{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T20:00:13Z","timestamp":1794081613100,"version":"4.8.0"},"reference-count":28,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2022,4,8]],"date-time":"2022-04-08T00:00:00Z","timestamp":1649376000000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"United Nations University, Institute for the Advanced Study","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Kyoto University School of Public Health Super Global Course","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Inter-Graduate School Program for Sustainable Development and Survivable Societies, Kyoto University","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,2,24]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine the prevalence of hypertension and access to related healthcare services among rural residents of Mumbwa district in Zambia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study with probability cluster sampling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Rural Zambia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>We recruited 690 residents from Mumbwa district aged 25\u201364 years who had been living in the study area for \u22656 months and had adopted the lifestyle of the study area. Pregnant women and women who had given birth in the past 6 months were excluded. The data collection\u2014questionnaire survey and anthropometric and biological measurements\u2014was conducted between May and July 2016.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the overall sample, 39.7% and 33.5% of the men and women had hypertension (systolic blood pressure (BP)\u2265140 or diastolic BP \u226590 mm Hg), respectively. Among the participants without a previous diagnosis of hypertension, 30.3% presented with hypertension at the time of measurement. In the multivariable analysis, alcohol intake and urban residence in men, and older age group, higher education and body mass index \u226525 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      in women were significantly associated with hypertension. Among the 21.8% who never had their BP measured, 83.8% were men; among these men, older age (adjusted OR (AOR), 0.43; 95% CI 0.25 to 0.73) and HIV positive status (AOR, 0.37; 95% CI 0.14 to 0.97) were negatively associated, while current smoker status (AOR, 2.09; 95% CI 1.19 to 3.66) was positively associated with the lack of BP measurements.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We found that hypertension is prevalent in the target rural area. However, many were not aware of their hypertension status and many never had their BP measured, indicating a serious gap in cardiovascular disease prevention services in Zambia. There is an urgent need for health promotion and screening for hypertension, especially in the primary health services of rural Zambia. Issues related to healthcare accessibility in men require particular attention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-055668","type":"journal-article","created":{"date-parts":[[2022,4,8]],"date-time":"2022-04-08T12:08:19Z","timestamp":1649419699000},"page":"e055668","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Hypertension, its correlates and differences in access to healthcare services by gender among rural Zambian residents: a cross-sectional study"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4649-8428","authenticated-orcid":false,"given":"Yukiko","family":"Tateyama","sequence":"first","affiliation":[{"name":"Kyoto University Health Service, Kyoto, Japan"},{"name":"Global Health Interdisciplinary Unit, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teeranee","family":"Techasrivichien","sequence":"additional","affiliation":[{"name":"Global Health Interdisciplinary Unit, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan"},{"name":"International Institute of Socio-epidemiology, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patou Masika","family":"Musumari","sequence":"additional","affiliation":[{"name":"Global Health Interdisciplinary Unit, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan"},{"name":"International Institute of Socio-epidemiology, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Pilar","family":"Suguimoto","sequence":"additional","affiliation":[{"name":"International Institute of Socio-epidemiology, Kyoto, Japan"},{"name":"National Institute of Health, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita Nyaboke","family":"Ongosi","sequence":"additional","affiliation":[{"name":"International Institute of Socio-epidemiology, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Zulu","sequence":"additional","affiliation":[{"name":"Center for Primary Care Research, University of Zambia School of Medicine, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Dube","sequence":"additional","affiliation":[{"name":"Ndola District Health Office, Ndola, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masako","family":"Ono-Kihara","sequence":"additional","affiliation":[{"name":"Global Health Interdisciplinary Unit, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan"},{"name":"International Institute of Socio-epidemiology, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Kihara","sequence":"additional","affiliation":[{"name":"Global Health Interdisciplinary Unit, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan"},{"name":"International Institute of Socio-epidemiology, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,4,8]]},"reference":[{"key":"2025121409510604000_12.4.e055668.1","unstructured":"World Health Organization . Fact sheets. Cardiovascular diseases (CVDs). Available: https:\/\/www.who.int\/en\/news-room\/fact-sheets\/detail\/cardiovascular-diseases-(cvds) [Accessed 30 Sep 2021]."},{"key":"2025121409510604000_12.4.e055668.2","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1161\/HYPERTENSIONAHA.114.04394","article-title":"Burden of undiagnosed hypertension in sub-Saharan Africa: a systematic review and meta-analysis","volume":"65","author":"Ataklte","year":"2015","journal-title":"Hypertension"},{"key":"2025121409510604000_12.4.e055668.3","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.gheart.2017.06.001","article-title":"Roadmap to Achieve 25% Hypertension Control in Africa by 2025","volume":"13","author":"Dzudie","year":"2018","journal-title":"Glob Heart"},{"key":"2025121409510604000_12.4.e055668.4","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0189264","article-title":"Knowledge and awareness of and perception towards cardiovascular disease risk in sub-Saharan Africa: a systematic review","volume":"12","author":"Boateng","year":"2017","journal-title":"PLoS One"},{"key":"2025121409510604000_12.4.e055668.5","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2017-000348","article-title":"Quantifying unmet need for hypertension care in South Africa through a care cascade: evidence from the SANHANES, 2011-2012","volume":"2","author":"Berry","year":"2017","journal-title":"BMJ Glob Health"},{"key":"2025121409510604000_12.4.e055668.6","unstructured":"World Health Organization . Global status report on noncommunicable diseases, 2014. Available: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/148114\/9789241564854_eng.pdf [Accessed May 2021]."},{"key":"2025121409510604000_12.4.e055668.7","unstructured":"World Health Organization . Zambia STEPS Survey 2017 Factsheet. Available: https:\/\/www.afro.who.int\/publications\/zambia-steps-survey-2017-factsheet [Accessed May 2021]."},{"key":"2025121409510604000_12.4.e055668.8","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-015-2258-4","article-title":"Prevalence of hypertension and its treatment among adults presenting to primary health clinics in rural Zambia: analysis of an observational database","volume":"15","author":"Yan","year":"2015","journal-title":"BMC Public Health"},{"key":"2025121409510604000_12.4.e055668.9","doi-asserted-by":"crossref","unstructured":"Mulenga D , Siziya S , Rudatsikira E , et al . District specific correlates for hypertension in Kaoma and Kasama rural districts of Zambia. Rural Remote Health 2013;13.doi:10.22605\/RRH2345","DOI":"10.22605\/RRH2345"},{"key":"2025121409510604000_12.4.e055668.10","unstructured":"Central Statistical Office Zambia . 2010 census of population and Housing\u2014Volume 11 national descriptive tables, 2012.. Available: http:\/\/catalog.ihsn.org\/index.php\/catalog\/4124\/download\/55313 [Accessed May 2021]."},{"key":"2025121409510604000_12.4.e055668.11","unstructured":"World Health Organization . WHO STEPS Surveillance Manual., 2017. Available: http:\/\/www.who.int\/ncds\/surveillance\/steps\/STEPS_Manual.pdf?ua=1 [Accessed May 2021]."},{"key":"2025121409510604000_12.4.e055668.12","doi-asserted-by":"crossref","DOI":"10.1186\/1744-8603-5-10","article-title":"An overview of cardiovascular risk factor burden in sub-Saharan African countries: a socio-cultural perspective","volume":"5","author":"BeLue","year":"2009","journal-title":"Global Health"},{"key":"2025121409510604000_12.4.e055668.13","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0212739","article-title":"Dietary habits, body image, and health service access related to cardiovascular diseases in rural Zambia: a qualitative study","volume":"14","author":"Tateyama","year":"2019","journal-title":"PLoS One"},{"key":"2025121409510604000_12.4.e055668.14","doi-asserted-by":"crossref","unstructured":"Coates J , Anne S , Paula B . Household food insecurity access scale (HFIAS) for measurement of household food access: indicator guide (V. 3), 2007. Available: http:\/\/www.fao.org\/fileadmin\/user_upload\/eufao-fsi4dm\/doc-training\/hfias.pdf [Accessed May 2021].","DOI":"10.1037\/e576842013-001"},{"key":"2025121409510604000_12.4.e055668.15","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.310"},{"key":"2025121409510604000_12.4.e055668.16","doi-asserted-by":"crossref","first-page":"97","DOI":"10.11604\/pamj.2018.30.97.14717","article-title":"Hypertension prevalence and risk factors in rural and urban Zambian adults in Western Province: a cross-sectional study","volume":"30","author":"Rush","year":"2018","journal-title":"Pan Afr Med J"},{"key":"2025121409510604000_12.4.e055668.17","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2015-010085","article-title":"Sex differences in the risk profile of hypertension: a cross-sectional study","volume":"6","author":"Ghosh","year":"2016","journal-title":"BMJ Open."},{"key":"2025121409510604000_12.4.e055668.18","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1161\/01.HYP.0000218586.21932.3c","article-title":"Alcohol and hypertension: an update","volume":"47","author":"Beilin","year":"2006","journal-title":"Hypertension"},{"key":"2025121409510604000_12.4.e055668.19","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.87.2.160"},{"key":"2025121409510604000_12.4.e055668.20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2018\/6959165","article-title":"Hypertension and associated factors in rural and urban areas Mali: data from the step 2013 survey","volume":"2018","author":"B\u00e2","year":"2018","journal-title":"Int J Hypertens"},{"key":"2025121409510604000_12.4.e055668.21","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/S2213-8587(17)30432-1","article-title":"Prevalence of obesity, hypertension, and diabetes, and cascade of care in sub-Saharan Africa: a cross-sectional, population-based study in rural and urban Malawi","volume":"6","author":"Price","year":"2018","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2025121409510604000_12.4.e055668.22","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0156309","article-title":"Population-Based assessment of hypertension epidemiology and risk factors among HIV-positive and general populations in rural Uganda","volume":"11","author":"Kwarisiima","year":"2016","journal-title":"PLoS One"},{"key":"2025121409510604000_12.4.e055668.23","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0161544","article-title":"Hypertension and obesity in Dakar, Senegal","volume":"11","author":"Macia","year":"2016","journal-title":"PLoS One"},{"key":"2025121409510604000_12.4.e055668.24","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1161\/HYPERTENSIONAHA.119.14147","article-title":"Regional patterns and association between obesity and hypertension in Africa: evidence from the H3Africa chair study","volume":"75","author":"Akpa","year":"2020","journal-title":"Hypertension"},{"key":"2025121409510604000_12.4.e055668.25","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1016\/S0140-6736(19)30955-9","article-title":"The state of hypertension care in 44 low-income and middle-income countries: a cross-sectional study of nationally representative individual-level data from 1\u00b71 million adults","volume":"394","author":"Geldsetzer","year":"2019","journal-title":"The Lancet"},{"key":"2025121409510604000_12.4.e055668.26","unstructured":"World Health Organization . Global health Observatory data Repository. Available: https:\/\/apps.who.int\/gho\/data\/node.main.HWFGRP?lang=en [Accessed Nov 2021]."},{"key":"2025121409510604000_12.4.e055668.27","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.539569"},{"key":"2025121409510604000_12.4.e055668.28","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1161\/HYPERTENSIONAHA.115.07108","article-title":"Predicting Out-of-Office blood pressure in the clinic (PROOF-BP): derivation and validation of a tool to improve the accuracy of blood pressure measurement in clinical practice","volume":"67","author":"Sheppard","year":"2016","journal-title":"Hypertension"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-055668","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T17:51:14Z","timestamp":1765734674000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-055668"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":28,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4,8]]},"published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1136\/bmjopen-2021-055668"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-055668","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4]]}}}