Type of Article:-Research Article
Prevalence of major Non-communicable diseases and its socio-demographic
characteristics in adult population of Block Hajin, Bandipoora J&K.
1) Dr Showkat ahmad khan, P.G., Department of community Medicine, Sheri-i-kashmir Institute
of Medical Sciences , Soura, Srinagar (Jammu & Kashmir). E-mail:dr.showket.khan@gmail.com.
2) Dr Rafiq Mir, Associte professor, Department of Community Medicine, SKIMS Medical
college Bemina , Srinagar (Jammu & Kashmir). E-mail:-dr.mmrafiq@gmail.com.
3) Dr Anjum Fazili, Additional professor, Department of Community Medicine, Sheri-i-kashmir
Institute of Medical Sciences , Soura, Srinagar (Jammu & Kashmir). E-mail:anjubfazili@gmail.com
4) Dr Rohul jabeen, Additional professor, Department of Community Medicine, Sheri-i-kashmir
Institute of Medical Sciences , Soura, Srinagar (Jammu & Kashmir). E-mail:rjsskims@gmail.com
5) Syed Shuja Qadri, Senior Resident, Department of Community Medicine, Sheri-i-kashmir
Institute of Medical Sciences , Soura, Srinagar (Jammu & Kashmir). E-mail:ssaqadri@yahoo.com
6) Dr Rifat Jan
PG Deptt Of Community Medicine GMC Srinagar
Corresponding author: - Dr Rafiq Mir, Associte professor, Department of Community Medicine,
SKIMS Medical college Bemina , Srinagar (Jammu & Kashmir). E-mail:dr.mmrafiq@gmail.com.Contact:-9419005278.
Abstract
Background:- Non-communicable disease is a medical condition or disease which noninfectious, of long duration and generally of slow progression. Major NCDs include
cardiovascular diseases, strokes, diabetes mellitus, cancers and chronic respiratory diseases.
They account for a significant part of overall mortality, morbidity & disability, result in huge
economic losses to nations, are a cause of psychosocial suffering and are therefore recognized as
major public health problem. Objective:- To find out prevalence and socioeconomic
characteristics of NCDs in study population of block Hajin. Design:- Community based crosssectional epidemiological study conducted between May to October 2013. Results:- Out of the
total study population it was seen that the general prevalence of NCDs was 209 (34.83%) of
which 125(34.72%) were males and 125(34.72%) were females respectively. The most common
NCD was Hypertension (66.02%) followed by Diabetes (22%) and Cancers (11.96%)
respectively. Age, sex, type of family, SE status were significantly associated with the
occurrence of NCDs (p<0.01). Conclusion: The rising burden of chronic NCDs affecting older
people place a heavy burden on healthcare system as a result of increased demand and access to
healthcare services. Concerted effort is needed to develop strategies for the prevention and
management of NCDs, especially among economically disadvantaged individuals who need
these services the most.
Key words:- Non-communicable disease, Morbidity, Mortality.
Introduction
A non-communicable disease is a medical condition or disease which non-infectious,
of long duration and generally of slow progression. Major NCDs include cardiovascular diseases,
strokes, diabetes mellitus, cancers and chronic respiratory diseases. They account for a
significant part of overall mortality, morbidity & disability, result in huge economic losses to
nations, are a cause of psychosocial suffering and are therefore recognized as major public health
problem(1) .Non-communicable diseases (NCDs) are increasingly recognized as a major cause of
mortality and morbidity across the globe. They represent the highest burden among all three
major groups of non-infectious causes of disease including pre-transitional causes, NCDs,
accidents and injuries (2).
Chronic non-communicable diseases (NCDs) account for approximately 63% of deaths and 43%
of global disease burden (2008).By 2020, these NCDs will account for 73% deaths and 60%
global disease burden. Almost 80% of NCDs occur in developing countries4. The burden of
NCDs is also increasing in South Asia. Almost half of all deaths in Asia are now attributable to
NCDs, accounting for 47% of global burden of disease(5).Non-communicable diseases (NCDs)
are top killers in the South-East Asia Region (SEAR), causing 7.9 million deaths annually. The
number of deaths is expected to increase by 21% over the next decade. In SEAR NCDs kill
people at a relatively younger age compared to the rest of the world. In India 53% of deaths in
2005 is attributed to Non Communicable Diseases. Almost half of these are due to
cardiovascular diseases. Cardiovascular diseases are projected to be the largest cause of death
and disability in 2020 .(WHO Report-2002). Current projections also suggest that total cancer
burden will double by 20266. According to a recent projection, seven out of every 10 deaths in
low-income countries will be from chronic NCDs by 2020(7), which pose a serious challenge to
the developing countries
(8)
. WHO have been advocating policy makers to develop efficient
strategies to halt ‘Tomorrow’s Pandemic’ of the chronic NCDs (9,10).
The NCD epidemic exacts a massive socioeconomic toll throughout the world. It is rising
rapidly in lower-income countries and among the poor in middle- and high-income countries.
The NCD epidemic is thwarting poverty reduction efforts and robbing societies of funds that
could otherwise be devoted to social and economic development. If common development goals
are to be achieved, they must do more than raise incomes and consumption; they must free as
many people as possible from disease and disability, and reduce the widening gap between the
haves and have nots(11). The present study was undertaken to assess the prevalence and
socioeconomic characteristics of NCDs in adult population of block Hajin utilizing WHO STEPS
approach. The data collected will provide the baseline information for health services planning
and will help in formulating an integrated strategy on NCD prevention and control. The data
could also be used to plan and evaluate health promotion and disease prevention programs.
Methodology
The study was a population based cross sectional survey of 25-64 years old in rural block
Hajin. A pre tested and pre structured proforma based on modified WHO STEPS approach
questionnaire was utilized. Socioeconomic status was assessed by utilizing Udai Pareek’s scale.
The sample size came out to be 600 individuals. A multistage cluster sampling design was used.
All the villages along with their population were enlisted. Then cumulative population was
calculated. The cumulative population was divided by 30 to get cluster interval. First cluster was
chosen randomly and subsequent clusters based on cluster interval. Each cluster was divided into
segments based on natural boundaries or Mohallas and one segment selected randomly was taken
for HH survey. Continuous HH were surveyed till total 20 individuals are studied. If the number
of individuals was less than adjacent segments were utilized. The list of all the villages of health
block Hajin was made. Out of this list 30 villages were chosen randomly. From each of the
villages one of the household was chosen and from each cluster 20 individuals were selected.
Each house hold received a number. The individuals in each household were selected by Kish
method. The study population consisted of 240 males and 360 females. The individuals were
interviewed for the presence of any NCDs.
Results
The study was a population based cross sectional survey conducted on 25-64 years old
participants in rural block area of Hajin, Bandipora (J&K) May to October 2013 for a period of 6
months.
Table 1 shows the demographic characters of study population. it was seen that out of a
total of 600 study subjects 360 were females and 240 were males. Further it was observed that
the participants (male and female) were somewhat equally distributed among all age groups. Our
study found that the general prevalence of NCDs in study population came out to be
209(34.83%) with males accounting for 35% and females 34.72% respectively (Table 2).in the
present study it was observed that the most common NCD was hypertension (66.02%) followed
by diabetes (22%) and cancers (11.96%) respectively (Table3).
Regarding the Socio-demographic characteristics of study population it was revealed that
the commonest NCDs among males was found to be cancers (68%) followed by
hypertension(36.9%) whereas in females it was seen that commonest NCD was diabetes
(65.21%) followed by hypertension (63.04%). Overall it was found that the NCDs had a
significant association with the sex of the study subjects (p<0.05) (Table 4). Regarding the
distribution of NCDs as per the age of study subjects it was revealed that the commonest age
group which was affected by one or the other major type of NCDs was 45-54 years (33.97%)
followed by the age group of 55-64 years (27.75%) whereas less prevalence of NCDs was found
in age group of 25-34 years (15.78%). Overall NCDs had a highly significant association with
the age of study subjects (p<0.001) (Table 5).
As far as distribution of NCDs was concerned as per the type of family it was found that
joint families (59.8%) had higher prevalence as compared to nuclear families (40.19%)
respectively. Further in joint families the commonest NCDs were diabetes (78.2%) and
hypertension (70.28%) whereas in nuclear families it was cancers (80%) and hypertension
(29.71%) respectively. Overall the NCDs had a significant association with type of the family
(p< 0.05) (Table 6).
It was observed in our study that the prevalence of NCDs was more in the upper class
people (40.19%) followed by upper middle class (22.48%) whereas the prevalence was lower in
lower class people (11.48%) respectively. Overall the distribution of NCDs among various
socioeconomic classes was found to be significant (p<0.05) (Table7).
Regarding the distribution of NCDs as per the education status of study participants, it
was found that the prevalence of NCDs was more in illiterate people of society (30.62%)
followed by primary education (28.22%) and middle education people (27.75%) whereas the
prevalence among high class and graduate people was less (8.13% & 5.26%).Overall the
prevalence of NCDs showed an increasing trend with the decrease in the education of the people
(Table 8).
Table 1 Demographic description of study population
Age group
Male
Female
N
%
Total
N
%
N
%
25-34
66
36.2
116
63.7
182
30.3
35-44
69
37.9
113
62.08
182
30.5
45-54
68
43.3
89
56.68
157
26.1
55-64
36
46.1
42
53.84
78
13
Total
240
40
360
60
600
100
Table 2 General prevalence of NCDs in study population
Study subjects
NCDs
Non-NCDs
Total
Male
84(35%)
156 (65%)
240
Females
125(34.72%)
235(65.27)
360
Total
209 (34.83%)
391(65.16%)
600
Table-3 Pattern of major NCDs
Major NCDs
Number
Percentage
Hypertension
138
66.02%
Diabetes
46
22%
Cancers
25
11.96%
Total
209
100%
Table 4 Distribution of NCDs as per sex.
Male
NCDs
N
Female
%
N
%
TOTAL
P value
Hypertension
51
36.9
87
63.04
138
Diabetes
16
34.78
30
65.21
46
Cancers
17
68
8
32
25
Total
84
40.19
125
59.80
209
P<0.05
Table 5 Distribution of NCDs as per age.
NCDs
25-34
N
Hypertension 24
(180)
%
35-44
N
(179)
%
45-54 ((154)
N
%
55-64 (87)
N
%
Total
17.39
33
23.91
53
38.40
28
20.28
138
Diabetes
8
17.39
10
21.73
9
19.56
19
41.30
46
Cancers
1
4
4
16
9
36
11
44
25
Total
33
15.78
47
22.48
71
33.97
58
27.75
209
P
value
P<0.001
Table 6 Distribution of NCDs as per type of family
NCDs
Nuclear family
Joint family
TOTAL
P value
Hypertension
41
29.71%
97
70.28%
138
Diabetes
10
21.73%
36
78.2%
46
Cancers
20
80%
5
20%
25
Total
84
40.19%
125
59.8%
209
P<0.05
Table 7 Distribution of NCDs as per Socioeconomic status.
Upper Class
NCDs
Upper
Middle
Lower
Lower
Middle
Class
Middle
Class
Class
N
%
Total
P
Class
N
%
N
%
value
N
%
N
%
Hypertension
52
37.68
28
20.28
23
16.66
17
12.31
18
13.04
138
Diabetes
22
47.82
10
21.73
7
15.21
3
6.52
4
8.6
46
Cancers
10
40
9
36
3
12
1
4
2
8
25
Total
84
40.19
47 22.48
33 15.78
21 10.04
24 11.48
209
Table 8 Distribution of NCDs as per education status.
NCDs
Illiterate
Primary
Middle
High
Graduate
(132)
(276)
(126)
(42)
(24)
N
%
N
%
N
%
N
%
N
Total
%
Hypertension
43
31.15
41
29.71
39
28.26
10
26.31
5
3.6
138
Diabetes
13
28.26
12
26.08
12
26.08
5
10.86
4
8.6
46
Cancers
8
32
6
24
7
28
2
8
2
8
25
Total
64
30.62
59
28.22
58
27.75
17
8.13
11
5.26
209
P<0.05
Discussion
Our study was conducted in order to find out the prevalence and socio-demographic
characteristics of NCDs in adult population of health block Hajin following WHO STEP wise
protocol. The main objective of the study was to establish a baseline that would be used to
identify the risk factors and in measuring the impact of risk factor reduction interventions.
In our study it was revealed that prevalence of NCDs was 34.83% (males 35%, females
34.72%).a total of 66.2%,22% and 11.96% were suffering from hypertension ,diabetes and
cancers. However in a study by Mehan et al(12) it was revealed that about 32.2% and 6.6% of the
subjects were found to have diabetes and hypertension respectively. Further it was revealed in
their study that there were more males (33.9% versus 30.8%) with diabetes and hypertension as
compared to females (8.9% versus 4.6%) whereas in a study by Mufunda et al(13) it was found
that the prevalence of hypertension among the study participants was 15.9% out of which 17%
were males 15% were females. In another study from urban Rajasthan prevalence of diabetes
was 14.7% in men and 14.2% in women. In a study in Iran by Asgari F et al(14) it was observed
that out of major NCDs 25.2% had hypertension and 7.7% had diabetes in age group 25-64
years.
Commenting on socio-demographic characteristics of NCDs in our study population it
was found the variables like age, sex , type of family and socioeconomic status were
significantly associated with occurrence of NCDs..however in a study by Mehan MB et al(12) it
was found that there was no significant association between these risk factors and prevalence of
NCDs. These results are contrary to the results of our study. In a study by Asgari et al(14) it was
found that the prevalence of NCDs increase with increasing age and was prevalent among
women and urban dwellers.
Conclusion
The risk factors of today are diseases of tomorrow. Hence identifying these risk factors in
population occupies central place in surveillance system. Therefore public health strategies have
to be driven by the motive of identifying prevalence and socio-demographic characteristics in
populations and countries need to know the profile of risk factors of populations in different
settings.
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