The Magnitude of Non-communicable diseases & their Risk factors in Malawi
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Transcript of The Magnitude of Non-communicable diseases & their Risk factors in Malawi
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The Magnitude of Non-communicable diseases & their
Risk factors in Malawi
Malawi NCD STEPS SURVEY 2009
BY DR KELIAS MSYAMBOZA
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What are NCDs
• A group diseases used to be regarded as “diseases of the west, affluent, rich, or urban people”
• Include:– Cardiovascular diseases (Hypertension, Heart
diseases, Stroke)– Cancer– Chronic respiratory diseases e.g. asthma– Diabetes– Mental diseases etc
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Importance of NCDs to Malawi
• Because of change in life styles, NCDs are increasingly becoming significant causes of morbidity and mortality in developing countries
• In Malawi, in adults, NCDs are probably the 2nd commonest cause of illness, lost of productive days and death after HIV/AIDS
• NCDs are part of 1st objective of PoW for SWAp 2004-2010:
“To reduce the disease burden due to communicable & Non-communicable diseases thru improving access to quality EHP, essential non-EHP services Emergency and Trauma services mainly targeted at the poor”
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NCD STEPS Survey objectives
1. To determine the magnitude of selected NCDs:– High blood pressure (Hypertension)– Diabetes– People with or at risk of Heart diseases (Raised cholesterol)
2. To determine the magnitude of risk factors:– Tobacco smoking– Excessive alcohol intake– Overweight/obesity– Physical inactivity– Inadequate fruits and vegetable intake
3. To use data to advocate for resources, policies, regulations etc for NCDs
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Materials & Methods
Method Outcome
Participants - 25-64 year olds
Sample size N=z2p(1-p)/e2 5,760
Survey design Population based National sample
EA selection PPS 144 EAs selected
HH selection Systematic 40 per EA
Participant Kish 1 per Household
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STEPS
Component Equipment
STEP 1 Questionnaire PDA
STEP 2 Physical measurements
(BP, HT, WT, waist & hip circ)
Weighing scales, tape measures, rulers, BP machines
STEP 3 Biochem tests
(FBS, total chol
Accutrend plus machines
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Results
Age group (yrs)
Males Females Both sexes
n % n % n %
25-34 719 30.8 1616 69.2 2335 44.9
35-44 459 34.7 862 65.3 1321 25.4
45-54 296 32.8 604 67.1 902 17.3
55-64 216 33.2 434 66.8 650 12.5
25-64 1,690 32.5 3,516 67.5 5,206 100.0
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Magnitude of selected NCDs by Gender
NCD Prevalence(%)
Males Females Both sexes
Hypertension (HT) 38.0* 28.8 31.6
Diabetes 6.6 4.8 5.3
Raised cholesterol 7.0 11.3* 10.0
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Magnitude of selected NCDs by Urban/Rural
NCD Prevalence(%)
Urban Rural Both
High Blood pressure 27.9 32.0 31.6
Diabetes 7.4 9.2 5.3
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NCD risk factors by Gender
Risk factor Prevalence (%)
Males Females Both
Tobacco smoking 26.3* 2.9 10.4
Alcohol 30.3* 4.1 12.6
Heavy drinking 19.2* 2.3 7.8
Physical inactivity 6.4 12.6* 10.6
Overweight 16.1 28.0* 23.9
≥3 risk factors 18.0 15.4 16.2
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NCD risk factors by Urban/Rural
Risk factor Prevalence (%)
Urban Rural Both
Tobacco smoking 6.6 10.9* 10.4
Alcohol 13.4 12.5 12.6
Physical inactivity 24.1* 8.7 10.6
Overweight 38.6* 21.9 23.9
≥3 risk factors 22.6 15.5 16.2
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People with or at risk of NCDs (N=4,561,430; 2008 census)
% No. of people
High BP 31.6 1,459,658
Diabetes 5.3 241,756
High Cholesterol 10.0 456,143
Tobacco smokers 10.4 638,600
Alcohol drinkers 12.6 574,740
Overweight 23.9 1,090,182
≥3 NCD risk factors 16.2 738,951
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Conclusion
• NCDs & their risk factors are major public health problems in Malawi
• Majority (94.4%) of people with high blood pressure and diabetes do not know that they have a problem
• Thus what we are seeing at health facilities is only 6% of people with High blood pressure and or diabetes.
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Proposed way forward
• There is need to establish NCD control programme
• There is need to develop multi-sectoral comprehensive Plan of Action & policies for NCDs
• There is need to allocate resources for NCDs within and or outside SWAp
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Proposed way forward cont…
• There is need to support and or strengthen the existing efforts such as:
– Age limit for alcohol drinking,– Drinking and driving– Opening and closing hours for alcohol selling– Taxation on alcohol
– Age limit for tobacco smoking– Ban on public smoking and workplaces– Taxation on cigarettes & other tobacco products– Consider ban on tobacco advertising, promotion &
sponsorship
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Acknowledgments
• MoH- Clinical Department
• WHO
• Data collectors
• DHOs
• HSAs
• Chiefs
• Participants
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Prevalence of NCDs & their risk factors in some countries in the region
% MW MZ ZWE BTW
Tobacco 10.4 18.7 11.8 19.5
Alcohol 12.6 77.2 24.5 27.4
Obesity 5.5 7.1 14.1 15.7
EBP 31.6 33.1 17.9 32.11
EBS 5.3 1.4 2.4 19.5