scholarly journals Reasons for poor blood pressure control in Eastern Sub-Saharan Africa: looking into 4P’s (primary care, professional, patient, and public health policy) for improving blood pressure control: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mende Mensa Sorato ◽  
Majid Davari ◽  
Abbas Kebriaeezadeh ◽  
Nizal Sarrafzadegan ◽  
Tamiru Shibru ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Risk ◽  
Scoping Review ◽  
Public Health Policy ◽  
Pressure Control ◽  
Access To Medicines ◽  
Sub Saharan Africa ◽  
Annual Screening ◽  
Prescribed Medicines ◽  
Sub Saharan

Abstract Aim Hypertension control in Sub-Saharan Africa (SSA) is the worst (less than one out of ten) when compared to the rest of the world. Therefore, this scoping review was conducted to identify and describe the possible reasons for poor blood pressure (BP) control based on 4Ps’ (patient, professional, primary healthcare system, and public health policy) factors. Methods PRISMA extension for scoping review protocol was used. We systematically searched articles written in the English language from January 2000 to May 2020 from the following databases: PubMed/Medline, Embase, Scopus, Web of Science, and Google scholar. Results Sixty-eight articles were included in this scoping review. The mean prevalence of hypertension, BP control, and patient adherence to prescribed medicines were 20.95%, 11.5%, and 60%, respectively. Only Kenya, Malawi, and Zambia out of ten countries started annual screening of the high-risk population for hypertension. Reasons for nonadherence to prescribed medicines were lack of awareness, lack of access to medicines and health services, professional inertia to intensify drugs, lack of knowledge on evidence-based guidelines, insufficient government commitment, and specific health behaviors related laws. Lack of screening for high-risk patients, non-treatment adherence, weak political commitment, poverty, maternal and child malnutrition were reasons for the worst BP control. Conclusion In conclusion, the rate of BP treatment, control, and medication adherence was low in Eastern SSA. Screening for high-risk populations was inadequate. Therefore, it is crucial to improve government commitment, patient awareness, and access to medicines, design country-specific annual screening programs, and empower clinicians to follow individualized treatment and conduct medication adherence research using more robust tools.

scholarly journals Effect of Therapeutic Group Education on Adherence and Blood Pressure Control among Uncontrolled Hypertensive Patients in Sub Saharan Africa

2018 ◽  
Vol 08 (03) ◽  
pp. 183-195 ◽  
Author(s):  
Chris Nadège Nganou-Gnindjio ◽  
Héloïse Guidelle Kenmogne Domning ◽  
Liliane Mfeukeu-Kuate ◽  
Bâ Hamadou ◽  
Félicité Kamdem ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Sub Saharan Africa ◽  
Therapeutic Group ◽  
Group Education ◽  
Hypertensive Patients ◽  
Sub Saharan

scholarly journals The Effect of Nebivolol on Office Blood Pressure of Blacks Residing in Sub-Saharan Africa (A Pilot Study)

2021 ◽  
Vol 7 ◽  
Author(s):  
Dike Ojji ◽  
Boni Maxime Ale ◽  
Lamkur Shedul ◽  
Ejiroghene Umuerri ◽  
Emmanuel Ejim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
African Americans ◽  
Beta Blockers ◽  
Pressure Control ◽  
Sub Saharan Africa ◽  
Genetic Admixture ◽  
Environment Interaction ◽  
Clinical Trial Registration ◽  
Black Patients ◽  
Sub Saharan

Introduction: There is substantial clinical evidence that monotherapy with beta-blockers are less effective in reducing blood pressure among hypertensive Black patients compared to Whites. The highly selective beta-1 agents like nebivolol and bisoprolol have, however, been reported to be effective in reducing blood pressure in African Americans. However, results in African Americans cannot be extrapolated to native Africans because of genetic admixture and gene-environment interaction. There is, therefore, the need for us to generate data that are applicable to Africans residing in sub-Saharan Africa. We therefore decided to evaluate the efficacy and tolerability of highly selective beta-1 agent nebivolol in hypertensive Black patients residing in sub-Saharan Africa.Materials and Methods: The nebivolol study was a multicenter, prospective, observational program among hypertensive patients with 4- and 8-week follow up which was conducted in 5 cities in Nigeria of Abuja, Calabar, Enugu, Oghara, and Port Harcourt. Dosages of nebivolol used in keeping with local prescribing information were 5 and 10 mg once daily each. The effectiveness of treatment was assessed by change from baseline in mean office systolic and diastolic blood pressures, and the proportion of patients achieving the therapeutic goal of <140/90 mmHg. Safety and tolerability of this medication were also assessed.Results: We report the results of the 140 patients studied. The mean age and body mass index were 46.9 ± 7.3 years and 22.3 ± 5.8 kg/m2, respectively, and 57.1% were female. Nebivolol reduced SBP and DBP by 7.6 and 6.6 mmHg, respectively, in 4 weeks, and by 11.1 and 8.0 mm Hg, respectively, in 8 weeks. Blood pressure control was achieved in 54.8% of the patients in 4 weeks and increased to 60.4% in 8 weeks. There was no change in metabolic profile between randomization and at 8 weeks, and erectile dysfunction occurred in 1.3% of the study population.Conclusions: Nebivolol 5 and 10 mg appear efficacious in Nigerian Africans with no negative metabolic effect and minimal side effect profile.Clinical Trial Registration:www.ClinicalTrials.gov, Study Identification: NCT 03598673.

scholarly journals Telephones in public health policy processes in sub-Saharan Africa: a scoping review

2021 ◽  
Author(s):  
Wendkouni A. S. Ouedraogo ◽  
Sandrine Biau ◽  
Emmanuel Bonnet ◽  
Valéry Ridde
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Scoping Review ◽  
Public Health Policy ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals Community-based care models for arterial hypertension management in non-pregnant adults in sub-Saharan Africa: A scoping review protocol

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 487
Author(s):  
Lucia González Fernández ◽  
Emmanuel Firima ◽  
Jacqueline Huber ◽  
Fabian Raeber ◽  
Alain Amstutz ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Scoping Review ◽  
Best Practice ◽  
Pressure Control ◽  
Organ Damage ◽  
Sub Saharan Africa ◽  
Primary Data ◽  
Community Based ◽  
Care Models ◽  
Sub Saharan

Introduction: Arterial hypertension (aHT) is the most important cardiovascular risk factor (CVRF) in adults living in sub-Saharan Africa (SSA), leading to an excess of cardiovascular disease (CVD) morbidity and mortality. Life-long aHT service delivery models in the region remain mostly anchored to health facilities and are provided by physicians or nurses, thus limiting access to care. Over the past years, decentralized community-based aHT care models have been piloted, aiming to improve access to prevention, diagnosis, and treatment. Although individual studies suggest that community-based care is well-received and potentially efficacious, a synthesized overview of such care models is missing. Hence, the aim of this scoping review is to map out and summarize existing interventions for community-based aHT diagnosis and care in non-pregnant adults in SSA. Additionally, we will describe outcomes in terms of acceptability, blood pressure control, patient engagement in care, and occurrence of aHT caused end-organ damage. Methods and analysis: We will apply the Arksey and O’Malley scoping review methodology and best practice, as outlined by Levac and the Joanna Briggs Institute scoping review guidelines. The research questions have been identified through a literature review and expert consultation. A systematic literature search will be conducted in four databases using a tailored search strategy, including a supplemental search through backward and forward citation. Abstracts and full text screening as well as the extraction of data will be conducted by two independent reviewers. Discrepancies will be resolved by a third reviewer. Information will be presented in both tabular and narrative form. Ethics and dissemination: This scoping review will summarize findings from existing publications, rather than primary data, and as such, does not require ethics review. Findings will be disseminated through stakeholder meetings, conference presentations, websites, and a peer-reviewed publication.

scholarly journals Poor blood pressure control and its associated factors among peoples living with Diabetes Mellitus in sub-Saharan Africa: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Yonas Akalu ◽  
Yigizie Yeshaw ◽  
Getayeneh Antehunegn Tesema ◽  
Sofonyas Abebaw Tiruneh ◽  
Achamyeleh Birhanu Teshale ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Associated Factors ◽  
Meta Analysis ◽  
Pressure Control ◽  
Sub Saharan Africa ◽  
Random Effects Model ◽  
Pooled Prevalence ◽  
Poor Blood Pressure Control ◽  
Sub Saharan

Abstract Background Poor blood pressure control among people living with diabetes mellitus (DM) is one of the primary causes of cardiovascular complications and death in sub-Saharan Africa (SSA). However, there is paucity of evidence on the prevalence and associated factors of poor blood pressure control in SSA. Therefore, this review aimed to estimate the prevalence and its associated factors among people living with DM in SSA. Methods We systematically searched PubMed, African Journals online, Hinari, Google scholar and direct Google to access observational studies conducted in SSA. Microsoft excel spreadsheet was used to extract the data and then exported into STATA/MP version 16.0 for further analysis. Heterogeneity across studies was checked using Cochrane Q test statistic and I2 test and small study effect were checked using Funnel plot symmetry and Egger’s statistical test at 5% significant level. A random-effects model was used to estimates the pooled prevalence of poor blood pressure control with a 95% confidence interval (CI). Results Of the 1,043 articles retrieved, 21 articles with an overall sample size of 6308 were eligible for the meta-analysis. After performing random-effects model, the pooled prevalence of poor blood pressure control was 69.8% (95% CI: 63.43, 76.25%). Poor adherence to antihypertensive treatment (OR = 1.7; 95% CI: 1.03–2.80, I2 = 0.0%, p = 0.531) and overweight (OR = 2.4, 95% CI: 1.57–3.68, I2 = 0.00%, p = 0.47) were significantly associated with poor blood pressure control. Conclusions Only one third of diabetic patients in SSA had achieved target blood pressure. Hence, there is an urgent need for initiatives to improve and control hypertension, and preventive measures should concentrate on modifiable risk factors. Systematic Review registrations: The review protocol has been registered in PROSPERO with protocol number of CRD42020187901.

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