Urban-rural differences in the prevalence of non-communicable diseases risk factors among 25–74 years old citizens in Yangon Region, Myanmar: a cross sectional study

Abstract

BackgroundRecent societal and political reforms in Myanmar may upturn the socio-economy and, thus, contribute to the country’s health transition. Baseline data on urban-rural disparities in non-communicable disease (NCD) risk factors are not thoroughly described in this country which has been relatively closed for more than five decades. We aim to investigate urban-rural differences in mean values and the prevalence of selected behavioral and metabolic risk factors for non-communicable diseases and 10-years risk in development of coronary heart diseases (CHD).MethodsTwo cross-sectional studies were conducted in urban and rural areas of Yangon Region in 2013 and 2014 respectively, using the WHO STEPwise approach to surveillance of risk factors of NCDs. Through a multi-stage cluster sampling method, 1486 participants were recruited.ResultsAge-standardized prevalence of the behavioral risk factors tended to be higher in the rural than urban areas for all included factors and significantly higher for alcohol drinking (19.9% vs. 13.9%; p = 0.040) and low fruit & vegetable consumption (96.7% vs. 85.1%; p = 0.001). For the metabolic risk factors, the tendency was opposite, with higher age-standardized prevalence estimates in urban than rural areas, significantly for overweight and obesity combined (40.9% vs. 31.2%; p = 0.023), obesity (12.3% vs.7.7%; p = 0.019) and diabetes (17.2% vs. 9.2%; p = 0.024). In sub-group analysis by gender, the prevalence of hypercholesterolemia and hypertriglyceridemia were significantly higher in urban than rural areas among males, 61.8% vs. 40.4%; p = 0.002 and 31.4% vs. 20.7%; p = 0.009, respectively. Mean values of age-standardized metabolic parameters showed higher values in urban than rural areas for both male and female. Based on WHO age-standardized Framingham risk scores, 33.0% (95% CI = 31.7–34.4) of urban dwellers and 27.0% (95% CI = 23.5–30.8) of rural dwellers had a moderate to high risk of developing CHD in the next 10 years.ConclusionThe metabolic risk factors, as well as a moderate or high ten-year risk of CHD were more common among urban residents whereas behavioral risk factors levels were higher in among the rural people of Yangon Region. The high prevalences of NCD risk factors in both urban and rural areas call for preventive measures to reduce the future risk of NCDs in Myanmar.

Association between body mass index and ready-to-eat food consumption among sedentary staff in Nay Pyi Taw union territory, Myanmar

“…The low physical activity was associated with overweight and obesity [52]. This finding is consistent with studies done in Myanmar, Malaysia, and the United States [53][54][55]. Working environments should promote physical activity and integrating enough public spaces for physical exercise should be considered in urban development and planning.…”

Prevalence differences in major non-communicable diseases in a low- middle income country: a comparative study between an urban and a rural district in Vietnam

“…19,20 Our study showed that people living in urban areas of Vietnam are more likely to consume more alcohol, have a higher BMI, and have been diagnosed with diabetes more when compared to those in rural areas. The result is in alignment with the studies of NCD behavioral risk factors between urban and rural dwellers in other lower-and middle-income countries in Asia such as Myanmar, 21 and Cambodia, 22 as well as in other countries from different geographical area such as Africa: the Zulu community, Uganda, and Cameroon, [23][24][25] where rural-urban disparities persist.…”

Screening Results of Non-Communicable Diseases in Adult and Elderly People Living in the Rural Area; Cross-sectional Descriptive Study

“…It was also found that the smoking rate was lower than the rates in literature both in Turkey and the world, and the prevalence rates of diabetes and obesity were higher than the rates in literature both in Turkey and the world. In addition, it was founded that the cancer screening rates were higher when compared with the studies done in Turkey in the past, but lower in comparison with those of developed countries (15,(19)(20)(21).…”

“…The prevalence of circulatory system diseases was found to be 25.6% in rural areas and 21.7% in urban areas (23). In the study by Htet et al, it was determined that the prevalence of behavioral risk factors in individuals living in rural areas for NCD was higher than that in those living in urban areas (21). In this study, because more than half of the participants had a chronic disease, health personnel working at FHCs in rural areas have important responsibility.…”

“…In a study conducted in Turkey, it was determined that the prevalence of diabetes was 13.7% in 2008 and increased to 21% in 2015 (15). In the study conducted in Myanmar (21), the prevalence of diabetes was found to be 9.2%. In a study conducted by Omech et al (25) using FINDRISC, it was found that 16.5% of individuals were at a high risk, and 23.5% were at a very high risk.…”