Lifestyle diseases are rampant in rural population in KZN, say health researchers

A health-screening programme in the uMkhanyakude district, northern KwaZulu-Natal, has found a high burden of undiagnosed or poorly controlled non-communicable diseases, according to a study published in The Lancet Global Health. 

A startling finding by the researchers was that four out of five women over the age of 30 were living with a chronic health condition, and that the HIV-negative population and older people — especially those over 50 — bore a higher burden of undiagnosed diseases such as diabetes and hypertension.

The study was co-led by Dr Emily Wong, an infectious disease physician-scientist and resident faculty member at the Africa Health Research Institute, (AHRI). 

During the research into the 18-month study health workers screened 17,118 people aged 15 years and older, via mobile camps within one kilometre of each participant's home in the uMkhanyakude district.

They found high and overlapping burdens of HIV, tuberculosis, diabetes and hypertension among men and women.

While the HIV cases were, for the most part, well diagnosed and treated, some demographic groups, including men in their 20s and 30s, still had high rates of undiagnosed and untreated HIV.

The majority of people with tuberculosis, diabetes or hypertension were either undiagnosed or not well controlled.

Tuberculosis remains one of the leading causes of death in SA, and the high rates of undiagnosed and asymptomatic tuberculosis that health workers found is a concern.

“Our findings suggest that the massive efforts of the past 15 years to test and treat for HIV have done very well for that one disease,” Wong said. “But in that process, we may have neglected some of the other important diseases that are highly prevalent,” said Wong. 

Researchers found that:

• Half of the people 15 years or older had at least one active disease, and 12% had two or more diseases. The incidences of diabetes and high blood pressure were 8.5% and 23%, respectively.
• One-third of the people were living with HIV, but this was mostly well diagnosed and treated. Women bore a particularly high burden of HIV, high blood pressure and diabetes.
• For tuberculosis, 1.4% of the people had active disease, and 22% had lifetime disease. About 80% of the undiagnosed tuberculosis was asymptomatic, and men had higher rates of active tuberculosis.

Researchers also identified several disease patterns by geographical location — for example, the highest burden of HIV was seen near main roads, while higher rates of tuberculosis and non-communicable diseases were seen in more remote areas.

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