2006-12-31-世界卫生组织-2007_STEPS_Country_Report_Democratic_People_s_Republic_of_Korea_10页_508kb

报告摘要

Summary of the Final Report: Survey of NCD Risk Factor Based on STEPwise Approach

Core Content

This report details a survey conducted in three rural areas of North Korea using the WHO STEPwise approach to assess the prevalence of non-communicable disease (NCD) risk factors such as tobacco use, alcohol consumption, BMI, and blood pressure. The survey aimed to support policy-making for NCD prevention and control.

Objectives

To survey the prevalence of major NCD risk factors in rural areas.
To use the survey results for informing NCD prevention and control policies.

Activities Undertaken

Training: A 3-day training session was conducted for officials and household doctors involved in the survey, covering WHO STEPwise methodology, sampling, interview skills, and data collection procedures.
Survey Implementation: The survey was carried out by trained household doctors in three rural areas:
- Ssangryong ri, Kilju county, North Hamgyong province
- Suhung ri, Hamju county, South Hamgyong province
- Pyoksong township, South Hwanghae province
Data Collection:
- A total of 2,400 individuals were surveyed (1,200 males and 1,200 females).
- Two survey teams were formed, each with two household doctors (total 12 persons).
- Follow-up visits were made for individuals who missed the initial survey or had mobility issues.
Monitoring: Professionals from the Institute of Public Health Administration were involved in monitoring the survey process after training in March 2005.

Methodology

Study Design: A cross-sectional study was conducted.
Sampling: Based on WHO STEPwise Surveillance Manual, one individual per household aged 25–64 was randomly selected.
Pilot Testing: A pilot test was conducted with 20 individuals to refine the survey form.
Data Collection:
- Standardized instruments and procedures were used for measuring BMI, waist circumference, and blood pressure.
- Blood pressure was measured three times with 5-minute intervals using an OMRON Monitor.
Data Entry and Analysis: Data was entered into Epi Info 2005 and analyzed by sex and age group.

Key Findings

Tobacco Use

Prevalence: 54.8% of males (95% CI: 51.2–57.4) were current daily smokers.
Smokeless Tobacco: No users were reported among both sexes.
Smoking Habits:
- Average age of starting smoking: 22.8 years (95% CI: 22.4–23.2).
- Average daily cigarette consumption: 14.8 cigarettes (95% CI: 14.1–15.5).

Alcohol Consumption

Abstainers (last year): 45.1% of males and 97.1% of females (both sexes: 71.3%).
Current Drinkers (past 30 days): 43.4% of males and 2.8% of females (both sexes: 22.9%).
Heavy Drinking: 26.3% of male current drinkers consumed 5 or more drinks daily (mean standard drinks per day: 3.2).

BMI

Mean BMI: 21.5 for males and 21.3 for females.
Overweight Prevalence (BMI ≥25):
- 4.2% in males (95% CI: 3.5–5.2)
- 4.6% in females (95% CI: 3.5–6.0)
Average Waist Circumference:
- 75.5 cm for males
- 74.2 cm for females
- 74.9 cm for both sexes combined.

Blood Pressure

Mean Systolic Blood Pressure (SBP):
- 126.1 mmHg for males
- 122.3 mmHg for females
- 124.1 mmHg for both sexes combined.
Mean Diastolic Blood Pressure (DBP):
- 86.4 mmHg for males
- 86.3 mmHg for females
- 86.3 mmHg for both sexes combined.
Raised Blood Pressure (SBP ≥140 or DBP ≥90):
- 25.6% in males (95% CI: 23.5–29.1)
- 23.0% in females (95% CI: 21.1–27.3)
- 24.3% for both sexes combined (95% CI: 22.0–28.7).
Severely Raised Blood Pressure (SBP ≥170 or DBP ≥100):
- 8.7% in males (95% CI: 6.9–10.3)
- 7.4% in females (95% CI: 5.9–9.8)
- 8.0% for both sexes combined (95% CI: 6.9–10.3).

Conclusion

Tobacco Use: High among males, with no female smokers reported. The prevalence increases with age up to 45–54 years and then decreases.
Alcohol Consumption: Low among females, but higher among males. Heavy drinking is a significant issue in the rural population.
BMI: Low overall, but overweight prevalence is moderate, with higher rates among males.
Blood Pressure: Increases with age, and males have higher rates of raised blood pressure than females.

Recommendations

Control Activities: Prioritize tobacco and heavy drinking control in rural areas, especially in the 45–54 age group.
Expand Survey: Extend the survey to more regions to assess nationwide NCD risk factors.
Provide Resources: Ensure availability of necessary equipment and materials for future surveys, including:
- Training tools (Laptop, Computer Projector)
- Measurement devices (OMRON Monitor, blood glucose and cholesterol devices, test strips, blood carrying equipment)
- These should be included in the workplan for 2008–2009 to support the expansion of NCD risk factor assessments.