Epidemiology of chronic multimorbidity and temporary migration in a rural South African community in health transition: A cross-sectional population-based analysis

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dc.contributor.authorArmstrong Dzomba
dc.contributor.authorCarren Ginsburg
dc.contributor.authorChodziwadziwa W. Kabudula
dc.contributor.authorRachel R. Yorlets
dc.contributor.authorPedzisai Ndagurwa
dc.contributor.authorSadson Harawa
dc.contributor.authorMark N. Lurie
dc.contributor.authorStephen T. McGarvey
dc.contributor.authorStephen Tollman
dc.contributor.authorMark A. Collinson
dc.contributor.authorMichael J. White
dc.contributor.authorFrancesc X. Gomez-Olive
dc.date.accessioned2023-11-01T12:12:42Z
dc.date.available2023-11-01T12:12:42Z
dc.date.issued2023-04-21
dc.description.abstractIntroduction: In sub-Saharan African settings, the increasing non-communicable disease mortality is linked to migration, which disproportionately exposes subpopulations to risk factors for co-occurring HIV and NCDs. Methods: We examined the prevalence, patterns, and factors associated with two or more concurrent diagnoses of chronic diseases (i.e., multimorbidity) among temporary within-country migrants. Employing a cross-sectional design, our study sample comprised 2144 residents and non-residents 18–40 years interviewed and with measured biomarkers in 2018 in Wave 1 of the Migrant Health Follow-up Study (MHFUS), drawn from the Agincourt Health and Demographic Surveillance System (AHDSS) in rural north-eastern South Africa. We used modified Poisson regression models to estimate the association between migration status and prevalent chronic multimorbidity conditional on age, sex, education, and healthcare utilisation. Results: Overall, 301 participants (14%; 95% CI 12.6–15.6), median age 31 years had chronic multimorbidity. Multimorbidity was more prevalent among non-migrants (14.6%; 95% CI 12.8–16.4) compared to migrants (12.8%; 95% CI 10.3–15.7). Nonmigrants also had the greatest burden of dual-overlapping chronic morbidities, such as HIV-obesity 5.7%. Multimorbidity was 2.6 times as prevalent (PR 2.65. 95% CI 2.07– 3.39) among women compared to men. Among migrants, men, and individuals with secondary or tertiary education manifested lower prevalence of two or more conditions. Discussion: In a rural community with colliding epidemics, we found low but significant multimorbidity driven by a trio of conditions: HIV, hypertension, and obesity. Understanding the multimorbidity burden associated with early adulthood exposures, including potential protective factors (i.e., migration coupled with education), is a critical first step towards improving secondary and tertiary prevention for chronic disease among highly mobile marginalised sub-populations.
dc.description.librarianPM2023
dc.facultyFaculty of Health Sciences
dc.identifier.urihttps://hdl.handle.net/10539/36870
dc.language.isoen
dc.schoolPublic Health
dc.subjecthuman migration, epidemics, infectious diseases, non-communicable diseases, LMIC
dc.titleEpidemiology of chronic multimorbidity and temporary migration in a rural South African community in health transition: A cross-sectional population-based analysis
dc.typeArticle
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