Prevalence of Hypertension, awareness, treatment, and blood pressure control in Sierra Leone: A systematic review and meta-analysis

Background In recent years, the prevalence of Hypertension (HTN) has increased in sub-Saharan countries. However, reports on the prevalence of HTN in Sierra Leone are limited. Therefore, we conducted a systematic review and meta-analysis to assess the overall estimates of the prevalence of HTN in Sierra Leone. Method A systematic search of electronic databases (PubMed, Embase, African Journal Online and Google Scholar) was conducted by three independent investigators using keywords such as “hypertension”, “prevalence”, “blood pressure”, and “Sierra Leone”. A random-effects model was used to estimate the prevalence across studies. Heterogeneity among studies was assessed using the Cochran Q test and I 2 statistic, and publication bias was assessed using funnel plots and the Egger test. Results We pooled the data from 15 studies (n=14,707) that met the inclusion criteria. The overall prevalence of HTN in Sierra Leone was 27.64% [95% CI = 27.45, 27.82], with significant heterogeneity observed among studies (I 2 =99.82%, p-value < 0.001). The pooled prevalence of Hypertension among males was higher than that among females (25.11% [95% CI = 24.90-25.32], I 2 =99.79%, p-value < 0.001) and 24.11% [95% CI = 23.92,24.31, I 2 =99.67%, p-value < 0.001]). The prevalence of HTN among urban residents (29.76%) was almost twice that among their rural counterparts (15.77%). Of those with HTN, 37.21% were aware of their illness, 12.87% received treatment, and only 29.73% had blood pressure control. Conclusion More than 1 in 4 adults aged ≥ 15 years are living with HTN in Sierra Leone, with a low awareness rate and even lower treatment and control rates. Our findings highlighted the need for robust and comprehensive hypertension prevention, treatment and control policies.