Prevalence of Hypertension, awareness, treatment, and blood pressure control in Sierra Leone: A systematic review and meta-analysis

Background: In recent years, the prevalence of Hypertension (HTN) has increased in sub-Saharan countries. However, reports on the prevalence of HTN in Sierra Leone are limited. Therefore, we conducted a systematic review and meta-analysis to assess the overall estimates of the prevalence of HTN in Sierra Leone. Method: A systematic search of electronic databases (PubMed, Embase, African Journal Online and Google Scholar) was conducted by three independent investigators using keywords such as hypertension, prevalence, blood pressure, and Sierra Leone. A random-effects model was used to estimate the prevalence across studies. Heterogeneity among studies was assessed using the Cochran Q test and I2 statistic, and publication bias was assessed using funnel plots and the Egger test. Results: We pooled the data from 15 studies (n=14,707) that met the inclusion criteria. The overall prevalence of HTN in Sierra Leone was 27.64% [95% CI = 27.45, 27.82], with significant heterogeneity observed among studies (I2 =99.82%, p-value < 0.001). The pooled prevalence of Hypertension among males was higher than that among females (25.11% [95% CI = 24.90-25.32], I2 =99.79%, p-value < 0.001) and 24.11% [95% CI = 23.92,24.31, I2 =99.67%, p-value < 0.001]). The prevalence of HTN among urban residents (29.76%) was almost twice that among their rural counterparts (15.77%). Of those with HTN, 37.21% were aware of their illness, 12.87% received treatment, and only 29.73% had blood pressure control. Conclusion: More than 1 in 4 adults aged ≥ 15 years are living with HTN in Sierra Leone, with a low awareness rate and even lower treatment and control rates. Our findings highlighted the need for robust and comprehensive hypertension prevention, treatment and control policies. Keywords: Prevalence, Hypertension, Treatment, Systematic review, Meta-analysis, Sierra Leone ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors.