Abstract:
Chronic conditions are a significant source of disease burden in Ghana including The
Tema General Hospital (TGH). When concurrent in an individual, the outcomes are
poorer. Yet medical research, preventive and clinical services are focused on single
disease entities. The few studies conducted have predominantly been in developed
countries and the elderly. This research determined the prevalence, distribution and
socio-demographic risk factors of concurrent chronic conditions in our setting, to
inform appropriate prevention and clinical care planning and practices.
A cross-sectional study was conducted in adult patients of the medical clinic of the
main OPD of TGH from 21 st May to 8 th June 2012. Consecutive patients were
sampled and interviewed using a structured questionnaire to collect data on socio-
demographic characteristics and medical history. Medical diagnoses were extracted
from the medical records. Concurrent chronic condition was defined as the presence
of two or more of 13 pre-selected conditions in an individual, and its association with
a range of socio-demographic characteristics was determined using multivariate
logistic regression.
Of the 1,399 records analysed, 38.8% (95% CI: 36.3 – 41.4) had concurrent chronic
conditions. As much as 48.6% of the persons with concurrent chronic conditions were
young adults (18-59 years). The most common combination of conditions was
diabetes mellitus and hypertension. Age, sex and a family history of chronic condition
were independently associated with concurrent chronic conditions. Of these, age was
the most significant; compared with the referent age group of 18 – 39 years, the
adjusted odds for people aged 60 years and above was higher (OR =15.82 ,95%
CI:10.66- 23.48, p <0.0001). Notably, the increasing prevalence observed with
increasing age plateaus at a prevalence of about 60% by age 57 years.
This study shows that concurrent chronic conditions are common in adult attendants
of the medical clinic of the main OPD of the TGH. The most common combination
was the pair of hypertension-diabetes mellitus and confirmed increasing age, female
sex and a family history of a chronic condition as independent risk factors for
concurrent chronic conditions. These prompt the need for research, medical
education, prevention and clinical care plans on concurrent chronic conditions.
