Multimorbidity and complex multimorbidity in Brazilian rural workers
Autoři:
Glenda Blaser Petarli aff001; Monica Cattafesta aff001; Monike Moreto Sant’Anna aff002; Olívia Maria de Paula Alves Bezerra aff003; Eliana Zandonade aff001; Luciane Bresciani Salaroli aff004
Působiště autorů:
Postgraduate Program in Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
aff001; Center for Health Sciences, Federal University of Espírito Santo, Vitória, Brazil
aff002; Department of Family Medicine, Mental and Collective Health, Medical school, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
aff003; Postgraduate program in Nutrition and Health, and Graduate Program in Collective Health, Center for Health Sciences, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
aff004
Vyšlo v časopise:
PLoS ONE 14(11)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0225416
Souhrn
Objective
To estimate the prevalence of multimorbidity and complex multimorbidity in rural workers and their association with sociodemographic characteristics, occupational contact with pesticides, lifestyle and clinical condition.
Methods
This is a cross-sectional epidemiological study with 806 farmers from the main agricultural municipality of the state of Espírito Santo/Brazil, conducted from December 2016 to April 2017. Multimorbidity was defined as the presence of two or more chronic diseases in the same individual, while complex multimorbidity was classified as the occurrence of three or more chronic conditions affecting three or more body systems. Socio-demographic data, occupational contact with pesticides, lifestyle data and clinical condition data were collected through a structured questionnaire. Binary logistic regression was conducted to identify risk factors for multimorbidity.
Results
The prevalence of multimorbidity among farmers was 41.5% (n = 328), and complex multimorbidity was 16.7% (n = 132). More than 77% of farmers had at least one chronic illness. Hypertension, dyslipidemia and depression were the most prevalent morbidities. Being 40 years or older (OR 3.33, 95% CI 2.06–5.39), previous medical diagnosis of pesticide poisoning (OR 1.89, 95% CI 1.03–3.44), high waist circumference (OR 2.82, CI 95% 1.98–4.02) and worse health self-assessment (OR 2.10, 95% CI 1.52–2.91) significantly increased the chances of multimorbidity. The same associations were found for the diagnosis of complex multimorbidity.
Conclusion
We identified a high prevalence of multimorbidity and complex multimorbidity among the evaluated farmers. These results were associated with increased age, abdominal fat, pesticide poisoning, and poor or fair health self-assessment. Public policies are necessary to prevent, control and treat this condition in this population.
Klíčová slova:
Agricultural workers – Alcohol consumption – Brazil – Depression – Hypertension – Pesticides – Socioeconomic aspects of health
Zdroje
1. National Center for Farmworker Health. Agricultural worker occupational health & safety. Texas; 2017 nov. 7p. Available from: http://www.ncfh.org/uploads/3/8/6/8/38685499/fs-occ_health.pdf
2. Lourenço AEP. Growing, harvesting, selling, but not eating: food and work related practices associated to obesity among family farmers in Bonfim, Petrópolis, Rio de Janeiro, Brazil. Rev bras saude ocup. 2012;37(125):127–42. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0303-76572012000100015&lng=en
3. Pickett W, King N, Lawson J, Dosman JA, Trask C, Brison RJ, et al. Farmers, mechanized work, and links to obesity. Prev Med. 2015;70:59–63. https://doi.org/10.1016/j.ypmed.2014.11.012 25448840
4. Li X, Cai L, Cui WL, Wang XM, et al. Association of socioeconomic and lifestyle factors with chronic non-communicable diseases and multimorbidity among the elderly in rural southwest China. J Public Health (Oxf). 2019 Mar 12. pii: fdz020. https://doi.org/10.1093/pubmed/fdz020 30860582
5. Ba NV, Minh HV, Quang LB, Chuyen NV, Ha BTT, Dai TQ, et al. Prevalence and correlates of multimorbidity among adults in border areas of the Central Highland Region of Vietnam, 2017. J Comorb. 2019; 9: 2235042X19853382. https://doi.org/10.1177/2235042X19853382 31192142
6. Goeres LM, Gille A, Furuno JP, Erten-Lyons D, Hartung DM, Calvert JF, et al. Rural-Urban Differences in Chronic Disease and Drug Utilization in Older Oregonians. J Rural Health. 2016 Jun;32(3):269–79. https://doi.org/10.1111/jrh.12153 26515108
7. Kuo RN, Lai MS. The influence of socio-economic status and multimorbidity patterns on healthcare costs: a six-year follow-up under a universal healthcare system. Int J Equity Health. 2013 Aug 20;12:69. https://doi.org/10.1186/1475-9276-12-69 23962201
8. World Health Organization. Primary health care: now more than ever. Geneva: World Health Organization; 2008. 119 p. Available from: https://www.who.int/whr/2008/en/
9. Palladino R, Tayu Lee J, Ashworth M, Triassi M, Millett C. Associations between multimorbidity, healthcare utilisation and health status: evidence from 16 European countries. Age Ageing. 2016;45(3):431–5. https://doi.org/10.1093/ageing/afw044 27013499
10. Holzer BM, Siebenhuener K, Bopp M, Minder CE. Evidence-based design recommendations for prevalence studies on multimorbidity: improving comparability of estimates. Popul Health Metr. 2017;15(1):9. https://doi.org/10.1186/s12963-017-0126-4 28270157
11. Harrison C, Henderson J, Miller G, Britt H. The prevalence of complex multimorbidity in Australia. Aust N Z J Public Health. 2016;40(3):239–44. https://doi.org/10.1111/1753-6405.12509 27027989
12. Nunes BP, Filho ADPC, Pati S, Teixeira DSC, Flores TR, Camargo-Figuera FA, et al. Contextual and individual inequalities of multimorbidity in Brazilian adults: a cross-sectional national-based study. BMJ Open. 2017;7(6):e015885. https://doi.org/10.1136/bmjopen-2017-015885 28601836
13. Harrison C, Britt H, Miller G, Henderson J. Examining different measures of multimorbidity, using a large prospective cross-sectional study in Australian general practice. BMJ Open 2014;4(7):e004694. https://doi.org/10.1136/bmjopen-2013-004694 25015470
14. Sociedade Brasileira de Cardiologia. 7th Brazilian Guideline of Arterial Hypertension. Arq Bras Cardiol. 2016;107(3):103. Available from: http://publicacoes.cardiol.br/2014/diretrizes/2016/05_HIPERTENSAO_ARTERIAL_INGLES.pdf
15. Sociedade brasileira de cardiologia. Sociedade brasileira de hipertensão. Sociedade brasileira de nefrologia. VI Brazilian Guidelines on Hypertension. Arq Bras Cardiol. 2010;95(1):1–51. https://doi.org/10.1590/S0066-782X2010001700001 20694399
16. Xavier HT, Izar MC, Faria Neto JR, Assad MH, Rocha VZ, Sposito AC, et al. V Brazilian Guidelines on Dyslipidemias and Prevention of Atherosclerosis. Arq Bras Cardiol. 2013;101(4):01–22. https://doi.org/10.5935/abc.2013S010
17. Amorim P. Mini International Neuropsychiatric Interview (MINI): validation of a short structured diagnostic psychiatric interview. J Bras Psiquiatr. 2000;22(3):106–15. https://doi.org/10.1590/S1516-44462000000300003
18. Associação Brasileira de Empresas de Pesquisa. Brazilian Economic Classification Criteria 2014. São Paulo: The Association; 2014. Available from: http://www.abep.org/criterio-brasil
19. World Health Organization. Obesity: preventing and managing the global epidemic: report of a WHO consultation. Geneva: WHO Consultation on Obesity; 2000, 252p. Available from: http://www.who.int/entity/nutrition/publications/obesity/WHO_TRS_894/en/index.html
20. Jantsch AG, Alves RFS, Faerstein E. Educational inequality in Rio de Janeiro and its impact on multimorbidity: evidence from the Pró-Saúde study. A cross-sectional analysis. Sao Paulo Med J. 2018;136(1):51–8. https://doi.org/10.1590/1516-3180.2017.0209100917 29513787
21. Prazeres F, Santiago L. Prevalence of multimorbidity in the adult population attending primary care in Portugal: a cross-sectional study. BMJ Open. 2015;5(9):e009287. https://doi.org/10.1136/bmjopen-2015-009287 26408832
22. Hussain MA, Katzenellenbogen JM, Sanfilippo FM, Murray K, Thompson SC. Complexity in disease management: A linked data analysis of multimorbidity in Aboriginal and non-Aboriginal patients hospitalised with atherothrombotic disease in Western Australia. PLoS One. 2018;13(8):e0201496. https://doi.org/10.1371/journal.pone.0201496 30106971
23. Madlock-Brown C, Reynolds RB. Identifying obesity-related multimorbidity combinations in the United States. Clin Obes. 2019 https://doi.org/10.1111/cob.12336 31418172
24. Newman D, Kishore SP. Prevalence of multiple chronic conditions in New York State, 2011–2016. PLoS One. 2019; 14(2): e0211965. https://doi.org/10.1371/journal.pone.0211965 30730970
25. Garin N, Koyanagi A, Chatterji S, Tyrovolas S, Olaya B, Leonardi M, et al. Global Multimorbidity Patterns: A Cross-Sectional, Population-Based, Multi-Country Study. J Gerontol A Biol Sci Med Sci. 2016;71(2):205–14. https://doi.org/10.1093/gerona/glv128 26419978
26. Pengpid S, Peltzer K. Multimorbidity in Chronic Conditions: Public Primary Care Patients in Four Greater Mekong Countries. Int J Environ Res Public Health. 2017;14(9). pii: E1019. https://doi.org/10.3390/ijerph14091019 28878150
27. Chen H, Cheng M, Zhuang Y, Broad JB. Multimorbidity among middle-aged and older persons in urban China: Prevalence, characteristics and health service utilization. Geriatr Gerontol Int. 2018;18(10):1447–1452. https://doi.org/10.1111/ggi.13510 30178629
28. Ofori-Asenso R, Chin KL, Curtis AJ, Zomer E, Zoungas S, Liew D. Recent Patterns of Multimorbidity Among Older Adults in High-Income Countries. Popul Health Manag. 2019;22(2):127–137. https://doi.org/10.1089/pop.2018.0069 30096023
29. Malta DC, Bernal RTI, Andrade SSCA, Silva MMA, Velasquez-Melendez G. Prevalence of and factors associated with self-reported high blood pressure in Brazilian adults. Rev Saude Publica. 2017;51(1). https://doi.org/10.1590/s1518-8787.2017051000006
30. Lobo LAC, Canuto R, Dias-da-Costa JS, Pattusi MP. Temporal trend of the prevalence of systemic arterial hypertension in Brazil. Cad Saude Publica. 2017;33(6). https://doi.org/10.1590/0102-311x00035316
31. Violán C, Foguet-Boreu Q, Roso-Llorach A, Rodriguez-Blanco T, Pons-Vigués M, Pujol-Ribera E, et al. Burden of multimorbidity, socioeconomic status and use of health services across stages of life in urban areas: a cross-sectional study. BMC Public Health. 2014;14(1). https://doi.org/10.1186/1471-2458-14-530 24885174
32. Woldesemayat EM, Kassa A, Gari T, Dangisso MH. Chronic diseases multi-morbidity among adult patients at Hawassa University Comprehensive Specialized Hospital. BMC Public Health. 2018;18(1):352. https://doi.org/10.1186/s12889-018-5264-5 29540155
33. Harrison C, Henderson J, Miller G, Britt H. The prevalence of diagnosed chronic conditions and multimorbidity in Australia: A method for estimating population prevalence from general practice patient encounter data. PLoS One. 2017;12(3):e0172935. https://doi.org/10.1371/journal.pone.0172935 28278241
34. Afshar S, Roderick PJ, Kowal P, Dimitrov BD, Hill AG. Multimorbidity and the inequalities of global ageing: a cross-sectional study of 28 countries using the World Health Surveys. BMC Public Health. 2015;15(1):776. https://doi.org/10.1186/s12889-015-2008-7 26268536
35. Romana GQ, Kislaya I, Salvador M, Gonçalves S, Nunes B, Dias C. Multimorbilidade em Portugal: Dados do Primeiro Inquérito Nacional de Saúde com Exame Físico. Acta Med Port. 2019; 32(1):30. Available from: https://www.researchgate.net/publication/330839809_Multimorbilidade_em_Portugal_Dados_do_Primeiro_Inquerito_Nacional_de_Saude_com_Exame_Fisico 30753801
36. Garin N, Olaya B, Perales J, Moneta MV, Miret M, Ayuso-Mateos JL, et al. Multimorbidity Patterns in a National Representative Sample of the Spanish Adult Population. PLoS One. 2014;9(1):e84794. https://doi.org/10.1371/journal.pone.0084794 24465433
37. Roberts KC, Rao DP, Bennett TL, Loukine L, Jayaraman GC. Prevalence and patterns of chronic disease multimorbidity and associated determinants in Canada. Health Promot Chronic Dis Prev Can. 2015;35(6):87–94. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26302227 26302227
38. Frølich A, Ghith N, Schiøtz M, Jacobsen R, Stockmarr A. Multimorbidity, healthcare utilization and socioeconomic status: A register-based study in Denmark. PLoS One. 2019 Aug 1;14(8):e0214183. https://doi.org/10.1371/journal.pone.0214183 31369580
39. van den Akker M, Vaes B, Goderis G, Van Pottelbergh G, De Burghgraeve T, Henrard S. Trends in multimorbidity and polypharmacy in the Flemish-Belgian population between 2000 and 2015. PLoS One. 2019 Feb 12;14(2):e0212046. https://doi.org/10.1371/journal.pone.0212046 30753214
40. Lee JT, Hamid F, Pati S, Atun R, Millett C. Impact of Noncommunicable Disease Multimorbidity on Healthcare Utilisation and Out-Of-Pocket Expenditures in Middle-Income Countries: Cross Sectional Analysis. PLoS One. 2015;10(7):e0127199. https://doi.org/10.1371/journal.pone.0127199 26154083
41. Macinko J, Andrade FCD, Nunes BP, Guanais FC. Primary care and multimorbidity in six Latin American and Caribbean countries. Rev Panam Salud Publica. 2019;43:e8. https://doi.org/10.26633/RPSP.2019.8 31093232
42. Hajat C, Stein E. The global burden of multiple chronic conditions: A narrative review. Prev Med Rep. 2018; 12: 284–293. https://doi.org/10.1016/j.pmedr.2018.10.008 30406006
43. Palladino R, Nardone A, Millett C, Triassi M The impact of multimorbidity on health outcomes in older adults between 2006 and 2015 in Europe. Eur J Public Health 2018;28(4). Available from: https://academic.oup.com/eurpub/article/28/suppl_4/cky213.400/5192462
44. Nguyen H, Manolova G, Daskalopoulou C, Vitoratou S, Prince M, Prina AM. Prevalence of multimorbidity in community settings: A systematic review and meta-analysis of observational studies. J Comorb. 2019; 9:1–15. https://doi.org/10.1177/2235042X19870934
45. Agborsangaya CB, Ngwakongnwi E, Lahtinen M, Cooke T, Johnson JA. Multimorbidity prevalence in the general population: the role of obesity in chronic disease clustering. BMC Public Health. 2013;13:1161. https://doi.org/10.1186/1471-2458-13-1161 24325303
46. Divo MJ, Martinez CH, Mannino DM. Ageing and the epidemiology of multimorbidity. Eur Respir J. 2014;44(4):1055–68. https://doi.org/10.1183/09031936.00059814 25142482
47. Nunes BP, Batista SRR, Andrade FB de, Souza Junior PRB de, Lima-Costa MF, Facchini LA, et al. Multimorbidity: The Brazilian Longitudinal Study of Aging (ELSI-Brazil). Rev Saude Publica 2018;52(2). https://doi.org/10.11606/s1518-8787.2018052000637
48. Costa CS, Flores TR, Wendt A, Neves RG, Tomasi E, Cesar JA, et al. Inequalities in multimorbidity among elderly: a population-based study in a city in Southern Brazil. Cad Saude Publica. 2018;34(11):e00040718. https://doi.org/10.1590/0102-311x00040718 30484558
49. Nunes BP, Thumé E, Facchini LA. Multimorbidity in older adults: magnitude and challenges for the Brazilian health system. BMC Public Health. 2015;15:1172. https://doi.org/10.1186/s12889-015-2505-8 26602756
50. Feely A, Lix LM, Reimer K. Estimating multimorbidity prevalence with the Canadian chronic Disease Surveillance system. Health Promot Chronic Dis Prev Can. 2017;37(7):215–222 https://doi.org/10.24095/hpcdp.37.7.02 28703703
51. Puth MT, Weckbecker K, Schmid M, Münster E. Prevalence of multimorbidity in Germany: Impact of age and educational level in a cross-sectional study on 19,294 adults. BMC Public Health. 2017;17(1):826. https://doi.org/10.1186/s12889-017-4833-3 29047341
52. Violan C, Foguet-Boreu Q, Flores-Mateo G, Salisbury C, Blom J, Freitag M, et al. Prevalence, determinants and patterns of multimorbidity in primary care: a systematic review of observational studies. PLoS One. 2014;9(7):e102149. https://doi.org/10.1371/journal.pone.0102149 25048354
53. Pathirana TI, Jackson CA. Socioeconomic status and multimorbidity: a systematic review and meta‐analysis. Aust N Z J Public Health. 2018;42(2):186–194. https://doi.org/10.1111/1753-6405.12762 29442409
54. Carvalho JN, Cancela MC, Souza DLB. Lifestyle factors and high body mass index are associated with different multimorbidity clusters in the Brazilian population. PLoS One. 2018;20:13(11):e0207649. https://doi.org/10.1371/journal.pone.0207649 30458026
55. Zhang R, Lu Y, Shi L, Zhang S, Chang F. Prevalence and patterns of multimorbidity among the elderly in China: a cross-sectional study using national survey data. BMJ Open 2019;9:e024268 https://doi.org/10.1136/bmjopen-2018-024268 31427309
56. Abad-Díez JM, Calderón-Larrañaga A, Poncel-Falcó A, Poblador-Plou B, Calderón-Meza JM, Sicras-Mainar A, et al. Age and gender differences in the prevalence and patterns of multimorbidity in the older population. BMC Geriatr. 2014;14:75. https://doi.org/10.1186/1471-2318-14-75 24934411
57. Aye SKK, Hlaing HH, Htay SS, Cumming R. Multimorbidity and health seeking behaviours among older people in Myanmar: A community survey. PLoS One. 2019;14(7):e0219543. https://doi.org/10.1371/journal.pone.0219543 31295287
58. Guerra SG, Berbiche D, Vasiliadis HM. Measuring multimorbidity in older adults: comparing different data sources. BMC Geriatr. 2019; 19(1):166. https://doi.org/10.1186/s12877-019-1173-4 31200651
59. Upadhyay J, Farr O, Perakakis N, Ghaly W, Mantzoros C. Obesity as a Disease. Med Clin North Am. 2018;102(1):13–33. https://doi.org/10.1016/j.mcna.2017.08.004 29156181
60. Booth HP, Prevost AT, Gulliford MC. Impact of body mass index on prevalence of multimorbidity in primary care: cohort study. Fam Pract. 2014;31(1):38–43. https://doi.org/10.1093/fampra/cmt061 24132593
61. Agrawal S, Agrawal PK. Association Between Body Mass index and Prevalence of Multimorbidity in Low-and Middle-income Countries: A Cross-Sectional Study. Int J Med Public Health. 2016. 6(2):73–83. https://doi.org/10.5530/ijmedph.2016.2.5 28894693
62. Kim KH, Kabir E, Jahan SA. Exposure to pesticides and the associated human health effects. Sci Total Environ. 2017;575:525–35. https://doi.org/10.1016/j.scitotenv.2016.09.009 27614863
63. Chang AY, Gómez-Olivé FX, Payne C, Rohr JK, Manne-Goehler J, Wade AN, et al. Chronic multimorbidity among older adults in rural South Africa. BMJ Global Health 2019;4:e001386. https://doi.org/10.1136/bmjgh-2018-001386 31423345
64. Miles A, Asbridge J. Multimorbidity-A manifestation of network disturbances? How to investigate? How to treat?. J Eval Clin Pract. 2017;23(1):193–8. https://doi.org/10.1111/jep.12723 28239933
Článek vyšel v časopise
PLOS One
2019 Číslo 11
- Řekněte mi, co jíte, a já vám řeknu, jaká je úroveň vaší kognice
- Duševní onemocnění se u teenagerů přenáší v rámci školní třídy
- Od kostiček k lidské kůži. Jak si postavit 3D biotiskárnu?
- Pomohou nám s detekcí karcinomu plic i včely?
- Původní český test ALBA pro odhalení mírných kognitivních deficitů získal certifikaci MZ ČR
Nejčtenější v tomto čísle
- A daily diary study on maladaptive daydreaming, mind wandering, and sleep disturbances: Examining within-person and between-persons relations
- A 3’ UTR SNP rs885863, a cis-eQTL for the circadian gene VIPR2 and lincRNA 689, is associated with opioid addiction
- A substitution mutation in a conserved domain of mammalian acetate-dependent acetyl CoA synthetase 2 results in destabilized protein and impaired HIF-2 signaling
- Molecular validation of clinical Pantoea isolates identified by MALDI-TOF
Zvyšte si kvalifikaci online z pohodlí domova
Všechny kurzy