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The burden of hypertension in the emergency department and linkage to care: A prospective cohort study in Tanzania.

Publication ,  Journal Article
Galson, SW; Stanifer, JW; Hertz, JT; Temu, G; Thielman, N; Gafaar, T; Staton, CA
Published in: PLoS One
2019

OBJECTIVES: Globally, hypertension affects one billion people and disproportionately burdens low-and middle-income countries. Despite the high disease burden in sub-Saharan Africa, optimal care models for diagnosing and treating hypertension have not been established. Emergency departments (EDs) are frequently the first biomedical healthcare contact for many people in the region. ED encounters may offer a unique opportunity for identifying high risk patients and linking them to care. METHODS: Between July 2017 and March 2018, we conducted a prospective cohort study among patients presenting to a tertiary care ED in northern Tanzania. We recruited adult patients with a triage blood pressure ≥ 140/90 mmHg in order to screen for hypertension. We explored knowledge, attitudes and practices for hypertension using a questionnaire, and assessed factors associated with successful follow-up. Hypertension was defined as a single blood pressure measurement ≥ 160/100 mmHg or a three-time average of ≥ 140/90 mmHg. Uncontrolled hypertension was defined as a three-time average measurement of ≥ 160/100 mmHg. Successful follow-up was defined as seeing an outpatient provider within one month of the ED visit. RESULTS: We enrolled 598 adults (mean age 59.6 years), of whom 539 (90.1%) completed the study. The majority (78.6%) of participants were aware of having hypertension. Many (223; 37.2%) had uncontrolled hypertension. Overall, only 236 (43.8%) of participants successfully followed-up within one month. Successful follow-up was associated with a greater understanding that hypertension requires lifelong treatment (RR 1.11; 95% CI 1.03,1.21) and inversely associated with greater anxiety about the future (RR 0.80; 95% CI 0.64,0.99). CONCLUSION: In a northern Tanzanian tertiary care ED, the burden of hypertension is high, with few patients receiving optimal outpatient care follow-up. Multi-disciplinary strategies are needed to improve linkage to care for high-risk patients from ED settings.

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Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2019

Volume

14

Issue

1

Start / End Page

e0211287

Location

United States

Related Subject Headings

  • Young Adult
  • Triage
  • Tertiary Care Centers
  • Tanzania
  • Prospective Studies
  • Middle Aged
  • Male
  • Hypertension
  • Humans
  • General Science & Technology
 

Citation

APA
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ICMJE
MLA
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Galson, S. W., Stanifer, J. W., Hertz, J. T., Temu, G., Thielman, N., Gafaar, T., & Staton, C. A. (2019). The burden of hypertension in the emergency department and linkage to care: A prospective cohort study in Tanzania. PLoS One, 14(1), e0211287. https://doi.org/10.1371/journal.pone.0211287
Galson, Sophie W., John W. Stanifer, Julian T. Hertz, Gloria Temu, Nathan Thielman, Temitope Gafaar, and Catherine A. Staton. “The burden of hypertension in the emergency department and linkage to care: A prospective cohort study in Tanzania.PLoS One 14, no. 1 (2019): e0211287. https://doi.org/10.1371/journal.pone.0211287.
Galson SW, Stanifer JW, Hertz JT, Temu G, Thielman N, Gafaar T, et al. The burden of hypertension in the emergency department and linkage to care: A prospective cohort study in Tanzania. PLoS One. 2019;14(1):e0211287.
Galson, Sophie W., et al. “The burden of hypertension in the emergency department and linkage to care: A prospective cohort study in Tanzania.PLoS One, vol. 14, no. 1, 2019, p. e0211287. Pubmed, doi:10.1371/journal.pone.0211287.
Galson SW, Stanifer JW, Hertz JT, Temu G, Thielman N, Gafaar T, Staton CA. The burden of hypertension in the emergency department and linkage to care: A prospective cohort study in Tanzania. PLoS One. 2019;14(1):e0211287.

Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2019

Volume

14

Issue

1

Start / End Page

e0211287

Location

United States

Related Subject Headings

  • Young Adult
  • Triage
  • Tertiary Care Centers
  • Tanzania
  • Prospective Studies
  • Middle Aged
  • Male
  • Hypertension
  • Humans
  • General Science & Technology