LETTER TO THE EDITOR
|Year : 2015 | Volume
| Issue : 4 | Page : 487-488
Awareness of the warning symptoms and risk factors of stroke among adults seeking health care from a rural hospital of India
Lipilekha Patnaik, Himanshu Sekhar Sahoo, Trilochan Sahu
Department of Community Medicine, Institute of Medical Sciences and SUM Hospital, S 'O' A University, Bhubaneswar, Odisha, India
|Date of Web Publication||17-Nov-2015|
Associate Professor, Community Medicine, IMS & SUM Hospital, S 'O' A University, Bhubaneswar, Odisha 751003
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Patnaik L, Sahoo HS, Sahu T. Awareness of the warning symptoms and risk factors of stroke among adults seeking health care from a rural hospital of India. Ann Indian Acad Neurol 2015;18:487-8
|How to cite this URL:|
Patnaik L, Sahoo HS, Sahu T. Awareness of the warning symptoms and risk factors of stroke among adults seeking health care from a rural hospital of India. Ann Indian Acad Neurol [serial online] 2015 [cited 2019 Oct 14];18:487-8. Available from: http://www.annalsofian.org/text.asp?2015/18/4/487/165479
Stroke is a major disabling health problem in developing countries like India. Stroke burden in India has been rising in the last few decades, in contrast to developed countries where it has plateaued or decreased. Currently, the average annual incidence rate of stroke in India is 145 per 100,000 populations, which is higher than the western nations.  Approximately, 12% of all strokes occur in the population <40 years of age.  From the current Indian population of about 1.2 billion, approximately 1.8 million people may suffer from stroke annually and about one-third of them may die. This entails the issue of prevention and treatment of stroke serious attention for developing countries. 
Early recognition of symptoms and prompt medical care are essential for providing appropriate treatment to prevent adverse clinical outcomes in patients with stroke.  Therefore, it is important to identify the level of awareness about stroke warning symptoms and risk factors for its prevention and to reduce the associated mortality and morbidity. A study was therefore undertaken to determine the level of awareness of warning symptoms and risk factors of stroke among patients attending rural health and training center (RHTC).
A hospital-based cross-sectional study was carried out in the RHTC, which was, the field practice area of department of Community Medicine during April-May 2013. Total number of consecutive adult patients above 18 years of age reporting the outpatient department of RHTC from 1 st April to 31 st May 2013 were included in the study with due informed consent. In the process, total study subjects were 540 and it was a convenient sample. The study subjects were interviewed using a predesigned, pretested and structured questionnaire. The questionnaire included items pertaining to warning symptoms of stroke and its risk factors identified by the American Heart Association.  The structured questionnaire contained 21 items, including 9 stroke and 12 items for risk factors. The participants were interviewed individually and they were asked to identify stroke symptoms and its risk factors. All the symptoms and risk factors were translated to local language and presented in a chart, which was shown to the study subjects to identify the symptoms and risk factors in the form of yes or no. The data were analyzed using SPSS software version 16.
The age of study population varied from 19-59 years. The mean age was 41.67 ± 11.36. In this study, 56.7% of people were male and 43.3% were female. In the present study, 35.4% were skilled workers including teacher/clerk or similar service holders. About 52% people were having primary education and 64.8% belong to the lower social class.
[Table 1] shows that the most frequent symptom identified was sudden numbness or weakness of the arm or leg on one side of the body (93.88%) followed by sudden trouble walking, loss of balance or coordination (91.48%) and sudden numbness or weakness of the face especially on one side of the body (86.11%). 6.1% of them could not identify any of the warning symptoms.
In our study, about 71% of study subjects were aware about less than 4 symptoms considered as having low level of awareness of stroke warning symptoms. In all, 41% were aware about less than 6 risk factors and considered having low level of awareness about stroke risk factors. The awareness of stroke warning symptoms was significantly lower in low socioeconomic group (P < 0.001) and among study subjects educated up to secondary level (P < 0.001). Similarly the awareness of risk factors was significantly lower in low socioeconomic group (P < 0.01) and among study subjects educated up to secondary level (P < 0.001). There is no difference in level of awareness in other socio-demographic variables like age, gender, occupation, type of family, etc.
The present study reveals the level of awareness of stroke warning symptoms and risk factors among rural adults attending a health institution which may be reflected as low level of awareness among rural population with significant association with socio-economic status and level of education.
In this rural setting, the focus of intervention should be toward improving the awareness about stroke warning symptoms and risk factors. The educational interventions by interns and social workers posted in RHTC can be the first step in this direction to increase awareness.
| References|| |
Kaul S, Bandaru VC, Suvarna A, Boddu DB, Stroke burden and risk factors in developing countries with special reference to India. J Indian Med Assoc 2009;107:358, 367-70.
Anand K, Chowdhury D, Singh KB, Pandav CS, Kapoor SK. Estimation of mortality and morbidity due to strokes in India. Neuroepidemiology 2001;20:208-11.
Dalal PM, Bhattacharjee M. Stroke epidemic in India: Hypertension-stroke control programme is urgently needed. J Assoc Physicians India 2007;55:689-91.
Moser DK, Kimble LP, Alberts MJ, Alonzo A, Croft JB, Dracup K, et al
. Reducing delay in seeking treatment by patients with acute coronary syndrome and stroke: A scientific statement from the American Heart Association Council on cardiovascular nursing and stroke council. Circulation 2006;114:168-82.
Rosamond W, Flegal K, Furie K, Go A, Greenlund K, Haase N, et al
. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2008 update: A report of American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2008;117:e25-146.