Mkuu R S, Gilreath T D, Barry A E, Nafukho F M, Rahman J, Chowdhury M A B, Wekullo C, Harvey I S
University of Florida, College of Medicine, Gainesville, FL, USA.
Texas A&M University, Transdisciplinary Center for Health Equity Research, College Station, TX, USA.
Public Health. 2021 Sep;198:180-186. doi: 10.1016/j.puhe.2021.07.031. Epub 2021 Aug 28.
Non-communicable diseases (NCDs) are the leading causes of death globally. In Kenya, the number of deaths resulting from NCDs is projected to surpass malaria and tuberculosis by 2030. Studies in Kenya show increasing NCDs; the aim of the present study is to examine the clustering of NCDs and risk factors in Kenya.
This is a cross-sectional study using data from the 2015 Kenya STEPwise Survey.
This study examined relationships between NCDs (e.g. obesity, hypertension and diabetes) and health behaviours (e.g. sedentary activity, and fruit and vegetable consumption). Survey probability weights, which estimated the sampling design effect, were applied to consider the sampling units, and stratifications were used during sampling so that the results could be generalisable to the national adult Kenyan population. In total, 4350 adults were included in the study sample.
Overall, 24.43% of participants were classified as having hypertension, 1.88% as having type 2 diabetes, and 27.94% were classified as being overweight or obese. The best-fit model was a four-class solution. Class 1 is best described as 'young with high NCD risk' and had the highest sedentary activity. Class 2 is best described as 'poor rural with lower NCD risk' with a high chance of smoking and alcohol consumption. Class 3 is best described as 'rural with high NCD risk' and had the highest fruit and vegetable consumption. Class 4 is best described as 'wealthy young urban dwellers with high NCD risk' with a high chance of alcohol consumption and smoking. Individuals in Class 4 had the highest chance (40%) of being overweight/obese, a 2% chance of type 2 diabetes and a 23% chance of having hypertension.
NCDs are clustered in groups with high-risk behaviours. The group with the highest chance of having NCDs also had the highest chance of engaging in high-risk behaviours. The findings of this study suggest that smoking and alcohol consumption increase NCD risk in rural areas. Tailored and targeted interventions are needed to curb the increasing NCD prevalence in Kenya.
非传染性疾病（NCDs）是全球主要的死亡原因。在肯尼亚，预计到2030年，非传染性疾病导致的死亡人数将超过疟疾和结核病。肯尼亚的研究表明非传染性疾病呈上升趋势；本研究的目的是调查肯尼亚非传染性疾病及其危险因素的聚集情况。
这是一项横断面研究，使用了2015年肯尼亚逐步调查的数据。
本研究调查了非传染性疾病（如肥胖、高血压和糖尿病）与健康行为（如久坐不动、水果和蔬菜摄入量）之间的关系。应用了估计抽样设计效应的调查概率权重来考虑抽样单位，抽样过程中采用了分层抽样，以便研究结果能够推广到肯尼亚全国成年人群体。研究样本总共纳入了4350名成年人。
总体而言，24.43%的参与者被归类为患有高血压，1.88%的参与者被归类为患有2型糖尿病，27.94%的参与者被归类为超重或肥胖。最佳拟合模型是一个四类解决方案。第1类最适合描述为“非传染性疾病风险高的年轻人”，其久坐活动水平最高。第2类最适合描述为“非传染性疾病风险较低的贫困农村人群”，吸烟和饮酒的可能性较高。第3类最适合描述为“非传染性疾病风险高的农村人群”，其水果和蔬菜摄入量最高。第4类最适合描述为“非传染性疾病风险高的富裕年轻城市居民”，饮酒和吸烟的可能性较高。第4类人群超重/肥胖的几率最高（40%），患2型糖尿病的几率为2%，患高血压的几率为23%。
非传染性疾病聚集在具有高风险行为的人群中。患非传染性疾病几率最高的人群从事高风险行为的几率也最高。本研究结果表明，吸烟和饮酒会增加农村地区非传染性疾病的风险。需要采取有针对性的干预措施来遏制肯尼亚非传染性疾病患病率的上升。
