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Caseload, management and treatment outcomes of patients with hypertension and/or diabetes mellitus in a primary health care programme in an informal setting
Author(s) -
Sobry Agnes,
Kizito Walter,
Van den Bergh Rafael,
TaylerSmith Katie,
Isaakidis Petros,
Cheti Erastus,
Kosgei Rose J.,
Vandenbulcke Alexandra,
Ndegwa Zacharia,
Reid Tony
Publication year - 2014
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12210
Subject(s) - medicine , diabetes mellitus , body mass index , blood pressure , pediatrics , primary care , emergency medicine , family medicine , endocrinology
Objective In three primary health care clinics run by Médecins Sans Frontières in the informal settlement of Kibera, Nairobi, Kenya, we describe the caseload, management and treatment outcomes of patients with hypertension ( HT ) and/or diabetes mellitus ( DM ) receiving care from January 2010 to June 2012. Method Descriptive study using prospectively collected routine programme data. Results Overall, 1465 patients were registered in three clinics during the study period, of whom 87% were hypertensive only and 13% had DM with or without HT . Patients were predominantly female (71%) and the median age was 48 years. On admission, 24% of the patients were obese, with a body mass index ( BMI ) > 30 kg/m 2 . Overall, 55% of non‐diabetic hypertensive patients reached their blood pressure ( BP ) target at 24 months. Only 28% of diabetic patients reached their BP target at 24 months. For non‐diabetic patients, there was a significant decrease in BP between first consultation and 3 months of treatment, maintained over the 18‐month period. Only 20% of diabetic patients with or without hypertension achieved glycaemic control. By the end of the study period, 1003 (68%) patients were alive and in care, one (<1%) had died, eight (0.5%) had transferred out and 453 (31%) were lost to follow‐up. Conclusion Good management of HT and DM can be achieved in a primary care setting within an informal settlement. This model of intervention appears feasible to address the growing burden of non‐communicable diseases in developing countries.