Screening and treatment of arterial hypertension in rural Rwanda

Abstract

Arterial hypertension is an increasing health challenge also in rural areas of sub-Saharan Africa. In Mata Sector, Nyaruguru District, Rwanda, the Associazione Mabawa – Ali per l’Africa launched a community-based hypertension screening and treatment program. The initiative relied on trained community health workers and supervisors operating under the guidance of a nurse specialized in hypertension surveillance and a physician with expertise in hypertension management. A total of 7,203 adults, representing approximately half of the local population, participated in the screening program. Elevated blood pressure was identified in 12% of participants, with prevalence increasing markedly with age. Individuals with confirmed hypertension were offered once-daily treatment with a fixed-dose combination of amlodipine, hydrochlorothiazide, and olmesartan. Blood pressure control was achieved in 94% after four months of treatment and was maintained in 83% at 24 months. These findings suggest that structured screening programs, local healthcare worker training, and access to fixeddose antihypertensive combinations can achieve effective blood pressure control even in remote rural areas.