Multimorbidity in Latin America and the Caribbean: a systematic review and meta-analysis

OBJECTIVE: To estimate the pooled prevalence of multimorbidity (≥2 non-communicable diseases in the same individual) among adults of the general population of Latin American and the Caribbean (LAC). DESIGN: Systematic review and meta-analysis. DATA SOURCES: MEDLINE, Embase, Global Health, Scopus and LILACS up to 1 July 2020. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: The outcome was the prevalence of multimorbidity. Reports were selected whether they enrolled adult individuals (age ≥18 years) from the general population. DATA EXTRACTION AND SYNTHESIS: Reviewers extracted relevant data and assessed risk of bias independently. A random-effects meta-analysis was conducted to report pooled prevalence estimates of multimorbidity; pooled estimates by pre-specified subgroups (eg, national studies) were also pursued. RESULTS: From 5830 results, we selected 28 reports, mostly from Brazil and 16 were based on a nationally representative sample. From the 28 selected reports, 26 were further included in the meta-analysis revealing a pooled multimorbidity prevalence of 43% (95% CI: 35% to 51%; I(2): 99.9%). When only reports with a nationally representative sample were combined, the pooled prevalence was 37% (95% CI: 27% to 47%; I(2): 99.9%). When the ascertainment of multimorbidity was based on self-reports alone, the pooled prevalence was 40% (95% CI: 31% to 48%; I(2): 99.9%); this raised to 52% (95% CI: 33% to 70%; I(2): 99.9%) for reports including self-reported and objective diagnosis. CONCLUSIONS: Our results complement and advance those from global efforts by incorporating much more reports from LAC. We revealed a larger presence of multimorbidity in LAC than previously reported. PROSPERO REGISTRATION NUMBER: CRD42020196177.