Purworejo Health and Demographic Surveillance System, Indonesia.
Glob Health Action. 2009 Sep 28;2. doi: 10.3402/gha.v2i0.1984.
Chronic non-communicable diseases (NCDs) are the leading cause of morbidity, mortality, and disability worldwide. More than 80% of chronic disease deaths occur in low-income and middle-income countries. Epidemiological data on the burden of chronic NCD and the risk factors which predict them are lacking in most low-income countries. The INDEPTH Network (http://www.indepth-network.org) which includes the Health and Demographic Surveillance System (HDSS) with many surveillance sites in low-middle income countries provided an opportunity to establish surveillance of the major chronic NCD risk factors in 2005 using a standardised approach.
This paper presents the conceptual framework and research design of the chronic NCD risk factor surveillance within nine rural INDEPTH HDSS settings in Asia.
This multi-site study was designed as a baseline cross-sectional survey with sufficient sample size to measure trends over time. In each of nine HDSS sites in five Asian countries, a sample of 2,000 men and women aged 25-64 years, using the WHO STEPwise approach to Surveillance (http://who.int/chp/steps), was selected using stratified random sampling (in each 10-year interval) from the HDSS sampling frame.
A total of 18,494 men and women from the nine sites were interviewed with an overall response rate of 98%. The major NCDs risk factors included self-reported information on tobacco and alcohol consumption, fruit and vegetable intake, physical activity patterns, and measured body weight, height, waist circumference, and blood pressure. A series of training sessions were conducted for research scientists, supervisors, and surveyors in each site. Data quality was ensured through spot check, re-check, and data validation procedures, including accuracy and completeness of data obtained. Standardised data entry programme, created using the EPIDATA software, was used to ensure uniform database structure across sites. The data merging and analysis were done using STATA Version 10.
This multi-site study confirmed the feasibility of conducting chronic NCD risk factor surveillance in the low and middle-income settings by integrating the chronic NCDs risk factor surveillance into an existing HDSS data collection and management setting. This collaborative work has provided reliable epidemiological data as a basis for developing chronic NCD prevention and control activities.
慢性非传染性疾病（NCDs）是全世界发病率、死亡率和残疾的主要原因。超过 80%的慢性病死亡发生在低收入和中等收入国家。大多数低收入国家缺乏关于慢性 NCD 负担和预测这些疾病的危险因素的流行病学数据。包括健康和人口监测系统（HDSS）在内的 INDEPTH 网络（http://www.indepth-network.org）在中低收入国家拥有许多监测站点，为 2005 年使用标准化方法监测主要慢性 NCD 危险因素提供了机会。
本文介绍了亚洲九个农村 INDEPTH HDSS 地点的慢性 NCD 危险因素监测的概念框架和研究设计。
这项多地点研究设计为基线横断面调查，样本量足够大，可测量随时间的趋势。在亚洲五个国家的九个 HDSS 地点中，使用世界卫生组织 STEPWISE 监测方法（http://who.int/chp/steps），从 HDSS 抽样框架中按分层随机抽样（每 10 年间隔一次）选择了 2000 名年龄在 25-64 岁的男性和女性。
共有来自九个地点的 18494 名男性和女性接受了访谈，总体应答率为 98%。主要的 NCD 危险因素包括自我报告的吸烟和饮酒、水果和蔬菜摄入、体力活动模式以及测量的体重、身高、腰围和血压。在每个地点都为研究科学家、主管和调查员举办了一系列培训课程。通过抽查、复查和数据验证程序（包括数据的准确性和完整性）确保数据质量。使用创建的 EPIDATA 软件的标准化数据输入程序，确保了站点之间统一的数据库结构。使用 STATA 版本 10 进行数据合并和分析。
这项多地点研究证实，通过将慢性 NCD 危险因素监测整合到现有的 HDSS 数据收集和管理环境中，可以在中低收入环境中进行慢性 NCD 危险因素监测。这项合作工作提供了可靠的流行病学数据，为制定慢性 NCD 预防和控制活动提供了依据。
