What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=451). Intervention: Hypertension knowledge and perception assessment. Primary outcome: Hypertension knowledge score.

March 25, 2019BMC Public Health57 citationsOpen Access

Hypertension in a rural community in South Africa: what they know, what they think they know and what they recommend

VJVita W. JongenNetherlands Center for Occupational Diseases SLSamanta Tresha Lalla‐EdwardUniversity of the Witwatersrand AVAlinda G. VosUniversity of the Witwatersrand

Key Result

Most community members demonstrated intermediate (74.3%) or good (14.0%) knowledge of hypertension, though poverty was identified as a major barrier to adopting healthy lifestyle choices.

Study Design

Type

Cross-Sectional (n=451)

Multicenter

Structured PICO

Population

451 adults aged 18 and older from a rural community in South Africa were surveyed to assess their knowledge and perceptions regarding hypertension.

Outcome

Knowledge and perceptions about hypertension, assessed via a cardiovascular risk perception questionnaire and focus group discussions.patient reported

In a rural South African community, general knowledge of hypertension risk factors was adequate, but poverty was identified as a major barrier to adopting healthy lifestyle choices.

Limitations

Participants were part of an ongoing cohort study with regular check-ups, potentially making them more aware of health issues than the general population.
Language barriers and translation by counsellors could have led to additional probing and influenced responses.
Conducted in a single rural geographic location, limiting generalizability to urban or other sub-Saharan settings.
Participants are part of an ongoing cohort study requiring yearly check-ups, which may make them more aware of health issues than the general population.
Language barriers required counsellors to assist in isiZulu or Sepedi, which could have led to additional probing and influenced responses.
Conducted in a single rural geographic location, limiting generalizability to urban settings or other sub-Saharan African countries.

Abstract

BACKGROUND: Hypertension is one of the most important risk factors for cardiovascular disease and has a high prevalence in South Africa and other low- and middle-income countries. However, awareness of hypertension has been reported to be low. Health programmes can increase awareness of hypertension and its causes, but hinge on the knowledge and perception of the targeted community. Therefore, this study investigated knowledge on and perceptions about hypertension of community members in a rural area in Limpopo, South Africa with the aim to increase awareness of hypertension and cardiovascular disease in the local population. METHODS: Using a mixed methods study approach, 451 participants of the Ndlovu Cohort Study, attending a follow-up visit between August 2017 and January 2018, completed a questionnaire on cardiovascular risk perception. A knowledge score was calculated for all participants. Sixty participants were invited to participate in six focus group discussions, of which 56 participated. Audio recordings were transcribed verbatim, transcripts coded, and thematic analysis of the data undertaken to obtain an understanding of knowledge and perception of hypertension in the community. RESULTS: Most members of the community seemed to have intermediate (74.3%) or good (14.0%) knowledge of hypertension based on the knowledge score, and only 11.8% of the population had poor knowledge. The risk factors of hypertension seemed to be well known in the community. Poverty was identified as a major vulnerability in this community limiting choices for healthy lifestyles such as nutritious foods, recreational physical activity and accessing health care timely. Participants proposed community-based activities as an effective way to reach out to community members for prevention and management of hypertension. CONCLUSION: This study highlights the need for improved health promotion efforts to increase knowledge of hypertension in rural communities, and to address poverty as a major obstacle to healthy life-style choices.

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