Addressing Risks Throughout the Life-cycle to Reduce Non-communicable Disease in Bangladesh (P10-085-19)

Abstract Objectives The rapidly increasing burden of non-communicable diseases (NCD) constitutes a major public health challenge undermining future social and economic development. Using Bangladesh as a case study, we review gaps in health and nutrition behavior throughout the life-cycle and suggest possible policy and program solutions Methods We utilized a conceptual framework lightly adapted from the WHO Package of Essential Non-communicable Disease Interventions for Primary Health Care in Low Resource Settings. This framework guided the review of secondary literature using peer-reviewed articles and grey literature including reports, policy documents, and policy briefs. Results Risk factors identified include sub-optimal breastfeeding and complementary feeding with caregivers frequently resorting to prepackaged junk food for children, particularly in urban settings. For older children, many schools are unable to promote physical activity and do not include life-skills training. There is also high promotion of tobacco products to adolescents and adults, with little regulation, resulting in high use rates. Adults who have NCD also have poor control and knowledge of their condition, leading to inadequate care. Among infants, risks could be reduced through better enforcement of restrictions on the marketing of breastmilk substitutes and the mandated provision of six-month maternity leave for working women. For older children, additional taxes on junk foods partnered with improved communication campaigns on consumption of locally available, nutritious, and low-cost complementary foods could nudge diets into healthier patterns. Life skill training in school would improve the nutrition and health knowledge of the population, promote better diets, and discourage tobacco and substance abuse. Bangladesh has no wide-spread community-based tobacco cessation program or peer-educator program for adults suffering from NCD to learn more about their condition along with encouraging regular care-seeking. Conclusions Current policies and programs need to realize the changing dimensions that influence NCDs in Bangladesh. A multisectoral life course approach is needed to address the risk factors to halt the progression of NCD. Funding Sources The program was funded by the Netherlands government under Netherland Fellowship program (Former NFP, currently known as OKP). The preparation of this abstract was funded by the EU.

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Baseline risk factor prevalence among adolescents aged 15–17 years old: findings from National Non-communicable Disease Monitoring Survey (NNMS) of India

BMJ Open ◽

10.1136/bmjopen-2020-044066 ◽

2021 ◽

Vol 11 (6) ◽

pp. e044066

Author(s):

Prashant Mathur ◽

Vaitheeswaran Kulothungan ◽

Sravya Leburu ◽

Anand Krishnan ◽

Himanshu Kumar Chaturvedi ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Rural Areas ◽

Communicable Disease ◽

National Level ◽

Developed Countries ◽

Overweight And Obesity ◽

Baseline Risk ◽

Attitudes And Practices ◽

Non Communicable Disease

ObjectiveTo generate national estimates of key non-communicable disease (NCD) risk factors for adolescents (15–17 years) identified in the National NCD Monitoring Framework and, study the knowledge, attitudes and practices towards NCD risk behaviours among school-going adolescents.Design and settingA community-based, national, cross-sectional survey conducted during 2017–2018. The survey was coordinated by the Indian Council of Medical Research—National Centre for Disease Informatics and Research with 10 reputed implementing research institutes/organisations across India in urban and rural areas.ParticipantsA multistage sampling design was adopted covering ages between 15 and 69 years—adolescents (15–17 years) and adults (18–69 years). The sample included 12 000 households drawn from 600 primary sampling units. All available adolescents (15–17 years) from the selected households were included in the survey.Main outcome measuresKey NCD risk factors for adolescents (15–17 years)—current tobacco and alcohol use, dietary behaviours, insufficient physical activity, overweight and obesity.ResultsOverall, 1402 households and 1531 adolescents completed the survey. Prevalence of current daily use of tobacco was 3.1% (95% CI: 2.0% to 4.7%), 25.2% (95% CI: 22.2% to 28.5%) adolescents showed insufficient levels of physical activity, 6.2% (95% CI: 4.9% to 7.9%) were overweight and 1.8% (95% CI: 1.0% to 2.9%) were obese. Two-thirds reported being imparted health education on NCD risk factors in their schools/colleges.ConclusionThe survey provides baseline data on NCD-related key risk factors among 15–17 years in India. These national-level data fill information gaps for this age group and help assess India’s progress towards NCD targets set for 2025 comprehensively. Though the prevalence of select risk factors is much lower than in many developed countries, this study offers national evidence for revisiting and framing appropriate policies, strategies for prevention and control of NCDs in younger age groups.

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Identifying individuals with multiple non-communicable disease risk factors in Kenya: a latent class analysis

Public Health ◽

10.1016/j.puhe.2021.07.031 ◽

2021 ◽

Vol 198 ◽

pp. 180-186

Author(s):

R.S. Mkuu ◽

T.D. Gilreath ◽

A.E. Barry ◽

F.M. Nafukho ◽

J. Rahman ◽

...

Keyword(s):

Risk Factors ◽

Latent Class Analysis ◽

Latent Class ◽

Disease Risk ◽

Communicable Disease ◽

Class Analysis ◽

Non Communicable Disease

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Non-communicable disease (NCD) risk factors and diabetes among adults living in slum areas of Dhaka, Bangladesh

PLoS ONE ◽

10.1371/journal.pone.0184967 ◽

2017 ◽

Vol 12 (10) ◽

pp. e0184967 ◽

Cited By ~ 14

Author(s):

Lal B. Rawal ◽

Tuhin Biswas ◽

Nusrat Nausheen Khandker ◽

Shekhar Ranjan Saha ◽

Mohammed Mahiul Bidat Chowdhury ◽

...

Keyword(s):

Risk Factors ◽

Communicable Disease ◽

Non Communicable Disease ◽

Slum Areas

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Multiple Imputation to Correct for Nonresponse Bias: Application in Non-communicable Disease Risk Factors Survey

Global Journal of Health Science ◽

10.5539/gjhs.v8n1p133 ◽

2015 ◽

Vol 8 (1) ◽

pp. 133 ◽

Cited By ~ 2

Author(s):

Hamid Heidarian Miri ◽

Jafar Hassanzadeh ◽

Abdolreza Rajaeefard ◽

Majid Mirmohammadkhani ◽

Kambiz Ahmadi Angali

Keyword(s):

Risk Factors ◽

Multiple Imputation ◽

Blood Sugar ◽

Disease Risk ◽

Communicable Disease ◽

Fasting Blood Glucose ◽

Nonresponse Bias ◽

Natural Logarithm ◽

Predictive Mean Matching ◽

Non Communicable Disease

BACKGROUND: This study was carried out to use multiple imputation (MI) in order to correct for the potential nonresponse bias in measurements related to variable fasting blood glucose (FBS) in non-communicable disease risk factors survey conducted in Iran in 2007. METHODS: Five multiple imputation methods as bootstrap expectation maximization, multivariate normal regression, univariate linear regression, MI by chained equation, and predictive mean matching were applied to impute variable fasting blood sugar. To make FBS consistent with normality assumption natural logarithm (Ln) and Box-Cox (BC) transformations were used prior to imputation. Measurements from which we intended to remove nonresponse bias included mean of FBS and percentage of those with high FBS. RESULTS: For mean of FBS results didn’t considerably change after applying MI methods. Regarding the prevalence of high blood sugar all methods on original scale tended to increase the estimates except for predictive mean matching that along with all methods on BC or Ln transformed data didn’t change the results. CONCLUSIONS: FBS-related measurements didn’t change after applying different MI methods. It seems that nonresponse bias was not an important challenge regarding these measurements. However use of MI methods resulted in more efficient estimations. Further studies are encouraged on accuracy of MI methods in these settings.

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Prevalence, clustering and sociodemographic distributions of non-communicable disease risk factors in Nepalese adolescents: secondary analysis of a nationwide school survey

BMJ Open ◽

10.1136/bmjopen-2018-028263 ◽

2019 ◽

Vol 9 (5) ◽

pp. e028263 ◽

Cited By ~ 4

Author(s):

Raja Ram Dhungana ◽

Bihungum Bista ◽

Achyut Raj Pandey ◽

Maximilian de Courten

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Alcohol Consumption ◽

Vegetable Intake ◽

Disease Risk ◽

Communicable Disease ◽

Fruit And Vegetable Intake ◽

Fruit And Vegetable ◽

Insufficient Physical Activity ◽

Non Communicable Disease

ObjectivesTo assess the prevalence, clustering and sociodemographic distribution of non-communicable disease (NCD) risk factors in adolescents in Nepal.DesignData originated from Global School Based Student Health Survey, Nepal conducted in 2015–2016.SettingThe study sites were the secondary schools in Nepal; 74 schools were selected based on the probability proportional to school enrolment size throughout Nepal.Participants5795 school-going children aged 13–17 years were included in the study.Primary outcomesNCD risk factors: smoking, alcohol consumption, insufficient fruit and vegetable intake, insufficient physical activity and overweight/obesity were the primary outcomes. Sociodemographic distributions of the combined and individual NCD risk factors were determined by Poisson regression analysis.ResultsFindings revealed the prevalence of smoking (6.04%; CI 4.62 to 7.88), alcohol consumption (5.29%; CI 4.03 to 6.92), insufficient fruit and vegetable intake (95.33%; CI 93.89 to 96.45), insufficiently physical activity (84.77%; CI 81.04 to 87.88) and overweight/obesity (6.66%; CI 4.65 to 9.45). One or more risk factors were present in 99.6%, ≥2 were in 83% and ≥3 were in 11.2%. Risk factors were more likely to cluster in male, 17 years of age and grade 7. Prevalence of smoking (adjusted prevalence ratio (aPR)=2.38; CI 1.6 to 3.51) and alcohol consumption (aPR=1.81; CI 1.29 to 2.53) was significantly high in male, and in 16 and 17 years of age. Prevalence of insufficient physical activity and overweight/obesity was significantly lower in higher grades.ConclusionInsufficient fruit and vegetable intake and insufficient physical activity were highly prevalent in the populations studied. Risk factors were disproportionately distributed and clustered in particular gender, age and grade. The study population requires an age and gender specific preventive public health intervention.

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