Chronic noncommunicable diseases in 6 low- and middle-income countries: Findings from wave 1 of the world health organization's Study on Global Ageing and Adult Health (SAGE)

Perianayagam Arokiasamy, Uttamacharya, Paul Kowal, Benjamin D. Capistrant, Theresa E. Gildner, Elizabeth Thiele, Richard B. Biritwum, Alfred E. Yawson, George Mensah, Tamara Maximova, Fan Wu, Yanfei Guo, Yang Zheng, Sebastiana Zimba Kalula, Aarón Salinas Rodríguez, Betty Manrique Espinoza, Melissa A. Liebert, Geeta Eick, Kirstin N. Sterner, Tyler M. BarrettKwabena Duedu, Ernest Gonzales, Nawi Ng, Joel Negin, Yong Jiang, Julie Byles, Savathree Lorna Madurai, Nadia Minicuci, J. Josh Snodgrass, Nirmala Naidoo, Somnath Chatterji

Research output: Contribution to journalReview articlepeer-review

64 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)414-428
Number of pages15
JournalAmerican journal of epidemiology
Volume185
Issue number6
DOIs
StatePublished - Mar 15 2017

Keywords

  • chronic disease
  • diagnosis
  • low- and middle-income countries
  • noncommunicable diseases
  • untreated diseases

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