Background Hypertension contributes significantly to cardiovascular and renal diseases. It can be controlled by lifestyle modifications, however in poor communities there is lack of awareness, and treatment and control of hypertension is often poor. The aim of this study was to determine hypertension knowledge, attitudes and practices in a disadvantaged rural community in Matebeleland South province of Zimbabwe. Methods We conducted a descriptive cross-sectional survey on hypertensive patients in the community. A pre-tested and validated interviewer-administered questionnaire was used to collect demographic, awareness, treatment and control data among consenting hypertensive patients. Results 304 respondents were enrolled into the study (mean age, 59 years), and a majority were women (65.4%). The treatment default rate was 30.9%, and 25% of respondents on medication did not know their blood pressure control status. Knowledge on hypertension was poor, with 64.8% of respondents stating that stress was its main cause, 85.9% stated that palpitations were a symptom of hypertension and 59.8% of respondents added salt on the table. The more education respondents had received, the more likely they were knowledgeable about hypertension (odds ratio for secondary education, 3.68 [95% CI: 1.61–8.41], and for tertiary education, 7.52 [95% CI: 2.76–20.46], compared to those without formal education). Those who believed in herbal medicines (50.7%) and those who used traditional medicines (14.5%) were 53% (95% CI: 0.29–0.76) and 68% (95% CI: 0.29–0.76) less likely to be knowledgeable about hypertension compared to those who did not believe in or use traditional medicines, respectively. Conclusion Members of the community had poor knowledge on hypertension. This was associated with a lack of education and with strong beliefs in herbal and traditional medicines in the community, which influenced attitudes and practices on hypertension. Dietary risk factors were linked to poor knowledge. Hypertensive medicine shortages at the clinic resulted in worsened hypertension care and poor hypertension outcomes in the community.

Background Hypertension is an important worldwide public health challenge because of its high prevalence and concomitant risks of cardiovascular and kidney diseases. The risk factors for hypertension are well known, and screening, diagnosis and treatment of hypertension have been well researched. However, this knowledge has not been translated into community practice as there remains a huge knowledge gap between the academics, health workers and the communities. There is need for community participation in developing and implementation of health interventions among marginalised communities. Aim The aim of this project was to improve the community’s knowledge about hypertension by positively influencing beliefs and behaviours, leading to improved community hypertension outcomes. Setting The study was undertaken in Ward 14, a rural area situated south-west of Gwanda District, Matebeleland South Province in Zimbabwe. Methods We conducted a health services research utilising qualitative methods by using a community-based participatory approach using a cooperative inquiry group. Results There was improvement in knowledge about awareness and primary prevention of hypertension. Community hypertension care was established through competence training of village health workers (VHWs) and more persons living with hypertension were enrolled into care. Pill pickup rate and treatment compliance improved and the community’s confidence in VHWs was restored. Community hypertension screening, treatment registers and health facility referrals were established. Conclusion The community was empowered; the VHW was established as a key link between the community and the formal health delivery. This was a sustainable form of improving community hypertension health outcomes.

Background: Hypertension (HT) is a key contributor to cardiovascular diseases (CVDs). The improved management of HT in the community and primary care settings should be a priority for low- and middle-income countries (LMICs). Improving the prevention and management of HT in primary care settings should also be a priority for developing countries. There is a need for more studies using community-based approaches that show the impact of these programmes on HT outcomes, which may motivate policymakers to invest in such approaches. The ward-based outreach team or village healthcare worker models were meant to provide such approaches, but many of these have become lower levels of curative care. We conducted a scoping review to examine how community-based participatory research (CBPR) was being used to improve HT management.Methods: Several electronic databases were searched, namely PubMed, MEDLINE, Google Scholar and Web of Science, generating 798 references. The publications were screened through several rounds. Data were extracted and imported into a Microsoft Excel spreadsheet, numerically summarised and qualitatively analysed.Results: Nine articles were included. These publications originated from the United States, Colombia, Canada, China, South Africa and Zimbabwe. Mixed methods, qualitative, randomised control trials and quasi-experimental studies were used to implement CBPR in the studies included. All the studies addressed complex health problems and inequities among the minorities utilising multiple stakeholder participation. Academic–community coalitions were formed, which enabled engagement and sharing of power equitably. As a result, there was acceptability and sustainability of interventions.Conclusion: A CBPR framework can be used to define the context, group dynamics, implementation and outcomes of HT. It is possible to apply CBPR in HT management to appropriately address health disparities while emphasising a community-driven approach. To achieve this, tailored health education platforms should be developed and implemented.

Background Ninety percent of the global annual malaria mortality cases emanate from the African region. About 80-90% of malaria transmissions in sub-Saharan Africa occur indoors during the night. In Zimbabwe, 79% of the population are at risk of contracting the disease. Although the country has made significant progress towards malaria elimination, isolated seasonal outbreaks persistently resurface. In 2017, Beitbridge District was experiencing a second malaria outbreak within twelve months prompting the need for investigating the outbreak. Methods An unmatched 1:1 case-control study was conducted to establish the risk factors associated with contracting malaria in Ward 6 of Beitbridge District from week 36 to week 44 of 2017. The sample size constituted of 75 randomly selected cases and 75 purposively selected controls. Data were collected using an interviewer-administered questionnaire and Epi Info version 7 was used to conduct descriptive, bivariate and multivariate analyses of the factors associated with contracting malaria. Results Fifty-two percent of the cases were females and the mean age of cases was 29±13 years. Cases were diagnosed using rapid diagnosed tests. Sleeping in a house with open eaves (OR: 2.97; 95%CI: 1.44-6.16; p<0.01), spending the evenings outdoors (OR: 2.24; 95%CI: 1.04-4.85; p=0.037) and sleeping in a poorly constructed house (OR: 4.33; 95%CI: 1.97-9.51; p<0.01) were significantly associated with contracting malaria while closing eaves was protective (OR:0.45; 95%CI: 0.20-1.02; p=0.055). After using backward stepwise logistic regression, sleeping in a poorly constructed house was still associated with getting sick from malaria (AOR: 5.88; 95%CI: 1.11-31.30; p=0.038). Those who had mosquito nets did not use them consistently. The district health team and the rural health center were well prepared for an outbreak response despite having limited human resources. Conclusion Health promotion messages should emphasize the importance of closing the entry points of the malaria vector, and the construction of better houses in the future. Residents had to be educated in the importance of consistent use of mosquito nets. The district had to improve malaria preventive measures like distribution of mosquito nets and lobby for more human resources to assist with malaria surveillance thus, curbing the recurrence of malaria outbreaks.

BackgroundHypertension is a significant contributor to cardiovascular and renal diseases. In poor communities there is lack of awareness, poor treatment and control. However, it can be controlled by lifestyle modifications. The aim of this study was to determine knowledge, attitudes and practices with regards to hypertension in a rural disadvantaged community in Matebeleland South province of Zimbabwe.MethodsWe conducted a descriptive cross-sectional survey. A pre-tested and validated interviewer administered questionnaire was used to collect demographic, awareness, treatment and control data among consenting hypertensive patients.Results304 respondents were enrolled into the study, their mean age was 59 years and 65.4% were females. Adding salt on the table (59.8%) was a risk factor. There were strong community beliefs in managing hypertension with herbs (50.7%) and use of traditional medicines (14.5%). Knowledge on hypertension was poor with 43.8% of hypertensive patients having had a discussion with a health worker on hypertension and 64.8% believing the main case of hypertension is stress while 85.9% stated palpitations as a symptom of hypertension. Defaulter rate was high at 30.9% with 25% of those on medication not knowing whether their blood pressure control status. Odds ratio for good knowledge for secondary and tertiary education were 3.68 (95%CI: 1.61-8.41) and 7.52 (95%CI: 2.76-20.46) respectively compared to no formal education. Those that believed in herbal medicines and those that used traditional medicines were 53% (95%CI: 0.29-0.76) and 68% (95%CI: 0.29-0.76) less likely to have good knowledge compared to those who did not believe and use traditional medicines respectively.ConclusionLack of education and poor socio-economic backgrounds were associated with poor knowledge on hypertension. Shortages of medication, poor health funding and weak health education platforms contributed to reduced awareness and control of hypertension in the community. Thus, community hypertension awareness, treatment and control needed to be upscaled.