Patterns of comorbidity and multimorbidity among middle-aged and elderly women in peri-urban Tanzania

• Published in: Journal of comorbidity Vol. 12; p. 26335565221076254
• Main Authors: Stieglitz, Laura-Marie, Bärnighausen, Till, Leyna, Germana H., Kazonda, Patrick, Killewo, Japhet, Rohr, Julia K., Kohler, Stefan
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2022; Sage Publications Ltd; SAGE Publishing
• Subjects: Chronic illnesses; Comorbidity; Middle age; Older people; Original; Tanzania; physical health; mental health; infectious diseases; urbanicity; older women; multiple chronic conditions; chronic morbidity; Sub-Saharan Africa
• ISSN: 2633-5565; 2633-5565; 2235-042X
• DOI: 10.1177/26335565221076254

Background Multimorbidity poses an increasing challenge to health care systems in Sub-Saharan Africa. We studied the extent of multimorbidity and patterns of comorbidity among women aged 40 years or older in a peri-urban area of Dar es Salaam, Tanzania. Methods We assessed 15 chronic conditions in 1528 women who participated in a cross-sectional survey that was conducted within the Dar es Salaam Urban Cohort Study (DUCS) from June 2017 to July 2018. Diagnoses of chronic conditions were based on body measurements, weight, blood testing, screening instruments, and self-report. Results The five most prevalent chronic conditions and most common comorbidities were hypertension (49.8%, 95% CI 47.2 to 52.3), obesity (39.9%, 95% CI 37.3 to 42.4), anemia (36.9%, 95% CI 33.3 to 40.5), signs of depression (32.5%, 95% CI 30.2 to 34.9), and diabetes (30.9%, 95% CI 27.6 to 34.2). The estimated prevalence of multimorbidity (2+ chronic conditions) was 73.8% (95% CI 71.2 to 76.3). Women aged 70 years or older were 4.1 (95% CI 1.5 to 10.9) times mores likely to be affected by multimorbidity and had 0.7 (95% CI 0.3 to 1.2) more chronic conditions than women aged 40 to 44 years. Worse childhood health, being widowed, not working, and higher food insecurity in the household were also associated with a higher multimorbidity risk and level. Conclusion A high prevalence of multimorbidity in the general population of middle-aged and elderly women suggests substantial need for multimorbidity care in Tanzania. Comorbidity patterns can guide multimorbidity screening and help identify health care and prevention needs.