Age and Medical Insurance Discrepancies and Similarities on Knowledge of Ischemic Stroke Symptoms and Risk Factors Among Public and Outpatients in Sub Saharan Africa A Cross Sectional Questionnaire Study in Greater Gaborone, Botswana

Q: What are the key findings of this study?

Outpatients had significantly higher awareness than the general public for 5 of 8 stroke symptoms and 6 of 10 stroke risk factors across all age groups (p<0.05).

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Ischemic Stroke (n=2808). Intervention: Outpatient status, age, and medical insurance status vs. General public and uninsured/insured subgroups. Primary outcome: Awareness and knowledge scores of 8 stroke symptoms and 10 stroke risk factors (p=<0.05).

Q: What does this research mean for the field?

Outpatients have significantly higher awareness than the general public for most stroke symptoms and risk factors across all age groups. Novelty: ClaimNovelty.CONTRADICTORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To determine knowledge of stroke symptoms and risk factors based on age and medical insurance among outpatients with stroke risk factors and the general public in Botswana.

Ookeditse Ookeditse

doi:10.52768/aepidemiolpublichealth/1141

October 6, 2026Annals of Epidemiology and Public HealthOpen Access

Age and Medical Insurance Discrepancies and Similarities on Knowledge of Ischemic Stroke Symptoms and Risk Factors Among Public and Outpatients in Sub Saharan Africa A Cross Sectional Questionnaire Study in Greater Gaborone, Botswana

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Key result

Outpatients show greater awareness than the general public for most stroke symptoms and risk factors.

P<0.05
n=2,808

Why the study?

The study sought to determine knowledge of ischemic stroke symptoms and risk factors by age and medical insurance status among outpatients with stroke risk factors and the general public in Botswana.

Key Points

To determine knowledge of stroke symptoms and risk factors based on age and medical insurance among outpatients with stroke risk factors and the general public in Botswana.
Conducted a cross-sectional electronic questionnaire study in Greater Gaborone, Botswana, evaluating outpatients (n=795) and the general public.
Used standardized, open-ended questions administered in English or Setswana on tablets to assess spontaneous recall of 8 stroke symptoms and 10 stroke risk factors.
Analyzed differences across age groups and medical insurance status using chi-square tests and non-parametric tests (Mann-Whitney U and Kruskal-Wallis H) with Bonferroni correction.
Across all age groups, outpatients had higher awareness than the general public for 5 out of 8 stroke symptoms and 6 out of 10 stroke risk factors (p<0.05).
Overall, 98.6% of outpatients and 99.0% of the public recalled at least one stroke symptom, with numbness on one side (85.7% vs 82.1%) and weakness on one side (84.0% vs 74.2%) most commonly identified.
Among the public, individuals without medical insurance had higher awareness than those with insurance for acute headache (38.0% vs 17.4%), blurred/double vision (32.3% vs 6.5%), and confusion (31.4% vs 9.8%).

Study Design

Type

Cross-Sectional (n=2,808)

Multicenter

Yes

Structured PICO

P

Population

2,808 adults aged 18-90 years in greater Gaborone, Botswana (2,013 general public and 795 outpatients with stroke risk factors) surveyed via open-ended questionnaires between June and October 2019.

O

Outcome

Awareness and knowledge of 8 ischemic stroke symptoms and 10 stroke risk factors, assessed via open-ended electronic questionnaire and stratified by age and medical insurance status.patient reported

Main Result

p-value: p=<0.05

This cross-sectional study in Botswana demonstrates significant discrepancies in stroke symptom and risk factor awareness based on outpatient status, age, and medical insurance, highlighting the need for targeted public health educational campaigns in Sub-Saharan Africa.

Limitations

Stroke symptoms and risk factors were weighted equally despite varying clinical prevalence and identifiability
Small sample sizes in certain subgroups reduced statistical power
Heterogeneity in how high stroke knowledge is defined across comparable studies
Self-reported characteristics and risk factors are prone to recall and reporting bias
Potential unmeasured demographic differences between responders and non-responders

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Implication

Enhanced stroke education needed for general public; leaves open effects on prevention behaviors in prospective studies.

Abstract

We determined knowledge of stroke symptoms and risk factors based on age and medical insurance among outpatients with stroke risk factors and the general public in a cross sectional study from Botswana.

Discussion

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Cite This Study

Ookeditse Ookeditse (2026) conducted a cross-sectional in Ischemic Stroke (n=2,808). Outpatient status, age, and medical insurance status vs. General public and uninsured/insured subgroups was evaluated on Awareness and knowledge scores of 8 stroke symptoms and 10 stroke risk factors (p=<0.05). Outpatients had significantly higher awareness than the general public for 5 of 8 stroke symptoms and 6 of 10 stroke risk factors across all age groups (p<0.05).

synapsesocial.com/papers/6ae28e94cbadf70daf6c43b7 https://doi.org/10.52768/aepidemiolpublichealth/1141

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Age and Medical Insurance Discrepancies and Similarities on Knowledge of Ischemic Stroke Symptoms and Risk Factors Among Public and Outpatients in Sub Saharan Africa A Cross Sectional Questionnaire Study in Greater Gaborone, Botswana

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Age and Medical Insurance Discrepancies and Similarities on Knowledge of Ischemic Stroke Symptoms and Risk Factors Among Public and Outpatients in Sub Saharan Africa A Cross Sectional Questionnaire Study in Greater Gaborone, Botswana

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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