Multimorbidity of non-communicable diseases in low-income and middle-income countries: a systematic review and meta-analysis

作者：Ogechukwu A Asogwa, Daniel Boateng, A Marza Florensa, Sanne A. E. Peters, Naomi Levitt, Josefien van Olmen, Kerstin Klipstein‐Grobusch · 发表于：BMJ Open · 年份：2022 · DOI：10.1136/bmjopen-2021-049133 · 被引用次数：243 · 研究领域：Chronic Disease Management Strategies、Global Public Health Policies and Epidemiology、Diabetes, Cardiovascular Risks, and Lipoproteins

INTRODUCTION: Multimorbidity is a major public health challenge, with a rising prevalence in low/middle-income countries (LMICs). This review aims to systematically synthesise evidence on the prevalence, patterns and factors associated with multimorbidity of non-communicable diseases (NCDs) among adults residing in LMICs. METHODS: We conducted a systematic review and meta-analysis of articles reporting prevalence, determinants, patterns of multimorbidity of NCDs among adults aged >18 years in LMICs. For the PROSPERO registered review, we searched PubMed, EMBASE and Cochrane libraries for articles published from 2009 till 30 May 2020. Studies were included if they reported original research on multimorbidity of NCDs among adults in LMICs. RESULTS: The systematic search yielded 3272 articles; 39 articles were included, with a total of 1 220 309 participants. Most studies used self-reported data from health surveys. There was a large variation in the prevalence of multimorbidity; 0.7%-81.3% with a pooled prevalence of 36.4% (95% CI 32.2% to 40.6%). Prevalence of multimorbidity increased with age, and random effect meta-analyses showed that female sex, OR (95% CI): 1.48, 1.33 to 1.64, being well-off, 1.35 (1.02 to 1.80), and urban residence, 1.10 (1.01 to 1.20), respectively were associated with higher odds of NCD multimorbidity. The most common multimorbidity patterns included cardiometabolic and cardiorespiratory conditions. CONCLUSION: Multimorbidity of NCDs is an important pr...