Integration of point-of-care screening for type 2 diabetes mellitus and hypertension into the COVID-19 vaccine programme in Johannesburg, South Africa
-
Published:2023-11-20
Issue:1
Volume:23
Page:
-
ISSN:1471-2458
-
Container-title:BMC Public Health
-
language:en
-
Short-container-title:BMC Public Health
Author:
Brennan Alana T,Vetter Beatrice,Masuku Sithabiso D,Mtshazo Bukelwa,Mashabane Nkuli,Sokhela Simiso,Venter Willem DF,Kao Kekeletso,Meyer-Rath Gesine
Abstract
Abstract
Background
South Africa grapples with a substantial burden of non-communicable diseases (NCDs), particularly type 2 diabetes (diabetes) and hypertension. However, these conditions are often underdiagnosed and poorly managed, further exacerbated by the strained primary healthcare (PHC) system and the disruptive impact of the COVID-19 pandemic. Integrating NCD screening with large-scale healthcare initiatives, such as COVID-19 vaccination campaigns, offers a potential solution, especially in low- and middle-income countries (LMICs). We investigated the feasibility and effectiveness of this integration.
Methods
A prospective cohort study was conducted at four government health facilities in Johannesburg, South Africa. NCD screening was incorporated into the COVID-19 vaccination campaign. Participants underwent COVID-19 rapid tests, blood glucose checks, blood pressure assessments, and anthropometric measurements. Those with elevated blood glucose or blood pressure values received referrals for diagnostic confirmation at local PHC centers.
Results
Among 1,376 participants screened, the overall diabetes prevalence was 4.1%, combining previously diagnosed cases and newly identified elevated blood glucose levels. Similarly, the hypertension prevalence was 19.4%, comprising pre-existing diagnoses and newly detected elevated blood pressure cases. Notably, 46.1% of participants displayed waist circumferences indicative of metabolic syndrome, more prevalent among females. Impressively, 7.8% of all participants screened were potentially newly diagnosed with diabetes or hypertension. Approximately 50% of individuals with elevated blood glucose or blood pressure successfully linked to follow-up care within four weeks.
Conclusion
Our study underscores the value of utilizing even brief healthcare interactions as opportunities for screening additional health conditions, thereby aiding the identification of previously undiagnosed cases. Integrating NCD screenings into routine healthcare visits holds promise, especially in resource-constrained settings. Nonetheless, concerted efforts to strengthen care linkage are crucial for holistic NCD management and control. These findings provide actionable insights for addressing the NCD challenge and improving healthcare delivery in LMICs.
Funder
National Institute of Diabetes and Digestive and Kidney Diseases The Foundation for Innovative New Diagnostics
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference29 articles.
1. Stats SA. 2018. Department of Statics. South Africa. Mortality and causes of death in South Africa: Findings from death notification. Available at: https://www.statssa.gov.za/publications/P03093/P030932018.pdf. 2. Shisana O, Labadarios D, Rehle T, Simbayi L, Zuma K, Dhansay A, Reddy P, Parker W, Hoosain E, Naidoo P, Hongoro C, Mchiza Z, Steyn NP, Dwane N, Makoae M, Maluleke T, Ramlagan S, Zungu N, Evans MG, Jacobs L, Faber M, SANHANES-1 Team. The South African National Health and Nutrition Examination Survey, 2012: SANHANES-1: the health and nutritional status of the nation. 2014 ed. Cape Town: HSRC Press; 2014. 3. Stokes A, Berry KM, Mchiza Z, Parker WA, Labadarios D, Chola L, Hongoro C, Zuma K, Brennan AT, Rockers PC, Rosen S. Prevalence and unmet need for Diabetes care across the care continuum in a national sample of South African adults: evidence from the SANHANES-1, 2011–2012. PLoS ONE. 2017;12(10):e0184264. https://doi.org/10.1371/journal.pone.0184264. 4. Berry KM, Parker WA, Mchiza ZJ, Sewpaul R, Labadarios D, Rosen S, Stokes A. Quantifying unmet need for Hypertension care in South Africa through a care cascade: evidence from the SANHANES, 2011–2012. BMJ Global Health. 2017;2(3):e000348. https://doi.org/10.1136/bmjgh-2017-000348. 5. Grundlingh N, Zewotir TT, Roberts DJ, et al. Assessment of prevalence and risk factors of Diabetes and pre-diabetes in South Africa. J Health Popul Nutr. 2022;41:7. https://doi.org/10.1186/s41043-022-00281-2.
|
|