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Researchers are evaluating the ADHINCRA Program, a package of evidence-based interventions aimed at improving the control of hypertension among adults aged 18 to 70 in Africa. The program targets factors related to patients, healthcare providers, and health systems to help reduce risks of cardiovascular disease, stroke, and kidney disease. This interventional study is sponsored by Johns Hopkins University and focuses on managing high blood pressure using a nurse-led approach. The ADHINCRA Program includes home blood pressure monitoring, a mobile health application, nurse-led lifestyle counseling, and treatment using a simplified hypertension control protocol. Participants are divided into four cohorts starting the program at staggered intervals immediately, and 3, 6, and 9 months thereafter. All cohorts receive the same intervention to assess its effectiveness and implementation over time. Participants will be monitored for blood pressure control at baseline and at 12 and 24 months after starting the program. Assessments include systolic and diastolic blood pressure measurements, medication adherence via the Hill-Bone Medication Adherence Scale, and evaluation of how well the program is adopted and maintained at clinical sites. Researchers will also compare the cost of this intervention to usual care. The study is planned to end in September 2028, with ongoing safety and adherence monitoring throughout.

Researchers are estimating the prevalence of high-risk human papillomavirus HR HPV infections among girls and women aged 9 to 50 years across eight countries in South Asia and sub-Saharan Africa. This study aims to understand HPV infection rates in low socio-economic populations and specific sub-groups, including sexually active young women, by conducting cross-sectional surveys and longitudinal studies. Additionally, qualitative sub-studies will explore how gender norms and stigma affect HPV burden and access to prevention and treatment services. The study uses a harmonized protocol across all participating countries with country-specific adaptations. Cross-sectional surveys will collect urine samples from girls and women in urban and rural areas to estimate HPV prevalence. Longitudinal studies will follow sexually active girls and women aged 15 to 35 years over 24 months, collecting vaginal swabs and urine samples to measure persistent HPV infection. Qualitative studies will include interviews and focus groups to understand social factors influencing HPV risks and healthcare access. Participants will provide samples and answer standardized questionnaires on demographics, sexual and reproductive history, HPV vaccination, cervical cancer screening, and related attitudes. Testing will occur at enrollment and every six months for two years in longitudinal studies. Researchers will monitor HPV infection rates, assess questionnaire responses, and analyze laboratory results. The study includes safety follow-up and detailed data collection to provide comprehensive insight into HPV prevalence, incidence, and social influences in these populations.