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Effect of Noncommunicable Disease Screening on Early Detection of Hypertension among Adults in Nigeria

Abstract

Noncommunicable diseases (NCDs) are an increasing public health concern in Nigeria, with hypertension being one of the major cardiovascular risk factors affecting adults. Noncommunicable disease screening refers to the systematic assessment of individuals for selected chronic health conditions and their associated risk factors before symptoms become apparent, using procedures such as blood pressure measurement, blood glucose testing, body mass index assessment, and other appropriate clinical assessments. Early detection of hypertension refers to the identification and diagnosis of elevated blood pressure at an early stage, particularly among individuals who may not yet have developed noticeable symptoms or complications. Hypertension is often asymptomatic, and delayed detection may allow prolonged exposure to elevated blood pressure, increasing the risk of stroke, heart disease, kidney disease, and other complications. In Nigeria, limited awareness, inadequate routine screening, poor access to healthcare facilities, financial barriers, low perceived risk, and irregular health-seeking behaviour may contribute to delayed hypertension detection among adults. Regular NCD screening may provide opportunities to identify individuals with elevated blood pressure, initiate appropriate clinical assessment, provide health education, and facilitate early management. Against this background, this study investigates the effect of noncommunicable disease screening on early detection of hypertension among adults in Nigeria. The study is anchored on the Health Belief Model, the Chronic Care Model, and the Theory of Preventive Health Behaviour. The Health Belief Model explains how individuals' perceptions of susceptibility, severity, benefits, barriers, and cues to action influence participation in preventive health services such as NCD screening. The Chronic Care Model emphasizes the importance of early identification, regular assessment, clinical follow-up, and appropriate management of chronic diseases within healthcare systems. The Theory of Preventive Health Behaviour explains participation in health screening as a preventive behaviour influenced by individual characteristics, health knowledge, perceived risk, and access to health services. Collectively, these theoretical perspectives provide a suitable framework for explaining how NCD screening may influence early detection of hypertension among adults in Nigeria. The study will adopt a quantitative cross-sectional research design. Primary data will be collected from adults in selected Nigerian communities, primary healthcare centres, hospitals, workplaces, markets, and other appropriate screening settings using structured questionnaires, screening records, blood pressure measurement tools, and health assessment forms. A multistage sampling technique will be employed to select states, local government areas, communities, healthcare facilities, and eligible adult participants. NCD screening will be assessed using indicators such as frequency of blood pressure screening, participation in routine NCD screening programmes, availability of screening services, accessibility of screening locations, screening attendance, blood pressure assessment, blood glucose assessment, body mass index assessment, health-risk assessment, and referral following abnormal screening results. Early detection of hypertension will be assessed using indicators such as newly identified elevated blood pressure, proportion of previously undiagnosed adults identified through screening, confirmation of hypertension following screening, age at detection, referral for clinical evaluation, and time between screening and diagnosis. Where possible, repeated blood pressure measurements and clinical records will be used to distinguish initial elevated readings from confirmed hypertension. Descriptive statistics will be used to summarize screening participation, participant characteristics, and hypertension detection patterns. Inferential statistical techniques, including chi-square tests, correlation analysis, and multiple regression analysis, will be used to determine the effect of NCD screening on early detection of hypertension. Diagnostic tests will also be conducted to assess the reliability of research instruments, model assumptions, goodness of fit, multicollinearity, and robustness of the findings. The study is expected to find that participation in noncommunicable disease screening has a significant positive effect on the early detection of hypertension among adults in Nigeria. Adults who participate regularly in NCD screening are expected to have a greater likelihood of having previously undiagnosed elevated blood pressure identified at an earlier stage than adults who rarely or never participate in screening. Routine blood pressure assessment may increase opportunities to identify hypertension among asymptomatic individuals and facilitate timely referral, clinical confirmation, health education, and initiation of appropriate management. NCD screening may also increase individuals' awareness of their cardiovascular risk and encourage subsequent engagement with healthcare services. Conversely, limited access to screening, low awareness, financial barriers, geographical challenges, and poor participation may contribute to delayed identification of hypertension. However, screening alone may not guarantee early diagnosis because the effectiveness of detection also depends on the accuracy of screening procedures, availability of trained healthcare workers, access to confirmatory assessment, referral systems, continuity of care, and availability of treatment. Therefore, NCD screening should be integrated with effective referral, diagnosis, treatment, and follow-up systems. The study is expected to contribute to the literature on noncommunicable disease screening, hypertension, early disease detection, cardiovascular disease prevention, health promotion, epidemiology, primary healthcare, and public health in Nigeria by providing empirical evidence on the role of screening in identifying hypertension at an early stage. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Nigeria Centre for Disease Control and Prevention, National Primary Health Care Development Agency, state ministries of health, primary healthcare authorities, hospitals, community health programmes, workplaces, healthcare professionals, development partners, and policymakers regarding strategies for strengthening hypertension screening. The study will also provide evidence-based recommendations for expanding routine NCD screening programmes, improving community-based blood pressure screening, increasing public awareness of hypertension, strengthening referral systems, integrating blood pressure assessment into routine healthcare encounters, improving access to screening services, and establishing regular monitoring of hypertension detection outcomes across Nigerian communities.

Keywords: Noncommunicable disease screening, early detection, hypertension, adults, Nigeria, blood pressure screening, cardiovascular disease prevention, NCDs, primary healthcare, health promotion, epidemiology, public health.