Healthcare professionals' knowledge of modifiable stroke risk factors: A cross-sectional questionnaire survey in greater Gaborone, Botswana

Background - Stroke remains the second leading cause of deaths and disability globally, with highest mortality in Africa (low- and middle-income countries). It is crucial for healthcare professionals to have sufficient stroke risk factors' knowledge in order to reduce the stroke burden. Aims - We investigated healthcare professionals' knowledge of modifiable stroke risk factors, and identified demographic factors influencing this knowledge. Methods - In this cross-sectional survey study from Botswana (upper middle-income country), structured questionnaires reflecting recent stroke guidelines were administered to a representative selection of healthcare workers in greater Gaborone. The response rate was 61.4%, comprising 84 doctors, 227 nurses and 33 paramedics. Categorical data were described using percentages and Chi-square tests. Associations between stroke risk factors' knowledge and demographic factors were analyzed with one-way ANOVA using SPSS 25 statistical software. Results - Awareness rate of individual stroke risk factors was highest for hypertension (96.5%), followed by obesity (93.3%), smoking (91.9%), elevated total cholesterol (91.0%), physical inactivity (83.4%), elevated low-density lipoprotein (LDL) cholesterol (81.1%), excessive alcohol drinking (77.0%), and lowest for diabetes (73.3%). For all-8 risk factors, doctors had the highest knowledge, followed by nurses and paramedics lowest (7.11 vs 6.85 vs 6.06, P < 0.05)

Causes of Infant Mortality in Botswana

Introduction: Infant mortality rate of Botswana has not reduced substantial in the last two decades (1990-2009); the HIV/AIDS epidemic has not helped the situation either. The aim of this project was to determine the major causes of infant death in Botswana and what the government is doing about it. Method: The statistical data used was from the Mortality and Morbidity report of 2006 from Department of Statistics at the Ministry of Health Botswana; literature review included several case report studies conducted by the CDC and ministry of health Botswana in early 2006 following a spike in reported infant death due to diarrhea. Several pamphlets and policy manuals in use in Botswana were also used to discuss the government efforts in reducing child death. Results: The study reveled that infant mortality is mainly caused by infectious diseases, taking account for over 67% of causes of infant death in Botswana. Pneumonia was responsible for 21.7%, while diarrhea was responsible for 27.7% of the deaths among infants. The study also showed that the government of Botswana has introduced several programs that should reduce infant mortality, and indeed success is evident in reducing mother to child transmission of HIV through the Prevention of Mother to Child Transmission of HIV program. Conclusion: Clearly a lot more needs to be done to address the issue of infant mortality, since major causes in Botswana as well as other developing countries are preventable diseases. One of the ways is to educate the public about health and the health services available for them. Another important issue is to educate the primary health worker at all levels

Age and healthy lifestyle behavior’s disparities and similarities on knowledge of myocardial infarction symptoms and risk factors among public and outpatients in a resource-limited setting, cross-sectional study in greater Gaborone, Botswana

Objectives In this cross-sectional study from Botswana, we investigated knowledge of myocardial infarction (MI) symptoms and risk factors among the general public and outpatients with MI risk factors based on age and lifestyle behaviors, in addition to assessing associations with sociodemographic and MI risk factors. Method Open-ended questionnaires about 8 MI symptoms and 10 risk factors, were administered by research assistants to a representative selection of outpatients (n=525) and the public (n=2248). Weight and height were measured in all participants and BMI was calculated. Knowledge scores were compared between the two groups. We examined whether sociodemographic and MI risk factors had impact on the scores. Analyses were further adjusted for lifestyle behavior (smoking status, dietary status and physical activities). Results The valid response rate was 97.9% comprising 97.8% for the public (n=2199) and 98.1% for outpatients (n=515). Public respondents (35.2±12.3 years) were younger than outpatients (38.5±12.6 years). The public comprised 56.9% females while outpatients 54.6%. In general, outpatients had higher knowledge of MI symptoms than the public, with mean scores±SD of 3.49±2.84 vs 2.80±2.54. Outpatients also had higher knowledge score of MI risk factors than the public, with mean scores, 5.33±3.22 vs 3.82±3.07. For MI symptoms, outpatients were more aware than the public for chest pains among all ages, for arm pain/ numbness, neck/ jaw pain radiating to/ from chest, and feeling sick or looking pallor on the skin among those aged 35–49 years. Among both the public and outpatients, lower knowledge of both MI symptoms and risk factors was associated with primary education, not residing/working together, history of hypertension, no history of heart disease/stroke, and obesity. There were similarities and disparities on MI knowledge among respondents with various numbers of healthy lifestyle behaviours. Conclusion Results call for urgent educational campaigns on awareness and knowledge of MI and using strategies based on age and lifestyle behavior

Public and outpatients’ awareness of calling emergency medical services immediately by acute stroke in an upper middle-income country: a cross-sectional questionnaire study in greater Gaborone, Botswana

Objectives In this cross-sectional study from Botswana, we investigated awareness of calling emergency medical services (EMS) and seeking immediate medical assistance by acute stroke among stroke risk outpatients and public. Method Closed-ended questionnaires on awareness of calling EMS and seeking immediate medical assistance by acute stroke, were administered by research assistants to a representative selection of outpatients and public. Results The response rate was 96.0% (93.0% for public (2013) and 96.6% for outpatients (795)). Public respondents had mean age of 36.1 ± 14.5 years (age range 18–90 years) and 54.5% were females, while outpatients had mean age of 37.4 ± 12.7 years (age range 18–80 years) and 58.1% were females. Awareness of calling EMS (78.3%), and of seeking immediate medical assistance (93.1%) by stroke attack was adequate. For calling EMS by acute stroke, outpatients had higher awareness than the public (p < 0.05) among those with unhealthy diet (90.9% vs 71.1%), family history of both stroke and heart diseases (90.7% vs 61.2%), no history of psychiatric diseases (93.2% vs 76.0%) and sedentary lifestyle (87.5% vs 74.8%). Predictors of low awareness of both calling EMS and seeking immediate medical assistance were no medical insurance, residing/working together, history of psychiatric diseases, and normal weight. Male gender, ≥50 years age, primary education, family history of both stroke and heart diseases, current smoking, no history of HIV/AIDS, and light physical activity were predictors of low awareness of need for calling EMS. Conclusion Results call for educational campaigns on awareness of calling EMS and seeking immediate medical assistance among those with high risk factor levels