Research Department of Epidemiology and Public Health, UCL (University College London), London WC1E 6BT, United Kingdom; Department of Public Health, University of The Gambia, Brikama Campus, P.O.Box, 3530, Serrekunda, The Gambia; Disease Control and Elimination theme, Medical Research Council Unit, The Gambia, at the London School of Hygiene and Tropical Medicine, Atlantic Road, Fajara, P.O.Box 273, Banjul, The Gambia.
Research Department of Epidemiology and Public Health, UCL (University College London), London WC1E 6BT, United Kingdom.
Prev Med. 2020 Dec;141:106300. doi: 10.1016/j.ypmed.2020.106300. Epub 2020 Oct 27.
Non-communicable diseases (NCDs) are the leading causes of morbidity and mortality globally. Co-occurrence of risk factors predisposes an individual to NCDs; the burden increases cumulatively with the number of risk factors. Our study aimed to examine the co-occurrence of NCD risk factors among adults in The Gambia. This study is based on a random nationally representative sample of 4111 adults aged 25-64 years (78% response rate) with data collected between January and March 2010 in The Gambia using the WHO STEPwise survey methods. We restricted our analysis to non-pregnant participants with valid information on five NCD risk factors: high blood pressure, smoking, obesity, low fruit and vegetable consumption, and physical inactivity (n = 3000 adults with complete data on all risk factors). We conducted age-adjusted and fully-adjusted gender stratified multinomial logistic regression analysis to identify factors associated with the number of NCD risk factors. More than 90% of adults had at least one risk factor. Only 7% (95% CI: 5.2-9.8) had no risk factor; 22% (95% CI: 19.1-24.9) had at least three. Older age and ethnicity were significantly associated with having three or more risk factors (versus none) among men in the fully adjusted model. Lower education, older age, and urban residence were significantly associated with three or more risk factors (versus none) among women. The burden of NCDs is expected to increase in The Gambia if preventive and control measures are not taken. There should be an integrated approach targeting all risk factors, including wider treatment and control of hypertension.
非传染性疾病（NCDs）是全球发病率和死亡率的主要原因。危险因素的同时存在使个体易患 NCD；随着危险因素数量的增加，负担也会累积增加。我们的研究旨在检查冈比亚成年人中 NCD 危险因素的同时存在情况。这项研究基于 2010 年 1 月至 3 月期间在冈比亚使用世界卫生组织 STEPWISE 调查方法进行的一项随机全国代表性样本，共调查了 4111 名年龄在 25-64 岁的成年人（应答率为 78%）。我们将分析仅限于非怀孕参与者，他们具有有关五种 NCD 危险因素的有效信息：高血压、吸烟、肥胖、水果和蔬菜摄入不足以及缺乏身体活动（n=3000 名具有所有危险因素完整数据的成年人）。我们进行了年龄调整和完全性别分层多变量逻辑回归分析，以确定与 NCD 危险因素数量相关的因素。超过 90%的成年人至少有一种危险因素。只有 7%（95%CI：5.2-9.8）没有危险因素；22%（95%CI：19.1-24.9）至少有三种。在完全调整模型中，年龄较大和族裔与男性中存在三种或更多危险因素（而非没有）显著相关。在女性中，较低的教育程度、年龄较大和城市居住与存在三种或更多危险因素（而非没有）显著相关。如果不采取预防和控制措施，冈比亚的 NCD 负担预计会增加。应该采取综合方法针对所有危险因素，包括更广泛的高血压治疗和控制。
