title: Field testing in Suriname of two blood pressure-measuring devices for low-resource and middle-resource countries, according to a WHO protocol.
abstract: BACKGROUND
  High blood pressure (BP) is known to be the greatest modifiable risk factor of cardiovascular diseases, of which 80% occur in low-resource and middle-resource settings. Yet, BP measurement in these countries remains extremely poor. In 2005, a WHO committee invited manufacturers to produce devices especially for use in low-resource settings. Our study assesses the accuracy, performance, and acceptability of two submitted oscillometric devices under field circumstances in Suriname (South America), namely, the Microlife BP 3AS1-2 and Omron HEM-SOLAR.
  
  
  METHODS
  We compared BP measurements of test devices using a conventional Mercury sphygmomanometer, performed by local healthcare workers under field circumstances. Three hundred and forty-two individuals were included. Statistics included t-tests, analysis of variance, and Bland-Altman plots.
  
  
  RESULTS
  The mean systolic/diastolic BP differences (SD) were -3.5 (8.0)/-7.0 (6.0) for Omron versus Mercury and -6.4 (7.8)/-6.5 (6.0) mmHg for Microlife versus Mercury. Microlife was more accepted by healthcare workers, and both devices performed adequately under field conditions.
  
  
  CONCLUSIONS
  The acceptability, durability, and performance of both test devices were adequate. However, Microlife BP 3AS1-2 underestimated systolic pressure almost twice as much compared with Omron HEM-SOLAR, with identical diastolic underestimations. Guaranteed global availability, users could make a choice between the Omron HEM-SOLAR being more accurate in BP measurement, and Microlife BP 3AS1-2 being more accepted by healthcare workers.
authors: Department of Vascular Medicine, Academical Medical Centre Amsterdam, The Netherlands. p.v.kewalbansing@gmail.com
authors: Preschana V
authors: PV
authors: Kewalbansing
authors: Avinash R P P
authors: AR
authors: Ishwardat
authors: Lizzy M
authors: LM
authors: Brewster
authors: Glenn
authors: G
authors: Oehlers
authors: Gert A
authors: GA
authors: van Montfrans
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001314:Auscultation; D001795:Blood Pressure Determination / Q000295:instrumentation* / Q000451:nursing; D015992:Body Mass Index; D003258:Consumer Behavior; D003906:Developing Countries; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D009726:Nurses / Q000523:psychology; D009991:Oscillometry; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019722:Sphygmomanometers / Q000191:economics; D013532:Suriname; D055815:Young Adult