Care cascades for hypertension and diabetes: Cross-sectional evaluation of rural districts in Tanzania

• DOI: 10.1371/journal.pmed.1004140
• Publication Date: 2022-12-05T18:29:26Z
• Authors: Brianna Osetinsky; Grace Mhalu; Sally Mtenga; Fabrizio Tediosi
• Keywords: Cross-sectional study

Noncommunicable diseases (NCDs), especially hypertension and diabetes, are rapidly rising in sub-Saharan Africa, necessitating health systems transformations. In Tanzania, current policies aim to improve control of but information is still needed assess the gaps treatment.We conducted a cross-sectional household survey 784 adults two districts Tanzania from December 2020 January 2021, capturing cascade-of-care for diabetes. The ages respondents ranged 18 89 years. Of those screened positive these conditions, we measured proportion each step cascades: awareness, care engagement, treatment, control. We multivariable logistic regression analyses all four steps along cascade with independent variables social protection schemes, prior diagnosis comorbid demographic information. our sample, 771 who had their blood pressure measured, 41% (95% confidence interval (CI): 38% 44%) were hypertension, 707 sugar 6% CI: 4% 8%) 43% 49%) diagnosis, 25% 21% 31%) engaged care, 3% 25%) on 11% 8% 15%) controlled. 42 80% 69% 93%) diagnosis. diabetes much less drop-off, so 66% 52% 82%) 48% 32% 63%) controlled at point testing. Healthcare fee exemptions independently associated higher odds being previously diagnosed (OR 5.81; 95% CI [1.98 17.10] p < 0.005), 4.71; [1.59 13.90] retained treatment 2.93; [1.03 8.35] 0.05). Prior was highly 3.26; [1.39 7.63] 0.005). primary limitations this study reliance screening single time only people available village sample dependence self-report inform three healthcare visits engagement use.The high burden low levels underscores importance improving awareness hypertension. differences cascades demonstrates that chronic NCD possible setting, efforts will be across entire