Non-Communicable Disease Risk Factor Survey Bangladesh 2010
The rapid rise of non-communicable diseases (NCDs) represents one of the major health challenges to global development. NCDs were estimated to have contributed to almost 60% of deaths in the world and among them about 80% occur in the developing countries.1 NCDs are already of major importance in developed countries and are rapidly becoming a major public health threat in the developing world. These diseases constituted 43% of the global burden of disease in 1999. Based on current trends, by 2020 they will account for 73% of deaths and 60% of the disease burden in the developing countries.2
The underlying cause of NCD epidemic is the increase in lifestyle related risk factors resulting from social and economic changes. In many countries the increasing impact of globalization has given momentum to this process.2 Currently neighbouring India is also experiencing an epidemic of NCDs attributed to lifestyle changes resulting from urbanization.3 WHO report in 2002 identified unhealthy diet, physical inactivity, tobacco use, harmful use of alcohol, overweight, raised blood pressure, raised total cholesterol levels and raised blood glucose as the most prevalent NCD risk factors among the world population.4 Among the modifiable risk factors unhealthy diet, physical inactivity, alcohol and tobacco use are categorized into primary risk factors and overweight, raised blood pressure, raised total cholesterol levels and raised blood glucose are categorized as intermediate risk factors. Most population has been experiencing an increased prevalence of both primary and intermediate risk factors. Hypertension alone is the main risk factor for developing ischemic heart disease, stroke, heart and renal failures and eripheral vascular diseases.4
NCD associated risk factors are largely modifiable. Therefore, by identifying and preventing the risk factors, NCDs such as coronary heart disease and stroke would be prevented by 80%, cancer by 40% and type 2 diabetes by 90%. Projections by experts estimate that an annual reduction of chronic disease death rates by 2% in the next 10 years will account for 36 million lives be saved.5 In addition, one third of all cancers could be prevented by eating healthy food, maintaining normal weight and being physically active throughout the lifespan.6
Like many other countries, Bangladesh has been experiencing an epidemiological transition from communicable disease to NCDs.7 Among the NCDs, cardiovascular diseases (CVD), diabetes, chronic obstructive pulmonary disease (COPD) and cancers are most prevalent. With economic development and increased level of control and treatment of infectious diseases NCDs are becoming a major health problem in Bangladesh.8 However, representative national level data on NCDs and their risk factors are still inadequate in Bangladesh. Major established risk factors explain approximately 75% of the occurrence of coronary heart disease within opulations.9 A few studies have so far reported prevalence of individual risk factors such as hypertension, smoking and dietary habit, from urban and rural populations.10,11 However only few of them are done recently,12,13 and showed a significantly increasing gradient in NCD prevalence.
To respond to the increased burden of NCDs, WHO put due emphasis on gathering information on NCDs and their risk factors, as they are necessary for designing prevention and control programme with specific goal and measurable outcome. Population specific data on risk factors are essential in order to set priorities, develop targeted programmmes on NCDs. Anticipating the NCD epidemic, WHO has initiated the worldwide STEP wise approach to Surveillance (STEPS) of risk factors for NCDs. STEPS focuses on the periodic collection of data on key risk factors associated with major NCDs which is indispensable for designing community based interventions to reduce risk factors in the population.14 Prevalence of common NCDs are increasing and most of these NCDs share common preventable risk factors. Major risk factors of today will be the diseases of tomorrow. Therefore measuring risk factors for NCDs is an attempt to predict the future distribution of NCDs in a population and is vital for promoting disease prevention and control programmes.9 Therefore it is of prime importance to conduct a nationwide survey on NCD risk factors taking into account of national representatives.