title: Multilingual Validation of the Questionnaire for Verifying Stroke-Free Status in West Africa.
abstract: OBJECTIVE
  The Questionnaire for Verifying Stroke-Free Status (QVSFS), a method for verifying stroke-free status in participants of clinical, epidemiological, and genetic studies, has not been validated in low-income settings where populations have limited knowledge of stroke symptoms. We aimed to validate QVSFS in 3 languages, Yoruba, Hausa and Akan, for ascertainment of stroke-free status of control subjects enrolled in an on-going stroke epidemiological study in West Africa.
  
  
  METHODS
  Data were collected using a cross-sectional study design where 384 participants were consecutively recruited from neurology and general medicine clinics of 5 tertiary referral hospitals in Nigeria and Ghana. Ascertainment of stroke status was by neurologists using structured neurological examination, review of case records, and neuroimaging (gold standard). Relative performance of QVSFS without and with pictures of stroke symptoms (pictograms) was assessed using sensitivity, specificity, positive predictive value, and negative predictive value.
  
  
  RESULTS
  The overall median age of the study participants was 54 years and 48.4% were males. Of 165 stroke cases identified by gold standard, 98% were determined to have had stroke, whereas of 219 without stroke 87% were determined to be stroke-free by QVSFS. Negative predictive value of the QVSFS across the 3 languages was 0.97 (range, 0.93-1.00), sensitivity, specificity, and positive predictive value were 0.98, 0.82, and 0.80, respectively. Agreement between the questionnaire with and without the pictogram was excellent/strong with Cohen k=0.92.
  
  
  CONCLUSIONS
  QVSFS is a valid tool for verifying stroke-free status across culturally diverse populations in West Africa.
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.). stephensarfo78@gmail.com.
authors.forename: Fred
authors.initials: F
authors.lastname: Sarfo
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Mulugeta
authors.initials: M
authors.lastname: Gebregziabher
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Bruce
authors.initials: B
authors.lastname: Ovbiagele
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Rufus
authors.initials: R
authors.lastname: Akinyemi
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Lukman
authors.initials: L
authors.lastname: Owolabi
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Reginald
authors.initials: R
authors.lastname: Obiako
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Onoja
authors.initials: O
authors.lastname: Akpa
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Kevin
authors.initials: K
authors.lastname: Armstrong
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Albert
authors.initials: A
authors.lastname: Akpalu
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Sheila
authors.initials: S
authors.lastname: Adamu
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Vida
authors.initials: V
authors.lastname: Obese
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Nana
authors.initials: N
authors.lastname: Boa-Antwi
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Lambert
authors.initials: L
authors.lastname: Appiah
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Oyedunni
authors.initials: O
authors.lastname: Arulogun
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Yaw
authors.initials: Y
authors.lastname: Mensah
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Abiodun
authors.initials: A
authors.lastname: Adeoye
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Aridegbe
authors.initials: A
authors.lastname: Tosin
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Osimhiarherhuo
authors.initials: O
authors.lastname: Adeleye
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Eric
authors.initials: E
authors.lastname: Tabi-Ajayi
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Ibinaiye
authors.initials: I
authors.lastname: Phillip
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Abubakar
authors.initials: A
authors.lastname: Sani
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Suleiman
authors.initials: S
authors.lastname: Isah
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Nasir
authors.initials: N
authors.lastname: Tabari
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Aliyu
authors.initials: A
authors.lastname: Mande
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Atinuke
authors.initials: A
authors.lastname: Agunloye
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Godwin
authors.initials: G
authors.lastname: Ogbole
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Joshua
authors.initials: J
authors.lastname: Akinyemi
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Ruth
authors.initials: R
authors.lastname: Laryea
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Sylvia
authors.initials: S
authors.lastname: Melikam
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Ezinne
authors.initials: E
authors.lastname: Uvere
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Gregory
authors.initials: G
authors.lastname: Adekunle
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Salaam
authors.initials: S
authors.lastname: Kehinde
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Paschal
authors.initials: P
authors.lastname: Azuh
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Abdul
authors.initials: A
authors.lastname: Dambatta
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Naser
authors.initials: N
authors.lastname: Ishaq
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Raelle
authors.initials: R
authors.lastname: Saulson
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Donna
authors.initials: D
authors.lastname: Arnett
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Hemnant
authors.initials: H
authors.lastname: Tiwari
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Carolyn
authors.initials: C
authors.lastname: Jenkins
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Dan
authors.initials: D
authors.lastname: Lackland
authors.affiliation: From the Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana (F.S., S.A., V.O., N.B.-A., L.A.); Department of Neurology, Medical University of South Carolina, (M.G., B.O., K.A., R.S., C.J., D.L.); Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria (R.A.); Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria (L.O., S.I., N.T., A.M., A.D., N.I.); Department of Medicine, Ahmadu Bello University, Zaria, Nigeria (R.O., E.T.-A., I.P., A.S., P.A.); Department of Medicine, University of Ibadan, Ibadan, Nigeria (O. Akpa, O. Arulogun, A. Adeoye, A.T., O. Adeleye, A. Agunloye, G.O., J.A., S.M., E.U., G.A., S.K., M.O.); Department of Medicine, University of Ghana Medical School, Accra, Ghana (A. Akpalu, Y.M., R.L.); and Department of Biostatistics, University of Alabama at Birmingham (D.A., H.T.).
authors.forename: Mayowa
authors.initials: M
authors.lastname: Owolabi
mesh_terms: D000328:Adult; D000354:Africa, Western / Q000208:ethnology; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D005260:Female; D006801:Humans; D038622:Internationality; D008297:Male; D008875:Middle Aged; D019303:Multilingualism; D020521:Stroke / Q000175:diagnosis* / Q000208:ethnology*; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: Ghana; cross-sectional studies; neurology; sensitivity and specificity; stroke