Depression and its associated factors among adult hypertensive patients attending follow-up in South Gondar zone public hospitals, Ethiopia, 2023.

INTRODUCTION: Depression is the most common public health issue affecting the world's population. Like patients with other chronic medical diseases, hypertensive patients experience many intense emotions which increase their risk for the development of depression. This study aimed to assess the magnitude of depression and its associated factors among hypertensive patients in South Gondar zone governmental hospitals, Northwest Ethiopia, 2023. METHODS: An institutional-based cross-sectional study was used in government hospitals of South Gondar Zone. A total of 311 patients were sampled randomly and included in the study. Statistical Package for Social Sciences (SPSS) version 25 was used for analysis. Data were analyzed mainly by using descriptive statistics and binary logistics regression. RESULTS: A total of 311 patients participated with a 100% response rate. Almost half of the participants were female. The mean age of the respondents was 58.85 years. More than 60% of the respondents had a co-morbid illness. Among participants, 83 (26.7%) of hypertensive patients had depression. Being female, age, uneducated, having poor social support, the presence of co-morbid illness and complications, uncontrolled hypertension, having less than or equal to two dietary regimen and duration of hypertension greater than ten years were significantly associated with depression. CONCLUSION: The magnitude of depression was found to be high. This indicated that depression is a common co-morbid illness among hypertensive patients. Healthcare professionals and other stakeholders should consider and diagnose co-morbid diseases like depression among hypertensive patients. It is also better to give particular emphasis to highly vulnerable groups like females, elders, uneducated and those who have poor social support.

Correction: Delayed ART initiation in "Test and Treat era" and its associated factors among adults receiving antiretroviral therapy at public health institutions in Northwest Ethiopia: A multicenter cross-sectional study.

[This corrects the article DOI: 10.1371/journal.pone.0271127.].

Wasting and its associated factors among children aged from 6 to 59 months in Debre Tabor town, Amhara region of Ethiopia, 2019: a multicentre community-based cross-sectional study.

OBJECTIVES: Wasting is acute malnutrition that has harmful short-term consequences for children and is determined by an inadequate diet. This study aimed to assess the prevalence and associated factors of wasting among children aged 6-59 months in Debre Tabor town, Ethiopia. DESIGN: This study was a community-based cross-sectional. SETTING: The study was conducted at Debre Tabor town, Ethiopia. PARTICIPANTS: A total of 436 children aged 6-59 months participants were enrolled. OUTCOME MEASURES: A weight-for-height z-score, which is below -2 SD of the WHO median standard curve, was used to measure wasting. Logistic regression analyses were done to see which independent variables have an association with the dependent variable and a p value of <0.05 was considered significant at the 95% CI. RESULTS: The result revealed that wasting in children aged 6-59 months was 6.2%. Children in the age group of 6-11 months were 4.3 times more likely to have wasted than those in the age group of 24-59 months (adjusted OR (AOR): 4.3; 95% CI: 1.5 to 12.5). Similarly, parents who have poor wealth status in their family are 3.1 times more likely to have wasted children than those who have rich wealth status in their family (AOR: 3.1 (1.01 to 9.35)). Moreover, mothers who gave birth at the age group of 20-25 years were 4.3 times more likely to have wasted children than those who gave birth at an age group of greater than 30 years (AOR: 4.3 (4.3 (1.56 to 12.5)). CONCLUSION: Wasting is still an important public health problem for children in the age group of 6-59 months. The age of the child, the wealth status of the family, and giving birth before 20 years of age were significantly associated with wasting. Therefore, the government of Ethiopia should pay further attention to the wealth status of the family; create awareness among the mothers regarding childhood undernutrition care, and design further nutritional intervention programmes.

The magnitude of common mental illness and associated factors among adult holy water users in Amhara regional state Orthodox Tewahido churches, Ethiopia, 2021.

BACKGROUND: Because they are prevalent, persistent, and have substantial negative effects on physical health, psychological well-being, and economic implications, common mental illnesses like depression, anxiety, and somatic complaints are major public health problems. Patients with mental illness are devoted to religious therapy including holy water as a coping mechanism for their illnesses. The aim of this study was to investigate the magnitude and associated factors of common mental illness among adult holy water users. METHODS: Facility-based cross-sectional study design was conducted in Amhara regional state orthodox Tewahido churches. A simple random sampling techinque was used to select participants. Data were collected by using the Brief Psychiatric Rating Scale for mental illnesses symptoms and a structured interviewer administered questionnaire was used. Data were entered into EpiData version 4.6 and exported to SPSS version 25 for analysis. Variables with a p-value of 0.25 in the bivariable logistic regression were entered into multivariable logistic regression. RESULT: Three hundred eighty-two participants were involved in the study. The magnitude of Common mental illnesses among holy water users was 58.9%. Unemployed, using more than one substance, having Poor and moderate social support, current daily alcohol drinker and past history of mental illness were significantly associated with common mental illness. CONCLUSION: The magnitude of common mental illness among adult holy water users was high. Giving special attention to decreasing unemployment, establishing social support services, and decreasing substance utilization are the keys to preventing common mental illnesses.

Underweight and its associated factors among pediatrics attending HIV Care in South Gondar Zone public health facilities, Northwest Ethiopia, 2021.

BACKGROUND: Malnutrition associated with HIV infection is a complex condition, with HIV-positive children having a higher mortality rate than HIV-negative children, resulting in significant morbidity and mortality in children. Data from a variety of situations are needed to counter this, but the evidence is limited, especially for the nutritional status of HIV-infected children. Therefore, this study aims to assess the magnitude of underweight and factors associated with it in children receiving antiretroviral therapy. METHODS: An institutional-based cross-sectional study was conducted among HIV-positive children in South Gondar, Northwest Ethiopia. Data were collected using an interviewer-administered questionnaire and anthropometry measurement. Data were coded and entered into Epi-Data Version 3.1 and analyzed using SPSS Version 25. Bivariable and multivariable binary logistic regression models were used to identify factors associated with nutritional status and variables with p-values ˂0.05 in multivariable logistic regression were considered as statistically significant factors. RESULTS: Of 406 participants, 379 participant were included in the study, which corresponds to a response rate of 93.3%. About one-third (36.4%) of the caregivers were not first relatives and 162 (42.7%) were unable to read and write. Of the study participants, 101 (26.6%) had a CD4 count below the normal threshold. Ninety (23.7%) of those questioned did not follow any nutritional advice from health care workers. In this study, the prevalence of underweight was 106 (28%). In the multivariable analysis being younger age, having low CD4 count, having recurrent diarrhea, and having poor adherence to dietary advice was significantly associated with being underweight. CONCLUSION: This study found that the prevalence of underweight among HIV-positive children in south Gondar is significantly high. Therefore, HIV-positive pediatrics who are young, have low CD4 counts, have recurrent diarrhea, and do not adhere to dietary recommendations need to detect and monitor nutritional problems promptly.

Magnitude of birth asphyxia and its associated factors among live birth in north Central Ethiopia 2021: an institutional-based cross-sectional study.

BACKGROUND: The leading cause of neonatal death worldwide is birth asphyxia. Yearly, in the first month of life, 2.5 million children died around the world. Birth asphyxia is a major problem, particularly in developing nations like Ethiopia. The goal of this study was to determine the magnitude of birth asphyxia and the factors that contributed to it among neonates delivered at the Aykel Primary Hospital in north-central Ethiopia. METHODS: From August 1 to August 31, 2021, a hospital-based cross-sectional study was conducted on 144 live births. An Apgar score less than 7 in the fifth minute of birth authorized the diagnosis of birth asphyxia. Variable contention (P < 0.250) for multivariable analysis was determined after data examination and cleaning. Then, to identify important factors of birth asphyxia, a multivariable logistic regression model with a p-value of 0.05 was developed. Finally, a significant relationship between a dependent variable and independent factors was defined as a p-value less than 0.05 with a 95% confidence interval. RESULTS: The majority of the mothers, 71.53%, received at least one Antenatal care visit, and more than half of the newborns were male (62.50%). The percentage of neonates that had asphyxia at delivery was 11.11% (95% CI: 6.3 -16.9%). Male newborns were 5.02 times more probable than female newborns to asphyxiate [AOR: 5.02, 95% CI (1.11-22.61)]. Mothers who have not had at least one Antenatal Care visit were 3.72 times more likely to have an asphyxiated newborn than those who have at least one Antenatal Care visit [AOR: 3.72, 95%CI (1.11-12.42)]. Similarly, mothers who had an adverse pregnancy outcome were 7.03 times more likely to have an asphyxiated newborn than mothers who had no such history [AOR: 7.03, 95% CI (2.17-22.70)]. CONCLUSION: Birth asphyxia in newborn has come to a standstill as a major public health issue. The sexual identity of the newborn, Antenatal Care visits, and a history of poor pregnancy outcomes were all found to be significant risk factors for birth asphyxia. These findings have great importance for various stakeholders who are responsible for reducing birth asphyxia; in addition, policymakers should establish and revise guidelines associated to newborn activities and workshops.

Delayed ART initiation in "Test and Treat era" and its associated factors among adults receiving antiretroviral therapy at public health institutions in Northwest Ethiopia: A multicenter cross-sectional study.

BACKGROUND: Antiretroviral therapy (ART) has shown promising effects on the reduction of new HIV infection as well as HIV-related morbidity and mortality. In order to boost the effect of ART on ending HIV epidemics by 2030, the World Health Organization (WHO) indeed introduced a universal test and treat strategy in 2015 that recommends rapid (within seven days) initiation of ART for all HIV-positive patients. However, in low-income countries, a substantial number of HIV-positive patients were not enrolled in time, and information on delayed ART initiation status in Ethiopia is limited. METHOD: A multicenter cross-sectional study was conducted on 400 HIV-positive adults receiving ART at public health institutions in Bahir Dar city, Northwest Ethiopia. A structured checklist was used to extract data from the patient's medical record. Data was entered into Epi-data version 4.6 and exported to SPSS version 26 for further analysis. Both simple and multivariable binary logistic regressions were executed, and variables with a p-value < 0.05 in the final model were considered significant predictors of delayed ART initiation. RESULTS: The magnitude of delayed ART initiation was 39% (95% CI: 34%-44%). Being male [Adjusted odds ratio(AOR) = 1.99, 95%CI:1.3-3.2], having opportunistic infections (OIs) [AOR = 2.50, 95%CI:1.4-4.6], having other chronic diseases [AOR = 3.70,95%CI:1.7-8.3], substance abuse [AOR = 3.79, 95%CI: 1.9-7.4], having ambulatory functional status [AOR = 5.38, 95%CI: 1.4-9.6] and didn't have other HIV-positive family member [AOR = 1.85, 95%CI: 1.2-2.9] increases the odds of delayed ART initiation. CONCLUSION AND RECOMMENDATION: The burden of delayed ART initiation is found to be high. The presence of OIs and other chronic problems, substance abuse, ambulatory functional status, being male, and not having other HIV-positive family members were identified as significant predictors of delayed ART initiation. Special emphasis needs to be considered for those individuals with the identified risk factors.

Prevalence of timely complementary feeding initiation and associated factors among mothers having children aged 6-24 months in rural north-central Ethiopia: Community based cross-sectional study.

BACKGROUND: Complementary foods are defined as any solid or liquid foods other than breast milk offered to children. Timely initiation of complementary foods during infancy is necessary for growth and development. The first two years of life are important period for rapid physical, cognitive and social development that requires optimal nutrition. Currently, there is no study done in this rural community about timely initiation of complementary feeding. OBJECTIVE: The main aim of this study was to assess the prevalence of timely initiation of complementary feeding among mothers having children aged 6-24 months in Farta district, rural Ethiopia. METHODS: A community-based cross-sectional study was employed from December 2020 to February 2021 among 570 mothers by using multi-stage sampling techniques. Data were collected using a structured interviewer-administered questionnaire and entered into Epi Data 4.6 then transferred to Statistical Package for Social Science version 25 for analysis. Bivariate and multivariable logistic regression analysis with a 95% confidence interval carried out to determine the association between explanatory and the outcome variables. A P-value of < 0.05 was considered statistically significant. RESULTS: The prevalence of timely initiation of complementary feeding among mothers having children aged 6-24 months was 51.9%. Institutionaldelivery [(AOR = 2.10, 95% CI: (1.31-3.32)],Keeping livestock [(AOR = 2.21, 95% CI: (1.35, 3.65)], Postnatal follow up [(AOR = 0.60, 95% CI:(0.36, 0.77)],merchants [(AOR = 4.58; 95% CI:1.99, 10.55)], and daily labourer [(AOR = 2.88, 95% CI:(1.50-5.51)] were statistically associated with timely initiation of complementary feeding. CONCLUSION: This finding revealed that the prevalence of timely initiation of complementary feeding is still low. Factors affecting timely initiations of complementary feeding were home delivery, unable to attend postnatal care follow-up, being housewife and farmers. All health professionals including health extension workers should give special attention to advising and counseling for mothers and their husbands about timely initiation of complementary feeding.

Potential determinant factors of under-five mortality in the Amhara region of Ethiopia.

BACKGROUND: Even though child mortality decreased greatly (44%, since 1990), children in developing countries are eight times more likely to die before they attain their five years birthday. When comparing under-five mortality around the world, the African including Ethiopia and Southeast Asian regions showed an uneven child death rate. Therefore, this study was aimed to identify the potential determinant factors of under-five mortality in the Amhara regional state of Ethiopia. METHODS: Statistics from a national representative cross-sectional survey of the Ethiopian Demographic and Health Survey (EDHS) of the year 2016 were used. Data was collected from the population of all under-five children in randomly selected enumeration areas of the Amhara region of Ethiopia. To investigate the relationship between the dependent variable (under-five mortality) and various independent factors, inferential statistics such as binary logistic regression and multiple logistic regressions were used. In multivariable analysis, statistically significant variables in binary logistic regression analysis, i.e. (p-value 0.250), were entered, and P-value 0.050 was considered significant at 95% CI. RESULTS: The survey was included 977 children under the age of five and more than half of children in the family (68%) were ≤ 4. The findings showed that children whose mothers had no formal education were 2.59 times more likely to die than children whose mothers had formal education [AOR: 2.59(1.12-5.99)]. Similarly, children who did not receive breastfeeding from their mothers were 3.61 times more likely to die than children who received breastfeeding from their mothers [AOR: 3.61(1.83-6.19)]. CONCLUSION AND RECOMMENDATION: The number of children in the family, as well as the mother's educational status and current breastfeeding status, were all found to be important factors in under-five mortality in the study area. As a result, the potential determinants of under-five mortality should be addressed as part of a program targeted at lowering childhood mortality.

Clinical Non-Adherence and Its Associated Factors Among HIV-Positive Pediatric Patients Attending HIV Care in South Gondar Zone Public Health Facilities, Northwest Ethiopia, 2021.

BACKGROUND: Poor clinical adherence is the main factor that hinders ART adherence level in children and its ultimate effect on viral load suppression and decreasing morbidity and mortality of children. Although data from different settings are necessary to tackle such types of problems, the pieces of evidence are limited in the case of clinical adherence level. Therefore, this study was intended to assess clinical non-adherence and its associated factors among HIV-infected pediatrics on highly active antiretroviral therapy. METHODS: A multi-center cross-sectional study was conducted from July 1 to August 30, 2021, among HIV-infected children receiving ART in the South Gondar Zone. Data were collected through face-to-face interviews, and reviewing patients' documents using a structured checklist. Data were entered into Epi-data version 4.6 and exported to the Statistical Package for Social Science version 23 for analysis. Binary logistic regression was used to assess the association between the factors and the outcome variable. The significance of variables was declared when a p-value was less than 0.05. RESULTS: From 422 participants, 383 have involved in the study making the response rate of 90.7%. Almost half of the study participants 190 (49.6%) were girls. Two hundred ninety-one (76%) of caretakers were biological mothers, and 203 (53%) did not have adherence supporters. About 179 (46.7%) of caretakers did not disclose the status of the child about the illness. The overall prevalence of non-adherence among children on ART was 31.9% (95% CI: 27.2-36.6). Rural residency, diagnostic status non-disclosure, no adherence supporter, having no biological caretaker and co-morbid illness were significantly associated with clinical non-adherence of HIV positive children. CONCLUSION: Clinical non-adherence among children among HIV-positive children attending care in south Gondar zone health facilities is unacceptably high. Attention shall be given to HIV-positive pediatrics who reside in rural areas, whose status was not disclosed, had no adherence supporter, had a non-biological caretaker, and had comorbidity to have good clinical adherence on ART service.

Magnitude of mortality and its associated factors among Burn victim children admitted to South Gondar zone government hospitals, Ethiopia, from 2015 to 2019.

BACKGROUND: Burn is one of the leading causes of preventable death and disability every year in low and middle-income countries, which mainly affects those aged less than 15 years. Death from burn injuries carries the most significant losses, which often have grave consequences for the countries. Even though data from different settings are necessary to tackle it, pieces of evidence in this area are limited. Thus, this study was aimed to answer the question, what is the Magnitude of Mortality? And what are the factors associated with mortality among burn victim children admitted to South Gondar Zone Government Hospitals, Ethiopia, from 2015 to 2019? METHODS: Institutional-based cross-sectional study design was used to study 348 hospitalized burn victim pediatrics', from 2015 to 2019. A simple random sampling method was used. Data were exported from Epidata to SPSS version 23 for analysis. Significant of the variables were declared when a p-value is < 0.05. RESULT: The mortality rate of burn victim children in this study was 8.5% (95% CI = 5.5-11.4). Medical insurance none users burn victim children were more likely (AOR 3.700; 95% CI =1.2-11.5) to die as compared with medical insurance users, burn victim children with malnutrition were more risk (AOR 3.9; 95% CI = 1.3-12.2) of mortality as compared with well-nourished child. Moreover, electrical (AOR 7.7; 95% CI = 1.8-32.5.2) and flame burn (AOR 3.3; 95% CI = 1.2-9.0), total body surface area greater than 20% of burn were more likely (AOR 4.6; 95% CI 1.8-11.8) to die compared to less than 20% burn area and burn victim children admitted with poor clinical condition at admission were four times (AOR 4.1, 95% CI = 1.3-12.0) of mortality compared to a good clinical condition. CONCLUSION: The mortality among burn victim children was higher than most of the studies conducted all over the world. Medical insurance none users, being malnourished, burned by electrical and flame burn, having total body surface area burnt greater than 20%, and having poor clinical condition at addition were significantly associated with mortality of burn victim pediatrics. Therefore, timely identification and monitoring of burn injury should be necessary to prevent mortality of burn victim pediatrics.

Knowledge on Stroke Warning Signs and Associated Factors Among Hypertensive Patients, Northwest Ethiopia: An Institution-Based Cross-Sectional Study.

INTRODUCTION: Stroke is one of the leading causes of death globally and is a major cause of disability worldwide. It is a preventable and treatable disease by the prevention of modifiable risk factors and early recognition of warning signs, respectively. OBJECTIVE: To assess knowledge on stroke warning signs and associated factors among hypertensive patients at South Gondar Zone Comprehensive Specialized Hospital, Northwest Ethiopia, 2020. METHODS: An institution-based cross-sectional study was conducted in South Gondar Zone Comprehensive Specialized Hospital from June 1-30, 2020. A systematic random sampling technique was used and data were collected through face to face interviews. Data were entered into Epi data version 4.6.0.0 and exported to SPSS version 25 for cleaning and analysis. Bivariate and multivariable logistic regression analysis was used and variables with p <0.05 in the multivariable analysis were considered as statistically significant. RESULTS: Two hundred and fifty-three hypertensive patients completed the questionnaire with a response rate of 100%. Among the total respondents, 15% (95% CI: 10.7, 19.4) of participants had good knowledge of stroke warning signs. Younger age (AOR: 2.82; 95% CI: 1.18, 6.74), urban residence (AOR: 2.9; 95% CI: 1.04, 8.11), being educated (AOR: 2.6; 95% CI: 1.09, 6.23) and having long duration hypertension follow up (AOR: 2.7; 95% CI: 1.25, 5.81) were significantly associated with good knowledge of stroke warning signs. CONCLUSION: This study revealed that participants had poor knowledge of stroke warning signs. Younger age, urban residence, being educated and having long duration hypertension follow up were predictors of good stroke warning signs knowledge. Health information dissemination needs to be strengthened for hypertensive patients, particularly for older, rural residents, the non-educated and those having short duration of hypertension follow up.

Under-nutrition and associated factors among children on ART in Southern Ethiopia: a facility-based cross-sectional study.

BACKGROUND: Malnutrition is very common in HIV-infected individuals. Even though data from different settings are necessary to tackle it, pieces of evidence are limited especially in the case of the nutritional status of HIV-infected children. Hence, this study aims to assess the nutritional status and associated factors among children on antiretroviral therapy. METHODS: An institutional-based cross-sectional study was conducted among 383 HIV-positive children in Southern Ethiopia. Data were collected using an interviewer-administered questionnaire and anthropometry measurement. Data were coded and entered into Epi-Data Version 3.1 and analyzed using SPSS Version 25. Bi-variable and multi-variable binary logistic regression models were used to identify factors associated with nutritional status and variables with p-values <0.05 in multi-variable logistic regression were considered as statistically significant. RESULTS: The prevalence of wasting among HIV-positive children in Southern Ethiopiaselected Hospitals was 36.3% (95% CI, 31.6-41.0) while stunting on the same study population was 5.5% (95% CI, 3.4-7.8). Rural residence, lack of maternal education, low CD4 counts (< 500), using an unprotected water source, having a non-biological mother and recurrent oral lesion were significantly associated with wasting. Furthermore, history of hospital admission, recurrent oral lesion, low CD4 counts (< 500), advanced WHO clinical stage were statically associated with stunting with p-value < 0.05. CONCLUSION: This study found that the prevalence of under-nutrition among HIV-positive children in Ethiopia was significantly high. Therefore, timely identification and monitoring of nutritional problems should be necessary to enhance the effectiveness of ART treatment and to prevent further related complications.

Nurses' cleaning practice of non-critical medical equipment in the era of COVID 19: A cross-sectional study in Debre-Tabor comprehensive specialized hospital.

OBJECTIVES: This study was aimed at assessing the cleaning practice of non-critical medical equipment (NCME) in the era of corona virus disease-2019 of nurses working in Debre-Tabor comprehensive specialized hospital (DTCSH), north-central Ethiopia. DESIGN: Facility based cross-sectional study was conducted in DTCSH, Ethiopia, from July 05 to August 05, 2020. SETTING: The study was conducted in inpatient and outpatient units of the hospital. PARTICIPANTS: A total of 76 randomly selected staff nurses and 6 head nurses were included for observational study and interview respectively. RESULTS: Only 1.3%-5.3% of nurses cleaned stethoscopes, thermometers, pulse oximeters, and glucometers right after using these devices for patients. None of them cleaned the blood pressure apparatus before or after checking a patient's blood pressure and glucometer before determining blood glucose levels. Lack of disinfecting materials and lack of training on infection prevention were perceived by head nurses as major barriers for proper cleaning practices. CONCLUSION: Nurses' cleaning practice of NCME was very low. Therefore, proper supply of materials needed to clean these devices need to be secured. Besides, nurses need to get training on infection prevention.

Knowledge on Prevention of Stroke and Its Associated Factors Among Hypertensive Patients at Debre Tabor General Hospital: An Institution-Based Cross-Sectional Study.

INTRODUCTION: Globally, stroke is the second leading cause of death. About 70% of strokes were occurring in low- and middle-income countries, and high blood pressure is the main risk factor of stroke due to its poor recognition of stroke prevention methods. Therefore, the study aimed to assess knowledge on stroke prevention and its associated factors among hypertensive patients at Debre-Tabor General Hospital, Northwest Ethiopia, 2020. METHODS: An institutional-based cross-sectional study was conducted in Debre-Tabor General Hospital from February 20 to March 20/2020. A systematic random sampling technique was used. Data were collected through an interviewer-administered questionnaire. Data were entered into Epi data version 4.2.0.0 and exported to SPSS version 25 for cleaning and analysis. A reliability test was done, and the Cronbach alpha coefficient value was 0.709. Bivariate and multivariable binary logistic regression analyses were done, and variables with a p-value of ≤0.05 in the multivariable analysis were considered as statistically significant at a 95% confidence interval. RESULTS: From 423 study participants, 410 of them responded completely and a response rate is 96.92%. Among the total respondents, 24.9% (95% CI: 20.7, 29.3) of participants had good knowledge of stroke prevention methods. Young age (AOR: 2.082; 95% CI (1.071, 4.049)), urban residence (AOR: 3.230; 95% CI (1.665, 6.267)), and having long followed-up duration (AOR: 3.015; 95% CI (1.870, 4.861)) were factors associated with good knowledge on stroke prevention methods. CONCLUSION: This study revealed that participants had poor knowledge of stroke prevention. Young age, urban residence, and having long duration hypertension follow-up were predictors of good knowledge on stroke prevention. These findings have immense importance of different stakeholders that have responsibilities on the reduction of hypertension complications characteristically stroke. Further, it is chief for health-care providers for hypertension intervention activities.