Clustering of chronic non-communicable disease risk factors among selected Asian populations: levels and determinants

Abstract

BackgroundThe major chronic non-communicable diseases (NCDs) operate through a cluster of common risk factors, whose presence or absence determines not only the occurrence and severity of the disease, but also informs treatment approaches. Primary prevention based on mitigation of these common risk factors through population-based programmes is the most cost-effective approach to contain the emerging epidemic of chronic NCDs.ObjectivesThis study was conducted to explore the extent of risk factors clustering for the major chronic NCDs and its determinants in nine INDEPTH Health and Demographic Surveillance System (HDSS) sites of five Asian countries.DesignData originated from a multi-site chronic NCD risk factor prevalence survey conducted in 2005. This cross-sectional survey used a standardised questionnaire developed by the WHO to collect core data on common risk factors such as tobacco use, intake of fruits and vegetables, physical inactivity, blood pressure levels, and body mass index. Respondents included randomly selected sample of adults (25–64 years) living in nine rural HDSS sites in Bangladesh, India, Indonesia, Thailand, and Vietnam.ResultsFindings revealed a substantial proportion (>70%) of these largely rural populations having three or more risk factors for chronic NCDs. Chronic NCD risk factors clustering was associated with increasing age, being male, and higher educational achievements. Differences were noted among the different sites, both between and within country.ConclusionsSince there is an extensive clustering of risk factors for the chronic NCDs in the populations studied, the interventions also need to be based on a comprehensive approach rather than on a single factor to forestall its cumulative effects which occur over time. This can work best if it is integrated within the primary health care system and the HDSS can be an invaluable epidemiological resource in this endeavor.

How is Indonesia coping with its epidemic of chronic noncommunicable diseases? A systematic review with meta-analysis

“…Fig 6 shows that most of the 130 included studies considered age (n = 115) [14–17, 22–29, 31–50, 53, 55, 56, 59–64, 66–73, 75–77, 80–92, 95–102, 104–108, 110–129, 131, 133–143, 155, 156] and/or sex (n = 112) [15–19, 21–26, 28, 29, 31–38, 40–50, 53, 55, 56, 58–92, 95–108, 110–112, 114–116, 118–123, 125–129, 131, 133–143, 155, 156] in their analyses. On average around 40% of all studies included some sort of socioeconomic indicator mirroring educational attainment [15, 17, 21–24, 32, 34, 35, 37–…”

“…On average around 40% of all studies included some sort of socioeconomic indicator mirroring educational attainment [15, 17, 21–24, 32, 34, 35, 37–40, 42–44, 47, 48, 50, 55, 56, 60, 63, 66, 68, 69, 71, 73, 75, 76, 79, 81, 83–85, 91, 92, 95, 99, 101, 102, 104–108, 111, 112, 114, 122, 123, 125–127, 129, 131, 133, 135–138, 140, 142, 155, 156], income or wealth [15, 17, 20–22, 25, 28, 37, 39, 43, 47, 52, 55, 56, 60, 63, 66, …”

Risk-Attributable Burden of Chronic Diseases and Cost of Prevention in Bangladesh

“…While the country’s large inequalities and rampant poverty represent a general case of issues facing developing settings, especially those in Southeast Asia – many of the solutions will have to account for the starkly different profiles of risk factors even within similar countries [17]. …”

“…A secondary parameter to the PAF is the multiple population attributable ratio (MPAR), which combines the PAFs multiplicatively to give the total amount of disease incidence that would be averted if all the risk factors were eliminated [15, 16]. Clustering of risk factors or joint occurrence in single individuals is shown to be potentially important in older and less-educated populations in Bangladesh, but is not yet taken into account in this analysis [17]. …”

DodaLab: An urban health and demographic surveillance site, the first three years in Hanoi, Vietnam

“…Examples are follow-up of chronic and non-communicable diseases [20,21] as well as maternal and child health that have actually been focused during the first Dodalab years [22,23].…”