2008-12-31-世界卫生组织-2009_STEPS_Fact_Sheet_Malawi_2页_70kb

报告摘要

Malawi STEPS Survey Summary (2009)

Core Information

The STEPS (Surveillance of Trends and Emerging Patterns) survey in Malawi was conducted between July 2009 and September 2009. It aimed to assess chronic disease risk factors among adults aged 25-64 years, using a multi-stage cluster sample design to ensure representative data. The survey included three steps:

Step 1: Collection of socio-demographic and behavioral data, including tobacco use, alcohol consumption, and fruit and vegetable intake.
Step 2: Physical measurements such as body mass index (BMI), height, weight, and blood pressure.
Step 3: Biochemical measurements to evaluate blood glucose and cholesterol levels.

A total of 5,206 adults participated in the survey, with a 95.5% overall response rate. 67.5% of participants were female.

Main Findings

Tobacco Use

Overall: 14.1% of adults currently smoke tobacco (95% CI: 12.7–15.6).
Males: 25.9% currently smoke tobacco (95% CI: 23.3–28.5).
Females: 2.9% currently smoke tobacco (95% CI: 2.1–3.8).
Daily smokers: 12.4% of adults smoke daily (95% CI: 11.0–13.7).
- Males: 22.8% smoke daily (95% CI: 20.5–25.2).
- Females: 2.4% smoke daily (95% CI: 1.7–3.2).
Age of initiation: On average, daily smokers started smoking at 22.1 years (95% CI: 21.4–22.9).
Cigarette use: 46.4% of daily smokers use manufactured cigarettes (95% CI: 40.3–52.4).
- Males: 49.9% use manufactured cigarettes (95% CI: 43.3–56.4).
- Females: 14.6% use manufactured cigarettes (95% CI: 7.8–21.4).
Daily cigarette consumption:
- Overall: 2.8 cigarettes per day (95% CI: 2.4–3.3).
- Males: 3.0 cigarettes per day (95% CI: 2.5–3.5).
- Females: 1.5 cigarettes per day (95% CI: 0.1–3.0).

Alcohol Consumption

Overall: 16.9% of adults consumed alcohol in the past 30 days (95% CI: 15.1–18.7).
Males: 30.1% consumed alcohol in the past 30 days (95% CI: 27.2–33.1).
Females: 4.2% consumed alcohol in the past 30 days (95% CI: 3.2–5.2).
Heavy episodic drinking:
- Males: 19.0% engaged in heavy episodic drinking (95% CI: 16.5–21.5).
- Females: 2.3% engaged in heavy episodic drinking (95% CI: 1.6–3.1).

Fruit and Vegetable Consumption

Overall: 2.0 days of fruit consumption per week (95% CI: 1.8–2.1), with 0.5 servings per day (95% CI: 0.4–0.5).
Females: Consumed more vegetables (5.7 days/week, 95% CI: 5.6–5.9) and slightly more fruit servings (0.5 per day, 95% CI: 0.4–0.6) compared to males.
Overall: 97.5% of adults consumed less than 5 servings of fruits and vegetables per day (95% CI: 96.8–98.2).

Physical Activity

Overall: 9.5% of adults had low levels of physical activity (<600 MET-minutes per week, 95% CI: 8.0–10.9).
Males: 6.3% had low physical activity (95% CI: 4.8–7.8).
Females: 12.6% had low physical activity (95% CI: 10.6–14.7).
Overall: 83.7% of adults had high levels of physical activity (≥3000 MET-minutes per week, 95% CI: 81.5–85.9).
Vigorous activity: 17.8% of adults did not engage in vigorous activity (95% CI: 15.5–20.1).
- Males: 13.2% did not engage in vigorous activity (95% CI: 10.9–15.5).
- Females: 22.3% did not engage in vigorous activity (95% CI: 19.3–25.3).

Physical Measurements

Body Mass Index (BMI)

Overall: Mean BMI was 23.0 (95% CI: 22.8–23.1).
Males: Mean BMI was 22.4 (95% CI: 22.3–22.6).
Females: Mean BMI was 23.5 (95% CI: 23.3–23.7).
Overweight (BMI ≥25):
- Overall: 21.9% (95% CI: 20.4–23.5).
- Males: 16.1% (95% CI: 14.1–18.0).
- Females: 28.1% (95% CI: 25.9–30.2).
Obese (BMI ≥30):
- Overall: 4.6% (95% CI: 4.0–5.3).
- Males: 2.0% (95% CI: 1.3–2.6).
- Females: 7.3% (95% CI: 6.3–8.4).

Blood Pressure

Overall: Mean systolic blood pressure (SBP) was 132.8 mmHg (95% CI: 131.8–133.8), and mean diastolic blood pressure (DBP) was 79.1 mmHg (95% CI: 78.5–79.8).
Raised BP (SBP ≥140 or DBP ≥90):
- Overall: 32.9% (95% CI: 30.6–35.2).
- Males: 37.2% (95% CI: 33.6–40.8).
- Females: 29.2% (95% CI: 27.1–31.3).
Raised BP without medication:
- Overall: 94.9% (95% CI: 93.5–96.3).
- Males: 96.4% (95% CI: 94.7–98.1).
- Females: 93.3% (95% CI: 91.1–95.5).

Biochemical Measurements

Fasting Blood Sugar

Overall: Mean fasting blood glucose was 76.9 mg/dl (95% CI: 74.6–79.2).
Impaired fasting glycaemia (blood glucose between 5.6–6.1 mmol/L or 100–110 mg/dl):
- Overall: 4.2% (95% CI: 3.0–5.4).
- Males: 5.7% (95% CI: 3.9–7.5).
- Females: 2.7% (95% CI: 1.6–3.8).
Raised fasting blood glucose (≥7.0 mmol/L or 126 mg/dl):
- Overall: 5.6% (95% CI: 2.6–8.5).
- Males: 6.5% (95% CI: 2.6–10.3).
- Females: 4.7% (95% CI: 2.4–7.0).

Total Cholesterol

Overall: Mean total cholesterol was 168.6 mg/dl (95% CI: 167.0–170.3).
Raised total cholesterol (≥190 mg/dl or ≥5.0 mmol/L):
- Overall: 8.7% (95% CI: 7.4–10.0).
- Males: 6.3% (95% CI: 4.6–8.1).
- Females: 11.0% (95% CI: 9.4–12.6).

Summary of Combined Risk Factors

The survey highlights the presence of multiple chronic disease risk factors among adults aged 25–64 in Malawi:

Current daily smokers: 12.4% of adults.
Overweight (BMI ≥25): 21.9% of adults.
Less than 5 servings of fruits and vegetables per day: 97.5% of adults.
Raised BP (SBP ≥140 or DBP ≥90): 32.9% of adults.
Low level of physical activity: 9.5% of adults.

These risk factors were often co-occurring, particularly among males, who showed higher prevalence in tobacco use, alcohol consumption, and overweight compared to females.