BackgroundNon-communicable diseases, mainly cardiovascular diseases, diabetes, cancer and chronic respiratory diseases, are responsible for approximately 63% of all deaths occurring worldwide in any given year. The majority of these deaths have occurred in low- and middle-income countries (LMICs). The latest World Health Organization (WHO) report shows that the increase in diabetes is also most pronounced in the LMICs. The South African Labour and Development Research Unit estimated a 9% prevalence within the adult population in 2016. In the Eastern Cape Province, hypertensive heart disease has become the second most common cause of death, followed by diabetes, the third most common cause of death.Aim and settingThe aim of this study was to report on the follow-up of patients in the community with known hypertension or diabetes or who were deemed at-risk (as identified during a prior community-wide survey).MethodsData were collected via a household primary health screening, monitoring and follow-up process, which included taking anthropometric measurements, blood pressure (BP) and blood glucose and referring to clinics for further testing and treatment where necessary.ResultsOf the 1885 participants followed up by the community health outreach workers, 1702 were known to be hypertensive and 183 were deemed at-risk [of these, only 24 (13.2%) had normal or high normal systolic BP readings]. There were 341 participants with diabetes and 34 at-risk of diabetes [of these, 28 (82%) had levels of 11 mmol/l or higher at follow-up]. There was a significant improvement in BP and glucose control over repeated visits.ConclusionIn this rural area of the Eastern Cape, South Africa, the follow-up of patients with hypertension or diabetes as well as those individuals at-risk adds value to hypertension and glucose control.

BackgroundMiddle and lower income countries are challenged with a double burden of disease: while still coping with the onslaught of Human Immunodeficiency Virus (HIV) and increasing levels of tuberculosis (TB), there is a considerable increase in the level of noncommunicable diseases (NCDs). The poor are especially disadvantaged and are at an increased risk for NCDs. Adequate healthcare resources for this environment can only be allocated once the extent and exact nature of the problem is determined.Aim and settingThe aim of this study was to collect demographic and NCD-related data in the poorest community of the poorest province of South Africa in order to determine the extent of the problem and advise on allocation of resources accordingly.MethodsData were collected via a household primary health screening process, which included taking anthropometric measurements, blood pressure and blood glucose and referring to clinics for further testing and treatment where necessary.ResultsIt was found that the population screened was generally older, consisted of women, and had a high incidence of obesity and hypertension. Of note was the fact that in those without known hypertension, close to 40% of individuals had possible newly diagnosed hypertension. This increased with increase in age and body mass index (BMI). The total prevalence of diabetes was close to 5%, but possible new diabetes was considerably lower at approximately 1%.ConclusionIn this rural area of the Eastern Cape, South Africa, undiagnosed hypertension is a major concern and renewed efforts at detection and control are warranted.

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