PREVALENCE, AWARENESS AND RISK FACTORS OF HYPERTENSION AMONG

MARKET TRADERS IN MBARARA CITY, SOUTHWESTERN UGANDA.

NABIRYE AFUSA 2018/BSP/085/PS

NAMPIJJA RITAH 2018/BSP/049/PS

NINSIIMA PATIENCE 2018/BSP/055/PS

NJAKA SADIC 2018/BSP/081/PS

ZIRIMENYA JOEL 2018/BSP/074/PS

A RESEARCH DISSERTATION SUBMITTED TO THE DEPARTMENT OF

PHYSIOTHERAPY IN PARTIAL FULLFILMENT OF THE REQUIREMENTS FOR THE

AWARD OF BACHELOR OF SCIENCE IN PHYSIOTHERAPY AT MBARARA

UNIVERSITY OF SCIENCE AND TECHNOLOGY.

SUPERVISOR: DR ARUBAKU WILFRED

NOVEMBER, 2022
 ABSTRACT

Background: Hypertension, a silent killer, is the principal causes of mortality and morbidity

globally, and approximately 1.4 billion people worldwide are living with it. It is highly prevalent

in developing countries. Data about its prevalence, risk factors and awareness is crucial to

curbing its implications in a low resource setting like Uganda.

Purpose: To find out the prevalence, risk factors, and awareness of hypertension among market

traders in Mbarara City in southwestern Uganda.

Methodology: A descriptive cross-sectional study with a stratified proportionate random

sampling design was carried out among market traders in 4 markets in Mbarara, a city in

southwestern Uganda. A modified HELM guided questionnaire on 357 study participants aged

>25 years was used together with a height board, automatic blood pressure machines and

weighing scales.

Results: The prevalence of hypertension was 32.5%. Females contributed 26.3% and males

6.2%. The mean systolic and diastolic blood pressure were 142.11 and 83.45 mmHg,

respectively. Out of the total 116 hypertensive participants, 93.4% (109/116) were newly

diagnosed. On average, the participants were overweight (BMI: 29.56). The majority of the

participants were found to be physically inactive.

Conclusion:  A third of the study participants were hypertensive and half were pre-hypertensive.

Awareness about hypertension status was low. Low levels of physical activity and obesity were

the prevalent risk factors of hypertension.

i
Key words: Blood pressure, hypertension, body mass index, physical activity, non-

communicable diseases, risk factors, awareness, prevalence

ii
 TABLE OF CONTENTS

ACKNOWLEDGEMENT..............................................................................................................vi

DECLARATION...........................................................................................................................vii

ABBREVIATIONS......................................................................................................................viii

OPERATIONAL DEFINITIONS..................................................................................................ix

CHAPTER 1: INTRODUCTION....................................................................................................1

1.0 Introduction............................................................................................................................1

1.1 Background............................................................................................................................1

1.2 Research study questions.......................................................................................................3

1.3 General research objective.....................................................................................................3

1.4 Specific research objectives...................................................................................................3

1.5 Problem statement..................................................................................................................4

1.6 Justification for the research study.........................................................................................5

1.7 Significance of the study........................................................................................................6

1.8 Conceptual framework...........................................................................................................7

CHAPTER 2: LITERATURE REVIEW.........................................................................................8

2.0 Introduction............................................................................................................................8

2.1 The burden of hypertension...................................................................................................8

2.2 Awareness about hypertension...............................................................................................9

2.3 Risk factors of hypertension................................................................................................10

2.4 Outcomes of hypertension...................................................................................................11

CHAPTER 3: METHODOLOGY.................................................................................................12

3.0 Introduction..........................................................................................................................12

iii
 3.1 Study Design........................................................................................................................12

3.2 Study setting.........................................................................................................................12

3.3 Study population..................................................................................................................12

3.4 Sample size estimation.........................................................................................................13

3.5 Sampling..............................................................................................................................13

3.6 Inclusion criteria..................................................................................................................13

3.7 Exclusion criteria.................................................................................................................13

3.8 Data collection procedure....................................................................................................13

3.9 Data Entry and Analysis......................................................................................................14

3.10 Ethical considerations........................................................................................................14

3.11 Quality assurance...............................................................................................................15

CHAPTER 4: RESULTS...............................................................................................................16

4.0 Introduction..........................................................................................................................16

4.1 Demographics......................................................................................................................16

Table 4.1.0 Demographics of the traders...................................................................................16

4.2 Lifestyle and health status characteristics of the participants..............................................17

Table 4.2.0 Lifestyle and Health status characteristics of the traders........................................18

4.3 BMI and Blood Pressure grades according to Gender and Age categorization...................20

Table 4.3.0 BMI and Blood pressure grades according to Gender and age categorization.......21

4.4 Awareness about hypertension.............................................................................................21

CHAPTER 5: DISCUSSION OF RESULTS................................................................................23

5.1 Prevalence of hypertension..................................................................................................23

5.2 Awareness about hypertension.............................................................................................24

iv
 5.3 Risk factors of hypertension................................................................................................24

6: RECOMMENDATIONS...........................................................................................................27

7: LIMITATIONS OF THE STUDY............................................................................................27

8: CONCLUSION.........................................................................................................................28

9. REFERENCES..........................................................................................................................29

10 APPENDICES..........................................................................................................................43

Appendix 1 Consent form..........................................................................................................43

Appendix 2 questionnaire..........................................................................................................47

Appendix 3 Time frame.............................................................................................................51

Appendix 4 Budget....................................................................................................................52

v
ACKNOWLEDGEMENT

To begin with, we thank God, who enabled us to get this far with our research study and made it

a success. We also want to thank our wonderful parents for their unending financial support in

meeting the research's financial needs.

With a lot of enthusiasm, we thank the Department of Physiotherapy, Mbarara University of

Science and Technology, for equipping us with special knowledge and skills that have enabled

us to successfully complete our research study.

We also thank our dear supervisor, Dr. Arubaku Wilfred for his upper hand and tireless efforts in

always reviewing our work and pointing out areas for improvement.

We also pass a vote of thanks to Niyonsenga Jean Damascene and Nuwahereza Amon, who are

lecturers in the Department of Physiotherapy, and Nabbosa Maria, a Principal Physiotherapist at

Mbarara Regional Referral Hospital, for assisting us with material for our research study.

In addition, we appreciate Ms. Turyakira Eleanor, a senior statistician in the Department of

Community Health, for her unending support in making us get more familiar with STATA, a

data analysis software.

Finally, a special thanks to each and every member of our research group for the great idea we

came up with and the unity and enthusiasm exhibited all throughout our research study.

vi
DECLARATION

We hereby declare that this work that we have presented for the attainment of the Bachelor of

Science in Physiotherapy at Mbarara University of Science and Technology is our own work and

it has never been presented to any other institution/university for another award whatsoever.

All resources used have been well acknowledged with complete references.

Researcher Registration number Signature

1. ZIRIMENYA JOEL 2018/BSP/074/PS _______________

2. NABIRYE AFUSA 2018/BSP/085/PS _______________

3. NAMPIJJA RITAH 2018/BSP/049/PS _______________

4. NJAKA SADIC 2018/BSP/081/PS _______________

5. NINSIIMA PATIENCE 2018/BSP/055/PS ________________

SUPERVISOR SIGNATURE DATE

DR WILFRED ARUBAKU ______________ _______________

vii
viii
ABBREVIATIONS

BMI: Body Mass Index

CVD: Cardiovascular Disease

DBP: Diastolic Blood Pressure

LMICs: Low-and Middle-Income Countries

NCDs: Non-Communicable Diseases

SBP: Systolic Blood Pressure

WHO: (World Health Organization)

ix
OPERATIONAL DEFINITIONS

BLOOD PRESSURE: The pressure exacted by blood within the arterial system of the body and

is measured in mmHg (Walker et al., 1990).

SYSTOLIC BLOOD PRESSURE: The maximal pressure in the arterial system generated

during the contraction of the ventricles (Walker et al., 1990).

DIASTOLIC BLOOD PRESSURE: The minimal pressure within the arterial system of the

body when the ventricles are relaxing (Walker et al., 1990).

HYPERTENSION: When a person’s systolic blood pressure (SBP) is greater or equal to 140

mmHg or when the diastolic blood pressure is greater or equal to 90 mmHg or when one is on

antihypertensive medication (Burnier and Egan, 2019).

PHYSICAL ACTIVITY: Any movement of the body executed by skeletal muscles that

requires energy expenditure (WHO, 2022).

PHYSICAL EXERCISE: A form of physical activity that is organized and involves repetitions

with the main goal of enhancing and sustaining physical fitness (Caspersen et al., 1985).

OVERWEIGHT OR OBESE: An abnormally increased deposition of fat in the body which

may negatively affect someone’s health (OO et al., 2020).

BODY MASS INDEX (BMI): An indicator of a person's thinness or fatness using their weight

and height. It is usually used to show whether a person’s weight is normal for their height. It

therefore categorizes individuals as: obese, overweight, normal or underweight (Carr and

Friedman, 2005).

x
BMI is graded as below according to the National Heart, Lung and Blood Institute:

Category BMI range (Kg/m2)

Underweight <18.5

Normal 18.5-24.9

Overweight 25-29.9

Obese >or=30

Classification of Blood pressure according to the joint national committee on prevention,

detection, evaluation and treatment of high blood pressure as seen in the table below (Maiyaki

and Garbati, 2014).

BP CLASSIFICATION SYSTOLIC BLOOD DIASTOLIC BLOOD

PRESSURE PRESSURE

Normal <120 <80

Pre-hypertension 120-139 80-89

Stage 1 hypertension 140-159 90-99

Stage 2 hypertension >or =160 >or =100

Stage 3 hypertension >or =180 >or =110

xi
CHAPTER 1: INTRODUCTION

1.0 Introduction

This chapter presents the background of the study, the problem statement, study objectives, study

questions as well as justification and significance of the study.

1.1 Background

Economically developing countries are undergoing an epidemiological transition from

communicable diseases to non-communicable diseases (Maiyaki and Garbati, 2014). Non-

communicable diseases (NCDs), as reported by the World Health Organization (WHO), are the

major cause of death worldwide, with 41 million people dying annually, approximately 71% of

the overall deaths in the whole world. The four main non-communicable killers include

cardiovascular diseases, cancers, respiratory diseases, and diabetes, which are responsible for

17·9 million, 9·0 million, 3·9 million, and 1·6 million deaths each year, respectively. These

together account for more than 80% of all premature NCD deaths (Budreviciute et al., 2020).

Over the past 20 years, a drastic rise in the incidence of non-infectious diseases in Sub-Saharan

Africa has been fueled by a high incidence of cardiovascular risk factors. For example, physical

inactivity, obesity, air pollution, hyperlipidemia, unhealthy diets, hypertension and diabetes have

been noted (Melaku et al., 2016).

Hypertension is the predominant risk factor for NCDs globally, thus a major precipitant for

mortality and morbidity yet its control is not routinely emphasized (Lim et al., 2012,

Kaddumukasa et al., 2017, Rahman et al., 2018). If hypertension is not controlled it will lead to

1
catastrophic outcomes which include: renal failure, stroke, cardiac failure and myocardial

infarction among other NCDs (Guwatudde et al., 2015).

Hypertension is commonly found in populations greater than 25 years of age, with a prevalence

of 40% (Campbell and Zhang, 2018). Additionally, the proportion of the population’s

understanding of hypertension, its treatment, and control is low in low and middle-income

countries despite the increasing prevalence (Bosu, 2015, Mills et al., 2020). In comparison to

other continents, Africa faces the greatest burden of hypertension, which is the main adjustable

risk factor for NCDs with the greatest incidence, prevalence, and case fatality of NCDs (Owolabi

et al., 2016). A study in 2013 estimated that the number of adults with hypertension in Sub-

Saharan Africa would have exceeded 125 million by 2025 (Kotwani et al., 2013).

Hypertension, like other NCDs, is becoming increasingly common in Uganda. Results from the

Uganda national NCDs risk factor survey carried out in 2015, where 3906 participants were

recruited, showed that 1033 of the participants had hypertension. The prevalence of hypertension

from this survey in urban areas and rural areas was 28.9% and 25.8%, respectively, and these

numbers might have increased (Guwatudde et al., 2015)

A study done in Mbarara City, Kakoba division, southwestern Uganda about sedentary lifestyle

and hypertension in the peri-urban areas, which included 310 participants, concluded that 69.7%

of the participants were newly diagnosed with hypertension (Twinamasiko et al., 2018).

Therefore, studies on awareness, risk factors, and prevalence of hypertension in Uganda are still

scarce, and this study will seek to find out the awareness, prevalence, and risk factors of

hypertension among market traders in Mbarara City in southwestern Uganda.

2
1.2 Research study questions

I. What is the awareness of hypertension among market traders in Mbarara, a city in

southwestern Uganda?

II. What is the prevalence of hypertension among market traders in Mbarara, a city in

southwestern Uganda?

III. What are the risk factors for hypertension among market traders in Mbarara, a city in

southwestern Uganda?

1.3 General research objective

To establish the awareness of hypertension, its prevalence and risk factors among market traders

in Mbarara City, southwestern Uganda.

1.4 Specific research objectives

I. To establish awareness about hypertension among market traders in Mbarara, a city in

southwestern Uganda.

II. To determine the prevalence of hypertension among market traders in Mbarara, a city in

southwestern Uganda.

III. To establish the risk factors of hypertension among market traders in Mbarara, a city in

southwestern Uganda.

3
1.5 Problem statement

Hypertension is one of the major modifiable predisposing factors for NCDs globally, thus a

major precipitant for mortality and morbidity, yet its control is not routinely emphasized (Lim et

al., 2012, Kaddumukasa et al., 2017, Rahman et al., 2018). In addition, hypertension is a main

risk factor for preventable death (Castro-Porras et al., 2021). According to the World Health

Organization, approximately 1.4 billion people worldwide are hypertensive, and a high

prevalence has been observed in Africa, mostly in low and middle-income countries, with

approximately 46% of adults who are aged 25 years of age and above having hypertension

(Ibrahim and Damasceno, 2012).

Many studies have indicated a rise in the prevalence of hypertension amongst market traders. A

study in 3 markets in Lagos, Nigeria among 391 participants found that 46.6% with hypertension

were unaware of their hypertensive status (Achonu et al., 2022). One in the market of Dantokpa

in Benin among 255 women market traders showed that 34% were hypertensive and of these,

14% were newly screened (Ibrahim et al., 2020). A study in Maiduguri, Borno state in a regional

market in Nigeria among 411 market traders showed that 102 were hypertensive and of these,

25% had undiagnosed hypertension (1 in every 4 market traders) (Vincent-Onabajo et al., 2017).

The effect of hypertension on the heart and blood vessels has been shown to induce heart attacks,

heart failure, strokes, kidney damage and deaths (Kaplan, 2010, Fuchs and Whelton, 2020).

Predisposing factors to hypertension include: age, sedentary lifestyle, high BMI, alcoholism,

tobacco smoking and diet (Guwatudde et al., 2015, Asemu et al., 2021).

4
Lack of awareness of unrecognized hypertension poses greater risk to the individual,

predisposing them to the occurrence of many NCDs (Nwoha et al., 2022). The low levels of

awareness about hypertension reported in Africa is a major threat to public health since the

population in this area is increasing and, therefore, there will be significantly large populations

not aware of the increased risk of complications associated with hypertension in years to come

(de-Graft Aikins et al., 2010).

The prevalence of hypertension and awareness data is very important in understanding the extent

of the problem, recognizing groups at risk for hypertension and examining the outcomes of

interventions in policy and practice (van de Vijver et al., 2014).

Various studies have characterized market traders with a sedentary lifestyle, obesity, and old age

with low levels of awareness about hypertension, which are the major predisposing factors to

hypertension (Fatiu et al., 2011, Ulasi et al., 2011, Awosan et al., 2014, Oparah et al., 2021).

In Uganda, data about hypertension among market traders is still limited and therefore less

attention is paid to market traders in regard to their increasing predisposition to hypertension.

This could lead to increased prevalence and complications of the disease in this population,

increased hospital admissions, overwhelming the hospital systems in Uganda.

1.6 Justification for the research study

There are increasing numbers of patient admissions in most hospitals in Uganda for NCD related

cases for example a four-year retrospective study done at Mulago Hospital reported that majority

of patients (72%) had NCDs as the primary reason for admission (Kalyesubula et al., 2019) yet

5
the major risk factor, hypertension, has been given less attention to identify its prevalence, risk

factors, and level of awareness among people (Chang et al., 2019).

According to the WHO, cardiovascular diseases have been predicted to account for about a

quarter of deaths worldwide by 2030 (Gabert et al., 2017). There is a need to control these

numbers.

From recent studies, it has been suggested that people have little knowledge about hypertension

and its risk factors, leading to their failure to get hypertension screening and health education

about it.

There is still limited data about the prevalence, awareness and predisposing factors for

hypertension in Uganda; to be specific, the data among market traders, yet they are more at risk,

thus triggering the study.

1.7 Significance of the study

This research study would informgive a clue to the health policy makers about the prevalence

and the most common risk factors of hypertension in the study population so that more health

promotion projects aimed at increasing awareness of people about changing some of their

lifestyles could be carried out.

The study would benefit the researchers in identifying the awareness gap in the study population

and to estimate the extent to which the communities need to be reached out to in order to make

them more responsible for their health and hence reduce the prevalence of hypertension.

6
 Data regarding the prevalence, awareness, and control of hypertension in different settings is

crucial to provide a criterion for not only monitoring but also notifying the development of new

strategies for improving hypertension control by the ministry of health.

This study would emphasize the prioritization of preventive initiatives and screening for

hypertension in public health education and media campaigns by health policy markers so that it

could be detected and treated earlier to prevent the occurrence of particular NCDs.

1.8 Conceptual framework

Social Demographic
factors; age, sex, marital
status, education
background

Awareness Health complications

 Awareness about  Heart disease

hypertension  Stroke
 Awareness about  Kidney
blood pressure Prevalence disease
status of HTN  Respiratory
disease
 Death
Obesity among
others
Lifestyle

 Physical
inactivity
 Tobacco
Smoking
 Alcoholism
 Diet
 Too much salt
intake

7
CHAPTER 2: LITERATURE REVIEW

2.0 Introduction

This chapter points out literature of other studies in relation to this study and constitutes the

following; burden of hypertension, awareness about hypertension, risk factors and outcomes of

hypertension.

2.1 The burden of hypertension

Hypertension is the leading cause and risk factor of cardiovascular diseases (Ostchega et al.,

2020) and premature mortality and morbidity worldwide (Vincent-Onabajo et al., 2017). Mills et

al., (2020) reported that previous studies had estimated a an estimate of a 31.1% prevalence of

hypertension among of adults in 2010 which wasis approximately 1.13 billion people worldwide.

Additionally, the hypertension prevalence in low-income countries was higher with 31.5%,

which was approximately 1.04 billion people, in comparison to higher-income countries with

28.5%, which approximated 349 million people (Mills et al., 2020). Recent reports by WHO as

of aAugust 2021, reported a 33% prevalence of hypertension among adult population worldwide.

A study by Ostchega et al.; (,2020) among adult Americans suggested the hypertension

prevalence to be higher as people age, with a 22.4% prevalence found among those aged 18–39,

54.5% among those aged 40–59, and 74.5% among those aged 60 and over (Ostchega et al.,

2020).

Several studies and predictions from various systematic reviews also show significant increases

in hypertension prevalence in both village and town populations in Africa over time (Bosu et al.,

8
2017, Bakilo et al., 2021). A study in 2013 estimated that the number of adults with hypertension

in Sub-Saharan Africa would have exceeded 125 million by 2025 (Kotwani et al., 2013).

Hypertension is increasingly prevalent in Uganda (Green et al., 2020) yet there is insufficient

data about it in the country and the continent of Africa as a whole. Twinamasiko et al., 2018

theorized that since hypertension is asymptomatic, many of the affected people may not be aware

of their status (Twinamasiko et al., 2018).

According to the Uganda National Non-Communicable Diseases Risk Factor Survey, a high

prevalence of hypertension (26.4%) was reported among adults in central Uganda, with only

7.7% being aware that they had hypertension (Musinguzi and Nuwaha, 2013, Kaddumukasa et

al., 2017, Guwatudde et al., 2015).

A high prevalence of hypertension is seen more among the elderly, males, obese people, those

with a family history of hypertension, the physically inactive, and those on a diet with fewer

vegetables and more additional salt consumption (Helelo et al., 2014).

Several studies have reported a significant prevalence of hypertension among traders. A study

amongst Jos market traders in Nigeria reported a 26.6% prevalence of hypertension (Daboer et

al., 2021), another study carried out among traders in Sokoto central market observed a 29.1%

prevalence of hypertension (Awosan et al., 2014) while a community based study among

workers in Enugu state Nigeria observed a 32.8% hypertension prevalence (Ulasi et al., 2011).

9
2.2 Awareness about hypertension

The prevalence of hypertension and pre-hypertension is often underreported due to its silent

nature (Rahman et al., 2017, Aldiab et al., 2018). Despite the surging prevalence of

hypertension, the levels of hypertension awareness are generally low in low- and middle-income

counties which increases on the financial burden of these countries (Mills et al., 2020). The

WHO-SAGE population survey carried out in South Africa among 1847 participants concluded

that 43% (802 participants) were hypertensive, yet 58% of the hypertensive were unaware of the

condition (Ware et al., 2019).

In south-western Uganda, a study done in peri-urban areas of Mbarara showed that 69.7% of the

hypertensive were unaware (Twinamasiko et al., 2018).

When the population is aware of hypertension, it reduces its exposure to the modifiable risk

factors, which will in turn reduce the incidence of hypertension, hence limiting the occurrence of

CVD like strokes in the population (Mokdad et al., 2018).

2.3 Risk factors of hypertension

It is suggested that living a sedentary lifestyle is linked to hypertension and, therefore, physically

inactive populations should be focused on if we are to produce a greater effect in terms of

reducing the NCD burden (Twinamasiko et al., 2018). Others include: Excess salt intake,

alcoholism, cigarette smoking, individual’s sex, age, dietary habits, BMI>25Kg/m 2 (Landi et al.,

2018), family history and marital status (Asresahegn et al., 2017, Omorogiuwa et al., 2021).

10
A study by Mouhtadi in 2018 found that the aged were 2.7 times more susceptible to suffering

from hypertension, with males being 2.4 times more vulnerable to suffering from the condition

than females. Being obese increased one’s risk of getting hypertension in both males and females

as compared to those who had a normal body weight. Smokers had a higher prevalence of 59.3%

than non-smokers with 40.7%. Likewise, varying education levels also pose a risk to

hypertension where 48% of participants without a university degree had hypertension while 24%

of participants with a university degree had hypertension (Mouhtadi et al., 2018).

However, Akinremi in 2020 reported that cardiovascular diseases like hypertension are

increasingly affecting more of the younger and high-stress populations like single parents,

women, and those responsible for their family’s welfare decisions (Akinremi, 2020).

A cross-sectional study in northeast China concluded that there was a positive correlation

between a reduced sleep period and hypertension among people aged 18–44 years (Chang et al.,

2022).

2.4 Outcomes of hypertension

Diseases like atrial fibrillation, heart valve diseases, dementia, aortic syndromes, heart failure,

chronic kidney disease, among others, have been attributed to increased blood pressure as

demonstrated by various cohort studies (Akinremi, 2020). In addition, increased blood pressure

has been linked to increased risks of coronary heart disease and stroke. The severe organ damage

due to hypertension also contributes to its deadly nature (Vincent-Onabajo et al., 2017).

11
CHAPTER 3: METHODOLOGY

3.0 Introduction

This chapter includes; the study design, study setting, study population, sample size estimation,

sampling, inclusion and exclusion criteria, data collection procedure, data entry and analysis,

ethical considerations and quality assurance.

3.1 Study Design

A descriptive cross-sectional study design utilizing quantitative methods among market traders

in Mbarara City, southwestern Uganda was used.

3.2 Study setting

This study was conducted in the markets of Mbarara City in southwestern Uganda. Mbarara City

has six divisions which include: Kamukuzi, Nyamitanga, Biharwe, Kakiika, Nyakayojo, and

Kakoba. Each division has at least one main market, making a total of eight main markets in

Mbarara City. These include: Koranorya, Mbarara central market, Kizungu, Lugazi,

Rwebikoona, Ruti, Marksingh, and Kakooba markets. There are a number of market traders in

Mbarara City, estimated to be 5000 in the 8 major markets stated. There were both men and

women, most of whom were over 25 years of age, selling different items. These traders included:

boutique owners, retail shop traders, grocery sellers, clothing, cutlery sellers, charcoal sellers,

and many more.

3.3 Study population

The target population of the study was market traders operating in different markets in Mbarara

City. The study was carried out in four markets, which were randomly selected from the eight

12
major markets. The selected markets included: Rwebikoona, Marksingh, Central Market, and

Koranorya.

3.4 Sample size estimation

To estimate the sample size, a Raosoft online calculator was used to compute the sample size of

the target population using a margin of error at 5%, a confidence level of 95%, a target

population size of approximately 5000 and a response distribution of 50%. The sample size was

357 study participants (Hazra and Gogtay, 2016). Sample allocation was done for each market

due to the different number of traders in the different markets, where Central market was

allocated 110, Koranorya 110, Rwebikoona 55 and Markahn Ssingh 82 participants.

3.5 Sampling

Each market population was divided into two strata, female and male, and then male and female

participants were recruited conveniently.

3.6 Inclusion criteria

Market traders aged 25 and above were recruited; traders who had been operating in the market

for over 6 months trading, spending at least 4 hours a day and more than 4 days per week

working in the market were also recruited (Odugbemi et al., 2012).

3.7 Exclusion criteria

Pregnant women at the time of data collection were not recruited into the study in order to

eliminate pregnancy-induced hypertension.

3.8 Data collection procedure

Consent forms were given to each participant in the study for them to consent, and then

researcher-guided questionnaires (Modified version of HELM scale) both English and

13
Runyankole versions with close-ended questions were used to examine the awareness of

participants about hypertension and lifestyle of the market traders. Each questionnaire had an

identification number for each participant and space for demographic data. A height board was

used to measure the height of each participant, and values were noted on paper in meters (cm). A

calibrated weighing scale was used to measure the weight of each study participant, and values

were noted on paper in kilograms (Kgs). Using weight and height values obtained for each study

participant, BMI values were calculated using an online BMI calculator and values were noted

on paper in Kg/m2. Two automatic blood pressure machines were used to measure the current

blood pressure of each participant after allowing 5 minutes for each participant to relax. Then 3

blood pressure measurements were taken, each at an interval of 1 minute from the other, and the

average blood pressure value was the mean of the last two blood pressure values, for both

systolic and diastolic blood pressures in (mmHg).

3.9 Data Entry and Analysis

Values and text data were entered into Microsoft Excel software program. The researchers then

copied the raw data from the Microsoft Excel program and pasted it into the Stata software

program. The latter was used to generate frequency distribution tables for categorical data and to

calculate mean values for continuous variables.

3.10 Ethical considerations

The proposal was presented for approval to the Faculty of Medicine Research Committee of

Mbarara University of Science and Technology (MUST) for approval. Permission was sought

from the chairperson of each market for the study to be conducted. There was voluntary

participation in the study, and prior informed consent was given by each participant. The

participants retained their right to decline participating or responding to any question without any

14
repercussions or being intimated by the researchers. For data confidentiality, the researchers used

unique identification numbers for each participant and kept consent forms separate from the

questionnaires under lock and key. In the dissemination of the researchers’ findings, the

identification of each participant remained anonymous.

3.11 Quality assurance

To ensure that instruments for data collection like the automatic blood pressure machines,

weighing scales and height boards were in good working condition, they were first tested on the

researchers to ensure that each researcher knew how to accurately take blood pressure, height,

and weight. An approved questionnaire was used.

15
CHAPTER 4: RESULTS

4.0 Introduction

This chapter presents results of a study conducted among market traders from four markets in

Mbarara City, southwestern Uganda, about the prevalence, awareness, and risk factors of

hypertension among market traders. It includes the demographics of the study participants,

lifestyle and health characteristics, BMI and blood pressure grades according to gender and age

categorization and awareness about hypertension.

4.1 Demographics

In this study, a total of 357 subjects were enrolled, with 263(73.67%) being females and

94(26.33%) males. The mean age was 41.6 ± 11.04 years.

Overall, the majority of the subjects were females, 73.7% (263/357) and males constituted the

smallest percentage, 26.3% (94/357). The marital status showed that 71.2% (254/357) of the

participants were married, 11.2% (40/357) were divorced, 10.4% (37/357) were widowed, and

7.35% (26/357) were single.

Looking at the educational level, we found that the majority, 51.82% (185/357), went to primary,

41.2% (147/357) went to secondary, 4.2% (15/357) were degree holders, 1.7% (6/357) were

diploma holders, and 1.12% (4/357) received no formal education as seen in table 4.1.0 below.:

16
Table 4.1.0 Demographics of the traders

Freq Cum
Parameters Percent.
. .
Site      
Central 110 30.81 30.81
Koranorya 110 30.81 61.62
Makahn
82 22.97 84.59
SinghMarkansingh
Rwebikoona 55 15.41 100
Total 357 100  
       
Sex      
Female 263 73.67 73.67
Male 94 26.33 100
       
Marital status      
Married 254 71.15 82.35
Divorced 40 11.2 11.2
Widowed 37 10.36 92.71
Single 26 7.28 100
       
Level of education    
Degree 15 4.2 4.2
Diploma 6 1.68 5.88
Primary 185 51.82 57.7
Secondary 147 41.18 98.88
No formal education 4 1.12 100

4.2 Lifestyle and health status characteristics of the participants

The mean BMI of the study participants was 29.56 ±6.17 Kg/m2. The body mass index of the

participants was distributed as follows; 43.7% (157/357) were obese, 31.9% (114/357) were

overweight, 23.3% (83/357) had normal BMI, and 1.1% (4/357) were underweight. Furthermore,

66.7% (238/357) of the market traders sit for more than 4 hours daily.

17
There were participants with normal blood pressure (<120mmHg systolic and <80mmHg

diastolic), pre-hypertensive (120-139mmHg systolic and 80-89mmHg diastolic), hypertensive-

grade 1(140-159mmHg systolic and 90-99mmHg), hypertensive-grade 2 (160-179mmHg

systolic and 100-109mmHg diastolic) and hypertensive-grade 3(> or =180mmHg systolic and >

or =110mmHg diastolic).

The mean systolic blood pressure and diastolic blood pressure were 134.46 ± 18.68 mmHg and

83.45±12.26 mmHg, respectively. Of those who were hypertensive, 93.4% (109/116) were

newly diagnosed. Overall, 44.6% (160/357) were pre-hypertensive and , 32.5% (116/357)

participants were hypertensive, where 21.9% (78/357) had grade 1 hypertension, 7.8% (28/357)

grade 2 hypertension, and 2.8% (10/357) grade 3 hypertension. 22.7% (81/357) had normal

blood pressure.

The results of the study show that the majority of participants 52.7% (188/357) use a motorbike

from home to their place of work, 36.4% (137/357) walk, 5.0% (18/357) use a vehicle, 2.5%

(9/357) use a bicycle, and 1.4% (5/357) walk and use a motorbikes

Overall, 98.3% (351/357) of the participants do not smoke cigarettes, with only 1.7% (6/357) of

them being current smokers. In addition, 72.8% (260/357) of the participants do not drink any

form of alcohol, with 27.17% (97/357) of those who drink alcohol as seen in table 4.2.0 below.

18
Table 4.2.0 Lifestyle and Health status characteristics of the traders

Parameter Freq. Percent. Cum.

Class of BMI      
Normal 83 23.25 23.25
Obese 156 43.7 66.95
Overweight 114 31.93 98.88
Underweight 4 1.12 100
       
Grade of BP      
Grade 1 HTN 78 21.85 21.85
Grade 2 HTN 28 7.84 29.69
Grade 3 HTN 10 2.8 32.49
Normal 81 22.69 55.18
Pre-HTN 160 44.62 100
       
Mode of transport    
Bicycle 9 2.52 2.52
Motorbike 188 52.66 55.18
Vehicle 18 5.04 60.22
Walk 137 36.38 98.6
Walk, motorbike 5 1.4 100
       
Physical
     
exercise
Football, jog 1 0.28 0.28
Jog 7 1.96 2.24
Don't do 349 97.7 100
       
Smoke cigarette      
Yes 6 1.68 1.68
No 351 98.32 100
       
Drink alcohol      
Yes 97 27.17 27.17
No 260 72.83 100
Sitting time      
<4hrs 119 33.33 33.33
>4hrs 238 66.67 100

19
4.3 BMI and bBlood pPressure grades according to gGender and aAge categorization

Overall, for the participants who were hypertensive, females contributed 26.3% (94/357) and

males contributed 6.2% (22/357). For those with grade 1 hypertension, females contributed

16.8% (60/357) and males contributed 5.0% (18/357). Among those with grade 2 hypertension,

females contributed 7.3% (26/357) and males 0.6% (2/357). For grade 3 hypertension, males

contributed 0.6% (2/357) and females 2.2% (8/357). Females contributed 16.8% (60/357) and

males 5.9% (21/357) to normal blood pressure. Overall, females contributed 30.5% (109/357)

and males 14.3% (51/357) to the pre-hypertensive.

For overall BMI, males contributed 11.8% (42/357) and females 11.5% (41/357) for normal

BMI. For the obese, females contributed 39.2% (140/357) and males 4.5% (16/357. For those

who were overweight, females contributed 22.7% (81/357) and males 9.2% (33/357), and for

underweight, males contributed 0.8% (3/357) and females 0.3% (1/357).

Of those who were hypertensive, 18.2% (65/357) were aged between 35 and 50 years, 10.1%

(36/357) were above 50 years of age, and 4.2% (15/357) were below 35 years. Of those with pre-

hypertension, 21.1% (75/357) were between 35 and 50 years old, 17.4% (62/357) were below 35

years old, and 6.4% (23/357) were above 50 years old. 11.8% (42/357) of those with normal

blood pressure were between the ages of 35 and 50, 8.96% (32/357) were under the age of 35,

and 1.96% (7/357) were over the age of 50.

Of those who were obese, 24.7% (88/357) were between 35 and 50 years old, 10.4% (37/357)

were below 35 years old, and 8.7% (31/357) were above 50 years old. For the overweight, 16.8%

(60/357) were between 35 and 50 years old, 8.7% (31/357) were below 35 years old, and 6.4%

20
 (23/357) were above 50 years old. For underweight, 0.6% (2/357) were below 35 years of age

and the same percentage of 0.3% (1/357) were between 35-50 years and above 50 years of age.

Those below 35 years and between 35 -50 years of age had the same percentage of normal BMI

of 10.1% (36/357) as shown in table 4.3.0 below:

Table 4.3.0 BMI and Blood pressure grades according to Gender and age categorization

    Grade of Blood pressure Grade of BMI

Paramete Pre- Grade Grade Grade Under Over
  Normal Normal Obese
r HTN 1 2 3 weight weight
Gende Male 2(0.56 42(11.76
21(5.88) 51(14.29) 18(5.04) 2(0.56) 3(0.84) 33(9.24) 16(4.48)
r No (%) ) )
Female 60(16.81 109(30.53 60(16.81 26(7.28 8(2.24 41(11.48 81(22.69 140(39.22
  1(0.28)
No (%) ) ) ) ) ) ) ) )
<35 0(0.00 36(10.08
  32(8.96) 62(17.37) 14(3.92) 1(0.28) 2(0.56) 31(8.68) 37(10.36)
years ) )
35-50 42(11.76 41(11.48 18(5.04 6(1.68 36(10.08 60(16.81
Age 75(21.01) 1(0.28) 88(24.65)
years ) ) ) ) ) )
4(1.12
  >50 years 7(1.96) 23(6.44) 23(6.44) 9(2.52) 11(3.08) 1(0.28) 23(6.44) 31(8.68)
)

4.4 Awareness about hypertension

In this study, 94.96% (339/357) didn’t know the range for normal blood pressure, 74.79%

(267/357) of the participants knew that hypertension would cause premature death, stroke, visual

disturbance and heart disease. 54.9% (196/357) didn’t know that hypertension causes kidney

disease.

61.90% (221/357) of the participants didn’t know that smoking tobacco, excessive alcohol

consumption, and eating red meat would cause hypertension. 76.47% (273/357) were aware that

excessive salt and fat consumption, physical inactivity, and stress can all lead to hypertension.

21
61.63% (220/357) of the participants knew that hypertension is not just a result of aging and that

treatment is necessary and that both treatment and change in lifestyle are important in controlling

high blood pressure. Overall, participants’ awareness about risk factors of hypertension was

good.

22
CHAPTER 5: DISCUSSION OF RESULTS

5.0 Introduction

This chapter relates the results above to the findings of other studies and gives probable

explanations for the prevalence, awareness and risk factors of hypertension found among the

Mbarara City market traders.

5.1 Prevalence of hypertension

The results highlighted a remarkable prevalence of both pre-hypertension and hypertension of

44.62% (160/357) and 32.5% (116/357), respectively, among our study population. This

prevalence was higher than a 26.5% HTN prevalence reported in a Ugandan national non-

communicable disease risk factor survey done in 2015 (Wesonga et al., 2016). This could be

accounted for by the fact that, on average, the market traders are overweight and most of them

are physically inactive. Females contributed a higher percentage of those who were pre-

hypertensive and hypertensive because, overall, females constituted a higher proportion of the

total population compared to males, which is in agreement with other similar studies done in

Sub-Saharan Africa. Another study among 255 market women traders in Dantokpa, Benin,

reported a 34% prevalence of hypertension among those traders (Ibrahim et al., 2020). A study

among 391 participants in 3 markets in Lagos, Nigeria, reported that 30.9% of the traders were

hypertensive (Achonu et al., 2022). However, a community-based study in a market population

in Enugu, Nigeria reported that 42.2% of the traders were hypertensive, a percentage higher than

this study’s prevalence (Ulasi et al., 2011). Participants between 35 and 50 years of age had the

highest prevalence of hypertension at 18.2% compared to other age categories. This could be

explained by the fact that this was the age category which contributed the greatest percentage of

23
traders who were overweight or obese. A similar study among people aged 35 to 60 years old

found a prevalence of hypertension of 20.5% which was similar to our findings (Mayega et al.,

2012)

5.2 Awareness about hypertension

Overall, 97.2% (347/357) were not aware of their blood pressure status. Of those who were

hypertensive, 93.4% didn’t know their blood pressure status. This could be explained by the fact

that very few individuals consulted medical personnel about their blood pressure status. This is

comparable to a lower 53.4% of those who did not know their blood pressure status in a

descriptive study which was carried out in three markets in Lagos (Achonu et al., 2022).

54.9% had ever consulted a health worker about their blood pressure status. However, this was

earlier in life when either they were pregnant or during the management of other illnesses.

Many participants knew the consequences of hypertension because many of them had had a

relative with hypertension who was suffering from one of the effects of the condition.

5.3 Risk factors of hypertension

A large percentage of study participants were found to be overweight or obese (75%), which is

way greater than a study done in Ondo state, Nigeria among market traders in Owo, which

reported that 39.9% of the traders were overweight or obese (OO et al.) and another study done

in Port Harcourt, Nigeria among market traders with a percentage of those overweight or obese

at 44% (Wordu and Akusu, 2018). The same study had a different distribution of the overweight

or obese individuals in terms of sex, where males were found to be more obese (33.0%) than

females (29%), which contradicts the results of this study, yet the number of participants was

24
almost the same (Wordu and Akusu, 2018). These findings may be attributed to a sedentary

lifestyle adopted by market traders due to the nature of their job that requires them to sit most of

the time unless they have customers (Odugbemi et al., 2012). BMI is closely associated with

gender and ethnicity, according to a study conducted among market traders in the Fiji Islands,

which discovered that obesity was more prevalent in women (58%) than in men (Ratumaiyale et

al., 2020). Current research has established a close correlation between high BMI and marital

status. A systematic review of changes in weight-related outcomes, diet, and physical activity

among the cohabiting and married concluded that being married resulted in a higher BMI and

reduced levels of physical activity, which could explain why most participants in the current

study who were married were also overweight or obese (Werneck et al., 2020).

A correlation between hypertension and obesity has already been established by various studies

(Leggio et al., 2017, Jiang et al., 2016) and therefore, the implication of this finding is that

individuals who are overweight or obese have a higher chance of suffering from a range of

health-related issues, hypertension inclusive.

Very few participants in our study population were found to smoke cigarettes, and a significant

percentage of market traders were found to be alcoholic (27.1%). This is comparable with

slightly higher values in other studies (Wordu and Akusu, 2018). Another study of 200

participants in mammy markets in Sokoto, Nigeria found a prevalence of alcoholism in market

traders of 75%, which was higher than in our study.  Alcoholism has been positively correlated

with the occurrence of hypertension and other cardiovascular diseases in many research studies

(Odugbemi et al., 2012).

25
This study found out that most of the market traders are physically inactive, with 97.7% of

market traders not involving themselves in any form of physical exercise. According to this

study, some of the physical exercises included: jogging, walking, football and cycling for at least

30 mins (Odugbemi et al., 2012). Also, most of the market traders sit for more than 4 hours a day

and use their motorcycles as a means of transport to and from work. These results correlate with

a 92% prevalence of physical inactivity which was found in an urban market in Lagos, Nigeria

(Odugbemi et al., 2012). A higher prevalence of physical inactivity was found in this study as

compared to a study among traders in Calabar metropolis, Nigeria which found a 58.3%

prevalence of physical inactivity (Ukweh et al., 2021). Based on the nature of the traders’ daily

work, the higher levels of physical inactivity found was not surprising because they spend most

of their time seated in their stalls; that is, from 8am to 7pm with little or minimal chance of

breaks since failure to remain consistently available in their stalls could lead to the loss of

potential customers or buyers since customers’ visits are not predictable.

26
CHAPTER 6: INTRODUCTION, SUMMARY, CONCLUSIONS, LIMITATIONS AND

RECOMMENDATIONS.

6.0 Introduction:

In this chapter, a summary of the main findings is provided and a concise conclusion is drawn.

The limitations of the study and some recommendations suggested are made at the end of the

chapter.

6.1 Summary

Hypertension remains one of the major causes of mortality and morbidity in low-and-high

income countries. From the study, it is noted that hypertension is a major problem among market

traders in Mbarara City in southwestern Uganda. The study found a prevalence of 44.6% and

32.5% of prehypertension and hypertension respectively among the market traders. Physical

inactivity and overweight/obesity were the most prevalent risk factors of hypertension among the

traders.

6.2 Conclusion

Due to the global change in the trend of diseases from communicable diseases to non-

communicable diseases, which include cardiovascular diseases, hypertension is among the

leading causes of mortality and disability, especially among populations whose lifestyle is a key

risk factor. Market traders were found to be among the populations at risk due to their reduced

physical activity and prolonged stays in one place, which triggered research in this area. A high

prevalence of hypertension was found among market traders, where a greater percentage were

newly diagnosed, while those that knew their blood pressure status were mostly mothers who got

27
measured when they were pregnant. This implies that people are still not keen on the general

wellbeing of their lives. A discrepancy between knowledge about the risk factors and effects of

hypertension and the prevalence of hypertension shows that people are unable to use the

knowledge they have to improve their health and that the kind of job they do may limit their

physical activity levels.

This study can be used as a stepping stone for further studies among market traders in other parts

of Uganda to check what is happening in these regions. Since it highlights some of the major

health issues, it presents areas where emphasis should be put in Uganda’s healthcare system to

see that the prevalence of cardiovascular diseases is reduced.

6.3 Limitations

This research study had certain limitations which included limited literature about our target

population (market traders).

The study also considered anyone having a systolic blood pressure of > or equal to 140 mmHg or

a diastolic blood pressure of > or equal to 90 mmHg to be hypertensive, yet there could have

been other factors contributing to the high blood pressure on the data collection day, for

example, stress, strenuous activity, and others.

6.4 Recommendations

To the market executive

Each market should at least have a clinic to do a mandatory general checkup for all traders.

28
To the health workers

Health workers should explain to patients about their vitals because most of the market traders

who had ever gone for a checkup complained that the health workers didn’t explain to them their

vital findings, of which blood pressure was inclusive.

To the researchers

Further research should be done to find out more about the prevalence of hypertension among

market traders in Mbarara City southwestern Uganda using correlative studies.7: LIMITATIONS OF

THE STUDY

This research study had certain limitations which included limited literature about our target

population (market traders).

The study also considered anyone having a systolic blood pressure of > or equal to 140 mmHg or

a diastolic blood pressure of > or equal to 90 mmHg to be hypertensive, yet there could have

been other factors contributing to the high blood pressure on the data collection day, for

example, stress, strenuous activity, and others.

29
8: CONCLUSION

Due to the global change in the trend of diseases from communicable diseases to non-

communicable diseases, which include cardiovascular diseases, hypertension is among the

leading causes of mortality and disability, especially among populations whose lifestyle is a key

risk factor. Market traders were found to be among the populations at risk due to their reduced

physical activity and prolonged stays in one place, which triggered research in this area. A high

prevalence of hypertension was found among market traders, where a greater percentage were

newly diagnosed, while those that knew their blood pressure status were mostly mothers who got

measured when they were pregnant. This implies that people are still not keen on the general

wellbeing of their lives. A discrepancy between knowledge about the risk factors and effects of

hypertension and the prevalence of hypertension shows that people are unable to use the

knowledge they have to improve their health and that the kind of job they do may limit their

physical activity levels.

This study can be used as a stepping stone for further studies among market traders in other parts

of Uganda to check what is happening in these regions. Since it highlights some of the major

health issues, it presents areas where emphasis should be put in Uganda’s healthcare system to

see that the prevalence of cardiovascular diseases is reduced.

30
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MILLS, K. T., STEFANESCU, A. & HE, J. 2020. THE GLOBAL EPIDEMIOLOGY OF

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10 APPENDICES

Appendix 1: Consent form

MBARARA UNIVERSITY OF SCIENCE AND TECHNOLOGY

INSTITUTIONAL REVIEW COMMITTEE

P.O. Box 1410, Mbarara, Uganda

Tel: +256-4854-33795 Fax: + 256 4854 20782

Email: irc@must.ac.ugmustirb@gmail.com

Website: www.must.ac.ug

Study title

AWARENESS, PREVALENCE AND RISK FACTORS OF HYPERTENSION AMONG

MARKET TRADERS IN MBARARA, A CITY IN SOUTHWESTERN UGANDA

Dear respondent, you are kindly requested to participate in a study which will investigate about

awareness, prevalence and risk factors of hypertension among market traders in Mbarara city.

You are free to ask the investigators any question about what you do not understand concerning

the study which will be promptly answered.

Purpose of the study

During the study process, the researchers’ main aim will be to assess the current awareness about

hypertension, its prevalence and risk related factors among market traders in Mbarara city.

45
Following your assent, a questionnaire written in English/ Runyakole will be administered to you

containing questions that will cover social demographics except the name, other questions

related to your current awareness about hypertension and about your lifestyles to get a clue about

some of those lifestyles that might redispose you to getting hypertension. Your blood pressure,

height and weight will be measured to help us know your blood pressure status, and the risk

factors for hypertension.

What you need to know about this study

As you are being requested to participate in the study, this consent letter explains the research

study and your part in the study. Please read it carefully, take as much time as you need for

proper understanding of the information in it. Please note that you are a volunteer and thus you

can choose to take part or not and you remain with the right to quit at any time as your will.

There will be no penalty if you decide not to participate or quite the study.

Why are you being requested to participate

The researchers do believe that you are equipped with the information required to fulfill the aims

of their study.

Discomforts / fears

You will experience some minimal discomforts during blood pressure measurements and the

information provided will be confidentially handled.

Benefits of the study

Being the first study to be conducted at Mbarara University of science and technology, the

findings could act as a foundation for further research. This study will be used by policy makers

46
of Mbarara city to develop policies that will provide favorable working conditions for market

traders. Will also be used to create awareness about hypertension, identify the prevalence of

hypertension and the risk factors for hypertension among market traders in Mbarara city. You

will also be able to know your current blood pressure status at the end of the research study.

Incentives / rewards for participating

There will be no incentives or payment given but your co-operation is of value to the researcher.

Risks

There will be a risk of disclosure of abnormal results. This will be dealt with by referral to other

health care providers for further management

Confidentiality

You can be assured that the researchers will not use your name on a questionnaire or anywhere

and the information you provide will not be shared with anyone unless you permit the

researchers to do so. Thus, you will be interviewed individually in a place free from interference,

and the response you will provide to the researchers will be coded and the data capturing tools

will be kept under lock and key.

Researchers

1. ZIRIMENYA JOEL (0757884715/0773078515)

2. NAMPIJJA RITAH (0756859523)

3. NINSIIMA PATIENCE (0759453859)

4. NABIRYE AFUSA (0754567010)

47
5. NJAKA SADIC (0757017259)

What your signature / thumb print means on this consent form:

Your signature on this consent form means that you have been informed about the study to be

conducted, purpose, procedure, discomforts, confidentiality, benefits of the study and you have

been given a chance to ask any question before your sign and you have voluntarily agreed to

participate in the study.

Initials of participant __________________ Signature/ thumbprint of participant________

Date___________

48
49
Appendix 2: Questionnaire

RESEARCH STUDY QUESTIONNAIRE:

AWARENESS, PREVALENCE AND RISK FACTORS OF HYPERTENSION AMONG

MARKET TRADERS IN MBARARA CITY IN SOUTH WESTERN UGANDA

Identification number of participant: _____

Demographic and social factors:

1. Age:

2. Sex: Marital status:

Single

Married

Divorced

Level of education

50
AWARENESS ABOUT HYPERTENSION/ HIGH BLOOD PRESSURE

1. When somebody’s blood pressure is 115/75, it is

High

Low

Normal

Do not know

2. If someone’s blood pressure is 160/100, it is---?

High

Low

Normal

Do not know

3. When someone has high blood pressure, it usually lasts for?

A few years

5-10 years

The rest of their life

Do not know

4. Have you ever consulted your health worker about your blood pressure status?

Yes

Never

5. Rate your confidence in detecting hypertension/high blood pressure

Very confident

51
 Confident

Not confident. I will need more guidance.

6. Do you know of anyone who has high blood pressure?

Yes

No

7. High blood pressure if left untreated, can cause a person to have a stroke

Yes

No

Do not know

8. Increased blood pressure can cause heart diseases such as heart attack if left

untreated

Yes

No

I don’t know

9. Increased blood pressure can cause premature death if left untreated

Yes

No

I don’t know

10. Increased blood pressure can cause kidney failure if left untreated

Yes

No

I don’t know

11. Increased blood pressure can cause visual disturbances if left untreated

52
 Yes

No

I don’t know

12. High blood pressure can be cure?

Yes

No

Do not know

13. Eating much salt usually makes blood pressure

Go up

Go down

Stay the same

Do not know

14. Smoking a packet of cigarettes per day will not affect a person risk of hypertension

Yes

No

Do not know

15. A person with high blood pressure should eat less fat

Yes

No

Do not know

16. A person with high blood pressure should eat fruits and vegetables frequently

Yes

Know

53
 Do not know

17. Moderate to vigorous exercise 30 minutes/day 3-5 times a week lowers blood

pressure

Yes

No

Do not know

18. Do you know your current blood pressure status?

Yes

No

19. If Yes, are you:

Normal

Hypertensive

20 When did you last test for your blood pressure?

One year ago

More than a year ago

Never

21. Excessive alcohol consumption does not cause hypertension

Yes

No

I don’t know

22. Stress does not cause hypertension

54
 Yes

No

I don’t know

23. Physical inactivity can cause hypertension

Yes

No

I don’t know

Hypertension is a result of aging, so treatment is unnecessary

Yes

No

I don’t know

19. If the medication for increased blood pressure can control blood pressure, there no

need to change lifestyle

Yes

No

I don’t know

20. If individuals with increased blood pressure change their lifestyle, they don’t need

treatment

Yes

No

I don’t know

55
 21. Drugs for increased blood pressure must be taken every day

Yes

No

I don’t know

22. Individuals with increased blood pressure must take their medication only when

they feel ill

Yes

No

I don’t know

23. The best type of meat for individuals with increased blood pressure is

Red meat

White meat

I don’t know

LIFESTYLE OF MARKET ATTENDANTS

1. How long do you stay seated in a day?

Less than

Most of the times

2. What means of transport do you use?

Walk

Bicycle

Motor bike

Vehicle

56
3. Do you do physical exercises?

Yes

no

4. If yes, which physical exercises do you engage in and how long per session

Jogging

Walking

Foot ball

Others

5. Do you smoke cigarettes?

Yes

No

6. If yes how many sticks a day?

2-5

More than 5

7. Do you drink alcohol?

Yes

No

8. If yes how many bottles do you take in a week?

<5

5-10

>10

57
58
 SUBMISSION
Appendix 3: Time frame

YEAR 2021

MONTHS OF THE J A S O N D

YEAR
U U E C O E

L G P T V C

PROPOSAL

WRITING

ETHICAL

APPROVAL

DATA

COLLECTION

DATA ENTRY AND

ANALYSIS

REPORT WRITING

DISSEMINATION

OF RESULTS

RESEARCH BOOK

59
Appendix 4: Budget

ITEM NO OF ITEMS

Consent forms 360

Questionnaire(both for 360

english and runyakole)

Transport Five people@40000

printing and binding (final)

Miscillaneous

TOTAL AMOUNT

60