Data from: Low levels of hypertension screening in HIV care clinics in rural Uganda: a mixed methods study
Data files
Aug 12, 2024 version files 144.42 KB
Abstract
Background: The prevalence of hypertension (HTN) among people living with HIV (PLHIV) has increased over the last decade globally. Given the dual burden of disease and significant prior investment in HIV care, integrating care for HTN and HIV is recommended. However, data on HTN screening, treatment, and control prior to such integration are lacking. Using a mixed-methods approach, we assessed the baseline status of HTN screening, treatment, and control in 52 Ugandan public health facilities, participating in an ongoing cluster randomised trial of an integrated HIV/HTN care model.
Methods: From November 2020 to March 2021, we reviewed patient records and randomly sampled 50 PLHIV without a documented HTN diagnosis per health facility and all PLHIV with a documented HTN diagnosis per health facility. We surveyed the sampled participants, took their blood pressure measurements, and described the HTN care cascade. We also conducted in-depth interviews with 24 patients and 12 providers to explore their experience with HTN screening and care. We used an in-depth thematic approach to analyze the resulting qualitative data.
Results: Among 2,645 PLHIV, <1% (20/2,645) reported having their BP measured within 6 months before the survey. The prevalence of HTN was 13.6% (359/2,645), including 287 (10.5%) newly diagnoses and 32 (1.2%) prior diagnoses that were not documented in their health record. Of 49 (1.9%) with a previously documented HTN diagnosis, 31 (63%) were on HTN treatment, and 53% had controlled HTN. In-depth interviews with providers and patients revealed a lack of blood pressure equipment, high patient load, limited technical HTN knowledge, and patients' fear of anticipated long waiting times as reasons for low HTN screening in the HIV clinics.
Conclusion: Regular screening for the detection of HTN patients was hardly performed. There is an urgent need for interventions to advance the integration of HTN care in HIV clinics.
README: Low levels of hypertension screening in HIV care clinics in rural Uganda: a mixed methods study
https://doi.org/10.5061/dryad.9p8cz8wqg
This is the data from a baseline status assessment of Hypertension (HTN) screening, treatment, and control in 52 Ugandan public health facilities, participating in an ongoing cluster randomized trial of an integrated HIV/HTN care model. The study was funded by the European and Developing Countries Clinical Trials Partnership (EDCTP).
From November 2020 to March 2021, we reviewed patient records and randomly sampled 50 persons living with HIV (PLHIV) without a documented HTN diagnosis per health facility and all PLHIV with a documented HTN diagnosis per health facility. We surveyed the sampled participants, took their blood pressure measurements, and described the HTN care cascade.
Description of the data and file structure
The data provided are in a comma-separated-value (CSV) file that includes variable names as column headers.
The data file name is Uganda_Int_HIV_HTN_baseline_EUopensci.deident.v3.csv
The corresponding data dictionary is an excel document filename is Uganda_Int_HIV_HTN_baseline_EUopensci.datadictionary.v3.xlsx
| Variable Name | Question | Variable Type | Variable Codes |
|---|---|---|---|
| hc_code | Health Center (coded) | Numeric | De-identifed code |
| clinicid | Participant/Clinic ID: collected from the ART card/register - deidentified | Numeric | De-identifed code |
| age_category | Age <=40 | Numeric | 0 = age > 40 1 = age <= 40 |
| female | Reported as female | Numeric | 0 = Male 1=Female |
| artyr | Years on ART - calculated from ART start date (grouped) | Numeric | 1 = up_to_1_year 2 = from_2_to_5 3 = from_6_to_9 4 = from_10_to_35 |
| hc4 | Is Clinic a Health Center 4 level | Numeric | 0 = No 1 = Yes |
| smoke | Current smoking | Numeric | 1 = Yes 2 = No |
| alcohol | Current alcohol use | Numeric | 1 = Yes 2 = No |
| overweight | Obesity or overweight | Numeric | 0 = No 1 = Yes -9 = missing |
| marital_status | Current marital status | Numeric | 1 = Single never married 2 = Married/Cohabitating 3 = Divorced/ separated/ widowed -9 = missing |
| exercise | Lack of physical work or exercise | Numeric | 0 = No 1 = Yes |
| bpmdate6mon | Blood pressure measured in last 6 months at clinic | Numeric | 0 = No 1 = Yes |
| htn_now | Prior HTN diagnosis or prior HTN diagnosis not documented in health record or new HTN diagnosis | Numeric | 0 = No 1 = Yes |
| category | Patient category at baseline visit | Numeric | 1 = HTN 2 = No known HTN |
| prior_unknown | Prior HTN diagnosis not documented in health record | Numeric | 0 = No 1 = Yes |
| new_dx | New HTN diagnosis at visit | Numeric | 0 = No 1 = Yes |
| bpfinal | Final BP recording (Sys/Dia): | String | Sys/Dia -9/-9 = missing |
| htn_stage | Severity of HTN during the survey categorized using the 2020 guidelines of the American Society of Hypertension and the International Society of Hypertension | Numeric | 0 = Normal (<140/90 mmHg) 1 = Grade 1 (140-159/90-99) 2 = Grade 2 (160-179/100-109) 3 = Grade 3 (>=180/110) |
| treat | On HTN treatment | Numeric | 0 = No 1 = Yes |
Sharing/Access information
This data is shared as required by the publishing journal and under the terms of the Creative Commons Zero "No rights reserved" data waiver (CC0 1.0 Public domain dedication)(http://creativecommons.org/publicdomain/zero/1.0/)
Methods
Data Collection: From November 2020 to March 2021, we reviewed patient records and randomly sampled 50 PLHIV without a documented HTN diagnosis per health facility and all PLHIV with a documented HTN diagnosis per health facility. We surveyed the sampled participants, took their blood pressure measurements, and described the HTN care cascade.
Data Processing: Data included is the raw data collected from EMR and study surveys.