{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T07:01:22Z","timestamp":1777532482884,"version":"3.51.4"},"reference-count":39,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,8,21]],"date-time":"2019-08-21T00:00:00Z","timestamp":1566345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To describe changes in prevalence of hypertension, diabetes, HIV and tuberculosis, and prevalence of comorbidity, and to investigate associations between each condition, and combinations of conditions, with self\u2010reported general health and hospital admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study used data from a longitudinal population\u2010based HIV and health surveillance cohort, conducted by the Africa Health Research Institute in Umkhanyakude district of rural KwaZulu\u2010Natal, South Africa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Prevalence of hypertension, HIV and diabetes increased from 2009 to 2015, and prevalence of tuberculosis decreased. 81% of the 47\u00a0334 participants were female; hypertension and diabetes were the commonest conditions in people over age 50, whereas HIV was most common in those younger than 50\u00a0years. Comorbidity of communicable and non\u2010communicable conditions was commonest in 40\u2010 to 60\u2010year\u2010olds. The adjusted odd ratios (OR) for better self\u2010reported general health with multimorbidity were 0.53 (95% CI 0.51\u20130.56), 0.29 (95% CI 0.27\u20130.29), 0.25 (95% CI 0.21\u20130.37) and 0.21 (95% CI 0.12\u20130.37) for one, two, three and four conditions, respectively, vs. no conditions. Tuberculosis was most strongly and inversely associated with better general health (OR 0.34 (0.31\u20130.37) and most strongly associated with hospital admission (OR 3.26 (2.32\u20132.99)).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The high prevalence of communicable and non\u2010communicable conditions in this rural South African population is giving rise to a burden of multimorbidity, as increased access to antiretroviral treatment has reduced mortality in people with HIV. Healthcare systems must adapt by working towards integrated primary care for HIV\/AIDS and non\u2010communicable diseases.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13297","type":"journal-article","created":{"date-parts":[[2019,8,7]],"date-time":"2019-08-07T07:29:02Z","timestamp":1565162942000},"page":"1198-1207","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Prevalence and health effects of communicable and non\u2010communicable disease comorbidity in rural KwaZulu\u2010Natal, South Africa"],"prefix":"10.1111","volume":"24","author":[{"given":"Monica","family":"Sharman","sequence":"first","affiliation":[{"name":"Norwich Medical School University of East Anglia Norwich UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Max","family":"Bachmann","sequence":"additional","affiliation":[{"name":"Department of Population Health and Primary Care, Norwich Medical School University of East Anglia Norwich UK"},{"name":"School of Nursing and Public Health University of KwaZulu Natal Durban South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,8,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61399-9"},{"key":"e_1_2_6_3_1","unstructured":"Multimorbidity: a priority for global health research [PDF file].Academy of Medical Sciences 2018. 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