Public Awareness of Stroke Risk Factors, Warning Symptoms, Prevention Measures, and Stroke Management Among Adults in Two Major Cities in Yemen: A Cross-Sectional Study

Background: Stroke remains a major global health challenge and a leading cause of mortality and long-term disability worldwide. In low-income, conflict-affected countries such as Yemen, the burden is amplified by fragile healthcare systems and limited access to preventive and acute care services. Hence, this study addresses a critical awareness gap by assessing awareness of stroke risk factors, symptom recognition, prevention strategies, and stroke management among adult community members in two major urban cities in Yemen. Methodology: A cross-sectional survey design was employed using paper-based questionnaire. Participants were recruited through convenience sampling. Data analysis included descriptive statistics, non-parametric tests, correlation analysis, and bivariate logistic regression analysis. Results: Our study revealed a high level of overall recognition-based awareness was observed among surveyed participants (87.9%; 95% CI: 84.7– 91.1%). Specific areas of high recognition included obesity or overweight (89.4%) and high blood pressure (86.2%) as risk factors, dizziness/loss of balance (79.1%) as a symptom, and taking prescribed medications (87.2%) and regular medical checkups (86.9%) for prevention. Awareness of immediate medical care (87.7%) and future prevention medications (85.9%) also stood out in stroke management domain. A personal or family history of chronic diseases was strongly associated with greater overall stroke awareness score (p< 0.001), as was a history of stroke itself (p=0.03). Bivariate regression analysis highlighted significant associations between high awareness and education level for symptoms, prevention, and stroke management domains scores (p < 0.001). Conclusion: Despite the encouraging overall awareness, the findings highlight areas where targeted public health interventions may be warranted, particularly for less recognized aspects of stroke awareness. These should focus on reinforcing awareness, particularly concerning less recognized symptoms, and addressing disparities linked to socio-economic factors. These findings highlight the need for targeted stroke awareness interventions in urban settings, while underscoring the importance of further nationally representative studies. This study sheds light on the current level of stroke awareness and offers vital insights for policymakers and medical professionals to create culturally appropriate and successful educational campaigns. Keywords: stroke awareness, stroke risk factors, symptom recognition, stroke prevention, stroke management, health literacy, urban populations, low-resource settings, Yemen