Prevalence and correlates of multiple non-communicable disease risk factors among adults in Zambia: results of the first national STEPS survey in 2017

INTRODUCTION: The prevalence of non-communicable diseases (NCDs) is increasing in African countries. This study aimed to estimate the prevalence and correlates of multiple NCD risk factors (NCDRF) among the adult population in Zambia. METHODS: Nationally representative cross-sectional data from 4,302 individuals aged 18-69 years of the “2017 Zambia STEPS survey” were analysed. RESULTS: The prevalence of insufficient fruit and vegetable consumption was 90.4%, followed by overweight/obesity (24.4%), low physical activity (19.5%), hypertension (18.9%), daily tobacco use (10.7%), sedentary behaviour (8.9%), suicidal behaviour (8.5%), alcohol dependence (7.4%), raised total cholesterol (7.4%), and diabetes (6.2%). The distribution of NCDRF was 41.5% 0-1 NCDRF, 48.2% 2-3, 10.4% 4-10, and 26.7% 3-10 NCDRF. In adjusted ordinal logistic regression analysis, compared to persons aged 18-34 years, individuals aged 50-69 years were 3.58 times (AOR: 3.58, 95% CI: 3.95-4.49) more likely to have a higher number of NCDRF. Women were 24% (AOR: 1.24, 95% CI: 1.03-1.49) more likely than men to have a higher number of NCDRF. Persons living in urban locations were 71% (AOR: 1.74, 95% CI: 1.43-2.16) more likely than persons living in rural locations to have a higher number of NCDRF, and compared to individuals with lower than primary education, persons with more than primary education were 20% (AOR: 0.80, 95% CI: 0.65-0.98) less likely to have a higher number of NCDRF. CONCLUSION: More than one in four study participants had three to ten NCDRF and several associated factors were found that can aid to target interventions.