# Stroke awareness and response among university students in five Middle Eastern and North African countries: a multicenter cross-sectional study

## TL;DR

This study assesses university students' stroke knowledge and response in five Middle Eastern and North African countries, finding gaps in practical action despite decent knowledge.

## Contribution

The study provides novel insights into stroke awareness and response among university students in the MENA region, highlighting regional disparities and the influence of education and demographics.

## Key findings

- Participants had a median SKT score of 11 with 68.17% accuracy, but only 21.4% correctly identified sudden confusion as a stroke emergency.
- Medical students scored significantly higher on stroke knowledge and response tests compared to nonmedical students.
- Egyptian and Algerian students had the highest stroke knowledge scores, while gender and personal connection to stroke also influenced results.

## Abstract

Stroke is a major cause of mortality worldwide, including in the Middle East and North Africa (MENA) region. Enhancing stroke knowledge across society is crucial to improving outcomes. Limited data exist on stroke knowledge among university students in the MENA region. This study evaluates their stroke-related knowledge and behavior.

We conducted a cross-sectional study to assess stroke knowledge and responses using the Stroke Knowledge Test (SKT) and Stroke Action Test (STAT) through an online questionnaire. Multivariate linear regression analyzed the relationship between sociodemographic factors and SKT/STAT scores.

A total of 1,169 participants (response rate 97.2%) completed the questionnaire, with a mean age of 21.67 years. Females comprised 68.8% of respondents. Participants were primarily from Egypt (41.9%), Palestine (19.2%), Algeria (15.7%), Jordan (11.6%), and Sudan (11.5%). The median SKT score was 11 (IQR: 9–14), with an overall accuracy of 68.17%. Gender, personal connection to stroke, and country significantly influenced SKT scores (p < 0.001). Egyptian and Algerian students scored highest (median 12, IQR: 9–14; p < 0.001). The STAT revealed a lower mean accuracy of 42.1%, with only 21.4% correctly identifying “sudden confusion” as a stroke emergency. Medical students achieved significantly higher SKT and STAT scores compared to nonmedical students and reported relying on educational curricula (75.5%) for information, while nonmedical students used social media, friends, and television.

University students in the Arab world demonstrate relatively satisfactory stroke knowledge but insufficient practical response to stroke symptoms. Targeted medical educational initiatives and programs are needed to address this gap and improve stroke outcomes in Egypt.