Integrated community-based versus facility-based care for people with HIV, diabetes, and hypertension in sub-Saharan Africa (INTE-COMM): an open-label, multicountry, cluster-randomised trial
Primary result · Blood pressure or fasting glucose control (hypertension or diabetes)Result — go to the resultAdjusted risk difference 1.80 95% CI −4.52 to 8.12Authors' conclusion
In sub-Saharan Africa, integrated community care could reach a high standard of care for people with diabetes or hypertension without adversely affecting outcomes for people with HIV.
Study context
- Population
- Adults ≥18 years with HIV, T2D or hypertension (or a combination), clinically stable, in regular care ≥6 months, 14 primary care facilities in Tanzania and Uganda124 groups
- Participants
- 1,864 adults
- Comparison
- Integrated community-based care vs integrated facility-based care
- Community caren = 62 groups
- Facility caren = 62 groupsreference
- Primary endpoint
- Coprimary: (1) composite of blood pressure (<140/90 mm Hg) or fasting glucose (<7.0 mmol/L) control in those with hypertension and/or diabetes; (2) viral load suppression (<1000 copies per mL or undetectable) in those with HIV alone
- Follow-up
- 12 months
Methodological detailsopen-label, multicountry
- Open-label
- Multicountry
Primary result
As reported in the abstract
Blood pressure or fasting glucose control (hypertension or diabetes)
Adjusted risk difference
1.80
95% CI −4.52 to 8.12
P = 0.58
Events by treatment group
Community carevs Facility care
adjusted risk difference 1.80 (95% CI −4.52 to 8.12); P = 0.58
Further findings
| Outcome | Community care | Facility care | Adjusted risk difference (CI) | P value | |
|---|---|---|---|---|---|
| Viral load suppression (HIV alone; coprimary) · 12 monthsIntention-to-treat · non-inferiority | 99.1% | 98.7% | 0.44 (−1.12 to 1.99) | P for non-inferiority < 0.0001 | |
| −2−1012Difference (linear scale) |
Events
| Outcome | Community care | Facility care |
|---|---|---|
| Deaths | 7 | 7 |
Original publication
Integrated community-based versus facility-based care for people with HIV, diabetes, and hypertension in sub-Saharan Africa (INTE-COMM): an open-label, multicountry, cluster-randomised trial. Lancet. Published 14 March 2026. doi:10.
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