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*

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    152 Citations (SciVal)

    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
    Pages (from-to)414-428
    Number of pages15
    JournalAmerican Journal of Epidemiology
    Volume185
    Issue number6
    DOIs
    Publication statusPublished (VoR) - 15 Mar 2017

    Funding

    FundersFunder number
    National Institute on AgingR01AG034479

      Keywords

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

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