A Survey on Knowledge of Stroke Subtypes and Etiology at Moi Teaching and Referral Hospital (P1.260)

Objective: In Kenya, stroke comprises a common neurologic emergency. Being able to identify the stroke subtypes (IS= ischemic stroke, HS=hemorrhagic stroke) and etiology is a critical component in appropriate management. Understanding the current provider knowledge base is important in formulating future management strategies. Background: Ischemic stroke has been on the rise and now constitutes an important cause of morbidity worldwide, including Kenya. In 2010, most of the global burden of stroke in the younger population in low income economies was due to HS. The incidence in East sub-Saharan Africa was 73 to 101 per 100,000 person-years). Around the same time, a review of Moi Teaching and Referral Hospital (MTRH) between 2010-2014 revealed, the most common subtype was HS (52[percnt]). Of all strokes, anterior circulation stroke was the primary location (97[percnt]). There were many comorbidities but the majority had HTN (73[percnt]). This survey measures the recognition of stroke subtypes by medical providers at MTRH. Methods: A survey was given to health care providers at different stages in their careers. Clinical officers, interns, medical officers, and registrars were included in the sampling frame. They completed the survey at their own pace. Results: Of the respondents, the most common stroke subtype worldwide was felt to be IS (n=132, 66.8[percnt]). HS was only to be the most common in 4.5 [percnt] (n=9). Respondents felt that at MTRH, the most common etiology of IS was small vessel occlusion (n=69, 34.7[percnt]). The second most was cardio-embolic (n=49, 24.6[percnt]). Conclusions: HS is an under recognized part of stroke subtype at MTRH. Kenya has yet to develop specific national guidelines for HS management. The goal is to utilize the results from this survey to develop education and process improvement initiatives. We hope this will translate into improved care and outcomes for patients with stroke at MTRH. Disclosure: Dr. Lin has nothing to disclose. Dr. Guhwe has nothing to disclose. Dr. Vakani has nothing to disclose. Dr. Kussin has nothing to disclose. Dr. Graffagnino has received personal compensation for activities with Alsius and Medivance as an advisor.