Identifying the prevalence and correlates of multimorbidity in middle-aged men and women: a cross-sectional populationbased study in four African countries
Date
2023-02-15
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Abstract
Objectives To 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).
Design Cross-sectional, multicentre, population-based
study.
Setting Six urban and rural communities in four subSaharan African countries.
Participants Men (n=4808) and women (n=5892) between
the ages of 40 and 60 years from the AWI-Gen study.
Measures Sociodemographic 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.
Results Multimorbidity 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.
Conclusions The 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.