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

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.

Keywords:

• stroke
• hypertension
• global health
• knowledge
• risk factors
• warning factors

Public Interest Statement

Stroke is a neurological condition, with a rapidly increasing burden in resource limited settings. Community attitudes and knowledge influence stroke prevention, including risk factor identification, management, community and individual response to stroke symptoms when they occur. The success of primary preventive measures and timely medical attention immediately following a stroke is influenced by the public’s knowledge and perception of stroke and its risk risk factors. In this article, we describe the knowledge and attitudes of stroke in an adult, urban population in Uganda. We observed that stroke knowledge is poor while, stress and hypertension are the leading perceived risk factors in our settings. Increasing 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.

Competing Interests

The authors declare no competing interest.

Acknowledgments

We thank Levi Mugenyi for the guidance on the statistical analysis and Doreen Birungi for the support and guidance. We also thank our survey subjects for participating in this study.

Author’s contributions

MK, JN and JK and collected data during the survey; IM MS and EK performed data analyses; MS, CB, and EK designed the study; IM, MK, JK, and JN wrote the paper. MS, CB and EK revised the manuscript for important intellectual content. All authors discussed the results and commented on the manuscript. All authors read and approved the final manuscript.

Funding

This study was supported by a grant from the National Institute of Neurological Disorders and Stroke of the National Institute of Health R21NS094022-01 PIs: Martha Sajatovic and Elly Katabira.

Additional information

Notes on contributors

Mark Kaddumukasa

Our research is focused on developing a better understanding of stroke burden reduction in urban areas in Uganda. This involves the adoption and development of culturally appropriate self-management interventions for the high risk populations. The research in this paper describes one of the study phases, where we try to understand the baseline knowledge and attitudes before designing appropriate interventions in adult populations living in urban areas. This is important because it is not clear what correct information these communities possess and what key areas should we emphasize when developing appropriate interventions for stroke prevention among high risk groups within urban areas in Uganda.