2006-12-31-世界卫生组织-2007_STEPS_Country_Report_India_142页_1mb

Summary of IDSP Non-Communicable Disease Risk Factors Survey, Phase-I States of India (2007-08)

Core Content

The Integrated Disease Surveillance Project (IDSP), under the Government of India and led by the Indian Council of Medical Research (ICMR), conducted a Non-Communicable Disease (NCD) Risk Factors Survey in seven Indian states (Andhra Pradesh, Kerala, Madhya Pradesh, Maharashtra, Mizoram, Tamil Nadu, and Uttarakhand) in 2007-08. This survey aimed to collect data on key risk factors for NCDs such as tobacco and alcohol use, diet, physical activity, and the prevalence of hypertension and diabetes.

The survey was implemented through a multi-stage sampling approach, with seven State Survey Agencies, five Regional Resource Centers, and the National Institute of Medical Statistics (NIMS) as the National Nodal Agency. It provided state-wise estimates of NCD risk factors across different demographic and geographic strata.

Main Objectives

• To assess the prevalence of NCD risk factors in selected states.
• To understand the socio-demographic patterns of these risk factors.
• To support targeted prevention and effective health care planning for NCDs.
• To provide baseline data for future surveillance and intervention strategies.

Key Risk Factors Assessed

1. Tobacco Use

• Current Smokers/Smokeless Tobacco Users: Data was collected on smoking and smokeless tobacco use, including:
  • Current daily smokers/smokeless users (those who use tobacco daily).
  • Past daily smokers/smokeless users (those who used daily in the past but not in the last year).
  • Non-smokers/never users (those who have never smoked or used smokeless tobacco).
• Patterns by sex and residence (urban vs. rural) were analyzed.
• Age of initiation, age at cessation, and exposure to tobacco smoke were also evaluated.

2. Alcohol Consumption

• Current drinkers (those who consumed alcohol in the year preceding the survey).
• Former drinkers (those who consumed alcohol in the past but not in the last year).
• Lifetime abstainers (never consumed alcohol).
• High-risk drinkers (binge drinkers) were defined as those consuming more than 5 standard drinks per day (4 for women).
• Patterns by age, sex, and residence were analyzed.

3. Diet and Physical Activity

• Fruits and Vegetables Consumption:
  • Standard serving: 80 grams, equivalent to different units depending on the type of food.
  • Less than five servings per day was identified as inadequate.
• Physical Activity:
  • Measured in MET minutes (Metabolic Equivalent).
  • Differentiated between work-related, travel-related, and recreational activity.
  • Low physical activity was defined as less than 30 minutes of moderate activity per day.

4. Chronic Conditions

• Hypertension:
  • Stage I: Blood pressure 140-159 mmHg (systolic) or 90-99 mmHg (diastolic).
  • Stage II: Blood pressure ≥160 mmHg (systolic) or ≥100 mmHg (diastolic).
• Diabetes:
  • Assessed through history of raised blood sugar, treatment, and lifestyle modification.

5. Anthropometric Measurements

• Body Mass Index (BMI):
  • Underweight: <18.5 kg/m².
  • Normal weight: 18.5–24.9 kg/m².
  • Overweight: ≥25 kg/m².
• Central Obesity:
  • Measured by waist circumference.
  • Cut-off levels:
    • Males: 90 cm (Indian standard), 102 cm (global standard).
    • Females: 80 cm (Indian standard), 88 cm (global standard).

Key Findings

• The survey covered a significant number of households and individuals across the seven states.
• Tobacco use was prevalent in both urban and rural areas, with notable differences in patterns across states.
• Alcohol consumption varied by age, sex, and residence, with higher prevalence in certain regions.
• Poor dietary habits were observed, particularly in terms of low fruit and vegetable intake.
• Low physical activity was common, especially among older adults and those with lower education levels.
• Hypertension and diabetes were found to be significant public health concerns, with Stage I and II prevalence reported.

Implementation and Collaboration

• The survey was conducted under the guidance of ICMR and supported by the National Technical Advisory Committee (NTAC) and National Monitoring Committee (NMC).
• Partners included:
  • State Survey Agencies.
  • Regional Resource Centers.
  • NIMS as the National Nodal Agency.
• The World Bank provided financial support for the Phase-I survey.
• Technical support was received from various experts and institutions, including AYUSH practitioners, WHO, and NICD.

Conclusion

This survey marks a critical step in NCD surveillance in India, providing valuable insights into the risk factors associated with non-communicable diseases. The findings will help the Government of India in developing targeted prevention and control strategies. It also lays the foundation for further research and policy development in the field of NCDs.