Risk Factors For Non-communicable Diseases Research Articles

P204 BANGLADESH HEARTS: LESSONS LEARNED FROM A NATIONAL HYPERTENSION CONTROL PROGRAM, 2018-2024

Background and Objective: In Bangladesh, 21% of all adults aged >=18 years have hypertension but among hypertensives, only 14.1% have blood pressure (BP) controlled (<140/90 mmHg) .1 To improve hypertension control and prevent cardiovascular disease, the Non-Communicable Disease Control Program under the Ministry of Health & Family Welfare launched the Bangladesh Hypertension Control Initiative (BHCI) with technical support from the National Heart Foundation of Bangladesh and Resolve to Save Lives. Method: The BHCI gradually implemented the World Health Organization (WHO) HEARTS standardized hypertension control package in 172 sub-district facilities (35% of all sub-district facilities) & 10 district-level facilities in 23 districts from 2018 to 2024. BHCI facilities implemented a simple, evidence-based, step-by-step, and drug & dose-specific hypertension treatment protocol, a reliable supply of protocol medicines free of charge to patients, team-based care including non-physician members, and the Simple digital hypertension management app to collect real-time data and facilitate patient and program monitoring over time. A continuous quality improvement initiated in 2020 focused on lowering missed visit rate and raising blood pressure control. Missed visit rate was the proportion of all enrolled patients failing to attend a scheduled clinic visit in the prior three months; BP control was proportion with BP <140/90 mmHg at their last visit in the prior three months. Results: From March 2019 to February 2024, the BHCI had enrolled 364,038 hypertensive patients in treatment (Figure). Facility-based BP control increased from 37% in July 2020 when the quality improvement program started to 57% by April 2024. Missed visits decreased from 53% in July 2020 to 29% by April 2024. Conclusion: BHCI is on track for national scale-up in Bangladesh and can serve as a model for WHO-HEARTS hypertension control programs in other LMIC countries. Reference: 1. World Health Organization. National STEPS survey for non-communicable diseases risk factors in Bangladesh 2018. Panel A: number of hypertension patients enrolled in treatment. Panel B: rates of missed hypertension management visits and blood pressure controlled <140/90

Changes in nutritional status, risk factors and food intake in stroke subjects: cohort study analysis of non-communicable disease risk factors

Background: Stroke is a major cause of death and disability worldwide, affecting 15 million people annually. In Indonesia, the prevalence is 10.9%. Major risk factors include high blood pressure, obesity, inactivity, poor diet, and smoking. Objective: This study aims to analyze long-term trends in risk factors, nutritional status, and food intake among stroke patients from 2011-2021, assessing their impact on stroke incidence. Methods: Data from a longitudinal cohort study of 5,329 subjects, including 215 stroke patients, were analyzed using Microsoft Excel 2019 and SAS software. ANOVA was used to assess annual changes in risk factors, nutritional status, and food intake. Survival analysis was conducted with SAS PROC LIFETEST and PROC LIFEREG. Results: The cohort was primarily female (62.8%), aged 60 or older (57.2%), senior high school education (25.6%), civil servants (30.7%), and low income (57.2%). Significant changes were noted in BMI (p=0.037), fasting blood glucose (FBG) (p=0.001), HDL (p=0.049), abdominal circumference, smoking habits, physical activity (p<0.001), protein intake (p=0.026), and intake of energy, fat, carbohydrates, and sodium (p<0.001). Factors significantly associated with stroke included age, FBG, postprandial glucose, smoking (p<0.0001), LDL (p=0.0380), HDL (p=0.0126), physical activity (p=0.0455), energy intake (p=0.0002), fat intake (p=0.0007), and sodium intake (p=0.0012). Conclusions: The study highlights significant changes in nutritional status, glucose levels, HDL cholesterol, physical activity, and smoking habits. These factors, along with age, cholesterol levels, and dietary intake, impact stroke incidence, underscoring the need for comprehensive stroke prevention strategies.

Together we win! Narratives of couples pursuing a healthy diet and physical activity: A qualitative study.

Metabolic syndrome (MetS) is a major risk factor for non-communicable diseases, including type 2 diabetes mellitus, cardiovascular disease, and cancer. The risk of MetS can be transmitted via epigenetic processes from both the mother and the father. Therefore, it is essential that both members of a couple are targeted in pre-conception nutrition and physical activity-based lifestyle programs. However, lifestyle interventions targeting both members of a couple are scarce in the literature. This study, therefore, aimed to explore the barriers and facilitators of a couples-based lifestyle intervention. Nulliparous couples who had an interest in having children in the future were recruited to the study and each member interviewed separately to gain insight into to gain insight into designing future couples-based lifestyle interventions. Interviews were conducted between June and October 2021. Reflexive thematic analysis (RTA) was applied to conduct and analyse semi-structured, in-depth interviews with nulliparous couples who had an interest in having children in the future. Four major themes were identified in nine couples aged 25-34 years (here referred to as "millennials"): Millennials are committed to preparation for their future offspring; millennials know features of a good program likely to have high adherence and long-term behavior change; millennials acknowledge the importance of couples-based programs; and millennials appreciate that future global emergencies may require lifestyle modifications. This study found that millennial couples showed a strong intention to create optimal emotional, financial, and health conditions for their children. They supported couples-based approach (CBA) lifestyle interventions to mitigate potential epigenetic risks. Couples believed that participating together in these programs would enhance adherence to healthy habits, promoting long-term well-being. The findings advocate for exploring and testing CBA interventions that target both partners, as joint participation not only aids in healthy conception and reduces metabolic syndrome risks but also establishes a foundation for family health. These insights highlight the potential of CBA interventions to positively impact future generations.

Lifestyle Differences in the Metabolic Comorbidity Score of Adult Population From South Asian Countries: A Cross-Sectional Study

BackgroundMetabolic comorbidities are involved in the development and progression of non-communicable diseases (NCDs). There is convincing evidence that lifestyles are important contributors to metabolic comorbidities. This study measured the metabolic comorbidity score of South Asian adults, and identified its relationship with lifestyles. MethodsWe studied five South Asian countries including Afghanistan, Bangladesh, Bhutan, Nepal, and Sri Lanka, using WHO's Stepwise approach to NCD risk factor surveillance data between 2014 and 2019. This was a nationally representative and cross-sectional survey on participants aged 15-69 years old. The sample size was 27,616. The outcome was metabolic comorbidity score, calculated based on total cholesterol, fasting plasma glucose, blood pressure, and abdominal obesity. Total metabolic comorbidity score of each participant varied between 0-8. It was then divided into three ranges – the lowest range (total metabolic comorbidity score <3), medium range (total metabolic comorbidity score ≥3 & ≤5), and the highest range (total metabolic comorbidity score ≥6). Based on the outcome of non-parametric receiver operating characteristics analysis, the medium and the highest range together was considered as higher metabolic comorbidity score. The lowest range was considered as lower metabolic comorbidity score. The higher metabolic comorbidity score was coded as “1”and the lower metabolic comorbidity score was coded as “0”. Thus, the outcome variable, metabolic comorbidity score, became a binary variable. Exposures included physical inactivity (<150 minutes of MVPS /week), high daily sedentary time (≥ 9 hours/day), use of tobacco (present or past smoking or daily use of smokeless tobacco products), and consumption of alcohol (at least once/month in the last one year). Binomial logistic regression model produced the odds ratios (OR) with corresponding 95% confidence intervals (CI). ResultsThe prevalence of higher metabolic comorbidity score was 34% among South Asian adults, 25% among the male respondents and 41% among the female respondents. Participants who were physically inactive (OR, 1.26; 95% CI, 1.17-1.36), had high sedentary time (OR, 1.24; 95% CI, 1.11-1.33), and consumed alcohol (OR, 1.40; 95% CI, 1.23-1.53) showed higher metabolic comorbidity score compared with the participants who were physically active, had low sedentary time and did not consume alcohol respectively. However, we found an inverse association (OR, 0.75; 95% CI, 0.71-0.81) between the use of tobacco and metabolic comorbidity score. ConclusionsOne third of South Asian adults had higher metabolic comorbidity score. Physical inactivity, daily sedentary hours and minimal alcohol consumption was associated with higher metabolic comorbidity score.

Predicting high blood pressure using machine learning models in low- and middle-income countries

Responding to the rising global prevalence of noncommunicable diseases (NCDs) requires improvements in the management of high blood pressure. Therefore, this study aims to develop an explainable machine learning model for predicting high blood pressure, a key NCD risk factor, using data from the STEPwise approach to NCD risk factor surveillance (STEPS) surveys. Nationally representative samples of adults aged 18-69 years were acquired from 57 countries spanning six World Health Organization (WHO) regions. Data harmonization and processing were performed to standardize the selected predictors and synchronize features across countries, yielding 41 variables, including demographic, behavioural, physical, and biochemical factors. Five machine learning models - logistic regression, k-nearest neighbours, random forest, XGBoost, and a fully connected neural network - were trained and evaluated at global, regional, and country-specific levels using an 80/20 train-test split. The models’ performance was assessed using accuracy, precision, recall, and F1 score. Feature importance analysis identified age, weight, heart rate, waist circumference, and height as key predictors of blood pressure. Across the 57 countries studied, model performances varied considerably, with accuracy ranging from as low as 58.96% in some models for specific countries to as high as 81.41% in others, underscoring the need for region and country-specific adaptations in modelling approaches. The explainable model offers an opportunity for population-level screening and continuous risk assessment in resource-limited settings.

Risk factors for non-communicable diseases in Afghanistan: insights of the nationwide population-based survey in 2018

BackgroundNoncommunicable diseases (NCDs) account for a substantial number of deaths in Afghanistan. Understanding the prevalence and correlates of major NCD risk factors could provide a benchmark for future public health policies and programs to prevent and control NCDs. Therefore, this study aimed to examine the prevalence and correlates of NCD risk factors among adults aged 18–69 years in Afghanistan.MethodsWe used data from the Afghanistan STEPS Survey 2018. The study population were 3650 (1896 males and 1754 females) adults aged 18–69 years sampled from all 34 provinces through a multistage cluster sampling process. Information on behavioural and biological risk factors was collected. We used STATA (version 18.0) for data analysis.ResultsOf the total participants, 42.8% were overweight or obese, 8.6% were current smokers, 26.9% had insufficient physical activities, 82.6% had low consumption of fruits and vegetables, and only 0.5% had ever consumed alcohol. Approximately 15% of participants had a high salt intake, while 25% and 8% had elevated blood pressure and blood glucose levels, respectively. Similarly, around 18% had elevated total cholesterol. The study revealed a lower prevalence of current smoking among females [AOR = 0.17, 95%CI (0.09–0.30)] compared with males, but a higher prevalence in those who had higher education levels [1.95 (1.13–3.36)] compared with those with no formal education. Insufficient physical activity was higher in participants aged 45–69 years [1.96 (1.39–2.76)], females [4.21 (1.98–8.84)], and urban residents [2.38 (1.46–3.88)] but lower in those with higher education levels [0.60 (0.37–0.95)]. Participants in the 25th to 75th wealth percentiles had higher odds of low fruit and vegetable consumption [2.11 (1.39–3.21)], while those in the > 75th wealth percentile had lower odds of high salt intake [0.63 (0.41–0.98)]. Being overweight/obese was more prevalent in participants aged 45–69 years [1.47 (1.03–2.11)], females [1.42 (0.99–2.01)], currently married [3.56 (2.42–5.21)] or ever married [5.28 (2.76–10.11)], and urban residents [1.39 (1.04–1.86)]. Similarly, high waist circumference was more prevalent in participants aged 45–69 years [1.86 (1.21–2.86)], females [5.91 (4.36–8.00)], those being currently married [4.82 (3.12–7.46)], and those being in 25th to 75th wealth percentile [1.76 (1.27–2.43)]. A high prevalence of elevated blood pressure was observed in participants aged 45–69 years [3.60 (2.44–5.31)] and currently married [2.31 (1.24–4.31)] or ever married [6.13 (2.71–13.8)] participants. Elevated blood glucose was more prevalent in older adults ([1.92 (1.09–3.39)] for 45–69 and [3.45 (2.44–5.31)] for 30–44 years), urban residents [2.01 (1.33–3.03)], and ever-married participants [4.89 (1.48–16.2)]. A higher prevalence of elevated cholesterol was observed in females [2.68 (1.49–4.82)] and those currently married [2.57 (1.17–5.63)] or ever married [4.24 (1.31–13.73)].ConclusionThis study used up-to-date available data from a nationally representative sample and identified the prevalence of NCDs and associated risk factors in Afghanistan. Our findings have the potential to inform and influence health policies by identifying people at high risk of developing NCDs and can assist policymakers, health managers, and clinicians to design and implement targeted health interventions.

Paper-based and mobile application-based self-monitoring tool for healthy dietary intake, development and applicability: a non-randomized trial

BackgroundUnhealthy diet is a key risk factor for Non-Communicable Diseases (NCDs) that contribute to increased morbidity and premature mortality. With increased computer literacy and mobile phone penetration, there is a high opportunity for mobile application-based interventions. The current study was conducted to develop a mobile application to monitor dietary intake and to assess its acceptability and effectiveness in diet control compared to a similar paper-based intervention.A mobile application was developed based on research evidence and opinions of local experts. The mobile application was introduced to a selected group of office workers who were in preparation, action, and maintenance stages of the Trans Theoretical Model (TTM) and a paper-based intervention was used as the comparator. Socio-demographic data were collected through a self-administered questionnaire. Participants were followed up for three months for adherence. The effectiveness of interventions was assessed at the end of three months by comparing the progressive change in the stage of change and the change from unhealthy to healthy dietary intake between two groups as primary and secondary outcomes respectively.ResultsAmong 123 office workers who participated in the study, 19.5% preferred the mobile intervention over the paper-based intervention. Younger, unmarried office workers and those who do not have children, had a higher acceptance for the mobile intervention (p < 0.05). There was no difference in adherence (in all three months) or outcomes between the two groups of intervention.Conclusion and recommendationsMobile application-based interventions are better accepted among the young age group and further studies are recommended to explore their applicability.Trial registrationThe study was registered in the Sri Lankan Clinical Trial Registry (Registration No. SLCTR/2020/025; Date 15th December 2020).

Annual and Seasonal Patterns of Dietary Intake in Australian Adults: A Prospective Cohort Study.

Poor diet is a major risk factor for non-communicable disease. The aims of this study were to describe temporal patterns and seasonal changes in diet across the year in Australian adults. A total of 375 adults from a prospective cohort study conducted between 1 December 2019 and 31 December 2021 in Adelaide, Australia, were asked to complete the Dietary Questionnaire for Epidemiological Studies at eight timepoints over a year. Average intakes over the previous month of total energy, macronutrients, healthy food groups, and discretionary foods and beverages were derived. Temporal patterns in diet were analysed descriptively. Multilevel linear regression modelling was used to assess seasonal differences in diet. Of the 375 participants recruited, 358 provided sufficient data for analysis. Intake of total energy, all macronutrients, and most discretionary foods and beverages peaked in December. Total energy intake was higher in summer than in autumn, winter, and spring. Fruit intake was higher in summer than in winter. Consumption of alcoholic beverages was higher in summer than in autumn, winter, and spring. Consumption of non-alcoholic beverages was higher in summer than in autumn and winter. This study identified temporal differences in dietary intake among Australian adults. Seasonal effects appear to be driven largely by increases in consumption of foods and beverages over the December (summer) holiday period. These findings can inform the design and timing of dietary interventions.

Mediterranean Diet in Older Irish Adults: Prevalence, Patterns, Predictors and Pertinence.

The Mediterranean diet (MD) shows the strongest evidence in support of healthy aging and prevention of age-related diseases. It is associated with a decreased risk of chronic disease, such as cardiovascular disease, obesity, hypertension, diabetes mellitus and cognitive disease. Given the health-promoting aspects of this diet, we conducted a secondary analysis of data from the LifeAge study ("Promoting the shift: sedentary Lifestyle towards active Ageing-LifeAge" Project No 603121-EPP-1-2018-1-ES-SPO-SCP) with the primary aim to determine the proportion of older Irish adults adhering to the MD and to examine the association between adherence to the MD (assessed using the Mediterranean Diet Adherence Screener (MEDAS) scoring tool) and anthropometric risk factors of non-communicable diseases. Of the 131 eligible participants (71.8% female, n = 94) (medically well, aged > 50 years and physically independent) (mean age = 66.2 ± 6.5 years), the mean cumulative MD score across the cohort was 5.8 ± 2.2, with 41% classified as moderate-to-high MD adherers (scoring > 7 MEDAS). Females had a significantly higher score compared to males (female 6.24 ± 1.98; male 4.86 ± 2.53; p = 0.002). Age (y), waist circumference (cm) and waist-hip ratio (WHR) each had a significant (p < 0.05) weak and negative correlation with MD score (r = -0.193, -0.240, -0.284, respectively). Visceral fat level had a significant (p < 0.05) moderate and negative correlation with MD score (r = -0.327). This analysis is the first to assess adherence to the MD in older Irish adults. MD adherence was lower in the Irish older cohort than that reported in older adults in Mediterranean regions and was adhered to more by females and those with a more favourable anthropometric profile. The health-promoting aspects of the diet are evident in non-Mediterranean regions as is demonstrated by the lesser incidence of some non-communicable diseases in moderate-to-high adherers. With the evidence of the protective effects of the MD, external to Mediterranean regions, it would be helpful to establish limitations to adherence, especially in aging populations living in non-Mediterranean regions.

Classroom intervention to improve behavioral intention toward regular physical activity among adolescents.

During adolescence, a critical phase in human life, the groundwork for a healthful future is established. Physical inactivity poses a significant risk factor for non-communicable diseases (NCDs) and related mortality worldwide. To assess adolescents' behavioral intentions regarding regular physical activity, the Theory of Planned Behavior (TPB) examines 'Attitude,' 'Subjective norm,' and 'Perceived behavioral control.' Utilizing TPB, this study focuses on evaluating the impact of a school-based health promotion intervention on behavioral intentions toward physical activity among urban adolescents in West Bengal, India. A school-based nonrandomized controlled interventional study with parallel group design was conducted among adolescents aged between 12 and 16 years. Behavioral intention towards performing regular physical activity was determined with the measurements of the constructs from the TPB. Cluster analysis was conducted using measurements from both the intervention and control groups. Participants with higher mean scores in the constructs were classified as intenders, while the rest were considered non-intenders. The intervention's impact was evaluated by calculating the Relative Risk (RR) through a generalized linear model with robust standard error estimates, to ascertain the probability of belonging to the higher intention cluster. Following the intervention, construct-wise scores improved significantly, particularly the perceived behavioral control mean score in the intervention group. The Relative Risk (RR) of becoming an intender for regular physical activity in the intervention group was 1.24 (95% CI: 1.04-1.48) when compared to the control group. Health Promoting Schools has been recognized as a strategic and cost-effective vehicle to promote positive development and healthful living, and the current evidence suggests they can effectively reduce the emergence of significant NCD risk factor like physical inactivity. Schools must establish strong partnerships with diverse stakeholders to address barriers beyond the school environment and enhance their control over critical issues.

Geroscience in the continuum from healthy longevity to frailty.

The socioeconomic and technological developments of the past decades have enabled unique progress associated to increased life expectancy and better health for alarge part of the world's population; however, multimorbidity, frailty and disability are also on the rise. Geroscience as the new biology of aging is based on the evidence that the main risk factor for noncommunicable chronic diseases (NCD) is the aging process; however, its technology is mostly used for the scientific study of longevity and its interaction with aging medicine and geriatrics is still limited. In this perspective, the need for atighter exchange between geroscience and geriatrics for longer health span and intrinsic capacity is discussed in the context of existing evidence and knowledge gaps.

Training cadres and establishment of an integrated development post for non-communicable diseases based on a mosque

Introduction: Non-communicable diseases (NCDs) are the highest cause of death due to non-communicable diseases in Indonesia. This condition is certainly very worrying, because the trend of NCDs is increasing followed by a shift in disease patterns, where previously NCDs were experienced by the elderly group, are now starting to threaten younger age groups. Public awareness of NCD risk factors needs to be increased. This requires community participation in PTM (penyakit tidak menular) integrated development activities (Posbindu). Posbindu PTM is an activity for early detection and monitoring of the main risk factors for PTM through community participation. The aim of this activity is cadre training and the establishment of a mesque-based Posbindu PTM. Methods: The method used is Asset Based Community Development (ABCD). The ABCD method is a service method that focuses on the strengths and capacities of local communities. The establishment of the PTM Posbindu was carried out at the Aisyah Abdul Latif Farah Mosque, Namorambe District, Deli Serdang Regency. There were 10 cadres recruited at Posbindu PTM Mosque. Results: The results of the establishment of the mask-based PTM Posbindu are expected to be able to detect PTM risk factors as early as possible and reduce the number of PTM congregants at mosques in particular and society in general. Conclusion: The socialization and formation of the mosque-based Posbindu PTM received positive support from the Deli Serdang Health Service and the Aisyah Abdul Latif Farah Mosque.

Distribution and disparities of healthy lifestyles and noncommunicable diseases risk factors between men and women aged 20-59 years in Bangladesh: Evidence from a nationwide survey.

Noncommunicable diseases (NCDs) are public health threats globally and recognized impediments to socioeconomic development. This study aimed to identify the prevalence and clustering of NCDs risk factors among Bangladeshi men and women aged 20-59 years using nationally representative data. This study was conducted in 82 rural, nonslum urban, and slum clusters across all eight administrative divisions of Bangladesh using multistage cluster sampling. A total of 4917 men and 4905 women aged 20-59 years were included in the study. Descriptive analyses were performed to report the prevalence and distribution of behavioral and clinical risk factors. Multivariable binary logistic regression was performed to identify factors associated with the coexistence of three or more NCD risk factors. The prevalence of tobacco use (any form), insufficient physical activity, inadequate fruit and vegetable consumption, overweight and obesity, and central obesity were 38.3%, 13.6%, 87.1%, 42.3%, and 36.0%, respectively. Furthermore, 21.9% and 4.9% participants had hypertension and self-reported diabetes, respectively. Regarding the clustering of risk factors, 37.1% men and 50.8% women had at least three NCD risk factors. Only 3.0% men and 1.8% women reported no NCD risk factors. Age, place of residence, education, and wealth status were associated with the presence of at least three risk factors for both sexes. Since a large proportion of Bangladeshi 20-59 years old population had multiple risk factors, population-based programs with multisectoral approaches are essential to reduce NCDs among Bangladeshi women and men.

Prevalence of Non-communicable Disease Risk Factors Among Adults in a Rural Field Practice Area of a Tertiary Care Medical Center in Karnataka.

Background Non-communicable diseases (NCDs), also referred to as chronic diseases, typically have a long duration and arise from a combination of genetic, physiological, environmental, and behavioral factors. Each year, 17 million people under the age of 70 die from non-communicable diseases (NCDs), with 86% of these premature deaths occurring in low- and middle-income countries. Objectives To estimate the prevalence of NCD risk factors among adults (18-65 years) in a rural population. Methods A cross-sectional study was conducted by selecting 200 participants from 200 households using convenience sampling. Participants aged 18-65 years were included, and locked households were excluded. Sociodemographic profiles were assessed using semi-structured questionnaires, and NCD risk factors were assessed using a Community-Based Assessment Checklist (CBAC). Descriptive statistics and associations were analyzed. Results The majority of participants were men (53.5%), married (89.5%), and belonged to the class 2 socioeconomic classification. The prevalence of NCD risk factors was 17%, with smoking (12.5%), alcohol consumption (6%), and waist circumference (1.8% for men and 27.9% for women) being the most common risk factors. Older age, lower educational attainment, unemployment, and lower-incomeclasses were associated with a higher risk of NCDs. Conclusion The study identifies key risk factors for non-communicable diseases (NCDs) as family history, waist circumference over 90 cm, daily alcohol consumption, and tobacco use, all significantly increasing the risk. Physical activity under 150 minutes per week and occupational exposure to crop residue showed no significant effect.

Severity of Postcovid Syndrome in Convalescent Covid-19 and Their Association with the Main Risk Factors for Chronic Non-Communicable Diseases

Severity of Postcovid Syndrome in Convalescent Covid-19 and Their Association with the Main Risk Factors for Chronic Non-Communicable Diseases

Epidemiology of non-communicable diseases among professional drivers in LMICs: a systematic review and meta-analysis.

This systematic review collected evidence on the burden of non-communicable diseases (NCDs) among professional drivers and reported on the most common factors that increase the risk of NCDs in this specific population in low- and middle-income countries (LMICs). The protocol for this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO). We conducted a thorough search on PubMed/MEDLINE, EMBASE, Scopus, Global Health, Web of Science and Africa-wide information databases on 11 May 2023. We adapted the Joanna Briggs Institute (JBI) tool to assess the quality of the studies. We estimated the prevalence of hypertension, prediabetes, diabetes mellitus (DM), overweight and obesity among professional drivers using a random effect model to compute pooled and subgroup analyses. In addition, we conducted a narrative synthesis of the risk factors and recommendations presented in the included studies. Forty-one studies, including 48 414 study participants, met the criteria for inclusion. The pooled prevalence of hypertension, DM and obesity among professional drivers was 36.7% [95% confidence interval (CI): 31.8-41.6%], 15.2% (95% CI: 7.0-23.4%) and 27.2% (95% CI: 18.7-35.8%), respectively. Unsupportive environment, work stress, sedentary lifestyle, consumption of unhealthy foods and shift work were the most common modifiable risk factors reported. Our findings also show a significant burden of hypertension, DM and obesity among professional drivers in LMICs. The prevalence of DM and obesity was two- and three-fold higher than findings in general populations, respectively. Our findings indicate an urgent need for tailored interventions for different occupation-related risk factors for NCDs among professional drivers in LMICs.

Disparities and Determinants of Testing for Early Detection of Cervical Cancer among Nepalese Women: Evidence from a Population-Based Survey.

Cervical cancer presents a considerable challenge in South Asia, notably in Nepal, where screening remains limited. Past research in Nepal lacked national representation and a thorough exploration of factors influencing cervical cancer screening, such as educational and socioeconomic disparities. This study aims to measure these gaps and identify associated factors in testing for early detection of cervical cancer among Nepalese women. Data from the 2019 Nepal Noncommunicable Disease Risk Factors survey (World Health Organization STEPwise approach to noncommunicable risk factor surveillance), involving 2,332 women aged 30 to 69 years, were used. Respondents were asked if they had undergone cervical cancer testing through visual inspection with acetic acid, Pap smear, or human papillomavirus test ever or in the past 5 years. The slope index of inequality (SII) and relative concentration index were used to measure socioeconomic and education-based disparities in cervical cancer test uptake. Only 7.1% [95% confidence interval (CI): 5.1-9.9] Nepalese women had ever undergone cervical cancer testing, whereas 5.1% (95% CI: 3.4-7.5) tested within the last 5 years. The ever uptake of cervical cancer testing was 5.1 percentage points higher (SII: 5.1, 95% CI: -0.1 to 10.2) among women from the richest compared with the poorest households. Education-based disparities were particularly pronounced, with a 13.9 percentage point difference between highly educated urban residents and their uneducated counterparts (SII: 13.9, 95% CI: 5.8-21.9). Less than one in ten women in Nepal had a cervical cancer testing, primarily favoring higher educated and wealthier individuals. Targeted early detection and cervical cancer screening interventions are necessary to address these disparities and improve access and uptake.

Efficacy of digital interventions on physical activity promotion in individuals with noncommunicable diseases: an overview of systematic reviews

BackgroundPhysical inactivity is considered one of the main modifiable risk factors for noncommunicable diseases. It has been proven that an active lifestyle is an efficient means of preventing and managing noncommunicable diseases. Multiple barriers have been identified that hinder engagement in conventional physical activity programs and the achievement of physical activity recommendations. Digital interventions may expand opportunities to resolve these barriers and empower people with noncommunicable diseases to be physically active. This overview of systematic reviews aims to evaluate the efficacy of digital interventions on physical activity promotion among individuals with major noncommunicable diseases.MethodA protocol was registered in the PROSPERO database (CRD42022364350). A qualitative synthesis method was applied to summarize the efficacy data. The assessment of methodological quality using AMSTAR-2 for each systematic review was performed by two independent reviewers.ResultsSearches in nine databases resulted in seven systematic reviews for inclusion. Most of the primary studies included in these seven reviews were conducted in high-income countries. The reviews addressed five populations: participants with cancers, cardiovascular diseases, chronic obstructive pulmonary disease, type 2 diabetes, and osteoarthritis. Digital interventions were classified into two categories: interventions based on digital activity trackers and remote interventions via digital facilities. Additional components were identified in both categories of interventions such as motivational content, counseling, goal setting, tailored feedback/reminders, and other behavioral change techniques. The overall quality of the reviews ranged from critically low to low. The findings provided some evidence that both categories of interventions were effective in promoting physical activity.ConclusionThe findings of this overview suggest that some types of digital interventions, such as self-monitoring with digital activity trackers and remote interventions via digital facilities, may be effective means of promoting physical activity across major noncommunicable diseases. The findings should be interpreted cautiously since the methodological quality of the included reviews ranged from critically low to low, and there was no consistent assessment of the certainty of evidence. Further systematic reviews are required on efficacy of digital interventions with more rigorous conducting and reporting of systematic review methodologies.

A study of the prevalence of Risk factors of NonCommunicable diseases amongst medical students in Rama Medical College, Kanpur

•Noncommunicable diseases (NCDs) are slowly progressive. They are of long duration and responsible for more than 50% of the global burden of disease, including heart disease, stroke, cancer, diabetes, and chronic lung disease. • few studies to date have examined the prevalence of tobacco and alcohol use among UGs and PGs. Out of the available studies, tobacco and alcohol use prevalence was 9.0% in UGs and 7.1% in PGs; however, they may be at a higher risk of substance use problems due to higher stress levels. • Few studies on NCDs and their risk factors have been conducted among medical students in Kanpur, so we have planned this study in this area. AIM: To study the prevalence of risk factors for noncommunicable diseases among medical students at Rama Medical College, Kanpur.

Level of Physical Activity and Relationship with Alcohol Use Among Youth: A Cross-sectional Study

Background: Alcohol use and physical inactivity are major risk factors for noncommunicable diseases. Adequate physical activity keeps one healthy, but a sedentary lifestyle may contribute to other unhealthy practices like Alcohol use. They address them more strategically. Objectives: To assess the level of physical activity and identify its association with Alcohol use among college-going youth at Rama University, Kanpur. Material &amp; Methods: Data on physical activity and Alcohol use were collected from students aged 18-24 studying medical and non-medical courses at Rama University through an online questionnaire. We used a self-modified questionnaire based on the Global Adult Alcohol Survey (GATS) to assess Alcohol use status and the GPAQ (Global Physical Activity Questionnaire) to assess physical activity. Results: The chance of consuming Alcohol is significantly lower among physically active respondents. Conclusions: Our findings indicate a significant relationship between physical activity and Alcohol use among youth. Promotion of physical activity may be a useful educational tool for reducing Alcohol use.