Prevalence and factors associated with diabetes, hypertension, and ischemic heart disease and/or stroke multimorbidity in Morocco: Results of a national STEPS survey in 2017

Abstract

INTRODUCTION This study aimed to estimate the prevalence and associated factors of non-communicable diseases (NCDs) multimorbidity among adults in Morocco. METHODS National data were analyzed from 6989 adults (aged 18–69 years, median 37 years) who participated in the cross-sectional 2017 Morocco STEPS survey. Logistic regressions were calculated with multimorbidity, adjusted for age, sex, education level, residence and smoking status, physical activity, sedentary behavior, and body mass index. RESULTS The prevalence of diabetes was 10.7%, hypertension 19.5%, ischemic heart disease/stroke 3.3%, and multimorbidity 5.0%. In the adjusted logistic regression model, older age (aged ≥50 years) (AOR=5.11; 95% CI: 3.64–7.18), urban residence (AOR=1.75; 95% CI: 1.26–2.43), moderate sedentary behavior (AOR=1.41; 95% CI: 1.08–1.85), overweight (AOR=1.74; 95% CI: 1.21–2.49) and obesity (AOR=2.34; 95% CI: 1.63–3.36) were positively associated with multimorbidity. More than primary education (AOR=0.67; 95% CI: 0.46–0.99), and high physical activity (AOR=0.70; 95% CI: 0.62–0.95) were negatively associated with multimorbidity. In addition, in unadjusted analysis, male sex and current smoking were negatively associated with multimorbidity. CONCLUSIONS One in 20 adults in Morocco had multimorbidity and associated sociodemographic factors (older age, lower education level, and urban residence) and health factors (sedentary behavior, low physical activity, overweight and obesity) were identified that can help plan interventions.