title: 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).
abstract: 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.
authors.affiliation: International Institute for Population Sciences, Mumbai, India.
authors.forename: Perianayagam
authors.initials: P
authors.lastname: Arokiasamy
authors.affiliation: International Institute for Population Sciences, Mumbai, India.
authors.lastname: Uttamacharya
authors.affiliation: Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland.|Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Kowal
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Twin Cities, MN, USA.
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Capistrant
authors.affiliation: Department of Anthropology, University of Oregon, Eugene, Oregon, USA.
authors.forename: Theresa E
authors.initials: TE
authors.lastname: Gildner
authors.affiliation: Department of Biology , Vassar College , Poughkeepsie , New York , USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Thiele
authors.affiliation: Department of Community Health , University of Ghana , Accra , Ghana.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Biritwum
authors.affiliation: Department of Community Health , University of Ghana , Accra , Ghana.
authors.forename: Alfred E
authors.initials: AE
authors.lastname: Yawson
authors.affiliation: Center for Translation Research and Implementation Science (CTRIS), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: George
authors.initials: G
authors.lastname: Mensah
authors.affiliation: Sechenov First Moscow State Medical University, Moscow, Russia.
authors.forename: Tamara
authors.initials: T
authors.lastname: Maximova
authors.affiliation: Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Wu
authors.affiliation: Department of Neurology, 2nd Clinical Medical College of Jinan University, Shenzhen, Guangdong, China.
authors.forename: Yanfei
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Division of Geriatric Medicine, The Albertina and Walter Sisulu Institute of Ageing in Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Sebastiana Zimba
authors.initials: SZ
authors.lastname: Kalula
authors.affiliation: Center for Evaluation Research and Surveys, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
authors.forename: Aarón
authors.initials: A
authors.lastname: Salinas Rodríguez
authors.affiliation: Center for Evaluation Research and Surveys, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
authors.forename: Betty
authors.initials: B
authors.lastname: Manrique Espinoza
authors.affiliation: Department of Anthropology, University of Oregon, Eugene, Oregon, USA.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Liebert
authors.affiliation: Department of Anthropology, University of Oregon, Eugene, Oregon, USA.
authors.forename: Geeta
authors.initials: G
authors.lastname: Eick
authors.affiliation: Department of Anthropology, University of Oregon, Eugene, USA.
authors.forename: Kirstin N
authors.initials: KN
authors.lastname: Sterner
authors.affiliation: Department of Anthropology, University of Oregon, Eugene, Oregon, USA.
authors.forename: Tyler M
authors.initials: TM
authors.lastname: Barrett
authors.affiliation: Institute of Quantitative Biology, Biochemistry and Biotechnology, School of Biological Sciences, University of Edinburgh, Edinburgh, UK.
authors.forename: Kwabena
authors.initials: K
authors.lastname: Duedu
authors.affiliation: Department of Physics, University of Notre Dame, 225 Nieuwland Science Hall, Notre Dame, Indiana, USA.
authors.forename: Ernest
authors.initials: E
authors.lastname: Gonzales
authors.affiliation: Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.|Centre for Demographic and Ageing Research, Umeå University, Umeå, Sweden.
authors.forename: Nawi
authors.initials: N
authors.lastname: Ng
authors.affiliation: Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Joel
authors.initials: J
authors.lastname: Negin
authors.affiliation: Department of Pharmaceutical Analysis, School of Pharmacy, Hebei Medical University, Shijiazhuang, Hebei Province, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Research Centre for Gender, Health and Ageing, University of Newcastle, Newcastle, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Byles
authors.affiliation: Polymer Science and Technology, CSIR - Central Leather Research Institute, Chennai, India.
authors.forename: Savathree Lorna
authors.initials: SL
authors.lastname: Madurai
authors.affiliation: National Research Council, Neuroscience Institute, Padova, Italy.
authors.forename: Nadia
authors.initials: N
authors.lastname: Minicuci
authors.affiliation: Department of Anthropology , University of Oregon , Eugene , Oregon , USA.
authors.forename: J Josh
authors.initials: JJ
authors.lastname: Snodgrass
authors.affiliation: Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland.
authors.forename: Nirmala
authors.initials: N
authors.lastname: Naidoo
authors.affiliation: Division of Information, Evidence and Research, World Health Organization, Avenue Appia, Geneva, Switzerland.
authors.forename: Somnath
authors.initials: S
authors.lastname: Chatterji
mesh_terms: D000368:Aged; D000375:Aging; D002908:Chronic Disease / Q000191:economics / Q000453:epidemiology*; D016000:Cluster Analysis; D003906:Developing Countries / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D014943:Global Health / Q000706:statistics & numerical data*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D057566:Self Report; D017678:Sex Distribution; D012923:Social Class; D014944:World Health Organization
keywords: chronic disease; diagnosis; low- and middle-income countries; noncommunicable diseases; untreated diseases