ArticleGlobalization and health2013
Screening for diabetes and hypertension in a rural low income setting in western Kenya utilizing home-based and community-based strategies.
Article in Globalization and health, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 5 of them syntheses that pooled it.
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53 citing papers in PubMed, 5 syntheses or guidelines pooled it, 79 citations in OpenAlex.
- Assessment of Barriers and Facilitators to the Delivery of Care for Noncommunicable Diseases by Nonphysician Health Workers in Low- and Middle-Income Countries: A Systematic Review and Qualitative Analysis.JAMA network open · 2019Pooled it
- Models of integration of HIV and noncommunicable disease care in sub-Saharan Africa: lessons learned and evidence gaps.AIDS (London, England) · 2018Pooled it
- Readiness of Sub-Saharan Africa Healthcare Systems for the New Pandemic, Diabetes: A Systematic Review.Journal of diabetes research · 2018Pooled it
- The association between HIV and atherosclerotic cardiovascular disease in sub-Saharan Africa: a systematic review.BMC public health · 2017Pooled it
- A systematic review of primary care models for non-communicable disease interventions in Sub-Saharan Africa.BMC family practice · 2017Pooled it
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- Cardiovascular Disease Screening Programs in Low- and Middle-Income Countries: A Systematic Review.JACC. Advances · 2026Article
- Community-based interventions for non-communicable diseases in Africa: a scoping review of scope, effectiveness, and implementation factors.BMC public health · 2026Article
- Driving NCD screening at scale: outcomes of a digital, CHW-led hypertension surveillance program in rural Rwanda.BMC public health · 2026Article
- Community-based model of care to improve access to and utilization of health services for common non-communicable diseases among culturally and linguistically diverse populations in Australia: an implementation research protocol.Archives of public health = Archives belges de sante publique · 2026Article
- Bayesian multilevel analysis of multimorbidity among women in Somalia: prevalence, patterns, and determinants.Archives of public health = Archives belges de sante publique · 2026Article
- Reciprocal innovation in implementation science and global health: reflections from the EXTRA-CVD (extending the HIV treatment cascade for cardiovascular disease prevention) study.BMC global and public health · 2026Review
- Strategies to integrate non-communicable disease interventions in HIV and tuberculosis care contexts in low- and middle-income countries: a scoping review.BMJ global health · 2026Article
- Service-Delivery Models to Increase the Uptake of Non-Communicable Disease Screening in South-Central Ethiopia: A Difference-In-Differences Analysis.Diseases (Basel, Switzerland) · 2024Article
- Effectiveness of community-based interventions for prevention and control of hypertension in sub-Saharan Africa: A systematic review.PLOS global public health · 2024Article
- Programmatic Cost-Effectiveness of a Second-Time Visit to Detect New Tuberculosis and Diabetes Mellitus in TB Contact Tracing in Myanmar.International journal of environmental research and public health · 2022Article
- Trained health extension workers correctly identify high blood pressure in rural districts of northwest Ethiopia: a diagnostic accuracy study.BMC health services research · 2022Article
- Peer support and social networking interventions in diabetes self-management in Kenya and Uganda: A scoping review.PloS one · 2022Article
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundThe burdens of hypertension and diabetes are increasing in low- and middle-income countries (LMICs). It is important to identify patients with these conditions early in the disease process. The goal of this study, therefore, is to compare community- versus home-based screening for hypertension and diabetes in Kenya.
methodsThis was a feasibility study conducted by the Academic Model Providing Access to Healthcare (AMPATH) program in Webuye, a town in western Kenya. Home-based (door-to-door) screening occurred in March 2010 and community-based screening in November 2011. HIV counselors were trained to screen for diabetes and hypertension in the home-based screening with local district hospital based staff conducting the community-based screening. Participants >18 years old qualified for screening in both groups. Counselors referred all participants with a systolic blood pressure (SBP) ≥ 160 mmHg and/or a random blood glucose ≥ 7 mmol/L (126 mg/dL) to a local clinic for follow-up. Differences in likelihood of screening positive between the two strategies were compared using Fischer's Exact Test. Logistic regression models were used to identify factors associated with the likelihood of following-up after a positive screening.
resultsThere were 236 participants in home-based screening: 13 (6%) had a SBP ≥ 160 mmHg, and 54 (23%) had a random glucose ≥ 7 mmol/L. There were 346 participants in community-based screening: 35 (10%) had a SBP ≥ 160 mmHg, and 27 (8%) had a random glucose ≥ 7 mmol/L. Participants in community-based screening were twice as likely to screen positive for hypertension compared to home-based screening (OR=1.93, P=0.06). In contrast, participants were 3.5 times more likely to screen positive for a random blood glucose ≥ 7 mmol/L with home-based screening (OR=3.51, P<0.01). Rates for following-up at the clinic after a positive screen were low for both groups with 31% of patients with an elevated SBP returning for confirmation in both the community-based and home-based group (P=1.0). Follow-up after a random glucose was also low with 23% returning in the home-based group and 22% in the community-based group (P=1.0).
conclusionCommunity- or home-based screening for diabetes and hypertension in LMICs is feasible. Due to low rates of follow-up, screening efforts in rural settings should focus on linking cases to care.
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