STROKE AWARENESS, INTENDED EMERGENCY ACTION, AND CARE EXPERIENCE IN KAZAKHSTAN: A CROSS-SECTIONAL TWO-MODULE SURVEY (STROKETIMEBRAIN)

Shayakhmet Makhanbetkhan, Yerzhan Adilbekov, Botagoz Turdaliyeva, R. BARRANCO-PONS, A.T. Maidan, D.A. OSSER, A.A. MAKHMUTOV, Marat Sarshayev, M.M. MUSSABEKOV, Abzal Zhumabekov

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Mynzhylky Berdikhojayev

Vestnik, 2026

Full text Open access: Gold Metadata (CSL-JSON)
DOI 10.53065/kaznmu.2026.77.2.003
Data confidence 70 medium
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Abstract

Introduction. Stroke remains a leading cause of death and disability, with rising global burden. Transient ischemic attack (TIA) is often overlooked despite requiring urgent care. Evidence on stroke awareness, intended action, and access to acute care in Kazakhstan is limited. Aim. To assess public stroke awareness and its sociodemographic distribution, test whether knowledge predicts appropriate intended action, describe barriers in the acute stroke pathway, and identify targets for system improvement. Materials and Methods. Two independent cross-sectional online surveys (StrokeTimeBrain v1.4) were conducted in February–April 2026. Module A included community adults aged ≥18 years (n=383), and Module B included patients and caregivers with a suspected stroke/TIA care contact within the previous 24 months (n=397). Outcomes included a composite knowledge score (0–15), three symptom vignettes, and a four-item care-experience scale. Analyses used χ2 tests, nonparametric comparisons, and logistic/Poisson regression adjusted for age, sex, education, residence, and region. Results. Overall knowledge was modest (mean 6.5/15). Only 20.4% identified the ≤4.5-hour thrombolysis window, and reperfusion-treatment awareness was low, although 94.5% knew the emergency number. Knowledge increased with age, while the youngest respondents were least informed. Appropriate “call EMS” responses declined from 83.6% for slurred speech to 60.8% for transient/TIA symptoms (p<0.001). Correct intended action was associated mainly with urban residence (aOR 3.22), not with total knowledge score. Willingness to use telestroke was high (78.1%). Among care users, satisfaction was high (7.9/10), and imaging delay was the main bottleneck (42.1%). Conclusion. Stroke awareness in Kazakhstan was modest and unevenly distributed. Education should emphasize urgency and TIA, while system improvement should prioritize EMS, imaging, and telestroke capacity, especially in weaker regions. Key words: stroke, transient ischemic attack, health knowledge, emergency medical services, patient satisfaction, health services accessibility.