Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, P. O Box 65000, Dar es Salaam, Tanzania.
Department of Global Health Entrepreneurship, Division of Public Health, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan.
BMC Public Health. 2019 Jul 22;19(1):972. doi: 10.1186/s12889-019-7320-1.
Childhood lifestyle, health-risk behaviours contribute to two-thirds of non-communicable diseases (NCDs) premature mortality in adult populations. The co-occurrence of risk factors for NCDs is more harmful to health than that of individual risk factor effects when are added independently. The main objective of the present study was to explore the prevalence, sociodemographic distribution, and the co-occurrence of risk factors for NCDs among in-school adolescents.
The present study is based on the secondary analysis of the first nationwide representative sample of the 2014 Tanzania Global School-based Student Health Survey (GSHS). A total sample of 3,793 in-school adolescents was included in the present analysis. The dependent variables were as follows: an unhealthy diet, physical inactivity, tobacco use, excessive alcohol use, and suicide attempt. The analysis involved the Chi squire χ test, multinomial and multivariate regression models: to determine the association between the variables of interest. In all analyses, the set level of statistical significance was a p-value of less than 0.05 at 95% confidence intervals.
The most prevalent combination of risk factors for NCDs were as follows: unhealthy diet and physical inactivity 666 (17.6%); unhealthy diet and suicide attempt 151 (4.0); unhealthy diet and tobacco use 98 (2.8); and unhealthy diet, physical inactivity, and suicide attempt 81 (2.1). In the adjusted regression model; having three 0.60 [0.40-0.91], and a sum of four and five 0.46 [0.28-0.79] risk factors than having no risk factor showed a significant declined with increasing in adolescents age. Primary in-school adolescents than secondary in-school adolescents were significantly more likely to have two 1.81 [1.42-2.32], three 2.40 [1.63-3.54]; and a sum of four and five 2.90 [1.61-5.13] combinations of risk factors.
The co-occurrence of lifestyle health-risk factors for NCDs was prevalent among in-school adolescents: it was significantly higher among younger adolescents. A multi-strategy public health intervention program may be more effective than that of a single risk factor approach: therefore, suitable for resource-limited settings, such as Tanzania.
儿童时期的生活方式和健康风险行为是导致成年人中三分之二非传染性疾病（NCD）过早死亡的原因。当独立添加时，NCD 危险因素的同时发生比单个危险因素的影响更有害健康。本研究的主要目的是探讨在校青少年 NCD 危险因素的流行率、社会人口分布以及同时发生情况。
本研究基于 2014 年坦桑尼亚全球学校学生健康调查（GSHS）的首次全国代表性样本的二次分析。本分析共纳入 3793 名在校青少年。因变量为以下内容：不健康饮食、身体活动不足、使用烟草、过度饮酒和自杀未遂。分析涉及卡方检验、多项和多变量回归模型：以确定感兴趣变量之间的关联。在所有分析中，统计学显著性水平设定为 95%置信区间内的 p 值小于 0.05。
NCD 危险因素最常见的组合如下：不健康饮食和身体活动不足 666 例（17.6%）；不健康饮食和自杀未遂 151 例（4.0%）；不健康饮食和使用烟草 98 例（2.8%）；以及不健康饮食、身体活动不足和自杀未遂 81 例（2.1%）。在调整后的回归模型中；与没有危险因素的青少年相比，有三个 0.60 [0.40-0.91]和四个和五个 0.46 [0.28-0.79]危险因素的青少年年龄越大，下降趋势越明显。与中学青少年相比，小学青少年更有可能有两个 1.81 [1.42-2.32]、三个 2.40 [1.63-3.54]和四个和五个 2.90 [1.61-5.13]组合的危险因素。
在校青少年中，NCD 生活方式健康危险因素的同时发生情况较为普遍：在年龄较小的青少年中更为常见。与单一危险因素方法相比，多策略公共卫生干预计划可能更有效：因此，适合资源有限的环境，例如坦桑尼亚。
