Epidemiology and awareness of hypertension in a rural Ugandan community: A cross-sectional study

Prashant Kotwani, Dalsone Kwarisiima, Tamara D. Clark, Jane Kabami, Elvin H. Geng, Vivek Jain, Gabriel Chamie, Maya L. Petersen, Harsha Thirumurthy, Moses R. Kamya, Edwin D. Charlebois, Diane V. Havlir

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38 Scopus citations

Abstract

Background: Hypertension is one of the largest causes of preventable morbidity and mortality worldwide. There are few population-based studies on hypertension epidemiology to guide public health strategies in sub-Saharan Africa. Using a community-based strategy that integrated screening for HIV and non-communicable diseases, we determined the prevalence, awareness, treatment rates, and sociodemographic factors associated with hypertension in rural Uganda. Methods. A household census was performed to enumerate the population in Kakyerere parish in Mbarara district, Uganda. A multi-disease community-based screening campaign for hypertension, diabetes, and HIV was then conducted. During the campaign, all adults received a blood pressure (BP) measurement and completed a survey examining sociodemographic factors. Hypertension was defined as elevated BP (≥140/≥90 mmHg) on the lowest of three BP measurements or current use of antihypertensives. Prevalence was calculated and standardized to age distribution. Sociodemographic factors associated with hypertension were evaluated using a log-link Poisson regression model with robust standard errors. Results: Community participation in the screening campaign was 65%, including 1245 women and 1007 men. The prevalence of hypertension was 14.6%; awareness of diagnosis (38.1%) and current receipt of treatment (20.6%) were both low. Age-standardized to the WHO world standard population, hypertension prevalence was 19.8%, which is comparable to 21.6% in the US and 18.4% in the UK. Sociodemographic factors associated with hypertension included increasing age, male gender, overweight, obesity, diabetes, alcohol consumption, and family history. Prevalence of modifiable factors was high: 28.3% women were overweight/obese and 24.1% men consumed ≥10 alcoholic drinks per month. Conclusions: We found a substantial burden of hypertension in rural Uganda. Awareness and treatment of hypertension is low in this region. Enhanced community-based education and prevention efforts tailored to addressing modifiable factors are needed.

Original languageEnglish
Article number1151
JournalBMC Public Health
Volume13
Issue number1
DOIs
StatePublished - Dec 9 2013

Keywords

  • Blood pressure
  • Community health
  • Epidemiology
  • Health campaign
  • Hypertension
  • Non-communicable disease
  • Public health
  • Rural
  • Sub-Saharan Africa
  • Uganda

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