One in five South Africans are multimorbid: An analysis of the 2016 demographic and health survey

Rifqah Abeeda Roomaney; Brian van Wyk; Annibale Cois; Victoria Pillay-van Wyk

doi:10.1371/journal.pone.0269081

One in five South Africans are multimorbid: An analysis of the 2016 demographic and health survey

PLoS One. 2022 May 26;17(5):e0269081. doi: 10.1371/journal.pone.0269081. eCollection 2022.

Authors

Rifqah Abeeda Roomaney^{1

2}, Brian van Wyk², Annibale Cois^{1

3}, Victoria Pillay-van Wyk¹

Affiliations

¹ Burden of Disease Research Unit, South African Medical Research Council, Cape Town, Western Cape, South Africa.
² School of Public Health, University of the Western Cape, Cape Town, Western Cape, South Africa.
³ Division of Health Systems and Public Health, Department of Global Health, University of Stellenbosch, Western Cape South Africa.

Abstract

Multimorbidity is a global research priority, yet relatively little is known about it in low and middle income countries. South Africa has the largest burden of HIV worldwide but also has a growing burden of non-communicable diseases; potentially leading to uncommon disease combinations. Information about the prevalence of multimorbidity and factors associated with it can assist in healthcare planning and targeting groups of people for interventions. This study aimed to determine the prevalence of multimorbidity by age and sex, as well as factors associated with multimorbidity in people 15 years and older. This study analyses the nationally representative 2016 South African Demographic Health Survey. The sample included 10 336 people who participated in the Adult Health questionnaire and approximately 7 961 people who provided biomarkers. Multivariate logistic regression was used to measure the association of multimorbidity with age, sex, living in an urban or rural area, education level, wealth level, employment status, body mass index, current alcohol or tobacco use. All analyses were conducted using STATA 15. Multimorbidity was present in 20.7% (95% CI: 19.5%- 21.9%) of participants; in 14.8% (95% CI: 13.4% - 16.3%) of males and 26.2% (95% CI: 24.7-27.7%) of females. Multimorbidity increased with age; with the highest odds in the 55-64 years old age group (OR: 24.910, 95% CI: 14.901-41.641, p < 0.001) compared to those aged 15-24 years. The odds of multimorbidity was also higher in young females compared to young males (OR: 2.734, 95% CI: 1.50-4.99, p = 0.001). Possessing tertiary education (OR: 0.722, 95% CI: 0.537-0.97, p = 0.031), being employed (OR: 0.813, 95% CI: 0.675-0.979, p = 0.029) or currently using alcohol (OR: 0.815, 95% CI: 0.686-0.968, p = 0.02) was protective against multimorbidity. Multimorbidity is prevalent within the South African population, with females and older adults being most affected. However, multimorbidity is also observed in younger adults and most likely driven by the high prevalence of HIV and hypertension.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Female
HIV Infections* / epidemiology
Humans
Male
Middle Aged
Multimorbidity
Noncommunicable Diseases* / epidemiology
Prevalence
South Africa / epidemiology

Grants and funding

The work reported herein was made possible through funding by the Burden of Disease Research Unit at the South African Medical Research Council. RAR conducted this research under the South African Medical Research Council through its Division of Research Capacity Development under the Internship Scholarship Programme from funding received from the South African National Treasury. The content hereof is the sole responsibility of the authors and does not necessarily represent the official views of the South African Medical Research Council or the funders. Grant number: NA.