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Okop KJ, Kedir K, Kasenda S, Niyibizi JB, Chipeta E, Getachew H, Sell K, Lambert EV, Puoane T, Rulisa S, Bunn C, King AC, Bavuma C, Howe R, Crampin AC, Levitt NS. Multi-country collaborative citizen science projects to co-design cardiovascular disease prevention strategies and advocacy: findings from Ethiopia, Malawi, Rwanda, and South Africa. BMC Public Health 2023; 23:2484. [PMID: 38087240 PMCID: PMC10714547 DOI: 10.1186/s12889-023-17393-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Cardiovascular diseases (CVD) were responsible for 20.5 million annual deaths globally in 2021, with a disproportionally high burden in sub-Saharan Africa (SSA). There is growing evidence of the use of citizen science and co-design approaches in developing interventions in different fields, but less so in the context of CVD prevention interventions in SSA. This paper reports on the collaborative multi-country project that employed citizen science and a co-design approach to (i) explore CVD risk perceptions, (ii) develop tailored prevention strategies, and (iii) support advocacy in different low-income settings in SSA. METHODS This is a participatory citizen science study with a co-design component. Data was collected from 205 participants aged 18 to 75 years in rural and urban communities in Malawi, Ethiopia and Rwanda, and urban South Africa. Fifty-one trained citizen scientists used a mobile app-based (EpiCollect) semi-structured survey questionnaire to collect data on CVD risk perceptions from participants purposively selected from two communities per country. Data collected per community included 100-150 photographs and 150-240 voice recordings on CVD risk perceptions, communication and health-seeking intentions. Thematic and comparative analysis were undertaken with the citizen scientists and the results were used to support citizen scientists-led stakeholder advocacy workshops. Findings are presented using bubble graphs based on weighted proportions of key risk factors indicated. RESULTS Nearly three in every five of the participants interviewed reported having a relative with CVD. The main perceived causes of CVD in all communities were substance use, food-related factors, and litter, followed by physical inactivity, emotional factors, poverty, crime, and violence. The perceived positive factors for cardiovascular health were nutrition, physical activity, green space, and clean/peaceful communities. Multi-level stakeholders (45-84 persons/country) including key decision makers participated in advocacy workshops and supported the identification and prioritization of community-specific CVD prevention strategies and implementation actions. Citizen science-informed CVD risk screening and referral to care interventions were piloted in six communities in three countries with about 4795 adults screened and those at risk referred for care. Health sector stakeholders indicated their support for utilising a citizen-engaged approach in national NCDs prevention programmes. The citizen scientists were excited by the opportunity to lead research and advocacy. CONCLUSION The collaborative engagement, participatory learning, and co-designing activities enhanced active engagement between citizen scientists, researchers, and stakeholders. This, in turn, provided context-specific insights on CVD prevention in the different SSA settings.
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Affiliation(s)
- Kufre J Okop
- Chronic Disease Initiative for Africa, Department of Medicine, University of Cape Town, South Africa, Cape Town.
- Citizen Science Research Foundation (CSRF), Cape Town, South Africa.
| | - Kiya Kedir
- Armauer Hansen Research Institute (AHRI), Addis Ababa, CA, Ethiopia
| | - Stephen Kasenda
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi, Lilongwe, Malawi
| | - Jean Berchmans Niyibizi
- Directorate of Research and Innovation, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Effie Chipeta
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi, Lilongwe, Malawi
- Centre for Reproductive Health, College of Medicine, University of Malawi, Blantyre, Malawi
| | | | - Kerstin Sell
- Chair of Public Health and Health Services Research, IBE, Faculty of Medicine, LMU Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Estelle Victoria Lambert
- UCT Research Centre for Health Through Physical Activity, Lifestyle and Sport, Division of Exercise Science and Sports Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Thandi Puoane
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Stephen Rulisa
- School of Medicine and Pharmacy, College of Medicine and Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Christopher Bunn
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi, Lilongwe, Malawi
- College of Social Sciences, University of Glasgow, Glasgow, UK
| | - Abby C King
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, USA, CA
- Department of Medicine (Stanford Prevention Research Center), Stanford University School of Medicine, Stanford, USA, CA
| | - Charlotte Bavuma
- School of Medicine and Pharmacy, College of Medicine and Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Rawleigh Howe
- Armauer Hansen Research Institute (AHRI), Addis Ababa, CA, Ethiopia
| | - Amelia C Crampin
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi, Lilongwe, Malawi
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Naomi S Levitt
- Chronic Disease Initiative for Africa, Department of Medicine, University of Cape Town, South Africa, Cape Town
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Dzudie A, Djomou A, Ba H, Njume E, Ndom MS, Mfekeu LK, Ndongo S, Kouam CK, Awungia A, Ze S, Menanga A, Kengne AP, Xia X, Beaney T, Poulter NR, Kingue S. MMM17-Cameroon, analysis and opportunities-Sub-Saharan Africa. Eur Heart J Suppl 2019; 21:D31-D33. [PMID: 31043871 PMCID: PMC6479431 DOI: 10.1093/eurheartj/suz081] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2019] [Indexed: 12/28/2022]
Abstract
Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative aimed at raising awareness on high BP and temporary increasing screening for hypertension worldwide. We here provide the results of the 2017 MMM (MMM17) edition in Cameroon. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2017 nationwide. BP measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. The campaign was advertised through various media and screening stations were set-up in local markets, churches, and outpatient departments of health facilities. In all, 16 093 individuals were screened during MMM17, of whom 4595 (29.2%) had hypertension. A total of 2742 (19.8%) of individuals not receiving anti-hypertensive medication were found to be hypertensive. Of those on medication, 1048 (57.2%) had uncontrolled BP. After adjusting for age, sex, and use of BP lowing medications, systolic and diastolic BPs were significantly higher in people on anti-hypertensive treatment, with higher waist circumference. MMM17 was the largest BP screening campaign undertaken in Cameroon, and although treatment and control rates are higher than previously reported, they are still well below optimum levels. MMM has highlighted the need for routine population-based surveys and suggests that opportunistic screening can identify significant numbers with raised BP.
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Affiliation(s)
- Anastase Dzudie
- Cameroon Cardiac Society, Cameroon.,Clinical Research Education, Networking and Consultancy, Douala, Cameroon
| | | | | | - Epie Njume
- Clinical Research Education, Networking and Consultancy, Douala, Cameroon
| | | | | | | | | | | | | | | | | | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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