Prevalence of risk factors for non-communicable diseases in a rural population of Bangladesh: a cross-sectional study
Authors: Sanjana Nujhat, Wafa Alam, Ayushka Parajuli, Wagdi Ali Mohammad Mohsen, Laurent Banyira, Rajat Das Gupta, Ipsita Sutradhar, Mehedi Hasan, Malay Kanti Mridha
Journal: The Lancet Global Health (2020)

BackgroundNon-communicable diseases (NCDs) account for 67% of annual deaths in Bangladesh. Behavioural and clinical risk factors such as high blood pressure, high blood glucose concentrations, dietary habits, physical inactivity, tobacco use, and alcohol consumption contribute to the prevalence of NCDs. In this study, we aim to estimate the prevalence of NCD risk factors and relevant characteristics in rural adult residents of Bangladesh.MethodsIn this cross-sectional survey, we included participants aged 18 years and older who resided in Parbatipur subdistrict of Bangladesh. We used a modified WHO STEPS tool to collect data. Additionally, questions were included on hypertension and diabetes within the questionnaire to evaluate participants' knowledge about NCDs and health-care-seeking practice. Standard bowl, teaspoon, and show cards were shown to respondents while asking about fruit, vegetables, salt, tobacco, and alcohol consumption. We used calibrated instruments to measure blood pressure, height, weight, and waist-hip circumference and asked respondents to self-report information about diabetes and lipid profile. To calculate the prevalence of hypertension, we considered participants with a previous diagnosis of hypertension and also those who had diastolic blood pressure ≥90 mm Hg or systolic blood pressure ≥140 mm Hg, or both, measured during the study. We used STATA (version 13.0) for data analysis.FindingsBetween Nov 17 and Dec 4, 2018, we collected data from 421 participants; median age was 41·9 years (SD 15·7) and 50·1% of participants (n=211) were women. Nearly half (41·6%) of respondents had hypertension. Self-reported prevalence of diabetes and high cholesterol was 4·3% and 1·0% respectively. Prevalence of physiological risk factors such as overweight (BMI 25·0–29·9 kg/m2), obesity (BMI ≥30 kg/m2), high waist circumference (≥100 cm for men and ≥90 cm for women), and high waist-hip ratio (≥0·90 for men and ≥0·80 for women) were 32·5%, 10·5%, 11·6%, and 87·4%, respectively. Other risk factors included smoking or consumption of smokeless tobaccos, or both (49·9%), inadequate physical activity (56·3%), inadequate consumption of fruits and vegetables (76·0%), and intake of extra salt in food (35·1%). Although most respondents had heard about hypertension (93·1%) and diabetes (94·3%), knowledge and practice of NCD prevention were found to be poor. Regarding the risk factors of developing hypertension and diabetes, most respondents mentioned that they did not know (46·8% and 64·4%, respectively) about this.InterpretationEven in a rural setting, lifestyle and dietary habits may be responsible for the high prevalence of NCDs that hinders people's quality of life and productivity. A comprehensive behaviour modification intervention should be undertaken by the public and private sectors to address the reduction of risk factors for NCDs. A limitation of this study was that it took place in the harvesting season when respondents were mostly busy and anxious about collecting their crops.FundingMasters dissertation funded by BRAC James P Grant School of Public Health, BRAC University.