Prevalence of noncommunicable diseases risk factors and their determinants in Malawi: Evidence from 2017 WHO Stepwise survey

Introduction: By 2030, the noncommunicable diseases (NCDs) are expected to overtake communicable, maternal, neonatal, and nutritional diseases combined as the leading cause of mortality in sub-Saharan Africa. With the increasing trend in NCDs, the NCD risk factors (NCDRF) need to be understood at local level to guide NCD risk mitigation efforts. Therefore, we provide a detailed analysis of some modifiable NCDRF and their determinants in Malawi using the 2017 Stepwise survey (STEPS). Methods: This is a secondary analysis of the Malawi 2017 STEPS. Data were analyzed using frequencies, proportions, odds ratios, and their associated 95% confidence intervals (95%CI). We fitted multiple logistic regression of the NCDRF on the explanatory variables using the likelihood ratio test. The level of statistical significance was set at P < 0.05. Results: Of the 4187 persons, 9% were current smokers, 1% were taking alcohol, 16% had a high salt intake, 64% had insufficient fruit intake, 21% had low physical activity, 25% had high blood sugar, and 11% had high blood pressure. Smoking odds increased with age but decreased with the level of education. Females had lower odds of engaging in harmful alcohol use than males (adjusted odds ratio [AOR] = 0.04, 95%CI: 0.01-0.17, P < 0.001). Females had lower odds of high salt uptake than the males (AOR = 0.70, 95%CI: 0.58-0.84, P = 0.0001). Persons in nonpaid jobs had higher odds of salt uptake than those employed (AOR = 1.70, 95%CI: 1.03-2.79, P = 0.04). Females were 22% more likely to have insufficient fruit uptake compared to males (AOR = 1.22, 95%CI: 1.06-1.41, P = 0.007). Conclusion: The high prevalence of physical inactivity, high salt consumption, insufficient fruit intake, raised blood glucose and high relative blood pressure calls for a sound public health approach. The Malawi Ministry of Health should devise multisectoral approaches that minimize exposure to modifiable NCDRF at population and individual levels.