Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct 6;11(10):e048676.
doi: 10.1136/bmjopen-2021-048676.

Multimorbidity in South Africa: a systematic review of prevalence studies

Rifqah Abeeda Roomaney  1   2 , Brian van Wyk  2 , Eunice Bolanle Turawa  3   4 , Victoria Pillay-van Wyk  3
Affiliations

Multimorbidity in South Africa: a systematic review of prevalence studies

Rifqah Abeeda Roomaney et al. BMJ Open. .

Abstract

Objectives: To review prevalence studies of multimorbidity in South Africa to identify prevalence estimates, common disease clusters and factors associated with multimorbidity.

Design: Systematic review.

Setting: South Africa (general community and healthcare facilities).

Data sources: Articles were retrieved from electronic databases (PubMed, Web of Science, Scopus, CINAHL, Science Direct and JSTOR).

Eligibility criteria: Studies addressing the prevalence of multimorbidity in South Africa were eligible for inclusion. A systematic search was done in various databases up to December 2020. A risk of bias assessment was conducted for each article using a modified checklist.

Study selection: Two researchers independently screened titles and abstracts; assessed the risk of bias of each study and extracted data. Included studies were described using a narrative synthesis.

Results: In total, 1407 titles were retrieved; of which 10 articles were included in the narrative synthesis. Six studies had a low risk of bias and three had a moderate risk of bias. One study was not assessed for risk of bias, because there was no criteria that apply to routine health information systems. Three of the included studies were population-based surveys, four were community-based cohorts and three cross-sectional studies of health facility data. The prevalence of multimorbidity was low to moderate (3%-23%) in studies that included younger people or had a wide range of selected age groups; and moderate to high (30%-87%) in studies of older adults. The common disease clusters were hypertension and diabetes, hypertension and HIV, and TB and HIV.

Conclusion: All studies indicated that multimorbidity is a norm in South Africa, especially among older adults. Hypertension is the main driver of multimorbidity. Research on multimorbidity in South Africa needs to be strengthened with high-quality study designs.

Prospero registration number: CRD42020196895.

Keywords: epidemiology; public health.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
PRISMA flow diagram. PRISMA, Preferred Reporting Items for Systematic reviews and Meta-Analyses.
Figure 2
Figure 2
Graph of multimorbidity prevalence estimates for studies that include younger age groups.
Figure 3
Figure 3
Graph of multimorbidity prevalence in studies including persons aged 50 years and older.
See this image and copyright information in PMC

References

    1. Nguyen H, Manolova G, Daskalopoulou C, et al. . Prevalence of multimorbidity in community settings: a systematic review and meta-analysis of observational studies. J Comorb 2019;9:2235042X1987093–15. 10.1177/2235042X19870934 - DOI - PMC - PubMed
    1. Xu X, Mishra GD, Jones M. Mapping the global research landscape and knowledge gaps on multimorbidity: a bibliometric study. J Glob Health 2017;7:010414. 10.7189/jogh.07.010414 - DOI - PMC - PubMed
    1. World Health Organization . Multimorbidity: technical series on safer primary care; report No.: 9241511656. Geneva: World Health Organization, 2016. http://apps.who.int/iris/bitstream/10665/252275/1/9789241511650-eng.pdf
    1. Wei MY, Mukamal KJ, Multimorbidity MKJ. Multimorbidity, mortality, and long-term physical functioning in 3 prospective cohorts of community-dwelling adults. Am J Epidemiol 2018;187:103–12. 10.1093/aje/kwx198 - DOI - PMC - PubMed
    1. Kanesarajah J, Waller M, Whitty JA, et al. . Multimorbidity and quality of life at mid-life: a systematic review of general population studies. Maturitas 2018;109:53–62. 10.1016/j.maturitas.2017.12.004 - DOI - PubMed

Publication types

LinkOut - more resources