2006-12-31-世界卫生组织-2007_STEPS_Country_Report_Bhutan_102页_912kb

Summary of the 2007 STEPS Survey in Thimphu, Bhutan

Core Content

The 2007 STEPS Survey was conducted in Thimphu, Bhutan, to assess the prevalence of noncommunicable diseases (NCDs) and associated risk factors among adults aged 25–74 years. The survey, which was completed in 2009, included 2484 participants, with a slight gender imbalance (45.8% male, 54.2% female). It was a cross-sectional study, modified from the WHO STEPS survey tool, and supported by the Ministry of Health and WHO.

The survey aimed to gather data on key risk factors such as tobacco use, alcohol consumption, dietary habits, physical activity, and biochemical indicators like blood pressure, blood glucose, and cholesterol levels. The findings provide a baseline for future NCD prevention and control strategies in Bhutan.

Main Objectives

• To evaluate exposure to NCD risk factors
• To determine the prevalence of raised blood pressure, blood glucose, and cholesterol levels
• To establish a foundation for public health interventions

Key Findings

Tobacco Use

• Overall smoking prevalence: 6.8%
• Daily smokers: 5.8% of the population
• Average age of initiation: 20.8 years
• Smokeless tobacco use: 19.4% of the population, with 83.0% using it daily
• High exposure: Combined exposure to tobacco is high, with 83.3% of daily users exposed to at least one form of tobacco

Alcohol Consumption

• Current drinkers: 30.8% of the population
• Gender difference: Males had a significantly higher rate of alcohol consumption (34.9%) than females (25.5%)
• Binge drinking: 11.9% of men and 12.1% of women engaged in binge drinking in the last week
• Drinking frequency: 7.9% of males drank 5–6 days per week, compared to 3.2% of females

Dietary Habits

• Fruit and vegetable consumption: Only 33.4% of the population consumed 5 or more servings per day
• Fruit consumption: Average of 1.2 servings per day, with 3.7 days per week
• Vegetable consumption: Average of 3.2 servings per day, with 6.4 days per week
• High fat usage: Vegetable oil was the most commonly used fat/oil (96.8%), with an average monthly consumption of 1.6 liters per adult

Physical Activity

• Low activity levels: 58.6% of the population engaged in less than the minimum recommended physical activity (600 MET-minutes per week)
• High activity levels: Only 23.7% met the high activity threshold (≥3000 MET-minutes per week)
• Sedentary behavior: 50% of respondents spent 2 hours or more in sedentary activities per day
• Vigorous activity: 82.2% of the population did not engage in vigorous physical activity

Blood Pressure and Diabetes

• Raised blood pressure: 22.1% of the population had raised BP (SBP ≥140 and/or DBP ≥90 mmHg)
• Diabetes prevalence: 2.5% of the population had a diabetes diagnosis in the last 12 months
• Traditional healers: Used for BP and diabetes management, though less frequently than health professionals

Physical and Biochemical Measurements

• Obesity: 12.1% of the population (BMI ≥30 kg/m²)
• Overweight: 52.9% of the population (BMI ≥25 kg/m²)
• Mean BMI: 25.6 for both sexes
• Mean waist circumference: 83.7 cm for males, 82.1 cm for females
• Raised cholesterol: 43.9% of the population had total cholesterol ≥5.0 mmol/L
• Impaired fasting glycaemia: 21.7% of the population had fasting glucose levels between 6.1 and 7.0 mmol/L
• Raised fasting blood glucose: 7.5% of the population had fasting glucose ≥7.0 mmol/L

Risk Factor Exposure

• Overall exposure: 93.1% of the population was exposed to at least one NCD risk factor
• Multiple risk factors: 56.5% exposed to 1–2, 38.4% exposed to 3–5
• Gender difference: Women were more likely to be exposed to multiple risk factors (38.4%) than men (31.9%)
• Age group difference: Older adults (45–74 years) had higher exposure to multiple risk factors (46.2%) than younger adults (25–44 years, 28.1%)

Main Recommendations

1. Intensify health promotion: Focus on reducing exposure to NCD risk factors through targeted public health interventions.
2. Promote healthy lifestyles: Encourage physical activity, healthy dietary choices, and cessation of tobacco and alcohol use.
3. Multi-sectoral approach: Implement strategies across sectors to address the multi-factorial nature of NCDs.
4. Disseminate findings: Share the survey results with policymakers, health professionals, and communities to foster collaboration and awareness.
5. Conduct further studies: Analytical epidemiological studies are needed to understand behavioral and attitudinal aspects of NCD risk factors for effective intervention design.

Conclusion

The survey highlights that despite Bhutan's relatively low NCD prevalence, the population is heavily exposed to multiple risk factors, which may lead to an increase in NCD incidence in the future. Urgent and evidence-based public health interventions are essential to prevent and control the growing threat of NCDs.