Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil.
Department of Internal Medicine, School of Medicine, Federal University of Goiás, Goiânia, Brazil.
Front Public Health. 2023 Jun 2;11:1193428. doi: 10.3389/fpubh.2023.1193428. eCollection 2023.
Multimorbidity, defined as the coexistence of two or more chronic diseases in the same individual, represents a significant health challenge. However, there is limited evidence on its prevalence and associated factors in developing countries, such as Brazil, especially stratified by sex. Thus, this study aims to estimate the prevalence and analyze the factors associated with multimorbidity in Brazilian adults according to sex.
Cross-sectional population-based household survey carried out with Brazilian adults aged 18 years or older. The sampling strategy consisted of a three-stage conglomerate plan. The three stages were performed through simple random sampling. Data were collected through individual interviews. Multimorbidity was classified based on a list of 14 self-reported chronic diseases/conditions. Poisson regression analysis was performed to estimate the magnitude of the association between sociodemographic and lifestyle factors with the prevalence of multimorbidity stratified by sex.
A total of 88,531 individuals were included. In absolute terms, the prevalence of multimorbidity was 29.4%. The frequency in men and women was 22.7 and 35.4%, respectively. Overall, multimorbidity was more prevalent among women, the older people, residents of the South and Southeast regions, urban area residents, former smokers, current smokers, physically inactive, overweight, and obese adults. Individuals with complete high school/incomplete higher education had a lower prevalence of multimorbidity than those with higher educational level. The associations between education and multimorbidity differed between sexes. In men, multimorbidity was inversely associated with the strata of complete middle school/incomplete high school and complete high school/incomplete higher education, while in women, the association between these variables was not observed. Physical inactivity was positively associated with a higher prevalence of multimorbidity only in men. An inverse association was verified between the recommended fruit and vegetable consumption and multimorbidity for the total sample and both sexes.
One in four adults had multimorbidity. Prevalence increased with increasing age, among women, and was associated with some lifestyles. Multimorbidity was significantly associated with educational level and physical inactivity only in men. The results suggest the need to adopt integrated strategies to reduce the magnitude of multimorbidity, specific by gender, including actions for health promotion, disease prevention, health surveillance and comprehensive health care in Brazil.
多种疾病共存，即同一人同时患有两种或两种以上的慢性疾病，这是一个重大的健康挑战。然而，在发展中国家，如巴西，关于其患病率及其相关因素的证据有限，特别是按性别分层的证据有限。因此，本研究旨在根据性别估计巴西成年人的多种疾病患病率，并分析其相关因素。
这是一项基于人群的横断面家庭调查，纳入了年龄在 18 岁及以上的巴西成年人。抽样策略包括三阶段的集聚计划。这三个阶段是通过简单随机抽样进行的。数据通过个人访谈收集。多种疾病根据自我报告的 14 种慢性疾病/状况的清单进行分类。采用泊松回归分析估计社会人口统计学和生活方式因素与按性别分层的多种疾病患病率之间的关联程度。
共纳入 88531 人。从绝对数值来看，多种疾病的患病率为 29.4%。男性和女性的患病率分别为 22.7%和 35.4%。总体而言，女性、老年人、南部和东南部地区居民、城市居民、前吸烟者、现吸烟者、身体活动不足、超重和肥胖成年人中多种疾病更为常见。具有完整中学/不完全高等教育程度的个体的多种疾病患病率低于具有更高教育水平的个体。教育与多种疾病之间的关联在性别之间存在差异。在男性中，多种疾病与完整中学/不完全高中和完整中学/不完全高等教育程度呈负相关，而在女性中，这些变量之间的关联并不明显。身体活动不足与男性多种疾病患病率的升高呈正相关。在总样本和两性中，推荐的水果和蔬菜摄入量与多种疾病之间呈负相关。
每四个成年人中就有一个患有多种疾病。患病率随着年龄的增长、在女性中以及与某些生活方式相关而增加。多种疾病仅与男性的教育水平和身体活动不足显著相关。这些结果表明，巴西需要采取综合策略来降低多种疾病的严重程度，具体措施包括促进健康、预防疾病、健康监测和提供综合医疗保健，并且需要根据性别进行调整。
