The Burden of Hypertension (HTN) and Diabetes Mellitus Among People Living with HIV and the General Population in Two Urban Cities in Zimbabwe: A Cross-Sectional Analysis of Integrated Screening Program Data (December 2022–December 2024)
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Introduction
A pilot project was implemented between December 2022 and December 2024, to integrate HTN and DM screening into Zimbabwe’s clinical HIV program in Bulawayo and Chitungwiza. This sought to screen and determine the burden of non-communicable diseases (NCDs) among people living with HIV (PLHIV) as well as the general population aged ≥40 years. We set out to assess and compare HTN and DM prevalence among PLHIV and the general population (aged ≥40) in Zimbabwe.
Methods
A cross-sectional secondary data analysis utilizing routine program data was done. HTN and DM screening were integrated into HIV care services in public health facilities and in the community including outreach programs. Data on demographics, NCD risk factors, and screening outcomes were collected using the District Health Information Software (DHIS2) Tracker. All data were anonymized, securely stored, in compliance with ethical and data protection regulations.
Results
A total of 113,680 individuals were screened from December 2022 to December 2024, with 58% from the general population and 42% being PLHIV. Mean age was 53.1 (Q 1 =44.5: Q 3 =54.5) years. The prevalence of HTN among PLHIV was 48.2% compared to 46.4% in the general population; 47.6% among women compared to 46.3% in men (p<0.01). Overall prevalence of DM was 0.72% (821), with PLHIV having a prevalence of 0.44%, (209/47,624) compared to General population 0.93% (612/66,056), (p<0.05).
Conclusion
Majority of individuals screened for NCDs were PLHIV on ART, who also had a higher prevalence of HTN. The integration of NCDs screening and management with HIV programs is key for holistic patient centred care in chronic disease management. This has potential in improving outcomes for PLHIV while strengthening systems for general population. Collaborative efforts between government and partners are needed to equip primary care centres with resources (trained staff and equipment) to screen for NCDs, scale up integrated chronic disease management.
