Association of alcohol use and multimorbidity among adults aged 40 years and above in rural South Africa
Date
2023-05-14
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Abstract
We assessed the prevalence of reported alcohol use and its association with multimorbidity among
adults aged 40 years and above in a rural, transitioning South African setting. Findings could
potentially inform alcohol interventions integration in the prevention and treatment of chronic
conditions. We analysed data from the frst wave of The Health and Ageing in Africa—a longitudinal
Study in an INDEPTH community (HAALSI) nested within the Agincourt Health and Demographic
Surveillance Systems, conducted between November 2014 and November 2015 (n= 5059). We
computed descriptive statistics and performed univariate analysis to determine factors independently
associated with multimorbidity. Age, Body Mass Index, education, sex, and household wealth status
and variables with a p-value < 0.20 in univariate analysis were included in multivariable Modifed
Poisson regression models. Any factors with a p-value of < 0.05 in the fnal models were considered
statistically signifcant. The frst wave of HAALSI was completed by 5059 participants aged 40 years
and above and included 2714 (53.6%) females. The prevalence of reported ever alcohol use was 44.6%
(n= 2253) and of these 51.9% (n= 1171) reported alcohol use in the last 30 days. The prevalence of
HIV multimorbidity was 59.6% (3014/5059) and for multimorbidity without HIV 52.5% (2657/5059).
Alcohol use was associated with HIV multimorbidity among all participants (RR: 1.05, 95% CI: 1.02–
1.08), and separately for males (RR: 1.05, 95% CI: 1.00–1.10) and females (RR: 1.06, 95%CI: 1.02–
1.11). Similarly, alcohol use was associated with multimorbidity without HIV among all participants
(RR: 1.05, 95% CI: 1.02–1.09), and separately for males (RR: 1.06, 95% CI: 1.00–1.12) and females (RR:
1.06, 95% CI: 1.01–1.11). Reported alcohol use was common and associated with HIV multimorbidity
and multimorbidity without HIV among older adults in rural northeast South Africa. There is a need to
integrate Screening, Brief Interventions, and Referral for alcohol Treatment in the existing prevention
and treatment of multimorbidity in South Africa.