Prevalence and patterns of multi-morbidity among 30-69 years old population of rural Pathanamthitta, a district of Kerala, India: A cross-sectional study

Data set of a community based cross-sectional survey done to find the prevalence , its correlates and patterns in a population of a district in southern Kerala, India<b>Background</b>: Multi-morbidity is the coexistence of multiple chronic conditions in the same individual. With advancing epidemiological and demographic transitions, the burden of multi-morbidity is expected to increase India. The state of Kerala in India is also in an advanced phase of epidemiological transition. However, very limited data on prevalence of multi-morbidity are available in the Kerala population. <b>Methods</b>: A cross sectional survey was conducted among 410 participants in the age group of 30-69 years. A multi-stage cluster sampling method was employed to identify the study participants. Every eligible participant in the household were interviewed to assess the household prevalence. A structured interview schedule was used to assess socio-demographic variables, behavioral risk factors and prevailing clinical conditions, PHQ-9 questionnaire for screening of depression and active measurement of blood sugar and blood pressure. Co-existence of two or more conditions out of 11 was used as multi-morbidity case definition. Bivariate analyses were done to understand the association between socio-demographic factors and multi-morbidity. Logistic regression analyses were performed to estimate the effect size of these variables on multi-morbidity. <b>Results</b>: Overall, the prevalence of multi-morbidity was 45.4% (95% CI: 40.5-50.3%). Nearly a quarter of study participants (25.4%) reported only one chronic condition (21.3-29.9%). Further, 30.7% (26.3-35.5), 10.7% (7.9-14.2), 3.7% (2.1-6.0) and 0.2% reported two, three, four and five chronic conditions, respectively. Nearly seven out of ten households (72%, 95%CI: 65-78%) had at least one person in the household with multi-morbidity and one in five households (22%, 95%CI: 16.7-28.9%) had more than one person with multi-morbidity. With every year increase in age, the propensity for multi-morbidity increased by 10 percent (OR=1.1; 95% CI: 1.1-1.2). Males and participants with low levels of education were less likely to suffer from multi-morbidity while unemployed and who do recommended level of physical activity were significantly more likely to suffer from multi-morbidity. Diabetes and hypertension was the most frequent dyad. <b>Conclusion</b>: One of two participants in the productive age group of 30-69 years report multi-morbidity. Further, seven of ten households have at least one person with multi-morbidity. Preventive and management guidelines for chronic non-communicable conditions should focus on multi-morbidity especially in the older age group. Health-care systems that function within the limits of vertical disease management and episodic care (e.g., maternal health, tuberculosis, malaria, cardiovascular disease, mental health etc.) require optimal re-organization and horizontal integration of care across disease domains in managing people with multiple chronic conditions. Key words: Multi-morbidity, cross-sectional, household, active measurement, rural, India, pattern