Public knowledge and awareness of stroke in the northern West Bank, Palestine: a cross-sectional study

Stroke is a leading cause of death and disability worldwide. Early recognition of symptoms and rapid emergency medical service (EMS) activation improve outcomes. This study assessed public knowledge of stroke in the northern West Bank, Palestine, and identified predictors of awareness. A cross-sectional survey of 597 Palestinian residents aged ≥ 16 years was conducted across three governorates in the northern West Bank (Nablus, Jenin, and Tulkarem) between April and August 2025. A structured questionnaire assessed knowledge of stroke symptoms, risk factors, consequences, and emergency responses. Descriptive statistics, chi-square tests, and multivariate logistic regression were applied. Most participants (92.0%) had heard of stroke, 94.5% regarded it as a medical emergency, and 86.0% would call EMS. Commonly recognized symptoms were speech disturbance (82.6%) and unilateral weakness (77.2%), while vision problems (60.3%) and headache with neck stiffness (46.2%) were less well-known. Misconceptions such as fever (22.3%) and abdominal pain (11.7%) were reported. Hypertension was the most identified risk factor (78.7%); diabetes (42.9%) and physical inactivity (8.5%) were poorly recognized. Paralysis (76.2%) and loss of speech (73.5%) were frequently reported consequences, but only 41.5% acknowledged the need to relearn skills. Multivariate analysis showed education as the strongest predictor: though unexpectedly, participants with no formal education showed higher odds of good knowledge across symptoms (OR = 4.67), risk factors (OR = 3.65), consequences (OR = 3.71), and total knowledge (OR = 5.23; all p ≤ 0.005). Stressful lifestyle predicted lower symptom knowledge (OR = 0.66, p = 0.031), and personal stroke history predicted lower consequence knowledge (OR = 0.49, p = 0.042). While awareness of stroke emergencies was high, important gaps and misconceptions remain. Targeted, culturally tailored education is needed to strengthen recognition of risk factors, especially diabetes and inactivity, and to reinforce EMS activation.