Hypertension must be taken seriously in Zambia

 Hypertension must be taken seriously in Zambia

By Daily News Reporter

Hypertension is one of the most common medical complications encountered during pregnancy in Southern Africa development Community (SADC).

Accounting for 16 percent of maternal related deaths, Hypertension is becoming an increasing concern among expectant mothers and it’s currently the second leading cause of death after hemorrhage among the pregnant women in the region.

Low social –economic status have been proven to be important risk factors for high blood pressure though. There is inadequate data on the determinants of this condition.

The situation id further compounded by inadequate qualified staff in health facilities, long distances that some expectant mothers have to walk to access medical services. Poor road infrastructure to carry expectant mother to health facilities as well as lack of health facilities in some areas, are other factors leading to maternal deaths.

Some of the complications caused by hypertension are abnormal amount of protein in urine, an abnormal kidney or liver function and pain over the upper abdomen.

Changes in vision fluid in the lungs and low number of platelets in the blood or a severe headache in affected pregnant women are other complications caused by hypertension.

And according to SADC, health Policy Framework, hypertension may also lead to a decrease in the flow of nutrients to the baby through the placenta. This may result into growth problems of the baby.

And if the placenta is not providing enough nutrients and oxygen to the baby, it may be decided that early delivery is better for the baby than allowing the pregnancy to continue.

Another complication known as placental abruption Condition in which the placenta prematurely detaches from the wall of the uterus may occur some women have had to undergo cesarean delivery due to hypertension.

A cesarean delivery carries risks of infection, injury to internal organs and bleeding.

Long-term complications of hypertensive pregnancy related syndrome include increased risk of cardiovascular events in both mother and child, which may contribute to the rising epidemic of cardiovascular disease.

AND a recent study highlights hypertension as a significant risk factor among People Living with HIV (PLHIV) and pregnant women. The study, led by CIDRZ’s TASKPEN project, aims to improve the management of Non-Communicable Diseases (NCDs) in health facilities.

The survey conducted at two clinics in Lusaka revealed a high prevalence of hypertension among 447 PLHIV study participants aged 18 years and above. The baseline study found a prevalence of 33.9% and 39.9%.

The results were revealed by CIDRZ’s Dr. Daniel Mwamba when he presented the study findings during the 59th Zambia Medical Association Scientific Conference held in Livingstone recently.

Dr. Mwamba stated that most health workers needed more appropriate orientation regarding NCD treatment guidelines. He also emphasized the need to strengthen NCD management by improving data collection and surveillance.

In Eastern Province of Zambia, Chipata General Hospital is also faced

with an increase of pregnancy related complications due to hypertension.

According to Gynecologist Obstetrician Dr James Lungu (name withheld), said that high blood pressure accounted for 23 admissions of expectant mothers in the first quarter of this year.

“We recorded 29 cases in quarter two and 33 in quarter three.

As you can see, the number of cases is increasing.

It is a serious health concern that needs concerted efforts to be controlled,” he said.

Dr Lungu noted that hypertension usually leads to eclampsia or convulsions or seizures which he said affect most of the expectant mothers that have high BP.

“This may be before, during, or after delivery.

Most often it is during the second half of pregnancy.

The seizures last about a minute,

“Following the seizure, there is typically either a period of confusion or coma. High blood pressure can also lead to aspiration pneumonia, cerebral hemorrhage, kidney failure and cardiac arrest,” he said.

He explained that one death was recorded of an expectant mother who was taken to the health facility after she had already started bleeding from the brain.

The blood pressure of the patient was too high and it could not be controlled at a clinic. The patient had lapsed into a coma by the time she reached the hospital.

Dr Lungu noted that it is difficult to identify the causes of

hypertension during pregnancy.

He however, noted that expectant mothers who

report hypertension within 20 weeks of their pregnancy are hypertensive even before getting pregnant,

“It means that the hypertension was there even before though, it may manifest during pregnancy.

But if it is caused by pregnancy, it manifests 20 weeks after the conception,” he said.

Dr Lungu stated that it was important for expectant mothers to seek antenatal services for early detection to ensure that health experts control the condition.

“All pregnant women should have their blood pressure checked and those that already have hypertension can be closely monitored and their blood pressure can be controlled before it is too late,” he said.

It is worth noting that SADC’s integration agenda accords priority to social and human development including fostering cooperation in addressing health challenges which are reflected in the high burden of both communicable diseases such as HIV and AIDS, tuberculosis and malaria and non-communicable diseases which include diabetes, hypertension and cancer.

The region also prioritized the development of a protocol on health matters as this was seen as critical for enhancing regional integration within a legally enforceable framework.

Three key policy documents were developed to underpin implementation of the programme, namely: the Health Policy Framework, SADC Protocol on Health and the Regional Indicative Strategic Development Plan (RISDP).

The SADC Health Programme was developed taking into account global and regional health declarations and targets.

In this health policy, SADC noted that changing lifestyles and standards of living were altering the disease landscape in Southern Africa.

The World Health Organisation states that: “In African nations, non-communicable diseases are rising rapidly and are projected to exceed communicable, maternal, peri natal and nutritional diseases, as the most common causes of death by 2030.”

Incidents of non-communicable diseases such as heart disease, diabetes, and cancers can rise with improved economic development, resulting in an unhealthy, aging population.

It is important to note that countries in the region have made efforts to address hypertension by improving access to health facilities.

In Zambia, a number of health facilities have been constructed leading to a reduced distances that expectant mothers have to walk in order to access health facilities.

This is the case even in other countries in the region.

This can further be enhanced by improving staffing levels in the health sector especially among rural areas where in some cases, expectant mothers are attended to by unqualified staff.

There is need to improve access to ante natal services with adequate equipment and drugs for expectant mothers.

It is also important that SADC member states sensitize citizens to change their lifestyles and improve diet because, as these countries improve their economic statuses, the risk of non-communicable diseases such as hypertension is getting higher. Ante natal services should be encouraged for early detection and treatment of this life threatening disease.