# Linkage to and retention in chronic care among patients diagnosed with hypertension, diabetes, or HIV in DIMAMO PHRC clinics, South Africa

## TL;DR

This study examines how patients with hypertension, diabetes, or HIV in South Africa are linked to and retained in chronic care services, finding that retention is highest for those with single conditions.

## Contribution

The study quantifies linkage and retention rates in chronic care for patients with hypertension, diabetes, or HIV in South Africa, identifying demographic and diagnostic factors influencing retention.

## Key findings

- Retention in care was highest for diabetes patients (34.8%) and lowest for those with comorbid hypertension and diabetes (10.9%).
- Females had a higher prevalence of hypertension compared to males (30.9% vs 22.8%).
- Age, gender, and diagnosis were significant factors associated with retention in care.

## Abstract

Chronic conditions such as hypertension, diabetes mellitus, and HIV continue to be significant contributors to morbidity and mortality in sub-Saharan Africa, including South Africa. This study aims to quantify the proportion of patients diagnosed with hypertension, diabetes, and/or HIV who are successfully linked to and enrolled in chronic care services at DIMAMO PHRC clinics. The study employed a quantitative, cross-sectional analytical design using routinely collected clinic data covering a six-month period. The research was conducted at the DIMAMO PHRC, which serves as a Health and Demographic Surveillance System. The study population was composed of patients diagnosed with hypertension, diabetes, and HIV who were aged 18 years and above. Simple random sampling was used to select the study participants. Data was analyzed using SPSS. Chi-square tests were used to compare proportions among groups. Logistic regression was used to determine the factors associated with retention to care. The proportion of individuals diagnosed with hypertension was 28.9% in both sexes, with significantly more females being hypertensive compared to males (30.9% vs 22.8%, p = 0.001). The proportion of patients retained in the linkage-to-care intervention without interruptions for six months was highest among those diagnosed with diabetes at 34.8%, followed by those diagnosed with hypertension, HIV, and both hypertension and diabetes at 29.5%, 24.8%, and 10.9%, respectively. Regression analysis showed that retention in care without gaps longer than six months was significantly associated with age, gender, and diagnosis (single chronic conditions or combined). This study identified patterns of enrolment and retention in care among patients diagnosed with chronic conditions at DIMAMO PHRC. Findings reveal that retention was highest among patients with single conditions and lowest in those with comorbid hypertension and diabetes. These trends suggest potential areas for targeted interventions to improve linkage and continuity of care, particularly among older adults and those with multiple conditions.