Temporal analysis of non-communicable diseases and NCD-HIV/AIDS comorbidity in Malawi: A 4-year retrospective study 2020-2022.

Abstract

Objective: Non-communicable diseases are on the increase in the Sub-Saharan region, which is also the epicentre of HIV/AIDS. There is limited published data on trends and forecasts of the comorbidity of non-communicable diseases and HIV/AIDS in low- and middle-income countries. Hence, the aim of the study was to examine current trends and forecasts for non-communicable diseases and non-communicable disease-HIV/AIDS comorbidity.

Methods: Data on 30,686 patients from 2019 to 2022 were extracted from the non-communicable diseases Mastercards, from 70 health facilities in Malawi, using a form designed and implemented in KoboToolBox. All cases were aggregated to form weekly counts of non-communicable diseases and non-communicable disease-HIV/AIDS comorbidity and visualised using time series plots. Then the data was subset by the prominent non-communicable disease, which was hypertension and hypertension-HIV/AIDS comorbidity weekly counts. Extreme Gradient Boosting (XGBoost), a machine learning model, was used for model fitting, generating predictions, and forecasting.

Results: The forecasts showed that the counts of cases per week will range from 137 to 185 cases. Then specifically, hypertension and hypertension-HIV/AIDS comorbidity case counts averaged approximately within the range of 111-124 new cases per week from 2023 to 2030. The hypertension-HIV/AIDS comorbidity had forecasts ranging from 2 to 9 new cases per week. Although the number of new case counts per week had a consistent progression, the number of cases was on an increasing trend over time. Therefore, whether cases in general, hypertension and hypertension-HIV/AIDS comorbidity cases, or hypertension-HIV/AIDS comorbidity cases, the counts per week imply cumulatively higher case counts.

Conclusions: Despite the consistency in the projection to 2030, there is a need to consider the upward trend of these cases and implement intervention measures such as sensitisation to control the number of cases. Otherwise, Malawi may not be able to achieve SDG3 targets by 2030.