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Table 1 Study characteristics

From: The economic burden of treating uncomplicated hypertension in Sub-Saharan Africa: a systematic literature review

Study reference

Country

Health economic study design (CA: cost analysis; CEA: cost effectiveness anl., CD: cost description; CMA: cost minimization anl.; COD: Cost outcome description; CUA: cost utility anl.)

Costing approaches (BU: bottom up; HCA: human capital approach; RVA: replacement value approach; WP: willingess to pay; TD: top down)

Costing perspective (CG: caregiver; CO: companion; HO: household; HS: healthsystem; PA: patient; PR: provider, PY: payer; S: societal)

Cost components (0: total cost, 1A: direct medical cost; 1B: direct non medical cost; 2: indirect cost; 3: clinic cost; 4: intervention cost)

Study design generating effectiveness or outcomes (MA: meta analysis, OS: observational study, OT: other study designs, RCT: randomised controlled trial)

Setting (HC: health center; HP: Hospital; MI: missionary; NFP: not for profit organization; NGO: non governmental organization; R: rural; PRI: private; PU: public; U: urban)

Sample definition (AH: arterial hypertension, BP: blood pressure; SPB: systolic blood pressure, y: years)

Sample size (N)

Main outcomes (AH: arterial hypertension, CHE: catastrophic health expenditure, NCD: non communicable diseases)

Quality, (Quality tool used)

Labhardt et al. [32]

Cameroon

COD

BU

PA

1A, 1B

RCT

PU/MI, R, HC

patients diagnosed with uncomplicated AH

130

retention rates and costs of a nurse led intervention

Medium (Rob2)

Dzudie et al. [33]

Cameroon

CD

BU

PA

1A

NAa

PU, U, HP

patients diagnosed and treated for AH (≥140/90 mmHg)

408

prescribing patterns of AH drugs and evaluation of effects on BP control

Medium (COI quality)

Lulebo et al. [34]

Dem. Rep Congo

COD

BU

PA + CO

1A, 1B

OS

PU, HP/HC

patients diagnosed with AH (≥140/90)

260

AH control rates and costs of a task shifting intervention

High(CHEERS)

Zawudie et al. [35]

Ethiopia

CD

BU, HCA

PA + CO

0, 1A, 1B, 2

NAa

PU/NGO, R/U, HP

stage 1: 140–159/90–99 mmHg, stage 2: ≥ 160/100 mmHg

349

cost of illness (AH)

High (COI Quality)

Bedane [36]

Ethiopia

CD

BU

PA + CG

1A, 1B, 2

NAa

PU, U, HP

patients diagnosed with AH

422

out of pocket expenditures for AH patients and caregivers

Medium (COI Quality)

Tolla et al. [37]

Ethiopia

CD

BU

HO

1A, 1B

NAa

PU/PRI, U/R, HP

patients diagnosed with AH

235

out of pocket costs and CHE for cardiovascular disease treatment

High (COI Quality)

Adane et al. [38]

Ethiopia

CD

BU, HCA, RVA

PA

0, 1A, 1B, 2

NAa

PU, R/U, HP

patients diagnosed with AH

442

cost of illness (AH)

High (COI Quality)

Pozo-Martin et al. [39]

Ghana

CEA

BU

S, PA, PR

0, 1A, 1B, 2, 4

OS

PU/PRI, U, HP/HC

patients treated for AH at least for 12 months, age 18–79 y

10,000 c

evaluation of AH control with a community based intervention

High(CHEERS)

Jha et al. [40]

Guinea

CEA

TD

PR

1A, 3, 4

OTb

PU, HC

patients diagnosed with AH

37,100 d

cost and cost effectiveness of an antihypertensive intervention

Medium (CHEERS)

Subramanian et al. [41]

Kenya

CA

BU

PA

1A

NAa

PU/PRI, R/U, HP/HC

NRa

NRa

cost and affordability of different NCDs

High (COI Quality)

Subramanian et al. [42]

Kenya

CUA

BU

HS

1A, 4

MA RCT

NRa

cohort with risk index (with BP level and 10 year CVD risk)

1000,000 c

cost and cost effectiveness of a risk stratified mangement approach

High (CHEERS)

Oti et al. [43]

Kenya

COD

TD

PR

1A, 1B, 3, 4

OS

PU/PRI, U, PC

BP ≥ 140/90 mmHg

976

outcomes and costs of a community intervention

Medium (CHEERS)

Oyando et al. [44]

Kenya

CD

BU, HCA

PA + CG

0, 1A, 1B, 2

NAa

PU, R, HP/HC

self reported AH, treated for 6 months

212

patient costs for AH treatment

High (COI Quality)

Ba et al. [45]

Mali

CA

BU

PY (insurance)

1A, 1B

NAa

PU, HP

patients newly diagnosed with or not yet treated for AH

280

costs in regard to insurance status

High (COI Quality)

Gaziano et al. [46]

Multiple

CA

BU, WP

S

1A, 2, 3

NAa

NRa

SBP > 115 mmHg

NRa

global cost of AH illness and complications

High (COI Quality)

Osibogun et al. [47]

Nigeria

CD

BU

PA

1A

NAa

PU, HP

patients diagnosed with AH

147

prescribing patterns and cost of prescription

Medium (COI Quality)

Akunne et al. [48]

Nigeria

CA

BU

PA

1A

NAa

PU, HP

patients receiving treatment for AH

1050

prescibing pattern, cost and quality of care

Medium (COI Quality)

Bakare et al. [49]

Nigeria

CD

BU

PA

1A

NAa

PU, HP

patients diagnosed with AH

200

prescribing patterns, cost of prescription and laboratory

Medium (COI Quality)

Onwujekwe et al. [50]

Nigeria

CA

TD

HO

1A, 1B

NAa

PU/PRI, R/U, HP/HC

AH outpatient and inpatient visits

154

economic burden of different health conditions

High (COI Quality)

Ekwunife et al. [51]

Nigeria

CUA

BU

PR (third party)

1A

MA RCT

NRa

cohort with risk index according to 10 year CHD/stroke risk

1000 c

cost effectiveness of drug treatment with different drug classes

High (CHEERS)

Rosendaal et al. [52]

Nigeria

CUA

TD

PR (healthcare)

1A, 4

OS

PU/PRI, R

patients diagnosed with AH (JNC 7 guidelines)

10,000 c

costs and cost effectiveness within an insurance program

High (CHEERS)

Hendriks et al. [53]

Nigeria

CMA

BU, TD

PR (healthcare)

1A, 3

NAa

PRI, R, HP

patients diagnosed with AH

322

cost of cardiovascular prevention care in different scenarios

High (CHEERS)

Ilesanmi et al. [54]

Nigeria

CEA

BU

PA

1A, 1B

OS

PU, R, HP

patients diagnosed with AH (JNC 7 guidelines)

250

costs and cost effectiveness of AH treatment

Medium (CHEERS)

Oamen et al. [55]

Nigeria

CMA

BU

PA

1A

OS

PU, HP

patients diagnosed with AH with regular outpatient visits

255

antihypertensive drug use and comparative cost analysis

High(CHEERS)

Eberly et al. [56]

Rwanda

CD

TD

PR (public)

1A, 1B, 3

NAa

PU, R, HP

patients diagnosed with AH

223

costs for setting up and maintaining a NCD clinic

Medium (COI Quality)

Ndagijimana [57]

Rwanda

CA

TD

PR (Public)

1A, 1B, 3

NAa

PU, R, HP

patients diagnosed with AH

68

cost of providing AH care

Medium (COI Quality)

Bovet et al. [58]

Seychelles

CA

BU

PR

1A

NAa

PU, PC

BP stages: 1: 140–159/90–99, 2: > = 160/100

1255

costs for treating high risk cardiovascular disease patients

Medium (COI Quality)

Watkins et al. [59]

South Africa

CEA

BU

PA

1A, 4

MA OS

PU/PRI

NRa

1000,000 c

cost effectiveness and outcomes of a salt reduction policy

High (CHEERS)

Gaziano et al. [60]

South Africa

CEA

BU

HS

1A, 4

MA OS + RCT

NRa

cohort with different guidelines and risk profiles

10,000,000 c

cost and cost effectiveness of different guidelines

High (CHEERS)

Gaziano et al. [61]

South Africa

CEA

TD

PR

1A, 4

MA RCT

U/R, PC

NRa

NRa

cost and cost effectiveness of a community intervention

High (CHEERS)

Basu et al. [62]

South Africa

CEA

TD

HS

1A

MA OS

NRa

BP ≥ 140/90 mmHg or being on AH treatment

7099 c

costs and cost effectiveness of scaling up cardiovascular treatment

High (CHEERS)

Edwards et al. [63]

South Africa

COD

BU

PR (pharmacy)

1A

OS

PU, HC

patients diagnosed and treated for AH

1084

prescribing patterns and costs of new treatment guidelines

Low (Bevor-After)

Settumba et al. [64]

Uganda

CA

BU, TD

PR (public + private)

1A, 1B, 3

NAa

PU/PRI NFP, U/R, HP/HC

NRa

NRa

provider costs of different chronic diseases

High (COI Quality)

  1. aNA Not applicable, NR Not reported
  2. bsynthesis of several data sources, including RCTs, observational studies, and expert opinions
  3. csimulated cohorts
  4. dtarget population