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Prevalence, Awareness, Treatment and Control of Hypertension in Tshela Rural Areas. Democratic Republic of the Congo

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Prevalence, Awareness, Treatment and Control of Hypertension in Tshela Rural Areas. Democratic Republic of the Congo International Journal of Scientific and Research Publications, Volume 10, Issue 6, June 2020 803 ISSN 2250-3153 Prevalence, Awareness, Treatment and Control of Hypertension in Tshela Rural Areas. Democratic Republic of The Congo Blaise Makoso Nimi 1,2, Gedeon Longo Longo3 , Benjamin Longo Mbenza1,3, Memoria Makoso Nimi2 , Bienvenu Nkongo Mabiala2,4 , Elysée Buanga Khuabi2 and Jean –Marie Nimi Mbumba5 1Department of Internal Medicine, Faculty of Medicine, Kinshasa University, Kinshasa, Democratic Republic of Congo 2 Kasa Vubu University, Faculty of Medicine, Boma, DRCongo 3Lomo-Medical Center, Kinshasa, DRCongo 4 Higher Institute of Medical Technology (ISTM), Tshela 5School of Public Health, University of Kinshasa, DRCongo DOI: 10.29322/IJSRP.10.06.2020.p10294 http://dx.doi.org/10.29322/IJSRP.10.06.2020.p10294 Abstract- BACKGROUND AND AIM: Order to plan by the authorities in our country with limited resources, we have a study I. INTRODUCTION to assess the prevalence, awareness, control and factors associated ypertension is a major risk of disease risk 1. according to the with hypertension in rural Tshela, located in the southern part H World Health Organization estimates that approximately western DRC 40% of adults suffer from hypertension2. he is responsible Each METHODS: we conducted a cross-sectional study using a year, 9.4 million deaths from complications either from heart modified WHO STEP wise questionnaire for data collection disease or from stroke (BP) 3, 4. during face-to face interviews was conducted from October, 1 to The literature reports a gradual increase in the global December 15, 2018. A multistage cluster sampling method was prevalence of hypertension due to an aging population, the used and inclusion criteria were age ≥18 years and informed adoption of an unhealthy lifestyle 5. Hypertension being the risk consent. Information on demographic parameters, behavioral factor contributing the most to the burden of disease, the lifestyles, anthropometric and blood pressure (BP) measurements importance prevention, diagnosis and adequate control of was obtained. Hypertension was defined as an average of two BP hypertension is more than ever emphasized. Globally, however, ≥ 140/90 mmHg or self-reported history of antihypertensive less than half of all people are aware of their diagnosis and less medication use. Independent factors associated with hypertension than a third of people on treatment have controlled BP6,7. were identified using logistic regression analysis. P<0.05 defined n sub-Saharan Africa (SSA), its prevalence can reach 38% in the level of statistical significance. certain communities 8,9. but it is estimated that between 10 and RESULTS: The prevalence of hypertension was 34.5% 20 million can suffer from hypertension. These estimates are based with 56,1 % of hypertensive participants being unaware of their on estimates as many sub-Saharan African countries still lack hypertension status. Of those who were aware and on treatment, recent and detailed baseline data on the prevalence of HTN 10. In only 22, 6% had a controlled BP. Older age (p<0.001), ATS (p<= addition, few available studies report low awareness, low rates of 0.001) and DS(p<0.001) emerged as main cardiovascular risk patients on treatment and a low rate of hypertensin control in these factors associated with hypertension. populations. CONCLUSION we reported high prevalence, low In our country the Democratic Republic of Congo (DRC), awareness and suboptimal BP control, high cardiovascular risk the nationwide prevalence of hypertension and associated risk and associated with smoking and obesity as modifiable risk factors is not yet available due lack of an effective nationwide factors. Therapeutic lifestyle changes and pharmacological surveillance system and financial constraints; however, studies treatment are necessary for hypertensive participants. conducted in some urban and rural areas have reported a Hypertension was characterized by a high prevalence, low prevalence of hypertension ranging from 30% to 40% and an rate of awareness and suboptimal BP control, high cardiovascular increased CV mortality due, among others, to low awareness, risk and associated with smoking and obesity as modifiable risk under-diagnosis and under-treatment as well as poor hypertension factors. Therapeutic lifestyle changes and pharmacological control11-14 . If studies have been conducted in port cities like treatment are needed for those hypertensive participants with Kinshasa, Bukavu, Matadi and Boma, there is no data yet increased global cardiovascular risk. available on hypertension and risk factors associated with Tshela, DRC Index Terms- hypertension, prevalence, awareness, tshela This publication is licensed under Creative Commons Attribution CC BY. http://dx.doi.org/10.29322/IJSRP.10.06.2020.p102XX www.ijsrp.org International Journal of Scientific and Research Publications, Volume 10, Issue 6, June 2020 804 ISSN 2250-3153 II. METHODS ≥140/90 mm Hg, hypertensive subjects was defined by self- 21 Study design reporting ongoing treatment . The hypertension was defined as We conducted a cross-sectional study based on a randomly controlled when SBP < 140 mmHg and DBP < 90 mmHg under selected adult population pharmacological treatment. Low fruit/vegetable consumption of less than 5 portions of fresh and/or cooked fruits/vegetables a day Study setting 22. Insufficient physical activity was defined as self-reported less Tshela is a City located at 250 Km far from Matadi, the than 150 min of moderate intensive activity or less than 75 min Capital City of the south western Province of Kongo Central and vigorous intensive physical activity per week, including walking 690 Km far Kinshasa, the Capital City of DRC. and cycling 23. Study population A multistage stratified sampling method was used to allow Data analyses estimates by sex (male and female) and residence (urban and Data were analyzed using Statistical Package for the Social rural). A total of 1000 eligible individuals were successfully Sciences (SPSS) version 21 for Windows (SPSS Inc., Chicago, IL, interviewed among the households that gave informed consent. United States). Data were expressed as mean values ± standard Inclusion criteria deviations (SD) for continuous variables. Frequencies (n) and Was included in this study any person over the age of 18, percentages (%) were reported for categorical variables. Counts having resided in Tshela over 1 year and having consented (frequency = n) and percentages (%) were reported for categorical verbally or in writing. variables. Percentages were compared using the chi-square test. Data collection The logistic regression model analysis adjusted for obesity, The relevant parameters including socio-demographic data, physical activity, dietary practices, parity, income and alcohol use. anthropometric and behavioral measures were obtained after the A p-value of < 0.05. interview by trained personnel.. Data analyses Measures Data were analyzed using Statistical Package for the Social The anthropometric measurements (such as body weight, Sciences (SPSS) version 21 for Windows (SPSS Inc., Chicago, IL, waist circumference, height) blood pressure, and pulse rate were United States). Data were expressed as mean values ± standard collected by well-trained Medical students. Blood pressure was deviations (SD) for continuous variables. Frequencies (n) and measured using digital blood pressure meters (OMRON MIT5 percentages (%) were reported for categorical variables. Counts Connect, Kyoto, Japan). The average of the two measures was (frequency = n) and percentages (%) were reported for categorical used in the final analysis. variables. Percentages were compared using the chi-square test. The size was measured, in a standing position, in a The logistic regression model analysis adjusted for obesity, participant without shoes, using a flexible measuring tape physical activity, dietary practices, parity, income and alcohol use. (Hemostyl, Sulzbach, Germany).Body weight was also measured A p-value of < 0.05. with individuals wearing light clothing or standing without shoes using adigital weighing scale (Deluxe GBS-721;Seca Ethical approval Deutschland, Hamburg, Germany). Body mass index (BMI) was Obtained from the Ethical Committee of the Ministry of computed as weight in kilograms divided by height in meters Health (N°150/CNES/BN/PMMF/2019). Consent was taken from squared (Kg/m2). A flexible measuring tape was used to measure the subjects who volunteered to participate in the study. Identified the size at the level connecting the two iliac crests. hypertensive subjects were referred to the nearby clinic for During the survey, questionnaires on eating habits, risky treatment behavior (smoking and smoking, lack of consumption of fruits and vegetables) and physical activities were administered. III. RESULTS • Operational definitions The socio-economic level was calculated on the basis of Table1. General characteristics DRC Demographic and Health Survey (DHS) and classified into Of the 1000 participants, 372 (37.2%) were males while 628 three degrees : low, middle and high socioeconomic status (SES)15 (62.8%) were females. Their mean age was 47,7±16,0 years with . The cardiovascular risk factors were defined according to the 34,9%, 21,6%,19,6% and 23,9 % participants aged participants surveillance manual16. Talking alcohol was defined as aged respectively < 40 years, 40–49 years, 50-59 years and ≥60 consumption of more than 1 standard drink (which is the amount years .
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