|Year : 2019 | Volume
| Issue : 5 | Page : 387-390
Study on surveillance of risk factors for noncommunicable diseases in local population
Shiv Kumar, Remitha R Pillai, V Dwarakamai, N Sravanthy Reddy, Noyal Joseph
Department of Pharmacy Practice, NET Pharmacy College, Raichur, Karnataka, India
|Date of Submission||07-Jul-2018|
|Date of Acceptance||01-Oct-2018|
|Date of Web Publication||19-Sep-2019|
Department of Pharmacy Practice, NET Pharmacy College, Raichur - 584 103, Karnataka
Source of Support: None, Conflict of Interest: None
Context: Noncommunicable diseases (NCDs) are emerging as the major scope of death and disability worldwide, which is the result of demographic and epidemiological transition along with increase in risk factors resulting from social and economic changes. Aims: The present work was undertaken to study the prevalence of key risk factors for major NCDs in local population. Materials and Methods: This is a descriptive cross-sectional study conducted from November 2016 to April 2017 by utilizing the World Health Organization formulated STEPwise approach to Surveillance of NCD risk factors. Data were collected from 303 participants aged 25–64 years using structured data collection format which includes demographic details, physical measures, and behavioral measures. Results: The results of the present study shows that illiteracy, overweight, alcohol consumption, smoking/tobacco use, hypertension, physical inactivity, and unhealthy dietary habits are existing in the study population which acts as potential risk factors for the development of various NCDs. Conclusions: The study concludes that both behavioral and physiological risk factors for NCDs exist in the study population. The high prevalence of these risk factors predicts high chances of occurrence of NCDs such as cardiovascular diseases, cancer, and chronic respiratory diseases.
Keywords: Noncommunicable diseases, World Health Organization, STEPwise approach to Surveillance, risk factor
|How to cite this article:|
Kumar S, Pillai RR, Dwarakamai V, Reddy N S, Joseph N. Study on surveillance of risk factors for noncommunicable diseases in local population. Med J DY Patil Vidyapeeth 2019;12:387-90
|How to cite this URL:|
Kumar S, Pillai RR, Dwarakamai V, Reddy N S, Joseph N. Study on surveillance of risk factors for noncommunicable diseases in local population. Med J DY Patil Vidyapeeth [serial online] 2019 [cited 2020 Feb 28];12:387-90. Available from: http://www.mjdrdypv.org/text.asp?2019/12/5/387/267072
| Introduction|| |
Noncommunicable disease (NCD) refers to those conditions which are chronic, evolve slowly, and progress relentlessly. The World Health Organization (WHO) defines NCDs as those conditions which are chronic, evolve slowly, and progress relentlessly which includes chronic disease (principally cardiovascular disease [CVD], diabetes, cancer, and asthma/chronic respiratory disease), injuries, and mental health.
NCDs caused an estimated 39.5 million deaths in 2015 accounting for 56% of global deaths. About 80% of the burden occurs in low- and middle-income countries, and 25% is in individuals younger than 60 years. Approximately half of the total economic burden is reported to account for by CVD including stroke, ischemic heart disease, and peripheral vascular disease, which together cause more deaths than HIV/AIDs, malaria, and tuberculosis combined.
The risk factors for NCD include tobacco use, physical inactivity, unhealthy diet, and harmful use of alcohol are considered as behavioral/modifiable risk factor. These behaviors lead to four key metabolic/physiological changes that increase the risk of NCDs: raised blood pressure, overweight/obesity, hyperglycemia, and hyperlipidemia.
In the region, the burden of morbidity and mortality from NCDs occurs against a complex backdrop of globalization, rapid economic growth, unplanned urbanization, environmental degradation, climate change, and growing inequities within countries. Changing lifestyles and increased purchasing power in some populations have led to a reduction in breastfeeding, fewer meals prepared at home, and increasing consumption of fast food, tobacco, and alcohol. In addition, greater use of motorized transport and the lack of space for walking and biking have reduced physical activity for many people and worsened air quality. All of these factors point toward a dramatic increase in an already high NCD burden.
The WHO has formulated the STEPwise approach to Surveillance of NCD risk factors. It is based on sequential levels of surveillance of different aspects of NCDs, allowing flexibility and integration at any level by maintaining standardized questionnaires and protocols to ensure comparability over time and across borders.
| Materials and Methods|| |
The study was carried out in 303 participants from local population of Raichur, North Karnataka state, India, for 6 months from November 2016 to April 2017 by employing descriptive cross-sectional study design. The sample size was calculated using prevalence rates of CVDs among Indian population by the formula N = 4P (1 − P)/L, where P (prevalence) = 41, L (permissible error) =14. Men and women aged 25–64 years who gave informed consent were recruited to participate in the study. People who were below 25 years and above 64 years of age, people who were too frail or mentally unfit to participate, and people who were unable or unwilling to give informed consent were excluded from the study.
Data were collected using facilitated, semi-structured questionnaire adapted from the WHO-STEP Survey. STEP 1 involved data collection on respondents' socioeconomic characteristics such as educational status and income of the family. In STEP 2, information on risk factors of NCDs that is behavioral factors such as smoking and alcohol consumption and physical inactivity was collected. STEP 3 involved physical measurements such as weight, height, and blood pressure measurements. STEP 4 involved information on blood sugar levels (if available). The collected data are expressed in percentage.
The ethical approval to conduct the study was obtained from the Ethical Review Committee of Study Hospital. Written informed consents were obtained from each participant before the study.
| Results|| |
Three hundred and three participants from the age group of 25–64 years were included in our study. Most of the study population (41.58%) did not have even formal schooling. Around 160 participants (52.8%) lived with family having up to 5 members of above 18 years old, and 112 participants (37%) lived with 6–10 members and remaining population lived with more than 11 members.
Among 303 participants, 155 participants (51.16%) were never smoked or used tobacco in any form [Table 1]. However, 60 participants were smokers and 79 participants used tobacco in other forms. Around nine participants were using tobacco in other forms along with smoking.
Only 53 participants satisfied the WHO physical activity recommendations [Table 2]. Majority of the respondents (83.49%) had reported low daily intake of fruits
The recording of blood pressure in the study participants showed that 126 participants (41.58%) are already hypertensive and 93 participants (30.69%) are prehypertensive [Table 3].
On the basis of height and weight of participants, body mass index of the participants were recorded which showed that 93 participants (30.63%) have overweight and 82 participants (27.06%) are already obese [Table 4].
| Discussion|| |
The demographic characteristics of the study population revealed that most of them (41.58%) did not have even formal schooling and majority (90%) of them lived with joint family having 5 or more members. The high percentage of illiteracy will be the potential risk factor for NCDs since they will not be aware of basic knowledge regarding healthy lifestyle. As the family size increases, they cannot afford healthy lifestyle to all the members due to excessive financial burden.
In the study population, 182 participants (59.24%) were not using alcohol and 122 participants (40.76%) were using alcohol. Among these 122 participants, 42 participants stopped use of alcohol due to some health issue, whereas remaining 80 participants did not stop using alcohol even though they were getting health problems. These participants have high risk of CVDs. Among 303 participants, 155 participants (51.16%) were never smoked or used tobacco in any form which shows that 48.84% were smokers. The NCD risk factor survey, conducted by the National Institute of Medical Statistics, Indian Council of Medical Research, during 2007–2008 also showed similar results, i.e., 48% smokers in rest of the state except Andhra Pradesh, Maharashtra, Madhya Pradesh, Kerala, Mizoram, Tamil Nadu, and Uttarakhand. Hence, these people will be at lower risk of NCDs. However, 60 participants were smokers and 79 participants used tobacco in other forms. Few participants were also using tobacco in other forms along with smoking. Smoking or tobacco consumption is the most common risk factor for cancer and respiratory disorder such as asthma and COPD.
Among 303 participants, 250 participants (82.51%) are not using bicycle or walk certain distance even at least 10 min a day, and only 16.17% participants were involved with vigorous activity. Thankappan et al. also reported that only 23.7% of the participants from Kerala were involved with such activity. Due to less physical activity, there are greater chances of getting cardiovascular NCDs in these population. Majority of our study participants (83.49%) are consuming less than five serving of fruits and vegetables in a typical week, which is found to be higher than that reported from general population of Kerala (47%). The fruits and vegetables are rich sources of natural antioxidants, which provide defensive action against cancer development. Hence, these participants are at high risk of developing cancer due to their unhealthy dietary habits.
Most of the participants (75.57%) were found to have abnormal waist circumference. This increase in waist circumference indicates abnormal fat deposition in waste areas which is common risk factor for CVDs. The BMI values of participants indicate that 93 participants (30.63%) have overweight which is found to be higher than that found by Rao et al. in coastal areas of Karnataka (21.4%). Around 82 participants (27.06%) are already obese and are at higher risk of coronary artery diseases and heart attacks. The measurement of blood pressure indicated that 126 participants (41.58%) are already hypertensive. 1n 2014, the prevalence of hypertension was found to be 35% in population of North Karnataka by Madhumitha et al. Moreover, 93 participants (30.69%) are found to be at prehypertensive stage which increases the risk of developing hypertension in the future.
Hence, the results of the present study conclude that illiteracy, overweight, alcohol consumption, smoking/tobacco use, hypertension, physical inactivity, and unhealthy dietary habits exist in the study population, which act as potential risk factors for the development of various NCDs.
An immediate consideration is needed to reduce occurrence of NCDs in local population by focusing on decreasing the risk factors associated with these diseases especially by providing the proper education regarding life style changes so that awareness is created among the population which will also strengthen early detection and timely treatment of NCDs.
| Conclusions|| |
The survey concludes that both behavioral and physiological risk factors for NCDs exist in the study population and the most prevalent risk factors include hypertension, overweight, obesity, physical inactivity, tobacco use, and alcohol consumption. The high prevalence of these risk factors may be used to predict high chances of occurrence of NCDs such as CVDs, cancer, and chronic respiratory diseases.
Since pharmacist is easily accessible to the community, he/she can play an inevitable role to provide simple measures such as health education, nutritional education, and lifestyle modifications, which could go a long way to enhance the knowledge and awareness of the risk factors for NCDs and their prevention.
We express our sincere thanks to Dr. H. Doddayya, Principal, N.E.T Pharmacy College, Raichur, for his valuable help and providing necessary facilities to carry out this project. It is our pleasure to express our gratitude to Dr. Pavan Kalyan, Dr. Swetha, Faculty, Department of Community Medicine, for their valuable opinion and support to carry out this project.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Patel V, Chatterji S, Chisholm D, Ebrahim S, Gopalakrishna G, Mathers C, et al.
Chronic diseases and injuries in India. Lancet 2011;377:413-28.
Journal Article on the Internet: Global Health Observatory (GHO) Data NCD Mortality and Morbidity. World Health Organization; 2017. Available from: http://www.who.int/gho/en
. [Last accessed on 2017 Aug 16].
Anderson GF, Chu E. Expanding priorities – Confronting chronic disease in countries with low income. N Engl J Med 2007;356:209-11.
GBD 2015 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: A systematic analysis for the global burden of disease study 2015. Lancet 2016;388:1659-724.
World Health Organization. Global Strategy for the Prevention and Control of Non-communicable Diseases. Report by the Director General. A53/4. 53rd
World Health Assembly. Geneva: WHO; 2000.
National Institute of Medical Statistics, Indian Council of Medical Research (ICMR), IDSP Non-Communicable Disease Risk Factors Survey, Phase-I States of India, 2007-08. New Delhi, India: National Institute of Medical Statistics and Division of Non-Communicable Diseases, Indian Council of Medical Research; 2009.
Thankappan KR, Shah B, Mathur P, Sarma PS, Srinivas G, Mini GK, et al.
Risk factor profile for chronic non-communicable diseases: Results of a community-based study in Kerala, India. Indian J Med Res 2010;131:53-63.
] [Full text]
Rao CR, Kamath VG, Shetty A, Kamath A. High blood pressure prevalence and significant correlates: A quantitative analysis from coastal Karnataka, India. ISRN Prev Med 2013;2013:574973.
Madhumitha M, Naraintran S, Manohar C, Revathi S, Mallikarjun KB, Patil RS, et al.
Hypertension – Prevalence and risk factors among urban population in North Karnataka. Int J Cardiol Res 2014;6:39-45.
[Table 1], [Table 2], [Table 3], [Table 4]