Chronic multimorbidity among older adults in rural South Africa.

Journal: BMJ global health

Volume: 4

Issue: 4

Year of Publication: 

Affiliated Institutions:  Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. School of Demography, The Australian National University, Canberra, Australian Capital Territory, Australia. Harvard Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts, USA. Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. Department of Medicine, Stanford University School of Medicine, Palo Alto, California, USA.

Abstract summary 

The rapid ageing of populations around the world is accompanied by increasing prevalence of multimorbidity. This study is one of the first to present the prevalence of multimorbidity that includes HIV in the complex epidemiological setting of South Africa, thus filling a gap in the multimorbidity literature that is dominated by studies in high-income or low-HIV prevalence settings.Out of the full sample of 5059 people aged 40+, we analysed cross-sectional data on 10 conditions from 3889 people enrolled in the Health and Ageing in Africa: A longitudinal study of an INDEPTH Community in South Africa (HAALSI) Programme. Two definitions of multimorbidity were applied: the presence of more than one condition and the presence of conditions from more than one of the following categories: cardiometabolic conditions, mental disorders, HIV and anaemia. We conducted descriptive and regression analyses to assess the relationship between prevalence of multimorbidity and sociodemographic factors. We examined the frequencies of the most prevalent combinations of conditions and assessed relationships between multimorbidity and physical and psychological functioning.69.4 per cent (95% CI 68.0 to 70.9) of the respondents had at least two conditions and 53.9% (52.4-55.5) of the sample had at least two categories of conditions. The most common condition groups and multimorbid profiles were combinations of cardiometabolic conditions, cardiometabolic conditions and depression, HIV and anaemia and combinations of mental disorders. The commonly observed positive relationships between multimorbidity and age and decreasing wealth were not observed in this population, namelydue to different epidemiological profiles in the subgroups, with higher prevalence of HIV and anaemia in the poorer and younger groups, and higher prevalence of cardiometabolic conditions in the richer and older groups. Both physical functioning and well-being negatively associated with multimorbidity.More coordinated, long-term integrated care management across multiple chronic conditions should be provided in rural South Africa.

Authors & Co-authors:  Chang Angela Y AY Gómez-Olivé Francesc Xavier FX Payne Collin C Rohr Julia K JK Manne-Goehler Jennifer J Wade Alisha N AN Wagner Ryan G RG Montana Livia L Tollman Stephen S Salomon Joshua A JA

Study Outcome 

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Statistics
Citations :  Sudharsanan N, Bloom D, Sudharsanan N, et al. . The demography of aging in low- and middle-income countries: chronological versus functional perspectives In: Future DIR Demogr aging, 2018.
Authors :  10
Identifiers
Doi : e001386
SSN : 2059-7908
Study Population
Male,Female
Mesh Terms
Other Terms
HIV;ageing;multimorbidity;south africa
Study Design
Longitudinal Study,,Descriptive Study,Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
England