Prevalence and risk factors of hypertension among patients with hydrocele in Dar es Salaam, Tanzania, 2022

Abstract

Introduction: Hypertension is one of the leading causes of premature death worldwide. The last national survey reveals that in Tanzania, about 26% of all young adults aged 25-64 were estimated to have hypertension in 2013. Patients with Lymphatic Filariasis (LF) who develop hydrocele may be at high risk of developing hypertension due to their physically inactive lifestyle. Magnitude and factors associated with hypertension among hydrocele patients have not been determined. The study was done to determine the prevalence of hypertension and its associated factors among individuals with hydrocele due to LF in the Dar es Salaam region. Methods: A cross-sectional analysis of secondary data was conducted among patients with lymphatic filariasis–related hydrocele undergoing pre-surgical screening. Hypertension was defined as systolic blood pressure (BP) ≥ 140 mmHg and/or diastolic BP ≥90 mmHg. A chi-square test was performed to determine the significance of differences in hypertension across variables. A modified multivariate Poisson regression analysis was performed to determine the association between variables while adjusting for confounders. P-value ≤0.05 at 95% CI was statistically considered significant. Results: Among 484 patients with Lymphatic Filariasis hydrocele analysed, the prevalence of hypertension among the patients was 43.4% (n=211, 95%CI 39.2-48.1). Patients aged  45 years had a higher risk [Adjusted Prevalence Ratio (APR) 2.5, 95%CI: 1.35 – 4.64] of developing hypertension. Being diabetic (>7mmol/L) had a 52% (APR=1.52, 95% CI: 1.17-2.00) higher prevalence of hypertension. Obese patients had a 36% higher risk (APR =1.36, 95% CI: 1.05-1.75) of developing hypertension as compared to those with a normal body mass index. Other factors, including education, occupation, marital status, ivermectin/albendazole use, and duration of hydrocele, were not statistically significant after adjustment. Conclusion: The findings highlight a potential link between hydrocele due to lymphatic filariasis and hypertension, with its elevated risk. Integrating non-communicable disease management, particularly hypertension screening and care, into existing lymphatic filariasis programs could enhance patient outcomes. The LF elimination program is encouraged to consider such integrated approaches in affected regions.