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Hypertension screening, awareness, treatment, and control: a study of their prevalence and associated factors in a nationally representative sample from Nepal.

Authors
  • Dhungana, Raja Ram1
  • Pedisic, Zeljko1
  • Dhimal, Meghnath2
  • Bista, Bihungum2
  • de Courten, Maximilian3
  • 1 Institute for Health and Sport, Victoria University, Melbourne, Australia. , (Australia)
  • 2 Nepal Health Research Council, Kathmandu, Nepal. , (Nepal)
  • 3 Mitchell Institute for Education and Health Policy, Victoria University, Melbourne, Australia. , (Australia)
Type
Published Article
Journal
Global Health Action
Publisher
Informa UK (Taylor & Francis)
Publication Date
Dec 31, 2022
Volume
15
Issue
1
Pages
2000092–2000092
Identifiers
DOI: 10.1080/16549716.2021.2000092
PMID: 35132939
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The growing burden of hypertension is emerging as one of the major healthcare challenges in low- and middle-income countries (LMICs), such as Nepal. Given that they are struggling to deliver adequate health services, some LMICs have significant gaps in the cascade of hypertension care (including screening, awareness, treatment, and control). This results in uncontrolled hypertension, placing a high burden on both patients and healthcare providers. The objective of this study was to quantify the gaps in hypertension screening, awareness, treatment, and control in the Nepalese population. We used the data from a pooled sample of 9682 participants collected through two consecutive STEPwise approach to Surveillance (STEPS) surveys conducted in Nepal in 2013 and 2019. A multistage cluster sampling method was applied in the surveys, to select nationally representative samples of 15- to 69-year-old Nepalese individuals. Prevalence ratios were calculated using multivariable Poisson regression. Among the hypertensive participants, the prevalence of hypertension screening was 65.9% (95% CI: 62.2, 69.5), the prevalence of hypertension awareness was 20% (95% CI: 18.1, 22.1), the prevalence of hypertension treatment was 10.3% (95% CI: 8.8, 12.0), and the prevalence of hypertension control was 3.8% (95% CI: 2.9, 4.9). The unmet need of hypertension treatment and control was highest amongst the poorest individuals, the participants from Lumbini and Sudurpaschim provinces, those who received treatment in public hospitals, the uninsured, and those under the age of 30 years. The gaps in the cascade of hypertension care in Nepal are large. These gaps are particularly pronounced among the poor, persons living in Lumbini and Sudurpaschim provinces, those who sought treatment in public hospitals, those who did not have health insurance, and young people. National- and local-level public health interventions are needed to improve hypertension screening, awareness, treatment, and control in Nepal.

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