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).

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Arokiasamy, P; Uttamacharya, ; Kowal, P; Capistrant, BD; Gildner, TE; Thiele, E; Biritwum, RB; Yawson, AE; Mensah, G; Maximova, T; Wu, F; Guo, Y; Zheng, Y; Kalula, SZ; Salinas Rodríguez, A; Manrique Espinoza, B; Liebert, MA; Eick, G; Sterner, KN; Barrett, TM; Duedu, K; Gonzales, E; Ng, N; Negin, J; Jiang, Y; Byles, J; Madurai, SL; Minicuci, N; Snodgrass, JJ; Naidoo, N; Chatterji, S

Published Date

  • March 2017

Published In

Volume / Issue

  • 185 / 6

Start / End Page

  • 414 - 428

PubMed ID

  • 28399566

Pubmed Central ID

  • PMC6075549

Electronic International Standard Serial Number (EISSN)

  • 1476-6256

International Standard Serial Number (ISSN)

  • 0002-9262

Digital Object Identifier (DOI)

  • 10.1093/aje/kww125


  • eng