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Stroke is a leading cause of death worldwide and the vast majority of stroke-related deaths occur in low- and middle-income countries [1, 2]. Worldwide, 5·5 million people died of stroke in 2002 [3], and about 20% of these deaths occurred in South Asia [4]. The incidence of stroke is increasing in developing countries like Pakistan [5]. Enhancing public knowledge of stroke symptoms, acute treatments, and risk factors will be an important component of future treatment and prevention strategies.

We sought to determine the awareness of stroke symptoms and risk factors in high school children in Sargodha, Pakistan. We conducted a survey of high school students to determine their knowledge about stroke symptoms and risk factors using a questionnaire administered by school teachers. We randomly selected 15 high schools in Sargodha district and interviewed 20 students from each school. Nine of the 15 schools were government run and six were private schools. Students were between 14 and 18 years of age, male (151) and female (149).

Eighty-nine per cent had heard of stroke disease. Awareness was higher in females (60%) compared to males (31%) and in the 10th grade (51%) compared to 9th grade students (21%). Only 46% could name one stroke risk factor. Similarly, only 46% could name one stroke symptom. Twenty-three per cent said that they would call an ambulance for acute stroke and 33% knew that stroke patients may benefit from aspirin.

In summary, the majority of students in our study were not aware of stroke risk factors, symptoms, and what to do in the setting of acute stroke. Our data suggest that a need exists for new and creative strategies for educating middle and high school students in developing countries about stroke risk factors, symptoms, and the availability of acute stroke treatments.

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