Dietary risk factors for non-communicable diseases in Kenya: findings of the STEPS survey, 2015

Background

Burden of non-communicable diseases (NCD) is increasing worldwide. Risk factor surveillance informs public health interventions in NCD control. This study describes the dietary risk factors for NCD found in the Kenya STEPS survey, 2015.

Methods

We performed secondary analysis of the STEPS dataset to determine prevalence of dietary NCD risk factors and their determinants. New variables were created; high dietary salt, defined as addition of salt while eating or intake of processed foods high in salt and high dietary sugar, defined as intake of processed foods or drinks high in sugar in most meals or addition of sugar to beverages already with sugar, on a daily basis. We used the World Health Organization definition of minimum required intake of fruits and vegetables as consumption of less than five servings of fruits and vegetables per day. Perceptions of respondents on diet and health were also assessed. Accounting for complex survey sampling, we calculated prevalence of the various dietary modifiable determinants and adjusted odds ratios (AOR) to identify factors independently associated with dietary NCD risk factors.

Results

Of the 4484 individuals surveyed; mean age was 40.5 years (39.9–41.1 years), 60% were female. Prevalence of high reported dietary salt intake was 18.3% (95% CI 17.2%, 19.5%) and sugar 13.7% (95% CI 11.7–15.8%). Awareness of health risk from dietary salt was 88% and 91% for dietary sugar. Approximately 56% of the respondents were implementing strategies to reduce dietary salt and 54% were doing the same for dietary sugar. Only 6.0% (95% CI 4.3–7.6%) of the respondents reported intake of a minimum of five servings of both fruits and vegetables daily. Unhealthy diet was associated with being male (AOR 1.33, 95% CI 1.04, 1.70,), age below 46 years (AOR 1.78, 95% CI 1.42, 2.12) and being a student (AOR 15.6, 95% CI 2.44, 99.39).

Conclusion

Dietary risk communication should be targeted to males and people under 45 years of age, especially students. Further research is necessary to understand the knowledge: practice mismatch on unhealthy diets.

     

Surveillance for non-communicable disease risk factors in Maldives: results from the first STEPS survey in Male

Objective  

To identify the major risk factors for non-communicable diseases (NCDs) among the population of the capital city Male.     

Sociodemographic differentials of selected noncommunicable diseases risk factors among adults in Matlab, Bangladesh: findings from a WHO STEPS survey

The study examined noncommunicable diseases risk factors among adults 25 to 64 years old of the Matlab Health and Demographic Surveillance System using World Health Organization STEP-wise methodology. The prevalence of smoking was found to be very high for males (53.9%) and it increased initially with age, whereas smoking was almost nil for females (0.8%). About 30% each of males and females used smokeless tobacco and its consumption increased with age. Consumption of vegetable/fruit is very low in this population (90% below recommended level), whereas one third of males and two thirds of female have low levels of physical activities. The raised blood pressure was more prevalent among females than in males (21.0% vs 12.5%, respectively) and the same was true for being overweight (13.9% vs 10.3%, respectively). Raised blood pressure increased with age but overweight did not vary by age for males, whereas it increased initially for females. Smoking (males) and use of smokeless tobacco decreased with increase in education, but both blood pressure and overweight increased.     

天津社区居民慢性病患病现状及影响因素分析

目的了解天津市社区居民慢性病患病现状及其相关影响因素,为社区居民慢性病预防与控制提供科学依据。方法采用分层随机抽样方法对在天津市抽取的2 335名≥18岁社区居民进行问卷调查。结果天津市社区居民慢性病患病率为33.96%,其中男性和女性居民的患病率分别为33.89%和34.03%,差异无统计学意义(P>0.05);慢性病患病率随年龄的增长呈上升趋势(χ2=535.946,P=0.000);居于慢性病患病前10位的疾病依次为高血压、糖尿病、冠心病、脑梗塞、颈椎病、腰间盘突出、骨关节炎、脑血栓、脑出血和胆石症,患病率依次为21.60%、7.64%、5.76%1、.67%0、.87%0、.72%0、.64%0、.60%0、.44%和0.40%;多因素非条件Logistic回归分析结果表明,年龄≥30岁、吸烟、超重、肥胖和有慢性病家族史是天津市社区居民慢性病患病的危险因素。结论天津市社区居民慢性病患病率随年龄增长呈上升趋势;吸烟、超重、肥胖和有慢性病家族史的居民是慢性病防治的重点人群。     

新泰市居民慢性非传染性疾病及危险因素分析

目的 了解新泰市成人慢性非传染性疾病(以下简称慢性病)情况及其相关危险因素,为慢性病综合防治提供依据。方法 2013年5月,按照多阶段分层随机整群抽样原则,抽取山东省新泰市18~69周岁常住居民2 400人进行问卷调查、体格测量和生化指标检测,应用SPSS 16.0软件包进行统计学分析。 结果 共调查2 400人,回收有效问卷2 227份,其中农村居民1 486人,城区居民741人;男性1 093人,女性1 134 人。新泰市18~69周岁成人高血压、糖尿病、血脂异常患病率分别为22.45%、5.61%、40.01%,均随年龄增长呈上升趋势,但男女性差异无统计学意义(P>0.05),高血压、糖尿病患病率城乡差异无统计学意义(P>0.05),血脂异常患病率城区高于农村(P<0.05);临界高血压、糖耐量低减、空腹血糖受损、超重、肥胖及中心性肥胖率分别为17.47%、9.03%、3.64%、48.14%、13.11%、63.22%;吸烟率、饮酒率、嗜盐率、体育锻炼率分别为34.13%、25.55%、87.56%、56.76%,男性吸烟率、饮酒率、嗜盐率均高于女性(P<0.05)。结论 新泰市成人高血压、糖尿病、血脂异常患病形势不容乐观,慢性病高危人群数量及高风险因素比例较大,应从控制体重、戒烟限酒、减盐等方面做起,开展社区慢性病综合防控。     

慢性病危险因素控制现状与对策

慢性病已成为影响人民健康的重要公共卫生问题,影响到社会的稳定和可持续发展.慢性病的发生主要与吸烟、过量饮酒、不合理膳食、缺乏身体活动等不良生活方式相关,随着我国经济发展和生活水平提高,这些因素正在我国呈不断上升与蔓延趋势.慢性病综合防控不应仅仅停留在个人危险因素的干预层面,应从与之相关的社会决定因素出发,建立以政府为主导、多部门协作、社会广泛参与的慢性病综合防控体系,将提高人民健康水平、促进慢性病防控的目标融入到社会政策中去.     

Urban social determinants of non-communicable diseases risk factors in Argentina

We examined associations of individual-, neighborhood- and city-level education -as proxies of SES at different levels-, with diabetes, hypertension, obesity, smoking and binge drinking (non-communicable disease risk factors -NCD/RF) among Argentinian adults. We estimated mixed models based on 21,415 individuals from the 2013 National Survey of Risk Factors, living in 2,698 neighborhoods and 33 cities. Gradients by individual-level education differed by gender and NCD/RF, and some were modified by city education. In addition, we identified contextual effects of neighborhood and city education on some NCD/RF. Urban efforts to tackle NCD/RF in Argentina should be context- and gender-sensitive, and mainly focused on socially disadvantaged groups.     

Risk factors for chronic non-communicable diseases: a domiciliary survey in the municipality of S?o Paulo, SP (Brazil). Methodology and preliminary results

The non-communicable chronic diseases are important causes of death in Brazil, mainly in the great urban centres. There are various risk factors related to these diseases, whose remotion or attenuation would contribute to a fall in mortality. The methodology of the first comprehensive multicenter study into risk factors of non-communicable chronic diseases carried out in Latin America is explained. In Brazil, this study was carried out in the cities of S. Paulo, SP and Porto Alegre, RS. Preliminary results from the city of S. Paulo as to the prevalence of arterial hypertension (22.3%), tabagism (37.9%), obesity (18.0%), alcoholism (7.7%) and sedentarism (69.3%) are presented. These results are compared with existing data from Brazil and other countries, and the relationship between various risk factors and the mortality from cardiovascular diseases in S. Paulo and some developed countries is discussed.     

Smoking associated with other behavioral risk factors for chronic non-communicable diseases

The study interviewed 1,410 adults by telephone. Respondents comprised a random sample and represented the population over 18 years of age living in households with landline telephone services. Smoking prevalence was 21.8%, higher in males (25%) and in the 18-29 year bracket. Smoking and sedentary lifestyle occurred together in 13.9% of males and 14.2% of females; smoking and low fruit consumption in 12.9% of males and 12.3% of females; and smoking and low vegetable consumption in 5.8% of males and 5.1% of females. An association between smoking and excessive alcohol intake was only observed in males (3.5%). As observed for smoking alone, the simultaneous occurrence of smoking and other behavioral risk factors for CNCD was inversely associated with schooling. Evidence of clustering between smoking and sedentary lifestyle, smoking and excessive alcohol intake, and smoking and improper diet thus calls for interventions focused on prevention and the concomitant reduction of major behavioral risk factors.     

Surveillance of risk factors for non-communicable diseases among adolescents: the experience in Rio de Janeiro, Brazil

This paper presents the methodology and results of the implementation of a Surveillance System for Non-Communicable Disease Risk Factors in Adolescents. A random sample of 8th-grade students (n = 1,684) enrolled in municipal schools in Rio de Janeiro, Brazil, was studied. Students were asked to complete a confidential questionnaire on food consumption, physical activity, sedentary leisure-time activities, and tobacco consumption. Prevalence estimates of risk factors were calculated for the entire sample and by gender. Non-response rates ranged from 1.1 to 8.9%. The findings included low consumption of fruits (45.8%) and vegetables (20.0% and 16.5% for salads and cooked vegetables, respectively), regular consumption of soft drinks (36.7%) and candies (46.7%), extensive time on TV, computer, and videogames (71.7% spend at least 4h/day at these activities), low frequency of regular physical activity (40%), and 6.4% prevalence of smoking. Girls showed less physical activity and more smoking. The system appeared to be feasible and indicated high prevalence of risk factors for non-communicable diseases.     

苏州市区居民主要慢性非传染性疾病及其危险因素分析

[目的]　了解苏州市区慢性非传染性疾病(慢病)的流行状况,为今后社区综合防治提供依据。[方法]　用整群随机抽样的方法在苏州市平江区抽取35周岁以上常住人口2万名作为调查对象,数据用非条件logistic回归进行多因素分析。[结果]　苏州市区35周岁以上常住人口的患病率处于较高的水平。主要的慢病为高血压、慢性胃肠道疾病、慢性阻塞性肺病、冠心病和胆结石。调查还发现了许多影响健康的行为危险因素。[结论]　慢病已成为一个主要的公共卫生问题,防治亟待加强     

Socioeconomic inequalities in self-reported chronic non-communicable diseases in urban Hanoi,Vietnam

This study measures and decomposes socioeconomic inequalities in the prevalence of self-reported chronic non-communicable diseases (NCDs) in urban Hanoi, Vietnam. A cross-sectional survey of 1211 selected households was carried out in four urban districts in both slum and non-slum areas of Hanoi city in 2013. The respondents were asked if a doctor or health worker had diagnosed any household members with an NCD, such as cardiovascular diseases, chronic respiratory, diabetes or cancer, during last 12 months. Information from 3736 individuals, aged 15 years and over, was used for the analysis. The concentration index (CI) was used to measure inequalities in self-reported NCD prevalence, and it was also decomposed into contributing factors. The prevalence of chronic NCDs in the slum and non-slum areas was 7.9% and 11.6%, respectively. The CIs show gradients disadvantageous to both the slum (CI?=??0.103) and non-slum (CI?=??0.165) areas. Lower socioeconomic status and aging significantly contributed to inequalities in the self-reported NCDs, particularly for those living in the slum areas. The findings confirm the existence of substantial socioeconomic inequalities linked to NCDs in urban Vietnam. Future policies should target these vulnerable areas.     

Mosquitoes and their potential predators in rice agroecosystems of the Mekong Delta, southern Vietnam

Culex tritaeniorhynchus, Cx. gelidus, and Cx. quinquefasciatus, known vectors of Japanese encephalitis (JE), are distributed in rice agroecosystems in Asian countries. Very few integrated studies on the breeding habitats of rice-field mosquitoes, including JE vectors, have been conducted in Vietnam. We investigated the mosquito fauna and potential predators in 8 rice growing areas in the Mekong Delta region of southern Vietnam, during the wet and dry seasons of 2009. Mosquitoes and their predators were collected from a variety of aquatic habitats (rice fields, ponds, wetlands, shrimp ponds, ditches, canals, and rivers). We collected 936 Culex spp. (354 Cx. tritaeniorhynchus, 240 Cx. vishnui s.l., 189 Cx. fuscocephala, and 42 Cx. gelidus), 33 Uranotaenia, 25 Anopheles, and 9 Mimomyia (4 Mi. chamberlaini) in the dry season. During the rainy season, we collected 1,232 Culex spp. (132 Cx. vishnui s.l., 66 Cx. tritaeniorhynchus, 9 Cx. gelidus, 4 Cx. fuscocephala, and 2 Cx. bitaeniorhynchus), 236 Anopheles spp. (40 An. vagus and 1 An. sinensis), and 7 Uranotaenia (3 Ur. lateralis). Heteroptera such as Micronecta, Veliidae, and Pleidae were abundant and widely distributed in both seasons. Based on a stepwise generalized linear model, the abundance of mosquitoes and their predators in rice fields was high when the rice plant length was short and water depth was shallow. Therefore, the use of insecticides during the earlier stages of rice growth should be avoided in order to preserve the predator populations.     

Preventable risk factors for noncommunicable diseases in rural Indonesia: prevalence study using WHO STEPS approach

OBJECTIVE: To gain a better understanding of the health transition in Indonesia, we sought to describe the prevalence and distribution of risk factors for noncommunicable diseases and to identify the risk-factor burden among a rural population and an urban population. METHODS: Using the protocol of the WHO STEPwise approach to Surveillance (STEPS), risk factors for noncommunicable diseases were determined for 1502 men and 1461 women aged 15-74 years at the Purworejo Demographic Surveillance Site in 2001. FINDINGS: Smoking prevalence was high among men (913/1539; weighted percentage=53.9.%) in both rural and urban populations; it was almost non-existent among women. A higher proportion of the urban population and the richest quintile of the rural population had high blood pressure and were classified as being overweight or obese when compared with the poorest quintile of the rural population. Those classified as being in the richest quintile who lived in the rural area were 1.5 times more likely to have raised blood pressure and 8 times more likely to be overweight than those classified as being in the poorest quintile and living in the rural area. Clustering of risk factors was higher among those classified as being in the richest quintile of those living in the rural area compared with those classified as being in the poorest quintile; and the risks of clustering were just 20-30% lower compared with the urban population. CONCLUSION: Both the rural and urban populations in Purworejo face an unequally distributed burden of risk factors for noncommunicable diseases. The burden among the most well-off group in the rural area has already reached a level similar to that found in the urban area. The implementation of the WHO STEPS approach was feasible, and it provides a comprehensive picture of the burden of risk factors, allowing appropriate health interventions to be implemented to address health inequities.     

Prevalence and risk factors for MSDs in vegetable greenhouse farmers: a cross-sectional survey from Shandong rural area,China

Purpose: The aim of the research is a cross sectional survey on the prevalence of symptoms related to MSDs in vegetable greenhouse farmers from Shandong rural area and on the risk factors that may influence it. Methods: This cross-sectional survey was selected 249 farmers working in vegetable greenhouse from different districts of Shandong Province, China. The Questionnaire and the Rapid Upper Limb Assessment (RULA) technique were used to identify ergonomic risks. χ² analysis was used to find the relationship between MSDs and various factors. Also, logistic regression methodology was applied to get the most influencing factor for MSDs. Results: The prevalence of MSDs in farmers working in vegetable greenhouse is 87.5%, and the top 3 prevalent areas of MSDs in various parts of the body are: lower back (47.4%), neck (33.3%), and shoulder (31.7%). The results of Logistic regression analysis showed that age, years working in vegetable greenhouses, keeping their backs in the same position for a long time, and working hours greater than 10 hours per day were the risk factors for MSDs in the farmers. The outcome of the RULA grand score had been found to be higher than 5 in the overwhelming majority of the farmers. Conclusions: All findings infer that each task of greenhouse vegetable growing inflicts different levels of disorder in a farmers’ musculoskeletal structure. Interventions should be increased and reduce the bad ergonomic load level as soon as possible, provided to reduce the impact of such disorders.     

Overweight and coronary risk factors results from a western Austrian survey

Summary Objectives of the study are to estimate prevalence of weight categories in a western Austrian population and to determine differences in primary coronary risk factors between weight categories in adults. The study population consists of 635 males and 693 females aged 25 to 64 years from the state Vorarlberg in western Austria. Age-standardized prevalence of body-mass-index 25.0 to 29.9 kg/m² is 42.8% in men and 23.0% in women. The prevalence of a body-mass-index of 30.0 kg/m² or more is 8.6% in men and 13.3% in women. Categories of relative weight correlated in both sexes significantly with all investigated risk factors, i.e. total cholesterol, HDL cholesterol, triglycerides, fasting blood glucose and systolic blood pressure. Significance remained in multivariate regression analysis in all parameters for both sexes, when controlling for age. Thus, the survey clearly shows the importance of relative weight as an indicator of elevated coronary risk and the importance of overweight for public health.

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Zusammenfassung Ziel der Untersuchung war die Abschätzung der Prävalenz von Gewichtskategorien in einer westösterreichischen Bevölkerung und die Bestimmung von Unterschieden in primären koronaren Risikofaktoren. Die Studienpopulation besteht aus 635 Männern und 693 Frauen im Alter von 25 bis 64 Jahren aus dem Bundesland Vorarlberg. Die alterstandardisierte Prävalenz von Body-Mass-Indizes von 25.0 bis 29.9 kg/m² betrug bei Männern 42,8% und bei Frauen 23,0%. Die Prävalenz von Body-Mass-Indizes ab 30,0 kg/m² betrug bei Männern 8,6% und bei Frauen 13,3%. Die Kategorien des relativen Gewichtes korrellierten bei beiden Geschlechtern signifikant mit jedem untersuchten Risikofaktor. Diese sind Gesamtcholesterin, HDL-Cholesterin, Triglyzeride, Nüchternblutzucker und systolischer Blutdruck. Auch in der multivariaten Analyse unter Kontrolle des Alters blieb der signifikante Effekt des relativen Gewichtes auf alle Risikofaktoren bei beiden Geschlechtern bestehen. Damit zeigt diese Untersuchung die Bedeutung des relativen Gewichtes als Indikator des Koronarrisikos und die sozialmedizinische Bedeutung des Übergewichtes.

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Résumé Le but de cette étude est d'estimer la distribution du poids corporel dans la population et de mettre en évidence les différences de facteurs de risque cardio-vasculaires entre ces catégories. 635 hommes et 693 femmes, âgés de 25 à 64 ans et domiciliés dans le Vorarlberg (ouest de l'Autriche) constituent la population de l'étude. Après standardisation selon l'âge, la distribution de la population entre les bornes de l'indice corporel choisi comme référence (de 25,0 à 29,9 kg/m²) concerne 42,8% des hommes et 23% des femmes. L'indice corporel est au-delà de 30 kg/m² pour 8,6% des hommes et 13,3% des femmes. Dans les deux sexes, il existe une corrélation significative de l'indice corporel avec tous les facteurs de risque cardio-vasculaire recherchés (cholestérol total, cholestérol HDL, triglycérides, glucose sanguin, pression sanguine). La signification statistique persiste en analyse de régression multivariée, introduisant tous les paramètres et après contrôle de l'âge et du sexe. Ainsi, cette étude montre le rôle de l'indice corporel comme risque cardio-vasculaire et l'impact sanitaire de l'excès de poids dans la population générale.