During the May Measurement Month 2018 (MMM18) campaign, we aimed to raise hypertension awareness and measure blood pressure (BP) across different communities in Botswana. Study sites included four large villages and Gaborone (capital city). Screening sites were shopping malls, train stations, churches, and workplaces. Individuals aged ≥18 years were recruited through fliers, word of mouth, and as volunteer walk-ins at the sites. Demographic and risk factor data were collected through a questionnaire prior to measuring three BP readings per participant. Weight was measured while height was usually estimated. Hypertension was defined as: systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg or taking antihypertensive medication. The mean of readings 2 and 3 was used and was estimated using multiple imputation where missing. Amongst 4599 participants whose BPs were measured, 54.5% were female, while mean age was 35.9 years. A total of 1510 (32.8%) participants were hypertensive and of those, 712 (47.1%) were aware of the hypertension. Only 35.2% of hypertensives were on antihypertensive treatment with 54.4% had controlled BP. Amongst all hypertensives, only 19.1% had controlled BP. Risk factors associated with higher BP included obesity, more than 1 unit of alcohol/week and BP measured on Sunday. Less than half (47.1%) of those identified as having hypertension during MMM18 were aware of their condition, despite the escalating prevalence of hypertension in the country. Regular BP awareness and opportunistic BP measurement campaigns like MMM are recommended to improve detection and control of hypertension and other cardiovascular risk factors.
Introduction: Female sex workers are estimated to be 30 times more likely to be living with Human Immuno-deficiency Virus than other women of reproductive age and face an increased burden of sexually transmitted infections. Pre-Exposure Prophylaxis was introduced in Botswana in 2018 as an addition to combination-prevention strategies. Since then, no study was carried out to assess the efficiency of PrEP as an intervention. This study aimed to assess the uptake, adherence and retention of daily oral Pre-Exposure Prophylaxis among female sex workers in the Greater Gaborone City, Botswana. Methods: Retrospective, quantitative cross-sectional study was carried out Between August 2018 and May 2020. Purposive sampling was used to select the study site and exhaustive sampling was used to select recorded participant’s data. Descriptive statistics using Statistical Package for the Social Sciences (version 26), frequency and proportions were used to organise and analyse the data. Multiple regression analyses were performed to assess the association between variables and p =.05 was considered significant. Results: 207 Female sex workers participated in the study. Adherence to Pre-Exposure Prophylaxis was high (72.9%) but retention was low (16.9%). Unemployed female sex workers adhered more to Pre-Exposure Prophylaxis and age group 18-29 was less likely to be retained in the programme. Perception of no longer at substantial risk to Human Immuno-deficiency Virus infection, loss of interest to continue with Pre-Exposure Prophylaxis, drug side effects and busy life schedules were major reasons for non-retention. Conclusions: Lack of motivation challenged effective Pre-Exposure Prophylaxis retention. Widespread messaging to communities and Pre-Exposure Prophylaxis scale-up are necessary to generate demand and support for Pre-Exposure Prophylaxis uptake among Female sex workers.
Objective: During the May Measurement Month 2018 (MMM18) campaign, we aimed to raise hypertension awareness and measure blood pressure across different communities in Botswana. Design and method: Study sites were four large villages and Gaborone (capital city). Screening sites included shopping malls, train stations, churches and workplaces. Individuals aged over 18 years were recruited through fliers, word of mouth and volunteer walk-ins at the sites. Demographic and risk factor data were collected through a questionnaire prior to measuring three blood pressure (BP) readings per participant. Weight was measured while height was usually estimated. Hypertension was defined as: SBP above 140 mmHg or DBP above 90 mmHg or taking antihypertensive medication. The mean of readings 2 and 3 was used, and was estimated using multiple imputation where missing. Ethical clearance was obtained from the Ministry of Health and University of Botswana. Results: Amongst 4,599 participants whose BPs were measured, 54.5% were female, mean age was 35.9 years. A total of 1,510 (32.8%) participants were hypertensive with 712 (47.1%) aware of the hypertension. In participants not taking antihypertensive medication, the association between age and sex with SBP showed a linear increase, with the mean BP in males prominently higher than the mean BP in females across ages below 85–90 years, where they became equal. The DBP association showed an inverted U curve, with the mean DBP in males exceeding the mean DBP in females at age of 25 years, and the peak on the male curve at ages 45–50 years, while in females it was at ages 50–55 years. Only 35.2% of hypertensives were on anti-hypertensive treatment with 54.4% having controlled BP. Amongst all hypertensives, only 19.1% had controlled BP. Factors associated with higher BP included obesity, more than 1unit of alcohol/week and BP measured on Sunday. Conclusions: Less than half (52.9%) of those identified to have hypertension during MMM18 campaign were aware of their condition, despite the escalating prevalence of hypertension in the country. Regular BP awareness and opportunistic BP measurement campaigns like the MMM are recommended to improve detection and control of hypertension and other cardiovascular risk factors.
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