2001-12-31-世界卫生组织-2002_STEPS_Country_report_Fiji_79页_5mb

Fiji NCD STEPS Survey 2002 Summary

Core Content

The Fiji NCD STEPS Survey 2002 was a nation-wide cross-sectional study conducted from February to May 2002, aimed at assessing the prevalence of non-communicable diseases (NCDs) and their associated risk factors among individuals aged 15 to 64 years. The survey was implemented using the WHO STEPS (Stepwise Approach to Surveillance of Non-Communicable Diseases) methodology, which involves three sequential steps: data collection via questionnaires, physical measurements, and biochemical assessments.

The survey was a collaborative effort between the Ministry of Health (MOH), the World Health Organization (WHO), the Fiji School of Medicine (FSM), and the Menzies Centre for Population Health Research of the University of Tasmania, supported by AusAID. The primary objectives were to document the prevalence of key NCDs and to understand the major risk factors and their associations in the context of Fiji's health landscape.

Main Objectives

• Investigate and document the prevalence of key NCDs in Fiji.
• Determine the prevalence of and better understand the major risk factors for common NCDs.
• Provide baseline data for the development of the National Strategic Plan on Prevention and Control of NCDs (2004–2008).

Key Findings

1. Behavioral Risk Factors

• Tobacco Use:

  • Overall current smoking prevalence was 37%, with 43% being daily smokers.
  • Manufactured cigarettes were the most common form of tobacco used (77%).

• Alcohol Consumption:

  • Binge drinking was most common in the 35–44 age group across both genders.
  • Among current kava users, 47% reported smoking tobacco and 20% drinking alcohol during or after kava consumption.

• Diet and Physical Activity:

  • Low fruit and vegetable intake was observed, with 66% eating less than one serving of fruit per day and 26% eating less than one serving of vegetables per day.
  • Women, individuals over 35 years, urban dwellers, and Indo-Fijians were the least active in terms of physical activity.

2. Biochemical Risk Indicators

• Cholesterol Levels:

  • There was a trend of increasing mean cholesterol levels with age.
  • Males consistently had higher cholesterol levels than females in each age group.

• Triglycerides:

  • Urban males had a higher proportion (49%) in the high-risk group (≥1.70 mmol/L) compared to rural males (24%) and urban females (28%).

• HDL Cholesterol:

  • 31% of males and 35% of females were in the high-risk HDL group (≤0.90 mmol/L), though the difference was not statistically significant.

• Atherogenic Dyslipidemia:

  • The prevalence varied by ethnicity and gender, with higher rates among certain groups.

3. Health Conditions

• Overweight and Obesity:

  • 29% of the population aged 15–64 were overweight (BMI: 25–29.9), and 18% were obese (BMI > 29.9).
  • Females had higher BMI than males (Mean BMI: 26.7 vs 24.2).
  • Fijians had higher BMI than Indo-Fijians.

• Hypertension:

  • 19.1% of the population aged 15–64 had hypertension.
  • 63% were newly diagnosed.
  • Fijians had a higher proportion of hypertension (21%) than Indo-Fijians (16%).
  • Uncontrolled hypertension was more common among Fijians (81%) than Indo-Fijians (58%).

• Diabetes:

  • 16% of the population aged 25–64 had diabetes.
  • 53.2% of these were newly diagnosed.
  • Indo-Fijians had a significantly higher prevalence of diabetes (21.2%) than Fijians (11.5%).
  • Urban areas had a higher prevalence (24.7%) than rural areas (12.8%).

Limitations and Recommendations

Limitations

• The survey included only 25–64 year olds for the third step (biochemical measurements).
• Data quality was assessed, but potential biases and sampling limitations may exist.

Recommendations

• Implement comprehensive and holistic strategies at national, community, and individual levels to address NCDs and their risk factors.
• Focus on preventative care and health promotion to mitigate the rising burden of NCDs.
• Enhance early diagnosis and management of hypertension and diabetes to reduce complications.
• Promote healthier lifestyles, including increased physical activity, better dietary habits, and reduced use of tobacco and alcohol.

Conclusion

The Fiji NCD STEPS Survey 2002 marked a significant milestone in NCD research, providing baseline data essential for the formulation of the National Strategic Plan on Prevention and Control of NCDs (2004–2008). The survey highlighted the high prevalence of NCDs such as hypertension, diabetes, and obesity, along with their associated risk factors, which include tobacco use, alcohol consumption, low fruit and vegetable intake, and physical inactivity.

The results underscore the need for targeted interventions and sustainable surveillance systems to address the growing burden of NCDs in Fiji, which is expected to continue increasing due to epidemiological transition and westernization. The survey also emphasized the importance of community-based and individual-level prevention in combating NCDs and their risk factors.