Zaman M Mostafa, Bhuiyan Mahfuzur Rahman, Karim Md Nazmul, Rahman Md Mukhlesur, Akanda Abdul Waheed, Fernando Thushara
Division of NCD, World Health Organization, Dhaka, Bangladesh.
Division of Training, Bureau of Health Education, Dhaka, Bangladesh.
BMC Public Health. 2015 Jul 14;15:659. doi: 10.1186/s12889-015-1938-4.
Non-communicable diseases (NCDs) have already become major killers in Bangladesh. Once NCDs are developed, they become chronic health and economic problems. Their primary prevention is linked to their common risk factors. This study was conducted to determine the prevalence of NCD risk factors with a focus on their clustering in Bangladeshi adults.
This nationally representative study was done in 4,073 (1,812 men and 2,261 women) adults aged 25 years or older selected from rural and urban households. Multistage cluster sampling design was used. Selected variables were in line with steps I and II of WHO stepwise surveillance except alcohol.
Forty-four percent used tobacco in any form. Almost 93% did not consume adequate fruit and vegetables (5 servings or more). Thirty eight percent had low physical activity level (<600 MET-minutes/week). One-quarter (26%) were overweight (body mass index > =25 kg/m^2). Twenty-one percent had hypertension (blood pressure > =140/90 mmHg or medication) and about 5% had documented diabetes. Upon examination of risk factor clustering, we observed that 38% had at least three risk factors. After this threshold, clustering suddenly dropped down to a fairly low level. Using this threshold as a cut-off, clustering of risk factors was associated with age, male gender, urban residence, educational levels and quality of house in multivariate analysis.
Prevalence of NCD risk factors is fairly high in Bangladeshi adults with a tendency of clustering. If a risk factor such as hypertension is detected, a closer look for other risk factors has to be given in both at clinical and public health settings. Clustering raises risk by more than a summation of risk factors. Our findings, therefore, suggest that Bangladesh could expect a significant increase in NCDs in near future.
非传染性疾病(NCDs)已成为孟加拉国的主要杀手。一旦患上非传染性疾病,就会成为慢性健康和经济问题。其一级预防与常见风险因素相关。本研究旨在确定非传染性疾病风险因素的患病率,并重点关注其在孟加拉国成年人中的聚集情况。
这项具有全国代表性的研究选取了4073名(1812名男性和2261名女性)25岁及以上的成年人,他们来自农村和城市家庭。采用多阶段整群抽样设计。除酒精外,所选变量与世界卫生组织逐步监测的第一步和第二步一致。
44%的人使用任何形式的烟草。近93%的人未摄入足够的水果和蔬菜(5份或更多)。38%的人身体活动水平较低(<600代谢当量-分钟/周)。四分之一(26%)的人体重超重(体重指数>=25千克/平方米)。21%的人患有高血压(血压>=140/90毫米汞柱或正在服药),约5%的人有糖尿病记录。在检查风险因素聚集情况时,我们观察到38%的人至少有三种风险因素。超过这个阈值后,聚集情况突然降至相当低的水平。以这个阈值为界限,在多变量分析中,风险因素的聚集与年龄、男性性别、城市居住、教育水平和住房质量相关。
孟加拉国成年人中非传染性疾病风险因素的患病率相当高,且有聚集趋势。如果检测到诸如高血压等风险因素,在临床和公共卫生环境中都必须更密切地查找其他风险因素。聚集增加的风险超过了风险因素的简单相加。因此,我们的研究结果表明,孟加拉国在不久的将来非传染性疾病可能会大幅增加。