ArticleBMJ open2021
Integrating health services for HIV infection, diabetes and hypertension in sub-Saharan Africa: a cohort study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
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Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Integrated Care Models for HIV, Diabetes and Hypertension in Sub-Saharan Africa: A Systematic Review of Effectiveness, Implementation and Real-World Applicability.Journal of the International AIDS Society · 2026Pooled it
- Metformin for the prevention of diabetes among people with HIV and either impaired fasting glucose or impaired glucose tolerance (prediabetes) in Tanzania: a Phase II randomised placebo-controlled trial.Diabetologia · 2023 · on this mapTrial
- Implementing integrated care clinics for HIV-infection, diabetes and hypertension in Uganda (INTE-AFRICA): process evaluation of a cluster randomised controlled trial.BMC health services research · 2023Trial
- Article
- UNAIDS 95-95-95 targets in older people living with HIV in urban and rural KwaZulu-Natal, South Africa.BMC infectious diseases · 2026Article
- 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
- Observational
- Article
- A realist review to understand the complexity of effective management of type 2 diabetes and hypertension.Public health reviews · 2026Review
- Mixed methods assessment of an integrated hypertension and HIV care model: Acceptability, feasibility, and clinical outcomes at primary healthcare clinics in Wakiso District, Uganda.Journal of public health in Africa · 2026Article
- Linkage to and retention in chronic care among patients diagnosed with hypertension, diabetes, or HIV in DIMAMO PHRC clinics, South Africa.PLOS global public health · 2026Article
- Exploring barriers to hypertension medication adherence among people living with HIV enrolled in the iHEART-SA trial: a theoretical domains framework qualitative study.BMC public health · 2025Article
- Healthcare workers' perception of quality of care rendered to people living with HIV and non-communicable diseases at an urban district hospital in KwaZulu Natal, South Africa: a mixed mode study.BMC health services research · 2025Article
- Healthcare providers perspectives on HIV-NCD integration to Meet the needs of older adults living with HIV.BMC geriatrics · 2025Article
- Hypertension in Sub-Saharan Africa: Burden, Barriers and Priorities for Improving Treatment Outcomes.Circulation research · 2025Review
- Characterising acute and chronic care needs: insights from the Global Burden of Disease Study 2019.Nature communications · 2025Article
- Hypertension outcomes in a fragile setting: predictors of blood pressure reduction and control in the Central African Republic.Frontiers in public health · 2025Article
- HIV clinical outcomes among people with HIV and diabetes mellitus in Kampala, Uganda; A matched retrospective cohort study.PLOS global public health · 2025Article
- Digital continuous glucose monitoring systems for patients with HIV-diabetes comorbidity in Ethiopia: a situational analysis.Scientific reports · 2024Article
- Cost analysis of adding hypertension and diabetes management into routine HIV care in Mbarara and Ibanda districts, Uganda.BMC health services research · 2024Article
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Authors and funding
25 authors at 10 institutions in 4 countries.
Funding
Abstract
backgroundHIV, diabetes and hypertension have a high disease burden in sub-Saharan Africa. Healthcare is organised in separate clinics, which may be inefficient. In a cohort study, we evaluated integrated management of these conditions from a single chronic care clinic.
objectivesTo determined the feasibility and acceptability of integrated management of chronic conditions in terms of retention in care and clinical indicators. DESIGN AND
settingProspective cohort study comprising patients attending 10 health facilities offering primary care in Dar es Salaam and Kampala.
interventionClinics within health facilities were set up to provide integrated care. Patients with either HIV, diabetes or hypertension had the same waiting areas, the same pharmacy, were seen by the same clinical staff, had similar provision of adherence counselling and tracking if they failed to attend appointments. PRIMARY OUTCOME MEASURES: Retention in care, plasma viral load.
findingsBetween 5 August 2018 and 21 May 2019, 2640 patients were screened of whom 2273 (86%) were enrolled into integrated care (832 with HIV infection, 313 with diabetes, 546 with hypertension and 582 with multiple conditions). They were followed up to 30 January 2020. Overall, 1615 (71.1%)/2273 were female and 1689 (74.5%)/2266 had been in care for 6 months or more. The proportions of people retained in care were 686/832 (82.5%, 95% CI: 79.9% to 85.1%) among those with HIV infection, 266/313 (85.0%, 95% CI: 81.1% to 89.0%) among those with diabetes, 430/546 (78.8%, 95% CI: 75.4% to 82.3%) among those with hypertension and 529/582 (90.9%, 95% CI: 88.6 to 93.3) among those with multimorbidity. Among those with HIV infection, the proportion with plasma viral load <100 copies/mL was 423(88.5%)/478.
conclusionIntegrated management of chronic diseases is a feasible strategy for the control of HIV, diabetes and hypertension in Africa and needs evaluation in a comparative study.
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