Identifying the prevalence and correlates of multimorbidity in middle-aged men and women: a cross-sectional population-based study in four African countries

Abstract

ObjectivesTo determine the prevalence of multimorbidity, to identify which chronic conditions cluster together and to identify factors associated with a greater risk for multimorbidity in sub-Saharan Africa (SSA).DesignCross-sectional, multicentre, population-based study.SettingSix urban and rural communities in four sub-Saharan African countries.ParticipantsMen (n=4808) and women (n=5892) between the ages of 40 and 60 years from the AWI-Gen study.MeasuresSociodemographic and anthropometric data, and multimorbidity as defined by the presence of two or more of the following conditions: HIV infection, cardiovascular disease, chronic kidney disease, asthma, diabetes, dyslipidaemia, hypertension.ResultsMultimorbidity prevalence was higher in women compared with men (47.2% vs 35%), and higher in South African men and women compared with their East and West African counterparts. The most common disease combination at all sites was dyslipidaemia and hypertension, with this combination being more prevalent in South African women than any single disease (25% vs 21.6%). Age and body mass index were associated with a higher risk of multimorbidity in men and women; however, lifestyle correlates such as smoking and physical activity were different between the sexes.ConclusionsThe high prevalence of multimorbidity in middle-aged adults in SSA is of concern, with women currently at higher risk. This prevalence is expected to increase in men, as well as in the East and West African region with the ongoing epidemiological transition. Identifying common disease clusters and correlates of multimorbidity is critical to providing effective interventions.

An overview of multimorbidity and polypharmacy in older people living with HIV

“…34,35 The prevalence of multimorbidity in PLHIV ranges from 16% to 75% depending on the definition employed. 6,10,23,[36][37][38] Other than being at a higher risk of coinfections and opportunistic infections, PLHIV also experience accelerated aging due to the complex interaction between the patient's lifestyle, ongoing inflammation despite good virological control, and toxicity from ART. However, the exact underlying mechanisms resulting in accelerated aging remain to be elucidated.…”

“…Older PLHIV, despite being virally suppressed, exhibit higher multimorbidity rates at a younger age compared with HIV-uninfected peers. 6,7 Having multiple comorbidities simultaneously increases the likelihood of polypharmacy. Research indicates that in older PLHIV, the burden of multimorbidity and polypharmacy is more linked to the duration of HIV infection than to advanced age itself.…”

“…Older PLHIV, despite being virally suppressed, exhibit higher multimorbidity rates at a younger age compared with HIV‐uninfected peers 6,7 . Having multiple comorbidities simultaneously increases the likelihood of polypharmacy.…”

Prevalence and determinants of multiple chronic conditions (MCC) among young adults in Indian households: an analysis of NFHS-5

“…In developing countries multimorbidity tends to be more prevalent among the wealthier population, while in developed countries it is higher among the poor. Combinations of MCC varies across nations for example in China [ 12 ] hypertension with hearing impairment, and in Africa [ 13 ] dyslipidemia with hypertension are a few. Characterizing the patterns is a primary step to plan need-based interventions for specific populations.…”

Multimorbidity in South Africa: Is the health system ready?

“…14 In South Africa, an upper middle-income country, 15 despite limitations, a growing body of literature has sought to characterise the epidemiology and consequences of multimorbidity in the country. [16][17][18][19][20] Our project consisted of a systematic review of prevalence studies on multimorbidity, 21 which informed, and was followed up by the systematic analyses of the three most recent national health surveys. [22][23][24] The systematic review found a paucity of local studies and a lack of standardization of studies reporting multimorbidity estimates.…”