Patterns of HIV, TB, and non-communicable disease multi-morbidity in an informal peri-urban setting in Cape Town, South Africa

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dc.contributor.advisorCoetzee, Daviden_ZA
dc.contributor.authorOni, Toluen_ZA
dc.date.accessioned2015-12-08T11:47:24Z
dc.date.available2015-12-08T11:47:24Z
dc.date.issued2015en_ZA
dc.description.abstractBACKGROUND: 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.en_ZA
dc.identifier.apacitationOni, T. (2015). <i>Patterns of HIV, TB, and non-communicable disease multi-morbidity in an informal peri-urban setting in Cape Town, South Africa</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/15702en_ZA
dc.identifier.chicagocitationOni, Tolu. <i>"Patterns of HIV, TB, and non-communicable disease multi-morbidity in an informal peri-urban setting in Cape Town, South Africa."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2015. http://hdl.handle.net/11427/15702en_ZA
dc.identifier.citationOni, T. 2015. Patterns of HIV, TB, and non-communicable disease multi-morbidity in an informal peri-urban setting in Cape Town, South Africa. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Oni, Tolu AB - 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. DA - 2015 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - Patterns of HIV, TB, and non-communicable disease multi-morbidity in an informal peri-urban setting in Cape Town, South Africa TI - Patterns of HIV, TB, and non-communicable disease multi-morbidity in an informal peri-urban setting in Cape Town, South Africa UR - http://hdl.handle.net/11427/15702 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15702
dc.identifier.vancouvercitationOni T. Patterns of HIV, TB, and non-communicable disease multi-morbidity in an informal peri-urban setting in Cape Town, South Africa. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2015 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/15702en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherPublic Healthen_ZA
dc.titlePatterns of HIV, TB, and non-communicable disease multi-morbidity in an informal peri-urban setting in Cape Town, South Africaen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMMeden_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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