The hypertension cascade of care in the midst of conflict: the case of the Gaza Strip

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dc.contributor.authorBassam A. Abu Hamad
dc.contributor.authorZeina Jamaluddine
dc.contributor.authorGloria Safadi
dc.contributor.authorMarie-Elizabeth Ragi
dc.contributor.authorRaeda El Sayed Ahmad
dc.contributor.authorEszter P. Vamos
dc.contributor.authorSanjay Basu
dc.contributor.authorJohn S. Yudkin
dc.contributor.authorMohammed Jawad
dc.contributor.authorChristopher Millett
dc.contributor.authorHala Ghattas
dc.date.accessioned2023-01-23T11:52:54Z
dc.date.available2023-01-23T11:52:54Z
dc.date.issued2022-12-12
dc.description.abstractAlthough hypertension constitutes a substantial burden in conflict-affected areas, little is known about its prevalence, control, and management in Gaza. This study aims to estimate the prevalence and correlates of hypertension, its diagnosis and control among adults in Gaza. We conducted a representative, cross-sectional, anonymous, household survey of 4576 persons older than 40 years in Gaza in mid-2020. Data were collected through face-to-face interviews, anthropometric, and blood pressure measurements. Hypertension was defined in anyone with an average systolic blood pressure ≥140 mmHg or average diastolic blood pressure ≥90 mmHg from two consecutive readings or a hypertension diagnosis. The mean age of participants was 56.9 ± 10.5 years, 54.0% were female and 68.5% were Palestinian refugees. The prevalence of hypertension was 56.5%, of whom 71.5% had been diagnosed. Hypertension was significantly higher among older participants, refugees, ex-smokers, those who were overweight or obese, and had other co-morbidities including mental illnesses. Two-thirds (68.3%) of those with hypertension were on treatment with one in three (35.6%) having their hypertension controlled. Having controlled hypertension was significantly higher in females, those receiving all medications for high blood pressure and those who never or rarely added salt to food. Investing in comprehensive but cost-effective initiatives that strengthen the prevention, early detection and timely treatment of hypertension in conflict settings is critical. It is essential to better understand the underlying barriers behind the lack of control and develop multi-sectoral programs to address these barriers.
dc.description.sponsorshipACKNOWLEDGEMENTS: We would like to thank the Palestinian Central Bureau of Statistics for their methodological support, and the tremendous efforts of our data collectors and field supervisors in the Gaza Strip who showed courage, resilience, and dedication to conduct this survey in the most challenging of circumstances. The authors would like to express their deepest appreciation to the participants who contributed to this study. Participants were most generous in sharing their time and experiences. AUTHOR CONTRIBUTIONS: All authors have made substantive intellectual contributions to this project. EV, CM, JY, MJ, SB, HG, BA, and ZJ conceptualized the study. EV, CM, JY, MJ, SB, HG, and BA acquired the funding for this study. CM, JY, MJ, SB, HG, BA, and ZJ developed the research tools and methodology. HG, RA, GS, MR, ZJ, and BA curated the data. HG, ZJ, GS, MR, BA and RA conducted the formal data analysis. BH, ZJ, RA, GS, MR, HG, and MJ performed the investigation. ZJ, GS, MR, BA, MJ, and HG wrote the first draft of this manuscript. All authors reviewed and edited the draft and agreed to submit the manuscript for publication. FUNDING: This study was jointly funded by the UK’s Department for International Development (DFID), the Medical Research Council (MRC), the Economic and Social Research Council (ESRC) and Wellcome Trust’s Health Systems Research Initiative (HSRI) (MR/ S012877/1).
dc.identifier.urihttps://dspace.alquds.edu/handle/20.500.12213/7684
dc.language.isoen
dc.titleThe hypertension cascade of care in the midst of conflict: the case of the Gaza Strip
dc.typeArticle
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