The Burden of Hypertension and Diabetes in an Emergency Department in Northern Tanzania

Abstract

Introduction: Little is known about the burden of hypertension and diabetes on emergency department (ED) utilization and hospitalizations in sub-Saharan Africa.Methods: A retrospective review of adult ED patients in northern Tanzania was performed from September 2017 through March 2018. Hypertension was defined as documented diagnosis of hypertension or blood pressure ≥ 140/90 mm Hg. Diabetes was defined as documented diagnosis of diabetes mellitus or random glucose ≥ 200 mg/dL.Results: Of 3961 adult ED patients, 1359 (34.3%) had hypertension, 518 (13.1%) had diabetes, and 273 (6.9%) had both. Both hypertension (OR 1.42, 95% CI 1.23-1.63, P<.001) and diabetes (OR 2.05, 95% CI 1.66-2.54, P<.001) were associated with increased odds of admission. Of 2418 hospital admissions, 694 (28.7%) were for complications of hypertension or diabetes. Of 499 patients admitted for hypertensive complications, the most common admission diagnoses were: heart failure (163 patients, 32.7%); stroke (147 patients, 29.5%); and severe hypertension (139 patients, 27.9%). Of 278 patients admitted for diabetic com­plications, the most common admission di­agnoses were: hyperglycemia (158 patients, 56.9%); infection (60 patients, 21.6%); and stroke (28 patients, 10.1%).Conclusions: The burden of hypertension and diabetes in a Tanzanian ED is high, and the ED may serve as an opportune location for case identification and linkage-to-care interventions. Given the large proportion of Africans with undiagnosed hyperten­sion and diabetes, an ED-based screening program would likely identify many new cases of these diseases. The high burden of hypertension- and diabetes-related hos­pitalizations highlights the urgent need for improvements in primary preventative care in Tanzania.Ethn Dis.2019;29(4):559-566; doi:10.18865/ed.29.4.559

Lack of association of Vascular Risk Factors with HIV-associated neurocognitive disorders in cART-treated adults aged ≥50 years in Tanzania

“…This is the rst study investigating vascular associations for HAND in older PLWH in SSA. Hypertension was less prevalent than rates reported in Tanzanian rural elders (69%, age ≥ 70) [50] and urban older adults (48%, age ≥ 55) [51] , but broadly similar to adult ED attendees (34.3%) [52] and SSA-wide estimates for adults of all ages (30%) [53] . This is surprising given that in both high-and low-income settings older PLWH and those receiving c-ART appear to have higher hypertension prevalence [54,55] .…”

Utilização de serviços de urgência e emergência por complicações agudas da hipertensão e/ou diabetes

“…A Hipertensão Arterial Sistêmica (HAS) e o Diabetes Mellitus (DM) configuram as principais causas de morte e invalidez em todo o mundo 1,2 . Estima-se que até 2050 seis países de renda média, entre eles o Brasil, apresentarão mudanças demográficas importantes, com aumento considerável do número de adultos que necessitarão de tratamento para doenças crônicas 3 .…”

Prevalence of Controlled Systemic Hypertension and Its Associated Risk Factors among Hypertensive Patients at Mbeya Zonal Referral Hospital, Tanzania.

“…A study done in states that hypertension in sub-Saharan Africa is a widespread problem of immense economic importance because of its high prevalence in urban areas, its frequent under diagnosis, and the severity of its complications [11] . In Tanzania for example, a study done in Northern Tanzania in 2019 showed the complications such as heart failure, stroke, renal failure, ischemic heart disease, chronic kidney disease [12] .…”