2007-12-31-世界卫生组织-2008_STEPS_Fact_Sheet_Zambia_Lusaka_2页_63kb

STEPS Survey Summary: Chronic Disease Risk Factors in Zambia (Lusaka)

Overview

The STEPS (Surveillance of Trends in Cardiovascular Disease and Diabetes) survey in Zambia (Lusaka) was conducted from January to May 2008. It aimed to assess chronic disease risk factors among adults aged 25 years and older using a cluster sample design to ensure representative data. A total of 1,912 adults participated in the survey, which included three main steps:

1. Step 1: Collection of socio-demographic and behavioral data.
2. Step 2: Physical measurements such as height, weight, and blood pressure.
3. Step 3: Biochemical measurements to evaluate blood glucose and cholesterol levels.

Core Content

Step 1: Socio-Demographic and Behavioral Information

• Tobacco Use:

  • Both Sexes: 6.5% currently smoke tobacco, with 5.0% smoking daily.
  • Males: 17.0% currently smoke, 12.9% smoke daily.
  • Females: 1.3% currently smoke, 1.1% smoke daily.
  • Average age started smoking: 21.7 years overall, with males starting slightly later at 21.9 and females at 20.8.
  • Manufactured cigarettes: 68.4% of smokers use manufactured cigarettes, with higher prevalence among males (72.8%) than females (42.9%).
  • Daily cigarette consumption: Males smoke an average of 8.4 cigarettes per day, while females smoke 6.8.

• Alcohol Consumption:

  • Both Sexes: 74.2% are abstainers, and 20.8% are current drinkers.
  • Males: 56.6% are abstainers, 38.3% are current drinkers.
  • Females: 83.0% are abstainers, 12.0% are current drinkers.
  • Frequent drinking: 22.4% of current drinkers consume alcohol on 4 or more days per week.
  • Binge drinking: 48.5% of males and 45.3% of females engage in binge drinking (defined as 5 or more drinks for males and 4 or more for females in a single day).

• Fruit and Vegetable Consumption:

  • Both Sexes: 3.2 days per week on average for fruit, and 6.8 days for vegetables.
  • Servings per day: 0.7 servings of fruit and 1.9 servings of vegetables.
  • Low intake: 97.0% of adults consume less than 5 combined servings of fruits and vegetables daily.

• Physical Activity:

  • Both Sexes: 17.2% have low activity levels (<600 MET-minutes/week), while 46.1% have high activity levels (≥3000 MET-minutes/week).
  • Median time spent in physical activity per day: 90.0 minutes overall, 100.0 minutes for males, and 81.4 minutes for females.
  • Vigorous activity: 76.0% of adults do not engage in vigorous physical activity.

Step 2: Physical Measurements

• Body Mass Index (BMI):

  • Both Sexes: Mean BMI is 24.6, with 39.6% being overweight (BMI ≥25) and 14.4% obese (BMI ≥30).
  • Males: Mean BMI is 22.4, with 20.9% overweight and 5.2% obese.
  • Females: Mean BMI is 25.6, with 49.0% overweight and 19.0% obese.

• Blood Pressure:

  • Mean systolic blood pressure (SBP): 132.5 mmHg overall, 135.1 for males, and 131.2 for females.
  • Mean diastolic blood pressure (DBP): 81.9 mmHg overall, with no significant difference between sexes.
  • Raised BP (SBP ≥140 and/or DBP ≥90): 33.3% overall, 36.6% for males, and 31.7% for females.
  • Severely raised BP (SBP ≥160 and/or DBP ≥100): 16.0% overall, with similar rates across sexes.

Step 3: Biochemical Measurements

• Fasting Blood Glucose:

  • Mean fasting blood glucose: 4.4 mmol/L overall, with no significant difference between sexes.
  • Impaired fasting glycaemia: 2.2% overall, with higher rates in males (3.3%) than females (1.7%).
  • Raised blood glucose: 4.6% overall, with similar rates across sexes (3.8% males, 5.0% females).

• Total Blood Cholesterol:

  • Mean total blood cholesterol: 4.6 mmol/L overall, with males at 4.5 and females at 4.7.
  • Raised total cholesterol (≥5.0 mmol/L): 23.8% overall, with higher rates in females (26.5%) than males (18.5%).
  • Severely raised total cholesterol (≥6.2 mmol/L): 6.1% overall, with similar rates across sexes (4.7% males, 6.8% females).

Summary of Combined Risk Factors

• Risk factors included:

  • Current daily smokers
  • Less than 5 servings of fruits and/or vegetables per day
  • Low level of physical activity (<600 MET-minutes/week)

• Percentage with none of the risk factors: 1.0% overall, with similar rates for males (0.9%) and females (1.0%).

• Percentage with at least three risk factors:

  • Aged 25–44 years: 16.6% overall, with similar rates across sexes.
  • Aged 45–64 years: 46.8% overall, with slightly higher rates in males (47.4%) and females (46.6%).
  • Aged 25–64 years: 23.7% overall, with similar rates across sexes.

Key Information

• The survey highlights a high prevalence of low fruit and vegetable consumption (97.0% overall).
• Overweight and obesity are significant issues, with 39.6% of adults classified as overweight and 14.4% as obese.
• Tobacco and alcohol use are more prevalent among males, with male smokers being more likely to consume manufactured cigarettes.
• Physical activity levels are generally low, with 76.0% of adults not engaging in vigorous activity.
• Blood pressure and cholesterol levels are elevated in a substantial portion of the population, indicating a high risk for cardiovascular diseases.
• Combined risk factors show that a significant portion of the population (up to 46.8%) has at least three risk factors, particularly among adults aged 45–64 years.

This data underscores the importance of public health interventions targeting lifestyle behaviors such as smoking, alcohol consumption, physical inactivity, and poor diet in Lusaka, Zambia.