2010-12-31-世界卫生组织-2011_STEPS_Country_Report_Maldives_104页_3mb

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# WHO STEPS Survey Summary: Noncommunicable Disease Risk Factors in Maldives (2011)

## Introduction
This report summarizes data from the second round of the WHO STEPwise approach to chronic disease surveillance conducted in Malé, Maldives in 2011, focusing on key behavioral and biological risk factors. Comparisons were made with data from a 2004 survey to assess progress towards understanding and controlling the burden of noncommunicable diseases (NCDs) in the population.

## Methodology
*   **Survey Design:** A cross-sectional survey methodology was employed, using a multistage random sampling technique targeting individuals aged 15–64 years residing in Malé.
*   **Data Collection:** Data was gathered through standardized questionnaires covering demographics, smoking habits, alcohol use, diet, physical activity, and clinical measurements (height, weight, blood pressure). Biochemical tests faced high non-response rates.
*   **Instruments:** The survey utilized the official WHO STEPwise instrument for NCD risk factor surveillance.

## Key Findings

### Smoking
*   **Prevalence:** Approximately 18.8% of surveyed individuals (34.7% of men, 3.4% of women) were current smokers.
*   **Trends:** While the proportion of current daily smokers decreased slightly compared to 2004 (22.0% in 2004), the average age at which participants started smoking was lower in 2011.

### Diet
*   **Fruits & Vegetables:** Consumption remained remarkably low. Around 93% of respondents consumed less than five servings daily (adjusted for local serving sizes).
*   **Oils:** Most households primarily used vegetable oil for cooking.

### Physical Activity
*   **Levels:** Over half (53.3%) of the respondents were classified as having low levels of physical activity (<600 MET-minutes/week).
*   **Duration:** Population medians indicated significantly less than recommended time spent on physical activity daily, particularly among women.

### Body Weight and Blood Pressure
*   **Obesity/Hypertension:** High rates of overweight/obesity and raised blood pressure were observed. About 37% of men and women combined were classified as overweight.
*   **BP Control:** Alarmingly, only about 16.6% of the surveyed population had raised blood pressure (SBP ≥140 or DBP ≥90 mmHg or were on treatment). Furthermore, 83% of those with raised blood pressure were **NOT REceiving treatment**.

## Discussion & Recommendations

*   **Stagnant Behaviors:** Significant challenges remain in addressing smoking, dietary intake (especially fruits/veg), and physical inactivity, despite efforts. Hypertension control is particularly poor.
*   **Needs:** Further, strong public health actions are needed, including tobacco control measures (like enforcing smoke-free legislation), promoting healthy dietary patterns (fruit/vegetable consumption, reducing salt/sugar), increasing opportunities for physical activity, and improving access to and uptake of hypertension treatment.
*   **Recommendations & Surveillance:** Data should guide the National Strategic Plan updates, enable evidence-based interventions, and support continued surveillance efforts for NCD risk factors.

## Limitations
*   **Sample Size & Representativeness:** Data represents only participants from Malé due to resource constraints.
*   **Non-Response:** High drop-off in biochemical testing.
*   **Data Quality:** Some reported rates of detailed information were low, limiting deeper analysis.
*   **Generalizability:** Findings are for Malé only and may not reflect the Maldives population nationally.

## Summary of Combined Risk Factors
Approximately one in five participants (20.6%) had *three or more* risk factors out of the five assessed (smoking, low fruit/vegetable intake, low physical activity, overweight/obese, or raised BP/untreated).