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Gaps in awareness, treatment, and control of hypertension in Ethiopia: a care cascade analysis using nationally
1Applied Human Nutrition Department, Bahir Dar University, Bahir Dar, Ethiopia.
Objective:
This study aimed to determine the prevalence of hypertension, awareness, treatment, and control among Ethiopian adults and to identify factors contributing to cascade attrition.
Methods:
Nationally representative 2015 WHO STEPS data (Ethiopia, January-June 2015; n = 9800 adults ≥15 years). Hypertension: BP ≥140/90 mmHg or on medication. Awareness (among hypertensives), treatment (among aware), and control (among treated) were assessed using multivariable logistic regression.
Results:
Hypertension prevalence was 15.6% (95% CI: 14.9,16.3). Among 1528 hypertensives, 45.2% (95% CI: 42.1,48.3) were aware; 68.4% (95% CI: 64.0,72.5) of aware received treatment; 32.1% (95% CI: 27.4,37.1) of treated had controlled BP. Overall control was 9.9% (95% CI: 8.4,11.6). Lower awareness was associated with male sex (AOR: 0.53), rural residence (AOR: 0.30), younger age, lower education, and lower income. Rural residence (AOR: 0.42) and low income (AOR: 0.60) reduced the likelihood of treatment. Diabetes (AOR: 0.48) and obesity (AOR: 0.52) were negative predictors of control.
Conclusions:
Fewer than 10% of Ethiopian hypertensives have controlled BP. Major gaps exist in awareness and treatment initiation, disproportionately affecting men, rural residents, and poorer individuals. Diabetic and obese patients need more intensive management.
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