2001-12-31-世界卫生组织-2002_STEPS_Country_Report_Bangladesh_125页_2mb

Summary of "Behavioural Risk Factors of Non-Communicable Diseases in Bangladesh"

Core Content

This document presents a comprehensive analysis of the behavioural risk factors associated with Non-Communicable Diseases (NCDs) in Bangladesh, focusing on tobacco use, dietary patterns, and physical activity status. The study was conducted as part of a WHO-sponsored initiative to establish a national health behavioural risk factor surveillance system, targeting adults aged 25–64 in both urban and rural settings. The study employed the WHO STEPwise approach (STEPS) to NCD risk factors, with modifications to align with the local Bangladeshi context.

Main Findings

• Tobacco Usage:

  • Rural respondents had a higher prevalence of smoking compared to urban residents.
  • Smoking prevalence decreased with increasing social status in urban areas.
  • Despite high awareness of the health risks associated with smoking, the prevalence remains significant.
  • Smokeless tobacco use is also common, particularly in rural areas.
  • Awareness of the dangers of tobacco is widespread, but the actual consumption persists.

• Physical Activity:

  • Physical activity levels were lower in urban areas than in rural ones.
  • In rural areas, females were more physically active than males.
  • In urban areas, the gender difference in physical activity was minimal.
  • Sedentary lifestyles and lack of exercise are significant contributors to NCDs.

• Dietary Patterns:

  • There is a notable difference in dietary habits between urban and rural populations.
  • Rural dwellers consumed less greasy and fatty food compared to urban residents.
  • Lower social classes in urban areas also showed lower intake of unhealthy foods.
  • Obesity is more prevalent in urban areas, especially among higher social classes.

• BMI Trends:

  • Rural participants generally had lower BMI than urban residents.
  • BMI increased with higher social class in urban areas.
  • Slum and lower social class urban residents had BMI patterns similar to rural populations.

• Health Seeking Behavior:

  • Most NCD patients were treated by modern allopathic doctors.
  • Urban populations had a stronger preference for private healthcare facilities.
  • There is a need for more community-based health education and awareness programs.

• Cancer and Cardiovascular Diseases:

  • Cardiovascular diseases and cancer are the leading causes of death in Bangladesh.
  • The prevalence of hypertension and other chronic diseases is rising.
  • The burden of NCDs is significant, especially in a low-income country like Bangladesh.

Key Risk Factors

• Smoking: A major risk factor for CHD, cancer, stroke, and other NCDs.
• Alcohol Consumption: Rare in Bangladesh, hence not included in the study.
• Unhealthy Diet: High intake of greasy and fatty foods is linked to increased NCD risk.
• Physical Inactivity: Associated with higher obesity rates and increased risk of chronic diseases.
• Obesity: A growing problem, especially in urban areas.
• High Blood Pressure: Common and often undiagnosed in developing countries.
• High Cholesterol and Blood Glucose: Also contribute to NCD risk.

Methodology

• The study followed the WHO STEPwise approach to NCD surveillance.
• Sampling Plan:
  • Urban areas: 7,282 participants from three socio-economic strata.
  • Rural areas: 4,127 participants from two unions in Dhamrai Upazilla.
• Data Collection:
  • Conducted via face-to-face interviews using a pre-tested questionnaire.
  • Anthropometric and blood pressure measurements were also taken.
• Training:
  • Research staff underwent a 6-day training program covering questionnaire completion, food frequency tabulation, and measurement techniques.
  • Supervisors conducted regular checks for data accuracy and reliability.
• Data Analysis:
  • Used SPSS for data entry and analysis.
  • Included univariate, bivariate, and multivariate approaches.
  • Followed WHO STEPS guidelines for analysis.

Key Recommendations

• Primary Prevention is essential to combat the global epidemic of NCDs.
• Community-based interventions are necessary to change health behaviors and improve lifestyle.
• Health education should be a core component to promote awareness and behavioral change.
• Surveillance systems must be strengthened to collect accurate and timely data on NCD risk factors.
• Cultural sensitivity is important in designing interventions, especially regarding tobacco and alcohol use.

Importance of the Study

• The study highlights the growing burden of NCDs in Bangladesh due to lifestyle changes.
• It underscores the need for integrated community-based programs to address risk factors.
• It provides a foundation for future interventions and policy-making to improve public health outcomes.

Key Personnel

• Principal Investigator: Professor Mahmudur Rahman, Ph.D, Director, IEDCR
• Co-Investigators:
  • Professor (Col) Mahmudur Rahman
  • Dr. Meerjady Sabrina Flora
  • Dr. Seikh Farid Uddin Akter
  • Dr. Shaila Hossain
• Consultant: Professor C G N Mascie-Taylor, University of Cambridge

Conclusion

The study emphasizes the urgent need for behavioral change and primary prevention strategies to address the rising prevalence of NCDs in Bangladesh. It advocates for the development of effective surveillance systems and community-based interventions to promote healthier lifestyles and reduce the burden of NCDs. The findings highlight the importance of understanding and addressing the unique risk factors in different socio-economic and geographic contexts.