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      The prevalence of non-communicable diseases in northwest Ethiopia: survey of Dabat Health and Demographic Surveillance System

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          Abstract

          Objective

          The main objective of this study was to investigate the magnitude and associated factors of non-communicable chronic diseases (NCDs) at the Dabat Health and Demographic Surveillance System (DHDSS) site in the northwestern part of Ethiopia.

          Design

          A population-based cross-sectional study was conducted from October to December 2014.

          Setting

          HDSS site, Ethiopia.

          Participants

          A total population of 67 397 living in 16 053 households was included in the study.

          Measures

          Structured interviewer-administered questionnaire was used to collect data. Self-reported morbidity was used to ascertain NCD. A binary logistic regression model was employed to identify the determinants of NCDs.

          Result

          One thousand one hundred sixty (1.7%) (95% CI 1.62 to 1.82) participants were found with at least one type of NCD. Heart disease and hypertension which accounted for 404 (32.2%) and 401 (31.9%), of the burden, respectively, were the most commonly reported NCDs, followed by 347 (27.7%) asthma, 62 (4.9%) diabetes mellitus and 40 (3.2%) cancer cases. Advanced age (≥65 year) (adjusted OR (AOR)=19.6; 95% CI 5.83 65.70), urban residence (AOR=2.20; 95% CI 1.83 to 2.65), household food insecurity (AOR=1.71; 95% CI 1.37 to 2.12) and high income (AOR=1.28; 95% CI 1.02 to 1.59) were significantly associated with the reported history of NCDs, whereas low (AOR=0.36; 95% CI 0.31 to 0.42) and moderate (AOR=0.33; 95% CI 0.22 to 0.48) alcohol consumption, farming occupation (AOR=0.72; 95% CI 0.57 to 0.91), and work-related physical activities (AOR=0.66; 95% CI 0.50 to 0.88) were inversely associated with NCDs.

          Conclusion

          There is a high burden of NCDs at the Dabat HDSS site. Promotion of regular physical exercise and reducing alcohol consumption are essential to mitigate the burden of NCDs. In addition, preventive interventions of NCDs should be strengthened among urban dwellers, older age people and people of higher economic status.

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          Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study.

          Christopher Murray, Alan Lopez (1997)
          Prevention and control of disease and injury require information about the leading medical causes of illness and exposures or risk factors. The assessment of the public-health importance of these has been hampered by the lack of common methods to investigate the overall, worldwide burden. The Global Burden of Disease Study (GBD) provides a standardised approach to epidemiological assessment and uses a standard unit, the disability-adjusted life year (DALY), to aid comparisons. DALYs for each age-sex group in each GBD region for 107 disorders were calculated, based on the estimates of mortality by cause, incidence, average age of onset, duration, and disability severity. Estimates of the burden and prevalence of exposure in different regions of disorders attributable to malnutrition, poor water supply, sanitation and personal and domestic hygiene, unsafe sex, tobacco use, alcohol, occupation, hypertension, physical inactivity, use of illicit drugs, and air pollution were developed. Developed regions account for 11.6% of the worldwide burden from all causes of death and disability, and account for 90.2% of health expenditure worldwide. Communicable, maternal, perinatal, and nutritional disorders explain 43.9%; non-communicable causes 40.9%; injuries 15.1%; malignant neoplasms 5.1%; neuropsychiatric conditions 10.5%; and cardiovascular conditions 9.7% of DALYs worldwide. The ten leading specific causes of global DALYs are, in descending order, lower respiratory infections, diarrhoeal diseases, perinatal disorders, unipolar major depression, ischaemic heart disease, cerebrovascular disease, tuberculosis, measles, road-traffic accidents, and congenital anomalies. 15.9% of DALYs worldwide are attributable to childhood malnutrition and 6.8% to poor water, and sanitation and personal and domestic hygiene. The three leading contributors to the burden of disease are communicable and perinatal disorders affecting children. The substantial burdens of neuropsychiatric disorders and injuries are under-recognised. The epidemiological transition in terms of DALYs has progressed substantially in China, Latin America and the Caribbean, other Asia and islands, and the middle eastern crescent. If the burdens of disability and death are taken into account, our list differs substantially from other lists of the leading causes of death. DALYs provide a common metric to aid meaningful comparison of the burden of risk factors, diseases, and injuries.
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            Diabetes in sub-Saharan Africa.

            Jean Claude N Mbanya, Ayesha Motala, Eugene Sobngwi … (2010)
            In Sub-Saharan Africa, prevalence and burden of type 2 diabetes are rising quickly. Rapid uncontrolled urbanisation and major changes in lifestyle could be driving this epidemic. The increase presents a substantial public health and socioeconomic burden in the face of scarce resources. Some types of diabetes arise at younger ages in African than in European populations. Ketosis-prone atypical diabetes is mostly recorded in people of African origin, but its epidemiology is not understood fully because data for pathogenesis and subtypes of diabetes in sub-Saharan African communities are scarce. The rate of undiagnosed diabetes is high in most countries of sub-Saharan Africa, and individuals who are unaware they have the disorder are at very high risk of chronic complications. Therefore, the rate of diabetes-related morbidity and mortality in this region could grow substantially. A multisectoral approach to diabetes control and care is vital for expansion of socioculturally appropriate diabetes programmes in sub-Saharan African countries. Copyright 2010 Elsevier Ltd. All rights reserved.
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              Non-communicable diseases in low- and middle-income countries: context, determinants and health policy.

              Juan Casas, Abdul Ebrahim, J. Geelhoed … (2008)
              The rise of non-communicable diseases and their impact in low- and middle-income countries has gained increased attention in recent years. However, the explanation for this rise is mostly an extrapolation from the history of high-income countries whose experience differed from the development processes affecting today's low- and middle-income countries. This review appraises these differences in context to gain a better understanding of the epidemic of non-communicable diseases in low- and middle-income countries. Theories of developmental and degenerative determinants of non-communicable diseases are discussed to provide strong evidence for a causally informed approach to prevention. Health policies for non-communicable diseases are considered in terms of interventions to reduce population risk and individual susceptibility and the research needs for low- and middle-income countries are discussed. Finally, the need for health system reform to strengthen primary care is highlighted as a major policy to reduce the toll of this rising epidemic.
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                Author and article information

                Journal
                Journal ID (nlm-ta): BMJ Open
                Journal ID (iso-abbrev): BMJ Open
                Journal ID (hwp): bmjopen
                Journal ID (publisher-id): bmjopen
                Title: BMJ Open
                Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Electronic): 2044-6055
                Publication date Collection: 2017
                Publication date (Electronic): 22 October 2017
                Volume: 7
                Issue: 10
                Electronic Location Identifier: e015496
                Affiliations
                [1 ] departmentDepartment of Human Nutrition , Institute of Public Health, College of Medicine and Health Sciences, University of Gondar , Gondar, Ethiopia
                [2 ] departmentDepartment of Health Service Management and Health Economics , Institute of Public Health College of Medicine and Health Sciences, University of Gondar , Gondar, Ethiopia
                [3 ] departmentDepartment of Epidemiology and Biostatistics , Institute of Public Health College of Medicine and Health Sciences, University of Gondar , Gondar, Ethiopia
                [4 ] departmentDepartment of Environmental and Occupational Health and Safety , Institute of Public Health College of Medicine and Health Sciences, University of Gondar , Gondar, Ethiopia
                [5 ] Dabat Research Centre Health and Demographic Surveillance System, Institute of Public Health College of Medicine and Health Sciences, University of Gondar , Gondar, Ethiopia
                [6 ] departmentDepartment of Physiotherapy , School of Medicine, College of Medicine and Health Sciences, University of Gondar , Gondar, Ethiopia
                [7 ] departmentDepartment of Reproductive Health , Institute of Public Health, College of Medicine and Health Sciences, University of Gondar , Gondar, Ethiopia
                Author notes
                [Correspondence to ] Dr Solomon Mekonnen Abebe; solomekonnen@ 123456yahoo.com
                Article
                Publisher ID: bmjopen-2016-015496
                DOI: 10.1136/bmjopen-2016-015496
                PMC ID: 5665308
                PubMed ID: 29061601
                SO-VID: 48e7280a-9486-4b8f-98c8-c3a507f13efe
                Copyright © © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
                License:

                This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

                History
                Date received : 12 December 2016
                Date revision received : 27 May 2017
                Date accepted : 01 June 2017
                Categories
                Subject: Epidemiology
                Subject: Research
                Subject: 1506
                Subject: 1692
                Custom metadata
                special-feature unlocked

                ScienceOpen disciplines: Medicine
                Keywords: diabetic foot,cardiac epidemiology,hypertension
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: diabetic foot, cardiac epidemiology, hypertension

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