P61 High rates of health clinic attendance following identification of high cardiovascular disease risk using a health extension worker mediated community screening pilot study in Ethiopia. (26th August 2022)

• Record Type: Journal Article
• Authors: Kedir, Kiya; Mesfin, Firaol; Getachew, Hailemichael; Hailu, Belachew; Geremew, Bezinash; Levitt, Naomi; Okop, Kufre; Howe, Rawleigh
• Is Part Of: Journal of epidemiology and community health. Volume 76(2022)Supplement 1
• Page Start: A73
• Page End: A74
• Publication Date: 2022-08-26
• Subjects: Cardiovascular risk screening; Public health -- Periodicals; Epidemiology -- Periodicals; 614.4
• DOI: 10.1136/jech-2022-SSMabstracts.154
• Languages: English
• ISSNs: 0143-005X

Abstract

Abstract : Background: Cardiovascular disease (CVD) and its risk factors are rising in sub-Saharan Africa, and community level screening has been advocated. The present study was a pilot utilizing lessons learned from previous citizen science (CS)-based research into community perceptions of CVD risk. The goal was to assess the feasibility of community CVD screening, assess rates of voluntary clinic attendance, and explore reasons for non-attendance. Methods: A total of 1300 community members were screened from 10 health clinic catchment areas representing urban (Addis Ababa, Adama) and multiple rural sites of increasing distance from Adama in Ethiopia. 12 health extension workers (HEW) from the sites areas underwent comprehensive training, in part based on experiences from prior citizen science based research into community level CVD risk perception. All health care practitioners at referral clinics had been provided with training in non-communicable disease care by either government or nongovernment organization based courses. Community participants were identified by door-to-door screening, given introductory education into the study using a non-language-based set of visual tools oriented by CS research, and a standard structured questionnaire with participant information captured on a mobile tablet and later transferred to a database for analysis. Community participants were identified with at least a 10% 1-year CVD risk as assessed by a modified Framingham tool using body mass index in replace of cholesterol, referred to neighboring health clinic, and followed up by HEW one month later. Results: More 95% of community members identified agreed to participate in the study, and of those 9.1% of rural and 13.9% of urban participants were found to have CVD risk. 62% had either prior or current hypertension, 22% had a history of diabetes, 49% were overweight, 12% were smokers, and nearly all > 40 years of age. After one month follow-up, 74% of those with risk had attended a local clinic. Those with prior diagnoses of hypertension and/or diabetes had identical rates of clinic attendance as those without such diagnoses. Of those attending clinics, 63% were provided medication scripts, and 97% provided with counselling. 89% of those attending clinics indicated they intended to continue future follow-up. Among those who did not follow-up 25% cited financial difficulty, 45% inconvenience, and 25% answered that they felt fine and saw no point to attend. Conclusion: We observed high rates of acceptance of screening and referral to health clinics in Ethiopia by a pilot community level CVD screening study.