Non-communicable disease screening and HIV testing and counselling in rural KwaZulu-Natal, South Africa (NCD) 2015

The data set includes information on anthropometry, mental health, general health state, blood pressure, LDL Cholesterol, Rapid Glucose Assessment, pulse, Working memory, NCD risk factors, chronic condition and health service coverage and health care utilisation.

The data set consists of 587 cases and 227 variables.

South Africa faces dual epidemics of HIV and non-communicable chronic diseases (NCDs; hypertension, diabetes, obesity). Differentiated care for HIV, community health workers providing testing and linkage services in the community, has the potential to integrate NCD screening with community-based HIV testing, improve service delivery and avert leading causes of morbidity and mortality. However, characterization of prevalence of NCDs and integration with HIV linkage is limited; evidence from community-based HIV testing and counselling programs are required

A home based HIV counselling and testing study was conducted rural and peri-urban communities in Kwa-Zulu Natal, South Africa between November 2011 and June 2012. 545 contiguous households were approached and all adults over the age of 18 were offered an HIV test.  During follow-up visits in January 2015 HIV, depression, obesity, blood glucose, cholesterol and blood pressure screening were conducted using point-of-care tests. This study used an integrated home based testing and screening service to identify individuals who were either HIV positive or at risk of developing cardiometabolic diseases.

Its objective was to provide a better understanding of the complexity, severity and prevalence of non-communicable disease in a community which is known to have one of the highest rates of HIV incidence and prevalence in the world.

The dataset includes information from 587 participants on the following:

• HIV status
• Anthropometry (height and weight, waist and hip circumference)
• Mental Health (PHQ-9)
• General Health State
• Blood Pressure, LDL Cholesterol, Rapid Glucose Assessment, Pulse
• Working Memory (Digit Span)
• NCD Risk Factors
• Chronic condition and Health Service Coverage
• Health Care Utilisation

Random sample from the 50 000 people living in Mpumuza.

Persons younger than 18 living in Mpumuza and all household members not previously enrolled, and members unable to give written consent.

All households previously screened and enrolled were revisited for follow-up. Participants were visited, consented and offered the standard HBCT service. Participants then took part in the HBCT-NCD follow-up data collection activities. Data will be collected using survey, anthropometric and biological measures with the purpose of establishing the prevalence of a range of non-communicable diseases and associated risk factors.

Households were informed about the additional HBCT-NCD data collection activity, and invited to participate. Inclusion criteria for the HBCT-NCD activities included: 1) a participant in the parent HBCT study, and 2) would have been able to receive counseling and point-of-care testing after an overnight fast. Survey, anthropometric and biological measurement data were collected. Data collection covered community, household and individual factors.

The sample frame consists of all households previously enumerated in the HBCT study.

Inclusion criteria: All adults enrolled during the HBCT study visit who were present during the follow-up HBCT-NCD visit, and who were available to receive blood pressure, lipid and glucose counselling and point-of-care testing.

Exclusion criteria: All household members not previously enrolled, and members unable to give written consent.

All 545 households were revisited a maximum of two times and household members previously enrolled in the HBCT study will be offered and opportunity to receive the standard HBCT service. Participants will then be taken through the data collection activities of the HBCT-NCD follow-up.

Study Procedures

All eligible households will be visited. They will then be informed of the services being offered and the additional data collection activity, with a focus on their more general health and wellbeing. Those willing to participate will be taken through the informed consent process before being offered standard HBCT. Following this, the HBCT-NCD data collection activities will commence. Data will be collected by trained interviewers in a direct interview with the household member. The activities that will make up the HBCT-NCD visit include:

Glucose and lipid counts were obtained using point of care equipment. If readings were abnormal participants were asked to fast overnight and then revisited in order to collect measurements under conditions of fasting. After 3 months a telephonic interview was conducted to assess linkage to care and record any medication that may have been prescribed.

Mobile phones were used to collect all operational and interview data to increase efficiency data capture and analysis. This method has been successfully employed on several studies conducted by the HSRC. Information from the questionnaires were uploaded to a secured server at the HSRC Research Center office. The de facto standard for securing network traffic is Secure Sockets Layering (SSL). This technology is fully supported by the handsets used in this study and ensures that all data transferred between the device and the server is encrypted. Similarly when reviewing, exporting or managing data via the web-based Research Management Console all communications between browser and server are encrypted. The study database was backed-up regularly. All biological samples were barcoded and a photograph of the barcode captured on the mobile phone as part of the survey. Physical measurements were also captured onto the mobile phone based survey.

• Information via a survey questionnaire: i.e. socioeconomic and demographic variables; risk factors such as tobacco, alcohol, nutrition and physical activity; a general health assessment; health care utilisation and Mental Health.
• Physical measurements: body weight, height, waist circumference, hip circumference
• Biochemical measurements: blood glucose and total cholesterol;
• Repeat HIV testing for participants who tested negative at the first HBCT visit and who report their current HIV status as negative.
• Blood Pressure measurement - in accordance with the American Heart Association recommendations.

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