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. 2023 Mar 14;13(3):e067788.
doi: 10.1136/bmjopen-2022-067788.

Identifying the prevalence and correlates of multimorbidity in middle-aged men and women: a cross-sectional population-based study in four African countries

Lisa K Micklesfield  1 , Richard Munthali  2 , Godfred Agongo  3   4 , Gershim Asiki  5 , Palwende Boua  6   7 , Solomon Sr Choma  8 , Nigel J Crowther  9 , June Fabian  10 , Francesc Xavier Gómez-Olivé  11 , Chodziwadziwa Kabudula  11 , Eric Maimela  8 , Shukri F Mohamed  12 , Engelbert A Nonterah  4   13 , Frederick J Raal  14 , Hermann Sorgho  15 , Furahini D Tluway  16 , Alisha N Wade  11 , Shane A Norris  2   17 , Michele Ramsay  16 ; as members of AWI-Gen and the H3Africa Consortium
Affiliations

Identifying the prevalence and correlates of multimorbidity in middle-aged men and women: a cross-sectional population-based study in four African countries

Lisa K Micklesfield et al. BMJ Open. .

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 sub-Saharan 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.

Keywords: EPIDEMIOLOGY; Lipid disorders; PUBLIC HEALTH.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Prevalence of 0, 1, 2, 3 and 4 or more chronic conditions (including HIV infection, cardiovascular disease, chronic kidney disease, asthma, diabetes, dyslipidaemia and hypertension) in men and women from South, East and West Africa, and the full AWI-Gen cohort.
Figure 2
Figure 2
Multimorbidity clustering for the total AWI-Gen cohort in (A) women and (B) men.
Figure 3
Figure 3
Multimorbidity clustering in (A) South African women, (B) South African men, (C) East African women, (D) East African men, (E) West African women and (F) West African men.
See this image and copyright information in PMC

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