Africa’s burden of disease: The University of Cape Town Sub-Saharan Africa Centre for Chronic Disease

Househam, K. C.

doi:10.7196/samj.3977

Cited by 13 publications

(10 citation statements)

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“…The evidence in this study associating increasing BMI with increasing likelihood of multimorbidity is supported by earlier studies [43 -47, 62]. Similarly, several studies agreed with our finding of increased likelihood of multimorbidity among regular smokers [21,31,32,52]. However, the results of Nadel and colleagues are at variance with our finding of an association of smoking habit and multimorbidity in men [24].…”

Section: Discussionsupporting

confidence: 89%

A Study of Lifestyle Factors among Patients with Diagnosis of Multi-Morbidity in a Primary Care Setting in Western Nigeria

Sogunle¹

2017

TIJMD

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Multi-morbidity can be defined as the simultaneous occurrence of two or more chronic health conditions in the same person, without defining a primary disease [1, 2]. Most health systems have prominently pure single disease outlook. In these settings, multimorbidity was found to be associated with suboptimal care, increased mortality, poor quality of life and an increased demand on healthcare utilization [3,4,5,6,]. Globally, the estimated prevalence of multi-morbidity in adults is 25% [7, 8]. Most of the evidence on multi-morbidity relating to risk factors, prevalence and effects, comes from high income countries [7,8, 9] Few studies have been conducted in low and middle income countries [10, 11, 12]. There is therefore a need to conduct this study to contribute to the body of knowledge on multi-morbidity with the developing world in perspective as findings on multi-morbidity in developed countries cannot be utilized for formulation of management guidelines for multi-morbidity in developing countries. This is because of variations in the socioeconomic, behavioral and demographic milieu which determine the pattern and distribution of chronic diseases in these two different populations [13, 14]. Epidemiological and demographic transition in developing nations resulted in a "double burden" of infections/infestations and non-communicable diseases. This study shall therefore contribute to the much needed but lacking scientific evidence in the developing clime to dictate changes in health system management and policies to tackle these health challenges. Available evidence indentified close relationship between lifestyle factors, chronic diseases and multi-morbidity [15-20]. The combination of preventive lifestyle factors has also been reported to prevent the occurrence of chronic medical conditions [21-24]. Several other studies also provided evidence on the association between individual lifestyle risk factors and multimorbidity; overweight/obesity [21, 25-29, 30], smoking [21, 31, 32, 33], heavy alcohol consumption [34], protective role of fruits and vegetables [35], physical inactivity [26, 39, 40] and chronic stress [36, 37, 38]. Two distinct trends emanated from these approaches. These include the association between several lifestyle facts and individual chronic diseases and the association between individual lifestyle factors and multimorbidity. It is therefore clear that the association of accumulating risk factors in the same individual with multimorbidity had not been given adequate attention even in the developed world not to talk of the developing nations [32]. The aim of the present study is to analyze the association between lifestyle factors and occurrence of multi-morbidity in the study population. We wanted to test the hypothesis that the accumulation of unhealthy lifestyle factors is associated with increased likelihood of multi-morbidity. Unhealthy lifestyle factors relates to lifestyles or behavioral characteristic or condition that increases the possibility of disease [20]. Study methods Study desi...

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Section: Discussionsupporting

confidence: 89%

A Study of Lifestyle Factors among Patients with Diagnosis of Multi-Morbidity in a Primary Care Setting in Western Nigeria

Sogunle¹

2017

TIJMD

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“…Studies investigating the prevalence and determinants of multimorbidity have primarily focused on high-income countries (HICs). Multimorbidity studies in LMICs are limited in geographical scope, the number of diseases studied and the effects of multimorbidity (absolute number of diseases or disease combinations) on health outcomes such as physical functioning, quality of life, or mental health [ 12 , 22 , 25 , 37 , 38 ]. Of the few existing studies on multimorbidity prevalence from LMICs, Khanam et al [ 12 ] estimated the prevalence of multimorbidity to be 53.8 % among the older adult population of Bangladesh.…”

Section: Introductionmentioning

confidence: 99%

The impact of multimorbidity on adult physical and mental health in low- and middle-income countries: what does the study on global ageing and adult health (SAGE) reveal?

Arokiasamy

Uttamacharya

Jain

et al. 2015

BMC Med

369

375

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BackgroundChronic diseases contribute a large share of disease burden in low- and middle-income countries (LMICs). Chronic diseases have a tendency to occur simultaneously and where there are two or more such conditions, this is termed as ‘multimorbidity’. Multimorbidity is associated with adverse health outcomes, but limited research has been undertaken in LMICs. Therefore, this study examines the prevalence and correlates of multimorbidity as well as the associations between multimorbidity and self-rated health, activities of daily living (ADLs), quality of life, and depression across six LMICs.MethodsData was obtained from the WHO’s Study on global AGEing and adult health (SAGE) Wave-1 (2007/10). This was a cross-sectional population based survey performed in LMICs, namely China, Ghana, India, Mexico, Russia, and South Africa, including 42,236 adults aged 18 years and older. Multimorbidity was measured as the simultaneous presence of two or more of eight chronic conditions including angina pectoris, arthritis, asthma, chronic lung disease, diabetes mellitus, hypertension, stroke, and vision impairment. Associations with four health outcomes were examined, namely ADL limitation, self-rated health, depression, and a quality of life index. Random-intercept multilevel regression models were used on pooled data from the six countries.ResultsThe prevalence of morbidity and multimorbidity was 54.2 % and 21.9 %, respectively, in the pooled sample of six countries. Russia had the highest prevalence of multimorbidity (34.7 %) whereas China had the lowest (20.3 %). The likelihood of multimorbidity was higher in older age groups and was lower in those with higher socioeconomic status. In the pooled sample, the prevalence of 1+ ADL limitation was 14 %, depression 5.7 %, self-rated poor health 11.6 %, and mean quality of life score was 54.4. Substantial cross-country variations were seen in the four health outcome measures. The prevalence of 1+ ADL limitation, poor self-rated health, and depression increased whereas quality of life declined markedly with an increase in number of diseases.ConclusionsFindings highlight the challenge of multimorbidity in LMICs, particularly among the lower socioeconomic groups, and the pressing need for reorientation of health care resources considering the distribution of multimorbidity and its adverse effect on health outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-015-0402-8) contains supplementary material, which is available to authorized users.

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“…However, infant mortality rates have recently fallen dramatically in the Western Cape Province of South Africa as a result of the introduction of an effective MTCT prevention programme. [30] If the risks of vertical transmission of HIV from mother to child can be reduced throughout the country, if these risks become less significant than the risks associated with increasing maternal age, and if in the future first-trimester screening could be offered to women of all ages (as is recommended in the Netherlands [31] ) so that the DS risks can be refined, invasive testing for chromosome abnormalities will become a more viable and relatively safe option for women who are HIVpositive, of AMA and at increased risk.…”

Section: Resultsmentioning

confidence: 99%

The influence of HIV status on prenatal genetic diagnosis choices

et al. 2013

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Background. At-risk women of advanced maternal age (AMA) can choose to have second-trimester invasive testing for a prenatal genetic diagnosis on the fetus. Being HIV-positive can complicate the decision-making process. Objective. To document HIV status and prenatal genetic diagnosis choices in women of AMA attending genetic clinics in Johannesburg, South Africa, for counselling on the risks of abnormalities in their fetuses. Methods. Data on the characteristics of the sample, HIV status and prenatal diagnosis decisions were collected retrospectively from the files of 350 women (>34 years) counselled for AMA in genetic clinics in Johannesburg and Pretoria. The time period was 6 months in 2003 and 6 months in 2004. A sample of the women (n=15) who were HIV-positive were interviewed and completed questionnaires on their understanding of their situation. The data were analysed and submitted to statistical testing. Results. Of the 350 women, 183 (52.3%) were HIV-negative, 44 (12.6%) HIV-positive, and 123 (35.1%) of unknown status. Significantly more HIV-negative patients (79/183, 43.2%) than those who were HIV-positive (6/44, 13.6%) had amniocentesis performed for fetal diagnosis. Most of the interviewed women (12/15, 80.0%) understood the severity of HIV infection, 5 (33.3%) considered termination of pregnancy based on the transmission risk, and 4 (26.7%) would have requested amniocentesis and prenatal diagnosis if they had been HIV-negative. Conclusion. Decision-making regarding prenatal genetic diagnosis is influenced by HIV status among older women. Effective access to highly active antiretroviral therapy throughout pregnancy would make decision-making easier for these women.

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Africa’s burden of disease: The University of Cape Town Sub-Saharan Africa Centre for Chronic Disease

Cited by 13 publications

References 1 publication

A Study of Lifestyle Factors among Patients with Diagnosis of Multi-Morbidity in a Primary Care Setting in Western Nigeria

A Study of Lifestyle Factors among Patients with Diagnosis of Multi-Morbidity in a Primary Care Setting in Western Nigeria

The impact of multimorbidity on adult physical and mental health in low- and middle-income countries: what does the study on global ageing and adult health (SAGE) reveal?

The influence of HIV status on prenatal genetic diagnosis choices

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