Strategies for Managing Prehypertension in Adults in Kisangani: Adaptations to Limited Resources and Strengthening Primary Care in the Democratic Republic of Congo
Ossinga Bassandja *
Internal Medicine Department, Faculty of Medicine and Pharmay, University of Kisangani, Kisangani, Democratic Republic of Congo.
Kayembe Tshilumba
Internal Medicine Department, Faculty of Medicine and Pharmay, University of Kisangani, Kisangani, Democratic Republic of Congo.
Losimba Likwela
Department of Public Health, Faculty of Medicine and Pharmay, University of Kisangani, Kisangani, Democratic Republic of Congo.
Ngandu Wa Ngandu
Internal Medicine Department, Faculty of Medicine and Pharmay, University of Kisangani, Kisangani, Democratic Republic of Congo.
Kalaki Koposi
Kisangani Higher Institute of Medical Technology, Kisangani, Democratic Republic of Congo.
Darabu Sakina
Internal Medicine Department, Faculty of Medicine, University of Kindu, Kindu, Democratic Republic of Congo.
Atoba Bokele
Internal Medicine Department, Faculty of Medicine and Pharmay, University of Kisangani, Kisangani, Democratic Republic of Congo.
Jakwonga Moro
Internal Medicine Department, Faculty of Medicine and Pharmay, University of Kisangani, Kisangani, Democratic Republic of Congo.
Kingombe Museme
Internal Medicine Department, Faculty of Medicine and Pharmay, University of Kisangani, Kisangani, Democratic Republic of Congo.
Issa Yakusu
Internal Medicine Department, Faculty of Medicine and Pharmay, University of Kisangani, Kisangani, Democratic Republic of Congo.
Batina Agasa
Internal Medicine Department, Faculty of Medicine and Pharmay, University of Kisangani, Kisangani, Democratic Republic of Congo.
*Author to whom correspondence should be addressed.
Abstract
Prehypertension (PHTN) is widely recognised as a public health problem due to its high prevalence and its role in increasing the risk of cardiovascular disease and established hypertension (HTN). PHTN represents a major public health challenge in Africa, with prevalence ranging from 2.5% to 34% in children and adolescents, and from 32.9% to 56.8% in adults. This narrative review aims to explore strategies for managing PHTN, adapted to the context of Kisangani, by examining community-based approaches, models of shared responsibility, and organisational innovations that help strengthen primary care in a resource-constrained setting. The literature review was conducted in PubMed, Google Scholar and institutional archives, for the period 2020 to 2025. The narrative analysis was structured around four main areas. In a study conducted in Kisangani on 422 adult participants, the prevalence of PHTN was estimated at 33.8%. This prevalence is within the range observed in sub-Saharan Africa (30-56.8%), but remains worrying given the youth of the population studied (66.2% aged 18-29). The high prevalence of cardiovascular risk factors, particularly HTN and PHTN in Kisangani, provides strong justification for the implementation of early, community-based interventions. For the PHTN integrated control model in Kisangani to be successful, it should be based on strategic, multi-sectoral coordination. The WHO HEARTS framework, mHealth, task shifting, and community activities serve as the foundation for this strategy. It also discusses finance, staffing, and resource-related concerns and provides creative answers to guarantee successful cardiovascular disease prevention.
Keywords: Prehypertension, Kisangani, limited resources, primary healthcare, community care models, WHO HEARTS framework