Non-communicable diseases awareness and control in a rural population in an epidemiologically advanced stage of transition (Kerala): results of the epidemiology of non-communicable diseases in rural areas study

Abstract

Background: India carries the greatest burden of non-communicable diseases (NCDs) amongst nations. It is estimated that by the year 2030 there will be 101 million diabetics, 218 million hypertensives in India. NCDs would account for 53% of deaths in India by the year 2020 of which CVD would be the cause in 43%. Kerala is the diabetic and cardiovascular disease capital of India, with rates of prevalence as high as twice the national average. The age-adjusted CAD mortality rates per 100,000 is 382 for men and 128 for women in Kerala.Methods: The study was carried out in 5 contiguous panchayats of Ernakulam district, Kerala state. The study was carried out in 2 Phases. In the first phase individuals self-reported non communicable diseases and risk factors through the medium of an ASHA administered Questionnaire. In the second phase blood tests were done in individuals from the study population in those above the age of 30 years.Results: Of the 114,064 surveyed 63,051 individuals were above 30 years of age with a prevalence of diabetes at 11.1%, hypertension 15.6% and dyslipidemia 6.9% when self-reported. In the Phase 2 of the study blood sugar, total cholesterol and blood pressure was measured in close to 8000 individuals in whom 48% of individuals with high sugars, 37% with high blood pressure and 85% with high cholesterol values were unaware of their disease status. More females were unaware of their diabetic and lipid status and males of their hypertensive status. About 25% of diabetics, 40% of hypertensives and 6% of dyslipidemics had normal values. This study provided prevalence of NCDs on a large enough scale to help in policy planning if not for the country at least for the state of Kerala.Conclusions: The study results suggested low awareness and poor control of NCDs in the study population.