Research Article: Knowledge, attitudes and practices related to hypertension among residents of a disadvantaged rural community in southern Zimbabwe

Date Published: June 25, 2019

Publisher: Public Library of Science

Author(s): Pugie Tawanda Chimberengwa, Mergan Naidoo, Kahabi Ganka Isangula.

http://doi.org/10.1371/journal.pone.0215500

Abstract

Hypertension contributes significantly to cardiovascular and renal diseases. It can be controlled by lifestyle modifications, however in poor communities there is lack of awareness, and treatment and control of hypertension is often poor. The aim of this study was to determine hypertension knowledge, attitudes and practices in a disadvantaged rural community in Matebeleland South province of Zimbabwe.

We conducted a descriptive cross-sectional survey on hypertensive patients in the community. A pre-tested and validated interviewer-administered questionnaire was used to collect demographic, awareness, treatment and control data among consenting hypertensive patients.

304 respondents were enrolled into the study (mean age, 59 years), and a majority were women (65.4%). The treatment default rate was 30.9%, and 25% of respondents on medication did not know their blood pressure control status. Knowledge on hypertension was poor, with 64.8% of respondents stating that stress was its main cause, 85.9% stated that palpitations were a symptom of hypertension and 59.8% of respondents added salt on the table. The more education respondents had received, the more likely they were knowledgeable about hypertension (odds ratio for secondary education, 3.68 [95% CI: 1.61–8.41], and for tertiary education, 7.52 [95% CI: 2.76–20.46], compared to those without formal education). Those who believed in herbal medicines (50.7%) and those who used traditional medicines (14.5%) were 53% (95% CI: 0.29–0.76) and 68% (95% CI: 0.29–0.76) less likely to be knowledgeable about hypertension compared to those who did not believe in or use traditional medicines, respectively.

Members of the community had poor knowledge on hypertension. This was associated with a lack of education and with strong beliefs in herbal and traditional medicines in the community, which influenced attitudes and practices on hypertension. Dietary risk factors were linked to poor knowledge. Hypertensive medicine shortages at the clinic resulted in worsened hypertension care and poor hypertension outcomes in the community.

Partial Text

Hypertension, the most common incidentally diagnosed chronic disease, is a major risk factor for cerebro-vascular accidents as well as coronary heart diseases, with two-thirds of all cerebro-vascular accidents attributable to poor hypertension control [1,2]. Together with other cardiovascular diseases, these public health problems that are strongly linked to urbanization, aging populations, westernized socio-economic sedentary lifestyles promoting excessive salt and alcohol intake, smoking, obesity as well as lack of physical exercise [3–6].

A total of 304 people living with hypertension participated in the study and the mean age of the participants was 59 (Q1-Q3; 46–72) years. Table 1 shows the sociodemographic data for hypertensive patients who were enrolled into the study.

This study was conducted in a disadvantaged rural area where formal education is low and more than half of the participants (51%) were not educated beyond primary school and 11% had no formal education at all. Educational attainment was directly proportional to knowledge on hypertension as those with tertiary education had better knowledge as compared to those without formal education. In a community where formal education is low and the persons afflicted by disease are vulnerable due to socio-economic factors, poor health seeking behaviors are common. Poverty, ignorance, a poor educational background and weak community health education platforms were determinants of poor knowledge.

Members of the community had poor knowledge on hypertension. This was associated with a lack of education and with strong beliefs in herbal and traditional medicines in the community, which influenced attitudes and practices on hypertension. Dietary risk factors were linked to poor knowledge. Hypertensive medicine shortages at the clinic resulted in worsened hypertension care and poor hypertension outcomes in the community.

 

Source:

http://doi.org/10.1371/journal.pone.0215500

 

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