Diagnostic testing for hypertension, diabetes, and hypercholesterolaemia in low-income and middle-income countries: a cross-sectional study of data for 994 185 individuals from 57 nationally representative surveys

Simple item page
dc.contributor.authorSophie Ochmann*
dc.contributor.authorIsabelle von Polenz*
dc.contributor.authorMaja-Emilia Marcus
dc.contributor.authorMichaela Theilmann
dc.contributor.authorDavid Flood
dc.contributor.authorKokou Agoudavi
dc.contributor.authorKrishna Kumar Aryal
dc.contributor.authorSilver Bahendeka
dc.contributor.authorBrice Bicaba
dc.contributor.authorPascal Bovet
dc.contributor.authorLuisa Campos Caldeira Brant
dc.contributor.authorDeborah Carvalho Malta
dc.contributor.authorAlbertino Damasceno
dc.contributor.authorFarshad Farzadfar
dc.contributor.authorGladwell Gathecha
dc.contributor.authorAli Ghanbari
dc.contributor.authorMongal Gurung
dc.contributor.authorDavid Guwatudde
dc.contributor.authorCorine Houehanou
dc.contributor.authorDismand Houinato
dc.contributor.authorNahla Hwalla
dc.contributor.authorJutta Adelin Jorgensen
dc.contributor.authorKhem B Karki
dc.contributor.authorNuno Lunet
dc.contributor.authorJoao Martins
dc.contributor.authorMary Mayige
dc.contributor.authorSahar Saeedi Moghaddam
dc.contributor.authorOmar Mwalim
dc.contributor.authorKibachio Joseph Mwangi
dc.contributor.authorBolormaa Norov
dc.contributor.authorSarah Quesnel-Crooks
dc.contributor.authorNegar Rezaei
dc.contributor.authorAbla M Sibai
dc.contributor.authorLela Sturua
dc.contributor.authorLindiwe Tsabedze
dc.contributor.authorRoy Wong-McClure
dc.contributor.authorJustine Davies
dc.contributor.authorPascal Geldsetzer
dc.contributor.authorTill Bärnighausen
dc.contributor.authorRifat Atun†
dc.contributor.authorJennifer Manne-Goehler†
dc.contributor.authorSebastian Vollmer†
dc.date.accessioned2024-03-01T11:13:22Z
dc.date.available2024-03-01T11:13:22Z
dc.date.issued2023-09
dc.description.abstractBackground—Testing for the risk factors of cardiovascular disease, which include hypertension, diabetes, and hypercholesterolaemia, is important for timely and effective risk management. Yet few studies have quantified and analysed testing of cardiovascular risk factors in low-income and middle-income countries (LMICs) with respect to sociodemographic inequalities. We aimed to address this knowledge gap. Methods—In this cross-sectional analysis, we pooled individual-level data for non-pregnant adults aged 18 years or older from nationally representative surveys done between Jan 1, 2010, and Dec 31, 2019 in LMICs that included a question about whether respondents had ever had their blood pressure, glucose, or cholesterol measured. We analysed diagnostic testing performance by quantifying the overall proportion of people who had ever been tested for these cardiovascular risk factors and the proportion of individuals who met the diagnostic testing criteria in the WHO package of essential noncommunicable disease interventions for primary care (PEN) guidelines (ie, a BMI >30 kg/m2 or a BMI >25 kg/m2 among people aged 40 years or older). We disaggregated and compared diagnostic testing performance by sex, wealth quintile, and education using two-sided t tests and multivariable logistic regression models. Findings—Our sample included data for 994 185 people from 57 surveys. 19·1% (95% CI 18·5– 19·8) of the 943 259 people in the hypertension sample met the WHO PEN criteria for diagnostic testing, of whom 78·6% (77·8–79·2) were tested. 23·8% (23·4–24·3) of the 225 707 people in the diabetes sample met the WHO PEN criteria for diagnostic testing, of whom 44·9% (43·7– 46·2) were tested. Finally, 27·4% (26·3–28·6) of the 250 573 people in the hypercholesterolaemia sample met the WHO PEN criteria for diagnostic testing, of whom 39·7% (37·1–2·4) were tested. Women were more likely than men to be tested for hypertension and diabetes, and people in higher wealth quintiles compared with those in the lowest wealth quintile were more likely to be tested for all three risk factors, as were people with at least secondary education compared with those with less than primary education. Interpretation—Our study shows opportunities for health systems in LMICs to improve the targeting of diagnostic testing for cardiovascular risk factors and adherence to diagnostic testing guidelines. Risk-factor-based testing recommendations rather than sociodemographic characteristics should determine which individuals are tested.
dc.description.librarianPM2023
dc.facultyFaculty of Health Sciences
dc.identifier.urihttps://hdl.handle.net/10539/37734
dc.language.isoen
dc.schoolPublic Health
dc.titleDiagnostic testing for hypertension, diabetes, and hypercholesterolaemia in low-income and middle-income countries: a cross-sectional study of data for 994 185 individuals from 57 nationally representative surveys
dc.typeArticle
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
nihms-1925307.pdf
Size:
534.83 KB
Format:
Adobe Portable Document Format
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
2.43 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
SA-MRC/Wits Agincourt Unit (Research Outputs/Publications)