Hypertension Research Programme - HT01
Utilizing HIV/AIDS infrastructure as a gateway to chronic care of hypertension in Africa
Project locations: Uganda, Rwanda, and South Africa
Project duration: 2012 - 2017
- Canadian Institutes for Health Research (CIHR)
- Grand Challenges Canada (GCC)
- International Development Research Centre
- Canadian Stroke Network
The introduction of highly active antiretroviral therapy (HAART) has improved life expectancy but has also been found to increase the risk of hypertension, and cardiometabolic diseases in general. Limited data is available on local trends in cardiovascular risk and how non-communicable diseases (NCDs) are screened, assessed and managed in HIV positive people.
Primary research aim
The study aims to investigate the presence of cardiovascular risk factors in patients attending antiretroviral treatment facilities. Furthermore, perceptions and attitudes of HIV-clinic health care workers and attendees to co-management of HIV and non-communicable diseases will be explored. These findings are to inform intervention programs seeking to ensure optimum integrated HIV and NCD care to HIV+ individuals.
Research objectives and methodology
In phase 1, a cross-sectional survey will be conducted among people with HIV receiving care across randomly selected urban and non-urban public health facilities in Western Cape. Phase 2 uses focus groups and key-informant interviews in an exploratory design to triangulate and explore the integrated care for HIV/AIDS and NCDs simultaneously from the perspective of different role-players.
After approval of the study selected sites were invited to enroll in the study. Of the initial 30 sites put forward 5 were immediately declined by the local authorities due to other large scale on-going piloting studies in the selected areas while a further 11 sites were declined from a district level. A few of the declined sites were replaced and the present number of sites in the study are 18 (13 urban and 5 non-urban). Oversampling took place in the larger sites and a total of 640 participants have so far been screened. Although initially planned to run concurrently with phase 1 it soon became clear that it was necessary to first obtain enough knowledge about the function of the HIV treatment facilities before implementing phase 2. So far 3 focus groups and 2 key-informant interviews have been conducted.
Lessons learned so far include the challenges of conducting such a study in the protected health care facilities.
Project contact: Jamie Forrest – jforrest [at] geshealth.com
- University of Ottawa (Canada) - Dr Amber Featherstone, Dr Edward Mills and Prof Ivy Bourgeault & Dr Sanni Yaya
- University of Calgary (Canada) - Dr Norm Campbell
- Simon Fraser University (Canada) - Dr Michel Joffres
- McMaster University (Canada) - Dr P J Deveraux and Dr Lehana Thabane
- University of British Columbia (Canada) - Dr Richard Lester, Dr Nick Bansback
- Medecins San Frontieres - Mr Nathan Ford
- South African Medical Research Council (South Africa) - Dr Andre Kengne, Dr Anniza de Villiers
- Stellenbosch University (South Africa) - Dr Jean Nachega
- Rhodes University (South Africa) - Prof Isadore Kanfer
- Makerere University (Uganda) - Dr Robert Kalyesubula
- Mildmay Uganda (Uganda) - Dr Emmanuel Luyirika, Dr Barbara Mukasa
- IntraHealth Rwanda (Rwanda) - Dr Julius Kamwesiga
- Rwanda Ministry of Health (Rwanda) - Mr Jean Claude Tayari, Dr Vincent Mutabazi
- Global Evaluative Sciences (Canada) – Jamie Forrest
- Mateen FJ, Kanters S, Kalyesubula R, Mukasa B, Kawuma E, Kengne AP et al.Hypertension prevalence and Framingham risk score stratification in a large HIV-positive cohort in Uganda. J Hypertens. 2013;31(7):1372-8; discussion 8. doi:10.1097/HJH.0b013e328360de1c.
- Nguyen K, Peer N, Mills E, Kengne AP. Burden, determinants, and pharmacological management of hypertension in HIV-positive patients and populations. AIDS Reviews, 2015 Apr-Jun; 17(2):83-95
- Deuboué Tchialeu RI, Yaya S, Labonté R. Health Systems Readiness to Manage the Hypertension Epidemic in Primary Health Care Facilities in the Western Cape, South Africa: A Study Protocol JMIR Res Protoc 2016;5(1):e35, DOI: 10.2196/resprot.5381 PMID: 26925539 PMCID: 4791525
- Nguyen, K. A., Peer, N., de Villiers, A., Mukasa, B., Matsha, T. E., Mills, E. J., & Kengne, A. P. (2016). The Distribution of Obesity Phenotypes in HIV-Infected African Population. Nutrients, 8(6), 299. doi:10.3390/nu8060299
- Nguyen KA, Peer N, Mills EJ, Kengne AP. A Meta-Analysis of the Metabolic Syndrome Prevalence in the Global HIV-Infected Population. PLoS One. 2016 Mar 23;11(3):e0150970. doi: 10.1371/journal.pone.0150970. eCollection 2016.