Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana.
Department of Epidemiology, School of Public Health, CK Tedam University of Technology and Applied Sciences, Navrongo, Ghana.
BMC Prim Care. 2024 Oct 24;25(1):382. doi: 10.1186/s12875-024-02620-0.
Hypertension and type 2 diabetes mellitus (T2DM) are important contributors to noncommunicable disease related morbidity and mortality. Health systems could benefit from exploring the use of Faith-Based Centres (FBC) to screen and link suspected cases for further care in order to help achieve Sustainable Development Goal (SDG) 3. The study investigated the role of faith-based screening for T2DM and hypertension and the linkage of cases to the healthcare system and examined the care cascade in the Kassena Nankana Districts of Northern Ghana.
We screened individuals from 6 FBCs for elevated blood pressure and hyperglycaemia. Suspected hypertension and T2DM cases were referred to health facilities for confirmation and subsequently followed them up for 3 months. We assessed the prevalence of behavioural and metabolic risk factors, including hypertension and T2DM, and the retention of referred cases in the healthcare system over follow up period. We further assessed levels of awareness, treatment and adequate control of hypertension and T2DM.
A total of 631 participants were screened, (mean age 49 ± 16years, 73% female) from 6 Faith based Centres. More males than females reported smoking tobacco (14.5% vs. 0.7%) and been physically active (64.5% vs. 52.7%) while more females were obese (29.6 kg/m vs. 14.5 kg/m) and had a higher mean waist circumference (89.0 cm IQR 75-116 cm vs. 84.2 cm IQR 72-107 cm), hip circumference (101.5 ± 10.6 cm vs. 96.4 ± 8.6 cm) and waist-to-hip ratio (0.86 ± 0.1 cm vs. 0.87 ± 0.1 cm) than males. The prevalence of confirmed hypertension and T2DM was 27.9% and 3.5% respectively with no observed sex differences. We observed deficits in the hypertension and T2DM care cascade with reported low awareness, treatment and uncontrolled levels. A 3-month follow up showed a retention in care of 100% in month one and 94.9% in the third month. There was an increase in treatment (39.4% in month-1 and 82.8% in month-3) and control (26.3% in month-1 and 76.3% in month-3) of hypertension and T2DM combined.
Faith-based centres have the potential to enhance the screening, linkage to the healthcare system, and management of hypertension and T2DM. This improvement over the routine system could lead to earlier diagnoses, a reduction in complications, and decreased premature mortality from cardiovascular diseases. Consequently, these efforts would contribute significantly to achieving SDG 3.
高血压和 2 型糖尿病（T2DM）是导致非传染性疾病发病率和死亡率的重要因素。卫生系统可以从探索利用信仰中心（FBC）筛查和联系疑似病例以进一步接受治疗中受益，以帮助实现可持续发展目标 3。本研究调查了信仰为基础的筛查在 T2DM 和高血压中的作用，以及将病例与医疗保健系统联系起来，并检查了加纳北部卡萨纳纳坎纳地区的护理级联。
我们从 6 个 FBC 中筛选出血压升高和血糖升高的个体。疑似高血压和 T2DM 病例被转介到医疗机构进行确认，并随后对其进行 3 个月的随访。我们评估了行为和代谢风险因素的流行率，包括高血压和 T2DM，以及在随访期间被转诊病例在医疗保健系统中的保留情况。我们还评估了高血压和 T2DM 的知晓率、治疗率和控制率。
共有 631 名参与者（平均年龄 49±16 岁，73%为女性）来自 6 个信仰中心。与女性相比，更多的男性报告吸烟（14.5%比 0.7%）和进行体育活动（64.5%比 52.7%），而更多的女性肥胖（29.6kg/m 比 14.5kg/m），腰围（89.0cm IQR 75-116cm 比 84.2cm IQR 72-107cm）、臀围（101.5±10.6cm 比 96.4±8.6cm）和腰臀比（0.86±0.1cm 比 0.87±0.1cm）更高。确诊的高血压和 T2DM 的患病率分别为 27.9%和 3.5%，男女之间没有观察到差异。我们观察到高血压和 T2DM 护理级联存在缺陷，报告的知晓率、治疗率和控制率较低。3 个月的随访显示，第 1 个月的护理保留率为 100%，第 3 个月为 94.9%。高血压和 T2DM 的治疗率（第 1 个月为 39.4%，第 3 个月为 82.8%）和控制率（第 1 个月为 26.3%，第 3 个月为 76.3%）均有所增加。
信仰中心有可能加强高血压和 T2DM 的筛查、与医疗保健系统的联系以及管理。这种常规系统的改进可能会导致更早的诊断、减少并发症和降低心血管疾病的过早死亡率。因此，这些努力将对实现可持续发展目标 3 做出重大贡献。
