Prevalence of hypertension and its associated factors in Hawassa city administration, Southern Ethiopia: Community based cross-sectional study.

BACKGROUND: In association with the epidemiological, nutritional and demographic transition, many research findings showed that the number of risk factors that leads to increased prevalence of hypertension in low and middle income countries like Ethiopia is increasing. Several urban specific studies conducted in Ethiopia showed varying prevalence of hypertension. The aim of this study was to determine prevalence of hypertension and to identify factors associated with hypertension in Hawassa city administration, Southern Ethiopia. METHODS: A community-based cross sectional study was carried out in Hawassa city administration in 2017. A multi-stage sampling technique was used to select 612 study participants. Descriptive statistics was used to describe socio-demographic, behavioral and anthropometric variables. The economic status of household, 'wealth index', was constructed by running principal component analysis. Binary logistic regression analysis was performed to assess factors associated with hypertension at 95%CI. RESULTS: The overall prevalence of hypertension was 21.2% (95% CI: 18.1-24.7), (24.5% for urban and 14.7% for peri-urban). About two fifths of hypertension cases (42.3%) were newly diagnosed with elevated blood pressure during data collection. Age, occupation, wealth status, consuming vegetables and animal fat, usual mode of transport, body mass index (BMI), family history of hypertension and existence of diabetes were associated with presence of hypertension at 95%CI. The average diastolic blood pressure for urban was 2.18mmHg higher than that of peri-urban groups (p-0.01). CONCLUSION: More than one fifth of study participants had hypertension and about two fifths of hypertension cases were newly diagnosed. Health communication should be strengthened focusing on identified risk factors and attention should be given to early detect and tackle the effects of hypertension in resource limited setting.

A simple tool to evaluate the antiretroviral therapy programme in primary health care setting of Lesotho.

AIM: An evaluative tool for the antiretroviral therapy programme was developed for use in the primary health care setting of Lesotho. BACKGROUND: Information on processes followed in the development of standardized and acceptable evaluative tools is not always available to practicing nurses. METHODS: Behaviours affecting the antiretroviral therapy (ART) programme were contextualized using the conceptual model for social programmes and Intervention Wheel framework. A convergent parallel mixed-methods design was used to describe perceptions and explore experiences of nurses and patients. The Instrument Development Construct Validation process was used to develop an evaluative tool that was pre-tested on 17 respondents. Results were analysed using SPSS (23), and internal consistency using Cronbach's alpha coefficient was .768. RESULTS: The tool collects information on staffing patterns, services offered, patients seen, time spent seeking services, consultation time, Antiretroviral (ARV) availability, staff adequacy, staff competency, equipment adequacy, service efficiency, activity documentation, patient satisfaction, job satisfaction, monitoring and evaluation. CONCLUSIONS: The evaluative tool permits identification of factors affecting delivery of the ART programme, hence assisting nurses to improve services provided. IMPLICATIONS FOR NURSING MANAGEMENT: This method can be used to develop evaluative tools to assess implementation of public health services and inform successes, challenges and recognize improvement approaches.

Performance of the National Tuberculosis Control Program in the post conflict Liberia.

BACKGROUND: Tuberculosis is a major public health problem in Liberia. According to the World Health Organization (WHO), the incidence of tuberculosis in Liberia is significantly increasing from year to year. However, little is known about the performance of the programme and the challenges after the 14 years of civil war which ended in 2003.The purpose of the study was to evaluate the performance of the TB programme of Liberia. METHODS: The study utilised mixed research design; both quantitative and qualitative methods were used in this study conducted from 2013 to 2014. For the quantitative part of the study, a questionnaire, laboratory performance and eleven years TB programme data (2003-2013) were used. For the performance of tuberculosis laboratory testing, all the 107 functional tuberculosis microscopy centers in Liberia were included. For the qualitative part of the study, an interview of 10 informants and two focus group discussions (FGDs) were also conducted, each comprising of eight people. Themes and subthemes emerged from the two FGDs. Data was analysed in line with the Donabedian model. Quantitative findings were analysed and presented using both descriptive and inferential statistics. RESULTS: The study findings pointed out that there was overall improvement in the performance of the tuberculosis control programme in Liberia from 2003 to 2013. The percentage of cured patients was 60% in 2005 and 62% in 2013. Percentage of treatment completed was 16% in 2005 and 21% in 2013. The case detection rate was 57% and treatment success rate 80% in 2013. The default rate was 11% in 2013. Of the 139 participants, 120 (86%) completed TB treatment while 19 (14%) did not. CONCLUSION: Between 2003 and 2013, the National Leprosy and Tuberculosis Control Programme (NLTCP) succeeded in restoring the TB services and improving some of the TB treatment outcomes including the Directly observed treatment short courses(DOTS) coverage. Despite these improvements, the TB treatment, laboratory services and human resource capacity lagged behind. The TB programme of Liberia needs to develop new strategies to address its challenges.