A cross-sectional population survey on stroke knowledge and attitudes in Greater Kampala, Uganda

Determinants of stroke among adult hypertensive patients on follow up in Addis Ababa public hospitals, Ethiopia: A case control study

BACKGROUND

Stroke is a non-communicable disease that causes sudden global or focal neurological disorders. It is one of the major public causes of morbidity and mortality in low- and middle-income countries, including Ethiopia. Early identification of the determinants and prompt intervention remains critical to reduce morbidity and mortality from stroke.

OBJECTIVE

The study aimed to identify determinants of stroke among adult hypertensive patients on follow up in Addis Ababa public hospitals, Ethiopia.

METHODS

Unmatched case-control study design was conducted among 326(109 cases and 217 controls) study participants in Addis Ababa public hospitals from September 1-30, 2021. The cases were adult hypertensive patients who developed a stroke and the controls were adult hypertensive patients. The study participants were selected by consecutive sampling technique. Pretested structured interviewer assisted questionnaire and checklist were used to collect data. Data were entered into Epi data version 3.1; exported and analysed by SPSS version 23. All independent variables with p-value < 0.25 in the bi-variable logistic regression analysis were entered into multivariable logistic regression analysis. Finally, variables with p-value <0.05 were considered as determinants of the stroke.

RESULTS

In this study, current cigarette smoker(AOR = 5.55, 95% CI: 2.48, 12.43), current alcohol drinker(AOR = 4.27, 95% CI: 1.94, 9.38), medication non-compliance(AOR = 3.23, 95% CI: 1.62, 6.44), uncontrolled systolic blood pressure (AOR = 3.42, 95% CI: 1.64, 7.16), uncontrolled diastolic blood pressure(AOR = 4.29, 95% CI: 2.06, 8.93), high low density lipoprotein(AOR = 6.89, 95% CI: 3.57, 13.35) and diabetic mellitus(AOR = 3.25, 95% CI: 1.58, 6.69) were more likely to develop a stroke.

CONCLUSION AND RECOMMENDATION

Cigarette smoking, alcohol use, non-adherence to medication, uncontrolled systolic pressure, uncontrolled diastolic blood pressure, high low-density lipoprotein, and diabetic mellitus were determinants of stroke. Providing health education about lifestyle changes and the consequences of hypertension at all follow-up is very important.

Evaluating the Global Impact of Stroke Awareness Month: A Serial Cross-Sectional Analysis

INTRODUCTION

Stroke is the second-leading cause of mortality in the world and ranks fifth in terms of causes of death in the United States. "Time is brain" when it comes to the detection and treatment of a stroke as it can reduce morbidity and disability in the long run. May is recognized as Stroke Awareness Month to involve the concerned stakeholders. The goal of this month is to raise public awareness of the risk factors for stroke and to minimize its occurrence. We, for the first time, evaluated the actual impact of this awareness campaign to formulate evidence-based recommendations to promote stroke awareness.

METHODS

The total number of tweets posted in the month of May from 2014 to 2022 were extracted. The search queries used were "stroke awareness month OR stroke month OR #strokemonth OR #strokewarenessmonth" and "stroke OR #stroke". Social network analysis of the tweets was done to understand the context of posts. Network analysis provides the capacity to estimate complex patterns of relationships and gives insights into useful information about impact, reach, and interactions in an environment. The top 100 related hashtags, influencers, and keywords were extracted. Beyond social media usage, Google Trends web search analysis was done for the search term 'stroke awareness month' for interest by region of the last five years to get an overall idea of the internet search trends globally.

RESULTS

Out of the total 989,935 tweets about stroke posted in May 2022, only 1.07% of the tweets were specific to Stroke Awareness Month. The mean and standard deviation of the percentage of targeted action from 2014 to 2022 have been 3.14% and 1.35%, respectively. Forty-five percent of the top users never collaborated with each other. On Google Trends analysis, the event had primary involvement from the United States and the United Kingdom. The event had very limited reach in other continents, especially in Asian and African countries.

CONCLUSION

Our estimates highlight the limited digital impact of Stroke Awareness Month globally. The use of social media should be promoted, particularly in developing countries, to provide reliable information and generate user involvement on a global scale. Findings from this study can be leveraged to inform future policies for stroke awareness campaigns that improve public and global health.

Awareness about stroke among high and low risk individuals in Khartoum, Sudan: a cross-sectional study

Introduction

stroke causes 10.17% of all deaths in Sudan. Levels of stroke awareness amongst patients in Sudan are unknown. The aim of this study is to assess the level of awareness of stroke risk factors, symptoms and immediate management amongst high and low risk patients.

Methods

using descriptive cross-sectional study, participants of high and low risk groups were recruited from the referral clinics of three tertiary hospitals in Khartoum. Data was collected through interviews using structured questionnaire. Knowledge score was devised to assess the awareness about stroke symptoms, risk factors, and management.

Results

of the 286 participants, 150 were females. The mean age was 44.66 years. About 79.4% reported that stroke is preventable. Hypertension was the most identified risk factor (71.6%) while genetics (0.2%) and alcohol (0.2%) were the least identified risk factors. Twenty-seven percent (27.6%) did not know any stroke risk factors, while 32.9% did not know any warning symptoms. Paralysis of one side of the body was the most identified warning symptom (30.7%). The mean awareness score was 21.9 ± 3.4 among the high risk group vs. 22.1 ± 3.6 among the low risk group with no statistically significant difference between the two groups (p = .717). The mean awareness score was statistically associated with the level of education (p < 0.001).

Conclusion

the awareness level was relatively low and not statistically different between high and low risk groups. We recommend the development of an effective educational program for the whole community.

Level of Knowledge on Stroke and Associated Factors: A Cross-Sectional Study at Primary Health Care Centers in Morocco

Background:

Stroke is increasingly becoming a major cause of disability and mortality. However, it can be prevented by raising awareness about risk factors and early health care management of patients.

Objective:

The aim of this study is to assess the level of knowledge on stroke, its risk factors, and warning signs in the population attending urban primary health care centers in the city of Agadir, Morocco.

Methods:

This is a multicentric cross-sectional study with a descriptive and analytical purpose. The study was conducted at five urban primary health care centers in Agadir in centralwest Morocco. All persons over the age of 18 years who consulted the health centers and who agreed to fill in the questionnaire were recruited, except for the foreign population and health workers. An interview questionnaire was used to assess the level of knowledge on stroke.

Findings:

A total of 469 participants were involved in the study. The median knowledge score was 8 (Interquartile range 4–13). High blood pressure (55.7%), depression and stress (48.8%) were the most well-known risk factors. Sudden weakness of the face, arms or legs (37.3%) was the main warning sign cited by the participants. Multivariate analysis revealed that illiteracy (OR 1.92; CI_95%: 1.08–3.44) primary education (OR 3.43; CI_95%: 1.63–7.21), rural residential (OR 1.67; CI_95%: 1.07–2.59), no history of stroke among respondents (OR 16.41; CI_95%: 4.37–61.59) and no history of stroke among relatives, acquaintances, or neighbors (OR 4.42; CI_95%: 2.81–6.96), were independently associated with a lower level of knowledge of stroke (Table 4).

Conclusions:

The low level of knowledge on stroke among this Moroccan population indicates the importance of implementing stroke education initiatives in the community. More specifically, proximity education and awareness programs ought to be considered to anchor lifestyle preventive behaviors along with appropriate and urgent actions regarding the warning signs of stroke.

Feasibility study of a targeted self-management intervention for reducing stroke risk factors in a high-risk population in Uganda

INTRODUCTION

Stroke remains a global concern due to increasing lifespan, patterns of industrialization, adoption of harmful western diets, and an increasing prevalence of risk factors such as hypertension, obesity, and diabetes. We investigated an adopted novel self-management intervention, TargetEd mAnageMent Intervention (TEAM) to reduce modifiable stroke risk factors in Uganda.

METHODS

A six-month, uncontrolled, prospective pilot study to establish feasibility, acceptability and preliminary efficacy of TEAM in Ugandans at high risk for stroke was conducted. The primary outcome was change in systolic BP from baseline to 24-week follow-up. Secondary outcomes included change in diastolic BP, serum cholesterol, high and low density lipoprotein (HDL, LDL) and triglycerides.

RESULTS

Mean (SD) baseline systolic BP was 162.9 (±25.6) mmHg while mean (SD) baseline diastolic BP was 99.1 (±13.8) mmHg. There was a significant reduction in mean baseline blood pressure of 163/98.8mmHg to blood pressure of 147.8/88.0mmHg at 24weeks, P=0.023. There were also significant reductions in the serum total cholesterol levels at 24weeks with P=0.001.

CONCLUSION

Targeted training in self-management (TEAM) adapted to the Ugandan setting is feasible, highly acceptable to participants and appears to be associated with reduced blood pressure, improved lipid profiles and improved glucose control in diabetics.

Modifiable lifestyle risk factors for stroke among a high risk hypertensive population in Greater Kampala, Uganda; a cross-sectional study

OBJECTIVE

To describe the modifiable lifestyle risk factors for stroke among a high risk population for stroke. Africa suffers from rapid population growth, adoption of harmful western diets, and increased prevalence of hypertension and obesity.

RESULTS

A total of 440 study participants were screened and 87 individuals with hypertension plus at least one other known stroke risk factor were enrolled. The prevalence of hypertension and diabetes mellitus in the screened population was 19.7 and 1.8%, respectively. Among those with hypertension only 2.3% (2/87) had ever had serum lipid assessment. Seventy-two percent (68/87) had very high serum LDL-cholesterol, while 33.3% (29/87) had low levels of HDL-cholesterol, and 67.8% had mean blood pressures greater than 160/100 mmHg and 40% (35/87) were obese, with a BMI ≥30. Targeting individuals with modifiable stroke risk factors and implementing self-management programs may be a way to reduce stroke burden in Uganda.