Cost-effectiveness of leveraging existing HIV primary health systems and community health workers for hypertension screening and treatment in Africa: An individual-based modelling study

BackgroundCardiovascular disease (CVD) morbidity and mortality is increasing in Africa, largely due to undiagnosed and untreated hypertension. Approaches that leverage existing primary health systems could improve hypertension treatment and reduce CVD, but cost-effectiveness is unknown. We evaluated the cost-effectiveness of population-level hypertension screening and implementation of chronic care clinics across eastern, southern, central, and western Africa.
Methods and FindingsWe conducted a modelling study to simulate hypertension and CVD across 3000 scenarios representing a range of settings across eastern, southern, central, and western Africa. We evaluated two policies compared to current hypertension treatment: 1) expansion of HIV primary care clinics into chronic care clinics that provide hypertension treatment for all persons regardless of HIV status (chronic care clinic or CCC policy), and 2) CCC plus population-level hypertension screening of adults ≥40 years by community he..., , , # Cost-effectiveness of leveraging existing HIV primary health systems and community health workers for hypertension screening and treatment in sub-Saharan Africa: An individual-based modelling study

[https://doi.org/10.5061/dryad.5x69p8d9b](https://doi.org/10.5061/dryad.5x69p8d9b)

## Description of the data and file structure

The data files consist of the HIV synthesis mathematical model, within which we have incorporated parameters for hypertension and cardiovascular disease. We ran the model (hiv_synthesis.sas) 3000 times to generate a variety of setting scenarios representative of settings across East, South, Central, and West Africa. We then summarized outcomes over a 50-year time horizon using the Create Wide file (create_wide.sas). The final dataset for primary analysis from the 3000 model runs is contained in w_base105_d3pct.sas7bdat.

This dataset includes model estimates for each of three policies: current standard of care (SOC), implementation of chronic care clinics deliv...