Abstract
BackgroundThe population of Fiji has experienced emergence of non-communicable disease (NCD) and a plateau in life expectancy over the past 20 years.MethodsA mini-STEPS survey (n = 2765) was conducted in Viseisei in Western Fiji to assess NCD risk factors (RFs) in i-Taukei (Melanesians) and those of Indian descent aged 25–64 years (response 73 %). Hypertension (HT) was defined as systolic blood pressure (BP) ≥140 mmHg or diastolic BP ≥90 mmHg or on medication for HT; type 2 diabetes mellitus (T2DM) as fasting plasma glucose ≥7.0 mmol/L or on medication for T2DM; and obesity as a body mass index (kilograms/height(metres)2) ≥30. Data were age-adjusted to 2007 Fiji Census. Associations between RFs and ethnicity/education were investigated. Comparisons with Fiji STEPS surveys were undertaken, and the absolute risk of a cardiovascular disease (CVD) event/death in 10 years was estimated from multiple RF charts.ResultsNCD/RFs increased with age except excessive alcohol intake and daily smoking (women) which declined. Daily smoking was higher in men 33 % (95 % confidence interval: 31–36) than women 14 % (12–116); women were more obese 40 % (37–43) than men 23 % (20–26); HT was similar in men 37 % (34–40) and women 34 % (31–36), as was T2DM in men 15 % (13–17) and women 17 % (15–19). i-Taukei men had an odds ratio (OR) of 0.41 (0.28–0.58) for T2DM compared to Indians (1.00); and i-Taukei (both sexes) had a higher OR for obesity and low fruit/vegetable intake, daily smoking, excessive alcohol intake and HT in females. Increasing education correlated with lesser smoking, but with higher obesity and lower fruit/vegetable intake. Compared to the 2011 Fiji STEPS survey, no significant differences were evident in obesity, HT or T2DM prevalences. The proportion (40–64 years) classified at high or very high risk (≥20 %) of a CVD event/death (over 10 years) based on multiple RFs was 8.3 % for men (8.1 % i-Taukei, 8.5 % Indian), and 6.7 % for women (7.9 % i-Taukei, 6.0 % Indian).ConclusionsThe results of the survey highlight the need for individual and community interventions to address the high levels of NCD/RFs. Evaluation of interventions is needed in order to inform NCD control policies in Fiji and other Pacific Island nations.
Highlights
The population of Fiji has experienced emergence of non-communicable disease (NCD) and a plateau in life expectancy over the past 20 years
Most risk factor (RF) and NCD prevalences increased with age, except excessive alcohol intake and daily smoking which declined with increasing age
The prevalences of HT and type 2 diabetes mellitus (T2DM) were similar in both sexes. i-Taukei men had less than half the prevalence of T2DM than Fijians of Indian descent; and iTaukei had higher odds ratio (OR) for indices of obesity, low fruit/ vegetable intake, and daily smoking, excessive alcohol intake and HT in females
Summary
The population of Fiji has experienced emergence of non-communicable disease (NCD) and a plateau in life expectancy over the past 20 years. According to the World Health Organisation (WHO) NCDs include cardiovascular disease (CVD), diabetes, cancer and chronic lung disease, and are contributed to by risk factors (RFs) related to diet, exercise, and tobacco and alcohol consumption [2]. These RFs can be measured and monitored through population prevalence surveys, such as WHO STEPS surveys [3]. NCD control involves the individual approaches of detection and treatment of cases of NCD (secondary and tertiary prevention) and management of those found to be at high risk of NCD, especially because of multiple RFs (primary prevention) The effectiveness of these interventions at a population level in the context of Fiji is yet to be established
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