The Burden and Determinants of Non Communicable Diseases Risk Factors in Nepal: Findings from a Nationwide STEPS Survey

Abstract

BackgroundWorld Health Organization (WHO) estimates for deaths attributed to Non Communicable Diseases (NCDs) in Nepal have risen from 51% in 2010 to 60% in 2014. This study assessed the distribution and determinants of NCD risk factors among the Nepalese adult population.Methods and FindingsA nationally representative cross-sectional survey was conducted from Jan to June 2013 on the prevalence of NCD risk factors using the WHO NCD STEPS instrument. A multistage cluster sampling method was used to randomly select the 4,200 respondents. The adjusted prevalence ratio (APR) was used to assess the determinants of NCD risk factors using a Poisson regression model. The prevalence of current smoking (last 30 days) was 19% (95%CI:16.6-20.6), and harmful alcohol consumption (≥60 g of pure alcohol for men and ≥40 g of pure alcohol for women on an average day) was 2% (95%CI:1.4-2.9). Almost all (99%, 95%CI:98.3-99.3) of the respondents consumed less than five servings of fruits and vegetables combined on an average day and 3% (95%CI:2.7-4.3) had low physical activity. Around 21% (95%CI:19.3-23.7) were overweight or obese (BMI≥25). The prevalence of raised blood pressure (SBP≥140 mm of Hg or DBP≥90 mm of Hg) and raised blood glucose (fasting blood glucose ≥126 mg/dl), including those on medication were 26% (95%CI:23.6-28.0) and 4% (95%CI:2.9-4.5) respectively. Almost one quarter of respondents, 23% (95%CI:20.5-24.9), had raised total cholesterol (total cholesterol ≥190 mg/dl or under current medication for raised cholesterol). he study revealed a lower prevalence of smoking among women than men (APR:0.30; 95%CI:0.25-0.36), and in those who had higher education levels compared to those with no formal education (APR:0.39; 95%CI:0.26-0.58). Harmful alcohol use was also lower in women than men (APR:0.26; 95%CI:0.14-0.48), and in Terai residents compared to hill residents (APR:0.16; 95%CI:0.07-0.36). Physical inactivity was lower among women than men (APR:0.55; 95%CI:0.38-0.80), however women were significantly more overweight and obese (APR:1.19; 95%CI:1.02-1.39). Being overweight or obese was significantly less prevalent in mountain residents than in hill residents (APR:0.41; 95%CI:0.21-0.80), and in rural compared to urban residents (APR:1.39; 95%CI:1.15-1.67). Lower prevalence of raised blood pressure was observed among women than men (APR:0.69; 95%CI: 0.60-0.80). Higher prevalence of raised blood glucose was observed among urban residents compared to rural residents (APR:2.05; 95%CI:1.29-3.25). A higher prevalence of raised total cholesterol was observed among the respondents having higher education levels compared to those respondents having no formal education (APR:1.76; 95%CI:1.35-2.28).ConclusionThe prevalence of low fruit and vegetable consumption, overweight and obesity, raised blood pressure and raised total cholesterol is markedly high among the Nepalese population, with variation by demographic and ecological factors and urbanization. Prevention, treatment and control of NCDs and their risk factors in Nepal is an em...

Knowledge on Risk Factors of Coronary Heart Disease among Middle Aged Administrative Staffs of Kathmandu

“…This study revealed that all of the study participant's fruits and vegetables consumption was less than the minimum recommended five daily servings per day, which was consistent with result of national study, NCDs risk factor survey 2013 (Aryal et al;2013) which reported that majority 98.9 % did not consume an adequate amount of fruits and vegetables on a day.…”

Prevalence and Awareness of Hypertension among Adults and its Related Risk Factors

“…The difference was significant at 5% significance level (P <0.03). The prevalence is higher than a national level study of 2015 which reported 26 % prevalence of hypertension among Nepalese adults (Men 31 % and women 21 %) 9 , and a rural community study in 2015 which showed 20.5% prevalence (Male 30.6% and Female 13.8%).…”

“…9 The rate was higher in women (80.7%) in compare to men (75.3%). The practice of checking BP was found more among illiterate or without formal education (86.7%) in compare to those having higher-level education (73.1%) and school level formal education (78.2%).…”

“…5 Various studies in different places and time showed different prevalence. [6][7][8][9][10][11] Studies also showed many people having high blood pressure did not know they have hypertension. 6,12 The study was aimed to measure hypertension prevalence among adults in Kirtipur municipality, and to explore the risk behaviours of people.…”

Prevalence of hypertension and its associated risk factors in a sub-urban area of central Nepal

“…5 When it comes to Nepal, the prevalence of hypertension in various parts varies between studies which ranged between 3.3% and 44.9%. [6][7][8][9][10][11][12][13][14] Furthermore a repeat cross sectional study done in a rural Kathmandu revealed that prevalence of hypertension tripled from 6% in 1980 to 18% in 2006. 12 This figure indicates that the there is burgeoning burden of hypertension in Nepal.…”