Hypertension control and care at Mulago Hospital ambulatory clinic, Kampala-Uganda

Ssinabulya, Isaac; Nabunnya, Yvonne; Kiggundu, Brian; Musoke, Charles; Mungoma, Michael; Kayima, James

doi:10.1186/s13104-016-2293-y

Cited by 16 publications

(19 citation statements)

References 30 publications

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“…It is notable that in this random sample of patients attending clinics in Ghana for hypertension care, approximately 75% were females suggesting possible gender differences in health seeking behaviors [ 58 ]. This finding is of great concern as it suggests that a significant proportion of males with hypertension in Ghana are either unaware of their diagnosis, are not to receiving treatment or are not compliant with their hypertension treatment, as hypertension is common among African males [ 59 , 60 ]. Given the recent surge in morbidity and mortality from cardiovascular disease such as stroke in Ghana, [ 61 – 63 ] this gender-related disparity in health seeking behavior among males is a major public health issue requiring urgent attention.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with uncontrolled blood pressure among Ghanaians: Evidence from a multicenter hospital-based study

et al. 2018

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BackgroundThe burden of uncontrolled hypertension in Low-and-Middle Income Countries (LMICs) is high, with an increased risk of cardiovascular diseases and chronic renal failure in these settings.ObjectiveTo assess the factors associated with uncontrolled blood pressure control in a cross-section of Ghanaian hypertensive subjects involved in an on-going multicenter epidemiological study aimed at improving access to hypertension treatment.MethodsA cross-sectional study involving 2,870 participants with hypertension with or without diabetes who were enrolled at 5 hospitals in Ghana (2 tertiary, 2 district and 1 rural hospital). Data on demographics, medical history, lifestyle factors, anti-hypertensive medications and treatment adherence were collected. The 14-item version of the Hill-Bone compliance to high blood pressure therapy scale was used to assess adherence to treatment in 3 domains namely adherence to medications, salt intake and clinic appointments. Questionnaires on knowledge, attitudes and practices on hypertension, sources of antihypertensive medications and challenges with accessing these medications were also administered. Blood pressure, weight and height were measured for each subject at enrollment. Factors associated with uncontrolled blood pressure (>140/90mmHg) were assessed using a multivariate logistic regression model.ResultsThe mean ± SD age of study participants was 58.9 ± 16.6 years, with a female preponderance (76.8%). Among study participants, 1,213 (42.3%) study participants had blood pressure measurements under control. Factors that remained significantly associated with uncontrolled blood pressure with adjusted OR (95% CI) included receiving therapy at a tertiary level of care: 2.47 (1.57–3.87), longer duration of hypertension diagnosis: 1.01 (1.00–1.03), poor adherence to therapy: 1.21 (1.09–1.35) for each 5 points higher score on the Hill-Bone scale, reported difficulties in obtaining antihypertensive medications: 1.24 (1.02–1.49) and number of antihypertensive medications prescribed: 1.32 (1.21–1.44).ConclusionWe have found high rates of uncontrolled blood pressure among Ghanaian patients with hypertension accessing healthcare in public institutions. The system-level and individual-level factors associated with poor blood pressure control should be addressed to improve hypertension management among Ghanaians.

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Section: Discussionmentioning

confidence: 99%

Factors associated with uncontrolled blood pressure among Ghanaians: Evidence from a multicenter hospital-based study

et al. 2018

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“…Previous studies showed that the majority of patients received combination therapy. For example, according to Ssinabulya et al, the majority of patients were under combination therapy to control their blood pressure (more than 3 drugs) [23]. Also in the study of Leao et al, 62.2% of patients were receiving combination therapy, while only 19.8% of patients were being treated with monotherapy and 18% were not taking any medications.…”

Section: Discussionmentioning

confidence: 99%

Dobowy rytm ciśnienia tętniczego i powiązane czynniki u chorych z nadciśnieniem tętniczym

Lialestani

Aghaali

Pirsarabi

et al. 2018

Arterial Hypertension

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Introduction. Hypertension is a common, almost asymptomatic, detectable and treatable disease. Abnormal circadian rhythm of blood pressure is associated with increased risk of disorders such as sleep problems, metabolic syndrome, cardiovascular disease and cancer. On the other hand, 24-hour blood pressure monitoring, a method for detecting the abnormal pattern of blood pressure decrease over night, gets less clinicians' attention. This study aims to determine the circadian rhythm of blood pressure and its related factors in hypertensive patients. Material and methods. This analytical cross-sectional study was done in 2015. The study population was patients referred to the offices and clinics in the city of Qom and 183 of them were selected based on convenience sampling. Data were collected by use of demographic checklist and the results of 24-hour monitoring of blood pressure. Results. The mean age of patients was 52.08 ± 14.16 years, and 57.9% were female. The mean duration of hypertension history was 4.32 ± 4.96 years. 77% of the patients had non-dipper blood pressure pattern. In terms of age (p = 0.31) and duration of hypertension (p = 0.93), gender (p = 0.55) and type of hypertension treatment (p = 0.96), there was no significant difference between the two groups of dippers and non-dippers. Conclusions. In this study, the frequency of non-dipper pattern in patients with hypertension was higher than in similar studies. Since the importance of 24-hour blood pressure monitoring for proper evaluation and management, it is recommended that hypertensive patients undergo 24-hour blood pressure monitoring.

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“…There are several ongoing clinical trials examining such novel regimens. [41][42][43] Treatment outcomes for MDR-TB in Haiti are among the best in the world, 16,17 with the use of standard long-course therapy in conjunction with DST. The Haitian National TB Program is in the process of selecting a shorter course regimen that would lead to continued high success rates, without increasing toxicity.…”

Section: Discussionmentioning

confidence: 99%

Potentially High Number of Ineffective Drugs with the Standard Shorter Course Regimen for Multidrug-Resistant Tuberculosis Treatment in Haiti

Walsh

Souroutzidis

Vilbrun

et al. 2019

The American Journal of Tropical Medicine and Hygiene

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Multidrug-resistant tuberculosis (MDR-TB) outcomes are poor partly because of the long treatment duration; the World Health Organization conditionally recommends a shorter course regimen to potentially improve treatment outcomes. Here, we describe the drug susceptibility patterns of a cohort of MDR-TB patients in Haiti and determine the number of likely effective drugs if they were treated with the recommended shorter course regimen. We retrospectively examined drug susceptibility patterns of adults initiating MDR-TB treatment between 2008 and 2015 at the Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections in Port-au-Prince, Haiti. First-and second-line drug susceptibility testing (DST) was analyzed and used to determine the number of presumed effective drugs. Of the 239 patients analyzed, 226 (95%), 183 (77%), 135 (57%), and 38 (16%) isolates were resistant to high-dose isoniazid, ethambutol, pyrazinamide, and ethionamide, respectively. Eight patients (3%) had resistance to either a fluoroquinolone or a second-line injectable and none had extensively resistant TB. Of the 239 patients, 132 (55%) would have fewer than five likely effective drugs in the intensive phase of the recommended shorter course regimen and 121 (51%) would have two or fewer likely effective drugs in the continuation phase. Because of the high rates of resistance to first-line TB medications, about 50% of MDR-TB patients would be left with only two effective drugs in the continuation phase of the recommended shorter course regimen, raising concerns about the effectiveness of this regimen in Haiti and the importance of using DST to guide treatment.

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Hypertension control and care at Mulago Hospital ambulatory clinic, Kampala-Uganda

Cited by 16 publications

References 30 publications

Factors associated with uncontrolled blood pressure among Ghanaians: Evidence from a multicenter hospital-based study

Factors associated with uncontrolled blood pressure among Ghanaians: Evidence from a multicenter hospital-based study

Dobowy rytm ciśnienia tętniczego i powiązane czynniki u chorych z nadciśnieniem tętniczym

Potentially High Number of Ineffective Drugs with the Standard Shorter Course Regimen for Multidrug-Resistant Tuberculosis Treatment in Haiti

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