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Prevalence of hypertension and its treatment among adults presenting to primary health clinics in rural Zambia: analysis of an observational database

Overview of attention for article published in BMC Public Health, September 2015
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Title
Prevalence of hypertension and its treatment among adults presenting to primary health clinics in rural Zambia: analysis of an observational database
Published in
BMC Public Health, September 2015
DOI 10.1186/s12889-015-2258-4
Pubmed ID
Authors

Lily D. Yan, Benjamin H. Chi, Ntazana Sindano, Samuel Bosomprah, Jeffrey SA Stringer, Roma Chilengi

Abstract

Hypertension constitutes a growing burden of illness in developing countries like Zambia. Adequately screening and treating hypertension could greatly reduce the complications of stroke and coronary disease. Our objective was to determine the prevalence of hypertension and identify current treatment practices among adult patients presenting for routine care to rural health facilities in the Better Health Outcomes through Mentoring and Assessments (BHOMA) project. We conducted a retrospective analysis of routinely collected clinical data from 46 rural government clinics in Zambia. Our analysis cohort comprised patients ≥ 25 years with recorded blood pressure measurements, who sought care at primary health centers. Consistent with prior research, in our primary analysis, we only included data from first visits. Hypertension was defined as a systolic blood pressure ≥140 mmHg, or diastolic blood pressure ≥90 mmHg, or reported use of antihypertensive medication. A sensitivity analysis was performed using median blood pressure for individuals with multiple visits. RESULTS AND DISCUSSION: From January 2011 to December 2014, 116,130 first visits by adult patients met eligibility criteria. The crude prevalence of hypertension by onsite measurement or reported use of antihypertensive medication was 23.1 % [95 % CI: 22.8-23.3] (23.6 % in females, 22.3 % in males). The age standardized prevalence of hypertension across participating sites was 28.0 % [95 % CI: 27.7-28.3] (29.7 % in females, 25.8 % in males). Sensitivity analysis revealed a similar prevalence using data from all visits. Only 5.6 % of patients had a diagnosis of hypertension documented in their medical record. Among patients with hypertension, only 18.0 % had any antihypertensive drug prescribed, with nifedipine (8.9 %), furosemide (8.3 %), and propranolol (2.4 %) as the most common. Age standardized prevalence of hypertension in rural primary health clinics in Zambia was high compared to other studies in rural Africa; however, we diagnosed hypertension with only one measurement and this may have biased our findings. Future efforts to improve hypertension control should focus on population preventive care and primary healthcare provider education on individual management.

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Mendeley readers

The data shown below were compiled from readership statistics for 110 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 110 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 19 17%
Student > Bachelor 16 15%
Researcher 15 14%
Student > Postgraduate 10 9%
Student > Ph. D. Student 9 8%
Other 14 13%
Unknown 27 25%
Readers by discipline Count As %
Medicine and Dentistry 24 22%
Nursing and Health Professions 21 19%
Social Sciences 9 8%
Agricultural and Biological Sciences 6 5%
Pharmacology, Toxicology and Pharmaceutical Science 6 5%
Other 16 15%
Unknown 28 25%