1
|
Jirjees F, Al-Obaidi H, Barakat M, Kharaba Z, AlSalamat H, Khidhair Z, Alfoteih Y, Eltayib E, Mansour S, Hallit S, Malaeb D, Hosseini H. Knowledge and awareness of stroke in the United Arab Emirates: a cross-sectional study of the general population. F1000Res 2023; 12:1112. [PMID: 37868297 PMCID: PMC10587663 DOI: 10.12688/f1000research.134328.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND The study aimed to assess stroke knowledge among the general population in the United Arab Emirates (UAE) and determine the factors associated with stroke awareness among people. METHODS A cross-sectional study was conducted in the UAE between September and November 2021. The general population has self-administered an online bilingual survey (Arabic and English) distributed via social media platforms. The questionnaire covered general knowledge about stroke risk factors, consequences of stroke, and responding to somebody with acute stroke attack. RESULTS A total of 545 surveys were completed, with more than half of the participants being female (58.5%), married (55.4%) and employed (59.4%). The majority were less than 50 years old (90.5%) and had a university degree (71.0%). Many of the participants (70.8%) had a good general knowledge of stroke; however, around 20% of the participants were able to recognize all symptoms and risk factors of stroke. The most common sources of stroke-related information were the internet/social media (53.6%). Females were better able to correctly identify at least one stroke symptom and outcome than males (p=0.008). University education has significantly affected participants' ability to identify early stroke symptoms (p=0.001) correctly. In addition, diabetic people were more likely to recognize at least one stroke outcome than non-diabetic people (p=0.039). CONCLUSIONS The knowledge of stroke was good among highly educated people and females. However, the awareness of all stroke risk factors, symptoms, consequences and risk factors was inadequate among the general population of the UAE. Thus, there is still a gap between recognition of the relevant stroke and taking action among people.
Collapse
Affiliation(s)
- Feras Jirjees
- University of Sharjah, Sharjah, United Arab Emirates
| | | | - Muna Barakat
- Applied Science Private University, Amman, Jordan
| | | | | | | | | | | | - Sara Mansour
- Lebanese International University, Beqaa, Lebanon
| | | | - Diana Malaeb
- Gulf Medical University, Ajman, United Arab Emirates
| | - Hassan Hosseini
- Universite Paris-Est Creteil Val de Marne, Créteil, Île-de-France, France
| |
Collapse
|
2
|
Erameh CO, Emorinken A, Akpasubi BO. A comprehensive analysis of stroke admissions at a rural Nigerian tertiary health facility: Insights from a single-center study. J Neurosci Rural Pract 2023; 14:703-709. [PMID: 38059259 PMCID: PMC10696323 DOI: 10.25259/jnrp_76_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/04/2023] [Indexed: 12/08/2023] Open
Abstract
Objectives This research intended to examine the demographic and clinical attributes of stroke admissions in a rural Nigerian hospital. Materials and Methods A retrospective analysis of stroke admissions was conducted over 1 year. All necessary data were obtained from patients' records and SPSS was employed for data analysis. P < 0.05 was deemed significant. Results There were 52 stroke cases, accounting for 5.9% of medical admissions. The patients' mean age was 62.81 ± 12.71 years, while females constituted 51.9% of cases. Common risk factors included hypertension (76.9%), hyperlipidemia (38.5%), alcohol (26.9%), and diabetes mellitus (26.9%). Clinical manifestations included hemiparesis/plegia (84.6%), altered consciousness (63.5%), slurred speech (61.5%), cranial nerve deficit (61.5%), aphasia (42.3%), and headache (34.6%). Ischemic stroke (71.2%) predominated over hemorrhagic stroke (28.8%). The average hospitalization duration was 17.62 ± 8.91 days, and the mean onset to arrival time was 121.31 ± 136.06 h. Discharge and mortality rates were 82.7% and 13.5%, respectively. The association between stroke subtypes and mortality was significant (P = 0.001). Conclusion Stroke constitutes a significant portion of medical admissions in Nigeria, with ischemic stroke being more prevalent. High mortality rates underscore the urgent need to manage risk factors to prevent stroke.
Collapse
Affiliation(s)
- Cyril Oshomah Erameh
- Department of Internal Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria
| | - Airenakho Emorinken
- Department of Internal Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria
| | | |
Collapse
|
3
|
Alzayer R, Barakat M, Jirjees F, Alhamdan A, Aloraifej S, Cherri S, Mansour S, El Khatib S, Kharaba Z, Rahal M, Hallit S, Malaeb D, Hosseini H. Knowledge and awareness of stroke and associated factors in the Saudi general population: a cross-sectional study. Front Neurol 2023; 14:1225980. [PMID: 37808501 PMCID: PMC10552853 DOI: 10.3389/fneur.2023.1225980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 08/29/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Stroke is a major cause of death and disability globally and in Saudi Arabia as well. Prevention and management of stroke depend highly on raising knowledge and awareness about the disease. Purpose The purpose of this study was to evaluate Saudi adult's knowledge and awareness about stroke and determine the associated factors. Materials and methods A cross-sectional online survey was conducted in May-July 2022 among Saudi citizens. Assessments of stroke knowledge about risk factors, symptoms, and response to stroke symptoms were evaluated. Logistic regression was conducted to assess the association between the socio-demographic characteristics and knowledge. Results A total of 389 participants were enrolled with the majority (81.7%) being male participants. Less than half of the study subjects (43.3%) identified four out of five correct answers related to general knowledge about stroke. Almost all the participants were able to identify at least one risk factor associated with stroke. The majority of the participants (81.2%) believed that physical inactivity was the most common risk factor associated with stroke. Approximately three-quarters of participants considered difficulty speaking and understanding speech, followed by the sudden loss of consciousness as the most common stroke manifestation. Participants with a history of hypertension, dyslipidemia, and obesity had significantly higher odds of identifying at least one early stroke symptom (OR 2.271 [95% CI 1.402 3.677], 2.059 [95% CI 1.273 3.328], and 2.665 [95% CI 1.431 4.963], respectively). Conclusion Our study revealed that participants have good knowledge about stroke. Nonetheless, further efforts are required to raise awareness and educate the public to optimize and ensure better treatment outcomes.
Collapse
Affiliation(s)
- Reem Alzayer
- Clinical Pharmacy Practice, Mohammed Al-Mana College for Medical Sciences (MACHS), Dammam, Saudi Arabia
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
- MEU Research Unit, Middle East University, Amman, Jordan
| | - Feras Jirjees
- Clinical Pharmacy and Pharmacy Practice, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Shatha Aloraifej
- Clinical Pharmacy Practice, Mohammed Al-Mana College for Medical Sciences (MACHS), Dammam, Saudi Arabia
| | - Sara Cherri
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Sara Mansour
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Sami El Khatib
- Department of Biomedical Sciences, Lebanese International University, Bekaa, Lebanon
- Center for Applied Mathematics and Bioinformatics (CAMB), Gulf University for Science and Technology, Mubarak Al-Abdullah, Kuwait
| | - Zelal Kharaba
- Department of Clinical Pharmacy, College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Mohamad Rahal
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal El Dib, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Hassan Hosseini
- Neurology Department, Henri Mondor Hospital, AP-HP, Créteil, France
- INSERM U955-E01, Institut Mondor de Recherche Biomedicale (IMRB), UPEC-Universite Paris-Est, Créteil, France
| |
Collapse
|
4
|
Elshebiny A, Almuhanna M, AlRamadan M, Aldawood M, Aljomeah Z. Awareness of Stroke Risk Factors, Warning Signs, and Preventive Behaviour Among Diabetic Patients in Al-Ahsa, Saudi Arabia. Cureus 2023; 15:e35337. [PMID: 36974251 PMCID: PMC10039371 DOI: 10.7759/cureus.35337] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Objectives This study aims to measure the level of awareness about stroke symptoms, risk factors, and preventive health practices that could be taken to reduce the risk of stroke among diabetic patients in Al-Ahsa, Saudi Arabia. Methods A cross-sectional study was conducted in Al-Ahsa, Saudi Arabia in 2020. The sample included a total of 202 male and female Saudi adults aged 18-65 years, with either type 1 or type 2 diabetes mellitus, and living in Al Ahsa, Saudi Arabia. The information was collected randomly through an online questionnaire distributed among patients after getting their contact information from relevant governmental and private diabetes clinics and after signing the informed consent. For awareness and knowledge items, each correct answer was scored one point and the total summation of the discrete scores of the different items was calculated. A diabetic patient with a score less than 60% of the total score was considered to have poor awareness while a score of 60% or more of the total score was considered a good level of awareness. Results A total of 87 (43.1%) participants had an overall good awareness level, while 115 (56.9%) had poor awareness levels. Around 40.6% of the study patients had heard about stroke, 61.9% knew that stroke affects the brain, and 24.3% reported that stroke is higher among males. As for factors associated with stroke, the most reported was high blood pressure (71.8%), followed by diabetes mellitus (69.3%). Exactly 65.8% of participants knew about the mechanism of ischemic stroke and 42.6% reported hemorrhagic stroke. A high percentage of patients (73.1%) realize that they could reduce their risk of stroke. Conclusion The findings of the current study showed that less than half (43.1%) of the Saudi patients with DM had a good awareness level regarding stroke and its related risk factors and warning signs. Older patients (aged 50-65 years) with high social levels (high education and income) and those with a family history of stroke had significantly higher awareness levels. Hypertension, DM, and smoking are the highest reported known risk factors of stroke, and speech disorders are the highest known stroke presentation to the respondents.
Collapse
|
5
|
Malaeb D, Dia N, Haddad C, Hallit S, Sacre H, Barakat M, Mansour S, Salameh P, Hosseini H. Factors associated with knowledge and awareness of stroke among the Lebanese population: A cross-sectional study. F1000Res 2022; 11:425. [PMID: 35677174 PMCID: PMC9160706 DOI: 10.12688/f1000research.108734.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/08/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Evaluation of the knowledge about stroke in the general population is extremely vital as it prevents stroke development, limits complications, and achieves better quality of life. We assume that the general Lebanese population lacks awareness about stroke and its associated complications. This study aims to evaluate stroke knowledge and determine the factors associated with stroke awareness among the general Lebanese population. Methods: This cross-sectional study assessed respondents’ sociodemographic characteristics and the identification of risk factors, warning signs, stroke consequences, and early response to stroke symptoms. A total of 551 Lebanese adults without a history of stroke filled in an online self-reported questionnaire publicly shared on social applications. Logistic regression analysis was performed to identify the factors associated with poor knowledge of stroke. Results: Among the 551 participants enrolled, 403 (74.2%) were females and 312 (56.7%) were under 30 years of age. Females compared to males and employed compared to unemployed had significantly higher odds of identifying at least one risk factor (OR=4.3 [95%CI=1.1;16.8] and 6 [95%CI=1.2;29.6], respectively). Also, when compared to unemployed, employed participants had significantly higher odds of recognizing at least one of the early stroke symptoms (OR=3.3 [95%CI=1.2;8.9]) and identifying at least one of the stroke consequences (OR=5.3 [95%CI=1.1;25.9]). Reaching a university level of education compared to a school level was associated with significantly higher odds (OR=2.3 [95%CI=1.1;4.8]) of taking a patient to a hospital. Conclusion: Well-educated, employed, and female participants were more knowledgeable about stroke. Tailored interventions focusing on individuals with inadequate stroke literacy are needed. Further studies, more representative of the general Lebanese population with a larger sample size, are necessary to confirm our findings.
Collapse
Affiliation(s)
- Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- Life Sciences and Health Department, Paris-Est University, Paris, France
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Nada Dia
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Chadia Haddad
- Research department, Psychiatric Hospital of the Cross, JalEddib, Lebanon
- INSERM, Univ. Limoges, CH Esquirol, IRD, U1094 tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Souheil Hallit
- Research department, Psychiatric Hospital of the Cross, JalEddib, Lebanon
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, P.O Box 446, Lebanon
- Psychology Department, College of Humanities, Effat University, Jaddah, 21478, Saudi Arabia
| | - Hala Sacre
- Epidémiologie Clinique et Toxicologie, INSPECT-LB: Institut National de Santé Publique, Beirut, Lebanon
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Sara Mansour
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Pascale Salameh
- Epidémiologie Clinique et Toxicologie, INSPECT-LB: Institut National de Santé Publique, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
- School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Hassan Hosseini
- Stroke Unit, Service de Neurologie, CHU Henri Mondor- 94010, Créteil Cedex, France
- UPE-C, Faculté de Santé, Université Paris-Est Créteil, Paris, France
- INSERM U955-E01, IMRB, Créteil, France
| |
Collapse
|
6
|
Malaeb D, Dia N, Haddad C, Hallit S, Sacre H, Barakat M, Mansour S, Salameh P, Hosseini H. Factors associated with knowledge and awareness of stroke among the Lebanese population: A cross-sectional study. F1000Res 2022; 11:425. [PMID: 35677174 PMCID: PMC9160706 DOI: 10.12688/f1000research.108734.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/08/2022] [Indexed: 10/24/2023] Open
Abstract
Background: Evaluation of the knowledge about stroke in the general population is extremely vital as it prevents stroke development, limits complications, and achieves better quality of life. We assume that the general Lebanese population lacks awareness about stroke and its associated complications. This study aims to evaluate stroke knowledge and determine the factors associated with stroke awareness among the general Lebanese population. Methods: This cross-sectional study assessed respondents' sociodemographic characteristics and the identification of risk factors, warning signs, stroke consequences, and early response to stroke symptoms. A total of 551 Lebanese adults without a history of stroke filled in an online self-reported questionnaire publicly shared on social applications. Logistic regression analysis was performed to identify the factors associated with poor knowledge of stroke. Results: Among the 551 participants enrolled, 403 (74.2%) were females and 312 (56.7%) were under 30 years of age. Females compared to males and employed compared to unemployed had significantly higher odds of identifying at least one risk factor (OR=4.3 [95%CI=1.1;16.8] and 6 [95%CI=1.2;29.6], respectively). Also, when compared to unemployed, employed participants had significantly higher odds of recognizing at least one of the early stroke symptoms (OR=3.3 [95%CI=1.2;8.9]) and identifying at least one of the stroke consequences (OR=5.3 [95%CI=1.1;25.9]). Reaching a university level of education compared to a school level was associated with significantly higher odds (OR=2.3 [95%CI=1.1;4.8]) of taking a patient to a hospital. Conclusion: Well-educated, employed, and female participants were more knowledgeable about stroke. Tailored interventions focusing on individuals with inadequate stroke literacy are needed. Further studies, more representative of the general Lebanese population with a larger sample size, are necessary to confirm our findings.
Collapse
Affiliation(s)
- Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- Life Sciences and Health Department, Paris-Est University, Paris, France
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Nada Dia
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Chadia Haddad
- Research department, Psychiatric Hospital of the Cross, JalEddib, Lebanon
- INSERM, Univ. Limoges, CH Esquirol, IRD, U1094 tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Souheil Hallit
- Research department, Psychiatric Hospital of the Cross, JalEddib, Lebanon
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, P.O Box 446, Lebanon
- Psychology Department, College of Humanities, Effat University, Jaddah, 21478, Saudi Arabia
| | - Hala Sacre
- Epidémiologie Clinique et Toxicologie, INSPECT-LB: Institut National de Santé Publique, Beirut, Lebanon
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Sara Mansour
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Pascale Salameh
- Epidémiologie Clinique et Toxicologie, INSPECT-LB: Institut National de Santé Publique, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
- School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Hassan Hosseini
- Stroke Unit, Service de Neurologie, CHU Henri Mondor- 94010, Créteil Cedex, France
- UPE-C, Faculté de Santé, Université Paris-Est Créteil, Paris, France
- INSERM U955-E01, IMRB, Créteil, France
| |
Collapse
|
7
|
Barakat M, A. AlSalamat H, Jirjees F, Al-Obaidi H, k. Hussain Z, El Hadidi S, Mansour S, Malaeb D, Hosseini H. Factors Associated with Knowledge and Awareness of Stroke Among the Jordanian Population: A Cross-Sectional Study. F1000Res 2021; 10:1242. [PMID: 34987775 PMCID: PMC8672222 DOI: 10.12688/f1000research.74492.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 01/01/2023] Open
Abstract
Background and objective: Stroke is the second leading cause of death in Jordan and over the world. Knowledge and awareness towards stroke play a crucial role in the management and prevention of its complications. This study aims to assess the knowledge and awareness about stroke among the Jordanian population and determine factors associated with stroke awareness. Methods: This cross-sectional study through a web-based anonymous questionnaire that needed 10 minutes to be completed. It examined sociodemographic characteristics and recognition of the risk factors, warning signs, stroke consequences, and early response to stroke symptoms. Logistic regression analysis identified the factors associated with poor knowledge of stroke. Results: A total of 573 Jordanian adults participated in this study. The participant's ability to identify at least one early symptom of stroke and the proper response to the symptoms were significantly correlated with the educational level (OR of 3.4 and 2.5, respectively). At least one consequence of stroke was significantly associated with different demographic factors such as gender, socioeconomic income, females versus males and those with medium income versus low income had significantly higher odds (OR of 6.6 and 4.1, respectively). Conclusion: This study revealed a good knowledge and awareness level about stroke among Jordanians correlated mainly with their educational level. Therefore, new strategies should be considered to decrease the prevalence of stroke in Jordan, including the need for engagement in enhanced awareness campaigns.
Collapse
Affiliation(s)
- Muna Barakat
- Department of Clinical Pharmacy and therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, 11931, Jordan
| | - Husam A. AlSalamat
- Department of Basic Medical Sciences, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, 19117, Jordan
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, University of Jordan, Amman, 11942, Jordan
| | - Feras Jirjees
- College of Pharmacy, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Hala Al-Obaidi
- College of pharmacy, Ajman University, Ajman, United Arab Emirates
| | - Zainab k. Hussain
- Department of Biology, College of Science, University of Baghdad, Baghdad, Iraq
| | - Seif El Hadidi
- Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University in Egypt, Cairo, Egypt
| | - Sara Mansour
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Hassan Hosseini
- Life Sciences and Health Department, Paris-Est University, Paris, France
| |
Collapse
|
8
|
Barakat M, A. AlSalamat H, Jirjees F, Al-Obaidi H, k. Hussain Z, El Hadidi S, Mansour S, Malaeb D, Hosseini H. Factors Associated with Knowledge and Awareness of Stroke Among the Jordanian Population: A Cross-Sectional Study. F1000Res 2021; 10:1242. [PMID: 34987775 PMCID: PMC8672222 DOI: 10.12688/f1000research.74492.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 10/20/2023] Open
Abstract
Background and objective: Stroke is the second leading cause of death in Jordan and over the world. Knowledge and awareness towards stroke play a crucial role in the management and prevention of its complications. This study aims to assess the knowledge and awareness about stroke among the Jordanian population and determine factors associated with stroke awareness. Methods: This cross-sectional study through a web-based anonymous questionnaire that needed 10 minutes to be completed. It examined sociodemographic characteristics and recognition of the risk factors, warning signs, stroke consequences, and early response to stroke symptoms. Logistic regression analysis identified the factors associated with poor knowledge of stroke. Results: A total of 573 Jordanian adults participated in this study. The participant's ability to identify at least one early symptom of stroke and the proper response to the symptoms were significantly correlated with the educational level (OR of 3.4 and 2.5, respectively). At least one consequence of stroke was significantly associated with different demographic factors such as gender, socioeconomic income, females versus males and those with medium income versus low income had significantly higher odds (OR of 6.6 and 4.1, respectively). Conclusion: This study revealed a good knowledge and awareness level about stroke among Jordanians correlated mainly with their educational level. Therefore, new strategies should be considered to decrease the prevalence of stroke in Jordan, including the need for engagement in enhanced awareness campaigns.
Collapse
Affiliation(s)
- Muna Barakat
- Department of Clinical Pharmacy and therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, 11931, Jordan
| | - Husam A. AlSalamat
- Department of Basic Medical Sciences, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, 19117, Jordan
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, University of Jordan, Amman, 11942, Jordan
| | - Feras Jirjees
- College of Pharmacy, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Hala Al-Obaidi
- College of pharmacy, Ajman University, Ajman, United Arab Emirates
| | - Zainab k. Hussain
- Department of Biology, College of Science, University of Baghdad, Baghdad, Iraq
| | - Seif El Hadidi
- Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University in Egypt, Cairo, Egypt
| | - Sara Mansour
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Hassan Hosseini
- Life Sciences and Health Department, Paris-Est University, Paris, France
| |
Collapse
|
9
|
Okonkwo UP, Uzuh FN, Nwankwo MJ, Okoye EC, Ummuna JO, Igwe ES, Maduagwu SM, Ani KU, Akobundu UN, Nwanne CA. Awareness of the risk factors of stroke among non-teaching staff of the Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2021. [DOI: 10.1186/s43161-021-00057-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Abstract
Background
The prevalence of stroke is increasing in Nigeria due to a lack of awareness of their predisposing factors. There is therefore a need for good knowledge and awareness of stroke risk factors in the general populations. Thus, this study assessed the level of awareness of stroke risk factors among non-teaching staff in Nnamdi Azikiwe University, Nnewi Campus, Nigeria.
Results
Most of the participants were female, 89 (69%), and had a post-graduate degree, 84 (65.1%). A total of 129 participants participated in this survey, and 91 (70.5%) were familiar with the term “stroke.” The commonest risk factors were high blood pressure (86%), stress (74.4%), and lack of exercise (63.6%). The study showed that the awareness of stroke risk factors among the participants was poor (40.3%).
Conclusion
Stroke awareness was poor among the participants with the highest risk of stroke despite their high literacy level. Female participants, with a postgraduate level qualification and working as senior non-teaching staff, had a better awareness of stroke risk factors than their male colleagues. This shows a need to increase stroke awareness campaigns in the community.
Collapse
|
10
|
Baatiema L, Sanuade O, Kuumuori Ganle J, Sumah A, Baatiema L, Sumankuuro J. An ecological approach to understanding stroke experience and access to rehabilitation services in Ghana: A cross-sectional study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:e67-e78. [PMID: 33278317 DOI: 10.1111/hsc.13243] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 10/26/2020] [Accepted: 10/29/2020] [Indexed: 06/12/2023]
Abstract
Despite a growing burden of stroke in low-middle-income countries, research on patient's experiences and access to rehabilitation services remains limited. This study explores the experiences of stroke patients in relation to access and use of stroke rehabilitation services, coping strategies and strategies to improve care in Ghana. A cross-sectional study was conducted. A total of 136 adult stroke patients hospitalised and subsequently discharged in three major referral hospitals in Ghana participated in the study. A paper-based questionnaire was used to collect data. Data were inputted into STATA version 12, cleaned and analysed using descriptive statistics and Chi-Square tests. Findings showed that stroke patients experience stroke differently. Early detection (awareness) of stroke symptoms at onset was low (29.4%). Hypertension was the major (58.1%) predisposing risk factor for stroke, followed by diabetes (14.7%). Multiple barriers impede access to outpatient rehabilitation services: high cost of medications (43.4%), transportation constraints (10.3%), long waiting time (6.6%), forgetfulness about appointment (4.4%), limited education on rehabilitation (20.6%), lack of community support (12.5%) and ineffective communication with healthcare providers (5.2%). Recommended strategies to improve access to rehabilitation care included public education on stroke and its associated risk, reduction in the cost of drugs and increased stroke rehabilitation funding by the NHIS, especially for physiotherapy consultation and training support to caregivers on patient care. Given the difference in stroke experience and barriers in accessing rehabilitation care, multi-level health policy and service delivery reforms are needed to improve access to rehabilitation care, including national public awareness campaigns on early signs of stroke and subsidised cost of stroke rehabilitation.
Collapse
Affiliation(s)
- Leonard Baatiema
- Noguchi Memorial Institute for Medical Research, University of Ghana-Legon, Accra, Ghana
| | - Olutobi Sanuade
- Noguchi Memorial Institute for Medical Research, University of Ghana-Legon, Accra, Ghana
- Institute for Global Health, University College London, London, United Kingdom
| | - John Kuumuori Ganle
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Ghana
| | - Anthony Sumah
- Upper West Regional Health Directorate, Ghana Health Service, Wa, Accra, Ghana
| | - Linus Baatiema
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Joshua Sumankuuro
- Center for Health Policy, University of Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
11
|
Agbetou Houessou M, Hountada H, Yahouédéou B, Choki B, Kossi O, Adoukonou T. Knowledge of Stroke Risk Factors and Signs in Parakou, a Northern City of Benin in West Africa. Cerebrovasc Dis 2021; 50:88-93. [PMID: 33423030 DOI: 10.1159/000512715] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 10/28/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION We aimed to determine knowledge of stroke risk factors and signs in an urban population of northern Benin. METHODS A door-to-door purposeful sampling survey was conducted in resident population (age ≥15 years) of the district of Titirou in the city of Parakou (N = 255,478) in Benin between March 15 and July 15, 2016. In-person interviews were conducted with data collection on structured questionnaires with close and open questions, according to standard definitions. Multivariable logistic regression was used to assess predictors of good knowledge, defined by provision of a correct response in pre-defined set of questions on stroke risk factors and warning signs. RESULTS Of 4,671 participants (mean age 27.7 ± 12.9 years; females 50.6%), only 404 (8.6%) knew at least 1 stroke risk factor. Knowledge level of stroke risk factors (odds ratio, 95% confidence interval) was related to age (1.37, 1.27-1.48), level of education (2.54, 1.73-3.72), and family history of stroke (3.01, 2.08-4.26). Only 230 (4.9%) were able to cite at least 1 stroke symptom, and this knowledge was great with increasing age (1.04, 1.02-1.06), family (3.63, 2.41-5.49) and personal history of stroke (3.71, 1.86-7.42), and high level of education (4.35, 2.68-7.07). CONCLUSION Knowledge of stroke risk factors and signs is low in northern Benin. Greater public education and awareness campaigns are required to address the burden of stroke.
Collapse
Affiliation(s)
- Mendinatou Agbetou Houessou
- Department of Neurology, University of Parakou, Parakou, Benin, .,Clinic of Neurology, University Teaching Hospital of Parakou, Parakou, Benin,
| | - Hospice Hountada
- Clinic of Neurology, University Teaching Hospital of Parakou, Parakou, Benin
| | - Bertrand Yahouédéou
- Clinic of Neurology, University Teaching Hospital of Parakou, Parakou, Benin
| | - Blaise Choki
- Clinic of Neurology, University Teaching Hospital of Parakou, Parakou, Benin
| | - Oyéné Kossi
- Department of Neurology, University of Parakou, Parakou, Benin.,Clinic of Neurology, University Teaching Hospital of Parakou, Parakou, Benin
| | - Thierry Adoukonou
- Department of Neurology, University of Parakou, Parakou, Benin.,Clinic of Neurology, University Teaching Hospital of Parakou, Parakou, Benin.,UMR-1094 INSERM, University of Limoges, CHU Limoges, UMR 1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| |
Collapse
|
12
|
Nwaozuru U, Ezepue C, Iwelunmor J, Obiezu-Umeh C, Uzoaru F, Tshiswaka DI, Okubadejo N, Edgell R, Ezechi O, Gbajabiamila T, Musa AZ, Oladele D, Ogedegbe O, Williams O. Addressing Stroke Literacy in Nigeria Through Music: A Qualitative Study of Community Perspectives. J Stroke Cerebrovasc Dis 2020; 29:105312. [PMID: 33254374 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 09/07/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND The incidence of stroke in Nigeria is unknown, but stroke literacy, defined here as awareness of stroke warning symptoms and risk factors may be poor in high-risk communities. Although there is growing recognition of the use of music as a conduit to promote health literacy, African music is often overlooked as a source of health information. We sought to understand community-level perspectives on using African music to promote acute stroke literacy. METHODS A purposive sample of education, health and music professionals, high school and university students were recruited to participate in the qualitative study. Study participants completed a brainstorming exercise that elicited their perceptions of potential barriers and facilitators to the use of music to promote acute stroke literacy in Nigeria. Content analysis was used to identify key themes emerging from the brainstorming exercise. RESULTS A total of 44 individuals, comprising of 25 students with a mean age of 15.9 ± 1.6 years (52% females) and 19 professionals with a mean age of 39 ± 7.7 years (57.9% males) participated in the brainstorming exercise. Facilitators to the use of music to promote acute stroke literacy in Nigeria include the cultural relevance of music, the ubiquity of music, and government involvement. Key barriers include religious beliefs that discourage the use of "secular" music, cost-related barriers, and limited government support. CONCLUSIONS Findings from this study provide guidance aimed at improving acute stroke literacy in Nigeria, particularly the importance of government involvement in the development and implementation of stroke literacy interventions guided by African music. Future work should consider implementing interventions that leverage the cultural elements of African music and further assess the extent to which these identified facilitators and/or barriers may influence stroke literacy.
Collapse
Affiliation(s)
- Ucheoma Nwaozuru
- Saint Louis University, College for Public Health and Social Justice, Department of Behavioral Science and Health Education, 3545 Lafayette Ave, St. Louis, MO 63104, U.S.A
| | | | - Juliet Iwelunmor
- Saint Louis University, College for Public Health and Social Justice, Department of Behavioral Science and Health Education, 3545 Lafayette Ave, St. Louis, MO 63104, U.S.A..
| | - Chisom Obiezu-Umeh
- Saint Louis University, College for Public Health and Social Justice, Department of Behavioral Science and Health Education, 3545 Lafayette Ave, St. Louis, MO 63104, U.S.A
| | - Florida Uzoaru
- Saint Louis University, College for Public Health and Social Justice, Department of Behavioral Science and Health Education, 3545 Lafayette Ave, St. Louis, MO 63104, U.S.A
| | | | - Njideka Okubadejo
- University of Lagos, College of Medicine, Moyo Agoro St, Idi Oro, Ikeja, Nigeria
| | - Randall Edgell
- Saint Louis University, Department of Neurology, 3545 Lafayette Ave, St. Louis, MO 63104, U.S.A
| | - Oliver Ezechi
- Nigerian Institute of Medical Research, Clinical Sciences Department, Medical Compound, Yaba, Lagos, Nigeria
| | - Titilola Gbajabiamila
- Nigerian Institute of Medical Research, Clinical Sciences Department, Medical Compound, Yaba, Lagos, Nigeria
| | - Adeola Z Musa
- Nigerian Institute of Medical Research, Monitoring and Evaluation Unit, Yaba, Lagos, Nigeria
| | - David Oladele
- Nigerian Institute of Medical Research, Clinical Sciences Department, Medical Compound, Yaba, Lagos, Nigeria
| | - Olugbenga Ogedegbe
- NYU Langone Medical Center, Division of Health & Behavior, Department of Population Health, New York, NY 10032, U.S.A
| | - Olajide Williams
- Columbia University Irving Medical Center, Department of Neurology, 622 W 168th St, New York, NY 10032, U.S.A
| |
Collapse
|
13
|
Ranawaka U, Mettananda C, Thilakarathna C, Peiris A, Kasturiratna A, Tilakaratna Y. Stroke Awareness in Patients with Incident Stroke Compared to Patients without Stroke or Ischemic Heart Disease. J Stroke Cerebrovasc Dis 2020; 29:104790. [PMID: 32280001 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/21/2020] [Accepted: 02/24/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Stroke awareness is known to influence treatment seeking and risk reduction behavior, but there is limited data from Sri Lanka and South Asia. AIM To describe stroke awareness in incident stroke patients and to compare with patients without stroke and/or ischemic heart disease (IHD) in a Sri Lankan tertiary-care center. METHODS We studied awareness of stroke in all incident stroke patients admitted to a tertiary-care center in Sri Lanka and compared with a group of age- and sex-matched patients without stroke and/or IHD, over 2 years. Knowledge on stroke mechanisms, risk factors, symptoms, prognosis, treatment, and prevention were evaluated using a 40-item interviewer-administered questionnaire and converted to a composite score of 100%. Total awareness was categorized as Very poor (<24%), Poor (25%-49%), Good (50%-74%), and Very good (>74%). RESULTS One hundred and sixty four incident stroke patients (mean age 62.0 ± 11.5 years; 64.6% males) and 164 patients without stroke and/or IHD were studied. Mean stroke awareness was 47.79% ± 14.6 in stroke patients, and 47.73% ± 14.9 in the nonstroke and/or IHD patients (P = .95). Of the associations studied, better stroke awareness (>50%) was associated only with higher education levels (OR 1.90, 95%CI 1.33-2.72, P < .001) in stroke patients. CONCLUSIONS Stroke awareness is not satisfactory in incident stroke patients and is no better than in patients without stroke and/or IHD. Better stroke awareness was associated with higher education levels.
Collapse
Affiliation(s)
- Udaya Ranawaka
- Department of Medicine, Faculty of Medicine, University of Kelaniya, Sri Lanka; Professorial Medical Unit, North Colombo Teaching hospital, Ragama, Sri Lanka
| | - Chamila Mettananda
- Department of Pharmacology, Faculty of Medicine, University of Kelaniya, Sri Lanka.
| | | | - Anushka Peiris
- Department of Medicine, Faculty of Medicine, University of Kelaniya, Sri Lanka
| | | | - Yasoma Tilakaratna
- Department of Medicine, Faculty of Medicine, University of Kelaniya, Sri Lanka
| |
Collapse
|
14
|
Komolafe MA, Olorunmoteni OE, Fehintola FO. Effect of Health Education on Level of Awareness and Knowledge of Nigerian In-School adolescents on Stroke and Its Risk Factors. J Stroke Cerebrovasc Dis 2020; 29:104757. [PMID: 32173228 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104757] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 01/29/2020] [Accepted: 02/12/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Stroke education in adolescents has been established as an effective method of creating awareness about stroke, its warning signs and risk factors. It contributes to desired behavioural change in the adolescents as well as their parents. Thus, we aimed to determine the baseline knowledge of school attending adolescents about stroke and its risk factors as well as the effect of stroke education on their stroke awareness. METHODS This study employed a quasi-experimental study design and was conducted in secondary schools in Ile-Ife, Osun State, Nigeria. The schools were divided into intervention and control groups. We assessed the baseline knowledge of the students on stroke, its risk factors, warning signs, and ways of preventing it using a pre-tested structured questionnaire in both intervention and control groups. In the intervention group, health talks on stroke consisting of oral presentation and distribution of fliers were presented for 30 minutes in each selected school. Each school was visited 2 weeks after the health education intervention to assess their knowledge on stroke, its risk factors, and ways of preventing it. The control group was also visited after 2 weeks for a re-assessment of their stroke knowledge and the conduct of heath talk on other aspects of neurology such as sleep, epilepsy, etc. Results: A total of 1259 adolescents were studied with 661 in the intervention group and 598 in the control group. The mean age of the respondents was 13.56 ± 2.87 the intervention group and 13.38 ± 2.06 in the control group. There were higher mean scores on knowledge of stroke and its risk factors among the intervention group than seen in the control group after the stroke education. CONCLUSIONS Stroke education is an effective way of creating and maintaining stroke awareness among school-attending adolescents.
Collapse
Affiliation(s)
- Morenikeji A Komolafe
- Department of Internal Medicine, Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria
| | - Oluwatosin E Olorunmoteni
- Department of Paediatrics and Child Health, Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
| | - Funmito O Fehintola
- Department of Community Health, Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| |
Collapse
|
15
|
Adeloye D, Auta A, Fawibe A, Gadanya M, Ezeigwe N, Mpazanje RG, Dewan MT, Omoyele C, Alemu W, Harhay MO, Adewole IF. Current prevalence pattern of tobacco smoking in Nigeria: a systematic review and meta-analysis. BMC Public Health 2019; 19:1719. [PMID: 31864324 PMCID: PMC6925864 DOI: 10.1186/s12889-019-8010-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 11/27/2019] [Indexed: 11/10/2022] Open
Abstract
Background National smoking cessation strategies in Nigeria are hindered by lack of up-to-date epidemiologic data. We aimed to estimate prevalence of tobacco smoking in Nigeria to guide relevant interventions. Methods We conducted systematic search of publicly available evidence from 1990 through 2018. A random-effects meta-analysis and meta-regression epidemiologic model were employed to determine prevalence and number of smokers in Nigeria in 1995 and 2015. Results Across 64 studies (n = 54,755), the pooled crude prevalence of current smokers in Nigeria was 10.4% (9.0–11.7) and 17.7% (15.2–20.2) for ever smokers. This was higher among men compared to women in both groups. There was considerable variation across geopolitical zones, ranging from 5.4% (North-west) to 32.1% (North-east) for current smokers, and 10.5% (South-east) to 43.6% (North-east) for ever smokers. Urban and rural dwellers had relatively similar rates of current smokers (10.7 and 9.1%), and ever smokers (18.1 and 17.0%). Estimated median age at initiation of smoking was 16.8 years (IQR: 13.5–18.0). From 1995 to 2015, we estimated an increase in number of current smokers from 8 to 11 million (or a decline from 13 to 10.6% of the population). The pooled mean cigarettes consumption per person per day was 10.1 (6.1–14.2), accounting for 110 million cigarettes per day and over 40 billion cigarettes consumed in Nigeria in 2015. Conclusions While the prevalence of smokers may be declining in Nigeria, one out of ten Nigerians still smokes daily. There is need for comprehensive measures and strict anti-tobacco laws targeting tobacco production and marketing.
Collapse
Affiliation(s)
- Davies Adeloye
- Centre for Global Health, Usher Institute, University of Edinburgh, 30 West Richmond street, Edinburgh, EH8 9DX, UK. .,RcDavies Evidence-based Medicine, Lagos, Nigeria.
| | - Asa Auta
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Fylde Road, Preston, UK
| | - Ademola Fawibe
- Department of Medicine, University of Ilorin, Ilorin, Nigeria
| | - Muktar Gadanya
- Department of Community Medicine, Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria
| | | | | | | | | | | | - Michael O Harhay
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USA.,Palliative and Advanced Illness Research (PAIR) Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | |
Collapse
|
16
|
Osama A, Ashour Y, El-Razek RA, Mostafa I. Public knowledge of warning signs and risk factors of cerebro-vascular stroke in Ismailia Governorate, Egypt. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2019. [DOI: 10.1186/s41983-019-0079-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
17
|
Hertz JT, Madut DB, William G, Maro VP, Crump JA, Rubach MP. Perceptions of Stroke and Associated Health-Care-Seeking Behavior in Northern Tanzania: A Community-Based Study. Neuroepidemiology 2019; 53:41-47. [PMID: 30986785 PMCID: PMC6842572 DOI: 10.1159/000499069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 02/22/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Little is known about knowledge of stroke symptoms, perceptions of self-risk, and health-care-seeking behavior for stroke in East Africa. METHODS A 2-stage randomized population-based cluster survey with selection proportional to population size was performed in northern Tanzania. Self-identified household health-care decision makers were asked to list all symptoms of a stroke. They were further asked if they thought they had a chance of having a stroke and where they would present for care for stroke-like symptoms. A socioeconomic status score was derived via principal component analysis from 9 variables related to wealth. RESULTS Of 670 respondents, 184 (27.4%) knew a conventional stroke symptom and 51 (7.6%) thought they had a chance of having a stroke. Females were less likely to perceive themselves to be at risk than males (OR 0.49, 95% CI 0.28-0.89, p = 0.014). Of respondents, 558 (88.3%) stated they would present to a hospital for stroke-like symptoms. Preference for a hospital was not associated with knowledge of stroke symptoms or perception of self-risk but was associated with a higher socioeconomic status score (p < 0.001). CONCLUSIONS Knowledge of stroke symptoms and perception of self-risk are low in northern Tanzania, but most residents would present to a hospital for stroke-like symptoms.
Collapse
Affiliation(s)
- Julian T Hertz
- Division of Emergency Medicine, Duke University Medical Center, Durham, North Carolina, USA,
| | - Deng B Madut
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | | | - Venance P Maro
- Department of Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - John A Crump
- Otago Global Health Institute, University of Otago, Dunedin, New Zealand
| | - Matthew P Rubach
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| |
Collapse
|
18
|
Stroke in the 21 st Century: A Snapshot of the Burden, Epidemiology, and Quality of Life. Stroke Res Treat 2018; 2018:3238165. [PMID: 30598741 PMCID: PMC6288566 DOI: 10.1155/2018/3238165] [Citation(s) in RCA: 466] [Impact Index Per Article: 77.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 07/29/2018] [Accepted: 10/09/2018] [Indexed: 11/18/2022] Open
Abstract
Stroke is ranked as the second leading cause of death worldwide with an annual mortality rate of about 5.5 million. Not only does the burden of stroke lie in the high mortality but the high morbidity also results in up to 50% of survivors being chronically disabled. Thus stroke is a disease of immense public health importance with serious economic and social consequences. The public health burden of stroke is set to rise over future decades because of demographic transitions of populations, particularly in developing countries. This paper provides an overview of stroke in the 21st century from a public health perspective.
Collapse
|
19
|
Knowledge of Stroke Signs and Symptoms Among Residents in a Rural South Eastern Nigerian Community. J Stroke Cerebrovasc Dis 2018; 27:3306-3310. [DOI: 10.1016/j.jstrokecerebrovasdis.2018.07.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 07/16/2018] [Accepted: 07/20/2018] [Indexed: 11/23/2022] Open
|
20
|
Urimubenshi G, Cadilhac DA, Kagwiza JN, Wu O, Langhorne P. Stroke care in Africa: A systematic review of the literature. Int J Stroke 2018; 13:797-805. [DOI: 10.1177/1747493018772747] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Appropriate systems of stroke care are important to manage the increasing death and disability associated with stroke in Africa. Information on existing stroke services in African countries is limited. Aim To describe the status of stroke care in Africa. Summary of review We undertook a systematic search of the published literature to identify recent (1 January 2006–20 June 2017) publications that described stroke care in any African country. Our initial search yielded 838 potential papers, of which 38 publications were eligible representing 14/54 African countries. Across the publications included for our review, the proportion of stroke patients reported to arrive at hospital within 3 h from stroke onset varied between 10% and 43%. The median time interval between stroke onset and hospital admission was 31 h. Poor awareness of stroke signs and symptoms, shortages of medical transportation, health care personnel, and stroke units, and the high cost of brain imaging, thrombolysis, and outpatient physiotherapy rehabilitation services were reported as major barriers to providing best-practice stroke care in Africa. Conclusions This review provides an overview of stroke care in Africa, and highlights the paucity of available data. Stroke care in Africa usually fell below the recommended standards with variations across countries and settings. Combined efforts from policy makers and health care professionals in Africa are needed to improve, and ensure access, to organized stroke care in as many settings as possible. Mechanisms to routinely monitor usual care (i.e., registries or audits) are also needed to inform policy and practice.
Collapse
Affiliation(s)
- Gerard Urimubenshi
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Dominique A Cadilhac
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Clayton, Australia
- Stroke Division, The Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Melbourne, Victoria, Australia
| | - Jeanne N Kagwiza
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Olivia Wu
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Peter Langhorne
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| |
Collapse
|
21
|
Arisegi SA, Awosan KJ, Oche MO, Sabir AA, Ibrahim MT. Knowledge and practices related to stroke prevention among hypertensive and diabetic patients attending Specialist Hospital, Sokoto, Nigeria. Pan Afr Med J 2018; 29:63. [PMID: 29875944 PMCID: PMC5987157 DOI: 10.11604/pamj.2018.29.63.13252] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 01/07/2018] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Stroke has become a problem of public health importance worldwide. Knowledge and practices related to stroke prevention among hypertensive and diabetic patients are important in the control of the disease. In Nigeria, recent reports indicate an emerging epidemic of stroke. This study aimed to determine the knowledge and practices related to stroke prevention among hypertensive and diabetic patients in Sokoto, Nigeria. METHODS This was a cross-sectional study among 248 patients attending hypertension and diabetes clinic of Specialist Hospital, Sokoto, Nigeria, selected by systematic sampling technique. A semi-structured questionnaire was used to collect data on the research variables. Data were analyzed using IBM SPSS version 20 statistical package. RESULTS The mean age of respondents was 48.21 ± 15.07 years and they were predominantly females (65.7%). The respondents had good knowledge of stroke (70.3%), organs or parts of body affected by stroke (89.1%), signs or symptoms of stroke (87.0%), stroke risk factors (86.6%) and stroke prevention (90.8%). Formal education was the sole predictor of good knowledge of signs or symptoms of stroke (aOR = 3.99, 95% CI = 1.58-10.13, p = 0.004), stroke risk factors (aOR = 4.24, 95% CI = 1.68-10.67, p = 0.002) and stroke prevention (aOR = 3.45, 95% CI = 1.09-10.93, p = 0.035). Stroke prevention practices were sub-optimal and significantly associated with formal education and being employed. CONCLUSION These findings suggest the need for all stakeholders to focus on both patients' education and empowerment in halting the rising burden of stroke across the globe.
Collapse
Affiliation(s)
| | | | - Mansur Oche Oche
- Department of Community Health, UsmanuDanfodiyo University, Sokoto, Nigeria
| | - Anas Ahmad Sabir
- Department of Internal Medicine, Usmanu Danfodiyo University, Sokoto, Nigeria
| | | |
Collapse
|
22
|
Blixen C, Nakibuuka J, Kaddumukasa M, Nalubwama H, Amollo M, Katabira E, Sajatovic M. Community Perceptions of Barriers to Stroke Recovery and Prevention in Greater Kampala, Uganda: Implications for Policy and Practice. INTERNATIONAL JOURNAL OF HEALTHCARE 2017; 3:8-19. [PMID: 31080882 PMCID: PMC6510505 DOI: 10.5430/ijh.v3n2p8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Stroke risk and stroke burden are increasing in Sub Saharan Africa. Qualitative analysis was used to assess perceived barriers to stroke recovery and prevention in an urban/suburban Ugandan population in order to refine and implement a promising nurse and peer-led self-management intervention previously conducted in the United States. METHODS In depth interviews and focus groups were conducted with 48 participants (stroke survivors, caretakers, and those at risk for stroke. All interviews and focus groups were audiotaped, transcribed verbatim, and analyzed using content analysis, with an emphasis on dominant themes. RESULTS Three major domains of perceived barriers to stroke recovery and prevention emerged from the data: (1) Individual barriers (PTSD, stress, resistance to seeking care, medication non-adherence, unhealthy lifestyles, functional impairment, and a paucity of stroke knowledge); (2) Family/community barriers (lack of family and community support and caretaker burden); and (3) Provider and healthcare system barriers (lack of access and inadequate follow-up). Importantly, participants in this study identified a pressing need for increasing stroke awareness in the community as part of recovery and prevention efforts. CONCLUSIONS Stroke risk reduction efforts implemented at the patient, community, and healthcare system levels are needed. These efforts could, perhaps, be modeled along the lines of a previous very successful public health initiative to reduce HIV burden in Uganda.
Collapse
Affiliation(s)
- Carol Blixen
- Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA
| | - Jane Nakibuuka
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Mark Kaddumukasa
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Haddy Nalubwama
- School of Public Health, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Mathew Amollo
- School of Public Health, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Elly Katabira
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Martha Sajatovic
- Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA
| |
Collapse
|
23
|
Kaddumukasa M, Kayima J, Nakibuuka J, Mugenyi L, Ddumba E, Blixen C, Welter E, Katabira E, Sajatovic M. A cross-sectional population survey on stroke knowledge and attitudes in Greater Kampala, Uganda. COGENT MEDICINE 2017; 4. [PMID: 31098388 DOI: 10.1080/2331205x.2017.1327129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Background Stroke is a neurological condition with rapidly increasing burden in many low- and middle income countries. Africa is particularly hard-hit due to rapid population growth, patterns of industrialization, adoption of harmful western diets, and increased prevalence of risk factors such as hypertension and obesity. Reducing stroke risk factors and teaching people to respond to stroke warning signs can prevent stroke and reduce burden. However, being able to address gaps in knowledge and improving both preventative and early-response care requires a clear understanding of practical and potentially modifiable topics. In this cross sectional study, we assessed the knowledge and attitudes among an urban population residing within the greater Kampala, Uganda. Methods A population cross sectional survey was conducted in urban Mukono, district, central Uganda. Through the systematic sampling method, data were gathered from 440 adult participants who were interviewed about selected aspects of stroke knowledge, attitudes and perception using a pretested structured questionnaire. Results A total of 440 study participants were enrolled. The leading risk factors for stroke identified by the participants were stress (75.7%) and hypertension (45.2%) respectively. Only two (0.5%) of the study participants identified cigarette smoking as a stroke risk factor. Individuals with hypertension have poor knowledge regarding stroke in spite their high risk for stroke. Conclusion Stroke knowledge is poor while, stress and hypertension are the leading perceived risk factors in our settings. While stress is contributing factor, hypertension is likely a more amenable and practical intervention target. Targeting individuals with stroke risk factors to increase stroke knowledge and education is crucial for engagement in healthcare. Implementing a self-management program to support and motivate this high-risk group as well as adopting healthy life-styles may be a way to reduce stroke burden in Uganda.
Collapse
Affiliation(s)
- Mark Kaddumukasa
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - James Kayima
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Jane Nakibuuka
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Leviticus Mugenyi
- Infectious Diseases Research Collaboration, Mulago Hill Road, MUJHU3 Building. P.O. Box 7475 Kampala, Uganda
| | - Edward Ddumba
- Department of Medicine, St Raphael of St Francis Nsambya Hospital, Nkozi University, P.O. Box 7146, Kampala, Uganda
| | - Carol Blixen
- Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA
| | - Elisabeth Welter
- Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA
| | - Elly Katabira
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Martha Sajatovic
- Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA
| |
Collapse
|
24
|
Oh GJ, Moon J, Lee YM, Park HK, Park KS, Yun YW, Kang G, Kim BG, Seo JH, Lee H, Lee WK, Lee KS, Kim HS, Lee YH. Public Awareness of Stroke and Its Predicting Factors in Korea: a National Public Telephone Survey, 2012 and 2014. J Korean Med Sci 2016; 31:1703-1710. [PMID: 27709846 PMCID: PMC5056200 DOI: 10.3346/jkms.2016.31.11.1703] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 08/13/2016] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to investigate time trends in the public awareness of stroke and its predicting factors. The target population was 9,600 community-dwelling adults, aged 19-79 years, in 16 metropolitan cities and provinces in Korea. The survey samples in 2012 and 2014 were selected separately (entirely different sets of subjects) using a proportionate quota sampling method. Information concerning knowledge of stroke and demographics was collected by trained telephone interviewers using random digit dialing. After excluding subjects with a non-response or refusal to answer any question, the analyses included 8,191 subjects in 2012 and 8,127 subjects in 2014. Respondents' awareness of stroke warning signs (numbness or weakness, difficulty speaking or understanding speech, dizziness, visual impairment, and severe headache) was highest for difficulty speaking or understanding speech (80.9% in 2012 and 86.4% in 2014). There were significant increases in the proportion of respondents understanding the appropriate action (i.e., calling an ambulance) at the time of stroke occurrence (59.6% to 67.1%), and in the proportion aware of the general need for prompt treatment (86.7% to 89.8%). In multivariable logistic regression analysis, older age, higher education level, higher household income, current non-smoking, exposure to stroke-related public relations materials, and experience of stroke education were significantly associated with both high knowledge of stroke warning signs and awareness of the need for prompt treatment. Between 2012 and 2014, the public's awareness of stroke increased significantly. More specialized interventions, including public relations materials and education, should focus on subgroups who have lower stroke knowledge.
Collapse
Affiliation(s)
- Gyung Jae Oh
- Jeonbuk Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea
| | - Jiyoung Moon
- Gangwon Regional Cardiocerebrovascular Disease Center, Kangwon National University Hospital, Chuncheon, Korea
| | - Yu Mi Lee
- Daegu-Gyeongbuk Regional Cardiocerebrovascular Disease Center, Kyungpook National University Hospital, Daegu, Korea
| | - Hyeung Keun Park
- Jeju Regional Cardiocerebrovascular Disease Center, Jeju National University Hospital, Jeju, Korea
| | - Ki Soo Park
- Gyeongnam Regional Cardiocerebrovascular Disease Center, Gyeongsang National University Hospital, Jinju, Korea
| | - Yong Woon Yun
- Gwangju-Jeonnam Regional Cardiocerebrovascular Disease Center, Chonnam National University Hospital, Gwangju, Korea
| | - Gilwon Kang
- Chungbuk Regional Cardiocerebrovascular Disease Center, Chungbuk National University Hospital, Cheongju, Korea
| | - Byoung Gwon Kim
- Busan-Ulsan Regional Cardiocerebrovascular Disease Center, Dong-A University Hospital, Busan, Korea
| | - Jae Hee Seo
- Daejeon-Chungnam Regional Cardiocerebrovascular Disease Center, Chungnam National University Hospital, Daejeon, Korea
| | - Heeyoung Lee
- Gyeonggi Regional Cardiocerebrovascular Disease Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Won Kyung Lee
- Incheon Regional Cardiocerebrovascular Disease Center, Inha University Hospital, Incheon, Korea
| | - Kun Sei Lee
- Department of Preventive Medicine, School of Medicine, Konkuk University, Seoul, Korea
| | - Hee Sook Kim
- Division of Chronic Disease Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Young Hoon Lee
- Jeonbuk Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea
- Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.
| |
Collapse
|
25
|
Kaddumukasa M, Kayima J, Kaddumukasa MN, Ddumba E, Mugenyi L, Pundik S, Furlan AJ, Sajatovic M, Katabira E. Knowledge, attitudes and perceptions of stroke: a cross-sectional survey in rural and urban Uganda. BMC Res Notes 2015; 8:819. [PMID: 26708348 PMCID: PMC4691295 DOI: 10.1186/s13104-015-1820-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 12/17/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Information regarding the increasing burden of non-communicable diseases such as stroke is largely unknown among the vulnerable communities. This analysis, which is part of a larger U.S. National Institute of Heath-funded Medical Education Partnership Initiative neurological disorder survey, assessed community knowledge and attitudes on stroke and stroke risk factors. METHODS A population cross-sectional survey was conducted in urban and rural Mukono, district, central Uganda. Through the systematic sampling method, data were gathered from 377 adult participants who were interviewed about selected aspects of stroke knowledge, attitudes and perception using a pretested structured questionnaire. RESULTS A total of 377 participants were enrolled (47% urban). The leading risk factors identified by the participants were stress (36.6%) and hypertension (28.9%) respectively. None of the study participants identified cigarette smoking as a stroke risk factor. Seventy six percent of the participants did not recognize stroke as a disease of the brain. CONCLUSION Stroke knowledge is poor in both rural and urban Uganda. Tailored public health approaches that improve stroke awareness, knowledge and self management approaches are urgently needed to develop effective preventive measures and community response to stroke.
Collapse
Affiliation(s)
- Mark Kaddumukasa
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
| | - James Kayima
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
| | - Martin N Kaddumukasa
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
| | - Edward Ddumba
- Department of Medicine, St Raphael of St Francis Nsambya Hospital, Nkozi University, P.O. Box 7146, Kampala, Uganda.
| | - Levi Mugenyi
- Infectious Diseases Research Collaboration, Mulago Hill Road, MUJHU3 Building, P.O. Box 7475, Kampala, Uganda.
| | - Svetlana Pundik
- University Hospitals Case Medical Center, Neurological Institute Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.
| | - Anthony J Furlan
- University Hospitals Case Medical Center, Neurological Institute Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.
| | - Martha Sajatovic
- Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.
| | - Elly Katabira
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
| |
Collapse
|
26
|
Komolafe MA, Obembe AO, Olaogun MO, Adebiyi AM, Ugalahi T, Dada O, Kanu A, Adebiyi OC, Akilo F, Ogunkoya B, Fawale B. Awareness of Stroke Risk Factors and Warning Signs in Nigerian Adolescents Compared with Adults. J Stroke Cerebrovasc Dis 2015; 24:687-93. [DOI: 10.1016/j.jstrokecerebrovasdis.2014.11.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 11/05/2014] [Accepted: 11/14/2014] [Indexed: 10/24/2022] Open
|
27
|
Wahab KW, Kayode OO, Musa OI. Knowledge of stroke risk factors among Nigerians at high risk. J Stroke Cerebrovasc Dis 2014; 24:125-9. [PMID: 25440355 DOI: 10.1016/j.jstrokecerebrovasdis.2014.07.053] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 07/25/2014] [Accepted: 07/31/2014] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Although the first step toward effective primary prevention of stroke is awareness of its risk factors, there is limited information on knowledge of these risk factors among Nigerians at increased risk. We assessed the knowledge of risk factors for stroke among Nigerians at high risk. METHOD Using an interviewer-administered questionnaire in a cross-sectional design, high-risk patients (defined as those with a diagnosis of hypertension and/or diabetes) attending the specialist medical outpatient clinics of the University of Ilorin Teaching Hospital were requested to mention all the stroke risk factors they knew. The outcome measure was ability to mention at least 1 well-documented modifiable or potentially modifiable risk factor. Binary logistic regression analysis was used to determine predictors of the outcome measure. RESULTS The mean age of the respondents was 56.4 ± 12.6 years. Only 39.8% were able to mention at least 1 well-documented modifiable or potentially modifiable risk factor; hypertension was the most recognized (34.7%). Other risk factors mentioned by the respondents were: diabetes (7.3%), alcohol intake (4.5%), smoking (3.8%), overweight and obesity (1.9%), and heart disease (.6%). Factors found to be significantly associated with ability to correctly mention at least 1 stroke risk factor were younger age (<55 years), more than 12 years of formal education, family history of stroke, urban residence, and previous health education on stroke. CONCLUSIONS Despite being at high risk, knowledge of stroke risk factors is poor among our respondents. Intensive health education is needed to improve on this poor knowledge.
Collapse
Affiliation(s)
| | - Olabode O Kayode
- Department of Epidemiology and Community Health, University of Ilorin, Ilorin, Nigeria
| | - Omotosho I Musa
- Department of Epidemiology and Community Health, University of Ilorin, Ilorin, Nigeria
| |
Collapse
|
28
|
Predictors of poststroke health-related quality of life in Nigerian stroke survivors: a 1-year follow-up study. BIOMED RESEARCH INTERNATIONAL 2014; 2014:350281. [PMID: 24982864 PMCID: PMC4058476 DOI: 10.1155/2014/350281] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 05/05/2014] [Accepted: 05/12/2014] [Indexed: 11/20/2022]
Abstract
This study aims to identify the predictors in the different aspects of the health-related quality of life (HRQoL) and to measure the changes of functional status over time in a cohort of Nigerian stroke survivors. A prospective observational study was conducted in three hospitals of Kano state of Nigeria where stroke survivors receive rehabilitation. The linguistic-validated Hausa versions of the stroke impact scale 3.0, modified Rankin scale, Barthel index and Beck depression inventory scales were used. Paired samples t-test was used to calculate the amount of changes that occur over time and the forward stepwise linear regression model was used to identify the predictors. A total of 233 stroke survivors were surveyed at 6 months, and 93% (217/233) were followed at 1 year after stroke. Functional disabilities were significantly reduced during the recovery phase. Motor impairment, disability, and level of depression were independent predictors of HRQoL in the multivariate regression analysis. The involvement of family members as caregivers is the key factor for those survivors with improved functional status. Thus, to enhance the quality of poststroke life, it is proposed that a holistic stroke rehabilitation service and an active involvement of family members are established at every possible level.
Collapse
|
29
|
Donkor ES, Owolabi MO, Bampoh P, Aspelund T, Gudnason V. Community awareness of stroke in Accra, Ghana. BMC Public Health 2014; 14:196. [PMID: 24559414 PMCID: PMC3943505 DOI: 10.1186/1471-2458-14-196] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 02/13/2014] [Indexed: 11/16/2022] Open
Abstract
Background Community awareness of stroke, especially the risk factors and warning signs is important in the control of the disease. In sub-Saharan Africa, little is known about community awareness of stroke though the brunt of stroke is currently borne in this region. The aim of the study was to evaluate stroke awareness in Accra (capital city of Ghana) particularly, the risk factors and warning signs. Methods This was a cross-sectional study involving systematic sampling of 63 households in each of the 11 sub metropolitan areas of Accra. A structured questionnaire was used to collect stroke awareness data from respondents randomly sampled in the selected households. Logistic regression analyses were done to identify predictors of the main outcome variables including recognition of stroke risk factors, stroke warning signs and the organ affected by stroke. Results Only 40% (n = 277) of the 693 respondents correctly identified the brain as the organ affected in stroke. Similarly, less than half of the respondents could recognize any of the established stroke risk factors as well as any of the established stroke warning signs. Over 70% (n > 485) of the respondents either believed that stroke is a preventable disease, or lifestyle alterations can be made to reduce the risk of stroke, or stroke requires emergency treatment. In multivariate analysis, predictors of stroke awareness were: age <50 years (OR = 0.56, CI = 0.35-0.92, p = 0.021), presence of a stroke risk factor (OR = 2.37, CI = 1.52-3.71, p < 0.001) and Christian Religion (OR = 14.86, CI = 1.37-161.01, p = 0.03). Conclusion Though stroke is perceived as a serious and preventable disease in Accra, community awareness of the risk factors and warning signs is sub-optimal. This indicates that community-based education programs to increase public awareness of stroke could contribute to decreasing the risk of stroke and to increasing the speed of hospital presentation after stroke onset.
Collapse
Affiliation(s)
- Eric S Donkor
- College of Health Sciences, University of Ghana, Accra, Ghana.
| | | | | | | | | |
Collapse
|
30
|
Obembe AO, Olaogun MO, Bamikole AA, Komolafe MA, Odetunde MO. Awareness of risk factors and warning signs of stroke in a Nigeria university. J Stroke Cerebrovasc Dis 2013; 23:749-58. [PMID: 23910515 DOI: 10.1016/j.jstrokecerebrovasdis.2013.06.036] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 06/22/2013] [Accepted: 06/29/2013] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Rapid access to medical services which is an important predictor of treatment and rehabilitation outcome requires that there is an understanding of stroke risk factors and early warning signs. This study assessed awareness of stroke risk factors and warning signs among students and staff of Obafemi Awolowo University, Nigeria. METHODS This was a cross sectional survey involving 994 (500 students and 494 staff) respondents. Information on the awareness of stroke risk factors and warning signs was collected with the aid of a structured questionnaire. Descriptive and inferential statistics were used for data analysis. RESULTS Weakness (66.2%) was the most commonly identified warning sign of stroke with more staff (69.8%) identifying correctly than students (62.6%). Hypertension (83.4%) was the most commonly identified stroke risk factor, with more staff (91.7%) identifying correctly than students (83.2%). There were significant differences (p < 0.05) in the awareness of some risk factors (age, hypertension, stress and obesity), and warning signs (dizziness, numbness, weakness, headache and vision problems) between students and staff. Predictors for adequate awareness of both stroke risk factors and warning signs were younger age, smoking history and higher educational level. CONCLUSIONS Majority of the respondents recognized individual important stroke risk factors and warning signs, but few recognized multiple stroke risk factors and warning signs. Awareness programs on stroke should be organized, even in communities with educated people to increase public awareness on the prevention of stroke and on the reduction of morbidity in the survivors.
Collapse
Affiliation(s)
- Adebimpe O Obembe
- Department of Medical Rehabilitation, Faculty of Basic Medical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
| | - Matthew O Olaogun
- Department of Medical Rehabilitation, Faculty of Basic Medical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria; Physiotherapy Unit, Department of Medical Rehabilitation, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Adesola A Bamikole
- Department of Medical Rehabilitation, Faculty of Basic Medical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Morenikeji A Komolafe
- Department of Medicine, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria; Neurology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Marufat O Odetunde
- Physiotherapy Unit, Department of Medical Rehabilitation, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| |
Collapse
|
31
|
Okokhere PO, Bankole IA, Erohubie CA. Characteristics, risk factors and case fatality rate of stroke in hospitalized patients in semi-urban South-South Nigeria. SAGE Open Med 2013; 1:2050312113516112. [PMID: 26770696 PMCID: PMC4687779 DOI: 10.1177/2050312113516112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 11/08/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Stroke causes death and disability worldwide. Hypertension is the most prevalent risk factor. In Nigeria, studies on outcome and risk factors of stroke are from urban-based hospitals. This study aims to look at stroke outcome and the major modifiable risk factors of hospitalized stroke patients in semi-urban Nigeria. METHODS The medical records of stroke patients admitted between March 2008 and February 2010 were reviewed retrospectively. The relevant demographic, clinical and laboratory data of each patient were retrieved. RESULTS A total of 99 cases of stroke made up of 51 males and 48 females were reviewed. Mean age of the subjects was 66.22 ± 12.67 years. Mean systolic blood pressure and diastolic blood pressure at presentation were 171.41 ± 39.10 mmHg and 100.44 ± 21 mmHg, respectively. About 61.6% were known hypertensives, while 31.3%, not previously known to be hypertensive, had SBP ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. Overall, 85.9% of the subjects had SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg. In all, 46.5% had SBP ≥ 180 mmHg, and 63% of this number had SBP ≥ 200 mmHg; 42.4% had DBP ≥ 110 mmHg. Other major risk factors were hypercholesterolaemia (34.4%), diabetes mellitus (16.6%), previous cerebrovascular accident (15.2%) and smoking (9.4%). In all, 31.3% had two or more modifiable stroke risk factors. 36.4% of the subjects were comatose. Overall case fatality rate was 45.8%, 75% of the subjects with coma died, compared to 27.6% without coma (p < 0.01). CONCLUSION Mortality in our stroke patients is high. Hypertension is the commonest modifiable risk factor, and the presence of coma at presentation is associated with poor prognosis.
Collapse
Affiliation(s)
- Peter O Okokhere
- Department of Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria
| | - Idowu A Bankole
- Department of Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria
| | | |
Collapse
|
32
|
Vibo R, Kõrv L, Väli M, Tomson K, Piirsoo E, Schneider S, Kõrv J. Stroke Awareness in Two Estonian Cities: Better Knowledge in Subjects with Advanced Age and Higher Education. Eur Neurol 2013; 69:89-94. [DOI: 10.1159/000343805] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 09/07/2012] [Indexed: 11/19/2022]
|
33
|
Stroebele N, Müller-Riemenschneider F, Nolte CH, Müller-Nordhorn J, Bockelbrink A, Willich SN. Knowledge of Risk Factors, and Warning Signs of Stroke: A Systematic Review from a Gender Perspective. Int J Stroke 2011; 6:60-6. [DOI: 10.1111/j.1747-4949.2010.00540.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Stroke is one of the leading causes of death globally. Awareness of stroke risk factors and warning signs are important for stroke prevention and seeking care. The purpose of this systematic review was to review existing literature that assessed the knowledge of stroke risk factors and warning signs and allowed separate gender analysis. We conducted a systematic review of all published studies (to August 2008) examining knowledge of stroke risk factors and warning signs that included women and provided results separated by gender. Two reviewers selected studies for inclusion, assessed quality, and extracted data. The database search identified 2158 references for screening and 158 were selected for possible inclusion. Twenty-two studies were reviewed including 20 cross-sectional and two pretest–posttest design surveys. Overall, better stroke knowledge was observed in women compared with men in the majority of the studies although there is a general lack of knowledge in both genders. Four out of 18 studies reported better risk factor knowledge and eight out of 15 studies reported better knowledge in stroke warning signs in women compared with men. Women tended to know more evidence-based stroke risk factors than men. Stroke knowledge also appeared to be related to country of study origin, age, education, and medical history. Stroke knowledge among different populations and both in men and women is suboptimal. More research is necessary to further investigate gender differences in stroke knowledge with specific focus on how to use these differences to improve public health campaigns.
Collapse
Affiliation(s)
- Nanette Stroebele
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany
| | - Falk Müller-Riemenschneider
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany
| | - Christian H. Nolte
- Department of Neurology, Charité University Medical Center, Berlin, Germany
| | | | - Angelina Bockelbrink
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany
| | - Stefan N. Willich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany
| |
Collapse
|
34
|
Moreira E, Correia M, Magalhães R, Silva MC. Stroke Awareness in Urban and Rural Populations from Northern Portugal: Knowledge and Action Are Independent. Neuroepidemiology 2011; 36:265-73. [DOI: 10.1159/000328867] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 04/27/2011] [Indexed: 11/19/2022] Open
|
35
|
Teuschl Y, Brainin M. Stroke education: discrepancies among factors influencing prehospital delay and stroke knowledge. Int J Stroke 2010; 5:187-208. [PMID: 20536616 DOI: 10.1111/j.1747-4949.2010.00428.x] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Time is essential for the treatment of acute stroke. Much time is lost outside the hospital, either due to failure in identifying stroke symptoms or due to a delay in notification or transport. We review studies reporting factors associated with better stroke knowledge and shorter time delays. We summarise the evidences for the effect of stroke knowledge and education on people's reaction in the acute situation of stroke. METHODS We searched MEDLINE for studies reporting factors associated with prehospital time of stroke patients, or knowledge of stroke symptoms. Further, we searched for studies reporting educational interventions aimed at increasing stroke symptom knowledge in the population. FINDINGS We included a total of 182 studies. Surprisingly, those factors associated with better stroke knowledge such as education and sociodemographic variables were not related to shorter time delays. Few studies report shorter time delays or better stroke knowledge in persons having suffered a previous stroke. Factors associated with shorter time delays were more severe stroke and symptoms regarded as serious, but not better knowledge about the most frequent symptoms such as hemiparesis or disorders of speech. Only 25-56% of patients recognised their own symptoms as stroke. While stroke education increases the knowledge of warning signs, a few population studies measured the impact of education on time delays; in such studies, time delays decreased after education. This may partly be mediated by better organisation of EMS and hospitals. INTERPRETATION There is a discrepancy between theoretical stroke knowledge and the reaction in an acute situation. Help-seeking behaviour is more dependent on the perceived severity of symptoms than on symptom knowledge. Bystanders play an important role in the decision to call for help and should be included in stroke education. Education is effective and should be culturally adapted and presented in a social context. It is unclear which educational concept is best suited to enhance symptom recognition in the acute situation of stroke, especially in view of discrepancies between knowledge and action.
Collapse
Affiliation(s)
- Yvonne Teuschl
- Department of Clinical Medicine and Preventive Medicine, Danube University, Krems, Austria
| | | |
Collapse
|
36
|
Akinyemi RO, Ogah OS, Ogundipe RF, Oyesola OA, Oyadoke AA, Ogunlana MO, Otubogun FM, Odeyinka TF, Alabi BS, Akinyemi JO, Osinfade JK, Kalaria RN. Knowledge and perception of stroke amongst hospital workers in an African community. Eur J Neurol 2009; 16:998-1003. [DOI: 10.1111/j.1468-1331.2009.02666.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|