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

Abstract

Background: Stroke is increasingly becoming a major cause of disability and mortality. However, it can be prevented by raising awareness about risk factors and early health care management of patients. Objective: The aim of this study is to assess the level of knowledge on stroke, its risk factors, and warning signs in the population attending urban primary health care centers in the city of Agadir, Morocco. Methods: This is a multicentric cross-sectional study with a descriptive and analytical purpose. The study was conducted at five urban primary health care centers in Agadir in centralwest Morocco. All persons over the age of 18 years who consulted the health centers and who agreed to fill in the questionnaire were recruited, except for the foreign population and health workers. An interview questionnaire was used to assess the level of knowledge on stroke. Findings: A total of 469 participants were involved in the study. The median knowledge score was 8 (Interquartile range 4-13). High blood pressure (55.7%), depression and stress (48.8%) were the most well-known risk factors. Sudden weakness of the face, arms or legs (37.3%) was the main warning sign cited by the participants. Multivariate analysis revealed that illiteracy (OR 1.92; CI 95% : 1.08-3.44) primary education (OR 3.43; CI 95% : 1.63-7.21), rural residential (OR 1.67; CI 95% : 1.07-2.59), no history of stroke among respondents (OR 16.41; CI 95% : 4.37-61.59) and no history of stroke among relatives, acquaintances, or neighbors (OR 4.42; CI 95% : 2.81-6.96), were independently associated with a lower level of knowledge of stroke (Table 4). Conclusions: The low level of knowledge on stroke among this Moroccan population indicates the importance of implementing stroke education initiatives in the community. More specifically, proximity education and awareness programs ought to be considered to anchor lifestyle preventive behaviors along with appropriate and urgent actions regarding the warning signs of stroke.

Factors Associated with Knowledge and Awareness of Stroke Among the Jordanian Population: A Cross-Sectional Study

“…Despite being one of the most common modifiable risk factors for stroke, Diabetes Mellitus was relatively less identifiable by our study participants (68.4%). This finding has been reported elsewhere in previous studies ( Kharbach et al, 2020a ).…”

“…Moreover, hypertension (48.2%), followed by stress (43.1%), were identified as risk factors among participants in a study from Lebanon (43.1%) ( Khalil and Lahoud, 2020 ). Similarly, among 469 participants in a study from Morocco, hypertension (55.7%), followed by stress (48.8%), were identified as risk factors for stroke ( Kharbach et al, 2020b ). Despite being one of the most common modifiable risk factors for stroke, Diabetes Mellitus was relatively less identifiable by our study participants (68.4%).…”

Stroke Related Knowledge, Prevention Practices and Associated Factors Among Hypertensive Patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2021

“…Alcohol consumption and hypercholesterolemia were the subsequent risk factors identified. This is in agreement with the study done in Morocco where the most frequently identified warning signs and risk factors were sudden weakness of the arm, leg or face and hypertension, respectively ( 25 ).…”

“…Hypertensive patients who had secondary education, and above were more than four times more likely to have adequate stroke knowledge. This was concordant with the findings of a range of studies in which high educational level had been the most associated factor with adequate knowledge of stroke in hypertensive patients in Ethiopia ( 26 , 28 , 29 ), and Nigeria ( 14 , 32 ) Morocco ( 25 ), and Beirut ( 33 ). This may be due to the fact that individuals who have a higher educational level may have more interaction with society and have easy access to health-related information from various sources like the internet, news, books, magazines, and literature as compared with individuals who have no formal education, which is supported by the systematic reviews reporting that educational status has a significant impact on cardiovascular disease knowledge in SSA populations ( 24 , 34 ).…”

“…Even though early identification of stroke warning signs and risk factors is essential for stroke prevention and early management, there is low level of knowledge in the general population ( 24 , 25 ). The studies done in Ethiopia investigated only the warning signs, risk factors, and prevention knowledge of stroke ( 26 – 28 ).…”