Prevalence and predictors of uncontrolled hypertension, diabetes, and obesity among adults with HIV in northern Tanzania

Hertz, Julian T.; Prattipati, Sainikitha; Kweka, Godfrey L.; Mlangi, Jerome J; Tarimo, Tumsifu G.; Mmbaga, Blandina T.; Thielman, Nathan M.; Sakita, Francis; Rubach, Matthew P.; Bloomfield, Gerald S.; Manavalan, Preeti

doi:10.1080/17441692.2022.2049344

Cited by 11 publications

(18 citation statements)

References 38 publications

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“…In our study, almost 47.25% of HIV patients with hypertension were undiagnosed. In Tanzania and Brazil, HIV infected patients were not aware of their hypertension status, respectively 67.1% and 44.3% 36,51 .…”

Section: Discussionmentioning

confidence: 99%

Hypertension and associated factors in HIV-infected patients receiving antiretroviral treatment in Burundi: a cross-sectional study

Harimenshi

Niyongabo

Preux

et al. 2022

Sci Rep

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Currently, the life expectancy of people living with the human immunodeficiency virus (HIV) and the general population are similar. Hypertension is a major public health issue in Africa and is largely underdiagnosed. Most HIV-infected individuals, especially those on Anti-Retroviral Therapy (ART) have hypertension. Our project aims to determine the prevalence of hypertension and associated factors amongst HIV-infected adults treated by ART in Burundi. A cross-sectional study was conducted among HIV-infected subjects over the age of 20, managed in five healthcare centers for people living with HIV (PLWH). The World Health Organization STEPWISE survey and anthropometric measurements were employed. Blood pressure was measured according to the ESC 2018 recommendations. 1 250 HIV-infected patients aged between 35.4 and 50.2 years were included (18.4% men). The prevalence of hypertension was 17.4% (95% CI 13.2–22.1). Approximately 47.25% of HIV patients with hypertension were previously undiagnosed. Other factors were associated with HTN, such as being overweight (OR 2.88; 95% CI 1.46–5.62), obesity (OR 2.65; 95% CI 1.27–5.55), longer duration of HIV infection: ≥ 10 years (OR 1.04; 95% CI 1.14–3.20), diabetes (OR 2.1; 95% CI 1.37–3.32) and age (OR 1.13; 95% CI 1.09–1.14). Despite their young age, almost 20% of HIV-ART treated patients had hypertension, 50% of these were undiagnosed. Blood pressure monitoring is crucial in these patients, especially those identified as high-risk, with prompt life and disability-saving interventions.

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Section: Discussionmentioning

confidence: 99%

Hypertension and associated factors in HIV-infected patients receiving antiretroviral treatment in Burundi: a cross-sectional study

Harimenshi

Niyongabo

Preux

et al. 2022

Sci Rep

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“…We are experiencing an epidemiologic change in which the developing world has a growing number of non-communicable diseases 17 19 20. Cardiovascular diseases are underdiagnosed in sub-Saharan Africa and acute manifestations of these, such as myocardial infarction and cardiac arrest, result in a higher burden of deaths 21 22.…”

Section: Discussionmentioning

confidence: 99%

Emergency unit capacity in Northern Tanzania: a cross-sectional survey

et al. 2023

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IntroductionEmergency medicine (EM) is a growing field in Sub-Saharan Africa. Characterising the current capacity of hospitals to provide emergency care is important in identifying gaps and future directions of growth. This study aimed to characterise the ability of emergency units (EU) to provide emergency care in the Kilimanjaro region in Northern Tanzania.MethodsThis was a cross-sectional study conducted at 11 hospitals with emergency care capacity in three districts in the Kilimanjaro region of Northern Tanzania assessed in May 2021. An exhaustive sampling approach was used, whereby all hospitals within the three-district area were surveyed. Hospital representatives were surveyed by two EM physicians using the Hospital Emergency Assessment tool developed by the WHO; data were analysed in Excel and STATA.ResultsAll hospitals provided emergency services 24 hours a day. Nine had a designated area for emergency care, four had a core of fixed providers assigned to the EU, two lacked a protocol for systematic triage. For Airway and Breathing interventions, oxygen administration was adequate in 10 hospitals, yet manual airway manoeuvres were only adequate in six and needle decompression in two. For Circulation interventions, fluid administration was adequate in all facilities, yet intraosseous access and external defibrillation were each only available in two. Only one facility had an ECG readily available in the EU and none was able to administer thrombolytic therapy. For trauma interventions, all facilities could immobilise fractures, yet lacked interventions such as cervical spinal immobilisation and pelvic binding. These deficiencies were primarily due to lack of training and resources.ConclusionMost facilities perform systematic triage of emergency patients, though major gaps were found in the diagnosis and treatment of acute coronary syndrome and initial stabilisation manoeuvres of patients with trauma. Resource limitations were primarily due to equipment and training deficiencies. We recommend the development of future interventions in all levels of facilities to improve the level of training.

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“…Trained research assistants approached consecutive adult MCTC patients to offer enrolment, which was conducted over a six-month period between September 1st, 2020, and March 1st, 2021. Although all MCTC patients consenting to participation were enrolled in the parent study [ 15 , 21 ], only those who were found to have elevated blood pressure or hyperglycemia at time of enrolment were included in the present analysis, as detailed below.…”

Section: Methodsmentioning

confidence: 99%

“…Initial study procedures have been described in detail elsewhere and are summarized here [ 15 , 21 , 22 ]. Enrolment and data collection were conducted by three research assistants, each with over a decade of experience conducting clinical research.…”

Section: Methodsmentioning

confidence: 99%

“…Preliminary data from across SSA suggests that the prevalence of hypertension and diabetes among PWH is already substantial. Small, cross-sectional studies from Malawi, Tanzania, South Africa, Ethiopia, and Kenya have reported hypertension prevalence of 13–29% and diabetes prevalence of 6–18% among adults engaged in HIV care [ 8 – 15 ]. Of particular concern, these preliminary studies also found that large proportions of patients with hypertension and diabetes were unaware of their condition and were not currently taking any anti-hypertensive or anti-hyperglycemic therapy.…”

Section: Introductionmentioning

confidence: 99%

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Six-month blood pressure and glucose control among HIV-infected adults with elevated blood pressure and hyperglycemia in northern Tanzania: A prospective observational study

Sakita,

Prattipati,

Chick

et al. 2023

PLoS ONE

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Background People with HIV in sub-Saharan Africa are increasingly developing age-related comorbidities. The purpose of this prospective observational study was to describe 6-month outcomes among Tanzanians with HIV and elevated blood pressure or hyperglycemia under current care pathways. Methods Adults presenting for routine HIV care were enrolled and underwent blood pressure and blood glucose measurements. Participants with abnormal blood pressure or glucose were referred for further care, as per current guidelines. Participants’ blood pressure and point-of-care glucose were re-evaluated during their 6-month follow-up visit. Elevated blood pressure was defined as systolic ≥140 mmHg or diastolic ≥90 mmHg. Hyperglycemia was defined as fasting glucose ≥126 mg/dl or random glucose ≥200 mg/dl. An electrocardiogram was obtained at enrollment and at follow-up. Interim myocardial infarction and interim myocardial ischemia were defined as new pathologic Q waves and new T-wave inversions, respectively. Results Of 500 participants, 155 had elevated blood pressure and 17 had hyperglycemia at enrolment. At 6-month follow-up, 7 (4.6%) of 155 participants with elevated blood pressure reported current use of an anti-hypertensive medication, 100 (66.2%) had persistent elevated blood pressure, 12 (7.9%) developed interim myocardial infarction, and 13 (8.6%) developed interim myocardial ischemia. Among 17 participants with hyperglycemia, 9 (56%) had persistent hyperglycemia at 6 months and 2 (12.5%) reported current use of an anti-hyperglycemic medication. Conclusions Interventions are needed to improve non-communicable disease care pathways among Tanzanians with HIV.

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Prevalence and predictors of uncontrolled hypertension, diabetes, and obesity among adults with HIV in northern Tanzania

Cited by 11 publications

References 38 publications

Hypertension and associated factors in HIV-infected patients receiving antiretroviral treatment in Burundi: a cross-sectional study

Hypertension and associated factors in HIV-infected patients receiving antiretroviral treatment in Burundi: a cross-sectional study

Emergency unit capacity in Northern Tanzania: a cross-sectional survey

Six-month blood pressure and glucose control among HIV-infected adults with elevated blood pressure and hyperglycemia in northern Tanzania: A prospective observational study

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