2010-12-31-世界卫生组织-2011_STEPS_Country_report_Iran_Islamic_Republic_of_57页_1mb

Iran STEPs Summary (2011)

Core Content

The Iran STEPs (Stepwise Approach to Surveillance of Non-Communicable Disease Risk Factors) is a surveillance system recommended by the World Health Organization (WHO) to collect data on risk factors for non-communicable diseases (NCDs). It was implemented as the sixth round of the national survey in March 2011, involving 12,000 citizens aged 15-64 from 31 provinces. The survey aims to develop infrastructure for NCD risk factor surveillance, support evidence-based decision-making, and monitor the effectiveness of prevention and control programs.

Main Objectives

• Develop infrastructure for NCD risk factor surveillance
• Strengthen monitoring and evaluation of NCD control programs
• Provide reliable and up-to-date information on risk factors at national and provincial levels
• Prepare tools for evidence-based public health decision making
• Promote knowledge and capacity in NCD prevention and primary health care (PHC)

Methodology

• Conducted as a population-based cross-sectional survey
• Followed the WHO Stepwise approach, with three steps:
  1. Step 1: Interview-based on demographic and behavioral risk factors (e.g., tobacco use, diet, physical activity, hypertension, diabetes)
  2. Step 2: Physiological measures (e.g., blood pressure, BMI, waist circumference)
  3. Step 3: Biochemical measures (e.g., fasting blood glucose, blood lipids)
• Data collected using standardized protocols and entered into EpiInfo 6
• Weighted frequency estimates were calculated using Stata version 10, with 95% confidence intervals and significance levels at p < 0.05

Key Findings

1. Tobacco Use

• Overall prevalence of current smoking: 10.91%
  • Males: 20.84%
  • Females: 0.90%
• Daily smokers: 9.93% of all respondents
  • Males: 19.16%
  • Females: 0.63%
• Mean age at which daily smoking started: 21.23 years
  • Urban: 21.27 years
  • Rural: 20.82 years
• Average number of manufactured cigarettes smoked per day:
  • Overall: 10.15
  • Males: 12.53
  • Females: 7.74
  • Urban: 9.56
  • Rural: 13.59

2. Fruit and Vegetable Consumption

• Overall prevalence of less than 5 servings per day: 88.15%
  • Males: 89.50%
  • Females: 86.78%
• Urban: 87.07%
  • Males: 88.60%
  • Females: 85.51%
• Rural: 90.53%
  • Males: 91.70%
  • Females: 89.36%

3. Physical Activity

• Overall prevalence of low activity (<600 MET-minutes/week): 40.12%
  • Males: 31.53%
  • Females: 48.82%
• Mean minutes of physical activity per day:
  • Overall: 92.42
  • Males: 134.83
  • Females: 49.42
• Urban: 83.31
  • Males: 121.83
  • Females: 44.25
• Rural: 114.44
  • Males: 166.5
  • Females: 61.64

4. Overweight and Obesity

• BMI categories:
  • Underweight and normal weight: <25.0 kg/m²
  • Overweight: 25.0–<30.0 kg/m²
  • Obese: ≥30.0 kg/m²
• Overall mean BMI: 25.34 kg/m²
  • Males: 24.76 kg/m²
  • Females: 25.93 kg/m²
• Prevalence of overweight or obese: 48.24%
  • Males: 44.96%
  • Females: 51.59%

5. High Blood Pressure

• Overall prevalence: 19.01%
  • Males: 18.83%
  • Females: 19.21%

6. Diabetes Prevalence

• Mean fasting blood glucose: 93.02 mg/dl
  • Males: 92.87 mg/dl
  • Females: 93.16 mg/dl
• Prevalence of defined diabetes or treatment: 13.79%
  • Males: 13.02%
  • Females: 14.57%

7. Cholesterol Levels

• Overall mean cholesterol: 180.58 mg/dl
  • Males: 176.82 mg/dl
  • Females: 184.38 mg/dl
• Urban: 182.14 mg/dl
  • Males: 178.68 mg/dl
  • Females: 185.63 mg/dl
• Rural: 177.31 mg/dl
  • Males: 172.68 mg/dl
  • Females: 181.97 mg/dl
• Elevated cholesterol (≥5.2 mmol/L): 28.43%
  • Males: 25.89%
  • Females: 30.98%
• Elevated cholesterol (≥6.5 mmol/L): 5.34%
  • Males: 4.13%
  • Females: 6.57%

8. HDL Levels

• Overall mean HDL: 44.31 mg/dl
  • Males: 41.62 mg/dl
  • Females: 47.03 mg/dl
• Urban: 43.77 mg/dl
  • Males: 40.97 mg/dl
  • Females: 46.59 mg/dl
• Rural: 45.35 mg/dl
  • Males: 42.94 mg/dl
  • Females: 47.78 mg/dl

9. Triglycerides Levels

• Overall mean triglycerides: 149.38 mg/dl
  • Males: 157.23 mg/dl
  • Females: 141.37 mg/dl
• Urban: 156.73 mg/dl
  • Males: 166.90 mg/dl
  • Females: 146.36 mg/dl
• Rural: 134.98 mg/dl
  • Males: 137.69 mg/dl
  • Females: 132.22 mg/dl
• Elevated triglycerides (≥2.26 mmol/L): 19.61%
  • Males: 21.98%
  • Females: 17.18%

10. Raised NCD Risk

• Percentage with low risk (none of the risk factors): 2.79%
  • Males: 3.0%
  • Females: 2.58%
• Raised risk among 15-44 years: 26.96%
  • Males: 26.04%
  • Females: 27.91%
• Raised risk among 45-64 years: 54.29%
  • Males: 52.13%
  • Females: 56.48%

Additional Information

1. Demographic Information

• Total respondents: 12,104
• Urban: 8,343 (68.93%)
• Rural: 3,761 (31.07%)

2. Employment Status

• Government employee: 8.04% (overall)
• Non-government employee: 10.55% (overall)
• Self-employed: 34.78% (overall)
• Unpaid: 46.64% (overall)

3. Unpaid Work and Unemployment

• Percentage of unpaid workers:
  • Overall: 46.64%
  • Urban: 72.88%
  • Rural: 73.21%
• Percentage of unemployed:
  • Overall: 1.95%
  • Urban: 5.80%
  • Rural: 2.70%

4. Ex-Daily Smokers

• Overall percentage: 3.93%
  • Males: 7.36%
  • Females: 0.47%
• Mean years since quitting:
  • Overall: 10.30 years
  • Males: 9.49 years
  • Females: 11.11 years

5. Dietary Habits

• Mean number of days fruit consumed in a typical week:
  • Overall: 4.88 days
  • Males: 4.73 days
  • Females: 5.03 days
• Mean number of fruit and vegetable servings per day:
  • Overall: 4.88 servings
  • Urban: 4.88 servings
  • Rural: 4.88 servings

Conclusion

The Iran STEPs survey provides a comprehensive overview of NCD risk factors in the country. It highlights significant gender and urban-rural disparities in tobacco use, physical activity, and dietary habits. The findings are essential for developing targeted prevention strategies and improving public health policies in Iran.