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ObjectivesTo 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).DesignCross-sectional, multicentre, population-based study.SettingSix urban and rural communities in four sub-Saharan African countries.ParticipantsMen (n=4808) and women (n=5892) between the ages of 40 and 60 years from the AWI-Gen study.MeasuresSociodemographic 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.ResultsMultimorbidity 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.ConclusionsThe 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.

Original publication

DOI

10.1136/bmjopen-2022-067788

Type

Journal article

Journal

BMJ open

Publication Date

03/2023

Volume

13

Addresses

SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Lisa.Micklesfield@wits.ac.za.

Keywords

as members of AWI-Gen and the H3Africa Consortium, Humans, HIV Infections, Hypertension, Prevalence, Risk Factors, Cross-Sectional Studies, Sex Factors, Adult, Middle Aged, Africa South of the Sahara, Female, Male, Dyslipidemias, Multimorbidity