Incidence and predictors of hypertension and hypertension treatment success among adults on ART in Blantyre and Zomba, Malawi
| dc.contributor.author | Nyirenda, Osward | |
| dc.date.accessioned | 2022-07-22T09:10:20Z | |
| dc.date.available | 2022-07-22T09:10:20Z | |
| dc.date.issued | 2022-06-09 | |
| dc.description | Type of study: It is retrospective cohort study | en_US |
| dc.description.abstract | Type of study: It is retrospective cohort study design embedded in a large randomized controlled clinical trial that recruited and followed HIV positive adults on ART from November 2012 to July 2018 in Blantyre and Zomba. Problem: People living with human immunodeficiency virus (PLHIV) are at increased risk of premature deaths due to cardiovascular diseases (CVD) compared to the general population because of additional HIV specific factors and exposure to antiretroviral therapy (ART) (1). Results from a cross-sectional study done by Dimala et.al (2016) demonstrated that hypertension is more prevalent in people on ART compared to ART naïve population (2). Few studies that have been conducted in sub-Saharan Africa (SSA) to understand the incidence and risk factors of hypertension in PLHIV, have reported conflicting results (3–5). Some studies have reported low incidence of hypertension (3) while other studies have reported high incidence of hypertension (4,5). In Malawi there is limited data regarding incidence of hypertension, risk factors of hypertension and factors that are associated with hypertension control. These gaps are very concerning in PLHIV given that this population is currently experiencing dual burden of infections and non-communicable diseases (NCD) (6). Thus, this study seeks to determine the incidence and risk factors of hypertension and factors that are associated with hypertension treatment control in adults on ART. The results from this study will provide knowledge to enhance equitable allocation of resources by the ART managers. If the managers know and understand the burden of hypertension and factors related to treatment success, they can retrain their staff and provide BP machines in ART clinics for the health care workers to routinely screen PLHIV for hypertension. Additionally, if we find high nonadherence to hypertensive treatment due to pill burden, we will advocate for antihypertensive treatment with a single pill combination (SPC) of two drugs along with appropriate lifestyle interventions. Objectives: The broad objective of this study is: • Too determine the incidence of hypertension among adults on ART in Blantyre and Zomba, Malawi between 2012 and 2018. The specific objectives are:To determine the prevalence of hypertension (Systolic BP ≥140mmHg, Diastolic BP ≥90mmHg) among PLHIV on ART screened between November 2012 and July 2018 in Zomba and Blantyre, Malawi • To determine the risk factors of hypertension among adult PLHIV on ART screened between 2012 and July 2018 in Zomba and Blantyre, Malawi. • To determine the risk factors for developing hypertension among adult PLHIV stable on ART and followed up between November 2012 and July 2018 in Zomba and Blantyre, Malawi • To determine the risk of uncontrolled hypertension among hypertensive PLHIV stable on ART who were recruited and followed up between November 2012 and July 2018 in Zomba and Blantyre, Malawi • To determine predictors of poor hypertension control among adult PLHIV stable on ART and followed up between November 2012 and July 2018 in Zomba and Blantyre, Malawi. Methodology: This is a retrospectiveprospective study design using data from a large randomized controlled clinical trial that was conducted from November 2012 to July 2018 which recruited HIV infected adults on ART in Blantyre at Blantyre Malaria Project (BMP), Ndirande Research Clinic and in Zomba at Dignitas International, Tisungane Research Clinic. Data was handed over to the Principal Investigator in an excel format. In the secondary analysis, we will extract data to the workable excel sheet before analysis. The sample size of 307 is ideal for this study, however, to ensure that our sample is well representative, we will analyze all 2, 237 screened participants and 1, 499 enrolled participants from the parent study. Expected findings and dissemination: This study will provide information on how many people develop hypertension in PLHIV on ART. This will eventually assist government to plan equitable allocation of resources to PLHIV on ART to mitigate hypertension. The study willalso provide information on whether it is time to advocate for one Single Pill Combination (SPC) for hypertension as the means to address pill burden which result in poor adherence of antihypertensives in PLHIV on ART. This will ensure that PLHIV on ART are able to control hypertension and live healthy life and able to participate in developmental activities in their communities. Results from this study will be presented at the College of Medicine Research Hypertension in PLHIV Version 3.02.0, 11 May12 March 2022 Page 8 of 26 Dissemination Conference and other international fora. We will also share the results with College of Medicine Research and Ethics Committee (COMREC) and the Ministry of Health in Malawi, NCD department. We will prepare a manuscript for a peer reviewed journal publication. | en_US |
| dc.description.sponsorship | Self Sponsored | en_US |
| dc.identifier.uri | http://rscarchive.kuhes.ac.mw/handle/20.500.12988/1035 | |
| dc.language.iso | en | en_US |
| dc.publisher | Kamuzu University of Health Sciences | en_US |
| dc.relation.ispartofseries | Protocol;P.02/22/3568 | |
| dc.title | Incidence and predictors of hypertension and hypertension treatment success among adults on ART in Blantyre and Zomba, Malawi | en_US |
| dc.type | Plan or blueprint | en_US |