Multimorbidity refers to the situation where an individual is living with two or more chronic diseases. It has become a global research priority, yet relatively little is known about it in low- and middle-income countries. South Africa has the largest burden of HIV worldwide but also has a growing burden of non-communicable diseases; potentially leading to uncommon disease combinations. A greater understanding about the prevalence of multimorbidity and factors associated with it can assist in healthcare planning and targeting groups of people for interventions.
A recently published study in the PLOS One Journal has shed some light on this situation in South Africa. This study was led by Ms Rifqah Roomaney and Dr Victoria-Pillay van Wyk from the SAMRC’s Burden of Diseases Research Unit, in collaboration with the School of Public Health at the University of the Western Cape (UWC) and Stellenbosch University (SU).
Study design
The study analysed data from the nationally representative 2016 South African Demographic Health Survey and aimed to determine the prevalence of multimorbidity by age and sex, as well as factors associated with multimorbidity in people 15 years and older. The sample included 10 336 people who participated in the Adult Health questionnaire and approximately 7 961 people who provided biomarkers. Multivariate logistic regression was used to measure the association of multimorbidity with age, sex, living in an urban or rural area, education level, wealth level, employment status, body mass index, as well as current alcohol or tobacco use.
Significance of findings
Multimorbidity is prevalent within the South African population and was observed in 20.7% of participants. The proportion of multimorbidity was found to be higher in females with a prevalence of 26.2% as compared to 14.8% of males. The odds of multimorbidity were also higher amongst younger females as compared to young males and is most likely driven by the high prevalence of HIV and hypertension
Furthermore, it was also found that the prevalence of multimorbidity increased with age and; had the highest odds in the 55–64 years old age group. Possessing tertiary education, being employed or currently using alcohol was associated with a decreased odds ofmultimorbidity in this cohort. The association with alcohol use may be due to the ‘sick quitter’ hypothesis which theorises that people who are sick tend to give up alcohol due to interactions with medication, among other reasons.
Commenting on the study Ms Rifqah Roomaney said that the study “shows that multimorbidity is fairly common in South Africa, and the high levels are a concern, especially among older women”
Ms Roomaney is PhD-candidate and holds a PhD Scholarship from the Research Capacity Development (RCD) Division at the SAMRC – this paper forms part of her PhD.
Read the article | HERE