State of non-communicable diseases in Nepal

Gajananda Prakash Bhandari, Mirak Raj Angdembe, Meghnath Dhimal, Sushma Neupane, Choplal Bhusal, Gajananda Prakash Bhandari, Mirak Raj Angdembe, Meghnath Dhimal, Sushma Neupane, Choplal Bhusal

Abstract

Background: The prevalence of Non Communicable Diseases (NCDs) is still unknown in Nepal. The Ministry of Health and Population, Government of Nepal has not yet formulated policy regarding NCDs in the absence of evidence based finding. The study aims to find out the hospital based prevalence of NCDs in Nepal, thus directing the concerned authorities at policy level.

Methods: A cross sectional study was conducted to identify the hospital based prevalence of 4 NCDs (cancer, cardiovascular disease, diabetes mellitus and chronic obstructive pulmonary disease), wherein 400 indoor patients admitted during 2009 were randomly selected from each of the 31 selected health institutions which included all non-specialist tertiary level hospitals outside the Kathmandu valley (n = 25), all specialist tertiary level hospitals in the country (n = 3) and 3 non-specialist tertiary level hospitals inside the Kathmandu valley. In case of Kathmandu valley, 3 non-specialist health institutions- one central hospital, one medical college and one private hospital were randomly selected. The main analyses are based on the 28 non-specialist hospitals. Univariate (frequency and percentage) and bivariate (cross-tabulation) analysis were used.

Results: In non-specialist institutions, the hospital based NCD prevalence was 31%. Chronic obstructive pulmonary disease (43%) was the most common NCD followed by cardiovascular disease (40%), diabetes mellitus (12%) and cancer (5%). Ovarian (14%), stomach (14%) and lung cancer (10%) were the main cancers accounting for 38% of distribution. Majority of CVD cases were hypertension (47%) followed by cerebrovascular accident (16%), congestive cardiac failure (11%), ischemic heart disease (7%), rheumatic heart disease (5%) and myocardial infarction (2%). CVD was common in younger age groups while COPD in older age groups. Majority among males (42%) and females (45%) were suffering from COPD.

Conclusions: The study was able to reveal that Nepal is also facing the surging burden of NCDs similar to other developing nations in South East Asia. Furthermore, the study has provided a background data on NCDs in Nepal which should prove useful for the concerned organizations to focus and contribute towards the prevention, control and reduction of NCD burden and its risk factors.

Figures

Figure 1
Figure 1
Proportion of NCDs in non-specialist institutions, 2009.
Figure 2
Figure 2
Proportion of various NCDs in non-specialist institutions, 2009.
Figure 3
Figure 3
Comparison of different types of CVD at specialist and non-specialist institutions, 2009.
Figure 4
Figure 4
Comparison of different types of cancer at specialist and non-specialist institutions, 2009.
Figure 5
Figure 5
Distribution of NCDs in non-specialist institutions by sex, 2009.
Figure 6
Figure 6
Distribution of NCDs in non-specialist institutions by development regions, 2009.n = number of selected cases (denominator).

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