Multimorbidity patterns in South Africa: A latent class analysis

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

doi:10.3389/fpubh.2022.1082587

Multimorbidity patterns in South Africa: A latent class analysis

Front Public Health. 2023 Jan 11:10:1082587. doi: 10.3389/fpubh.2022.1082587. 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, South Africa.
² School of Public Health, University of the Western Cape, Cape Town, South Africa.
³ Division of Health Systems and Public Health, Department of Global Health, University of Stellenbosch, Stellenbosch, South Africa.

Abstract

Introduction: South Africa has the largest burden of HIV worldwide and has a growing burden of non-communicable diseases; the combination of which may lead to diseases clustering in ways that are not seen in other regions. This study sought to identify common disease classes and sociodemographic and lifestyle factors associated with each disease class.

Methods: Data were analyzed from the South African Demographic and Health Survey 2016. A latent class analysis (LCA) was conducted using nine disease conditions. Sociodemographic and behavioral factors associated with each disease cluster were explored. All analysis was conducted in Stata 15 and the LCA Stata plugin was used to conduct the latent class and regression analysis.

Results: Multimorbid participants were included (n = 2 368). Four disease classes were identified: (1) HIV, Hypertension and Anemia (comprising 39.4% of the multimorbid population), (2) Anemia and Hypertension (23.7%), (3) Cardiovascular-related (19.9%) and (4) Diabetes and Hypertension (17.0%). Age, sex, and lifestyle risk factors were associated with class membership. In terms of age, with older adults were less likely to belong to the first class (HIV, Hypertension and Anemia). Males were more likely to belong to Class 2 (Anemia and Hypertension) and Class 4 (Diabetes and Hypertension). In terms of alcohol consumption, those that consumed alcohol were less likely to belong to Class 4 (Diabetes and Hypertension). Current smokers were more likely to belong to Class 3 (Cardiovascular-related). People with a higher body mass index tended to belong to Class 3 (Cardiovascular-related) or the Class 4 (Diabetes and Hypertension).

Conclusion: This study affirmed that integrated care is urgently needed, evidenced by the largest disease class being an overlap of chronic infectious diseases and non-communicable diseases. This study also highlighted the need for hypertension to be addressed. Tackling the risk factors associated with hypertension could avert an epidemic of multimorbidity.

Keywords: South Africa; disease clusters; disease patterns; latent class analysis; multimorbidity; prevalence.

Publication types

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

MeSH terms

Aged
Diabetes Mellitus* / epidemiology
HIV Infections* / complications
HIV Infections* / epidemiology
Humans
Hypertension* / epidemiology
Latent Class Analysis
Male
Multimorbidity
Noncommunicable Diseases*
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. RR 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.