Prevalence of Risk Factors of Non-Communicable Diseases in a Rural Population of Eastern Uttar Pradesh
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Original Article ISSN (Print) : 2454-8952 International Journal of Medical and Dental Sciences, Vol 7(2), DOI: 10.18311/ijmds/2018/20122, July 2018 ISSN (Online) : 2320-1118 Prevalence of Risk Factors of Non-Communicable Diseases in a Rural Population of Eastern Uttar Pradesh Dhruva Agarwal1*, Siraj Ahmad2, Jai Vir Singh3, Mukesh Shukla4, Bhupesh Kori5 and Aditi Garg6 1,2,3,5Department of Community Medicine, Hind Institute of Medical Sciences, Barabanki, Lucknow Metro, Uttar Pradesh - 225003, India; [email protected], [email protected], [email protected], [email protected] 4Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh - 462020, India; [email protected] 6Department of Microbiology, Mayo Institute of Medical Sciences, Barabanki, Uttar Pradesh - 225001, India Abstract Introduction: Over past few decade morbidities and mortalities associated with NCDs (Non-Communicable Diseases) was done to determine the prevalence of common risk factors for major NCDs in a rural population of Barabanki district leads to a significant loss ofMaterials productive and life Methods: years both in developed and developing countries. Therefore, the present study in eastern Uttar Pradesh. The present cross-sectional study was conducted in Satrikh block of Barabanki district. Multistage sampling was used for enrolment of the study subjects. A Results:totalof 1824 Prevalence participants of tobacco aged ≥25 years were enrolled in the study. WHO STEPs- wise tool was used to collect information on behavioural risk factors like tobacco use, diet, alcohol useand associated anthropometric indices were measured. smoking, smokeless tobacco products use, alcohol consumption, less than five servings of fruits/vegetables, more than five grams of salt intake and overweight/obesity was found to be 26.2%, 27.08%, 24.1%, 91.61%, 10.9% and 34.86% respectively. Individuals with age more than 35 years, male subjects, illiterates and those who belonged to scheduled castes/ tribes were significantly (p<0.05) more predisposed to both smoked tobacco as well as smokeless tobacco use and alcohol consumption.Consumption of alcohol was significantly (p<0.05) higher among employed groups who belonged to upper and upper middle class while tobacco consumption was more prevalent in lower socioeconomic group. ConsumptionConclusion: of salt more than 5 grams per day was significantly higher among individuals in elder age group (35-65 days), among females, those who were literate, those who belonged to other backward castes and among government employees. The study revealed high prevalence of non-communicable disease risk factors among adults. This indicates towards need of prompt community based preventive measures and control strategies to lower the forthcoming consequences of NCDs. Keywords: Alcohol, Hypertension, Physical inactivity, Risk Factors 1. Introduction Communicable Diseases (NCDs) affects both males and females worldwide and currently are major challenge for Globally 70% of the total deaths (about 40 million) are all health care models.[2] Socio-demographic transition caused by non-communicable diseases. Cardiovascular has lead to substantial modification in the health behav- diseases account for majority (17.7 million) of deaths, iors and health profile of people both in developed and followed by cancers (8.8 million), chronic respiratory developing world economies.[3] The overall effect of this diseases (3.9 million) and diabetes (1.6 million).[1] Non economic transition with changes in behavioral lifestyle *Author for correspondence Prevalence of Risk Factors of Non-Communicable Diseases in a Rural Population of Eastern Uttar Pradesh pattern can be visualized in real world as epidemiologi- 2.3 Study Period cal transition from communicable to non communicable From 1st June 2016 to 31th May 2017. diseases.[4] By 2020 it is projected that, non communi- cable diseases will contribute more than 80% of the total 2.4 Sample Size morbidities and 70% of total mortalities.[5] Even in young country like India, the study reviews reflect that about Sample size was calculated based on the formula for esti- [9] 2 2 50% of total deaths and 62% of the total disease burden mation of proportion; z 1-α/2 p (1-p)/d ; where z was are attributed to NCDs.[6] value of standard normal variable at 5% level of signifi- Aiming the risk factors as a part of primordial and cance, pwas anticipated prevalence of risk factors (preva- preventive strategies is the most effectual way to tackle lence of Obesity from Sandhu et. al., 2015 was taken as the problem of non-communicable diseases. The key 6.2%);[10] and d was allowable error. Since the multistage behavioural risk factors recognized in the World Health sampling method was used the sample size was adjusted Report 2002, are tobacco use, harmful alcohol intake, for a design effect of 2, and sample size was calculated to low fruits and vegetables consumption as unhealthy diet be 1518. Accounting for a non-response rate of 20%, the and lack of physical activity while major biological risk final sample size was calculated as 1824. factors identified are increased Body Mass Index (BMI), raised arterial blood pressure, raised blood glucose and 2.5 Sampling Technique [7] total cholesterol levels. Risk factors nowadays ulti- Multistage sampling was used and during first stage eight mately become the diseases. Public health approach with villages from RHTC area was selected by simple random management of these risk factors are the most affordable method and number of study subjects per village was way to deal with the problem on long term. That why based on their proportionate size. In each village, houses from last two decades majority of programs and poli- were selected by systematic random sampling procedure. cies are aimed targeting these risk factors so as to make Every third house was studied till the required sample a extensive control. World Health Organization (WHO) size for that village was achieved. All members in the has also developed the STEPs approach to conduct sur- household aged ≥25 years were included in the study. veillance of NCD risk factors and conduct appropriate Individuals not available during visit were excluded from [8] interventions to reduce them. Similar approach has study. been adopted in present study with the view that if risk factors are managed properly, more than half of untimely 2.6 Study Approach deaths could be prevented. Although various studies [8] have assessed the prevalence of risk factors for non-com- WHO STEPs wise approach was used. municable diseases in urban India, but studies from rural India is relatively meagre. Thus, the current effort was 2.7 Data Collection done to study the prevalence of common NCDs risk fac- The individuals selected were approached, interviewed tors in a rural population of Barabanki district, Eastern and examined for physical measurement. For each study Uttar Pradesh. subject a separate questionnaire was filled. WHO STEPS based questionnaire was used to gather information 2. Materials and Methods regarding age, sex, marital status, religion, caste, educa- tional status, occupation, family history etc. and risk fac- 2.1 Study Design tors for non-communicable diseases i.e., tobacco smoking, consumption of smokeless tobacco and alcohol, dietary Community based Cross Sectional study habits, physical inactivity, body mass index, life style, phys- ical measurements, etc. Socioeconomic status was assessed 2.2 Study Population using Modified B G Prasad Socioeconomic scale 2016.[11] The study population comprised of individuals aged ≥25 Data was collected by structured interview method by years of either sex residing in the villages in the catchment using a pre-design and pretested questionnaire based on area of Rural Health Training Centre (RHTC), Satrikh, WHO STEPs approaches for surveillance of NCD in con- Barabanki district, U.P. text to STEP 1 and STEP 2 only.[8] 1668 Vol 7 (2) | July 2018 | http://www.informaticsjournals.com/index.php/ijmds/index International Journal of Medical and Dental Sciences Dhruva Agarwal, Siraj Ahmad, Jai Vir Singh, Mukesh Shukla, Bhupesh Kori and Aditi Garg 2.8 Data Analysis 3. Results Data collected was primarily entered in Microsoft In our study population, the age group of participants Excel and finally transferred to Epi-Info for analysis. ranged from 25-75 years. Among them 560(30.7%) Quantitative data was expressed in percentages and odds individuals were in 25 to 34 years’ age group, while ratios were calculated with 95% confidence interval for only 118(6.47%) individuals were above 65 years of age. assessment of risk factors. Value of p<0.05 was considered Mean age of the participants was 42.63±11.72 years. Out significant. of total 1824 participants, 780(42.8%) were males and 1044(57.2%) were females. The percentage of married 2.9 Ethical Considerations population was 87.1% among the total studied popula- Ethical approval was sought from institutional ethics tion. Among the study population, 730(40%) were literate committee before commencement of study. The purpose and 1094(60%) were illiterate. (Table 1) of the study was explained to each person in the local lan- The overall prevalence of risk factors smoked tobacco, guage and a written and informed consent was taken. smokeless tobacco, alcohol consumption, less than five Table 1. Distribution of study population on the basis of bio-social characteristics (N=1824) Characteristics Number Percentage