Cardiovascular disease prevention knowledge and associated factors among adults in Mukono and Buikwe districts in Uganda

Abstract

Background: With the growing epidemic of Cardiovascular Disease (CVD) in sub-Saharan Africa, behavioural change interventions are critical in supporting populations to achieve better cardiovascular health. Population knowledge regarding CVD is an important first step for any such interventions. This study examined CVD prevention knowledge and associated factors among adults in Mukono and Buikwe districts in Uganda. Methods: The study was cross-sectional in design conducted among adults aged 25 to 70 years as part of the baseline assessment by the Scaling-up Packages of Interventions for Cardiovascular disease prevention in selected sites in Europe and Sub-Saharan Africa (SPICES)project. Data were collected using pretested semi-structured questionnaires, and respondents categorized as knowledgeable if they scored at least five out of six in the knowledge questions. Data were exported into STATA version 15.0 statistical software for analysis conducted using mixed-effects Poisson regression with fixed and random effects and robust standard errors. Results: Among the 4372 study respondents, only 776 (17.7%) were knowledgeable on CVD prevention. Most respondents were knowledgeable about foods high in calories 2981 (68.2%), 2892 (66.1%) low fruit and vegetable intake and high salt consumption 2752 (62.9%) as CVD risk factors. However, majority 3325 (76.1%) thought the recommended weekly moderate physical activity was 30 min and half 2262 (51.7%) disagreed or did not know that it was possible to have hypertension without any symptoms. Factors associated with high CVD knowledge were: post-primary education [APR = 1.55 (95% CI: 1.18-2.02), p = 0.002], formal employment [APR = 1.69 (95% CI: 1.40-2.06), p < 0.001] and high socioeconomic index [APR = 1.35 (95% CI: 1.09-1.67), p = 0.004]. Other factors were: household ownership of a mobile phone [APR = 1.35 (95% CI: 1.07-1.70), p = 0.012] and ever receiving advice on healthy lifestyles [APR = 1.38 (95% CI: 1.15-1.67), p = 0.001]. Conclusions: This study found very low CVD knowledge with major gaps around recommended physical activity duration, diet and whether hypertension is asymptomatic. Observed knowledge gaps should inform suitable interventions and strategies to equip and empower communities with sufficient information for CVD prevention.

Community-level Knowledge, Attitudes, and Practices regarding Cardiovascular Diseases and Modifiable Risk Factors in India

“…Furthermore, a 2017 systematic review of 27 randomised trials found that mobile health interventions increased medication adherence, achievement of blood pressure targets, exercise, and increased awareness of diet and exercise for the secondary prevention of CVD 33 . A recent cross-sectional survey among 4,372 adults in Mukono and Buikwe districts in Uganda reported that participants who had received advice on healthy lifestyle through mobile phones had higher CVD knowledge as compared to those who had ever received healthy lifestyle advice; adjusted prevalence ratio = 1.37 (95% CI: 1.14, 1.65) 25 . However, data from recent trials of text-messaging showed null results 34,35 .…”

Drivers of cardiovascular disease risk factors in slums in Kampala, Uganda: a qualitative study

“…Interventions to deal with CVD risks within the community should include sensitisation and awareness-raising to provide community members with accurate information regarding CVD and the importance of healthy lifestyle practices. Other approaches include community screening for CVD risk factors and the use of mHealth-assisted community-based CVD risk screening techniques as has been the case in Kenya [ 36 , 37 ], India [ 37 ], and Bangladesh [ 38 ]. Moreover, in the community, health workers were highlighted as a critical source of CVD information.…”

Community-Based Interventions for Cardiovascular Disease Prevention in Low-and Middle-Income Countries: A Systematic Review

“…These improvements were achieved mostly through training, community mobilization, health education and consultation [ 38 , 40 , 45 , 46 , 49 ]. Worthy of note is that knowledge on CVD is still very low in many LMICs [ 63 , 64 ] and thus interventions are more likely to lead to significant changes. Regarding, changes in behavioral practices following implementation of intervention, greatest improvements were around physical activity with increase in proportion physically active and leisure-time activity.…”