Co-occurrence of non-communicable disease risk factors and its determinants among school-going adolescents of Kathmandu Metropolitan City

Abstract

Background Adolescence is a critical transition in human growth and adolescents tend to engage in various risky behaviors which are likely to continue into adulthood. Co-occurrence of non-communicable disease risk factors has the potential to increase risks of chronic disease comorbidity and increased mortality in later life. Behavioral risk factors are adopted due to changes in lifestyle and adolescents are more prone to acquire them. This study aimed to determine the prevalence and associated factors of co-occurrence of non-communicable disease risk factors among school-going adolescents of Kathmandu Metropolitan City. Methods We conducted a cross-sectional study among school-going adolescents of Kathmandu Metropolitan City in January/February 2020. We used stratified random sampling to select 1108 adolescents studying in 9, 10, 11, and 12 grades. We used Global Schools Health Survey tools to collect data. We entered data in EpiData 3.1 and exported it into Statistical Package for Social Science (SPSS) version 20 for statistical analysis. We estimated prevalence of NCDs risk factors and co-occurrence of risk factors. We applied multivariate multinomial logistic regression analysis adjusting for age, gender, ethnicity, religion, education, type of school, and parental education to determine factors associated with co-occurrence of NCDs risk factors. Results The prevalence of physical inactivity, unhealthy diet, harmful use of alcohol and tobacco among school-going adolescents were 72.3% (95%CI: 69.6–74.9), 41.1% (95%CI: 38.2–44.0), 14.8% (95%CI: 12.8–17.0) and 7.8% (95%CI:6.3–9.5) respectively. The adolescent with co-occurrence of two or more risk factors was 40.7% (95%CI: 37.8–43.7). The school-going adolescents who were in higher age group (AOR = 1.72, 95% CI- 1.06, 2.77), Hindus (AOR = 1.78, 95% CI-1.09, 2.89), other than Brahmin/Chhetri by ethnicity (AOR = 2.11, 95% CI-1.39, 2.22) and with lower education level of mothers (AOR = 2.40, 95% CI- 1.46,3.98) were more likely to have co-occurrence of NCDs risk factors after adjusting for all socio-demographic variables. Conclusion The co-occurrence of non-communicable disease risk factors was high among school going adolescents and was associated with age, religion, ethnicity and mother’s education. Integrated and comprehensive interventional programs should be developed by concerned authorities.

Ultra-processed food consumption and children and adolescents’ health

“…Therefore, developing strategies that consider the effects of several sociodemographic factors would be the most effective methods. Tandon et al 16 (2022) Cross-sectional 1108 adolescents aged 13 to 19 years attending grades 9 to 12 in public and private schools in Kathmandu, Nepal. To determine the pattern of co-occurrence of NCD risk factors and associated factors in adolescents.…”

Co-occurrence of and factors associated with health risk behaviors among adolescents: a multi-center study in sub-Saharan Africa, China, and India

“… 30 Such a variable selection is consistent with previous studies which focused on the key issues of adolescent HRBs. 5 , 11 , 17 , 23 , 24 Each behavior was organized as a categorical variable.…”

“…The set of correlates was selected for the regression analyses based on the literature on risk factors of HRBs and the availability of data in our study. 5 , 11 , 30 …”

“… 4 These factors can contribute to the development of non-communicable diseases later in their life and significantly increase the morbidity and mortality in low-income countries. 4 , 5 The World Health Organization's Global Burden of Disease study estimated that HRBs account for approximately two-thirds of all premature deaths in adults that are associated with childhood risk behaviors. 6 Besides, risky sexual behaviors also pose a substantial health concern for adolescents on a global scale.…”

“… 20 Similarly, in Nepal, a cross-sectional survey of 1108 adolescents revealed a prevalence of 40.7% having co-occurrence of HRBs. 5 In China, a cross-sectional study involving 4625 adolescents indicated that 67.7% of males and 58.1% of females were engaged in multiple HRBs. 21 The situation is even more pronounced in sub-Saharan Africa, home to the largest proportion of adolescents and youths, where an estimated 89.2% of adolescents were reported to engage in at least 2 HRBs, based on data pooled from nine countries.…”