2008-12-31-世界卫生组织-2009_STEPS_Country_Report_Mongolia_151页_2mb

Summary of the Mongolian STEPS Survey on the Prevalence of Noncommunicable Disease and Injury Risk Factors - 2009

Core Content

The Mongolian STEPS Survey on the Prevalence of Noncommunicable Disease (NCD) and Injury Risk Factors - 2009 is a comprehensive public health study conducted to assess the prevalence of NCD risk factors and injury-related issues among the Mongolian population. It was carried out as part of the National NCD Prevention and Control Programme, with support from the World Health Organization (WHO) and the Millennium Challenge Account (MCA) Mongolia Health Project.

The survey aimed to provide updated data for the midterm evaluation of the National Program and to establish baseline information for health interventions. It focused on modifiable risk factors for NCDs and injury, such as tobacco use, alcohol consumption, physical inactivity, poor diet, and obesity, as well as intermediate risk factors like hypertension, diabetes, and cancer screening practices.

The study collected data from 5,638 randomly selected individuals aged 15–64 from 36 soums (villages) in 20 aimags (provinces) and 6 districts of Ulaanbaatar. The data collection period was from October 8th to November 2nd, 2009, for selected aimags, and from December 10th to 25th, 2009, in Ulaanbaatar.

Data was collected using small handheld computers (PDAs) and was analyzed using EPI INFO version 3.5.1, taking into account the complex sample design. Sample weighting and adjustments were made to ensure the data reflected the actual population distribution.

Main Objectives

• To assess the prevalence of common modifiable risk factors for NCDs and major causes of injury.
• To determine the prevalence of hypertension, overweight, obesity, hypercholesterolemia, and hyperglycemia.
• To compare the current prevalence of NCD risk factors with those from the 2005 STEPS survey.

Key Findings

1. Tobacco Use

• 27.6% of the population smoked.
• 48.0% of men and 6.9% of women were current smokers.
• 87.9% of smokers smoked daily.
• 42.9% of the population was exposed to second-hand smoke at home.
• 35.6% of the population was exposed to second-hand smoke at work.

2. Alcohol Consumption

• 38.6% of all respondents consumed alcohol in the past 30 days.
• 49.8% of men and 27.2% of women were current drinkers.
• On average, current drinkers consumed 7.7 standard drinks per occasion, with 9.2 for men and 5.1 for women.
• Binge drinking (more than 5 drinks for men, 4 for women) was reported by 39.7% of men and 15.1% of women.

3. Diet and Physical Activity

• Average daily servings of fruits and vegetables were 1.8, 3.2 servings below WHO recommendations.
• 92.3% of the population consumed less than 5 servings of fruits and vegetables daily.
• Fruit and vegetable consumption was significantly lower in rural areas compared to urban areas.
• Daily salt intake was 7.3 grams, with rural residents consuming 1.6 grams more on average than urban residents.
• 7.5% of the population did not meet the minimum recommendation for physical activity.
• Urban men were 4 times more likely than rural men to be in the low physical activity category.
• Urban women were twice as likely as rural women to be in the low physical activity category.
• The median duration of physical activity per day was:
  • 214.2 minutes in high or moderate activity at work.
  • 30.0 minutes during transport.
  • 51.4 minutes in recreational settings.

4. Body Mass Index (BMI)

• The mean BMI of the study population was 24.6 kg/m².
• Men: 24.3 kg/m²; Women: 24.9 kg/m².
• Overweight prevalence: 39.8%.
• Obesity prevalence: 12.5%.
• Central obesity prevalence:
  • Men: 29.1% (WC ≥ 90 cm).
  • Women: 55.7% (WC ≥ 80 cm).

5. Cardiovascular Risk Factors

• High-risk cholesterol (≥ 5.0 mmol/L or ≥ 190 mg/dl or on medication): 25.0%.
• Hypercholesterolemia (≥ 6.2 mmol/L or ≥ 240 mg/dl or on medication): 8.5%.
• High-risk triglycerides (≥ 1.7 mmol/L or ≥ 150 mg/dl): 22.4%.
• Hypertriglyceridemia (≥ 2.0 mmol/L or ≥ 180 mg/dl): 29.5% in men and 15.4% in women.
• Increased blood LDL (≥ 3.0 mmol/L): 42.4%.
• Decreased blood HDL (≤ 1.0 mmol/L): 20.2%.
• Women had 2.7 times higher risk of decreased HDL compared to men.

6. Blood Pressure

• Mean systolic blood pressure (SBP):
  • Men: 129.8 mmHg.
  • Women: 121.4 mmHg.
• Hypertension prevalence: 27.3%.
• Men had significantly higher prevalence of hypertension than women.
• No significant difference in hypertension prevalence between urban and rural populations.

7. Diabetes

• Mean fasting blood glucose: 4.7 mmol/L.
• Impaired fasting glycaemia (IFG): 9.4% in the study population, 11.5% in men, 7.5% in women.
• Diabetes prevalence:
  • Study population: 6.5%.
  • Men: 8.9%.
  • Women: 4.1%.

8. Cancer Screening

• Cervical cancer screening:
  • VIA test: 5.2% of women.
  • Pap smear test: 11.4% of women.
• Breast cancer screening:
  • Breast self-examination: 33.3% of women.
  • Clinical breast examination: 3.2%.
  • Mammography: 1.7%.
• Cervical and breast cancer screening coverage was similar in urban and rural settings.

9. Injury and Violence

• Road traffic injury prevalence: 4.0%.
  • 22.7% due to speeding.
  • 9.1% due to drunk driving.
  • 83.6% of drivers and passengers did not use seatbelts regularly.
• Violent injury prevalence: 3.5%.
  • 4.4% in men and 2.5% in women.
  • Men were more likely to be victims of interpersonal violence.
  • 30.4% of women involved in violence reported being abused by family or partners.
  • 24.2% were abused by friends.
  • 62.3% of survey respondents reported child abuse.

Comparative Trends (2005 vs. 2009)

• Smoking prevalence remained about the same.
• Women started smoking at a younger age on average.
• Alcohol consumption decreased in percentage over the past 12 months, but frequency showed a slight increase.
• Fruit and vegetable consumption decreased significantly:
  • Fruit: from 0.8 to 0.4 servings.
  • Vegetables: from 1.6 to 1.3 servings.
• Daily salt intake decreased.
• Median time spent in physical activity increased slightly.
• Percentage with high physical activity increased from 70.4% to 81.8%.
• No significant change in NCD risk factor prevalence overall, but trends showed improvements in some areas like physical activity and diet.

Conclusion

The survey provided key data on the prevalence of NCD and injury risk factors in Mongolia, which is essential for public health planning and policy-making. It emphasized the need for targeted interventions to reduce risk factors like tobacco use, alcohol consumption, poor diet, and physical inactivity. The data was weighted and analyzed to ensure representativeness and comparability with global standards. The results will support future strategies and monitoring efforts for the National NCD Program and WHO initiatives.

Key Organizations and Contributors

• Ministry of Health (MOH)
• World Health Organization (WHO)
• Millennium Challenge Account (MCA) Mongolia Health Project
• Public Health Institute (PHI)
• Health Sciences University
• National Medical Research Institute
• National Cancer Center
• Mongolian State Committee of Physical Culture and Sports
• National Traumatology and Orthopaedic Research Center
• Child Rights Protection Center
• WHO Technical Officers and International Consultants

This survey is a valuable resource for understanding the current health landscape in Mongolia and for guiding health interventions and policy development.