Mbau L, Harrison R, Kizito W, Timire C, Namusonge T, Muhula S, Nyanjau L, Owiti P
Kenya Cardiac Society, Nairobi, Kenya.
Medecins Sans Frontieres, Brussels, Belgium.
Public Health Action. 2022 Jun 21;12(2):58-63. doi: 10.5588/pha.21.0051.
Prevalence of hypertension in Africa is rising but it remains underdiagnosed and poorly controlled. In Kenya, only 22% of individuals known to have hypertension were on treatment, and only 51.7% were controlled. This study will assess screening outcomes, retention and blood pressure (BP) control of a hypertension programme in Kenya.
This was a retrospective cohort study using data routinely collected between 2015 and 2018. All patients aged >18 years screened and treated in the programme were included.
Of 663,028 screening encounters, 70.4% were female; the median age was 34 years. Overall, 19% of the study population, mainly males and older persons, had high BP higher rates. Of 66,981 patients started on treatment, the majority were females (71.2%); the median age was 55 years. Only 12% of patients were reported as having been retained after 12 months, and 48.6% of patients on treatment 10.5-13.5 months after enrolment had controlled BP. Older age and treatment at primary care level were associated with better retention and females had better BP control.
The programme screened primarily females and younger individuals at lower risk. Retention was poor and close to half of patients retained had controlled BP. Hypertension programmes should target high-risk individuals, decentralise treatment, incorporate retention strategies and improve longitudinal data management.
非洲高血压患病率呈上升趋势，但仍存在诊断不足和控制不佳的情况。在肯尼亚，已知患有高血压的个体中只有22%接受治疗，且只有51.7%的患者血压得到控制。本研究将评估肯尼亚一项高血压项目的筛查结果、患者留存率和血压控制情况。
这是一项回顾性队列研究，使用2015年至2018年期间常规收集的数据。纳入该项目中所有年龄大于18岁且接受筛查和治疗的患者。
在663,028次筛查中，70.4%为女性；中位年龄为34岁。总体而言，研究人群中19%的人患有高血压，主要是男性和老年人，患病率较高。在66,981名开始接受治疗的患者中，大多数为女性（71.2%）；中位年龄为55岁。据报告，12个月后只有12%的患者仍在接受治疗，在入组后10.5 - 13.5个月接受治疗的患者中，48.6%的患者血压得到控制。年龄较大和在初级保健机构接受治疗与更好的留存率相关，女性的血压控制情况更好。
该项目主要筛查低风险的女性和年轻人。患者留存率较低，留存患者中近一半血压得到控制。高血压项目应针对高危个体，分散治疗，纳入留存策略并改善纵向数据管理。
