Prevalence and access to care for cardiovascular risk factors in older people in Sierra Leone: a cross-sectional survey
Introduction Prevalence of cardiovascular disease risk factors (CVDRFs) is increasing, especially in low-income countries. In Sierra Leone, there is limited empirical data on the prevalence of CVDRFs, and there are no previous studies on the access to care for these conditions.Methods This study in...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2020-09-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e038520.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841553633845444608 |
|---|---|
| author | Justine Davies Rachel Nugent Ioannis Bakolis Haja Wurie Maria Lisa Odland Miles Witham Rashid Ansumana Tahir Bockarie Joseph Lamin |
| author_facet | Justine Davies Rachel Nugent Ioannis Bakolis Haja Wurie Maria Lisa Odland Miles Witham Rashid Ansumana Tahir Bockarie Joseph Lamin |
| author_sort | Justine Davies |
| collection | DOAJ |
| description | Introduction Prevalence of cardiovascular disease risk factors (CVDRFs) is increasing, especially in low-income countries. In Sierra Leone, there is limited empirical data on the prevalence of CVDRFs, and there are no previous studies on the access to care for these conditions.Methods This study in rural and urban Sierra Leone collected demographic, anthropometric measurements and clinical data from randomly sampled individuals over 40 years old using a household survey. We describe the prevalence of the following risk factors: diabetes, hypertension, dyslipidaemia, overweight or obesity, smoking and having at least one of these risk factors. Cascades of care were constructed for diabetes and hypertension using % of the population with the disease who had previously been tested (‘screened’), knew of their condition (‘diagnosed’), were on treatment (‘treated’) or were controlled to target (‘controlled’). Multivariable regression was used to test associations between prevalence of CVDRFs and progress through the cascade for hypertension with demographic and socioeconomic variables. In those with recognised disease who did not seek care, reasons for not accessing care were recorded.Results Of 2071 people, 49.6% (95% CI 49.3% to 50.0%) of the population had hypertension, 3.5% (3.4% to 3.6%) had diabetes, 6.7% (6.5% to 7.0%) had dyslipidaemia, 25.6% (25.4% to 25.9%) smoked and 26.5% (26.3% to 26.8%) were overweight/obese; a total of 77.1% (76.6% to 77.5%) had at least one CVDRF. People in urban areas were more likely to have diabetes and be overweight than those living in rural areas. Moreover, being female, more educated or wealthier increased the risk of having all CVDRFs except for smoking. There is a substantial loss of patients at each step of the care cascade for both diabetes and hypertension, with less than 10% of the total population with the conditions being screened, diagnosed, treated and controlled. The most common reasons for not seeking care were lack of knowledge and cost.Conclusions In Sierra Leone, CVDRFs are prevalent and access to care is low. Health system strengthening with a focus on increased access to quality care for CVDRFs is urgently needed. |
| format | Article |
| id | doaj-art-a751e868b0bd441bbf910b679c6d624f |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-a751e868b0bd441bbf910b679c6d624f2025-01-09T07:05:12ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2020-038520Prevalence and access to care for cardiovascular risk factors in older people in Sierra Leone: a cross-sectional surveyJustine Davies0Rachel Nugent1Ioannis Bakolis2Haja Wurie3Maria Lisa Odland4Miles Witham5Rashid Ansumana6Tahir Bockarie7Joseph Lamin8King’s Centre for Global Health and Health Partnerships, King`s College London, London, UKDepartment of Global Health, University of Washington, Washington, Washington, USADepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UKNIHR Research Unit of Health in Fragility, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra LeoneDepartment of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, NorwayNIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne NHS Foundation Trust, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, UKNjala University, Bo, Sierra LeoneWarwick Medical School, University of Warwick, Coventry, UKMercy Hospital Research Laboratory, Bo, Sierra LeoneIntroduction Prevalence of cardiovascular disease risk factors (CVDRFs) is increasing, especially in low-income countries. In Sierra Leone, there is limited empirical data on the prevalence of CVDRFs, and there are no previous studies on the access to care for these conditions.Methods This study in rural and urban Sierra Leone collected demographic, anthropometric measurements and clinical data from randomly sampled individuals over 40 years old using a household survey. We describe the prevalence of the following risk factors: diabetes, hypertension, dyslipidaemia, overweight or obesity, smoking and having at least one of these risk factors. Cascades of care were constructed for diabetes and hypertension using % of the population with the disease who had previously been tested (‘screened’), knew of their condition (‘diagnosed’), were on treatment (‘treated’) or were controlled to target (‘controlled’). Multivariable regression was used to test associations between prevalence of CVDRFs and progress through the cascade for hypertension with demographic and socioeconomic variables. In those with recognised disease who did not seek care, reasons for not accessing care were recorded.Results Of 2071 people, 49.6% (95% CI 49.3% to 50.0%) of the population had hypertension, 3.5% (3.4% to 3.6%) had diabetes, 6.7% (6.5% to 7.0%) had dyslipidaemia, 25.6% (25.4% to 25.9%) smoked and 26.5% (26.3% to 26.8%) were overweight/obese; a total of 77.1% (76.6% to 77.5%) had at least one CVDRF. People in urban areas were more likely to have diabetes and be overweight than those living in rural areas. Moreover, being female, more educated or wealthier increased the risk of having all CVDRFs except for smoking. There is a substantial loss of patients at each step of the care cascade for both diabetes and hypertension, with less than 10% of the total population with the conditions being screened, diagnosed, treated and controlled. The most common reasons for not seeking care were lack of knowledge and cost.Conclusions In Sierra Leone, CVDRFs are prevalent and access to care is low. Health system strengthening with a focus on increased access to quality care for CVDRFs is urgently needed.https://bmjopen.bmj.com/content/10/9/e038520.full |
| spellingShingle | Justine Davies Rachel Nugent Ioannis Bakolis Haja Wurie Maria Lisa Odland Miles Witham Rashid Ansumana Tahir Bockarie Joseph Lamin Prevalence and access to care for cardiovascular risk factors in older people in Sierra Leone: a cross-sectional survey BMJ Open |
| title | Prevalence and access to care for cardiovascular risk factors in older people in Sierra Leone: a cross-sectional survey |
| title_full | Prevalence and access to care for cardiovascular risk factors in older people in Sierra Leone: a cross-sectional survey |
| title_fullStr | Prevalence and access to care for cardiovascular risk factors in older people in Sierra Leone: a cross-sectional survey |
| title_full_unstemmed | Prevalence and access to care for cardiovascular risk factors in older people in Sierra Leone: a cross-sectional survey |
| title_short | Prevalence and access to care for cardiovascular risk factors in older people in Sierra Leone: a cross-sectional survey |
| title_sort | prevalence and access to care for cardiovascular risk factors in older people in sierra leone a cross sectional survey |
| url | https://bmjopen.bmj.com/content/10/9/e038520.full |
| work_keys_str_mv | AT justinedavies prevalenceandaccesstocareforcardiovascularriskfactorsinolderpeopleinsierraleoneacrosssectionalsurvey AT rachelnugent prevalenceandaccesstocareforcardiovascularriskfactorsinolderpeopleinsierraleoneacrosssectionalsurvey AT ioannisbakolis prevalenceandaccesstocareforcardiovascularriskfactorsinolderpeopleinsierraleoneacrosssectionalsurvey AT hajawurie prevalenceandaccesstocareforcardiovascularriskfactorsinolderpeopleinsierraleoneacrosssectionalsurvey AT marialisaodland prevalenceandaccesstocareforcardiovascularriskfactorsinolderpeopleinsierraleoneacrosssectionalsurvey AT mileswitham prevalenceandaccesstocareforcardiovascularriskfactorsinolderpeopleinsierraleoneacrosssectionalsurvey AT rashidansumana prevalenceandaccesstocareforcardiovascularriskfactorsinolderpeopleinsierraleoneacrosssectionalsurvey AT tahirbockarie prevalenceandaccesstocareforcardiovascularriskfactorsinolderpeopleinsierraleoneacrosssectionalsurvey AT josephlamin prevalenceandaccesstocareforcardiovascularriskfactorsinolderpeopleinsierraleoneacrosssectionalsurvey |