A community survey of cardiovascular risk factors in an urban population in Botswana exploring potential for telemedicine

Background. - This paper reports the findings of a pilot study undertaken in Gaborone, Botswana to investigate the feasibility of using screening to address hypertension. An international research team, consisting of members of the University of Melbourne, Australia, and the Institut de neurologie tropicale, Limoges, France, collaborated with researchers from the University of Botswana, Botswana, to develop the pilot study. Methods. - Sampling of inhabitants was carried out from consecutive households from the central location of the local Bontleng Health Clinic. Eligible participants were 18 years and over, present during data collection, and able to participate in a short questionnaire and physicalexamination. A total of 92 participants were consented and enrolled in the pilot study. Results. - The research study and team were received with enthusiasm and there was mutualrespect by all involved in the study. Our study confirmed that the prevalence of hypertension inan urban Botswana population was around 30%, a figure that is comparable to other data fromsub-Saharan Africa. The significant clinical correlates in our study population for hypertensionwere obesity and high salt intake. Only 37% of participants had been exposed to any educationregarding raised blood pressure, cardiac disease or stroke.Conclusion. - While no single intervention has been shown to be effective the models of careneed to be multidimensional and based on an integration of expertise. Long-term follow-up, training, quality assurance and support for local health workers is essential. The positive findings from the social evaluation component of the study indicate that the proposed model ofintegrated care benefit can from the strong social bonds and support already available in the Botswana community. The paper recommends a model of care that would be piloted in Botswana using a randomized control trial where the intervention group would receive an integrated Telemedicine-supported model of care with the control group receiving care as usual.