Evaluation of a community-based hypertension improvement program (ComHIP) in Ghana: data from a baseline survey
Evaluation of a community-based hypertension improvement program (ComHIP) in Ghana: data from a baseline survey
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DOI：
10.1186/s12889-017-4260-5
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发表时间：
2017-04-28
影响因子：
4.5
通讯作者：
Perel, Pablo
中科院分区：
文献类型：
--
作者：
Lamptey, Peter;Laar, Amos;Perel, Pablo
背景：加纳面临着日益增加的非传染性疾病的负担，高血压在成年人中的发病率估计高达36%。尽管发病率很高，但加纳的高血压控制仍然很差（4%）。目前的项目旨在执行和评估一项以社区为基础的方案，以提高加纳东部地区对高血压的认识，并改善对高血压的治疗和控制。在本文中，我们提出的基线横断面调查的结果，重点是高血压的患病率，认识，治疗，和control.Methods：为了评估ComHIP项目，一个准实验设计，包括一个之前和之后的评估正在实施的干预和比较区。正在干预区实施队列研究，以评估高血压控制情况。在STATA第11版中分析了作为基线调查一部分收集的背景人体测量和临床数据。我们研究了个人的特点，与基线研究成果使用logistic regression models.Results：我们采访了2400名受访者（1200每个比较和干预区），虽然最终的样本量后，数据清洗1170名参与者在比较区和1167在干预区。除种族外，对照区和干预区的比较有利。总体而言，32.4%的研究受访者患有高血压（对照组31.4%;干预组33.4%）; 46.2%的高血压患者知道既往诊断为高血压（对照部位44.7%，干预部位47.7%），高血压控制率为1.3%（对照组为0.5%，干预组为2.1%）。年龄是高血压的预测因子，体重指数（BMI）、腰围和臀围的增加也是高血压的预测因子。校正年龄后，与高血压相关性最大的危险因素是超重（aOR = 2.30; 95%CI 1.53-3.46）或肥胖（aOR = 3.61; 95%CI 2.37-5.51）。老年人比年轻人更容易意识到自己的高血压状况。调整后的年龄与高血压或心血管疾病家族史的人，或有一个不健康的腰臀比，更有可能意识到他们的高血压status.Conclusions：高血压的高负担的研究人群中，再加上高认识，但高血压治疗和控制水平很低，需要深入调查的瓶颈，治疗和控制。尽管目前和以前的一般教育计划，特别是在干预区，低高血压治疗和控制率可能表明，这些计划不一定对人口的健康有影响。
Background: Ghana faces an increasing burden of non-communicable disease with rates of hypertension estimated as high as 36% in adults. Despite these high rates, hypertension control remains very poor in Ghana (4%). The current project aims to implement and evaluate a community-based programme to raise awareness, and to improve treatment and control of hypertension in the Eastern Region of Ghana. In this paper, we present the findings of the baseline cross-sectional survey focusing on hypertension prevalence, awareness, treatment, and control.Methods: To evaluate the ComHIP project, a quasi-experimental design consisted of a before and after evaluations are being implemented in the intervention and comparison districts. A cohort study component is being implemented in the intervention district to assess hypertension control. Background anthropometric and clinical data collected as part of the baseline survey were analyzed in STATA Version 11. We examined the characteristics of individuals, associated with the baseline study outcomes using logistic regression models.Results: We interviewed 2400 respondents (1200 each from the comparison and intervention districts), although final sample sizes after data cleaning were 1170 participants in the comparison district and 1167 in the intervention district. With the exception of ethnicity, the control and intervention districts compare favorably. Overall 32.4% of the study respondents were hypertensive (31.4% in the control site; and 33.4% in the intervention site); 46.2% of hypertensive individuals were aware of a previous diagnosis of hypertension (44.7% in the control site, and 47.7% in the intervention site), and only around 9% of these were being treated in either arm. Hypertension control was 1.3% overall (0.5% in the comparison site, and 2.1% in the intervention site). Age was a predictor of having hypertension, and so was increasing body mass index (BMI), waist, and hip circumferences. After adjusting for age, the risk factors with the greatest association with hypertension were being overweight (aOR = 2.30; 95% CI 1.53-3.46) or obese (aOR = 3.61; 95% CI 2.37-5.51). Older individuals were more likely to be aware of their hypertension status than younger people. After adjusting for age people with a family history of hypertension or CVD, or having an unhealthy waist hip ratio, were more likely to be aware of their hypertension status.Conclusions: The high burden of hypertension among the studied population, coupled with high awareness, yet very low level of hypertension treatment and control requires in-depth investigation of the bottlenecks to treatment and control. The low hypertension treatment and control rates despite current and previous general educational programs particularly in the intervention district, may suggest that such programs are not necessarily impactful on the health of the population.