scholarly journals Hypertension care cascade in the Ingwavuma rural community, uMkhanyakude District, KwaZulu-Natal province of South Africa

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12372
Author(s):  
Herbert Chikafu ◽  
Moses Chimbari
Keyword(s):  
South Africa ◽  
Blood Pressure ◽  
High Blood Pressure ◽  
Rural Areas ◽  
Substantial Reduction ◽  
Diagnostic Tools ◽  
Care Cascade ◽  
Kwazulu Natal ◽  
Hypertension Screening ◽  
And Control

Background Treatment and control of hypertension are associated with a substantial reduction in adverse cardiovascular disease outcomes. Although South Africa aims to reduce the burden of cardiovascular diseases, there is limited evidence on the hypertension care cascade (HCC) performance in rural areas where stroke and hypertension are high. This study estimated HCC performance and identified predictors of hypertension screening among adults in the Ingwavuma community of KwaZulu-Natal, South Africa. Methods This was a cross-sectional study. Data were collected using the WHO STEPwise approach to surveillance (STEPS) questionnaire from 400 adult participants, excluding pregnant women and those with physical or cognitive impairments. Three hundred and ninety-three participants had complete data, and 131 had high blood pressure. We calculated progression rates for screening, diagnosis, treatment and control of hypertension from the sub-sample of participants with high blood pressure and assessed the bivariate association between HCC stages and participant characteristics and their effect sizes. We used binary and multivariable logistic regression to identify predictors of hypertension screening. Results Eighty-eight per cent of participants reported prior screening for hypertension. However, only 53.5% of patients under pharmacological treatment for hypertension had controlled blood pressure. In bivariate regression, employed participants were 80.3% (COR = 0.197, 95% CI [0.042–0.921]) more likely to be screened. In multivariable regression, the likelihood of hypertension screening was 82.4% (AOR = 0.176, 95% CI [0.047–0.655]) lower among participants in a cohabiting union than single participants. Similarly, employed participants were 87.4% (AOR = 0.129, 95% CI [0.017–0.952]) less likely to be screened than their unemployed counterparts. Conclusions The considerable attrition from the HCC across socio-demographic categories indicates a need for community-wide interventions. Empowering health care workers for community-based health promotion and hypertension management through point-of-care diagnostic tools could improve HCC performance. Efforts to improve the HCC should also focus on social determinants of health, notably gender and formal educational attainment.

scholarly journals The effect of eligibility for antiretroviral therapy on body mass index and blood pressure in KwaZulu-Natal, South Africa

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aditi Kuber ◽  
Anna Reuter ◽  
Pascal Geldsetzer ◽  
Natsayi Chimbindi ◽  
Mosa Moshabela ◽  
...  
Keyword(s):  
South Africa ◽  
Blood Pressure ◽  
Body Mass Index ◽  
Antiretroviral Therapy ◽  
Body Mass ◽  
Treatment Guidelines ◽  
Causal Effect ◽  
Regression Discontinuity Design ◽  
National Treatment ◽  
Kwazulu Natal

AbstractWe use a regression discontinuity design to estimate the causal effect of antiretroviral therapy (ART) eligibility according to national treatment guidelines of South Africa on two risk factors for cardiovascular disease, body mass index (BMI) and blood pressure. We combine survey data collected in 2010 in KwaZulu-Natal, South Africa, with clinical data on ART. We find that early ART eligibility significantly reduces systolic and diastolic blood pressure. We do not find any significant effects on BMI. The effect on blood pressure can be detected up to three years after becoming eligible for ART.

Improving food security in the rural areas of KwaZulu-Natal province, South Africa: Too little, too slow

2013 ◽  
Vol 30 (4-05) ◽  
pp. 468-490 ◽  
Author(s):  
Marijke D'Haese ◽  
Nick Vink ◽  
Tharcisse Nkunzimana ◽  
Ellen Van Damme ◽  
Johan van Rooyen ◽  
...  
Keyword(s):  
South Africa ◽  
Food Security ◽  
Rural Areas ◽  
Kwazulu Natal

scholarly journals Linkage to primary care after home-based blood pressure screening in rural KwaZulu-Natal, South Africa: a population-based cohort study

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e023369 ◽  
Author(s):  
Mark J Siedner ◽  
Kathy Baisley ◽  
Joanna Orne-Gliemann ◽  
Deenan Pillay ◽  
Olivier Koole ◽  
...  
Keyword(s):  
South Africa ◽  
Blood Pressure ◽  
Linkage To Care ◽  
Sampling Weights ◽  
Rural South ◽  
Home Based ◽  
Kwazulu Natal ◽  
Blood Pressure Screening ◽  
The Impact ◽  
Rural South Africa

ObjectivesThe expanding burden of non-communicable diseases (NCDs) globally will require novel public health strategies. Community-based screening has been promoted to augment efficiency of diagnostic services, but few data are available on the downstream impact of such programmes. We sought to assess the impact of a home-based blood pressure screening programme on linkage to hypertension care in rural South Africa.SettingWe conducted home-based blood pressure screening withinin a population cohort in rural KwaZulu-Natal, using the WHO Stepwise Approach to Surveillance (STEPS) protocol.ParticipantsIndividuals meeting criteria for raised blood pressure (≥140 systolic or ≥90 diastolic averaged over two readings) were referred to local health clinics and included in this analysis. We defined linkage to care based on self-report of presentation to clinic for hypertension during the next 2 years of cohort observation. We estimated the population proportion of successful linkage to care with inverse probability sampling weights, and fit multivariable logistic regression models to identify predictors of linkage following a positive hypertension screen.ResultsOf 11 694 individuals screened, 14.6% (n=1706) were newly diagnosed with elevated pressure. 26.9% (95% CI 24.5% to 29.4%) of those sought hypertension care in the following 2 years, and 38.1% (95% CI 35.6% to 40.7%) did so within 5 years. Women (adjusted OR (aOR) 2.41, 95% CI 1.68 to 3.45), those of older age (aOR 11.49, 95% CI 5.87 to 22.46, for 45–59 years vs <30) and those unemployed (aOR 1.71, 95% CI 1.10 to 2.65) were more likely to have linked to care.ConclusionsLinkage to care after home-based identification of elevated blood pressure was rare in rural South Africa, particularly among younger individuals, men and the employed. Improved understanding of barriers and facilitators to NCD care is needed to enhance the effectiveness of blood pressure screening in the region.

scholarly journals High Blood Pressure prevention and control: from evidence to action

2018 ◽  
Vol 49 (2) ◽  
pp. 137-138
Author(s):  
Lena Barrera
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Latin American ◽  
Prevention And Control ◽  
National Health Survey ◽  
Middle Income ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Health Organization ◽  
And Control

The Pan American Health Organization (PAHO) with the World Hypertension League has established the 17th May to promote the prevention and control of High Blood Pressure (HBP). Currently nearly 1.13 billion of adults suffer from HBP (blood pressure ≥140/90 mm Hg) worldwide. While HBP prevalence decreased in high income countries (HIC) between 1975 and 2015, the opposite trend was observed in low- and middle- income countries (LMIC). Particularly, in Latin American and Caribbean countries the prevalence decreased from 40.6% to 26.8% and from 26.8% to 19.4% for men and women between 45 to 49 years old respectively. However, in 2015, HBP accounted for 8.9 of the total of disability adjusted life years (DALYS) and was associated with 4.9 million, 2.0 million and 1.5 million deaths due to ischemic heart disease, hemorrhagic stroke and ischemic stroke respectively. Therefore, HBP is the leading cardiovascular risk factor worldwide. In Colombia, the last National Health Survey reported a global prevalence of 22.8% and nearly 60% for those between 60 and 69 years in 2007

scholarly journals Updated hypertension prevalence, awareness, and control rates based on the 2017ACC/AHA high blood pressure guideline

2019 ◽  
Vol 21 (6) ◽  
pp. 758-765 ◽  
Author(s):  
Yaqing Zhou ◽  
Limei Jia ◽  
Baojin Lu ◽  
Guoqiang Gu ◽  
Haijuan Hu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Hypertension Prevalence ◽  
And Control

scholarly journals Prevalence, awareness and control of hypertension among Tunisian adults, 2016

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Cherif ◽  
N Ben Mansour ◽  
S Rejaibi ◽  
N Zoghlami ◽  
O Saidi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Associated Factors ◽  
Healthy Lifestyle ◽  
Health Examination ◽  
Control Input ◽  
Hypertension Control ◽  
Low Level ◽  
Lifestyle Measures ◽  
Hypertension Screening ◽  
And Control

Abstract Background Hypertension is becoming increasingly frequent mainly in low and middle income countries. We aimed to assess the prevalence, awareness and control of hypertension among Tunisian adults and identify associated factors with hypertension control. Methods Data were obtained from the 2016 Tunisian Health Examination Survey, a household survey stratified at three degrees. Adults (age≥18 years old) were interviewed using an individual questionnaire, then three blood pressure measurement were performed. Participants were considered hypertensive if they were previously diagnosed or had a systolic blood pressure (SBP) ≥140mmhg and/or a diastolic blood pressure (DBP) ≥ 90mmhg during the survey. Were considered under control, treated persons with SBP&lt;140 mmhg and a DBP&lt;90 mmhg. A weighted binary logistic regression was used to assess associated factors with hypertension control. Input model variables were: sociodemographic variables, comorbidities and lifestyle factors. Results In this study, 8908 adults were enrolled with a mean age of 42.8±0.2 years old and a sex ratio (M/F) equal to 0.96. Among respondents, 29.3% (95% CI: 28.2-30.5) had hypertension, 60.7% (95% CI: 58.7-62.6) of them were unaware of their disease and only (29.5%, 95% CI: 28.2-30.5) of treated patients had a controlled hypertension. In multivariate analysis, eating more than five fruits and vegetables per day was independently associated with a better hypertension control (AOR=1.7, 95% CI: 1.1-2.5). In addition, participants living in northern Tunisia were more likely to have a controlled hypertension than those living in the south (AOR=1.9, 95% CI: 1.2-2.9). Conclusions Almost third of Tunisian adults were hypertensive. Low level of awareness and control of hypertension were found in this study. This highlights the urge to reinforce hypertension screening interventions and to strengthen educational programs on this disease with a focus on blood pressure monitoring and healthy lifestyle measures. Key messages Tunisian adults had a low level of awareness and control of hypertension. Reinforcing hypertension screening interventions and increasing awareness about healthy lifestyle measures are recommended.

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