TY - JOUR
T1 - Chronic noncommunicable diseases in 6 low- and middle-income countries
T2 - Findings from wave 1 of the world health organization's Study on Global Ageing and Adult Health (SAGE)
AU - Arokiasamy, Perianayagam
AU - Uttamacharya,
AU - Kowal, Paul
AU - Capistrant, Benjamin D.
AU - Gildner, Theresa E.
AU - Thiele, Elizabeth
AU - Biritwum, Richard B.
AU - Yawson, Alfred E.
AU - Mensah, George
AU - Maximova, Tamara
AU - Wu, Fan
AU - Guo, Yanfei
AU - Zheng, Yang
AU - Kalula, Sebastiana Zimba
AU - Rodríguez, Aarón Salinas
AU - Espinoza, Betty Manrique
AU - Liebert, Melissa A.
AU - Eick, Geeta
AU - Sterner, Kirstin N.
AU - Barrett, Tyler M.
AU - Duedu, Kwabena
AU - Gonzales, Ernest
AU - Ng, Nawi
AU - Negin, Joel
AU - Jiang, Yong
AU - Byles, Julie
AU - Madurai, Savathree Lorna
AU - Minicuci, Nadia
AU - Snodgrass, J. Josh
AU - Naidoo, Nirmala
AU - Chatterji, Somnath
N1 - Publisher Copyright:
© The Author 2017.
PY - 2017/3/15
Y1 - 2017/3/15
N2 - In this paper, we examine patterns of self-reported diagnosis of noncommunicable diseases (NCDs) and prevalences of algorithm/measured test-based, undiagnosed, and untreated NCDs in China, Ghana, India, Mexico, Russia, and South Africa. Nationally representative samples of older adults aged ≥50 years were analyzed from wave 1 of the World Health Organization's Study on Global Ageing and Adult Health (2007-2010; n = 34,149). Analyses focused on 6 conditions: Angina, arthritis, asthma, chronic lung disease, depression, and hypertension. Outcomes for these NCDs were: 1) self-reported disease, 2) algorithm/measured test-based disease, 3) undiagnosed disease, and 4) untreated disease. Algorithm/measured test-based prevalence of NCDs was much higher than self-reported prevalence in all 6 countries, indicating underestimation of NCD prevalence in low- and middle-income countries. Undiagnosed prevalence of NCDs was highest for hypertension, ranging from 19.7% (95% confidence interval (CI): 18.1, 21.3) in India to 49.6% (95% CI: 46.2, 53.0) in South Africa. The proportion untreated among all diseases was highest for depression, ranging from 69.5% (95% CI: 57.1, 81.9) in South Africa to 93.2% (95% CI: 90.1, 95.7) in India. Higher levels of education and wealth significantly reduced the odds of an undiagnosed condition and untreated morbidity. A high prevalence of undiagnosed NCDs and an even higher proportion of untreated NCDs highlights the inadequacies in diagnosis and management of NCDs in local health-care systems.
AB - In this paper, we examine patterns of self-reported diagnosis of noncommunicable diseases (NCDs) and prevalences of algorithm/measured test-based, undiagnosed, and untreated NCDs in China, Ghana, India, Mexico, Russia, and South Africa. Nationally representative samples of older adults aged ≥50 years were analyzed from wave 1 of the World Health Organization's Study on Global Ageing and Adult Health (2007-2010; n = 34,149). Analyses focused on 6 conditions: Angina, arthritis, asthma, chronic lung disease, depression, and hypertension. Outcomes for these NCDs were: 1) self-reported disease, 2) algorithm/measured test-based disease, 3) undiagnosed disease, and 4) untreated disease. Algorithm/measured test-based prevalence of NCDs was much higher than self-reported prevalence in all 6 countries, indicating underestimation of NCD prevalence in low- and middle-income countries. Undiagnosed prevalence of NCDs was highest for hypertension, ranging from 19.7% (95% confidence interval (CI): 18.1, 21.3) in India to 49.6% (95% CI: 46.2, 53.0) in South Africa. The proportion untreated among all diseases was highest for depression, ranging from 69.5% (95% CI: 57.1, 81.9) in South Africa to 93.2% (95% CI: 90.1, 95.7) in India. Higher levels of education and wealth significantly reduced the odds of an undiagnosed condition and untreated morbidity. A high prevalence of undiagnosed NCDs and an even higher proportion of untreated NCDs highlights the inadequacies in diagnosis and management of NCDs in local health-care systems.
KW - chronic disease
KW - diagnosis
KW - low- and middle-income countries
KW - noncommunicable diseases
KW - untreated diseases
UR - http://www.scopus.com/inward/record.url?scp=85019563307&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85019563307&partnerID=8YFLogxK
U2 - 10.1093/aje/kww125
DO - 10.1093/aje/kww125
M3 - Review article
C2 - 28399566
AN - SCOPUS:85019563307
SN - 0002-9262
VL - 185
SP - 414
EP - 428
JO - American Journal of Epidemiology
JF - American Journal of Epidemiology
IS - 6
ER -