Determinants of Multimorbidity in a Low-Resource Setting: A Population-Based Cross-Sectional Study in Bangladesh
Syed Toukir Ahmed Noor1, Luthful Alahi Kawsar1, Mohammad Romel Bhuia1
1Department of Statistics, Shahjalal University of Science & Technology, Sylhet 3114, Bangladesh.
Insights
Multimorbidity affects over 65% of adults in Bangladesh, with higher prevalence in older age groups. Promoting healthy lifestyle habits like adequate sleep and nutrition can reduce the risk of developing multiple chronic conditions.
Area of Science:
- Public Health
- Epidemiology
- Gerontology
Background:
- Multimorbidity, defined as the coexistence of two or more chronic diseases, is a significant global health challenge.
- This condition disproportionately affects low-resource settings, with Bangladesh identified as a key area of concern.
Purpose of the Study:
- To investigate the prevalence of multimorbidity in the adult population of Bangladesh.
- To identify demographic, lifestyle, and clinical factors associated with multimorbidity in this population.
Main Methods:
- A cross-sectional study was conducted with 504 adult participants (18 years and older).
- Data on chronic conditions and potential risk factors were collected.
- The generalized linear mixed model was employed to analyze risk factors associated with multimorbidity.
Main Results:
- A high prevalence of multimorbidity was observed, with 65.3% of respondents affected.
- The most common conditions included allergic disorder, gastritis, low back pain, oral diseases, and arthritis.
- Older age, obesity, and being employed were associated with increased odds of multimorbidity, while adequate sleep, vegetable consumption, and water intake showed protective effects.
Conclusions:
- Multimorbidity is highly prevalent among adults in Bangladesh, particularly in older individuals.
- Factors such as age, obesity, employment status, sleep duration, diet, and hydration significantly influence multimorbidity.
- Promoting healthy lifestyle choices is crucial for mitigating the burden of multimorbidity in resource-limited settings.
Abstract:
Multimorbidity is a complex and highly prevalent health condition characterised by the coexistence of two or more chronic diseases within an individual. It is a growing public health issue worldwide, predominantly in low-resource countries like Bangladesh. Therefore, this study aimed to determine the prevalence and associated factors of multimorbidity among the adult population in Bangladesh. A cross-sectional study was carried out among 504 respondents who were 18 years or older. The generalised linear mixed model was used to identify the risk factors. Among the respondents, 65.3% (95% confidence interval [CI]: 61.0 to 69.3) had multimorbidity. The most common chronic conditions were allergic disorder (34%, 95% CI: 30 to 39), gastritis (31%, 95% CI: 27 to 35), low back pain (28.4%, 95% CI: 24.6 to 32.5), oral diseases (27%, 95% CI: 23 to 29) and arthritis (21%, 95% CI: 18 to 25). Middle-aged adults (adjusted odds ratio [AOR] = 7.97; 95% CI: 3.35 to 18.92) and older adults (AOR = 8.44; 95% CI: 1.90 to 36.64) had significantly higher odds of multimorbidity than young adults. Employed respondents had an 86% (AOR = 0.14; 95% CI: 0.07 to 0.36) lower odds of multimorbidity than non-working individuals. Higher sleeping duration (6 to 8 h: AOR = 0.44; 95% CI: 0.25 to 0.80; 8 to 10 h: AOR = 0.26; 95% CI: 0.11 to 0.60), regular vegetable consumption (AOR = 0.42; 95% CI: 0.22 to 0.80) and adequate water intake (AOR = 0.48; 95% CI: 0.29 to 0.79) were protective factors against multimorbidity, whereas obesity increased the odds (AOR = 3.32; 95% CI: 1.06 to 10.43). These findings emphasise the need to promote healthy lifestyle habits, such as maintaining a balanced diet, staying hydrated and engaging in regular physical exercise, to reduce the burden of multimorbidity in low-resource settings.
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