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Patterns of HIV, TB, and non-communicable disease multi-morbidity in an informal peri-urban setting in Cape Town, South Africa
BACKGROUND: Many 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. METHODS: We conducted a retrospective study to describe the epidemiology of MM in...
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| Format: | Thesis |
| Language: | English |
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Department of Public Health and Family Medicine
2015
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| _version_ | 1867613219807297536 |
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| access_status_str | Open Access |
| author | Oni, Tolu |
| author2 | Coetzee, David |
| author_browse | Coetzee, David Oni, Tolu |
| author_facet | Coetzee, David Oni, Tolu |
| author_sort | Oni, Tolu |
| collection | Thesis |
| description | BACKGROUND: Many 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. METHODS: We conducted a retrospective study to describe the epidemiology of MM in a primary care clinic in Khayelitsha, an informal township in Cape Town. Adults with at least one of HIV, tuberculosis (TB), diabetes (T2DM), 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. RESULTS: These 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% in 18-35yr and 30% in 36-45 year age groups). HPT and T2DM prevalence was higher a mong younger ART patients with MM compared to those not on ART. Of note, 37% of TB MM patients were also on treatment for H PT and 12% were on treatment for T2DM respectively, and 86% of T2DM patients were on HPT treatment. CONCLUSION: We 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 calls for policy interventions that integrate and coordinate management of co-morbid chronic diseases. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/15702 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:39.476Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2015 |
| publishDateRange | 2015 |
| publishDateSort | 2015 |
| publisher | Department of Public Health and Family Medicine |
| publisherStr | Department of Public Health and Family Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/15702 Patterns of HIV, TB, and non-communicable disease multi-morbidity in an informal peri-urban setting in Cape Town, South Africa Oni, Tolu Coetzee, David Public Health BACKGROUND: Many 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. METHODS: We conducted a retrospective study to describe the epidemiology of MM in a primary care clinic in Khayelitsha, an informal township in Cape Town. Adults with at least one of HIV, tuberculosis (TB), diabetes (T2DM), 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. RESULTS: These 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% in 18-35yr and 30% in 36-45 year age groups). HPT and T2DM prevalence was higher a mong younger ART patients with MM compared to those not on ART. Of note, 37% of TB MM patients were also on treatment for H PT and 12% were on treatment for T2DM respectively, and 86% of T2DM patients were on HPT treatment. CONCLUSION: We 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 calls for policy interventions that integrate and coordinate management of co-morbid chronic diseases. 2015-12-08T11:47:24Z 2015-12-08T11:47:24Z 2015 Master Thesis Masters MMed http://hdl.handle.net/11427/15702 eng application/pdf Department of Public Health and Family Medicine Faculty of Health Sciences University of Cape Town |
| spellingShingle | Public Health Oni, Tolu Patterns of HIV, TB, and non-communicable disease multi-morbidity in an informal peri-urban setting in Cape Town, South Africa |
| thesis_degree_str | Master's |
| title | Patterns of HIV, TB, and non-communicable disease multi-morbidity in an informal peri-urban setting in Cape Town, South Africa |
| title_full | Patterns of HIV, TB, and non-communicable disease multi-morbidity in an informal peri-urban setting in Cape Town, South Africa |
| title_fullStr | Patterns of HIV, TB, and non-communicable disease multi-morbidity in an informal peri-urban setting in Cape Town, South Africa |
| title_full_unstemmed | Patterns of HIV, TB, and non-communicable disease multi-morbidity in an informal peri-urban setting in Cape Town, South Africa |
| title_short | Patterns of HIV, TB, and non-communicable disease multi-morbidity in an informal peri-urban setting in Cape Town, South Africa |
| title_sort | patterns of hiv tb and non communicable disease multi morbidity in an informal peri urban setting in cape town south africa |
| topic | Public Health |
| url | http://hdl.handle.net/11427/15702 |
| work_keys_str_mv | AT onitolu patternsofhivtbandnoncommunicablediseasemultimorbidityinaninformalperiurbansettingincapetownsouthafrica |