatments, and outcomes.