Journal Article

A 6-month, prospective randomized controlled trial of the TargetEd MAnageMent

Kaddumukasa, Mark, Kaddumukasa, Martin, Burant, Christopher J, Katabira, Elly T, Mbalinda, Scovia Nalugo, Najjuma, Josephine, Birungi, Doreen, Conroy, Carla, Moore, Shirley, Mugenyi, Levicatus, Nakibuuka, Jane, Yala, Joy, Sajatovic, Martha

2025

Overview

Among low and middle-income countries, especially in Sub-Saharan Africa, the stroke burden is severe, with increasing trends in stroke incidence, prevalence, and mortality. This 6-month, prospective randomized controlled trial (RCT) compared a novel stroke risk reduction approach (TargetEd manAgeMent Intervention (TEAM)) vs. Enhanced Treatment as Usual (ETAU) in 247 Ugandans at risk for stroke. The mean sample age was 55.4 (±SD = 12.0) with majority being women (n = 168, 68%). In addition to hypertension, the most common risk factors were hyperlipidemia (n = 199, 80.6%) and obesity (n = 98, 39.7%). Overall mean SBP and DBP at baseline were 143.0 (SD = 19.8, range 94.5-206) and 89.3 (SD = 14.0, range 61-136) respectively. In TEAM, SBP significantly improved from 145.7 (±21.5) at baseline to137.4 (±18.1) at 6-months vs. change from 141.9 (±18.4) to 141.1 (±21.9) for ETAU (p = 0.031). There were similar reductions in DBP favoring TEAM (p = .012). Compared to ETAU, TEAM showed improved physical activity (p = .017), self-efficacy (p < .001) and stress (p = .014). There is a need for effective and practical approaches to reduce stroke burden in Sub-Saharan Africa. Inclusion of the TEAM approach in primary care seems to be a pragmatic and effective way to potentially reduce stroke burden in Uganda.

• Publisher: Public Library of Science
• Subject: Blood lipids / Care and treatment / Clinical trials / Exercise / Glycosylated hemoglobin / Health aspects / Hypertension / Mortality / Obesity / Patient compliance / Prevention / Risk factors / South Africa / Stroke (Disease) / Sub-Saharan Africa / Uganda