Article Text

Prevalence of multimorbidity in South Africa: a systematic review protocol
  1. Rifqah A Roomaney1,2,
  2. Brian van Wyk2,
  3. Eunice Bolanle Turawa1,3,
  4. Victoria Pillay-van Wyk1
  1. 1Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
  2. 2School of Public Health, University of the Western Cape, Cape Town, South Africa
  3. 3Faculty of Medicine and Health Sciences, Community Health, Stellenbosch University, Cape Town, South Africa
  1. Correspondence to Rifqah A Roomaney; rifqah.roomaney{at}


Introduction Multimorbidity has increased globally over the past two decades, due to ageing populations and increased burden of non-communicable diseases (NCDs). In a country like South Africa, with a growing burden of NCDs and a high prevalence of HIV, information on multimorbidity can improve planning for healthcare delivery and utilisation, and reduce costs in the context of constrained health resources. This review aims to synthesise prevalence studies on multimorbidity, and identify dominant clusters and trends of multimorbidity in South Africa.

Methods and analysis We will search electronic bibliographic databases (PubMed, Scopus, JSTOR, POPLINE, PsycINFO, ScienceDirect, Web of Science and CINAHL), and the reference lists of included articles. Two researchers will independently screen title and abstracts, and then full text to identify studies published before and in 2020 that report on prevalence of multimorbidity in South Africa. Risk of bias assessments will be done for each study. Information on the prevalence of multimorbidity and disease clusters will be extracted from each study. Where possible, prevalence of specific clusters of multimorbidity will be pooled using a random effects meta-analysis to account for variability between studies. The I2 statistic will be used to establish the extent of heterogeneity due to variation in prevalence estimates rather than due to chance. The systematic review will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses.

Ethics and dissemination Only published journal articles will be included in the systematic review. This review received ethics approval as part of a larger project by the University of the Western Cape Biomedical Science Research Ethics Committee (BM20/5/8). The findings from this research will be used to estimate the prevalence of multimorbidity in South Africa and will contribute to the design of future research projects. The findings will be disseminated in a peer-reviewed journal article.

PROSPERO registration number CRD42020196895.

  • epidemiology
  • health policy
  • primary care
  • public health

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  • Contributors RAR, VP-vW, BvW conceptualised the study. RAR wrote the first draft of the protocol. VP-vW, BvW, EBT provided input for subsequent drafts. All authors gave approval for publication.

  • Funding The work reported herein was made possible through funding by the Burden of Disease Research Unit at the South African Medical Research Council. RAR is funded through the South African Medical Research Council through its Division of Research Capacity Development under the Internship Scholarship Programme from funding received from the South African National Treasury. The content hereof is the sole responsibility of the authors and does not necessarily represent the official views of the South African Medical Research Council or the funders. Grant number: NA.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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