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Epidemiology
Original research
Prevalence of multimorbidity among Bangladeshi adult population: a nationwide cross-sectional study
  1. Nusrat Khan1,
  2. Mahfuzar Rahman1,
  3. Dipak Mitra2,
  4. Kaosar Afsana3,4
  1. 1 Research and Evaluation Division, BRAC, Dhaka, Bangladesh
  2. 2 School of Public Health, North South University, Dhaka, Dhaka District, Bangladesh
  3. 3 Health, Nutrition and Population Program, BRAC, Dhaka, Dhaka, Bangladesh
  4. 4 James P Grant School of Public Health, BRAC University, Dhaka, Dhaka District, Bangladesh
  1. Correspondence to Dr Nusrat Khan; nusrat.khan{at}brac.net

Abstract

Objective This study aimed to report prevalence and evaluate the association between multimorbidity and associated risk factors in the adult population of Bangladesh.

Design A cross-sectional study was conducted using a multistage clustered random sampling strategy.

Setting The study was conducted among the general population of 58 districts in Bangladesh.

Participants A total of 12 338 male and female individuals aged ≥35 were included for analysis in this study. Identified through a household listing conducted prior to the study, from 15 297 individuals meeting the inclusion criteria, 12 338 participants were included based on availability during data collection, consent and health condition.

Outcome measures Multimorbidity in terms of hypertension, diabetes, cancer, cardiovascular diseases, stroke and chronic obstructive pulmonary disease.

Results Approximately 8.4% (95% CI 7.0 to 9.7) of individuals suffer from multimorbidity, of which hypertension accounted for (30.1%) followed by diabetes (10.6%). The mean age of the population was 58.6 (SD ±9.2) years. The prevalence of multimorbidity was lower among men (7.7%) compared with women (8.9%). The likelihood of having multimorbidity among obese individuals were more than double than people with normal body mass index (BMI). Physical activity protected individuals from developing multimorbidity: however, the physical activity adjusted OR was 0.5 (95% CI 0.2 to 1.2). After adjusting for all covariates, higher age, higher educational status, economic status, and higher BMI were found to be significantly associated with the odds of developing multimorbidity, with an overall adjusted OR of 0.02 (95% CI 0.01 to 0.02).

Conclusion This study reported a high prevalence of multimorbidity in Bangladesh, although it explored the burden and identified risk factors considering only six chronic diseases. Further detailed exploration through longitudinal studies considering a wider range of diseases is needed to document the actual burden, develop effective preventive measures and clinical guidelines to improve the quality of life of the population.

  • global health
  • multimorbidity
  • risk factors
  • non-communicable disease (NCDS)

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2019-030886

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    Footnotes

    • Contributors Conceptualisation: NK, MR, KA. Formal analysis: NK, MR. Investigation: NK, MR, DM. Methodology: NK, MR, DM. Supervision: MR, KA. Writing original draft: NK. Writing—review and editing: NK, MR, KA, DM. All authors read and approved the final manuscript.

    • Funding This research activity was funded by the Strategic Partnership Arrangement(SPA) between BRAC, the UK Department for International Development(DFID) and the Australian Department of Foreign Affairs and Trade(DFAT) in 2015. The funders had no role in the design, analysis or writing ofthis manuscript.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Ethics approval The ethical approval was obtained from the Bangladesh Medical Research Council (BMRC). The purpose of the study was described to the participants. Both verbal and written consent was provided by participants prior to the census and main interview and the respondents were ensured of the confidentiality of information provided.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data available on request.