The hidden magnitude of raised blood pressure and elevated blood glucose in Ethiopia: A call for initiating community based NCDs risk factors screening program
Introduction: The burden of raised blood pressure and elevated blood glucose in sub-Saharan Africa has been increasing over the last couple of decades. However, a large proportion of the population with raised blood pressure and elevated blood glucose remain undiagnosed contributing to the increasing burden of the problem. There is paucity of published studies describing the burden of major NCDs in sub –Saharan Africa. Likewise, except very few studies in some pocket areas, there was no representative NCD risk factor survey undertaken in Ethiopia. This paper focuses on the data extracted from the survey on the prevalence of selected NCDs to elaborate more on the issues and to show the invisible magnitude of the two major health problems for policy and program development.
Methods: A cross sectional study was conducted in Ethiopia using the WHO step-wise approach to the surveillance of NCD risk factors. The survey was carried out between April and June 2015. The data collection processes included three steps. Step 1: This step comprised of a questionnaire to gather demographic and behavioural characteristics of the study population; Step 2: Physical measurement was done to build on the core data in Step 1 and to determine proportion of the study population with raised blood pressure, overweight and obesity; and Step 3: Biochemical measurements were undertaken to build on the core data in step 1 and step 2 to measure proportion of the study population with diabetes, raised blood glucose and abnormal lipid level. Data were collected digitally using personal digital assistants (PDAs) from which data were transferred to central server using internet file streaming system (IFSS). Data were cleaned and analysed using a combination of softwares namely, SPSS, Stata and Epi Info version 3.5.4.
Results: The survey included 9,788 study participants and of this, 77% had never been measured for blood pressure prior to current survey. However, based on the measurements made during the present survey among all respondents who were not taking medication for raised blood pressure, 15.6% (95% CI: 14.4-16.9) had raised blood pressure level ( SBP of ≥140 mmHg and/or a DBP of ≥90 mmHg). Likewise, among all respondents, 97 % had never been tested for blood sugar level prior to present survey. However, the current study revealed a total of 5.7 % of the study population had a blood glucose level of ≥ 110 mg/dl, with 6% (95% CI: 4.7-7.2) in men, and 5.8 %( 95% CI: 4.6-7.0) in women.
Conclusions: The prevalence of undiagnosed raised blood pressure and elevated blood sugar was high in Ethiopia and only very small percentage of people had been aware of their high blood pressure and elevated blood sugar. Policy makers in the health sector including other health development partners need to strengthen health system and design nation-wide population based strategy to establish community based screening program for blood pressure and blood glucose. [Ethiop. J. Health Dev. 2017;31(Special Issue):362-369]
Key words: Hidden magnitude, history, blood pressure, blood glucose, NCDs.