Assessing the Diagnostic Yield of a Targeted Community-Based Screening Programme for Chronic Kidney Disease in Hypertensive Adults: An Action Research Study in Cape Coast, Ghana

Chronic kidney disease (CKD) is a significant public health burden in Ghana, frequently undiagnosed until advanced stages. Hypertension is a leading risk factor. While community-based screening is advocated, evidence on the diagnostic yield within targeted at-risk populations in Ghana remains limited. This action research study aimed to assess the diagnostic yield of a targeted, community-based screening programme for CKD among hypertensive adults in Cape Coast, Ghana. Its objectives were to implement the screening programme, determine the proportion of participants identified with previously undiagnosed CKD, and identify systemic barriers to screening uptake. The study employed a participatory action research cycle of planning, action, observation, and reflection. Hypertensive adults were recruited through community health campaigns. Screening involved point-of-care testing for urine albumin-creatinine ratio and serum creatinine. Data on screening uptake, test results, and participant feedback were collected via surveys and focus group discussions with community health workers. The programme screened 487 hypertensive adults. The diagnostic yield for previously undiagnosed CKD (stages 1-4) was 18.7%. Key logistical barriers identified included distance to screening sites and limited community awareness of the link between hypertension and CKD. Targeted community-based screening identified a substantial burden of undiagnosed CKD among hypertensive adults in this setting. The action research approach successfully combined service delivery with practical learning for the local health system. Integrate routine CKD screening into existing hypertension management at community health centres. Implement community education campaigns focusing on the hypertension-kidney disease link. Further research should explore cost-effective screening algorithms and long-term follow-up pathways. Chronic kidney disease, hypertension, community-based screening, diagnostic yield, action research, Ghana, public health This study provides empirical evidence on the diagnostic yield of a targeted CKD screening programme within a Ghanaian community, highlighting both its potential and implementation barriers to inform local public health practice.