Multimorbidity in South Africa: a systematic review of prevalence studies

Roomaney, R A; Wyk, Brian van; Turawa, E B; Wyk, Victoria Pillay-van

doi:10.1136/bmjopen-2021-048676

Cited by 33 publications

(43 citation statements)

References 40 publications

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“…Furthermore, South Africa reports high burdens of disease due to tuberculosis (TB), NCDs, injuries, and maternal and child health ( 11 ). A systematic review of multimorbidity in the country ( 12 ) found that multimorbidity is prevalent, especially among women and older adults.…”

Section: Introductionmentioning

confidence: 99%

Multimorbidity patterns in South Africa: A latent class analysis

Roomaney

Wyk

Cois

et al. 2023

Front. Public Health

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IntroductionSouth Africa has the largest burden of HIV worldwide and has a growing burden of non-communicable diseases; the combination of which may lead to diseases clustering in ways that are not seen in other regions. This study sought to identify common disease classes and sociodemographic and lifestyle factors associated with each disease class.MethodsData were analyzed from the South African Demographic and Health Survey 2016. A latent class analysis (LCA) was conducted using nine disease conditions. Sociodemographic and behavioral factors associated with each disease cluster were explored. All analysis was conducted in Stata 15 and the LCA Stata plugin was used to conduct the latent class and regression analysis.ResultsMultimorbid participants were included (n = 2 368). Four disease classes were identified: (1) HIV, Hypertension and Anemia (comprising 39.4% of the multimorbid population), (2) Anemia and Hypertension (23.7%), (3) Cardiovascular-related (19.9%) and (4) Diabetes and Hypertension (17.0%). Age, sex, and lifestyle risk factors were associated with class membership. In terms of age, with older adults were less likely to belong to the first class (HIV, Hypertension and Anemia). Males were more likely to belong to Class 2 (Anemia and Hypertension) and Class 4 (Diabetes and Hypertension). In terms of alcohol consumption, those that consumed alcohol were less likely to belong to Class 4 (Diabetes and Hypertension). Current smokers were more likely to belong to Class 3 (Cardiovascular-related). People with a higher body mass index tended to belong to Class 3 (Cardiovascular-related) or the Class 4 (Diabetes and Hypertension).ConclusionThis study affirmed that integrated care is urgently needed, evidenced by the largest disease class being an overlap of chronic infectious diseases and non-communicable diseases. This study also highlighted the need for hypertension to be addressed. Tackling the risk factors associated with hypertension could avert an epidemic of multimorbidity.

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Section: Introductionmentioning

confidence: 99%

Multimorbidity patterns in South Africa: A latent class analysis

Roomaney

Wyk

Cois

et al. 2023

Front. Public Health

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“…A recent systematic review of prevalence studies from South Africa reported a 3%-23% prevalence of multimorbidity in studies with a wide range of age groups and 30%-71% in older adults. 26 The higher prevalence of multimorbidity in the South African sites in the current study (54%-66%) may be attributed to the advanced epidemiological transition and increasing urbanisation in South Africa. 27 This coincides with a higher BMI and prevalence of obesity in the three South African sites compared with the West and East African sites.…”

Section: Discussionmentioning

confidence: 58%

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

et al. 2023

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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.

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“…Additionally, the inclusion of certain diseases like HIV and tuberculosis seem to be context dependent (Ho et al 2021). Unless the focus is specifically on NCDs, South African studies on multimorbidity often include HIV and tuberculosis because they are both endemic chronic infections (Alaba and Chola 2013;Ataguba 2013;Chang et al 2019;Peltzer 2018;Roomaney et al 2022;Roomaney et al 2021;Sharman and Bachmann 2019;Wade et al 2021;Weimann et al 2016;Wong et al 2021).…”

Section: Measurement Of Multimorbiditymentioning

confidence: 99%

“…This has implications for individuals and health systems worldwide, but particularly in low-and middle-income countries (LMICs), which already face a large burden of NCD-related deaths (Basto-Abreu et al 2022). Existing research on multimorbidity has been highly concentrated in high-income countries (HICs), but the literature on multimorbidity in LMICs is expanding, with several studies recently published (Abebe et al 2020;Chang et al 2019;Kamkuemah et al 2022;Keetile et al 2020;Khorrami et al 2020;Roomaney et al 2021;Sharman and Bachmann 2019). The nature of multimorbidity and its potential risk factors may differ in LMICs compared to HICs.…”

Section: Introductionmentioning

confidence: 99%

“…In this article, we focus on multimorbidity in South Africa, an upper middle-income country with a complex history of inequalities and disease. Longitudinal evidence on 4 multimorbidity in South Africa is lacking and cross-sectional prevalence estimates vary widely, from 3%-70%, due to differences in age distribution and multimorbidity definitions across studies (Alaba and Chola 2013;Chang et al 2019;Oni et al 2015;Roomaney et al 2021;Weimann et al 2016). Across 10 studies of multimorbidity prevalence in South Africa, the five most common disease clusters included various combinations of hypertension, diabetes, HIV, and tuberculosis (Roomaney et al 2021).…”

Section: Introductionmentioning

confidence: 99%

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