Evaluating linkage to care for hypertension after community‐based screening in rural Uganda. Issue 4 (3rd February 2014)

• Record Type: Journal Article
• Authors: Kotwani, Prashant; Balzer, Laura; Kwarisiima, Dalsone; Clark, Tamara D.; Kabami, Jane; Byonanebye, Dathan; Bainomujuni, Bob; Black, Douglas; Chamie, Gabriel; Jain, Vivek; Thirumurthy, Harsha; Kamya, Moses R.; Geng, Elvin H.; Petersen, Maya L.; Havlir, Diane V.; Charlebois, Edwin D.
• Is Part Of: Tropical medicine & international health. Volume 19:Issue 4(2014:Apr.)
• Page Start: 459
• Page End: 468
• Publication Date: 2014-02-03
• Subjects: Tropical medicine -- Periodicals; Public health -- Periodicals; 616.988
• DOI: 10.1111/tmi.12273
• Languages: English
• ISSNs: 1360-2276

Abstract

<abstract abstract-type="main" id="tmi12273-abs-0001"> <title>Abstract</title> <sec id="tmi12273-sec-0001" sec-type="section"> <title>Objectives</title> <p>To determine the frequency and predictors of hypertension linkage to care after implementation of a linkage intervention in rural Uganda.</p> </sec> <sec id="tmi12273-sec-0002" sec-type="section"> <title>Methods</title> <p>During a multidisease screening campaign for HIV, diabetes and hypertension in rural Uganda, hypertensive adults received education, appointment to a local health facility and travel voucher. We measured frequency and predictors of linkage to care, defined as visiting any health facility for hypertension management within 6 months. Predictors of linkage to care were calculated using collaborative‐targeted maximum likelihood estimation (C‐TMLE). Participants not linking were interviewed using a standardised instrument to determine barriers to care.</p> </sec> <sec id="tmi12273-sec-0003" sec-type="section"> <title>Results</title> <p>Over 5 days, 2252 adults were screened for hypertension and 214 hypertensive adults received a linkage intervention for further management. Of these, 178 (83%) linked to care within 6 months (median = 22 days). Independent predictors of successful linkage included older age, female gender, higher education, manual employment, tobacco use, alcohol consumption, hypertension family history and referral to local <italic>vs</italic>. regional health centre. Barriers for patients who did not see care included expensive transport (59%) and feeling well (59%).</p> </sec> <sec id="tmi12273-sec-0004" sec-type="section"> <title>Conclusions</title> <p>A community health campaign that offered hypertension screening, education, referral appointment and travel voucher achieved excellent linkage to care (83%). Young adults, men and persons with low levels of formal education were among those least likely to seek care.</p> </sec> </abstract>