Dataset Information

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

ABSTRACT:

Objectives

The 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.

Setting

We conducted home-based blood pressure screening withinin a population cohort in rural KwaZulu-Natal, using the WHO Stepwise Approach to Surveillance (STEPS) protocol.

Participants

Individuals 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.

Results

Of 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.

Conclusions

Linkage 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.

SUBMITTER: Siedner MJ

PROVIDER: S-EPMC6286496 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Publications

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

Siedner Mark J MJ Baisley Kathy K Orne-Gliemann Joanna J Pillay Deenan D Koole Olivier O Wong Emily B EB Matthews Philippa P Tanser Frank F Herbst Kobus K Barnighausen Till T Bachmann Max M

BMJ open 20181206 12

<h4>Objectives</h4>The 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.<h4>Setting</h4>We conducted home-based blood pressure screening withini ...[more]

PMID: 30530475

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Dataset Information

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

Objectives

Setting

Participants

Results

Conclusions

Publications

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

Similar Datasets

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