title: Validation of the 8-item questionnaire for verifying stroke free status with and without pictograms in three West African languages.
abstract: BACKGROUND
  The Questionnaire for Verifying Stroke-free Status (QVSFS) has been validated in Western populations as a method for verifying stroke-free status in participants of clinical, epidemiological and genetic studies. This instrument has not been validated in low-income settings where populations have limited knowledge of stroke symptoms and literacy levels are low.
  
  
  OBJECTIVE
  To simultaneously validate the 8-item QVSFS in 3 languages spoken in West Africa (Yoruba, Hausa and Akan) for ascertainment of stroke-free status of control subjects in SIREN.
  
  
  METHODS
  Using a cross-sectional study design, 100 participants each from the 3 linguistic groups will be consecutively recruited from neurology and general medicine clinics of 5 tertiary referral hospitals in Nigeria and Ghana. Ascertainment of stroke status will be determined by neurologists using structured neurological examination, review of case records and neuro-imaging (Gold standard). The relative performance of QVSFS without and with pictures of stroke symptoms (pictograms) will be assessed using sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).
  
  
  CONCLUSIONS
  The proposed study will provide valuable data on the performance of the QVSFS in resource-limited settings.
authors.affiliation: Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Fred S
authors.initials: FS
authors.lastname: Sarfo
authors.affiliation: Medical University of South Carolina, SC, USA.
authors.forename: Mulugeta
authors.initials: M
authors.lastname: Gebregziabher
authors.affiliation: Medical University of South Carolina, SC, USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Ovbiagele
authors.affiliation: Federal Medical Centre, Abeokuta, Nigeria.
authors.forename: Rufus
authors.initials: R
authors.lastname: Akinyemi
authors.affiliation: Aminu Kano Teaching Hospital, Nigeria.
authors.forename: Lukman
authors.initials: L
authors.lastname: Owolabi
authors.affiliation: Ahmadu Bello University, Zaria, Nigeria.
authors.forename: Reginald
authors.initials: R
authors.lastname: Obiako
authors.affiliation: Medical University of South Carolina, SC, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Armstrong
authors.affiliation: University of Ibadan, Ibadan, Nigeria.
authors.forename: Oyedunni
authors.initials: O
authors.lastname: Arulogun
authors.affiliation: Korle Bu Teaching Hospital, Accra, Ghana.
authors.forename: Albert
authors.initials: A
authors.lastname: Akpalu
authors.affiliation: University of Ibadan, Ibadan, Nigeria.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Melikam
authors.affiliation: Medical University of South Carolina, SC, USA.
authors.forename: Raelle
authors.initials: R
authors.lastname: Saulson
authors.affiliation: Medical University of South Carolina, SC, USA.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Jenkins
authors.affiliation: University of Ibadan, Ibadan, Nigeria.
authors.forename: Mayowa
authors.initials: M
authors.lastname: Owolabi
keywords: Accuracy; Pictogram; Stroke-free phenotype; West Africa