Assessing the efficacy of a community-based screening program for undiagnosed hypertension.
Undiagnosed hypertension is common in Central Asia, yet community-based screening programs have not been rigorously evaluated in post-Soviet settings like Uzbekistan. We conducted a cluster-controlled trial across twelve mahallas (neighborhoods) in three districts, urban, peri-urban, and rural, betw...
| Publicado en: | Revista Latinoamericana de Hipertensión Vol. 21; no. 4; pp. 289 - 297 |
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| Autores principales: | , , , , , , , , |
| Formato: | Artículo |
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Revista Latinoamericana de Hipertension
2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=lth&AN=194342299&site=ehost-live header: @attributes: shortDbName: lth uiTerm: 194342299 longDbName: MedicLatina uiTag: AN controlInfo: bkinfo: jinfo: jid: 18564550 FICN jtl: Revista Latinoamericana de Hipertensión issn: 18564550 maglogo: N pubinfo: dt: 2026 vid: 21 iid: 4 pid: 81901 pub: Revista Latinoamericana de Hipertension artinfo: ui: 194342299 10.5281/zenodo.20445131 ppf: 289 ppct: 8 formats: fmt: @attributes: type: P size: 1.2MB tig: atl: Assessing the efficacy of a community-based screening program for undiagnosed hypertension. aug: au: Salimova, Toxtajan Mirzaeva, Dilfuza Anarboev, Sanjar Mirzajonov, Azimjon Khusenov, Olim Kholmatov, Davron Mukhayyo, Kattaboyeva Kamilya, Baybekova Zulfiya, Karimova affil: Department of Obstetrics and Gynecology, Bukhara State Medical Institute Named After Abu Ali Ibn Sino, Bukhara, Uzbekistan. Department of Obstetrics and Gynecology, Reproductology, Tashkent State Medical University, Tashkent, Republic of Uzbekistan. Department of Surgical Diseases No. 1 and Transplantology, Samarkand State Medical University, Samarkand, Uzbekistan. Department of Epidemiology and Infectious Diseases, Nursing Work, Fergana Medical Institute of Public Health, Fergana, Republic of Uzbekistan. Department of Internal Medicine in Family Medicine, Bukhara State Medical Institute Named After Abu Ali Ibn Sino, Bukhara, Uzbekistan. Department of Hospital Pediatrics, Andijan State Medical Institute, Andijan, Republic of Uzbekistan. Department of Therapeutic Sciences, Termez University of Economics and Service, Termez, Uzbekistan. Department of Russian Language Theory and Translation Studies, Andijan State Institute of Foreign Languages, Andijan, Uzbekistan. Jizzakh State Pedagogical University, Uzbekistan. su: Medical screening Health programs Public health Follow-up studies (Medicine) Rural health Blood pressure measurement Essential hypertension Central Asia Uzbekistan sug: subj: Central Asia Uzbekistan Medical screening Health programs Public health Follow-up studies (Medicine) Rural health Blood pressure measurement Essential hypertension keyword: cluster randomized trial community health workers Hypertension screening Detección de hipertensión ensayo aleatorizado por conglomerados trabajadores de salud comunitarios Uzbekistán ab: Undiagnosed hypertension is common in Central Asia, yet community-based screening programs have not been rigorously evaluated in post-Soviet settings like Uzbekistan. We conducted a cluster-controlled trial across twelve mahallas (neighborhoods) in three districts, urban, peri-urban, and rural, between March and June 2025. A total of 1,050 adults participated. In intervention clusters, trained community volunteers performed initial blood pressure measurements and referred individuals with elevated readings (≥140/90 mmHg) to local facilities for confirmatory testing within 14 days. Control clusters received usual care. The primary outcome was the proportion of previously undiagnosed individuals who obtained a confirmed diagnosis and documented treatment plan within three months. It is plausible that the intervention would improve detection, but we were not entirely sure how much the rural–urban divide would matter. And indeed, the results were a bit counterintuitive. Among those with initial elevated readings, 42.4% in intervention clusters achieved the primary outcome versus 26.8% in controls (adjusted OR 2.04, 95% CI: 1.32–3.15). The effect was most pronounced in the rural district (absolute difference 26.3 percentage points) and weakest in the urban setting (7.1 points). Then again, loss to follow-up between screening and confirmatory visits reached nearly 30%, mainly driven by older age and rural residence. Common wisdom in the field suggests that such attrition is a major implementation hurdle, but our findings also show that those who do return are likely to receive treatment. This means that community-based screening can work – provided that the linkage to follow-up care is strengthened, particularly in remote areas. One might argue that the modest absolute gains (approximately 1 additional confirmed case per 6–7 screened) are still meaningful given the low baseline detection rates in rural Uzbekistan. La hipertensión no diagnosticada es común en Asia Central; sin embargo, los programas de cribado comunitarios no se han evaluado rigurosamente en contextos postsoviéticos como Uzbekistán. Realizamos un ensayo controlado por conglomerados en doce mahallas (barrios) de tres distritos (urbano, periurbano y rural) entre marzo y junio de 2025. Participaron un total de 1050 adultos. En los conglomerados de intervención, voluntarios comunitarios capacitados realizaron mediciones iniciales de la presión arterial y derivaron a las personas con lecturas elevadas (≥140/90 mmHg) a centros locales para pruebas confirmatorias en un plazo de 14 días. Los conglomerados de control recibieron la atención habitual. El resultado principal fue la proporción de personas previamente no diagnosticadas que obtuvieron un diagnóstico confirmado y un plan de tratamiento documentado en un plazo de tres meses. Es plausible que la intervención mejore la detección, pero no estábamos completamente seguros de la influencia que tendría la división rural-urbana. Y, en efecto, los resultados fueron un tanto contraintuitivos. Entre aquellos con lecturas iniciales elevadas, el 42,4 % en los grupos de intervención alcanzó el resultado primario frente al 26,8 % en los controles (OR ajustado 2,04, IC del 95 %: 1,32–3,15). El efecto fue más pronunciado en el distrito rural (diferencia absoluta de 26,3 puntos porcentuales) y más débil en el entorno urbano (7,1 puntos). Por otro lado, la pérdida de seguimiento entre las visitas de detección y confirmación alcanzó casi el 30 %, debido principalmente a la edad avanzada y la residencia rural. La opinión generalizada en el campo sugiere que dicha deserción es un obstáculo importante para la implementación, pero nuestros hallazgos también muestran que quienes regresan tienen más probabilidades de recibir tratamiento. Esto significa que la detección comunitaria puede funcionar, siempre que se fortalezca la vinculación con la atención de seguimiento, particularmente en áreas remotas. Se podría argumentar que las modestas ganancias absolutas (aproximadamente 1 caso confirmado adicional por cada 6-7 examinados) siguen siendo significativas dadas las bajas tasas de detección iniciales en las zonas rurales de Uzbekistán. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: Y custom: Copyright of Revista Latinoamericana de Hipertensión is the property of Revista Latinoamericana de Hipertension and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. item: Revista Latinoamericana de Hipertensión holder: Revista Latinoamericana de Hipertension dt: @attributes: year: 2026 holdings: @attributes: islocal: N |
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