Patterns of HIV, TB, and non-communicable disease multi-morbidity in peri-urban South Africa- a cross sectional study

BMC Infectious Diseases

Research Article

Nuala McGrath¹  Elizabeth Youngblood²  Naomi S Levitt³  Tolu Oni⁴  Andrew Boulle⁵  Robert J Wilkinson⁶ 

[1] Academic Unit of Primary Care and Population Sciences, University of Southampton, Southampton, UK;Africa Centre for Health and Population Studies, University of Kwazulu Natal, Durban, South Africa;Department of Medicine, University of Cape Town, Cape Town, South Africa;Department of Medicine, University of Cape Town, Cape Town, South Africa;Chronic Disease Initiative for Africa, Cape Town, South Africa;Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Room 2.24, Entrance 5, Falmouth building Anzio road, Observatory 7925, Cape Town, South Africa;Health Impact Assessment Directorate, Western Cape Department of Health, Cape Town, South Africa;Centre for Infectious Disease Epidemiology Research, Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa;Health Impact Assessment Directorate, Western Cape Department of Health, Cape Town, South Africa;Centre for Infectious Disease Epidemiology Research, Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa;Health Impact Assessment Directorate, Western Cape Department of Health, Cape Town, South Africa;Department of Medicine, University of Cape Town, Cape Town, South Africa;Department of Medicine, Imperial College, W2 1PG, London, UK;Medical Research Council National Institute of Medical Research, NW7 1AA, London, UK;

关键词: HIV;    Tuberculosis;    Hypertension;    Diabetes;    Multimorbidity;   

DOI  :  10.1186/s12879-015-0750-1

 received in 2015-01-09, accepted in 2015-01-12,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundMany low and middle-income countries are experiencing colliding epidemics of chronic infectious (ID) and non-communicable diseases (NCD). As a result, the prevalence of multiple morbidities (MM) is rising.MethodsWe conducted a study to describe the epidemiology of MM in a primary care clinic in Khayelitsha. Adults with at least one of HIV, tuberculosis (TB), diabetes (DM), and hypertension (HPT) were identified between Sept 2012-May 2013 on electronic databases. Using unique patient identifiers, drugs prescribed across all facilities in the province were linked to each patient and each drug class assigned a condition.ResultsThese 4 diseases accounted for 45% of all prescription visits. Among 14364 chronic disease patients, HPT was the most common morbidity (65%). 22.6% of patients had MM, with an increasing prevalence with age; and a high prevalence among younger antiretroviral therapy (ART) patients (26% and 30% in 18-35 yr and 36–45 year age groups respectively). Among these younger ART patients with MM, HPT and DM prevalence was higher than in those not on ART.ConclusionsWe highlight the co-existence of multiple ID and NCD. This presents both challenges (increasing complexity and the impact on health services, providers and patients), and opportunities for chronic diseases screening in a population linked to care. It also necessitates re-thinking of models of health care delivery and requires policy interventions to integrate and coordinate management of co-morbid chronic diseases.

【 授权许可】

CC BY   
© Oni et al.; licensee BioMed Central. 2015