The burden and correlates of multiple cardiometabolic risk factors in a semi-urban population of Nepal: a community-based cross-sectional study

Gyawali, Bishal; Mishra, Shiva Raj; Ghimire, Saruna; Hansen, Martin Rune Hassan; Shah, Kishor Jung; Subedee, Koshal Chandra; Soti, Pabitra Babu; Neupane, Dinesh; Kallestrup, Per

doi:10.1038/s41598-019-51454-9

Cited by 11 publications

(7 citation statements)

References 23 publications

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“…A high prevalence of overweight and obesity (52.2%) had been observed in the study which is in line with the findings done in semi-urban population of Nepal (52.9%) [ 37 ]. The prevalence is low in comparison to the study conducted in Saudi Arabia (54.3%) [ 38 ].…”

Section: Discussionsupporting

confidence: 91%

Prevalence and determinants of non-communicable disease risk factors among adult population of Kathmandu

et al. 2021

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Background According to WHO, the deaths due to NCDs in Nepal have soared from 60% of all deaths in 2014 to 66% in 2018. The study assessed the prevalence and determinants of non-communicable disease risk factors among adult population of Kathmandu. Materials and methods A community based cross-sectional study was conducted from September 2019 to February 2020 among 18–69 years adults residing in municipalities of Kathmandu district. Multi-stage random sampling technique was used to select 245 subjects who were interviewed using WHO NCD STEPS instrument. Chi-square test and logistic regression analysis were done to explore the determinants of NCD risk factors. Results The prevalence of current smoking, alcohol consumption, low intake of fruits and vegetables and low physical activity was found to be 22%, 31%, 93.9% and 10.2% respectively. More than half (52.2%) of the participants were overweight or obese and the prevalence of raised blood pressure was 27.8%. Smoking was associated significantly with male gender (AOR = 2.37, CI: 1.20–5.13) and respondents with no formal schooling (AOR: 4.33, CI: 1.50–12.48). Similarly, the odds of alcohol consumption were higher among male gender (AOR: 2.78, CI: 1.47–5.26), people who were employed (AOR: 2.30, CI: 1.13–4.82), and those who belonged to Chhetri (AOR: 2.83, CI: 1.19–6.72), Janajati (AOR: 6.18, CI: 2.74–13.90), Dalit and Madhesi, (AOR: 7.51, CI: 2.13–26.35) ethnic groups. Furthermore, respondents who were aged 30–44 years (AOR: 5.15, CI: 1.91–13.85) and 45–59 years (AOR: 4.54 CI: 1.63–12.66), who were in marital union (AOR: 3.39, CI: 1.25–9.13), and who belonged to Janajati (AOR: 3.37, CI: 1.61–7.04), Dalit and Madhesi (AOR: 4.62, CI: 1.26–16.86) ethnic groups were more likely to be associated with overweight or obesity. Additionally, the odds of raised blood pressure were higher among people who were of older age (AOR: 6.91, CI: 1.67–28.63) and those who belonged to Janajati ethnic group (AOR: 3.60, CI: 1.46–8.87) after multivariate analysis. Conclusion The findings of the study highlighted high prevalence of behavioral and metabolic risk factors, which varied on different socio-demographic grounds. Thus, population specific health promotion interventions centered on public health interests is recommended to reduce risk factors of NCDs.

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Section: Discussionsupporting

confidence: 91%

Prevalence and determinants of non-communicable disease risk factors among adult population of Kathmandu

et al. 2021

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“…The 2013 STEPS survey reported that only 0.4% of the Nepali population was completely free of the eight established risk factors for non-communicable diseases [35]. In another study, about 68% of the participants had at least one cardiometabolic risk factor [36]. These facts imply that in the absence of effective intervention strategies against diabetes, its burden may continue to rise among Nepalese.…”

Section: Discussionmentioning

confidence: 99%

Burden of Diabetes and Prediabetes in Nepal: A Systematic Review and Meta-Analysis

et al. 2020

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Background: Unhealthy behaviors, such as energy-dense food choices and a sedentary lifestyle, both of which are established risk factors for diabetes, are common and increasing among Nepalese adults. Previous studies have reported a wide variation in the prevalence of prediabetes and diabetes in Nepal, and thus a more reliable pooled estimate is needed. Furthermore, Nepal underwent federalization in 2015, and the province-specific prevalence, which is necessary for the de novo provincial government to formulate local health policies, is lacking. This study aims to provide a comprehensive summary of the current literature on various aspects of diabetes in Nepal, i.e., the prevalence of prediabetes and diabetes as well as of the awareness, treatment, and control of diabetes in Nepal. Methods: This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched three electronic databases-PubMed, Scopus, and Web of Science-using a comprehensive search strategy to identify eligible studies published up to April 2, 2020. Data on prevalence estimates of prediabetes and diabetes were extracted and pooled in a metaanalysis using a random effect model. Subgroup analyses and meta-regression were conducted to assess heterogeneity across the studies. The quality of included studies was assessed using the New Castle-Ottawa scale. Results: We included 14 eligible studies that comprised a total of 44,129 participants and 3517 diabetes cases. Half of the included studies had good quality. Overall, the prevalence of prediabetes and diabetes was 9.2% (95% CI 6.6-12.6%) and 8.5% (95% CI 6.9-10.4%), respectively. Among the participants with diabetes, only 52.7% (95% CI 41.7-63.4%) were aware of their diabetes status, and 45.3% (95% Digital Features To view digital features for this article go to

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“…In Nepal, CVDs are the leading cause of lost disability-adjusted life years and mortality [ 34 35 ], and the nation-wide prevalence of type 2 diabetes is 8.4% (95% CI: 6.210.5%) [ 36 ], approaching 12% in semi-urban areas [ 37 ]. To the best of our knowledge, this is the first study evaluating the preparedness to deliver NCD care in Nepal, in terms of availability, prices, affordability and accessibility of both medicines and diagnostics that are essential to treat CVDs and diabetes.…”

Section: Discussionmentioning

confidence: 99%

Health System Capacity and Access Barriers to Diagnosis and Treatment of CVD and Diabetes in Nepal

Sharma

Kaplan

Satheesh

et al. 2021

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Background: Universal access to essential medicines and routine diagnostics is required to combat the growing burden of cardiovascular disease (CVD) and diabetes. Evaluating health systems and various access dimensions -availability, affordability, accessibility, acceptability, and quality -is crucial yet rarely performed, especially in low-and middle-income countries. Objective: To evaluate health system capacity and barriers in accessing diagnostics and essential medicines for CVD and diabetes in Nepal. Methods: We conducted a WHO/HAI nationally-representative survey in 45 health-facilities (public sector: 11; private sector: 34) in Nepal to collect availability and price data for 21 essential medicines for treating CVD and diabetes, during May-July 2017. Data for 13 routine diagnostics were obtained in 12 health facilities. Medicines were considered unaffordable if the lowest paid worker spends >1 day's wage to purchase a monthly supply. To evaluate accessibility, we conducted facility exit interviews among 636 CVD patients. Accessibility (e.g., private-public health facility mix, travel to hospital/pharmacy) and acceptability (i.e. Nepal's adoption of WHO Essential Medicine List, and patient medication adherence) were summarized using descriptive statistics, and we conducted a systematic review of relevant literature. We did not evaluate medicine quality. Results: We found that mean availability of generic medicines is low (<50%) in both public and private sectors, and less than one-third medicines met WHO's availability target (80%). Mean (SD) availability of diagnostics was 73.1% (26.8%). Essential medicines appear locally unaffordable. On average, the lowest-paid worker would spend 1.03 (public sector) and 1.26 (private sector) days' wages to purchase a monthly medicine supply. For a person undergoing CVD secondary-prevention interventions in the private sector, the associated expenditure would be 7.5-11.2% of monthly household income. Exit interviews suggest that a long/expensive commute to health facilities and poor medicine affordability constrain access. Conclusions:This study highlights critical gaps in Nepal's health system capacity to offer basic health services to CVD and diabetes patients, owing to low availability and poor affordability and accessibility. Research and policy initiatives are needed to ensure uninterrupted supply of affordable essential medicines and diagnostics.

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The burden and correlates of multiple cardiometabolic risk factors in a semi-urban population of Nepal: a community-based cross-sectional study

Cited by 11 publications

References 23 publications

Prevalence and determinants of non-communicable disease risk factors among adult population of Kathmandu

Prevalence and determinants of non-communicable disease risk factors among adult population of Kathmandu

Burden of Diabetes and Prediabetes in Nepal: A Systematic Review and Meta-Analysis

Health System Capacity and Access Barriers to Diagnosis and Treatment of CVD and Diabetes in Nepal

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