Background: It is crucial to assess genomic literacy related to stroke among Africans in preparation for the ethical, legal and societal implications of the genetic revolution which has begun in Africa. Objective: To assess the knowledge, attitudes and practices (KAP) of West Africans about stroke genetic studies. Methods: A comparative cross-sectional study was conducted among stroke patients and stroke-free controls recruited across 15 sites in Ghana and Nigeria. Participants' knowledge of heritability of stroke, willingness to undergo genetic testing and perception of the potential benefits of stroke genetic research were assessed using interviewer-administered questionnaire. Descriptive, frequency distribution and multiple regression analyses were performed. Results: Only 49% of 2029 stroke patients and 57% of 2603 stroke-free individuals knew that stroke was a heritable disorder. Among those who knew, 90% were willing to undergo genetic testing. Knowledge of stroke heritability was associated with having at least post-secondary education (OR 1.51, 1.25-1.81) and a family history of stroke (OR 1.20, 1.03-1.39) while Islamic religion (OR¼0.82, CI: 0.72-0.94), being currently unmarried (OR ¼ 0.81, CI: 0.70-0.92), and alcohol use (OR ¼ 0.78, CI: 0.67-0.91) were associated with lower odds of awareness of stroke as a heritable disorder. Willingness to undergo genetic testing for stroke was associated with having a family history of stroke (OR 1.34, 1.03-1.74) but inversely associated with a medical history of high blood pressure (OR ¼ 0.79, 0.65-0.96). Conclusion: To further improve knowledge of stroke heritability and willingness to embrace genetic testing for stroke, individuals with less formal education, history of high blood pressure and no family history of stroke require targeted interventions.

Summary Background Low Back Pain (LBP) is the leading cause of disability globally. Standardized outcome measures for measuring LBP disability exist but none was developed with consideration for the Nigerian culture and environment. Objective This study was aimed to develop a Nigerian culture- and environment-friendly LBP scale, the Ibadan Low Back Pain Disability Questionnaire (ILBPDQ). Methods Items on ILBPDQ were devised from literature review, interview of patients (231 consecutively-sampled patients with chronic non-specific LBP) and 12 professionals experienced in LBP management and were contentvalidated. The first draft of the questionnaire underwent pretesting twice among individuals with chronic non-specific LBP (n=35 and 114 respectively), factor analysis and experts' reviews to produce the final version. Results The final scale comprised 18 items with a two-factor structure (common Activity of Daily Living [ADL] and culture-specific ADL). It has eigen value ≥ 1 and explained 60% of variance. Items on ILBPDQ covered important constructs relevant to an average Nigerian patient with LBP. Conclusion A scale for assessing disability in LBP is made available for use in Nigeria and similar populations. Funding None declared

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Background: The Ibadan Low Back Pain Disability Questionnaire (ILBPDQ) was developed to meet the need for a LBP treatment outcome measure that was appropriate for the Nigerian culture and environment. The objective of this study was to determine the psychometric properties of ILBPDQ.Methods: This study used the validation design. One hundred and forty-two participants with LBP (LBPPs) and 142 age and sex-matched participants without LBP (NLBPPs) were included. The LBPPs were recruited consecutively from Physiotherapy clinics of selected tertiary hospitals in the six geopolitical zones of Nigeria. Both LBPPs and NLBPPs completed the ILBPDQ - the LBPPs completed the Numerical Pain Rating Scale (NPRS). The ILBPDQ was completed by 113 LBPPs two days after initial assessment. Sixty-four of the LBPPs received physiotherapy for 5-weeks, after which they were reassessed using ILBPDQ and NPRS.Results: ILBPDQ score of LBPPs was significantly higher than that of NLBPPs (construct validity) and LBPPs NPRS score correlated significantly with their ILBPDQ score (r = 0.50) at baseline and post intervention (r =0.35) (divergent validity). ILBPDQ scores at baseline and 48 hours later for LBPPs correlated significantly (Intra Class Correlation =0.80) (test re -test reliability). Cronbach’s α for ILBPDQ was 0.84 (internal consistency). The postintervention ILBPDQ and NPRS scores for LBPPs were significantly lower than their pre-intervention ILBPDQ scores (responsiveness) and NPRS scores. The changes in ILBPDQ and NPRS scores of the LBPPs correlated significantly (r =0.62) (responsiveness).Conclusion: The ILBPDQ demonstrated evidence of validity, reliability and responsiveness.Keywords: Low back pain, Functional disability, Outcome measure, Psychometric testing, NigeriaFunding: University of Ibadan Senate Research Grant.