Document Type
Article
Publication Date
8-22-2025
Abstract
Background 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. Aims 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. Methods Participants, enrolled across 3 Ugandan sites, were adults with high stroke risk. The primary outcome was a change in systolic blood pressure (SBP) from baseline to 6-month follow-up. Secondary outcomes included changes from baseline to 6 months on diastolic BP (DBP), serum lipids, glycosylated hemoglobin (HbA1c), self-efficacy and stress. Results 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). Conclusions 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.
Language
English
Publication Title
Plos One
Grant
R01NS118544
Rights
© 2025 Kaddumukasa et al. This is an Open Access work distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Kaddumukasa M, Kaddumukasa M, Mbalinda SN, Najjuma J, Nakibuuka J, Birungi D, et al. (2025) A 6-month, prospective randomized controlled trial of the TargetEd MAnageMent (TEAM) intervention vs. enhanced treatment as usual among Ugandans at risk for stroke. PLoS One 20(8): e0330606. https://doi.org/10.1371/journal.pone.0330606
Manuscript Version
Final Publisher Version