PS-BPP02-8: BRIDGING THE GAPS IN HYPERTENSION CARE IN NIGERIA: END-LINE EVALUATION OF COMMUNITY ACTION AGAINST NON-COMMUNICABLE DISEASES (COMAAND) PROJECT
Authors: Danladi Benjamin , Obagha Emmanuel Chijioke , Kamateeka Moreen , Chori Babangida Sylvester , Ogbonnaya Uche C , Attahiru Adams , Balogun Muhammad Shakir , Maduka Doris , Nguku Patrick , Osunkwo Damaris , Odili Augustine Nonso 
Published: January 2023

Title:
Bridging the Gaps in Hypertension care in Nigeria: End-line Evaluation of COMmunity Action Against Non-communicable Diseases (COMAAND) Project

Objective:
Non-Communicable Diseases (NCDs) have become a global public health burden leading to at least 70% of deaths globally. Cardiovascular Diseases (CVDs) are the primary drivers of this epidemic, and hypertension is the leading determinant of CVD mortality. We implemented an innovative community-based strategy focused on early detection and timely management of hypertension in three communities in Anambra state, Nigeria entitled COMmunity Action Against Non-communicable Diseases (COMAAND). We conducted a baseline study to establish hypertension's prevalence, awareness, treatment, and control in implementing communities. In this study, we set out to assess the same metrics we evaluated at baseline, and also compared them with the findings at baseline to establish the impact made by the project.

Design and Methods:
We conducted a cross-sectional survey (at baseline and end-line) using an adapted version of the May Measurement Month (MMM) questionnaire. Blood pressure was measured following the 2018 ESC/ ESC Guideline for treatment of arterial hypertension, and anthropometry was taken in line with the Diet Anthropometry and Physical Activity (DAPA) measurement toolkits of the National institute for health research, Medical Research Council (MRC) the UK. Hypertension was defined as blood pressure (BP) > = 140/90 mmHg, and/or self-reported treatment of hypertension with antihypertensive medication in the last 2 weeks. Awareness of hypertension was defined as a self-report of any previous diagnosis of hypertension by a healthcare professional. Treatment of hypertension was self-reported use of prescription medication for management of hypertension during the previous 2 weeks. Control of hypertension is a pharmacological treatment of hypertension associated with an average BP < 140/90 mmHg

Results:
360 participants were sampled across three participating communities, and are averagely 47 years old (there was no significant difference in the age of participants at end-line vs baseline. Body mass index and systolic BP reduced significantly at the end-line compared to baseline (23.8 kg/m2 vs 26.2 kg/m2, 130.1 mmHg vs 135.0 mmHg) respectively, as well as habits such as cigarette smoking and alcohol intake reduced at end-line compare to baseline (5.3% vs 26.6%, and 40.3% vs 62.1%) respectively. Hypertension prevalence reduced by 17.3%, Awareness increased by 36.8%, treatment increased by 111.1%, and control decreased by 18.6% at the end-line compared to baseline.

Conclusion:
COMAAND project has helped in bridging the gaps in hypertension care, especially in increasing awareness, and improving uptake of treatment.