LIFE COURSE DEVELOPMENT

The Study Of Human Development From Conception To Death

In addition to the existing heavy burden of infectious disease, South Africa is also grappling with increasing levels of chronic disease. Dr Clara Calvert, from the University of Edinburgh Centre for Global Health Research, analysed data from ninety-four adult participants from Soweto who were issued with a chronic disease risk self-measurement kit. The kit was delivered to each participant at their home by a Community Health Worker (CHW) and included a tablet with a set of instructions for taking each measurement and recording the data, an automated blood pressure monitor, a tape measure, a urine dipstick, and disinfecting spray and wipes.

After the participants took their own measurements and entered their results on the tablet, the CHW immediately repeated and recorded the same measurements on participants using the same equipment. This was to determine how accurate the self-recorded data was in comparison to the measures taken by the trained CHWs for blood pressure, resting heart rate, height, waist circumference and urine glucose and protein.

The overall percentage agreement between the self-measured and the CHW-measured variables ranged from 80% for urine testing to 91% for the identification of central obesity (classified as a waist circumference greater than half of the height measurement). Concordance correlation coefficients ranged from 0.78 for waist circumference to 0.93 for height. Self- and CHW measures for the categorization of high blood pressure were consistent for over 90% of participants and had a Kappa coefficient of 0.76 indicating substantial agreement.

Although participants experienced challenges with urine testing and height self-assessment, they recognized the value of self-testing and generally regarded procedures as simple. This pilot study adds to the expanding body of research on the use of home self-testing in disease prevention and detection, particularly for blood pressure and central obesity. The approach may make it easier to identify people at risk for cardiometabolic disease in low-income settings and present a viable alternative to in person attendance at healthcare facilities.