Multimorbidity in a large district hospital: A descriptive cross-sectional study

Abstract

Chronic conditions, particularly HIV, TB and non-communicable diseases, represented much of the disease profile in the internal medicine department. Of the comorbidities investigated, the greatest contributor to length of stay was HIV/TB co-infection. Factors such as HIV, TB and substance use that increase length of stay cannot be impacted upon by the district hospital staff in isolation. To improve the health of communities, we require partnerships between doctors, community health providers and patients with their families. Multimorbidity was widespread, suggesting the need to include an understanding of multimorbidity, including the patient perspective, in medical education and health system reform.

A retrospective review of speech-language therapy services provided to adult inpatients at a central-level hospital in Gauteng, South Africa

“…It is suggested, then, that this was the minimum average length of hospital stay, which is higher than international findings described. Like other studies that reported no correlation between multimorbidity and length of hospital stay (Hewitt et al, 2016;Roche & De Vries, 2017), multimorbidity of medical conditions was not associated with a longer duration of SLT service in this study.…”

Multimorbidity of chronic non-communicable diseases in low- and middle-income countries: A scoping review

“…27 Most of the studies (n = 46, 60.5%) had a primary purpose of reporting the prevalence and patterns of multimorbidity. Of the total 76 studies, 52 (68.4%) were conducted in only six middle-income countries: Brazil, 27 –42 China, 43 –54 South Africa, 25,26,55 –64 India, 65 –72 Mexico 73,74 and Iran. 75,76 Studies based on multicountry data (n = 11) were based on data obtained from the World Health Organization’s (WHO’s) Study on Global Ageing and Adult Health (SAGE) and World Health Surveys.…”

“…Studies used different approaches to diagnose chronic conditions in their study participants. Self-report was the main method (n ¼ 33, 43.4%), followed by a combination of self-report and physical or mental assessment (n ¼ 25, 32.9%), review of medical or electronic records 31,46,50,58,60,64,73,85,89,91 and direct physical assessment alone 63,85,90,99 (Supplemental file-3).…”

Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

“…There were approximately 10 million TB cases worldwide, and 1.5 million people died from TB in 2018 [1]. People from low-and middle-income countries (LMICs) are at a high risk of developing TB [2,3], with over 95% of TB cases and deaths occurring in LMICs [1]. Significant factors associated with increased risk of TB have been widely reported, including malnutrition, diabetes [4], poverty, overcrowding [5], alcoholism, smoking [6], human immunodeficiency virus (HIV) and chronic pulmonary disease [7].…”

“…In countries where TB is endemic [1], a concerning rapid increase in NCDs has been reported, especially in sub-Saharan Africa [3,24] and in South Asian regions [25], and particularly for those NCDs associated with TB. Despite this, evidence on NCD multimorbidity in people with TB in these areas remains scarce, with numerous gaps and limitations in the literature.…”