The social determinants of multimorbidity in South Africa
The social determinants of multimorbidity in South Africa
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DOI：
10.1186/1475-9276-12-63
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发表时间：
2013-08-20
影响因子：
4.8
通讯作者：
Chola, Lumbwe
中科院分区：
文献类型：
--
作者：
Alaba, Olufunke;Chola, Lumbwe
前言：多发性疾病是全世界日益关注的问题，大约每4个成年人中就有1人受到影响。关于多发病及其流行程度和影响的大部分证据来自高收入国家。人们对低收入国家，特别是撒哈拉以南非洲地区的多发病知之甚少。这项研究的目的是确定南非多发病的患病率，并检查其与各种社会健康决定因素的关系。方法：本研究使用的数据来自2008年南非国民收入动态调查(SA-NIDS)。多发病被定义为一个人同时患有两种或两种以上的慢性病。建立多项Logistic回归模型，分析多发病与社会经济状况、居住面积、肥胖等指标的关系。结果：南非成人多发病患病率为4%。超过70%患有多发病的成年人是女性。与多发病相关的因素有社会救助(优势比(OR)2.35；可信区间(CI)1.59~3.49)、居住(0.65；0.46~0.93)、吸烟(0.61；0.38~0.96)、肥胖(2.33；1.60~3.39)、抑郁(1.07；1.02~1.11)和去医疗机构就诊(5.14；3.75~7.05)。此外，收入与多发病呈显著正相关。这些发现与在发达国家进行的研究中的观察结果相似。结论：这些发现指出了与单一慢性病和多发病相关的因素的潜在差异。收入与多发病显著相关，但与单一慢性病无关。这一点应在今后对影响多病的因素的研究中进一步研究。
Introduction: Multimorbidity is a growing concern worldwide, with approximately 1 in 4 adults affected. Most of the evidence on multimorbidity, its prevalence and effects, comes from high income countries. Not much is known about multimorbidity in low income countries, particularly in sub-Saharan Africa. The aim of this study was to determine the prevalence of multimorbidity and examine its association with various social determinants of health in South Africa.Method: The data used in this study are taken from the South Africa National Income Dynamic Survey (SA-NIDS) of 2008. Multimorbidity was defined as the coexistence of two or more chronic diseases in an individual. Multinomial logistic regression models were constructed to analyse the relationship between multimorbidity and several indicators including socioeconomic status, area of residence and obesity.Results: The prevalence of multimorbidity in South Africa was 4% in the adult population. Over 70% of adults with multimorbidity were females. Factors associated with multimorbidity were social assistance (Odds ratio (OR) 2.35; Confidence Interval (CI) 1.59-3.49), residence (0.65; 0.46-0.93), smoking (0.61; 0.38-0.96); obesity (2.33; 1.60-3.39), depression (1.07; 1.02-1.11) and health facility visits (5.14; 3.75-7.05). Additionally, income was strongly positively associated with multimorbidity. The findings are similar to observations made in studies conducted in developed countries.Conclusion: The findings point to a potential difference in the factors associated with single chronic disease and multimorbidity. Income was consistently significantly associated with multimorbidity, but not single chronic diseases. This should be investigated further in future research on the factors affecting multimorbidity.