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. 2024 Sep 30;4(9):e0003721.
doi: 10.1371/journal.pgph.0003721. eCollection 2024.

Awareness, treatment, and control among adults living with arterial hypertension or diabetes mellitus in two rural districts in Lesotho

Lucia González Fernández  1   2   3 , Emmanuel Firima  1   2 , Ravi Gupta  4 , Mamoronts'ane Pauline Sematle  4 , Makhebe Khomolishoele  4 , Manthabiseng Molulela  4 , Matumaole Bane  4 , Mosa Tlahali  5 , Stephen McCrosky  1 , Tristan Lee  1 , Frédérique Chammartin  1 , Eleonora Seelig  6 , Felix Gerber  1   2 , Thabo Ishmael Lejone  1 , Irene Ayakaka  4 , Niklaus Daniel Labhardt  1 , Alain Amstutz  1   7   8
Affiliations

Awareness, treatment, and control among adults living with arterial hypertension or diabetes mellitus in two rural districts in Lesotho

Lucia González Fernández et al. PLOS Glob Public Health. .

Abstract

In Lesotho, the hypertension and diabetes care cascades are unknown. We measured awareness, treatment, and control of hypertension and diabetes among adults ≥18 years and identified factors associated with each step of the cascade, based on data from a population-based, cross-sectional survey in 120 randomly sampled clusters in the districts of Butha-Buthe and Mokhotlong from 1st November 2021 to 31st August 2022. We used multivariable logistic regression to assess associations. Among participants with hypertension, 69.7% (95%CI, 67.2-72.2%, 909/1305) were aware of their condition, 67.3% (95%CI 64.8-69.9%, 878/1305) took treatment, and 49.0% (95%CI 46.3-51.7%, 640/1305) were controlled. Among participants with diabetes, 48.4% (95%CI 42.0-55.0%, 111/229) were aware of their condition, 55.8% (95%CI 49.5-62.3%, 128/229) took treatment, and 41.5% (95%CI 35.1-47.9%, 95/229) were controlled. For hypertension, women had higher odds of being on treatment (adjusted odds ratio (aOR) 2.54, 95% CI 1.78-3.61) and controlled (aOR 2.44, 95%CI 1.76-3.37) than men. Participants from urban areas had lower odds of being on treatment (aOR 0.63, 95% CI 0.44-0.90) or being controlled (aOR 0.63, 95% CI 0.46-0.85). Considerable gaps along the hypertension and diabetes care cascades in Lesotho indicate that access and quality of care for these conditions are insufficient to ensure adequate long-term health outcomes.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study flow.
a Lesotho ‐ Subnational Population Statistics-UNFPA: https://data.humdata.org/dataset/cod-ps-lso. b Had no participants who were eligible for survey (i.e., participants received a basic package of services: BP and RBG measurements, members who were present were <10 years). c Individuals were enumerated but not present at the time of the survey or were not eligible (i.e., <10 years, or those who received a basic to package of services: BP and RBG measurements). d Individuals included had information in all four steps of the care cascades. Acronyms: RBG: random blood glucose; HbA1c: glycosylated hemoglobin.
Fig 2
Fig 2
Care cascades for hypertension (A) and diabetes (B), showing the percentage, with 95% confidence intervals, and number of participants in each step of the cascade.
See this image and copyright information in PMC

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