Prevalence of non-communicable diseases risk factors and their determinants: Results from STEPS survey 2019, Nepal

Abstract

Background The World Health Organization (WHO) recommends ongoing surveillance of non-communicable diseases (NCDs) and their risk factors, using the WHO STEPwise approach to surveillance (STEPS). The aim of this study was to assess the distribution and determinants of NCD risk factors in Nepal, a low-income country, in which two-thirds (66%) of annual deaths are attributable to NCDs. Methods A nationally representative NCD risk factors STEPS survey (instrument version 3.2), was conducted between February and May 2019, among 6,475 eligible participants of age 15–69 years sampled from all 7 provinces through multistage sampling process. Data collection involved assessment of behavioral and biochemical risk factors. Complex survey analysis was completed in STATA 15, along with Poisson regression modelling to examine associations between covariates and risk factor prevalence. Results The most prevalent risk factor was consumption of less than five servings of fruit and vegetables a day (97%; 95% CI: 94.3–98.0). Out of total participants, 17% (95% CI: 15.1–19.1) were current smoker, 6.8% (95% CI: 5.3–8.2) were consuming ≥60g/month alcohol per month and 7.4% (95% CI:5.7–10.1) were having low level of physical activity. Approximately, 24.3% (95% CI: 21.6–27.2) were overweight or obese (BMI≥25kg/m2) while 24.5% (95% CI: 22.4–26.7) and 5.8% (95% CI: 4.3–7.3) had raised blood pressure (BP) and raised blood glucose respectively. Similarly, the prevalence of raised total cholesterol was 11% (95% CI: 9.6–12.6). Sex and education level of participants were statistically associated with smoking, harmful alcohol use and raised BP. Participants of age 30–44 years and 45–69 years were found to have increased risk of overweight, raised BP, raised blood sugar and raised blood cholesterol. Similarly, participants in richest wealth quintile had higher odds of insufficient physical inactivity, overweight and raised blood cholesterol. On average, each participant had 2 NCD related risk factors (2.04, 95% CI: 2.02–2.08). Conclusion A large portion of the Nepalese population are living with a variety of NCD risk factors. These surveillance data should be used to support and monitor province specific NCD prevention and control interventions throughout Nepal, supported by a multi-sectoral national coordination mechanism.

Estimation of mean population salt intakes using spot urine samples and associations with body mass index, hypertension, raised blood sugar and hypercholesterolemia: Findings from STEPS Survey 2019, Nepal

“…A population-based cross-sectional study was carried out from February to May 2019 using a WHO STEPS survey, further details on methodology can be found elsewhere [ 11 ]. The survey population includes men and women aged 15–69 years who have been living at their place of residence for at least six months, although visitors who stayed in the households the night before the survey were also eligible for interview.…”

“…The population prevalence of NCDs in Nepal has been found to be high, with 11.7% suffering from COPD (11.7%), diabetes mellites (8.5%), chronic kidney disease (6%) and coronary artery diseases (3%) [ 9 ]. The 2019 World Health Organization (WHO) STEPwise approach to surveillance of non-communicable disease risk factor (STEPS) survey reported almost 24.5% of the Nepalese population had raised blood pressure [ 10 , 11 ]. This is concerning, in particular as hypertension and CVDs have been found to place a large economic burden, arising from increasing health-care costs, lowering workplace productivity, increasing sick days, and inflicting permanent disability, on the country [ 12 , 13 ].…”

Prevalence and factors associated with self-reported injuries in Nepal: a secondary analysis of the nationally representative cross-sectional STEPS Survey, 2019

“…One participant per household was selected for the survey. The detailed methodology has been presented elsewhere 33–35…”

Association of Physical Activity with Anthropometrics Variables and Health-Related Risks in Healthy Male Smokers

“…Smoking, coupled with a sedentary lifestyle (physical inactivity), is considered one of the major risk factors associated with non-communicable diseases. It is worth noting that not only do these factors foster the development of non-communicable diseases independently, but they also occur concurrently [ 9 , 10 ]. For instance, evidence has demonstrated an important negative association between physical exercise and risk for coronary heart disease such as angina, heart attack, heart failure, and abnormal heart rhythm [ 11 ], whilst a cohort analysis of US female nurses showed that PA, including moderate-intensity exercise such as walking, is correlated with a major reduction in the risk of stroke [ 12 ].…”