ArticleBMJ open2018
Linkage to primary care after home-based blood pressure screening in rural KwaZulu-Natal, South Africa: a population-based cohort study.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Trial
- Community based interventions for the primary prevention of cardiovascular disease in women living in rural, regional and remote areas: a scoping review.BMC health services research · 2026Article
- Association between body mass index, demographics, and hypertension risk in South African university students.BMC public health · 2026Article
- A formative evaluation of potential barriers and facilitators to inform effective implementation of a community-based hypertension care program in rural South Africa: The IMPACT-BP trial.SSM - health systems · 2025Article
- Prevalence and associations of hypertension detection, treatment and control in Cape Town.BMC public health · 2025Article
- Examining the referral of patients with elevated blood pressure to health resources in an under-resourced community in South Africa.BMC public health · 2024Article
- Effectiveness of community-based interventions for prevention and control of hypertension in sub-Saharan Africa: A systematic review.PLOS global public health · 2024Article
- Improvements in Hypertension Control in the Rural Longitudinal HAALSI Cohort of South African Adults Aged 40 and Older, From 2014 to 2019.American journal of hypertension · 2023Article
- Integrating health services for HIV infection, diabetes and hypertension in sub-Saharan Africa: a cohort study.BMJ open · 2021Article
- Cohort Profile Update: Africa Centre Demographic Information System (ACDIS) and population-based HIV survey.International journal of epidemiology · 2021Article
- Pitfalls of Single Measurement Screening for Diabetes and Hypertension in Community-Based Settings.Global heart · 2021Article
- Article
- BMI and All-Cause Mortality in a Population-Based Cohort in Rural South Africa.Obesity (Silver Spring, Md.) · 2020Article
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Authors and funding
11 authors.
Funding
Abstract
objectivesThe expanding burden of non-communicable diseases (NCDs) globally will require novel public health strategies. Community-based screening has been promoted to augment efficiency of diagnostic services, but few data are available on the downstream impact of such programmes. We sought to assess the impact of a home-based blood pressure screening programme on linkage to hypertension care in rural South Africa.
settingWe conducted home-based blood pressure screening withinin a population cohort in rural KwaZulu-Natal, using the WHO Stepwise Approach to Surveillance (STEPS) protocol.
participantsIndividuals meeting criteria for raised blood pressure (≥140 systolic or ≥90 diastolic averaged over two readings) were referred to local health clinics and included in this analysis. We defined linkage to care based on self-report of presentation to clinic for hypertension during the next 2 years of cohort observation. We estimated the population proportion of successful linkage to care with inverse probability sampling weights, and fit multivariable logistic regression models to identify predictors of linkage following a positive hypertension screen.
resultsOf 11 694 individuals screened, 14.6% (n=1706) were newly diagnosed with elevated pressure. 26.9% (95% CI 24.5% to 29.4%) of those sought hypertension care in the following 2 years, and 38.1% (95% CI 35.6% to 40.7%) did so within 5 years. Women (adjusted OR (aOR) 2.41, 95% CI 1.68 to 3.45), those of older age (aOR 11.49, 95% CI 5.87 to 22.46, for 45-59 years vs <30) and those unemployed (aOR 1.71, 95% CI 1.10 to 2.65) were more likely to have linked to care.
conclusionsLinkage to care after home-based identification of elevated blood pressure was rare in rural South Africa, particularly among younger individuals, men and the employed. Improved understanding of barriers and facilitators to NCD care is needed to enhance the effectiveness of blood pressure screening in the region.
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