Prevalence, pattern and determinants of chronic disease multimorbidity in Nepal: secondary analysis of a national survey
Raja Ram Dhungana, Khem Bahadur Karki, Bihungum Bista, Achyut Raj Pandey, Meghnath Dhimal, Mahesh Maskey
Abstract
OBJECTIVES: To assess the prevalence, pattern and determinants of non-communicable diseases (NCDs) multimorbidity in Nepal. DESIGN: Secondary analysis of the data from the NCD survey 2018, which was conducted between 2016 and 2018. SETTING: The data belong to the nationally representative survey, that selected the study samples from throughout Nepal using multistage cluster sampling. PARTICIPANTS: 8931 participants aged 20 years and older were included in the study. PRIMARY OUTCOMES: NCD multimorbidity (occurrence of two or more chronic conditions including hypertension, diabetes, chronic obstructive pulmonary disease, chronic kidney disease, coronary artery disease and cancer). Descriptive statistics, prevalence ratio and odds ratio were computed to assess pattern and determinants of multimorbidity. RESULTS: Mean (SD) age was 46.7 years (14.9 years). The majority of the participants were women (57.8%), without formal education (53.4%) and from urban areas (51.5%). Multimorbidity was present in 13.96% (95% CI: 12.9% to 15.1%). Hypertension and diabetes coexisted in 5.7%. Age, alcohol consumption, body mass index, non-high-density lipoprotein (non-HDL) level and rural-urban setting were significantly associated with multimorbidity. CONCLUSION: Multimorbidity was prevalent in particular groups or geographical areas in Nepal suggesting a need for coordinated and integrated NCD care approach for the management of multiplicative co-comorbid conditions.