Non-Communicable Disease And Risk Factors Among Adults In Bahir Dar, Ethiopia
Creators: name: Alamnia, Tilahun
Publisher: name: The Australian National University
Year: 2024

description: Non-communicable diseases (NCDs) are a major population health problem worldwide, posing substantial health, social, and economic consequences. Ethiopia, like many low- and middle-income countries, is experiencing a rapid surge of NCDs and they account for nearly half of the disease burden. The healthcare system in Ethiopia is struggling to respond to this growing health burden, and preventive programs are lacking in the population. This study aimed to evaluate the prevalence, risk factors, knowledge, attitudes, and perception of NCDs among adults in Bahir Dar, Ethiopia. The research design encompassed a community-based cross-sectional study with 423 randomly sampled adults, a qualitative study with 12 community participants and 32 primary healthcare providers, and systematic reviews informed by 74 observational and 12 interventional studies. Data collection involved a structured interviewer-administered questionnaire and physical measurements for the cross-sectional study, in-depth interviews and focus group discussions for the qualitative inquiry, and systematic reviews employing predefined data collection formats. Descriptive and inferential statistics were performed to present findings of the quantitative studies and thematic analyses for the qualitative study. This study found that the self-reported prevalence of NCDs among participating adults in Bahir Dar was 24%, with a multimorbidity rate (proportion of participants with two or more NCDs) of 8%. Increasing age, excess weight gain, and a family history of chronic diseases emerged as significant predictors of NCD prevalence. Metabolic and behavioural risk factors were widespread among participants with hypertension found in 21% of participants, overweight/obesity in 30%, and abdominal obesity in 67%. Only 5% of participants had adequate intake of fruit/vegetables, 53% consumed alcohol, 38% were physically inactive, 5% used khat, and 2% used tobacco. About 55% of participating adults had clusters of three or more NCD risk factors, and 15% had a ten-year moderate (10-20%) cardiovascular risk. Factors associated with cardiovascular risk are sex, abdominal obesity, and clusters of three or more risk factors. In addition, this survey suggested two types of dietary patterns in the study population, Westernized and Traditional, and there was a significant association between the consumption of Westernized dietary patterns and metabolic risk factors like hypertension. Furthermore, the prevalence of a low level of well-being was 40%, loneliness was 57%, and generalised anxiety disorder was 51% in the two weeks leading up to the survey. These were significantly related to marital status, educational status, occupational status, and income of participants. In exploring factors that could reduce the prevalence of risk factors and NCDs, this study reveals that 66% of participating adults had inadequate knowledge about NCDs, and 24% perceived NCDs as less dangerous than communicable diseases. NCD prevention in the population is influenced by various factors, such as low-risk perception about the diseases, lack of knowledge about preventive measures, traditional and cultural practices, barriers in healthcare services (accessibility, shortage of trained manpower, and resources), lack of government regulations and policies over risk factors, lack of collaboration with stakeholders, and low socioeconomic status of people. A systematic review of mobile text message interventions indicated that providing information to raise adults' awareness may potentially reduce NCD risk factors, including overweight and obesity. In conclusion, the widespread prevalence of NCDs and risk factors in the study population, compounded by socioeconomic problems, inadequate awareness, poor perceptions of the importance of prevention practices, and lack of preventive interventions, underscore the urgency for multifaceted public health interventions to control the rise of these diseases.