A province-based surveillance system for the risk factors of non-communicable diseases: A prototype for integration of risk factor surveillance into primary healthcare systems of developing countries

Summary Objectives To establish a surveillance system for risk factors of non-communicable diseases, develop a valid tool and methodology for surveillance surveys, and build capacity in 41 provincial surveillance sites to design and conduct the surveys and provide provincially interpretable baseline...

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Published in:	Public health (London) Vol. 123; no. 5; pp. 358 - 364
Main Authors:	Alikhani, S, Delavari, A, Alaedini, F, Kelishadi, R, Rohbani, S, Safaei, A
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier Ltd 01-05-2009
Subjects:	Adolescent Adult Developing Countries Diet Diseases Female Health Surveys Humans Hypertension - epidemiology Infectious Disease Internal Medicine Iran Iran - epidemiology Male Middle Aged Motor Activity Non-communicable disease Obesity - epidemiology Physical activity Population Surveillance - methods Prevalence Primary health care Risk Factors Smoking - epidemiology Surveillance Surveillance systems Young Adult Iran Non-communicable disease Surveillance Iran Primary health care Risk factors
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Summary:	Summary Objectives To establish a surveillance system for risk factors of non-communicable diseases, develop a valid tool and methodology for surveillance surveys, and build capacity in 41 provincial surveillance sites to design and conduct the surveys and provide provincially interpretable baseline data. Study design Population-based national study. Methods The World Health Organization's STEPwise approach to non-communicable disease surveillance was adapted to design a national risk factor surveillance model. The first national population-based and cross-sectional study was conducted in 2005 in 41 universities of medical sciences in all 30 provinces of Iran. This involved multi-stage cluster sampling from 25–64 year-old Iranians and non-institutionalized populations. A national technical unit at the Ministry of Health and Medical Education supervised all study processes including data management and analysis. Results From the national results, the survey estimated that the prevalence of daily current smoking was 17.9%. Of the target population, 5% consumed at least five combined servings of fruit and vegetables per day. The median daily time spent undertaking transport-related physical activity (43.8 min) was significantly higher than the median time spent on work-related physical activity (27.5 min) or recreational physical activity (28.6 min). Overall, 54.7% of the target population were overweight or obese, and waist circumference was greater among women than men. The prevalence of hypertension was 23.8%, with a higher prevalence among women than men. In addition, 6% of the target population had a high fasting blood glucose (≥126 mg/dl), and 45.1% had a total cholesterol level of at least 200 mg/dl. Conclusion Integration of province-based surveillance activities into the Iranian primary healthcare system is feasible. Provincial reports could provide a baseline picture of the most important risk factors for non-communicable diseases. There are several important risks with a prominent burden that may cause a progressive epidemic of major non-communicable diseases in the future in the absence of quality interventions.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0033-3506 1476-5616
DOI:	10.1016/j.puhe.2009.02.011