Multimorbidity, or the presence of two or more long-term health conditions in an individual, is a challenging and complex issue that affects many people worldwide. According to the World Health Organization, multimorbidity not only puts patients at greater risk but also complicates primary care, leading to increased healthcare costs.
Individuals with multimorbidity face a higher risk of early death, poorer quality of life, and the need to take multiple medications. This can result in harmful drug interactions, side effects, and difficulties in adhering to treatment plans. In African countries, the situation is further complicated by the convergence of several disease burdens, including non-communicable diseases like hypertension and diabetes, as well as infectious diseases like HIV and tuberculosis. Poverty and unequal access to healthcare further exacerbate the impact of multimorbidity on individuals in these regions.
Despite the significant impact of multimorbidity on populations of African descent, most research in this area has focused on populations of European ancestry or African-Americans, which do not fully represent the diverse health challenges faced by individuals in Africa. As specialists in genetic epidemiology and chronic disease management, it is crucial to address the gaps in understanding multimorbidity among people with African ancestry.
In a recent study examining 232 medical research publications from 2010 to June 2022, it was found that cardiometabolic diseases, including hypertension, heart disease, and diabetes, were the most studied conditions among populations of African descent, both on the continent and in the diaspora. However, there were notable differences in the way these conditions presented in each group.
In populations on the continent, cardiometabolic diseases often occurred alongside chronic infectious diseases like HIV and tuberculosis, while in diaspora populations, they were more commonly associated with other non-communicable diseases and psychiatric conditions such as depression and post-traumatic stress disorder.
Age, sex, and poverty were also significant factors influencing the prevalence of multimorbidity in individuals of African descent. Older individuals were more likely to have multiple health conditions, but on the continent, younger adults were also at risk due to the burden of infectious diseases. Women were more likely than men to have multiple conditions, particularly related to hypertension and diabetes, reflecting biological and social factors such as income inequalities and access to preventive care.
To address the growing challenge of multimorbidity among populations of African descent, it is crucial to include a greater diversity of participants in medical research studies, expand data collection to include genetic and metabolomic data, and study a wider range of chronic conditions. Integrated care approaches, like those implemented in some African countries, offer promising results by providing treatment for multiple conditions at the same facility during the same visit.
By addressing the gaps in research and implementing integrated care approaches, we can improve the understanding and management of multimorbidity among people of African descent, ultimately leading to better health outcomes for these populations.
