Caseload, management and treatment outcomes of patients with hypertension and/or diabetes mellitus in a primary health care programme in an informal setting.
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.


METHODS
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/m2. 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.


CONCLUSIONS
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.
Agnes
A
Sobry
Walter
W
Kizito
Rafael
R
Van den Bergh
Katie
K
Tayler-Smith
Petros
P
Isaakidis
Erastus
E
Cheti
Rose J
RJ
Kosgei
Alexandra
A
Vandenbulcke
Zacharia
Z
Ndegwa
Tony
T
Reid
D000293:Adolescent; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D019468:Disease Management; D005260:Female; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007630:Kenya; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000379:methods*; D011320:Primary Health Care / Q000379:methods / Q000458:organization & administration* / Q000592:standards; D011446:Prospective Studies; D012648:Self Care / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents