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National noncommunicable disease monitoring survey (NNMS) in India: Estimating risk factor prevalence in adult population

, Vaitheeswaran Kulothungan, Sravya Leburu, Anand Krishnan, Himanshu Kumar Chaturvedi, Harshal Ramesh Salve, Ritvik Amarchand, Baridalyne Nongkynrih, , Vinay Urs K. S., Lakshmy Ramakrishnan, A. Laxmaiah, Manjit Boruah, , , , Prabu Rajkumar, P. Sankara Sarma, Rinku Sharma, Muralidhar Tambe, , N. Arlappa, Tulika Goswami Mahanta, Rajnish P. Joshi, Neeti Rustagi, Sonia Gupta, Binod Kumar Behera, Sangita Chandrakant Shelke, Abhiruchi Galhotra, Pranab Jyoti Bhuyan, Abhijit P. Pakhare, Dewesh Kumar, Roshan K. Topno, Manoj Kumar Gupta, Atulkumar V. Trivedi, Suneela Garg
Published: 2 March 2021
PLoS ONE , Volume 16; doi:10.1371/journal.pone.0246712

Abstract: Background The primary objective of National NCD monitoring survey (NNMS) was to generate national-level estimates of key NCD indicators identified in the national NCD monitoring framework. This paper describes survey study protocol and prevalence of risk factors among adults (18–69 years). Materials and methods NNMS was a national level cross-sectional survey conducted during 2017–18. The estimated sample size was 12,000 households from 600 primary sampling units. One adult (18–69 years) per household was selected using the World Health Organization-KISH grid. The study tools were adapted from WHO-STEPwise approach to NCD risk factor surveillance, IDSP-NCD risk factor survey and WHO-Global adult tobacco survey. Total of 8/10 indicators of adult NCD risk factors according to national NCD disease monitoring framework was studied. This survey for the first time estimated dietary intake of salt intake of population at a national level from spot urine samples. Results Total of 11139 households and 10659 adults completed the survey. Prevalence of tobacco and alcohol use was 32.8% (95% CI: 30.8–35.0) and 15.9% (95% CI: 14.2–17.7) respectively. More than one-third adults were physically inactive [41.3% (95% CI: 39.4–43.3)], majority [98.4% (95% CI: 97.8–98.8)] consumed less than 5 servings of fruits and / or vegetables per day and mean salt intake was 8 g/day (95% CI: 7.8–8.2). Proportion with raised blood pressure and raised blood glucose were 28.5% (95% CI: 27.0–30.1) and 9.3% (95% CI: 8.3–10.5) respectively. 12.8% (95% CI: 11.2–14.5) of adults (40–69 years) had ten-year CVD risk of ≥30% or with existing CVD. Conclusion NNMS was the first comprehensive national survey providing relevant data to assess India’s progress towards targets in National NCD monitoring framework and NCD Action Plan. Established methodology and findings from survey would contribute to plan future state-based surveys and also frame policies for prevention and control of NCDs.
Keywords: India / Adults / Blood pressure / Obesity / Medical risk factors / Blood sugar / Alcohol consumption / Noncommunicable diseases

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