Prevalence,awareness and factors associated with hypertension in North West Tanzania

ABSTRACT

Background: Hypertension is a public health problem, and yet few people are aware of it and even fewer access effective treatment. With the ongoing demographic transition in many parts of Sub-Saharan Africa, people are changing from rural, manual work to urban lifestyles, hence the risk of hypertension increases.

Objective: This study aimed at determining the prevalence, awareness and risk factors associated with hypertension in North West Tanzania.

Design: A community-based cross-sectional study was conducted among adults in Magu District in 2013. Information on socio-demographic, economic and lifestyle characteristics, medical conditions, and risk factors for hypertension were collected according to the WHO Steps survey tool. Measurements of blood pressure, blood sugar, pulse rate, and anthropometry were taken. Multivariate logistic regression was used to estimate the odds ratios (OR) and 95% confidence intervals (95% CI) for factors associated with hypertension (Blood pressure ≥140/90mm/Hg). Frequencies and percentages were used to determine the awareness, and treatment among hypertensive participants.

Results: Among 9678 participants, the prevalence of hypertension was 8.0% and pre-hypertension 36.2%. There was a higher prevalence of hypertension at older ages, among females (8.2%) compared to males (7.7%), and among urban dwellers (10.1%) compared to rural residents (6.8%). Overweight, obese, and diabetic individuals had a higher risk of hypertension while HIV positive participants had a lower risk of hypertension (OR = 0.56; 95% CI 0.39 – 0.79). Among participants with hypertension, awareness was less than 10%.

Conclusion: By integrating blood pressure screening into our long-standing community HIV screening program, we were able to identify many previously undiagnosed cases of hypertension and pre-hypertension. Age, residence, overweight and obesity were the major associated factors for hypertension. Awareness and treatment rates are very low indicating the need for programs to improve awareness, and treatment of hypertension.

KEYWORDS:

• Hypertension
• prevalence
• tanzania
• community-based
• adult
• risk factors

Responsible Editor

Nawi Ng, Umeå University, Sweden

Responsible Editor

Nawi Ng, Umeå University, Sweden

Acknowledgments

We thank the regional and district health authorities for permission to carry out the study. We acknowledge the hard work of the study teams in collecting and managing the data for the study. We acknowledge the inputs from the TAZAMA project, and the National Institute for Medical Research in Mwanza to organize the study. We thank the study participants for their time and patience in attending the survey and providing the responses for these data.

This analysis was carried out as part of the MSc studies of NM, who would like to thank all those who helped to make the study possible. Dr. Peck is supported by a grant from the National Institute of Health(K01 TWO10281).

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics and consent

Ethics approval was obtained from Ethics Advisory Group, The Union, Paris, France and Ethics Review Committee at Department of Medical Research, Yangon. Permission to conduct the study was taken from NAP Myanmar. As this study involved analysis of secondary programmatic data, waiver of informed consent was sought and obtained from the ethics committees.

Paper context

Hypertension is a public health problem; and as Tanzania is now facing nutrition transition the risk of non-communicable diseases increases. Hence, appropriate measures should be taken by identifying and managing these patients. Determining the magnitude, awareness, and the contributing factors of hypertension in this HIV-surveillance community will be an added advantage. Findings from this study will have an important role in provision of preliminary information on the magnitude and severity of the problem and will also help in identifying proper management strategies as now we are faced with a double burden of diseases.

Additional information

Funding

Magu HDSS Round 7 was funded by Welcome Trust, The UK’s Department for International Development (DfID), the Bill and Melinda Gates Foundation (through the ALPHA network) and the US NIH (through the IeDEA consortium). This work was supported by Training Health Researchers into Vocational Excellence in East Africa (THRiVE); grant number 087540 funded by the Wellcome Trust. NM was supported for her MSc tuition and her project research by the THRiVE consortium.

Notes on contributors

Neema R. Mosha

NM, MU and JT designed the study. NM, JT, IM, JA and MM conducted or contributed to the data analysis. NM, JT, IM, JA, RP and MM interpreted the data. NM, JT and MM prepared the original manuscript. All co-authors contributed to subsequent revisions and approved the final version. NM is the guarantor of the manuscript. All authors read and approved the final manuscript.