Recognition, reaction, risk factors and adequate knowledge of stroke: A Brazilian populational survey.

Introduction: General population proper knowledge about stroke can improve stroke outcomes. We aimed to assess the awareness levels of laypeople regarding stroke recognition, reaction, risk factors, and adequate general knowledge (correct answers for those three questions) of stroke.

Methods: Cross-sectional survey-based study enrolling community population from 12 cities of Brazil's Northeast. The volunteers were verbally exposed to a typical case of stroke and then responded to an open-ended semi-structured questionnaire to evaluate their stroke knowledge.

Results: A total of 1475 subjects enrolled in this study (52.6% of women, mean±SD 36.2±15.3 years-old, 13.0±4.4 years of formal schooling). 1220/1475 (82.7%) recognized the situation as a stroke; 1148/1475 (77.8%) would react to it by taking the patient to the emergency department or calling for emergency medical assistance; 844/1475 (57.2%) knew at least one risk factor; and 190/1475 (12.9%) stated that symptoms could be reversed if the patient was treated "as soon as possible". Adequate general knowledge was found in 622/1475 (42,2%) of participants. Notably, among those who recognized the stroke, 19.9% (243/1220) would not react appropriately to it. The multivariate analysis showed that factors independently related to stroke recognition were female sex, higher education levels, private health insurance and previous experience with a similar situation. Adequate general knowledge was associated with longer school years and health insurance.

Conclusions: The frequency of stroke recognition and appropriate reaction were acceptable, however the general knowledge, knowledge of risk factors and notion that stroke treatment is time-sensitive were insufficient. Addressing the recognition-reaction gap requires targeted campaigns focusing on stroke treatment awareness.