Ideation and practices related to common communicable and non-communicable causes of morbidity and mortality among Couples' HIV Counseling and Testing Clients in Copperbelt, Zambia Open Access

Witt, Lauren R. (2013)

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BACKGROUND: The growing threat of cardiovascular disease and other common causes of morbidity and mortality in developing countries may be ameliorated with preventive action. Hypertension and other contributing illnesses to cardiovascular disease are not being managed by current health systems and little is known about the prevalence and trends of these diseases in Zambia.

OBJECTIVES: Knowledge and attitudes of and self-reported diagnosis of nine common causes of morbidity and mortality was assessed in adults who had completed Couples' Voluntary Counseling and Testing in the urban Copperbelt Province. METHODS: Four formative focus groups were conducted in Ndola to inform development of a regional cross-sectional survey. From June to August 2012, 126 participants in four cities were surveyed. Biomedical and social knowledge, experience with diseases, misinformation, importance of addressing disease prevention at the community level were assessed. RESULTS: Of survey respondents, 34.5% (N=116) did not use Insecticide Treated Nets in their homes and 26.7% (N=116) reported not having soap in their homes. No person in the respondent's household received regular deworming treatments in 62.1% (N=116) of the sample. Knowing someone with the target disease was associated with reporting that the disease is a large problem in the community with hypertension (CMH χ2= 11.9576, p= 0.0075) and diabetes (CMH χ2 = 12.9826, p=0.0047), but not with schistosomiasis (CMH χ2=4.4884, p= 0.2133) or syphilis CMH χ2= 5.5131, p= 0.1379).

CONCLUSIONS: Results from the knowledge assessment indicate that many diseases are thought to be caused by environmental and social factors; however, there is still some misinformation regarding etiology, risk factors, and treatment or prevention. Within this population, the willingness to learn about health was affirmed. Providing appropriate, empowering education will allow communities to manage risk at multiple levels and redefine social norms regarding healthy behavior. Prevention, screening, and treatment for common diseases with HIV testing as the point of entry can be a beneficial and cost-efficient strategy. Introducing awareness of other common causes of morbidity and mortality at HIV diagnosis may assist providers in care plan formation.

Table of Contents

Chapter 1
Introduction...1 References...7 Chapter 2
Literature Review: Hypertension and Service Integration in Zambia...9 Burden of Hypertension...9 HIV Infrastructure...11 Hypertension and HIV...13
Risk Perception of Hypertension...15

CVCT as Point of Entry in Hypertension Education and Screening...18

Conclusion...20 References...21 Chapter 3 Manuscript...25
Cover Page...26

Contribution of authors and Conflict of Interest Disclosure...27


Ideation and practices related to common communicable and non-communicable causes of morbidity and mortality among Couples' HIV Counseling and Testing Clients in Copperbelt, Zambia...29


Materials and Methods...31

Sampling and Ethics...31

Study Procedures...32

Measurements and Analysis...33






Chapter 4

Conclusion and Recommendations...57

References...63 Appendix of Forms Used...64

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