Non-communicable disease comorbidities in KwaZulu-Natal Province, South Africa

S B Kushitor, O A Sanuade, L Baatiema, M K Kushitor, E K Afrifa-Anane, R B Awuah


Background. The prevalence of chronic non-communicable disease (NCD) comorbidity in low- to middle-income countries is increasing, yet evidence on the pattern, prevalence, awareness and treatment of NCD comorbidity is inadequate.

Objectives. To investigate the prevalence, awareness, treatment and control of comorbid hypertension and diabetes, and the underlying risk factors in Mpumza, KwaZulu-Natal Province, South Africa (SA).

Methods. Data were gathered by the SA Human Sciences Research Council from 587 participants in KwaZulu-Natal in 2015. Percentages were used to describe all the variables. Cross-tabulations and χ2 tests were used to describe variations in the prevalences of hypertension, diabetes and comorbidities according to sociodemographic and socioeconomic variables and lifestyle risk factors.

Results. Approximately a third of the participants had hypertension (32%) and 9% had diabetes. The prevalence of comorbid hypertension and diabetes was 6%, and this was significantly higher among women, the aged, the obese, and the formerly married compared with their counterparts. Comorbidity awareness was high (86%). Although most of the participants with comorbidities were being treated with lifestyle changes, insulin and antihypertensive medication (74%), control of comorbidities was low (13%).

Conclusions. The study reported a higher burden of comorbid hypertension and diabetes among vulnerable populations in Mpumza, SA, particularly women, the obese, and those with a low level of education. In addition, control of comorbidities was low. Developing appropriate interventions to improve control of comorbidities can reduce the risk of macrovascular and microvascular diseases in this population.

Authors' affiliations

S B Kushitor, Food Security Initiative and Centre for Complex Systems in Transition, Stellenbosch University, Stellenbosch, South Africa

O A Sanuade, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana; Institute for Global Health, University College London, UK

L Baatiema, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana; Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, Accra, Ghana

M K Kushitor, Department of Health, Policy Planning and Management, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana

E K Afrifa-Anane, Akrofi-Christaller Institute of Theology, Mission and Culture, Akropong, Ghana

R B Awuah, Regional Institute for Population Studies, University of Ghana, Accra, Ghana; Vital Strategies, New York, USA

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Comorbidities; Diabetes; Hypertension; Non-communicable diseases; KwaZulu-Natal; South Africa

Cite this article

South African Medical Journal 2021;111(2):149-158. DOI:10.7196/SAMJ.2021.v111i2.14744

Article History

Date submitted: 2021-02-01
Date published: 2021-02-01

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