Chronic disease, risk factors and disability in adults aged 50 and above living with and without HIV: findings from the Wellbeing of Older People Study in Uganda
Identifieur interne : 001144 ( Main/Exploration ); précédent : 001143; suivant : 001145Chronic disease, risk factors and disability in adults aged 50 and above living with and without HIV: findings from the Wellbeing of Older People Study in Uganda
Auteurs : Joseph O. Mugisha [Ouganda, États-Unis] ; Enid J. Schatz [États-Unis] ; Madeleine Randell [Australie] ; Monica Kuteesa [Ouganda] ; Paul Kowal [Suisse, Australie] ; Joel Negin [Australie] ; Janet Seeley [Ouganda]Source :
- Global Health Action [ 1654-9716 ] ; 2016.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Enquêtes de santé, Enquêtes et questionnaires, Facteurs de risque, Facteurs sexuels, Facteurs socioéconomiques, Femelle, Humains, Infections à VIH (), Infections à VIH (épidémiologie), Maladie chronique (épidémiologie), Mâle, Ouganda (épidémiologie), Personnes handicapées (), Prévalence, Sujet âgé, Sujet âgé de 80 ans ou plus, Vieillissement, Études transversales.
- MESH :
- épidémiologie : Infections à VIH, Maladie chronique, Ouganda.
- Adulte d'âge moyen, Enquêtes de santé, Enquêtes et questionnaires, Facteurs de risque, Facteurs sexuels, Facteurs socioéconomiques, Femelle, Humains, Infections à VIH, Mâle, Personnes handicapées, Prévalence, Sujet âgé, Sujet âgé de 80 ans ou plus, Vieillissement, Études transversales.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Aging, Chronic Disease (epidemiology), Cross-Sectional Studies, Disabled Persons (statistics & numerical data), Female, HIV Infections (complications), HIV Infections (epidemiology), Health Surveys, Humans, Male, Middle Aged, Prevalence, Risk Factors, Sex Factors, Socioeconomic Factors, Surveys and Questionnaires, Uganda (epidemiology).
- MESH :
- complications : HIV Infections.
- epidemiology : Chronic Disease, HIV Infections, Uganda.
- statistics & numerical data : Disabled Persons.
- Aged, Aged, 80 and over, Aging, Cross-Sectional Studies, Female, Health Surveys, Humans, Male, Middle Aged, Prevalence, Risk Factors, Sex Factors, Socioeconomic Factors, Surveys and Questionnaires.
Abstract
Data on the prevalence of chronic conditions, their risk factors, and their associations with disability in older people living with and without HIV are scarce in sub-Saharan Africa.
In older people living with and without HIV in sub-Saharan Africa: 1) to describe the prevalence of chronic conditions and their risk factors and 2) to draw attention to associations between chronic conditions and disability.
Cross-sectional individual-level survey data from people aged 50 years and over living with and without HIV were analyzed from three study sites in Uganda. Diagnoses of chronic conditions were made through self-report, and disability was determined using the WHO Disability Assessment Schedule (WHODAS). We used ordered logistic regression and calculated predicted probabilities to show differences in the prevalence of multiple chronic conditions across HIV status, age groups, and locality. We used linear regression to determine associations between chronic conditions and the WHODAS.
In total, 471 participants were surveyed; about half the respondents were living with HIV. The prevalence of chronic obstructive pulmonary disease and eye problems (except for those aged 60–69 years) was higher in the HIV-positive participants and increased with age. The prevalence of diabetes and angina was higher in HIV-negative participants. The odds of having one or more compared with no chronic conditions were higher in women (OR 1.6, 95% CI 1.1–2.3) and in those aged 70 years and above (OR 2.1, 95% CI 1.2–3.6). Sleep problems (coefficient 14.2, 95% CI 7.3–21.0) and depression (coefficient 9.4, 95% CI 1.2–17.0) were strongly associated with higher disability scores.
Chronic conditions are common in older adults and affect their functioning. Many of these conditions are not currently addressed by health services in Uganda. There is a need to revise health care policy and practice in Uganda to consider the health needs of older people, particularly as the numbers of people living into older age with HIV and other chronic conditions are increasing.
Url:
DOI: 10.3402/gha.v9.31098
PubMed: 27225792
PubMed Central: 4880619
Affiliations:
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and without HIV: findings from the Wellbeing of Older People Study in Uganda</title><author><name sortKey="Mugisha, Joseph O" sort="Mugisha, Joseph O" uniqKey="Mugisha J" first="Joseph O." last="Mugisha">Joseph O. Mugisha</name><affiliation wicri:level="1"><nlm:aff id="AF0001">MRC/UVRI, Uganda Research Unit on AIDS, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>MRC/UVRI, Uganda Research Unit on AIDS</wicri:regionArea><wicri:noRegion>Uganda Research Unit on AIDS</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:aff id="AF0002">Department of Health Sciences, University of Missouri Columbia, Missouri, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Health Sciences, University of Missouri Columbia, Missouri</wicri:regionArea><placeName><region type="state">Missouri (État)</region></placeName></affiliation></author><author><name sortKey="Schatz, Enid J" sort="Schatz, Enid J" uniqKey="Schatz E" first="Enid J." last="Schatz">Enid J. Schatz</name><affiliation wicri:level="2"><nlm:aff id="AF0002">Department of Health Sciences, University of Missouri Columbia, Missouri, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Health Sciences, University of Missouri Columbia, Missouri</wicri:regionArea><placeName><region type="state">Missouri (État)</region></placeName></affiliation></author><author><name sortKey="Randell, Madeleine" sort="Randell, Madeleine" uniqKey="Randell M" first="Madeleine" last="Randell">Madeleine Randell</name><affiliation wicri:level="1"><nlm:aff id="AF0003">School of Public Health, University of Sydney, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>School of Public Health, University of Sydney</wicri:regionArea><wicri:noRegion>University of Sydney</wicri:noRegion></affiliation></author><author><name sortKey="Kuteesa, Monica" sort="Kuteesa, Monica" uniqKey="Kuteesa M" first="Monica" last="Kuteesa">Monica Kuteesa</name><affiliation wicri:level="1"><nlm:aff id="AF0001">MRC/UVRI, Uganda Research Unit on AIDS, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>MRC/UVRI, Uganda Research Unit on AIDS</wicri:regionArea><wicri:noRegion>Uganda Research Unit on AIDS</wicri:noRegion></affiliation></author><author><name sortKey="Kowal, Paul" sort="Kowal, Paul" uniqKey="Kowal P" first="Paul" last="Kowal">Paul Kowal</name><affiliation wicri:level="1"><nlm:aff id="AF0004">World Health Organization, Study on global AGEing and adult health, Geneva, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>World Health Organization, Study on global AGEing and adult health, Geneva</wicri:regionArea><wicri:noRegion>Geneva</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="AF0005">Research Centre for Gender, Health and Ageing, University of Newcastle, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Research Centre for Gender, Health and Ageing, University of Newcastle</wicri:regionArea><wicri:noRegion>University of Newcastle</wicri:noRegion></affiliation></author><author><name sortKey="Negin, Joel" sort="Negin, Joel" uniqKey="Negin J" first="Joel" last="Negin">Joel Negin</name><affiliation wicri:level="1"><nlm:aff id="AF0003">School of Public Health, University of Sydney, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>School of Public Health, University of Sydney</wicri:regionArea><wicri:noRegion>University of Sydney</wicri:noRegion></affiliation></author><author><name sortKey="Seeley, Janet" sort="Seeley, Janet" uniqKey="Seeley J" first="Janet" last="Seeley">Janet Seeley</name><affiliation wicri:level="1"><nlm:aff id="AF0001">MRC/UVRI, Uganda Research Unit on AIDS, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>MRC/UVRI, Uganda Research Unit on AIDS</wicri:regionArea><wicri:noRegion>Uganda Research Unit on AIDS</wicri:noRegion></affiliation><affiliation><nlm:aff id="AF0006">London School of Hygiene and Tropical Medicine, London UK</nlm:aff><wicri:noCountry code="subfield">London UK</wicri:noCountry></affiliation></author></analytic><series><title level="j">Global Health Action</title><idno type="ISSN">1654-9716</idno><idno type="eISSN">1654-9880</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Aging</term><term>Chronic Disease (epidemiology)</term><term>Cross-Sectional Studies</term><term>Disabled Persons (statistics & numerical data)</term><term>Female</term><term>HIV Infections (complications)</term><term>HIV Infections (epidemiology)</term><term>Health Surveys</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Prevalence</term><term>Risk Factors</term><term>Sex Factors</term><term>Socioeconomic Factors</term><term>Surveys and Questionnaires</term><term>Uganda (epidemiology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Enquêtes de santé</term><term>Enquêtes et questionnaires</term><term>Facteurs de risque</term><term>Facteurs sexuels</term><term>Facteurs socioéconomiques</term><term>Femelle</term><term>Humains</term><term>Infections à VIH ()</term><term>Infections à VIH (épidémiologie)</term><term>Maladie chronique (épidémiologie)</term><term>Mâle</term><term>Ouganda (épidémiologie)</term><term>Personnes handicapées ()</term><term>Prévalence</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Vieillissement</term><term>Études transversales</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Chronic Disease</term><term>HIV Infections</term><term>Uganda</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Disabled Persons</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Infections à VIH</term><term>Maladie chronique</term><term>Ouganda</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Aging</term><term>Cross-Sectional Studies</term><term>Female</term><term>Health Surveys</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Prevalence</term><term>Risk Factors</term><term>Sex Factors</term><term>Socioeconomic Factors</term><term>Surveys and Questionnaires</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Enquêtes de santé</term><term>Enquêtes et questionnaires</term><term>Facteurs de risque</term><term>Facteurs sexuels</term><term>Facteurs socioéconomiques</term><term>Femelle</term><term>Humains</term><term>Infections à VIH</term><term>Mâle</term><term>Personnes handicapées</term><term>Prévalence</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Vieillissement</term><term>Études transversales</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background</title><p>Data on the prevalence of chronic conditions, their risk factors, and their associations with disability in older people living with and without HIV are scarce in sub-Saharan Africa.</p></sec><sec id="st2"><title>Objectives</title><p>In older people living with and without HIV in sub-Saharan Africa: 1) to describe the prevalence of chronic conditions and their risk factors and 2) to draw attention to associations between chronic conditions and disability.</p></sec><sec id="st3"><title>Methods</title><p>Cross-sectional individual-level survey data from people aged 50 years and over living with and without HIV were analyzed from three study sites in Uganda. Diagnoses of chronic conditions were made through self-report, and disability was determined using the WHO Disability Assessment Schedule (WHODAS). We used ordered logistic regression and calculated predicted probabilities to show differences in the prevalence of multiple chronic conditions across HIV status, age groups, and locality. We used linear regression to determine associations between chronic conditions and the WHODAS.</p></sec><sec id="st4"><title>Results</title><p>In total, 471 participants were surveyed; about half the respondents were living with HIV. The prevalence of chronic obstructive pulmonary disease and eye problems (except for those aged 60–69 years) was higher in the HIV-positive participants and increased with age. The prevalence of diabetes and angina was higher in HIV-negative participants. The odds of having one or more compared with no chronic conditions were higher in women (OR 1.6, 95% CI 1.1–2.3) and in those aged 70 years and above (OR 2.1, 95% CI 1.2–3.6). Sleep problems (coefficient 14.2, 95% CI 7.3–21.0) and depression (coefficient 9.4, 95% CI 1.2–17.0) were strongly associated with higher disability scores.</p></sec><sec id="st5"><title>Conclusion</title><p>Chronic conditions are common in older adults and affect their functioning. Many of these conditions are not currently addressed by health services in Uganda. There is a need to revise health care policy and practice in Uganda to consider the health needs of older people, particularly as the numbers of people living into older age with HIV and other chronic conditions are increasing.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Anderson, G" uniqKey="Anderson G">G Anderson</name></author><author><name sortKey="Horvath, J" uniqKey="Horvath J">J Horvath</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Acosta, D" uniqKey="Acosta D">D Acosta</name></author><author><name sortKey="Rottbeck, R" uniqKey="Rottbeck R">R Rottbeck</name></author><author><name sortKey="Rodriguez, Jg" uniqKey="Rodriguez J">JG Rodríguez</name></author><author><name sortKey="Gonzalez, Lm" uniqKey="Gonzalez L">LM González</name></author><author><name sortKey="Almanzar, Mr" uniqKey="Almanzar M">MR Almánzar</name></author><author><name sortKey="Minaya, Sn" uniqKey="Minaya S">SN Minaya</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hirschhorn, Lr" uniqKey="Hirschhorn L">LR Hirschhorn</name></author><author><name sortKey="Kaaya, Sf" uniqKey="Kaaya S">SF Kaaya</name></author><author><name sortKey="Garrity, Ps" uniqKey="Garrity P">PS Garrity</name></author><author><name sortKey="Chopyak, E" uniqKey="Chopyak E">E Chopyak</name></author><author><name sortKey="Fawzi, Mc" uniqKey="Fawzi M">MC Fawzi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Alwan, A" uniqKey="Alwan A">A Alwan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Deepa, M" uniqKey="Deepa M">M Deepa</name></author><author><name sortKey="Pradeepa, R" uniqKey="Pradeepa R">R Pradeepa</name></author><author><name sortKey="Rema, M" uniqKey="Rema M">M Rema</name></author><author><name sortKey="Mohan, A" uniqKey="Mohan A">A Mohan</name></author><author><name sortKey="Deepa, R" uniqKey="Deepa R">R Deepa</name></author><author><name sortKey="Shanthirani, S" uniqKey="Shanthirani S">S Shanthirani</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ng, N" uniqKey="Ng N">N Ng</name></author><author><name sortKey="Van Minh, H" uniqKey="Van Minh H">H Van Minh</name></author><author><name sortKey="Tesfaye, F" uniqKey="Tesfaye F">F Tesfaye</name></author><author><name sortKey="Bonita, R" uniqKey="Bonita R">R Bonita</name></author><author><name sortKey="Byass, P" uniqKey="Byass P">P Byass</name></author><author><name sortKey="Stenlund, H" uniqKey="Stenlund H">H Stenlund</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Westaway, Ms" uniqKey="Westaway M">MS Westaway</name></author><author><name sortKey="Maluka, Cs" uniqKey="Maluka C">CS Maluka</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Thorogood, M" uniqKey="Thorogood M">M Thorogood</name></author><author><name sortKey="Connor, Md" uniqKey="Connor M">MD Connor</name></author><author><name sortKey="Hundt, Gl" uniqKey="Hundt G">GL Hundt</name></author><author><name sortKey="Tollman, Sm" uniqKey="Tollman S">SM Tollman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Westaway, Ms" uniqKey="Westaway M">MS Westaway</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kahn, K" uniqKey="Kahn K">K Kahn</name></author><author><name sortKey="Garenne, Ml" uniqKey="Garenne M">ML Garenne</name></author><author><name sortKey="Collinson, Ma" uniqKey="Collinson M">MA Collinson</name></author><author><name sortKey="Tollman, Sm" uniqKey="Tollman S">SM Tollman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Negin, J" uniqKey="Negin J">J Negin</name></author><author><name sortKey="Cumming, R" uniqKey="Cumming R">R Cumming</name></author><author><name sortKey="De Ramirez, Ss" uniqKey="De Ramirez S">SS de 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Strong</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ebrahim, S" uniqKey="Ebrahim S">S Ebrahim</name></author><author><name sortKey="Smeeth, L" uniqKey="Smeeth L">L Smeeth</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Maher, D" uniqKey="Maher D">D Maher</name></author><author><name sortKey="Waswa, L" uniqKey="Waswa L">L Waswa</name></author><author><name sortKey="Baisley, K" uniqKey="Baisley K">K Baisley</name></author><author><name sortKey="Karabarinde, A" uniqKey="Karabarinde A">A Karabarinde</name></author><author><name sortKey="Unwin, N" uniqKey="Unwin N">N Unwin</name></author><author><name sortKey="Grosskurth, H" uniqKey="Grosskurth H">H Grosskurth</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Australie</li><li>Ouganda</li><li>Suisse</li><li>États-Unis</li></country><region><li>Missouri (État)</li></region></list><tree><country name="Ouganda"><noRegion><name sortKey="Mugisha, Joseph O" sort="Mugisha, Joseph O" uniqKey="Mugisha J" first="Joseph O." last="Mugisha">Joseph O. Mugisha</name></noRegion><name sortKey="Kuteesa, Monica" sort="Kuteesa, Monica" uniqKey="Kuteesa M" first="Monica" last="Kuteesa">Monica Kuteesa</name><name sortKey="Seeley, Janet" sort="Seeley, Janet" uniqKey="Seeley J" first="Janet" last="Seeley">Janet Seeley</name></country><country name="États-Unis"><region name="Missouri (État)"><name sortKey="Mugisha, Joseph O" sort="Mugisha, Joseph O" uniqKey="Mugisha J" first="Joseph O." last="Mugisha">Joseph O. Mugisha</name></region><name sortKey="Schatz, Enid J" sort="Schatz, Enid J" uniqKey="Schatz E" first="Enid J." last="Schatz">Enid J. Schatz</name></country><country name="Australie"><noRegion><name sortKey="Randell, Madeleine" sort="Randell, Madeleine" uniqKey="Randell M" first="Madeleine" last="Randell">Madeleine Randell</name></noRegion><name sortKey="Kowal, Paul" sort="Kowal, Paul" uniqKey="Kowal P" first="Paul" last="Kowal">Paul Kowal</name><name sortKey="Negin, Joel" sort="Negin, Joel" uniqKey="Negin J" first="Joel" last="Negin">Joel Negin</name></country><country name="Suisse"><noRegion><name sortKey="Kowal, Paul" sort="Kowal, Paul" uniqKey="Kowal P" first="Paul" last="Kowal">Paul Kowal</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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