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Background: Non-communicable diseases (NCDs) are an important problem in South Africa; they account for 60% of all deaths. Early screening could help lower NCD incidences and long-term consequences.Objective: The study aimed to profile NCD risk factors among insourced support staff at the University of Pretoria in 2018.Design: A cross-sectional, descriptive study was conducted at the University of Pretoria, Hatfield Campus. The World Health Organization (WHO) STEPwise approach to chronic disease risk factor surveillance (STEPS) questionnaire was administered to collect data in three steps. The participants’ behavioural risk profiles were gathered using the face-to-face interview technique (STEP I), followed by their physical risk profile using anthropometric and blood pressure measurements (STEP II). Last was the biochemical risk profile, including finger-prick blood glucose and cholesterol measurement (STEP III). Data were analysed using Epi-Info, version 3.54.Subjects: A convenient sample of participants aged 18–64 years from the Departments of Industrial Hygiene and Building Services, Landscape Services, Sports Fields Management, and Security Services (n = 146, 60% were females) took part in the study.Results: Most participants (97.8%) had low daily fruit and vegetable intake. Some 80% of the study population always or often added salt to their food when cooking. Daily alcohol consumption was reported by a quarter of the sample. More than two-thirds of all the participants were overweight or obese and 61% had central obesity.Conclusion: The study identified a high prevalence of several NCD risk factors. Tailored nutrition education and monitoring are needed to lower the elevated risk.

Background: Non-communicable diseases (NCDs) are an important problem in South Africa; they account for 60% of all deaths. Early screening could help lower NCD incidences and long-term consequences. Objective: The study aimed to profile NCD risk factors among insourced support staff at the University of Pretoria in 2018. Design: A cross-sectional, descriptive study was conducted at the University of Pretoria, Hatfield Campus. The World Health Organization (WHO) STEPwise approach to chronic disease risk factor surveillance (STEPS) questionnaire was administered to collect data in three steps. The participants' behavioural risk profiles were gathered using the face-to-face interview technique (STEP I), followed by their physical risk profile using anthropometric and blood pressure measurements (STEP II). Last was the biochemical risk profile, including finger-prick blood glucose and cholesterol measurement (STEP III). Data were analysed using Epi-Info, version 3.54. Subjects: A convenient sample of participants aged 18–64 years from the Departments of Industrial Hygiene and Building Services, Landscape Services, Sports Fields Management, and Security Services (n = 146, 60% were females) took part in the study. Results: Most participants (97.8%) had low daily fruit and vegetable intake. Some 80% of the study population always or often added salt to their food when cooking. Daily alcohol consumption was reported by a quarter of the sample. More than two-thirds of all the participants were overweight or obese and 61% had central obesity. Conclusion: The study identified a high prevalence of several NCD risk factors. Tailored nutrition education and monitoring are needed to lower the elevated risk. [ABSTRACT FROM AUTHOR]

Introduction: The World Health Organization (WHO) 2030 agenda for Sustainable Development Goals (SDGs target 3.4) identifies non-communicable diseases (NCDs) as a key challenge for sustainable development. As one of the major NCD risks, here, we estimated the prevalence of overweight/obesity in adults and assessed country-economic variations using meta-analysis. Methods: The latest STEPwise approach to NCD risk factor surveillance (STEPS) report of WHO member states studied on overweight/obesity from 2000 to 2020 were reviewed and related data were assessed further. The prevalence of overweight/obesity was pooled using the random effects model. The subgroup analysis and meta-regression were performed based on countries’ economic status obtained from the World Bank’s country development index 2019. Study heterogeneity and publication bias were also observed. Results: Out of 73 studies with 469,766 participants analyzed, the highest overweight/obesity prevalence was found in American Samoa (93.5 %), while Democratic People’s Republic of Korea had the lowest prevalence (4.4 %). The overall weighted pooled prevalence of overweight/obesity regardless of countries economic status was 37.0 % [95 % CI: 33 %-42 %]. There was significant heterogeneity in the prevalence of overweight/obesity (I2 = 99.91 %; p

Abstract Background Obesity and dyslipidemia are important risk factors for hypertension (HTN). When these two conditions coexist, they may interact in a synergistic manner and increase the risk of developing HTN and its associated complications. The aim of this study was to investigate the synergistic effect of general and central obesity with dyslipidemia on the risk of HTN. Method Data from 40,387 individuals aged 25 to 64 years were obtained from a repeated cross-sectional study examining risk factors for non-communicable diseases (STEPS) in 2007, 2011 and 2016. Body mass index (BMI) was calculated as a measure of general obesity and waist circumference (WC) as a measure of central obesity. Dyslipidemia was defined as the presence of at least one of the lipid abnormalities. Hypertension was defined as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or current use of antihypertensive medication. To analyze the synergistic effect between obesity and dyslipidemia and HTN, the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI) were calculated. A weighted logistic regression model was performed to estimate the odds ratios (ORs) for the risk of HTN. Results The results showed an association between obesity, dyslipidemia and hypertension. The interaction between obesity and dyslipidemia significantly influences the risk of hypertension. In hypertensive patients, the presence of general obesity increased from 14.55% without dyslipidemia to 64.36% with dyslipidemia, while central obesity increased from 13.27 to 58.88%. This interaction is quantified by RERI and AP values of 0.15 and 0.06 for general obesity and 0.24 and 0.09 for central obesity, respectively. The corresponding SI of 1.11 and 1.16 indicate a synergistic effect. The OR also show that the risk of hypertension is increased in the presence of obesity and dyslipidemia. Conclusion Obesity and dyslipidemia are risk factors for HTN. In addition, dyslipidemia with central obesity increases the risk of HTN and has a synergistic interaction effect on HTN. Therefore, the coexistence of obesity and lipid abnormalities has many clinical implications and should be appropriately monitored and evaluated in the management of HTN.

Background: Obesity and dyslipidemia are important risk factors for hypertension (HTN). When these two conditions coexist, they may interact in a synergistic manner and increase the risk of developing HTN and its associated complications. The aim of this study was to investigate the synergistic effect of general and central obesity with dyslipidemia on the risk of HTN. Method: Data from 40,387 individuals aged 25 to 64 years were obtained from a repeated cross-sectional study examining risk factors for non-communicable diseases (STEPS) in 2007, 2011 and 2016. Body mass index (BMI) was calculated as a measure of general obesity and waist circumference (WC) as a measure of central obesity. Dyslipidemia was defined as the presence of at least one of the lipid abnormalities. Hypertension was defined as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or current use of antihypertensive medication. To analyze the synergistic effect between obesity and dyslipidemia and HTN, the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI) were calculated. A weighted logistic regression model was performed to estimate the odds ratios (ORs) for the risk of HTN. Results: The results showed an association between obesity, dyslipidemia and hypertension. The interaction between obesity and dyslipidemia significantly influences the risk of hypertension. In hypertensive patients, the presence of general obesity increased from 14.55% without dyslipidemia to 64.36% with dyslipidemia, while central obesity increased from 13.27 to 58.88%. This interaction is quantified by RERI and AP values of 0.15 and 0.06 for general obesity and 0.24 and 0.09 for central obesity, respectively. The corresponding SI of 1.11 and 1.16 indicate a synergistic effect. The OR also show that the risk of hypertension is increased in the presence of obesity and dyslipidemia. Conclusion: Obesity and dyslipidemia are risk factors for HTN. In addition, dyslipidemia with central obesity increases the risk of HTN and has a synergistic interaction effect on HTN. Therefore, the coexistence of obesity and lipid abnormalities has many clinical implications and should be appropriately monitored and evaluated in the management of HTN. [ABSTRACT FROM AUTHOR]

Aim: To analyze the data from the World Health Organization Nepal STEPS survey 2013 to determine the prevalence of total and domain-specific physical activity (PA) and associated factors among Nepalese adults. Methods: A multistage cluster sampling technique was used to proportionately select participants from the 3 ecological zones (Mountain, Hill, and Terai) in Nepal. The Global PA Questionnaire was used to assess PA. The data were analyzed using quantile and ordinary least square regression. Results: Only 4% of the adults did not meet the World Health Organization PA guidelines. Age had a negative monotonic association with total PA and occupational PA, with the highest difference at the upper tails of the PA distribution. Lower total PA and occupational PA were associated with secondary or higher education, being retired or in unpaid employment, living in Terai or urban areas, and nonsmoking. Age, higher education, unpaid employment, and Terai or urban residence were negatively associated, while being currently married was positively associated with transport-related PA. Conclusion: Increasing age, higher education, unpaid employment, unemployment or retirement, and urban residence were associated with lower PA, with the stronger association at the upper tails of the distribution. The correlates had dissimilar associations across the quantiles of PA distribution. [ABSTRACT FROM AUTHOR]

Background: Some years ago, chronic diseases were considered to be a problem for the wealthy and elderly population. Today, chronic conditions affect the poor, young, and middle-aged people in high-income countries. The global prevalence of diabetes mellitus (DM) has been continuously growing for over half a century and has reached pandemic proportions. In the present study, we aimed to estimate the trends in prediabetes and DM prevalence and to determine related risk factors among Kosovo people from 2011 to 2019. Methods and Results: A population-based survey was conducted among people aged 18-69 from April 2018 to June 2019 and those aged 15-64 using the WHO STEPs instrument. Detailed findings on the magnitude of DM and impaired fasting blood glucose (FBG) are presented in this paper. Prevalence of prediabetes in 2011 at 15-64 years was 6.0% (95% CI, 4.6% - 7.9%), and in 2019 at 18-69 years was 6.1% (95% CI, 5.3% - 7.1%), not a significant difference (P>0.05). To avoid bias from different ages, we compared prevalence by age groups. Only in the age group of 35-44 we found a significant difference in the prevalence of prediabetes. In this age group, the prevalence of prediabetes was 2.4% (95% CI, 0.9%-6.1%) in 2011 and 2.7% (95%CI, 0.9%-6.1%) in 2019. In 2019, the prevalence of prediabetes was higher among males than in 2011, when females prevailed. Prevalence of DM in 2011 at 15-64 years was 7.7% (95% CI, 6.0% - 9.7%), and in 2019 at 18 – 69 years was 7.9% (95% CI, 6.9% - 9.0%), not a significant difference (P>0.05). In the age groups of 45-54 and 55-64, we found a significant difference in the prevalence of DM by years. The prevalence of DM at 45-54 years was 13.5% (95% CI, 9.2% - 19.5%) in 2011 and 7.8% (95%CI, 6.0%-10.2%) in 2019 (P=0.032). The prevalence of DM at 55-54 years was 21.6% (95% CI, 15.8% - 28.9%) in 2011 and 13.2% (95%CI, 10.6%-16.3%) in 2019 (P=0.015). The prevalence of DM was higher among females in 2011 and 2019. Conclusion: Results from 2 STEPS in Kosovo show that we have no significant increase in the prevalence of prediabetes and DM in total. At the same time, we found a significant decrease in DM in the age group 45-64.

Purpose: Hypercholesterolemia is a major risk factor for a wide range of cardiovascular diseases. Developing countries are more susceptible to hypercholesterolemia and its complications due to the increasing prevalence and the lack of adequate resources for conducting screening and/or prevention programs. Using machine learning techniques to identify factors contributing to hypercholesterolemia and developing predictive models can help early detection of hypercholesterolemia, especially in developing countries. Methods: Data from the nationwide 2016 STEPs study in Iran were used to identify socioeconomic, lifestyle, and metabolic risk factors associated with hypercholesterolemia. Furthermore, the predictive power of the identified risk factors was assessed using five commonly used machine learning algorithms (random forest; gradient boosting; support vector machine; logistic regression; artificial neural network) and 10-fold cross validation in terms of specificity, sensitivity, and the area under the receiver operating characteristic curve. Results: A total of 14,667 individuals were included in this study, of those 12.8% (n = 1879) had (undiagnosed) hypercholesterolemia. Based on multivariate logistic regression analysis the five most important risk factors for hypercholesterolemia were: older age (for the elderly group: OR = 2.243; for the middle-aged group: OR = 1.869), obesity-related factors including high BMI status (morbidly obese: OR = 1.884; obese: OR = 1.499; overweight: OR = 1.426) and AO (OR = 1.339), raised BP (hypertension: OR = 1.729; prehypertension: OR = 1.577), consuming fish once or twice per week (OR = 1.261), and having risky diet (OR = 1.163). Furthermore, all the five hypercholesterolemia prediction models achieved AUC around 0.62, and models based on random forest (AUC = 0.6282; specificity = 65.14%; sensitivity = 60.51%) and gradient boosting (AUC = 0.6263; specificity = 64.11%; sensitivity = 61.15%) had the optimal performance. Conclusion: The study shows that socioeconomic inequalities, unhealthy lifestyle, and metabolic syndrome (including obesity and hypertension) are significant predictors of hypercholesterolemia. Therefore controlling these factors is necessary to reduce the burden of hypercholesterolemia. Furthermore, machine learning algorithms such as random forest and gradient boosting can be employed for hypercholesterolemia screening and its timely diagnosis. Applying deep learning algorithms as well as techniques for handling the class overlap problem seems necessary to improve the performance of the models. [ABSTRACT FROM AUTHOR]

ObjectiveThe study aimed to evaluate the prevalence and correlates of sedentary behavior and combination of sedentary behavior and low physical activity among adults in Afghanistan in 2018.MethodsThis was a national representative cross-sectional study. The study utilized the data from Afghanistan STEPS survey 2018, where 3,956 adults (ages between 18 and 69 years) were interviewed at community-dwelling level. Using the Global Physical Activity Questionnaire, we have calculated the sedentary behavior and physical inactivity. Logistic regression was applied to investigate factors associated high sedentary behavior and low physical activity.ResultsApproximately half of the participants (49.8%) exhibited high levels of sedentary behavior, 40.3% low physical activity and 23.5% had both high sedentary behavior and low physical activity. Adjusted logistic regression analysis revealed that individuals who were employed (AOR: 0.34, 95% CI: 0.13–0.88) or self-employed (AOR: 0.60, 95% CI: 0.38–0.94) had significantly lower odds of both high SB and low physical activity than those whose work status was unpaid. Furthermore, older age (AOR: 1.75, 95% CI: 1.35–2.28), urban residence (AOR: 3.17, 95% CI: 1.72–6.05), having 4 or 5 adult household members (AOR: 1.77, 95% CI: 1.21–2.58) and being underweight (AOR: 1.78, 95% CI: 1.02–3.12) were found to be associated with high sedentary behavior. Moreover, factors such as female sex, having 4 or 5 or 6 or more adult household members, urban residence, overweight, and diabetes were positively associated, and male sex (AOR: 0.24, 95% CI: 0.12–0.51), being employed (AOR: 0.34, 95% CI: 0.13–0.88) or self-employed (AOR: 0.60, 95% CI: 0.38–0.94) were negatively associated with the occurrence of combination of high sedentary behavior and low physical activity.ConclusionHalf of the participants had high sedentary behavior, and one in four had both high sedentary behavior and low physical activity together. These findings emphasize the importance of targeted interventions aimed at reducing sedentary behavior and promoting physical activity, particularly among vulnerable populations such as females, individuals from lower socioeconomic background, urban residents, and those with chronic conditions. Addressing these factors can contribute to improving public health outcomes and reducing negative health impacts of sedentary behavior in Afghanistan.

BackgroundUnderstanding national trends in risk factors of noncommunicable diseases (NCDs) may have health policy implications. The aim of the study was to assess the prevalence and social and demographic factors associated with risk factors of NCDs in adults from 2008 to 2019 in Sao Tome and Principe.MethodsIn repeat cross-sectional national STEPS surveys 2,457 adults (median age 37 years) in 2008 and 1,893 adults (median age 38 years) in 2019 in Sao Tome and Principe responded to structured interviews, physical and biochemical measures. Logistic regressions were applied to estimate predictors of NCD risk factors.ResultsHaving three to seven NCD risk factors significantly decreased among men but not women from 36.6% in 2008 to 26.8% in 2019. The proportion of specific risk factors of NCD increased significantly for low physical activity from 17.4% in 2008 to 30.9% in 2019, and overweight/obesity from 37.3% in 2008 to 51.0% in 2019. Insufficient fruit/vegetable consumption decreased from 83.1% in 2008 to 53.3% in 2019, frequent alcohol use from 32.6% in 2008 to 24.8% in 2019, and diabetes from 3.1% in 2008 to 1.2% in 2019, while the proportion of current tobacco use and hypertension remained unchanged from 2008 to 2019. Men engaged more often than women in current tobacco use and frequent alcohol use, and women had higher rates of low physical activity and overweight/obesity than men. Higher educational levels were positively associated with overweight/obesity, and inversely associated with frequent alcohol use and inadequate fruit/vegetable intake.ConclusionBetween 2008 and 2019, the prevalence of seven risk factors for NCDs in Sao Tome and Principe declined among men, but not among women. Several associated variables have been identified for each individual risk factor of NCD that may help guide interventions.

Pedro Pallangyo,1,2 Makrina Komba,1 Zabella S Mkojera,1 Henry A Mayala,3 Smita V Bhalia,2 Jalack Millinga,4 Salma Wibonela,4 Gudila Swai,4 Dickson A Minja,3 Mohamed Janabi2 1Department of Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania; 2Department of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania; 3Department of Clinical Support Services, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania; 4Department of Nursing, Jakaya Kikwete Cardiac Institute, Dar es Salaam, TanzaniaCorrespondence: Pedro Pallangyo, Email pedro.pallangyo@gmail.comBackground: Notwithstanding the ever-present burden of infectious diseases, the sub-Saharan Africa (SSA) region has experienced a 67% rise in the non-communicable disease (NCD) burden in less than three decades. Furthermore, regardless of the increased recognition of NCDs threat in the region, reliable local estimates and associated drivers are generally lacking. We therefore conducted this cross-sectional study to establish the pattern and correlates of the modifiable NCD risk factors among caregivers of patients attending a tertiary cardiovascular centre in Tanzania.Methods: A cross-sectional survey was conducted at Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania. We used a structured questionnaire bearing a modified WHO STEPwise Approach to NCD Risk Factor Surveillance (STEPS) tool to explore the modifiable behavioral and modifiable biological NCD risk factors.Results: A total of 1063 caregivers were enrolled in this study. The mean age was 40.5 years, and 55.7% were female. Nearly 80% of participants had a good knowledge regarding NCDs and 85.4% had a positive family history of NCDs. Overall, 1027 (96.6%) participants had at least one modifiable NCD risk factor while 510 (48.0%) had three or more (i.e., clustering). With respect to modifiable behavioral NCD risk factors, 34 (3.2%) were tobacco users, 56 (5.3%) had harmful alcohol consumption, 691 (65%) had unhealthy eating behavior, and 820 (77.1%) were physically inactive. Pertaining to modifiable biological NCD risk factors, 710 (66.8%) had excess body weight, 420 (39.5%) had hypertension and 62 (5.8%) were diabetic.Conclusion: A vast majority of caregivers of NCD patients in this tertiary setting were found to have modifiable NCD risk factors with a strong tendency of clustering. These findings call for intensification of both population strategies and targeted group interventions for better control of the NCD threat and its correlates.Keywords: STEPS survey, modifiable NCD risk factors, behavioral risks, biological risks, clustering

Background: Hyperglycemia is rising globally and its associated complications impose heavy health and economic burden on the countries. Developing effective survey-based screening tools for hyperglycemia using reliable surveillance data, such as the WHO STEPs surveys, would be of great importance in early detection and/or prevention of hyperglycemia, especially in low or middle-income regions. Methods: In this study, data from the nationwide 2016 STEPs study in Iran were used to identify socioeconomic, lifestyle, and metabolic factors associated with hyperglycemia. Furthermore, the ability of five commonly used machine learning algorithms (random forest; gradient boosting; support vector machine; logistic regression; artificial neural network) in the prediction of hyperglycemia on STEPs dataset were compared via tenfold cross validation in terms of specificity, sensitivity, and the area under the receiver operating characteristic curve. Results: A total of 17,705 individuals were included in this study, of those 29.624% (n = 5245) had (undiagnosed) hyperglycemia. Multivariate logistic regression analysis showed that older age (for the elderly group: OR = 5.096; for the middle-aged group: OR = 2.784), high BMI status (morbidly obese: OR = 3.465; obese: OR = 1.992), having hypertension (OR = 1.647), consuming fish more than twice per week (OR = 1.496), and abdominal obesity (OR = 1.464) were the five most important risk factors for hyperglycemia. Furthermore, all the five hyperglycemia prediction models achieved AUC around 0.70, and logistic regression (specificity = 70.22%; sensitivity = 70.2%) and random forest (specificity = 70.75%; sensitivity = 69.78%) had the optimal performance. Conclusions: This study shows that it is possible to develop survey-based screening tools for early detection of hyperglycemia using data from nationwide surveys, such as WHO STEPs surveys, and machine learning techniques, such as random forest and logistic regression, without using blood tests. Such screening tools can potentially improve hyperglycemia control, especially in low or middle-income countries. [ABSTRACT FROM AUTHOR]

Objective: To determine the trends in the prevalence of non-communicable diseases associated risk factors and implications for policies and strategies. Background: Non-Communicable Diseases (NCDs) contribute increasingly to disease burden in Nepal. The main drivers to this situation are the NCD related risk factors; and to determine their prevalence the Nepal Ministry of Health and Population conducted WHO Stepwise Approach to NCD Risk Factor Surveillance (STEPS) surveys in 2007, 2012 and 2019. This paper, by using results of STEPS surveys, explores the trends of NCD related risk factors and their implications for policies and strategies. Methods: This paper relies on the desk review of literature and secondary data, collected from the unpublished grey literature, mainly reports of the STEPS surveys. In addition, to corroborate findings, the evidence and experience from other countries available as published literature was brought. The data were analysed manually. Findings: Overall, during the period from first survey in 2007 to the last survey in 2019, there has been an increasing prevalence of NCDs associated lifestyle and behavioural, physical, and biochemical risk factors. Taking cognisance of these, several policies, and strategic documents, some of which generic, while others targeting the specific risk factors were produced. However, indicators and techniques used, across three STEPS surveys, were not consistent, thus limiting the comparison and analysis of data. Conclusions: The study concludes that different STEPS surveys did not use standard set of indicators and techniques. Yet, an increased prevalence of NCDs associated risk factors was noted. Several policies and strategic documents, generic as well as specific, were produced. But there is a need to define methodology, as to how results feed into the framing of policies and strategic, and their impact is monitored. [ABSTRACT FROM AUTHOR]

Arterial hypertension and diabetes mellitus are the most common non-communicable diseases in the world today imposing a heavy global burden on the healthcare systems. The objective of this study is to determine the prevalence of comorbid hypertension and diabetes, and its associated risk factors among Algerian population. This is a descriptive cross-sectional epidemiological study involving adults who were selected from NCDs risk factors STEPS Survey, conducted in Algeria. Differences in prevalence between hypertensives, diabetics and simultaneously hypertensive and diabetic patients were assessed using the chi-square test. We also looked at the role of demographic, socioeconomic, geographic and lifestyle factors of individuals' hypertensive/diabetic status using a logistic regression model. The median age was 52 years (IQR = 18). Whereas 52.0 % (CI: 49.2-54.8) of the sample had only hypertension, 21.7 % (CI: 19.2-24.0) had diabetes without hypertension and 26.3 % (CI: 23.8-29.1) had both diseases. The factors strongly associated with comorbid hypertension and diabetes includes elderly age group, obesity, marital status, and physical activity. Hypertension and diabetes are highly prevalent in Algeria. This emphasizes the role of the urgent quantification and monitoring of their risk factors, to plan appropriate preventive measures, to curb heavy burden of NCDs. [ABSTRACT FROM AUTHOR]

Introduction: The World Health Organization (WHO) 2030 agenda for Sustainable Development Goals (SDGs target 3.4) identifies non-communicable diseases (NCDs) as a key challenge for sustainable development. As one of the major NCD risks, here, we estimated the prevalence of overweight/obesity in adults and assessed country-economic variations using meta -analysis., Methods: The latest STEPwise approach to NCD risk factor surveillance (STEPS) report of WHO member states studied on overweight/obesity from 2000 to 2020 were reviewed and related data were assessed further. The prevalence of overweight/obesity was pooled using the random effects model. The subgroup analysis and meta -regression were performed based on countries' economic status obtained from the World Bank's country development index 2019. Study heterogeneity and publication bias were also observed., Results: Out of 73 studies with 469,766 participants analyzed, the highest overweight/obesity prevalence was found in American Samoa (93.5 %), while Democratic People's Republic of Korea had the lowest prevalence (4.4 %). The overall weighted pooled prevalence of overweight/obesity regardless of countries economic status was 37.0 % [95 % CI: 33 %-42 %]. There was significant heterogeneity in the prevalence of overweight/obesity (I2 = 99.91 %; p < 0.001). Subgroup analysis revealed a higher prevalence in high-income countries [60 %; 95 % CI: 47 %-72 %]. Meta-regression revealed a significant (p = 0.001) association and a 14 % increase chance of having overweight/obesity with increasing economic status., Conclusion: The prevalence of overweight/obesity is high worldwide, especially in high-income countries that demands a large-scale awareness campaigns and effective initiatives to control overweight/obesity and the associated risk factors of adults of these countries., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Abstract Background The promotion of a physically active lifestyle might help address the increasing burden of non-communicable diseases in Nepal. However, there is a lack of nationally representative estimates of physical activity (PA) prevalence in Nepal. The aim of this nationwide cross-sectional study was to determine domain-specific PA levels and the association of socio-demographic and lifestyle characteristics with total PA among Nepalese adults aged 15–69 years. Methods The data were collected using self-administered questionnaires in a nationally representative sample of 4143 adults (66.5% females), comprised of both rural and urban populations in Nepal. PA levels were assessed using the Global Physical Activity Questionnaire (GPAQ). Results Based on self-reported estimates, around 97% (95% confidence interval [CI]: 96–98%) of men and 98% (95% CI: 98–99%) of women were found to meet the recommended levels of PA. Both men and women reported high occupational PA, whilst most participants of both sexes did not report engaging in any leisure-time PA. A multiple regression analysis showed that less self-reported total PA was associated with older age, higher level of education, urban place of residence, never been married, being underweight, and smoking in both sexes and with overweight and obesity in males (p

Abstract Background Non-communicable diseases (NCDs), particularly cardiovascular diseases, diabetes, respiratory conditions and cancers, are the most common causes of morbidity and mortality globally. Information on the prevalence estimates of NCD risk factors such as smoking, low fruit & vegetable intake, physical inactivity, raised blood pressure, overweight, obesity and abnormal blood lipid are scarce in Somaliland. The aim of this study was to determine the prevalence of these selected risk factors for NCDs among 20–69 year old women and men in Hargeisa, Somaliland. Methods A cross-sectional study was conducted in five districts of Hargeisa (Somaliland), using the STEPwise approach to noncommunicable disease risk factor surveillance (STEPS) to collect data on demographic and behavioral characteristics and physical measurements (n = 1100). The STEPS approach is a standardized method for collecting, analysing and disseminating data on NCD risk factor burden. Fasting blood sugar, serum lipids (total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides) were collected in half of the participants. Results The vast majority of participants had ≤1 serving of fruits daily (97.7%) and ≤ 1 serving of vegetables daily (98.2%). The proportion of participants with low physical activity levels was 78.4%. The overall prevalence of high salt intake was 18.5%. The prevalence of smoking and khat chewing among men was 27 and 37% respectively, and negligible among women. In women, the prevalence of hypertension increased from 15% in the age group 20–34 years to 67% in the age group 50–69 years, the prevalence of overweight and obesity (BMI ≥ 25 kg/m2) from 51 to 73%, and the prevalence of diabetes from 3 to 22%. Similar age-trends were seen in men. Conclusion Most of the selected risk factors for noncommunicable diseases were high and increased by age in both women and men. Overweight and obesity and low physical activity needs intervention in women, while hypertension and low fruit and vegetable consumption needs intervention in both men and women. Somaliland health authorities should develop and/or strengthen health services that can help in treating persons with hypertension and hyperlipidaemia, and prevent a future burden of NCDs resulting from a high prevalence of NCD risk factors.

Abstract Background A non-communicable disease risk factor survey (based on World Health Organization STEP approach to Surveillance, i.e., WHO-STEPS) was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals. The study subjects were administered the WHO STEPS questionnaire and also underwent anthropometric and biochemical measurements. This study aimed at exploring the risk factors of diabetes using a Structural Equation Modeling (SEM) approach in the North Indian state of Punjab. Results Overall prevalence of diabetes mellitus among the study participants was found out to be 8.3% (95% CI 7.3–9.4%). The final SEM had excellent fit considering the model parameters. The following risk factors deemed to have a direct statistically significant effect on blood sugar status: family history of diabetes (4.5), urban residence (3.1), triglycerides (0.46), increasing waist circumference (0.18), systolic blood pressure (0.11), and increasing age (0.05). There are specific indirect effects of alcohol use (1.43, p = 0.001), family h/o diabetes (0.844, p = 0.001), age (0.156, p

Non-communicable diseases (NCDs) are a major global health problem. The objective of the study was to estimate the prevalence of common risk factors for NCDs in Lebanon, both among the Lebanese population and Syrian refugees, aged 18–69 years, residing in communities. Two national cross-sectional surveys using a two-stage cluster sampling design were conducted among the Lebanese and Syrian refugee adults. We used the World Health Organization (WHO) STEPwise approach through questionnaire assessment and physical and biochemical measurements. All reported results were weighted to provide prevalence estimates at the population level. A total of 1899 Lebanese and 2134 Syrians adults participated in the survey. More than one-third of participants were current smokers at the time of the assessment, and 23% of Lebanese participants were current drinkers (almost all Syrian refugees were lifetime abstainers). Vegetable and fruit consumption was rated moderately low, in 73% and 93% of Lebanese and Syrian refugees, respectively. Many respondents did not meet WHO recommendations on physical activity. More than one-third of participants had raised blood pressure or were on antihypertensive medications. One in 10 participants had either raised blood glucose level or were currently on glycemic control medications. For all risk factors and in both samples, women consistently had lower prevalence of NCD risk factors. Prevalence of risk factors for NCDs is high in Lebanon, and given the recent rise in population size, the financial and social burden of NCDs will grow dramatically in the next years. The results highlight the need for interventions to address behavioral changes, including reduction in smoking, improvement of dietary habits, optimization of management of diabetes and cardiovascular diseases, and conducting continuous surveillance to monitor the trends in NCD prevalence, their risk factors, and treatments. • The study estimated the prevalence of non-communicable disease (NCD) risk factors among Lebanese and Syrians. • Prevalence of risk factors for NCDs is high in Lebanon. • For all risk factors, women consistently had lower prevalence of NCD risk factors. • The 10-year cardiovascular disease risk was 8.2% for Lebanese and 9.7% for Syrians aged 40–69 years. • The financial and social burden of NCDs will grow dramatically in the next years. [ABSTRACT FROM AUTHOR]

Background and Aim: Type 2 diabetes mellitus (T2DM) is emerging as a significant public health challenge in Nepal. Behavioural, social and economic changes are likely to play a part in the rise of this chronic disease, as they are in many developing countries. A better understanding of the relationship between physical activity (PA), socioeconomic factors and T2DM can inform the design of prevention programs. This study aimed to identify the path relationships between PA, socioeconomic position, anthropometric and metabolic variables and T2DM.Methods and Results: This study analysed data from 1977 Nepalese adults aged 40-69 years from the cross-sectional WHO STEPS survey undertaken in 2013. The latent variable "PA" was created using the information on domains of PA while the latent variable "socioeconomic position" was created using the variables education, occupation and ethnicity. Participants' fasting blood glucose was used to determine their diabetes status. Structural equation modelling was conducted, and correlations and adjusted regression coefficients are reported. Individuals with higher education, in paid employment and from advantaged ethnic groups were more likely to have T2DM. Waist circumference, triglycerides and hypertension were found to have a statistically significant positive direct effect on T2DM. PA had indirect effects on T2DM, mediated by waist circumference. The indirect effects of socioeconomic position on T2DM were mediated by body mass index, waist circumference, triglycerides and total cholesterol.Conclusion: Among Nepalese adults, higher socioeconomic position had a significant direct effect on T2DM, while both PA and higher socioeconomic position had significant indirect effects. Policies and programs to address T2DM in Nepal should address the factors contributing to unhealthy weight status, particularly among those of higher socioeconomic status. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to analyze the extent of major noncommunicable diseases and their common risk factors in Burkina Faso. Materials and Methods: It was an analysis based on secondary data from the 2013 national STEPS survey in Burkina Faso. The analysis conducted in 2018 concerned behavioral risk factors and metabolic factors. A multiple regression model was used to determine the independent factors associated with these diseases. Results: The independent variables associated with behavioral risk factors were 1) young age(OR=0, 4423; p< 0,001) and males(OR=0,0030 ; p< 0,001) for smoking, 2) older age (OR= 2,01 ; p= 0,0066 and OR=2,18 ; p< 0,001) and males(OR=2,18 ; p< 0,001) for drinking and harmful use of alcohol, and 3) young age(OR=0,34 ; p< 0,001) and the urban environment(OR=1,57 ; p= 0,0236) for physical inactivity. The independent variables associated with metabolic risk factors were 1) young age (OR=1,33 ; p= 0,0295) and urban (OR=0,31 ; p<0,001) for overweight, 2) female (OR=2,55 ; p= 0,0010) and urban (OR= 0,13; p< 0,001) for obesity, and 3) advanced age (OR=2,49 ; p< 0,001and OR= 2,12 ; p= 0,0115), and urban setting (OR=0,47 ; p< 0,001 and OR= 0,49 ;p= 0,0320) for high blood pressure and diabetes. Conclusion: In Burkina Faso, prevention and health promotion actions to reduce these risk factors need to be stepped up with a multi-sectoral approach. [ABSTRACT FROM AUTHOR]

Abstract Background The rising morbidity and mortality due to non-communicable diseases can be partly attributed to the urbanized lifestyle leading to unhealthy dietary practices and increasing physical levels of inactivity. The demographic and nutrition transition in India has also contributed to the emerging epidemic of non-communicable diseases in this country. In this context, there is limited information in India on dietary patterns, levels of physical activity and obesity. The aim of the present study was thus to assess the urban rural differences in dietary habits, physical activity and obesity in India. Methods A household survey was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals using the WHO STEPS questionnaire. Results No rural urban difference was found in dietary practices and prevalence of overweight and obesity except the fact that a significantly higher proportion of respondents belonging to rural area (15.6 %) always/often add salt before/when eating as compared to urban area (9.1 %). Overall 95.8 % (94.6–97.0) of participants took less than 5 servings of fruits and/or vegetables on average per day. No significant urban rural difference was noted in both sexes in all three domains of physical activity such as work, transport and recreation. However, rural females (19.1 %) were found to be engaged in vigorous activity more than the urban females (6.3 %). Males reported high levels of physical activity in both the settings. Absence of recreational activity was reported by more than 95 % of the subjects. Higher prevalence of obesity (asian cut offs used) was seen among urban females (34.3 %) as compared to their rural counterparts (23.2 %). Abdominal obesity was found to be significantly higher among females in both the settings compared to males (p

Aims: India is the diabetes capital with home to 69.1 million people with DM, the second highest number of cases after China. Recent epidemiological evidence indicates a rising DM epidemic across all classes, both affluent and the poor in India. This article reports on the prevalence of diabetes and pre-diabetes in the North Indian state of Punjab as part of a large household NCD Risk Factor Survey. Methods: A household NCD STEPS survey was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals. All the subjects were administered the WHO STEPS questionnaire, anthropometric and blood pressure measurements. Every alternate respondent in the sample (n = 2499) was assayed for blood parameters. Results: Overall prevalence of DM among the study participants was found out to be 8.3% (95% CI 7.3-9.4%) whereas prevalence of prediabetes was 6.3% (5.4-7.3%). Age group (45-69 years), marital status, hypertension, obesity and family history of DM were found to be the risk factors significantly associated with DM. Out of all persons with DM, only 18% were known case of DM or on treatment, among whom only about one-third had controlled blood glucose status. Conclusions: The study reported high prevalence of diabetes, especially of undiagnosed cases amongst the adult population, most of whom have uncontrolled blood sugar levels. This indicates the need for systematic screening and awareness program to identify the undiagnosed cases in the community and offer early treatment and regular follow up. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to evaluate the prevalence and correlates of sedentary behavior and combination of sedentary behavior and low physical activity among adults in Afghanistan in 2018., Methods: This was a national representative cross-sectional study. The study utilized the data from Afghanistan STEPS survey 2018, where 3,956 adults (ages between 18 and 69 years) were interviewed at community-dwelling level. Using the Global Physical Activity Questionnaire, we have calculated the sedentary behavior and physical inactivity. Logistic regression was applied to investigate factors associated high sedentary behavior and low physical activity., Results: Approximately half of the participants (49.8%) exhibited high levels of sedentary behavior, 40.3% low physical activity and 23.5% had both high sedentary behavior and low physical activity. Adjusted logistic regression analysis revealed that individuals who were employed (AOR: 0.34, 95% CI: 0.13-0.88) or self-employed (AOR: 0.60, 95% CI: 0.38-0.94) had significantly lower odds of both high SB and low physical activity than those whose work status was unpaid. Furthermore, older age (AOR: 1.75, 95% CI: 1.35-2.28), urban residence (AOR: 3.17, 95% CI: 1.72-6.05), having 4 or 5 adult household members (AOR: 1.77, 95% CI: 1.21-2.58) and being underweight (AOR: 1.78, 95% CI: 1.02-3.12) were found to be associated with high sedentary behavior. Moreover, factors such as female sex, having 4 or 5 or 6 or more adult household members, urban residence, overweight, and diabetes were positively associated, and male sex (AOR: 0.24, 95% CI: 0.12-0.51), being employed (AOR: 0.34, 95% CI: 0.13-0.88) or self-employed (AOR: 0.60, 95% CI: 0.38-0.94) were negatively associated with the occurrence of combination of high sedentary behavior and low physical activity., Conclusion: Half of the participants had high sedentary behavior, and one in four had both high sedentary behavior and low physical activity together. These findings emphasize the importance of targeted interventions aimed at reducing sedentary behavior and promoting physical activity, particularly among vulnerable populations such as females, individuals from lower socioeconomic background, urban residents, and those with chronic conditions. Addressing these factors can contribute to improving public health outcomes and reducing negative health impacts of sedentary behavior in Afghanistan., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Pengpid, Noormal and Peltzer.)

Background: Understanding national trends in risk factors of noncommunicable diseases (NCDs) may have health policy implications. The aim of the study was to assess the prevalence and social and demographic factors associated with risk factors of NCDs in adults from 2008 to 2019 in Sao Tome and Principe., Methods: In repeat cross-sectional national STEPS surveys 2,457 adults (median age 37 years) in 2008 and 1,893 adults (median age 38 years) in 2019 in Sao Tome and Principe responded to structured interviews, physical and biochemical measures. Logistic regressions were applied to estimate predictors of NCD risk factors., Results: Having three to seven NCD risk factors significantly decreased among men but not women from 36.6% in 2008 to 26.8% in 2019. The proportion of specific risk factors of NCD increased significantly for low physical activity from 17.4% in 2008 to 30.9% in 2019, and overweight/obesity from 37.3% in 2008 to 51.0% in 2019. Insufficient fruit/vegetable consumption decreased from 83.1% in 2008 to 53.3% in 2019, frequent alcohol use from 32.6% in 2008 to 24.8% in 2019, and diabetes from 3.1% in 2008 to 1.2% in 2019, while the proportion of current tobacco use and hypertension remained unchanged from 2008 to 2019. Men engaged more often than women in current tobacco use and frequent alcohol use, and women had higher rates of low physical activity and overweight/obesity than men. Higher educational levels were positively associated with overweight/obesity, and inversely associated with frequent alcohol use and inadequate fruit/vegetable intake., Conclusion: Between 2008 and 2019, the prevalence of seven risk factors for NCDs in Sao Tome and Principe declined among men, but not among women. Several associated variables have been identified for each individual risk factor of NCD that may help guide interventions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Pengpid and Peltzer.)

Background: Oral diseases remain a significant public health problem in Nepal, as do oral health behaviours. Sociodemographic factors play a crucial role in driving oral hygiene practices. This study aims to identify oral hygiene practices and associated socio-demographic factors in Nepalese population. Methods: This descriptive, cross-sectional study recruited 4200 adults (15-69 years) through multistage cluster sampling. Data obtained from the WHO NCD STEPS instrument version 2.2 were analysed in STATA 13.0 using complex sample weighted analysis. Results: Prevalence of cleaning teeth at least once a day was 94.9 % (95 % CI: 93.7-95.9), while that of cleaning teeth at least twice a day was 9.9 % (95 % CI: 8.2-11.9). Use of fluoridated toothpaste was seen among 71.4 % (95 % CI: 67.9-74.7) respondents. A 3.9 % (95 % CI: 3.1-5.0) made a dental visit in the last 6 months. The 45-69 years age group had lesser odds of cleaning teeth at least once a day (AOR: 0.4; 95 % CI: 0.2-0.8), in comparison to 15-29 years age group. Women had greater odds of cleaning teeth at least twice a day (AOR: 1.7; 95 % CI: 1.1-2.4) and having visited a dentist in the last 6 months (AOR: 2.2; 95 % CI: 1.2-3.8) compared to men. With reference to rural residents, urban population had higher odds of using fluoridated toothpaste (AOR: 2.3; 95 % CI: 1.4-3.4) and making a dental visit within the last 6 months (AOR: 1.9; 95 % CI:1.1-3.6). Inhabitants of the Terai had five-fold (AOR: 4.9; 95 % CI: 3.1-7.8) greater odds of cleaning teeth once per day than did hill residents. Those with higher education had greater odds than non-formal education holders of cleaning teeth at least once a day (AOR: 9.0; 95 % CI: 2.9-27.7), cleaning teeth at least twice a day (AOR: 5.6; 95 % CI: 2.9-10.6), using fluoridated toothpaste (AOR: 13.9; 95 % CI: 8.4-23.1), and having visited a dentist in the last 6 months (AOR: 2.8; 95 % CI: 1.4-5.4). Conclusions: Cleaning teeth at least once a day is widely prevalent in Nepal and a substantial number of population use fluoridated toothpaste. However, cleaning teeth twice a day and visiting a dentist is less common. Being women, Terai residents, urban residents, and educated were significantly associated with oral hygiene practices assessed in this study. [ABSTRACT FROM AUTHOR]

Background: The rising morbidity and mortality due to non-communicable diseases can be partly attributed to the urbanized lifestyle leading to unhealthy dietary practices and increasing physical levels of inactivity. The demographic and nutrition transition in India has also contributed to the emerging epidemic of non-communicable diseases in this country. In this context, there is limited information in India on dietary patterns, levels of physical activity and obesity. The aim of the present study was thus to assess the urban rural differences in dietary habits, physical activity and obesity in India.Methods: A household survey was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals using the WHO STEPS questionnaire.Results: No rural urban difference was found in dietary practices and prevalence of overweight and obesity except the fact that a significantly higher proportion of respondents belonging to rural area (15.6 %) always/often add salt before/when eating as compared to urban area (9.1 %). Overall 95.8 % (94.6-97.0) of participants took less than 5 servings of fruits and/or vegetables on average per day. No significant urban rural difference was noted in both sexes in all three domains of physical activity such as work, transport and recreation. However, rural females (19.1 %) were found to be engaged in vigorous activity more than the urban females (6.3 %). Males reported high levels of physical activity in both the settings. Absence of recreational activity was reported by more than 95 % of the subjects. Higher prevalence of obesity (asian cut offs used) was seen among urban females (34.3 %) as compared to their rural counterparts (23.2 %). Abdominal obesity was found to be significantly higher among females in both the settings compared to males (p < 0.001).Conclusions: Poor dietary practices and physical inactivity seems to fuel the non-communicable disease epidemic in India. Non communicable disease control strategy need to address these issues with a gender equity lens. Rapid urbanization of rural India might be responsible for the absence of a significant urban rural difference. [ABSTRACT FROM AUTHOR]

Purpose: Hypercholesterolemia is a major risk factor for a wide range of cardiovascular diseases. Developing countries are more susceptible to hypercholesterolemia and its complications due to the increasing prevalence and the lack of adequate resources for conducting screening and/or prevention programs. Using machine learning techniques to identify factors contributing to hypercholesterolemia and developing predictive models can help early detection of hypercholesterolemia, especially in developing countries., Methods: Data from the nationwide 2016 STEPs study in Iran were used to identify socioeconomic, lifestyle, and metabolic risk factors associated with hypercholesterolemia. Furthermore, the predictive power of the identified risk factors was assessed using five commonly used machine learning algorithms (random forest; gradient boosting; support vector machine; logistic regression; artificial neural network) and 10-fold cross validation in terms of specificity, sensitivity, and the area under the receiver operating characteristic curve., Results: A total of 14,667 individuals were included in this study, of those 12.8% ( n  = 1879) had (undiagnosed) hypercholesterolemia. Based on multivariate logistic regression analysis the five most important risk factors for hypercholesterolemia were: older age (for the elderly group: OR = 2.243; for the middle-aged group: OR = 1.869), obesity-related factors including high BMI status (morbidly obese: OR = 1.884; obese: OR = 1.499; overweight: OR = 1.426) and AO (OR = 1.339), raised BP (hypertension: OR = 1.729; prehypertension: OR = 1.577), consuming fish once or twice per week (OR = 1.261), and having risky diet (OR = 1.163). Furthermore, all the five hypercholesterolemia prediction models achieved AUC around 0.62, and models based on random forest (AUC = 0.6282; specificity = 65.14%; sensitivity = 60.51%) and gradient boosting (AUC = 0.6263; specificity = 64.11%; sensitivity = 61.15%) had the optimal performance., Conclusion: The study shows that socioeconomic inequalities, unhealthy lifestyle, and metabolic syndrome (including obesity and hypertension) are significant predictors of hypercholesterolemia. Therefore controlling these factors is necessary to reduce the burden of hypercholesterolemia. Furthermore, machine learning algorithms such as random forest and gradient boosting can be employed for hypercholesterolemia screening and its timely diagnosis. Applying deep learning algorithms as well as techniques for handling the class overlap problem seems necessary to improve the performance of the models., Competing Interests: Competing interestsThe authors have no competing interests to declare that are relevant to the content of this article., (© The Author(s), under exclusive licence to Tehran University of Medical Sciences 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Objective: To identify the major risk factors for non-communicable diseases (NCDs) among the population of the capital city Male. Methods: We undertook a cross-sectional survey among the 25-64-year-age group using a multi-stage sampling method with households as sampling unit. Information on behavioral, physiological, and biochemical risk factors was obtained through standardized methods as recommended by the STEPS survey guideline of the World Health Organization. Age-adjusted prevalence was calculated using the census figures for the year 2000. Results: Among 2,028 individuals who participated in the survey, complete biochemical data were available for 1,506 subjects. The prevalence of NCD risk factors was high among both men and women in low education group: current smoking (39.9, 9.9%); overweight (BMI ≥ 23 kg/m) (60.8, 65.5%); abdominal obesity (24.2, 54.1%); raised blood pressure (29.7, 32.9%); raised blood glucose (4.3, 4.7%); hypercholesterolemia (53.7, 54.9%). Conclusion: The significant burden posed by the NCD risk factors along with the gender and socioeconomic differentials point to the need for public health action. The Ministry of Health has already initiated a comprehensive response to this threat. The experience and lessons from this survey will be useful for developing a comprehensive and sustainable surveillance system in the country. [ABSTRACT FROM AUTHOR]

Background: India which is home to more than one sixth of the world's population, accounts for more than two thirds of total deaths due to non-communicable diseases (NCD). Out of this, hypertension and diabetes are the most common NCDs. Awareness, treatment, and control of hypertension and diabetes remains a major challenge despite various national programs being run to curb the rising burden NCDs. In order to fill the knowledge gap, awareness, treatment, and control of diabetes and hypertension were studied by using data from the STEPS survey among the adult population in two major northern Indian states of Punjab and Haryana., Methods: Two state-wide NCD risk factors surveys were conducted using WHO STEPS methodology among 5,127 individuals in Punjab and 5,078 individuals in Haryana aged 18-69 years in the year 2014-15 and 2016-18. Standardized questionnaire was used to determine the behavioral risk factors in step one followed by anthropometric measurements for physical risk factors in step two and in the third step serum and urine samples were collected for biochemical risk factors., Results: The prevalence of hypertension in Punjab was 40.1% while that in Haryana was 26.2%. In Punjab, only 48.3% of the hypertensive were aware of their condition, 30.9% were on treatment while only 18.3% of the cases were controlled. While in Haryana 33.4% of the respondents were aware of their condition, 26.3% are on treatment while only 12% of the cases were controlled. Similarly, the prevalence of diabetes was 14.3 and 15.1% in Punjab and Haryana, respectively. In Punjab 34.2% of diabetics were aware of their condition, 28.2% were on treatment while only 14.2% of the cases were controlled. The awareness and control rates in Haryana were similar to that in Punjab. 29.5% of the respondents were aware of their condition, 22.4% were on treatment while only 13.8% of the cases of diabetes were controlled. Family history of diabetes and hypertension was found to be associated with higher odds of being aware, on treatment and controlled blood glucose and blood pressure levels in both Punjab and Haryana., Discussion: Hypertension and diabetes are a major public health problem in Punjab and Haryana and awareness, treatment and control rates are low which require specific interventions with a focus on access to treatment, regular follow up for better control. There is an urgent need to effectively implement the existing national NCD programmes in these states in India., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Thakur and Nangia.)

Background: Physical inactivity (PA) is one of the leading modifiable risk factors for noncommunicable diseases (NCDs) worldwide. This study aimed to determine PA levels and related sociodemographic factors as risk factors for NCDs among Iranian adults. Methods: In this cross sectional study, data were collected from the sixth nationwide STEPS survey in 31 provinces of Iran. A total of 6100 individuals aged 18-64 years were selected by a multistage cluster sampling method, and their PA levels were assessed using the Global Physical Activity Questionnaire (GPAQ). Data were analyzed using descriptive methods and analytical tests, including chi-square, ANOVA, and independent t tests in SPSS version 21 software. Results: The prevalence of vigorous, moderate, and low levels of PA was 36.3% (95%CI:35.1-37.5), 29.2% (95%CI:28-30.3), and 34.5% (95%CI:33.3-35.7) in participants, respectively. The mean ± SD of total MET-min/week was 1842.3±2619.3. Total mean ± SD duration of PA was 98.2 ± 115 min/week (125.8±142.6 and 77.2±84.5 min/week in men and women, respectively). Transport-related PA and severe PA at work had large and small contributions to overall PA, respectively. Urbanization, sex, age, family size, and occupation status were identified as factors associated with PA levels (p<0.001). Conclusion: This study revealed a significant prevalence of low PA among the target population and some sociodemographic characteristics identified as factors associated with PA. Identification of these factors can develop more effective interventions to promote PA., Competing Interests: Conflicts of Interest: None declared, (© 2020 Iran University of Medical Sciences.)

Objective: Globally, 8.8% of adults were estimated to have diabetes mellitus, with the low-and middle-income countries sharing the largest burden. However, the research evidence for targeted interventions is lacking in sub-Saharan Africa, particularly in Ethiopia. Therefore, this study aimed to assess the prevalence of diabetes mellitus, disaggregated by the epidemiology of diabetes mellitus morbidity and associated factors among adults in Dire Dawa town, Eastern Ethiopia., Methods: Data from a total of 872 randomly sampled adults aged 25-64 years were obtained for analysis using the World Health Organization STEPwise approach to non-communicable disease risk factors surveillance instruments. We estimated the prevalence of diabetes mellitus disaggregated by the previous diabetes mellitus diagnosis status and by the current blood sugar level control status. The bivariable and multivariable binary logistic regression model was used to identify correlates of diabetes mellitus, along with STATA version 14.2 for data management and analysis. All statistical tests were declared significant at p-value < 0.05., Results: 14.9% (95% confidence interval: 12.1, 17.4) of adults aged 25-64 years had diabetes mellitus in the study sample with 58.5% (95% confidence interval: 49.7, 66.7) on diabetes mellitus medication. Among adults currently taking diabetes mellitus medications, 30.3% (95% confidence interval: 19.8, 45.6) had uncontrolled diabetes mellitus. The magnitude of previously undiagnosed diabetes mellitus was 6.2% (95% confidence interval: 4.8, 8.0) in the study sample and 41.5% (95% confidence interval: 33.3, 50.3) among the diabetics. The odds of diabetes mellitus were higher among adults over the age of 55 years (adjusted odds ratio = 2.1, 95% confidence interval: 1.2, 3.6), currently married adults (adjusted odds ratio = 2.3, 95% confidence interval: 1.2, 4.4), and overweight adults (adjusted odds ratio = 1.6, 95% confidence interval: 1.1, 2.1). Adults with primary education (adjusted odds ratio = 0.4, 95% confidence interval: 0.2, 0.8) and no formal education (adjusted odds ratio = 0.5, 95% confidence interval: 0.2, 0.9) had lower odds of diabetes mellitus., Conclusion: The prevalence of diabetes mellitus among adults was high in Dire Dawa, with a third of the diabetics having poor control of their blood sugar levels and, nearly four in ten were previously undiagnosed. Adults who were overweight, currently married, and those over 55 years need to be targeted for regular diabetes health checkups and community-based screening. Also, a mechanism should be instituted to track a patient's adherence to medications and promote diabetes self-care management., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2020.)

Aim: This study aimed to analyze the extent of major noncommunicable diseases and their common risk factors in Burkina Faso., Materials and Methods: It was an analysis based on secondary data from the 2013 national STEPS survey in Burkina Faso. The analysis conducted in 2018 concerned behavioral risk factors and metabolic factors. A multiple regression model was used to determine the independent factors associated with these diseases., Results: The independent variables associated with behavioral risk factors were 1) young age(OR=0, 4423; p< 0,001) and males(OR=0,0030 ; p< 0,001) for smoking, 2) older age (OR= 2,01 ; p= 0,0066 and OR=2,18 ; p< 0,001) and males(OR=2,18 ; p< 0,001) for drinking and harmful use of alcohol, and 3) young age(OR=0,34 ; p< 0,001) and the urban environment(OR=1,57 ; p= 0,0236) for physical inactivity. The independent variables associated with metabolic risk factors were 1) young age (OR=1,33 ; p= 0,0295) and urban (OR=0,31 ; p<0,001) for overweight, 2) female(OR=2,55 ; p= 0,0010) and urban(OR= 0,13; p< 0,001) for obesity, and 3) advanced age(OR=2,49 ; p< 0,001and OR= 2,12 ; p= 0,0115), and urban setting(OR=0,47 ; p< 0,001 and OR= 0,49 ;p= 0,0320) for high blood pressure and diabetes., Conclusion: In Burkina Faso, prevention and health promotion actions to reduce these risk factors need to be stepped up with a multi-sectoral approach., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

Aims Raised blood cholesterol is an important risk factor for heart disease and stroke. Globally, one third of ischaemic heart disease is attributable to high cholesterol. This article reports prevalence of dyslipidemia in the North Indian state of Punjab as part of a large household Non Communicable Disease (NCD) Risk Factor Survey. Materials and methods A household NCD STEPS survey was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals. All the subjects were administered the WHO STEPS questionnaire, anthropometric and blood pressure measurements. Every alternate respondent in the sample (n = 2499) were assayed for lipid parameters. Results Over one fourth (27%) of the general adult population covered in this survey have either raised cholesterol or triglyceride levels. Hypercholesterolemia was found in 9.8% and hypertriglyceridemia in 21.6% of the population with no urban rural difference in both the sexes. Presence of more than 2 morbidities, diabetes and hypertension were significantly associated with all types of dyslipidemia. Conclusions The study reported high prevalence of dyslipidemia, calling for an urgent attention. [ABSTRACT FROM AUTHOR]

Problem statement Comorbidity of non-communicable diseases carries a significant risk of cardiovascular events and mortality. With the rising burden of diabetes, hypertension and other risk factors, and ageing population in India, this is likely to pose a major threat to the health system. It is therefore essential to understand this high risk group. This article reports prevalence of comorbid diabetes and hypertension and its associated risk factors in the North Indian state of Punjab. Methods A household NCD STEPS survey was done in Punjab, India in a multistage stratified sample of 5127 individuals. All the subjects were administered the WHO STEPS questionnaire, anthropometric and blood pressure measurements. Every alternate respondent in the sample (n = 2499) were assayed for blood glucose and lipid parameters. Results The prevalence of comorbid DM and HTN was 4.5% in the general adult population. DM, HTN and dyslipidemia co-existed in 1.8% of the population. Obesity and dyslipidemia are the most common comorbidities among persons with DM and HTN alone and comorbid DM and HTN. Factors strongly associated with comorbid DM and HTN include elderly age group, dyslipidemia, obesity and family history of DM. Conclusions The study reported high burden of comorbid diabetes and hypertension among the elderly, strongly associated with obesity and dyslipidemia. This emphasizes the role of nonpharmacological intervention such as weight reduction, physical activity, and dietary modification. [ABSTRACT FROM AUTHOR]