Abstract
Background: Hypertension (HT) and diabetes mellitus (DM) affect millions of individuals in South Africa and are among the leading causes of morbidity and mortality. Given the substantial public health and socio-economic burden South Africa faces due to the rising rates of chronic diseases, prevention strategies with community engagement may play a vital role in controlling these diseases and their associated sequelae.Objectives and methods: Project HOPE, an implementing partner of the Lilly Non Communicable Disease (NCD) Partnership programme in South Africa, conducted screening days and home visits as part of a non-communicable disease awareness campaign in the Zandspruit suburb of western Johannesburg (lower income, informal settlement). Standardised assessment tools were used, which included glucose and blood pressure measurement.Results: Of 7607 participants screened, 2773/7470 (37.1%) of those with blood pressure values could be classified as hypertensive with systolic blood pressure (BP) ≥ 140 mmHg or diastolic BP ≥ 90 mmHg. Of the 7607 glucose screened individuals, 630 (8.3%) had referable random capillary glucose levels ≥ 7.8 mmol/l. There was a clear gradient of increased prevalence over age and body mass index (BMI) categories.Conclusions: In this urban low-income suburb hypertension was common with hyperglycaemia less so. The number of participants returning to the clinic for confirmation of diagnoses was less than optimal and highlights the problem of community- based screening.
Highlights
Hypertension (HT) and diabetes mellitus (DM) affect millions of individuals in South Africa and are among the leading causes of morbidity and mortality
In 2011, within the broad category of Non Communicable Disease (NCD), stroke, hypertensive heart disease, diabetes mellitus (DM) and chronic kidney disease have been identified to account for 30% of the 9.5 million deaths, and 25.8% of the 675.4 million disability-adjusted life years (DALYs) recorded.[1]
Data from the Study on Global Ageing and Adult Health (SAGE), conducted by the World Health Organization (WHO), which surveyed more than 35 000 people aged 50 and over in South Africa, China, Ghana, India, Mexico and Russia, found that 78% of those who took part in South Africa had hypertension.[3]
Summary
Hypertension (HT) and diabetes mellitus (DM) affect millions of individuals in South Africa and are among the leading causes of morbidity and mortality. The American Diabetes Association’s guideline recommends that testing to detect type 2 diabetes and prediabetes in asymptomatic people should be considered in adults of any age who are overweight or obese (BMI ≥ 25 kg/m2) and who have one or more additional risk factors for diabetes. In those without these risk factors, testing should begin at age 45 years. They state that to test for diabetes or prediabetes, the A1C, FPG, or 2-hour 75-g OGTT are appropriate.[4]
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