Purpose. This study, designed to complement a large population survey on prevalence of stroke risk factors, assessed knowledge and perception of stroke and associated factors. Methods. A population survey was conducted in urban Nansana and rural Busukuma, Wakiso district, central Uganda. Adult participants selected by multistage stratified sampling were interviewed about selected aspects of stroke knowledge and perception in a pretested structured questionnaire. Results. There were 1616 participants (71.8% urban; 68.4% female; mean age: 39.6 years ± 15.3). Nearly 3/4 did not know any stroke risk factors and warning signs or recognize the brain as the organ affected. Going to hospital (85.2%) was their most preferred response to a stroke event. Visiting herbalists/traditional healers was preferred by less than 1%. At multivariable logistic regression, good knowledge of stroke warning signs and risk factors was associated with tertiary level of education (OR 4.29, 95% CI 2.13–8.62 and OR 5.96, 95% CI 2.94–12.06), resp.) and self-reported diabetes (OR 1.97, 95% CI 1.18–3.32 and OR 1.84, 95% CI 1.04–3.25), resp.). Conclusion. Knowledge about stroke in Uganda is poor although the planned response to a stroke event was adequate. Educational strategies to increase stroke knowledge are urgently needed as a prelude to developing preventive programmes. 1. Introduction Stroke is one of the leading causes of mortality and morbidity worldwide [1–4] with developing countries accounting for 85% of global deaths from stroke [1–3]. Lack of information and poor control of stroke risk factors contribute to the rising incidence of stroke amongst Africans [5–7]. 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 factors [6, 8–10]. The few studies done in Africa to assess the knowledge of stroke among health workers, stroke patients, carers of stroke patients, and the general population have reported low levels of knowledge about recognizing and preventing stroke [6, 8–12]. Published studies from Africa note that stroke-like symptoms may be considered both physical and social conditions resulting from natural or environmental causes and supernatural causes such as demons and witchcraft [13–15]. Health care access is strongly influenced by cultural knowledge and interpretation of disease symptoms [16, 17], structural and gender constraints [17, 18], and trust in providers [19]. In Uganda, public perception and level of knowledge of stroke warning
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