Risk factors for non-communicable diseases in Bangladesh: findings of the population-based cross-sectional national survey 2018

Baizid Khoorshid Riaz, Md Ziaul Islam, A N M Shamsul Islam, M M Zaman, Md Akram Hossain, Md Mujibur Rahman, Fahmida Khanam, K M Bayzid Amin, Irfan Nowroze Noor, Baizid Khoorshid Riaz, Md Ziaul Islam, A N M Shamsul Islam, M M Zaman, Md Akram Hossain, Md Mujibur Rahman, Fahmida Khanam, K M Bayzid Amin, Irfan Nowroze Noor

Abstract

Objectives: To determine the national prevalence of risk factors of non-communicable diseases (NCD) in the adult population of Bangladesh.

Design: The study was a population-based national cross-sectional study.

Setting: This study used 496 primary sampling units (PSUs) developed by the Bangladesh Bureau of Statistics. The PSUs were equally allocated to each division and urban and rural stratum within each division.

Participants: The participants were adults aged 18 to 69 years, who were usual residents of the households for at least 6 months and stayed the night before the survey. Out of 9900 participants, 8185 (82.7%) completed STEP-1 and STEP-2, and 7208 took part in STEP-3.

Primary and secondary outcome: The prevalence of behavioural, physical and biochemical risk factors of NCD. Data were weighted to generate national estimates.

Results: Tobacco use was significantly (p<0.05) higher in the rural (45.2%) than the urban (38.8%) population. Inadequate fruit/vegetable intake was significantly (p<0.05) higher in the urban (92.1%) than in the rural (88.9%) population. The mean salt intake per day was higher in the rural (9.0 g) than urban (8.9 g) population. Among all, 3.0% had no, 70.9% had 1 to 2 and 26.2% had ≥3 NCD risk factors. The urban population was more likely to have insufficient physical activity (adjusted OR (AOR): 1.2, 95% CI: 1.2 to 1.2), obesity (AOR: 1.5, 95% CI: 1.5 to 1.5), hypertension (AOR: 1.3, 95% CI: 1.3 to 1.3), diabetes (AOR: 1.6, 95% CI: 1.6 to 1.6) and hyperglycaemia (AOR: 1.1, 95% CI: 1.1 to 1.1).

Conclusions: Considering the high prevalence of the behavioural, physical and biochemical risk factors, diverse population and high-risk group targeted interventions are essential to combat the rising burden of NCDs.

Keywords: epidemiology; general diabetes; hypertension; lipid disorders; preventive medicine; public health.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Summary of combined *risk factors of non-communicable diseases. *Risk factors: Current daily smokers, less than five servings of fruits and vegetables per day, insufficient physical activity, overweight (body mass index ≥25 kg/m²), raised blood pressure and raised total cholesterol.

References

    1. WHO Global health estimates: deaths by cause, age, sex and country, 2000-2012. Geneva: World Health Organization, 2014.
    1. WHO Projections of mortality and causes of death, 2015 and 2030. Health statistics and information systems. Available:
    1. WHO Non communicable diseases progress monitor, 2017. Available:
    1. WHO Global status report on non-communicable diseases, 2014. Available:
    1. WHO Surveillance of chronic diseases: risk factors: country-level data and comparable estimates (surf reports 2): Bangladesh, 2005. Available:
    1. Wagner K-H, Brath H. A global view on the development of non communicable diseases. Prev Med 2012;54:S38–41. 10.1016/j.ypmed.2011.11.012
    1. Zaman MM, Bhuiyan MR, Karim MN, et al. . Clustering of non-communicable diseases risk factors in Bangladeshi adults: an analysis of steps survey 2013. BMC Public Health 2015;15:659. 10.1186/s12889-015-1938-4
    1. Mahta H. Prevalence of diabetes, coronary heart disease and the risk factors attributed to these disorders in the urban population of Bangladesh. SEARO, 2008. Available:
    1. WHO Burden of non-communicable diseases. WHO Bulletin, 2016.
    1. WHO 65th World health assembly, 2012.
    1. Islam N, Islam MN, Khanam K. Smoking habit among Bangladesh Secretariat staff. Bangladesh Med Res Counc Bull 1990;16:62–9.
    1. WHO Global adult tobacco survey (GATS) Bangladesh, 2009. Available:
    1. WHO 66th World health assembly, 2013.
    1. Bangladesh Bureau of Statistics (BBS) Global adult tobacco survey (GATS) Bangladesh, 2017.
    1. Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare Non-communicable disease risk factor survey in Bangladesh 2010. World Health organization – country office for Bangladesh, 2011. Available:
    1. Palipudi K, Rizwan SA, Sinha DN, et al. . Prevalence and sociodemographic determinants of tobacco use in four countries of the world Health organization: south-east Asia region: findings from the global adult tobacco survey. Indian J Cancer 2014;51:S24–32. 10.4103/0019-509X.147446
    1. Aryal KK, Mehata S, Neupane S, et al. . The burden and determinants of non communicable diseases risk factors in Nepal: findings from a nationwide steps survey. PLoS One 2015;10:e0134834. 10.1371/journal.pone.0134834
    1. Gurung MS, Pelzom D, Dorji T, et al. . Current tobacco use and its associated factors among adults in a country with comprehensive ban on tobacco: findings from the nationally representative STEPS survey, Bhutan, 2014. Popul Health Metr 2016;14:1–9. 10.1186/s12963-016-0098-9
    1. Thakur JS, Jeet G, Pal A, et al. . Profile of risk factors for non-communicable diseases in Punjab, Northern India: results of a state-wide steps survey. PLoS One 2016;11:e0157705. 10.1371/journal.pone.0157705
    1. Shaheen N, Irfan NM, Khan IN, et al. . Presence of heavy metals in fruits and vegetables: health risk implications in Bangladesh. Chemosphere 2016;152:431–8. 10.1016/j.chemosphere.2016.02.060
    1. Alamgir Zaman Chowdhury M, Fakhruddin ANM, Nazrul Islam M, et al. . Detection of the residues of nineteen pesticides in fresh vegetable samples using gas chromatography–mass spectrometry. Food Control 2013;34:457–65. 10.1016/j.foodcont.2013.05.006
    1. Pengpid S, Peltzer K, Kassean HK, et al. . Physical inactivity and associated factors among university students in 23 low-, middle- and high-income countries. Int J Public Health 2015;60:539–49. 10.1007/s00038-015-0680-0
    1. Haase A, Steptoe A, Sallis JF, et al. . Leisure-Time physical activity in university students from 23 countries: associations with health beliefs, risk awareness, and national economic development. Prev Med 2004;39:182–90. 10.1016/j.ypmed.2004.01.028
    1. Yahia N, Wang D, Rapley M, et al. . Assessment of weight status, dietary habits and beliefs, physical activity, and nutritional knowledge among university students. Perspect Public Health 2016;136:231–44. 10.1177/1757913915609945
    1. Konharn K, Santos MP, Ribeiro JC. Socioeconomic status and objectively measured physical activity in Thai adolescents. J Phys Act Health 2014;11:712–20. 10.1123/jpah.2011-0424
    1. Bhagyalaxmi A, Atul T, Shikha J. Prevalence of risk factors of non-communicable diseases in a district of Gujarat, India. J Health Popul Nutr 2013;31:78. 10.3329/jhpn.v31i1.14752
    1. Jayawardena R, Byrne NM, Soares MJ, et al. . Prevalence, trends and associated socio-economic factors of obesity in South Asia. Obes Facts 2013;6:405–14. 10.1159/000355598
    1. WHO Global status report on non-communicable diseases. Geneva: World Health Organisation, 2014.
    1. Zaman MM, Yoshiike N, Rouf MA, et al. . Cardiovascular risk factors: distribution and prevalence in a rural population of Bangladesh. J Cardiovasc Risk 2001;8:103–8. 10.1177/174182670100800207
    1. Akter S, Rahman MM, Abe SK, et al. . Prevalence of diabetes and prediabetes and their risk factors among Bangladeshi adults: a nationwide survey. Bull World Health Organ 2014;92:204–13. 10.2471/BLT.13.128371
    1. Biswas T, Islam A, Rawal LB, et al. . Increasing prevalence of diabetes in Bangladesh: a scoping review. Public Health 2016;138:4–11. 10.1016/j.puhe.2016.03.025
    1. Saquib N, Saquib J, Ahmed T, et al. . Cardiovascular diseases and type 2 diabetes in Bangladesh: a systematic review and meta-analysis of studies between 1995 and 2010. BMC Public Health 2012;12:434. 10.1186/1471-2458-12-434
    1. Emerging Risk Factors Collaboration, Sarwar N, Gao P, et al. . Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet 2010;375:2215–22. 10.1016/S0140-6736(10)60484-9
    1. Gupta R, Guptha S, Sharma KK, et al. . Regional variations in cardiovascular risk factors in India: India heart Watch. World J Cardiol 2012;4:112. 10.4330/wjc.v4.i4.112
    1. Jafar TH, Haaland BA, Rahman A, et al. . Non-communicable diseases and injuries in Pakistan: strategic priorities. Lancet 2013;381:2281–90. 10.1016/S0140-6736(13)60646-7

Source: PubMed

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