Feasibility of community-based hypertension screening and referral by village health teams in eastern Uganda: A quasi-experimental study.

IF 2.8 3区 医学 Q3 ENVIRONMENTAL SCIENCES
Andrew Marvin Kanyike, Raymond Bernard Kihumuro, Timothy Mwanje Kintu, Lee Seungwon, Ashley Winfred Nakawuki, Kevin Apio, Richard Katuramu
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引用次数: 0

Abstract

Background: Uganda has a high prevalence of hypertension (HTN) and low diagnosis rates due to healthcare system deficiencies, like scarce diagnostic resources and a shortage of health workers. Task-shifting roles to community health workers (CHWs) could potentially fill gaps in the control of HTN, but this is still underexplored. This study determined the feasibility of leveraging CHWs, called Village Health Teams (VHTs), for HTN screening and referral in Eastern Uganda.

Methods: We conducted a quasi-experimental study from June to November 2023 in Bugembe town council, Jinja City, Eastern Uganda. Twelve VHT members were trained and deployed to screen and refer hypertensive patients in their communities. The training covered the basics of hypertension, blood pressure measurement, and referral protocols. VHTs screened adults aged 18 years or older from their homes or workplaces using automatic blood pressure machines. Participants with elevated blood pressure (≥ 140/90 mmHg) on two measurements 15 min apart were referred to a local health center for diagnosis and management. Data was collected on participant demographics, blood pressure readings, and screening-referral cascade and analyzed using STATA 15.0. Change in the number of newly diagnosed patients at the facility before and after the intervention was assessed using a paired t-test. A p-value < 0.05 was considered statistically significant.

Results: The VHTs screened 5,215 individuals, with a mean age of 34 (SD: 12.3) years. The prevalence of elevated blood pressure (BP) was 22.4% (n = 1167). Factors associated with elevated BP were older age, being male, having had previous blood pressure measurements, and alcohol use. Approximately 23.8% (n = 278/1167) of participants with elevated BPs accepted referral, 24.8% (n = 69/278) reached the facility, and most of these (n = 65/69, 94.3%) were confirmed to be hypertensive. The monthly average number of new hypertensive patients at the health centre increased significantly from 4.6 ± 0.9 to 12.7 ± 1.4 four months before and after the intervention (t = 4.37, p = 0.0014).

Conclusion: VHTs can reliably screen for HTN with appropriate training. However, strategies are needed to improve the low referral rates post-screening in the community to achieve the desired outcomes of early diagnosis and management of HTN.

乌干达东部村卫生队进行社区高血压筛查和转诊的可行性:一项准实验研究。
背景:乌干达高血压(HTN)患病率高,诊断率低,这是由于卫生保健系统的缺陷,如诊断资源稀缺和卫生工作者短缺。将任务角色转移给社区卫生工作者(chw)可能会填补控制HTN方面的空白,但这方面的探索仍未充分。这项研究确定了在乌干达东部利用村卫生队(VHTs)进行HTN筛查和转诊的可行性。方法:我们于2023年6月至11月在乌干达东部金贾市Bugembe镇议会进行了一项准实验研究。对12名VHT成员进行了培训和部署,以便在其社区中筛查和转诊高血压患者。培训内容包括高血压的基础知识、血压测量和转诊方案。vht使用自动血压仪在家中或工作场所对18岁或以上的成年人进行筛查。两次测量血压升高(≥140/90 mmHg)间隔15分钟的参与者被转介到当地卫生中心进行诊断和治疗。收集参与者的人口统计数据、血压读数和筛查-转诊级联数据,并使用STATA 15.0进行分析。使用配对t检验评估干预前后该设施新诊断患者数量的变化。p值结果:vht筛查了5,215名个体,平均年龄为34岁(SD: 12.3)岁。血压升高的发生率为22.4% (n = 1167)。与血压升高相关的因素是年龄较大、男性、有过血压测量和饮酒。约23.8% (n = 278/1167)血压升高的参与者接受转诊,24.8% (n = 69/278)到达医院,其中大多数(n = 65/69, 94.3%)被确诊为高血压。干预前后4个月,保健中心每月平均新发高血压患者由4.6±0.9例增加到12.7±1.4例(t = 4.37, p = 0.0014)。结论:通过适当的训练,VHTs可以可靠地筛查HTN。然而,需要采取策略来改善社区筛查后转诊率低的情况,以实现HTN的早期诊断和管理的预期结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Health, Population, and Nutrition
Journal of Health, Population, and Nutrition 医学-公共卫生、环境卫生与职业卫生
CiteScore
2.20
自引率
0.00%
发文量
49
审稿时长
6 months
期刊介绍: Journal of Health, Population and Nutrition brings together research on all aspects of issues related to population, nutrition and health. The journal publishes articles across a broad range of topics including global health, maternal and child health, nutrition, common illnesses and determinants of population health.
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