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Behavioural Risk Factors of Noncommunicable Diseases among Nepalese Urban Poor: A Descriptive Study from a Slum Area of Kathmandu

DOI: 10.1155/2013/329156

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There has been a rapid rise in the burden of noncommunicable diseases in low-income countries like Nepal. Political and economical instability leading to internal migration give rise to haphazard urbanization in Nepal. This, coupled with negative effects of globalization, is largely responsible for changing lifestyle and developing risky behaviour among the urban poor that put them at high risk of developing noncommunicable diseases. A descriptive cross-sectional quantitative study was conducted from September to December 2012 in an urban slum of Kathmandu to explore the prevalence of four major behaviour risk factors namely physical inactivity, low fruit and vegetable consumption, and tobacco and alcohol use and to measure the burden of obesity and hypertension in the population. We used WHO NCDs Risk Factor steps 1 and 2 questionnaires in all the 689 households of the slum. The major behavioral risk factors for noncommunicable diseases were very common with at least a quarter of the population having the major risk factors. The results may serve to form a framework to future planning, policy-making, implementation, and evaluation of any measures undertaken to reduce these risk factors, especially as the government is planning to unveil the National Urban Health Policy soon. 1. Introduction It is well established that noncommunicable diseases (NCDs) are the leading cause of adult mortality and morbidity worldwide including the Southeast Asia region (SEAR) [1]. Four main NCDs, namely cardiovascular diseases (CVDs), diabetes, cancers, and chronic respiratory diseases, are mainly responsible for this high mortality and morbidity. Of the estimated 14.5 million total deaths in 2008 in SEAR, more than half (55%) of them were due to NCDs, mainly cardiovascular disease (25%) [1]. From the beginning, NCDs and particularly CVDs were termed diseases of the rich in the developed countries [2]. However, over the past two decades, CVD deaths have been declining in the high-income countries but increasing significantly in the low- and middle-income countries (LMICs) [3]. One of the reasons for this increase is the rising life expectancy like the one being seen in South Asia region which leads to shifting disease burden towards NCDs [4]. Moreover, at the same time, the trend of urbanization is drastically increasing in this region causing changes in lifestyle of the people. For example, shifting lifestyle towards low physical activity and unhealthy diet leads to a rise in prevalence of obesity and NCDs among urban population [5]. For this reason, NCDs have also been

References

[1]  World Health Organization, Non-Communicable Diseases in the South-East Asia Region: Situation and Response 2011, World Health Organization, New Delhi, India, 2011.
[2]  D. Yach and C. Hawkes, “Chronic diseases and risks,” in International Public Health, M. Merson, R. E. Black, and A. J. Mills, Eds., pp. 273–313, Jones & Bartlett Publishers, Burlington, Mass, USA, 2006.
[3]  S. Mendis, P. Puska, and B. Norrving, Global Atlas on Cardiovascular Disease Prevention and Control, World Health Organization, Geneva, Switzerland, 2011.
[4]  M. M. Engelgau, S. El-Saharty, P. Kudesia, V. Rajan, and S. Rosenhouse, Capitalizing on the Demographic Transition: Tackling Noncommunicable Diseases in South Asia, World Bank Publications, 2011.
[5]  A. Vaidya, S. Shakya, and A. Krettek, “Obesity prevalence in nepal: public health challenges in a low-income nation during an alarming worldwide trend,” International Journal of Environmental Research and Public Health, vol. 7, no. 6, pp. 2726–2744, 2010.
[6]  K. Anand, B. Shah, K. Yadav et al., “Are the urban poor vulnerable to non-communicable diseases? A survey of risk factors for non-communicable diseases in urban slums of Faridabad,” National Medical Journal of India, vol. 20, no. 3, pp. 115–120, 2007.
[7]  Linking Population, poverty and development, http://www.unfpa.org/pds/urbanization.htm.
[8]  M. R. Montgomery and A. C. Ezeh, “The health of urban populations in developing countries,” in Handbook of Urban Health, pp. 201–222, Springer, New York, NY, USA, 2005.
[9]  Central Bureau of Statistics, National Population and Housing Census 2011, National Planning Commission Secretariat, 2012.
[10]  CARE Nepal, Health Problems among Urban Poor in Selected Slums along Bishunumati River in Kathmandu, CARE Nepal Publications, 2008.
[11]  A. Vaidya, “Tackling cardiovascular health and disease in Nepal: epidemiology, strategies and implementation,” Heart Asia, vol. 3, no. 1, pp. 87–91, 2011.
[12]  Nepal Health Research Council, Prevalence of Non-Communicable Disease in Nepal: Hospital-Based Study, Nepal Health Research Council, 2010.
[13]  World Health Organization, 2008–2013 Action Plan for the Global Strategy for the Prevention and Control of Non-Communicable Diseases, World Health Organization, Geneva, Switzerland, 2010.
[14]  “300 families screened in slums,” http://www.hollows.org.au/news-media/300-families-screened-slums.
[15]  “Nepal—city slum dwellers' health condition appalling,” http://urbanhealthupdates.wordpress.com/2011/04/01/nepal-city-slum-dwellers-health-condition-appalling/.
[16]  “Mobile health clinics to target city slums,” http://www.myrepublica.com/portal/index.php?action=news_details&news_id=34541.
[17]  L. W. Riley, A. I. Ko, A. Unger, and M. G. Reis, “Slum health: diseases of neglected populations,” BMC International Health and Human Rights, vol. 7, article 2, 2007.
[18]  P. Waingankar and D. Pandit, “A cross sectional study of coronary heart disease in Urban slum population of Mumbai,” International Journal of Medical and Clinical Research, vol. 3, no. 5, pp. 180–189, 2012.
[19]  Ministry of Health and Population, Nepal Non-Communicable Diseases Risk Factors Survey 2007, Ministry of Health and Population, Kathmandu, Nepal, 2008.
[20]  World Health Organization, WHO Steps Instrument Question-by-Question Guide (Core and Expanded), World Health Organization, Geneva, Switzerland, 2008.
[21]  A. V. Chobanian, G. L. Bakris, H. R. Black et al., “Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure,” Hypertension, vol. 42, no. 6, pp. 1206–1252, 2003.
[22]  World Health Organization, Non-Communicable Disease Risk Factor Survey Myanmar 2009, World Health Organization, 2011.
[23]  World Health Organization and Indian Council of Medical Research, Report of the Surveillance of Risk Factors of Non-Communicable Diseases (STEP 1 and 2) from Chennai, World Health Organization and Indian Council of Medical Research, 2002.
[24]  R. Singh, M. Mukherjee, R. Kumar, and R. Pal, “Study of risk factors of coronary heart disease in Urban slums of patna,” Nepal Journal of Epidemiology, vol. 2, no. 3, pp. 205–212, 2012.
[25]  K. R. Thankappan, B. Shah, P. Mathur et al., “Risk factor profile for chronic non-communicable diseases: results of a community-based study in Kerala, India,” Indian Journal of Medical Research, vol. 131, no. 1, pp. 53–63, 2010.
[26]  S. R. Niraula, “Tobacco use among women in Dharan, Eastern Nepal,” Journal of Health, Population and Nutrition, vol. 22, no. 1, pp. 68–74, 2004.
[27]  A. Nath, S. Garg, S. Deb, A. Ray, and R. Kaur, “A study of the profile of behavioral risk factors of non communicable diseases in an urban setting using the WHO steps 1 approach,” Annals of Tropical Medicine and Public Health, vol. 2, no. 1, pp. 15–19, 2009.
[28]  A. Vaidya, P. K. Pokharel, P. Karki, and S. Nagesh, “Exploring the iceberg of hypertension: a community based study in an eastern Nepal town,” Kathmandu University Medical Journal, vol. 5, no. 19, pp. 349–359, 2007.

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