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Association between physical multimorbidity and common mental health disorders in rural and urban Malawian settings

Preliminary findings from Healthy Lives Malawi long-term conditions survey

Bibliographic Data

ID19590981
AuthorsOwen Nkoka (0000-0001-6984-2247, Malawi Epidemiology and Intervention Research Unit, corresponding author), Shekinah Munthali-Mkandawire (0000-0003-2615-1790, Malawi Epidemiology and Intervention Research Unit, corresponding author), Kondwani Mwandira (0000-0001-8362-7156, Malawi Epidemiology and Intervention Research Unit, corresponding author), Providence Nindi (Malawi Epidemiology and Intervention Research Unit, corresponding author), Albert Dube (0000-0002-6392-0475, Malawi Epidemiology and Intervention Research Unit, corresponding author), Innocent Nyanjagha (0009-0007-5132-125X, Malawi Epidemiology and Intervention Research Unit, corresponding author), Angella Mainjeni (Malawi Epidemiology and Intervention Research Unit, corresponding author), Jullita Malava (Malawi Epidemiology and Intervention Research Unit, corresponding author), Abena S Amoah (0000-0003-2270-1871, Leiden University, corresponding author), Estelle Mclean (0000-0001-6079-0663, London School of Hygiene & Tropical Medicine, corresponding author), R Stewart (0000-0002-4435-6397, Malawi Epidemiology and Intervention Research Unit, corresponding author), Robert C Stewart (0000-0002-0413-1388), Amelia C Crampin (0000-0002-1513-4330, London School of Hygiene & Tropical Medicine, corresponding author), Alison J Price (0000-0002-3891-3337, London School of Hygiene & Tropical Medicine, corresponding author)
EditorsJohn M Francis (0000-0003-1902-2683)
Year2024
Volume4
Issue4
Pagese0002955
Publication date2024-04-04
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0002955
PMID38574079
OpenAlexW4393929251
LanguageEN
Citations received1
References cited69

In low-income Africa, the epidemiology of physical multimorbidity and associated mental health conditions is not well described. We investigated the multimorbidity burden, disease combinations, and relationship between physical multimorbidity and common mental health disorders in rural and urban Malawi using early data from 9,849 adults recruited to an on-going large cross-sectional study on long-term conditions, initiated in 2021. Multimorbidity was defined as having two or more measured (diabetes, hypertension) or self-reported (diabetes, hypertension, disability, chronic pain, HIV, asthma, stroke, heart disease, and epilepsy) conditions. Depression and anxiety symptoms were measured using the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item General Anxiety Disorder scale (GAD-7) and defined by the total score (range 0–27 and 0–21, respectively). We determined age-standardized multimorbidity prevalence and condition combinations. Additionally, we used multiple linear regression models to examine the association between physical multimorbidity and depression and anxiety symptom scores. Of participants, 81% were rural dwelling, 56% were female, and the median age was 30 years (Inter Quartile Range 21–43). The age-standardized urban and rural prevalence of multimorbidity was 14.1% (95% CI, 12.5–15.8%) and 12.2% (95% CI, 11.6–12.9%), respectively. In adults with two conditions, hypertension, and disability co-occurred most frequently (18%), and in those with three conditions, hypertension, disability, and chronic pain were the most common combination (23%). Compared to adults without physical conditions, having one ( B -Coefficient ( B ) 0.79; 95% C1 0.63–0.94%), two- ( B 1.36; 95% CI 1.14–1.58%), and three- or more- physical conditions ( B 2.23; 95% CI 1.86–2.59%) were associated with increasing depression score, p -trend

Anxiety · Asthma · Comorbidity · Confidence interval · Cross-sectional study · Diabetes mellitus · Mental health · Multimorbidity · Physical therapy · Psychiatry · Quartile · Chronic Disease Management Strategies · Health disparities and outcomes · Healthcare Systems and Reforms · Medicine · Epidemiology · Internal Medicine

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Unique citing works1
Citations per year0,5
Citation span2024 - 2024 (1)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 1
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