Effectiveness of the Hypertension Screening Corner in Enhancing the Cascade of Care at Primary Healthcare Center Level: Evidence from Zambezia, Mozambique

Overview

Journal Glob Heart

Publisher Ubiquity Press

Specialty Cardiology & Vascular Diseases

Date 2024 Jul 15

PMID 39006864

Authors

Anna Sartorello

Roberto Benoni

Lucy Ramirez

Aldo Mundjane

Frederic Kalombola

Alfredo Ramos

Edgar Meque

Paolo Massaro

Neusa Jessen

Giovanni Putoto

Albertino Damasceno

Affiliations

Soon will be listed here.

Abstract

Background: Hypertension is the leading cause of cardiovascular disease, whose death burden is dramatically increasing in sub-Saharan Africa. To curb its effects, early diagnosis and effective follow-up are essential. Therefore, this study aims to evaluate the impact of a hypertension screening corner on the hypertension care cascade at the primary healthcare level.

Methods: A prospective cohort study was conducted between October 2022 and March 2023 in two PHCCs in Zambezia (Mozambique). The study involved a demographic and socioeconomic status (SES) questionnaire for those screened. Patients with blood pressure (BP) > 140/90 mmHg were given a follow-up questionnaire regarding the care cascade. The four cascade steps were: medical visit, diagnosis confirmation, follow-up visit, and recalling the follow-up appointment. The odds ratio (OR) of reaching each step of the cascade was assessed by binomial logistic regression.

Results: Patients with BP > 140/90 mmHg were 454, and 370 (86.0%) completed both study phases. Individuals attending the medical visit were 225 (60.8%). Those with low SES had a higher probability of visit attendance than those with middle (OR = 0.46, 0.95CI[0.23-0.88] p = 0.020) and high (OR = 0.21 0.95CI[0.10-0.42], p < 0.001). Hypertension diagnosis was confirmed in 181 (80.4%), with higher probability in the low SES group compared to the middle (OR = 0.24 IC95[0.08-0.66], p = 0.007) and high (OR = 0.23, IC95[0.07-0.74], p = 0.016) groups. The OR to complete step 1 and step 2 were higher for older age groups. A follow-up appointment was received and recalled by 166 (91.7%) and 162 (97.6%) patients, respectively.

Conclusions: The hypertension corner proved to be a useful tool for effective screening of hypertension with satisfactory retention in care, especially for people with lower socio-economic status.

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