Prevalence and patterns of multi-morbidity in the productive age group of 30-69 years: A cross-sectional study in Pathanamthitta District, Kerala.
Prevalence and patterns of multi-morbidity in the productive age group of 30-69 years: A cross-sectional study in Pathanamthitta District, Kerala.
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DOI：
10.12688/wellcomeopenres.16326.1
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发表时间：
2020-01-01
影响因子：
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通讯作者：
Jeemon, Panniyammakal
中科院分区：
文献类型：
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作者：
C, Rohini;Jeemon, Panniyammakal
背景：多重发病是个人和家庭中多种慢性疾病的共存。随着流行病学和人口结构的不断转变，预计印度的多重发病负担将会增加。方法：对喀拉拉邦Pathanamthitta地区410名年龄在30-69岁的参与者进行横断面代表性调查。采用多阶段整群抽样方法确定调查住户。我们在选定的家庭中采访了所有符合条件的参与者。采用结构化访谈时间表来评估社会人口变量、行为风险因素和主要临床状况。我们使用PHQ-9问卷进行抑郁症筛查。此外，我们还对血糖和血压进行了主动测量。多元逻辑回归用于识别与多发病相关的变量。结果：总体而言，多病患病率为45.4% （95% CI: 40.5-50.3%）。近四分之一的研究参与者（25.4%）报告只有一种慢性疾病（21.3-29.9%）。此外，30.7%（26.3-35.5）、10.7%（7.9-14.2）、3.7%（2.1-6.0）和0.2%分别报告了2、3、4和5种慢性疾病。大约十分之七的家庭中至少有一人患有多重疾病（72%,95% CI: 65-78%）。此外，五分之一的家庭（22%,95% CI: 16.7-28.9%）报告一人以上患有多重疾病。糖尿病和高血压是最常见的二联体（30.9%,95% CI: 26.5-35.7%），其次是高血压和抑郁症（7.8%,95% CI: 5.5-10.9%）。糖尿病、高血压和缺血性心脏病是男性常见的三联征（8.5%,95% CI: 4.8-14.1%），而女性为糖尿病、高血压和抑郁症（6.9%,95% CI: 4.2-11.1%）。年龄、性别和就业状况与多重发病有关。结论：在30-69岁的生产年龄组中，每两名参与者中就有一名多发病。此外，十分之七的家庭至少有一人患有多种疾病。多种疾病的高负担要求对多种慢性病采取综合预防和管理战略。
Background: Multi-morbidity is the coexistence of multiple chronic conditions in individuals and families. With advancing epidemiological and demographic transitions, the burden of multi-morbidity is expected to increase India. Methods: A cross-sectional representative survey was conducted among 410 participants aged 30-69 years in Pathanamthitta District, Kerala. A multi-stage cluster sampling method was employed to identify households for the survey. We interviewed all eligible participants in the selected households. A structured interview schedule was used to assess socio-demographic variables, behavioral risk factors and prevailing clinical conditions. We used the PHQ-9 questionnaire for depression screening. Further, we conducted active measurements of both blood sugar and blood pressure. Multiple logistic regression was used to identify variables associated with multi-morbidity. Results: Overall, the prevalence of multi-morbidity was 45.4% (95% CI: 40.5-50.3%). Nearly a quarter of the study participants (25.4%) reported only one chronic condition (21.3-29.9%). Further, 30.7% (26.3-35.5), 10.7% (7.9-14.2), 3.7% (2.1-6.0) and 0.2% reported two, three, four and five chronic conditions, respectively. At least one person with multi-morbidity was present in around seven out of ten households (72%, 95% CI: 65-78%). Further, one in five households (22%, 95% CI: 16.7-28.9%) reported more than one person with multi-morbidity. Diabetes and hypertension was the most frequent dyad (30.9%, 95% CI: 26.5-35.7%), followed by hypertension and depression (7.8%, 95% CI: 5.5-10.9%). Diabetes, hypertension and ischemic heart disease was the common triad in males (8.5%, 95% CI: 4.8-14.1%), while it was diabetes, hypertension and depression (6.9%, 95% CI: 4.2-11.1%) in females. Age, sex, and employment status were associated with multi-morbidity. Conclusion: Multi-morbidity is prevalent in one of two participants in the productive age group of 30-69 years. Further, seven of ten households have at least one person with multi-morbidity. The high burden of multi-morbidity calls for integrated preventive and management strategies for multiple chronic conditions.