Prevalence, patterns, and correlates of non-communicable disease multimorbidity among healthcare workers: a multicenter study from Bangladesh
摘要
Non-communicable diseases (NCDs) are an increasing public health concern in low- and middle-income countries, including Bangladesh. Limited data exist on NCD prevalence and multimorbidity among HCWs in Bangladesh. This study aimed to assess the prevalence, patterns, and factors associated with multimorbidity among Bangladeshi HCWs.
MethodsWe conducted a cross-sectional study (July 2021–March 2024) among HCWs in purposively selected 13 primary, 2 secondary, and 5 tertiary healthcare facilities across 4 administrative divisions in Bangladesh. HCWs were interviewed using a structured questionnaire covering socio-demographics, NCDs, and anthropometric measurements. Data were summarized using frequencies and percentages, and the factors associated with multimorbidity were assessed with two separate multivariable binary logistic regression models.
ResultsWe enrolled 2,881 HCWs, of whom 63% were female. Almost half of the respondents were aged 30–44 years, and the median age was 36 years (IQR 30–46 years). The overall prevalence of having at least one NCD was 1,162 (40%), with multimorbidity in 708 (25%) of the respondents. The most prevalent NCDs among HCWs were hypertension at 612 (21%), followed by diabetes at 409 (14%), chronic lung disease at 323 (11%), dyslipidemia at 160 (6%), and heart disease at 111 (3%). However, multimorbidity was derived from both objectively measured and self-reported conditions, which should be considered in interpreting prevalence estimates. Factors associated with multimorbidity included age ≥ 45 years (AOR: 35.2, 95% CI: 22.3–55.7) compared to individuals without NCDs (Model 1) and (AOR: 5.5, 95% CI: 3.2–9.6) compared to individuals with a single NCD (Model 2). Other associated factors, compared with individuals without NCDs (Model 1), included female (AOR: 1.8, 95% CI: 1.3–2.4), central obesity (AOR: 2.8, 95% CI: 1.9–4.0), higher education (AOR: 1.9, 95% CI: 1.1–3.2), and employment at tertiary healthcare facilities (AOR: 1.9, 95% CI: 1.4–2.7).
ConclusionOur study highlights a high burden of NCDs among HCWs in Bangladesh, with one in four HCWs experiencing multimorbidity. Older age (≥ 45 years), female, central obesity, higher education, and employment in tertiary healthcare facilities were associated with increased odds of multimorbidity. These findings underscore the need for targeted interventions, including workplace health programs, routine health screenings, and strategies to promote healthier lifestyles, to improve HCWs’ health and ensure a resilient healthcare system.