Non-communicable diseases and HIV/AIDS burden by socio-demographic characteristics in Malawi

Background
The co-existence of non-communicable diseases (NCDs) and HIV/AIDS is a health concern that needs to be promptly addressed in Sub-Saharan Africa. However, with limited data, responding to this problem may be difficult. This paper aims to describe the burden of NCDs and HIV/AIDS within patients’ socio-demographic and health facility characteristics across the cities and districts in Malawi.

Methods
We analysed health facility-based data extracted from NCD patient mastercards from 2019 to 2022 from 70 health facilities in 11 cities and districts in Malawi. Data analysis was done in R using mean, proportions, frequency distributions and charts. Hybrid k-means clustering was used to determine health facilities with similar cases.

Results
A total of 29,196 patients had at least one non-communicable disease, with 7.9% having NCDs comorbid with HIV/AIDS. The southern part of Malawi (54.2%), inland locations (69.9%) and health centres (55.3%) recorded large numbers of cases in their respective categories. The health facilities’ case clustering indicated that Neno and Salima district hospitals had similar cases. About 16.1% of the young adults (19 - 39 years) had either a non-communicable disease or NCD-HIV/AIDS comorbidity. The most prominent NCD was hypertension (63.2%), followed by asthma (9.2%). The most commonly employed intervention was medication for NCD (51.6%) and NCD-HIV/AIDS comorbidity (43.4%). Only 13% of all the health facilities in the selected cities/districts used NCD mastercards from which data for this study was extracted.

Conclusions
NCDs and NCD-HIV/AIDS comorbidity among young adults pose a major concern since the ailment would lead to days off during the peak of their productivity. The NCD and NCD-HIV/AIDS comorbidity is a major public health problem that needs more attention than realised since the cases reported in this study could be under-reported.