Preliminary Findings from Non-communicable Disease in Nepal (NCD Nepal) study

Background

Non-communicable disease in Nepal (NCD Nepal) study is a community-based prospective study to understand the epidemiology of NCDs in rural Nepalandto test the effectiveness of implementation approaches to reduce NCDs.

Methodology

The study is conducted in Ghorahi-Dang (Wards 3,4,6,7) in 7,052 estimated target population, 40-75 years old by organizing monthly mobile health clinics. All eligible participants receive comprehensive risk-factor assessment using validated questionnaire, physical examination; and high-risk participants receive laboratory investigations. Participants will be followed-up for 5 years or until death. Lifestyle counseling, pharmacotherapy and personalized follow-up will be offered.

Results:

A total of 1232 participants were enrolled between May 2018 –December 2019. The mean age was 54 years; 63.4% were female. About 14.2% were current smokers;14.5% used excessive alcohol. The mean daily salt intake was 13.1 gram/day,17.4% were engaged in vigorous-intensity(>6 metabolic equivalents-METS)physical activities. The mean body mass index, waist-circumference and blood pressure were 24.0kg/m2, 81.9cmand124/77mmHg, respectively. Hypertension was present in 30.2%;46.5% were unaware. Diabetes was present in 7.5%;16.3% were unaware. Elevated glucose and/or diabetes(maximum projected diabetes burden)was present in 27.3 %;76.5% were unaware. The mean total cholesterol, high-density lipoprotein cholesterol, triglycerides and serum creatinine(N=462)and HbA1C (N=96)were 167mg/dl,48mg/dl, 212.6mg/dl, 0.8mg/dL and 7%respectively. Estimated 10-year risk for developing atherosclerotic disease was 8.1% (N=270). Coronary artery disease was prevalent in 1.1%; heart failure, stroke, peripheral artery disease and chronic lung disease were each prevalent in <1%.

Conclusion

The NCD Nepal Study emphasizes on identification and risk modification of asymptomatic individuals in the community for NCDs. Studies like these can be a sustainable approach to address NCDs in resource-limited settings like Nepal.