title: Factors affecting diagnosis and management of hypertension in Mazowe District of Mashonaland Central Province in Zimbabwe: 2012.
abstract: BACKGROUND
  From 2005 to 2011 Mazowe District recorded a gradual decline in prevalence of hypertension in the face of rising incidence of complications like stroke. This raised questions on whether diagnosis and management of hypertensive patients is being done properly.
  
  
  METHODS
  We conducted an analytic cross sectional study at three hospitals in Mazowe District where we randomly selected 201 of 222 patients from out patients departments and interviewed a convenience sample of 23 healthcare workers. Structured interviewer administered questionnaires were used to collect data on demographic characteristics and knowledge from patients, as well as knowledge and practices from health workers. Physical measurements were done on all patients. Frequencies; proportions, odds ratios, Chi square test and stratified & logistic regression analysis were done using Epi info version 3.5.4 while graphs were generated using Microsoft excel®. Calculations were done at 95% confidence interval.
  
  
  RESULTS
  Prevalence, awareness, control, compliance, and complication rate of hypertension were: 69.7%, 56.2%, 22.0%, 59.8% and 20.7% respectively. Independent risk factors for hypertension were age (POR 3.09; 95% CI: 1.27-7.5), obesity (POR 4.37; 95% CI: 1.83-10.4), and previous high blood pressure reading (POR 19.86; 95% CI: 8.61-45.8). Complications included cardiac failure (8.6%), visual defects (4.3%) and stroke (3.6%). Co-morbid human immunodeficiency virus (10.7%) and diabetes mellitus (12.1%) were identified among respondents. Knowledge was poor in 47.7% of health workers.
  
  
  CONCLUSIONS
  Risk factors found in this study are consistent with other studies. Health service factors are the main reasons for poor diagnosis and management of hypertension. Health workers need training on diagnosis and management of hypertension. Guidelines, digital sphygmomanometers and adequate drug supply are needed. District has since purchased digital BP machines and requested assistance with training on clinical features of hypertension, use of digital machines, and how to properly measure BP. A policy document on non-communicable diseases including hypertension was subsequently developed by the Ministry of Health and Child Care and currently awaiting endorsement by parliament.
authors.affiliation: Department of Community Medicine, University of Zimbabwe, Mount Pleasant, Harare, Zimbabwe. mungatim@yahoo.com.
authors.forename: More
authors.initials: M
authors.lastname: Mungati
authors.forename: Portia
authors.initials: P
authors.lastname: Manangazira
authors.forename: Lucia
authors.initials: L
authors.lastname: Takundwa
authors.forename: Notion T
authors.initials: NT
authors.lastname: Gombe
authors.forename: Simbarashe
authors.initials: S
authors.lastname: Rusakaniko
authors.forename: Mufuta
authors.initials: M
authors.lastname: Tshimanga
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001364:Awareness; D016009:Chi-Square Distribution; D002983:Clinical Competence; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D015994:Incidence; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010361:Patients / Q000523:psychology; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult; D015030:Zimbabwe / Q000453:epidemiology
chemical_list: D000959:Antihypertensive Agents