2014-12-31-世界卫生组织-2015_STEPS_Country_Report_Ethiopia_203页_5mb

Ethiopia STEPS Report on Risk Factors for Non-Communicable Diseases and Prevalence of Selected NCDs (2015)

Core Content Overview

This report presents the findings of the Ethiopia STEPS survey, a national representative population-based study conducted in 2015 to assess risk factors for non-communicable diseases (NCDs) and the prevalence of selected NCDs. The survey was implemented by the Ethiopian Public Health Institute (EPHI) in collaboration with the Federal Ministry of Health (FMOH) and the World Health Organization (WHO), aiming to provide empirical evidence for the prevention and control of NCDs in Ethiopia.

Main Objectives

• To identify risk factors for chronic NCDs
• To assess the prevalence of selected NCDs
• To provide baseline data for policy and program development
• To support the establishment of an epidemiological surveillance system for NCDs

Methodology

The survey followed the WHO STEPS methodology, which is a standardized approach for collecting data on NCD risk factors. Key components of the methodology include:

• Survey Design: A cross-sectional study to collect data on NCD risk factors and prevalence.
• Survey Population: Adults aged 18–64 years from various regions of Ethiopia.
• Sample Size Determination: A representative sample was selected to ensure accuracy and generalizability of results.
• Sampling Procedure: Multi-stage cluster sampling was used to cover all regions.
• Survey Instrument: A structured questionnaire was used to collect data on demographics, tobacco use, alcohol consumption, diet, physical activity, khat use, and violence/injury.
• Data Collection: Conducted by trained field staff across Ethiopia.
• Data Quality Assurance: Implemented through training, supervision, and validation processes.
• Data Management: Centralized data collection and processing.
• Weighting of Data: Adjusted for population distribution to ensure representativeness.
• Data Analysis: Statistical methods were used to analyze the data and identify associations.
• Ethical Clearance: Obtained from the Institutional Review Board (IRB).

Key Findings

Tobacco Use and Policy

• Smoking Prevalence: Males had a higher smoking rate than females.
• Smoking Patterns: Daily smokers consumed varying amounts of tobacco, with a significant proportion using manufactured or hand-rolled cigarettes.
• Smoking Attempts to Quit: A notable proportion of current smokers attempted to quit in the past 30 days.
• Second-Hand Smoke Exposure: Both males and females were exposed to second-hand smoke in the home and workplace.
• Tobacco Policy Awareness: A majority of respondents were aware of health warnings on cigarette packages, though awareness varied by age and residence.

Alcohol Consumption

• Alcohol Use: Alcohol consumption was more common among males and urban populations.
• Drinking Frequency and Quantity: There was a wide variation in drinking frequency and quantity, with a significant portion of respondents consuming high volumes.
• Health Impact: A considerable number of respondents reported health-related issues due to alcohol use, including family problems and dependency.

Diet

• Fruit and Vegetable Intake: Low consumption of fruits and vegetables was observed across all age and sex groups.
• Salt Intake: High salt consumption was common, with many respondents adding salt before or during meals.
• Processed Foods: A significant proportion of respondents consumed processed foods high in salt.
• Awareness of Salt Health Risks: Most respondents recognized the health risks of excessive salt consumption.

Physical Activity

• Physical Activity Levels: A large proportion of respondents did not meet WHO physical activity recommendations.
• Sedentary Behavior: Sedentary lifestyles were prevalent, especially among females and in urban areas.
• Activity Type: Work, transport, and recreational activities were the main contributors to total physical activity.

Khat Use

• Khat Chewing Prevalence: Khat use was more common among males and in rural areas.
• Khat Use Patterns: Daily users were more prevalent, and many had tried to quit.
• Khat and Alcohol Use: A significant number of khat users also consumed alcohol.

Violence and Injury

• Injury Causes: Road traffic accidents, non-road traffic incidents, and violent incidents were the main causes of injury.
• Violent Injuries: A notable proportion of respondents experienced violent injuries, with higher rates among males and in urban areas.
• Sexual Abuse: A small but significant percentage of respondents reported experiencing sexual abuse.

NCD Prevalence and Management

• Blood Pressure: A significant proportion of respondents had raised blood pressure or were on medication for it.
• Blood Sugar: Impaired fasting glucose (IFG) and diabetes were also prevalent.
• Cholesterol Levels: High total cholesterol and low HDL cholesterol levels were common.
• Lifestyle Advice: A portion of respondents received lifestyle advice from health professionals.
• Cervical Cancer Screening: Screening rates varied by age and residence, with lower rates among women in rural areas.

Summary of Risk Factors

• Cardiovascular Disease (CVD) Risk: A high proportion of the population was at risk for CVD, with significant associations found between smoking, alcohol use, poor diet, and low physical activity.
• Combined Risk Factors: The report highlights the cumulative effect of multiple risk factors, such as smoking and alcohol use, on CVD risk.

Recommendations and Conclusion

• Policy Development: The report recommends the development of evidence-based public health interventions to address NCD risk factors.
• Health Promotion: Enhancing awareness and education on the risks of tobacco, alcohol, poor diet, and lack of physical activity.
• Surveillance System: Establishing a robust epidemiological surveillance system for NCDs.
• Community Engagement: Encouraging community involvement in promoting healthy lifestyles and reducing NCD risk factors.
• Healthcare Access: Improving access to healthcare services for NCD management and screening, particularly in rural areas.

Conclusion

The Ethiopia STEPS survey provides critical insights into the risk factors and prevalence of NCDs in the country. It underscores the urgent need for targeted interventions to reduce the growing burden of NCDs, especially in light of the increasing trends in health facilities. The findings will serve as a foundation for future public health policies and programs aimed at prevention and control of NCDs in Ethiopia.