nsm-ncd2013 symposium 1 - ncd in malaysia - a rising trend
DESCRIPTION
By Dr Tahir ArisTRANSCRIPT
Conference on Non-Communicable Diseases (NCDs)
26-27 March 2013
NCDs in Malaysia – A Rising Trend
National Health and Morbidity Survey 2011
Tahir A1 & Noor Ani A1 1Institute for Public Health, Ministry of Health Malaysia
NATIONAL HEALTH AND MORBIDITY
SURVEY 2011
(NHMS 4)
NHMS 2011 Methodology Target Population:
cover the residence in the non institutional living quarters (LQ)
Sampling Frame:
used the National Household Sampling Frame made up of Enumeration Blocks (EBs) derived from the Population and Housing Census, Malaysia (2010)
Sampling Design:
Multistage Random Sampling (28 strata)
Stage 1: PSU (EB): 794
Stage 2: SSU (LQ): 9528
All individual in LQ were selected
Field Achievement
Sample size: based on core topics (Health Care
Demands) for analysis up to State (urban/rural): 9,528 LQ
Minimum sample size: 680 respondents/strata (DE=2.5, prev: 23%)
• Success rate (LQ): 88.2%
• Average indiv/LQ: 4.1
1500000 1000000 500000 0 500000 1000000 1500000
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75+
Female
Estimated NHMS 2011 Census 2010
Male
Population Pyramid : Comparison Estimated NHMS 2011 & Malaysian Population (Census 2010)
FINDINGS: 1. DIABETES MELLITUS 2. HYPERTENSION 3. HYPERCHOLESTEROLEMIA 4. OVERWEIGHT AND OBESITY 5. VEGETABLES AND FRUIT INTAKE
15/4/2013 6
DIABETES MELLITUS NON-COMMUNICABLE DISEASES
DEFINITION
• Total diabetes:
Number of subjects with known diabetes plus subjects with Undiagnosed Diabetes
• Known Diabetes Mellitus: self reported by subject with confirm diagnosed by medical personnel.
• Undiagnosed Diabetes: Fasting capillary blood glucose 6.1 mmol /L or Random Blood Glucose 11.2 mmol /L (tested using validated tool: Cardio Check®), among people previously not known to have diabetes.
• Impaired Fasting Glucose: Fasting capillary blood glucose 5.6 to < 6.1 mmol/L (tested using validated tool: Cardio Check®), among people previously not known to have diabetes.
PREVALENCE OF DIABETES, ≥ 18 YEARS, NHMS III (2006) AND NHMS 2011
11.6
15.2
7 7.2
4.5
8
4.2 4.9
0
2
4
6
8
10
12
14
16
2006 2011
PR
EVA
LEN
CE
(%)
DIABETES
KNOWN DM
UNDIAGNOSED DIABETES
IMPAIRED FBS
PREVALENCE OF DIABETES, ≥ 30 YEARS, NHMS II (1996) NHMS III (2006) AND NHMS 2011
8.3
14.9
20.8
6.5
9.5 10.7
1.8
5.4
10.1
4.3 4.7 5.3
0
5
10
15
20
25
1996 2006 2011
PR
EVA
LEN
CE
(%)
DIABETES
KNOWN DM
UNDIAGNOSED DIABETES
IMPAIRED FBS
PREVALENCE OF DIABETES BY STATE, ≥ 18 YEARS, NHMS
2011
13.4
22.5
19.7
17.1
22
16.7 15
16.2
24.8
16.5
11.6
9
12.3 11.3
8.8
15.2
0
5
10
15
20
25
30
35
PR
EVA
LEN
CE
(%)
PREVALENCE OF DIABETES BY STRATA, ≥ 18 YEARS, NHMS 2011
15.1
15.6
7.3
7
7.8
8.5
5.1
4.3
0 2 4 6 8 10 12 14 16 18
Urban
Rural
PREVALENCE (%)
IMPAIRED FBS
UNDIAGNOSED DIABETES
KNOWN DM
DIABETES
PREVALENCE OF DIABETES BY AGE GROUP, ≥ 18 YEARS, NHMS 2011
2.1
4.9 5.3
9.4
10.9
17.6
20.6
26.7
31.6
36.2 36.6
30.3
31.9
0 0.8 0.8
2.6 3.4
7.6
9.1
15.1
17.9
23.1
25.5
20.3
19.4
2.1 4.1
4.5
6.8 7.5
10 11.4
11.6
13.7 13.1
11
10.1
12.5
4.1
3.5 4.4 5.2
5.5
4.6 6.2
6.1 5.1
4.3
5.7
4.7 5.1
0
5
10
15
20
25
30
35
40
18-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+
PR
EVA
LEN
CE
(%)
DIABETES
KNOWN DM
UNDIAGNOSED DIABETES
IMPAIRED FBS
PREVALENCE OF DIABETES BY SEX, ≥ 18 YEARS, NHMS 2011
15.8
14.6
7
7.5
8.8
7.1
5.1
4.7
0 2 4 6 8 10 12 14 16 18
Male
Female
PREVALENCE (%)
IMPAIRED FBS
UNDIAGNOSED DIABETES
KNOWN DM
DIABETES
PREVALENCE OF DIABETES BY ETHNICITY, ≥ 18 YEARS, NHMS 2011
17
13.9
24.9
9.3
7
7.9
7
14.4
3.2
1.6
9
6.8
10.5
6.1
5.4
5.7
4.3
4.9
3.9
2.6
0 5 10 15 20 25 30
Malay
Chinese
Indians
Other Bumis
Others
PREVALENCE (%)
IMPAIRED FBS
UNDIAGNOSED DIABETES
KNOWN DM
DIABETES
PREVALENCE OF DIABETES BY ETHNICITY, ≥ 18 YEARS,
NHMS 2011
17
13.9
24.9
9.3
7
0
5
10
15
20
25
30
Malays Chinese indians Other Bumiputeras Others
PR
EVA
LEN
CE
(%)
Burden of Diabetes in Malaysia: Trends & Projections by 2020 (Adults age 18 years and above)
HYPERTENSION NON-COMMUNICABLE DISEASES
DEFINITION • Hypertension
Respondents recording diastolic blood pressure (DBP) of ≥ 90 mm Hg and/or systolic blood pressure of ≥ 140 mm Hg
• Known hypertension
self reported by subject with confirmed diagnosis by medical personnel
• Undiagnosed hypertension
average BP reading of SBP ≥140 mm Hg and / or DBP ≥ 90 mm Hg (using validated tool: Omron HEM 907) among respondents previously not known to be hypertensive
• Total hypertension
Known + undiagnosed hypertension
32.2
32.7
0
5
10
15
20
25
30
35
2006 2011
PR
EVA
LEN
CE
(%)
PREVALENCE OF HYPERTENSION, ≥18 YEARS, NHMS III (2006), NHMS 2011
32.7
12.8
19.8
0
5
10
15
20
25
30
35
40
Overall Known Hpt Undiagnosed Hpt
PR
EVA
LEN
CE
(%)
PREVALENCE OF HYPERTENSION, KNOWN HYPERTENSION AND UNDIAGNOSED HYPERTENSION, ≥18 YEARS, NHMS
2011
36.4 38.2
27.9
32.8 34.1
29.9 28.4
42.9 41.1
28.7
26.8
29.1
40.5
27.1
22.5
32.7
0
5
10
15
20
25
30
35
40
45
50
PR
EVA
LEN
CE
(%)
PREVALENCE OF HYPERTENSION BY STATE ≥ 18 YEARS,
NHMS 2011
18.8
22.7
12.2
14.7
30.9
37.4
0 5 10 15 20 25 30 35 40
Urban
Rural
PREVALENCE OF HYPERTENSION, KNOWN HPT AND UNDIAGNOSED HPT BY STRATA, ≥ 18 YEARS, NHMS
2011
Hypertension
Known hpt
Undiagnosed hpt
PREVALENCE (%)
30.99
37.48
0
5
10
15
20
25
30
35
40
45
Urban Rural
STRATA
PREVALENCE HYPERTENSION BY STRATA, ≥18 YEARS, NHMS 2011
8.1 11.8
14.3
22.2
27.2
35.8
44
51.6
61
68.7
74.1 72.8
73.4
1 2 3
4.2
7.4
11.6
17.3
24.6 30
37.9 39.5 40.8 42
7.1 9.9 11.3
17.9
19.8
24.2 26.7
27 31
30.7
34.7
32 31.3
0
10
20
30
40
50
60
70
80
18-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+
PR
EVA
LEN
CE
(%)
PREVALENCE OF HYPERTENSION, KNOWN HPT AND UNDIAGNOSED HPT BY AGE GROUP, NHMS 2011
Hypertension 2011
Known Hpt 2011
Newly Hpt 2011
21.8
17.8
11.9
13.8
33.7
31.6
0 5 10 15 20 25 30 35 40
Male
Female
PREVALENCE OF HYPERTENSION, KNOWN HPT, UNDIAGNOSED HPT BY SEX, ≥ 18 YEARS, NHMS 2011
Hypertension
Known Hpt
Undiagnosed hpt
PREVALENCE (%)
21.8
17.8
0.0
5.0
10.0
15.0
20.0
25.0
Male Female
PREVALENCE UNDIAGNOSED HYPERTENSION BY SEX, ≥18 YEARS, NHMS 2011
20.6
18.3
17.9
23.6
16
13.4
14
12.7
12.9
4.8
34
32.3
30.6
36.4
20.9
0 5 10 15 20 25 30 35 40
Malays
Chinese
Indians
Other Bumiputras
Others
PREVALENCE (%)
Hypertension
Known Hpt
Undiagnosed Hpt
PREVALENCE (%)
PREVALENCE OF HYPERTENSION, KNOWN HPT, UNDIAGNOSED HPT BY ETHNICITY, ≥ 18 YEARS, NHMS 2011
Burden of Hypertension in Malaysia: Trends & Projections by 2020 (Adults age 18 years and above)
HYPERCHOLESTROLEMIA NON-COMMUNICABLE DISEASES
DEFINITION
A respondent is said to have desirable total cholesterol when level is below
5.2 mmol/L, and high total cholesterol when total cholesterol level equals and
above 5.2 mmol/L (ATP III, 2001).
• Known hypercholesterolemia:
Self-reported by respondents with confirmed diagnosis by a Doctor or Medical personnel.
• Undiagnosed hypercholesterolemia:
total cholesterol level equals and above 5.2 mmol/L among respondents previously not known to have hypercholesterolemia.
• Total hypercholesterolemia:
Respondents with known hypercholesterolemia plus newly diagnosed hypercholesterolemia.
PREVALANCE OF HYPERCHOLESTROLEMIA ≥ 18 YEARS, NHMS III (2006) AND NHMS 2011
20.7
35.1
0
5
10
15
20
25
30
35
40
2006 2011
PR
EVA
LEN
CE
(%)
35.1
8.4
26.6
0
5
10
15
20
25
30
35
40
Overall Known Hyperchol Undiagnosed Hyperchol
PR
EVA
LEN
CE
(%)
PREVALENCE OF HYPERCHOLESTROLEMIA, KNOWN HYPERCHOLESTROLEMIA AND UNDIAGNOSED
HYPERCHOLESTROLEMIA , ≥18 YEARS, NHMS 2011
PREVALENCE OF HYPERCHOLESTROLEMIA BY STATE, ≥ 18 YEARS, NHMS 2011
37.7
43.4
33.8 35.9
39.7
31.7 32.7
45 45.1
31.9 34.9
31.1 33.5
29.4
33.3 35.1
0
10
20
30
40
50
60
PR
EVA
LEN
CE
(%)
PREVALENCE OF HYPERCHOLESTROLEMIA, KNOWN AND UNDIAGNOSED BY STRATA, ≥ 18 YEARS, NHMS 2011
25.3
30.4
9.1
6.6
34.3
37
0 5 10 15 20 25 30 35 40
Urban
Rural
PREVALENCE (%)
Hypercholestrolemia
KnownHypercholestrolemia
UndiagnosedHypercholestrolemia
PREVALENCE OF HYPERCHOLESTROLEMIA, KNOWN AND UNDIAGNOSED BY AGE GROUP, ≥ 18 YEARS, NHMS 2011
0.6 1.3 2.5 3.9 5.4 8.7
13.6 15.6 18.7
23.8 22.6 22
17.7 10.7 16.1
19.9
26.5 29.2 31.9
33.1 35.9 37.3 31.9 34.6 32 36.5
11.3
17.4
22.4
30.4 34.6
40.5
46.7
51.4
55.9 55.7 57.2 53.9
54.2
0
20
40
60
80
100
120
140
18-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+
Hypercholestrolemia
UndiagnosedHypercholestrolemiaKnownHypercholestrolemia
PR
EVA
LEN
CE
(%)
PREVALENCE OF HYPERCHOLESTROLEMIA, KNOWN AND UNDIAGNOSED BY SEX, ≥18 YEARS, NHMS 2011
21.5
32
8.6
8.2
30.1
40.2
0 5 10 15 20 25 30 35 40 45
Male
Female
Hypercholestrolemia
KnownHypercholestrolemia
UndiagnosedHypercholestrolemia
PREVALENCE (%)
PREVALENCE OF HYPERCHOLESTROLEMIA BY SEX, ≥18 YEARS, NHMS 2011
30.1
40.2
0
5
10
15
20
25
30
35
40
45
Male Female
PREVALENCE (%)
PREVALENCE OF HYPERCHOLESTROLEMIA KNOWN AND UNDIAGNOSED, BY ETHNICITY, ≥ 18 YEARS, NHMS 2011
PREVALENCE (%)
30.3
22.2
24.1
23.9
23.6
8
11.2
11.3
5.9
1.6
38.4
33.4
35.5
29.8
25.2
0 5 10 15 20 25 30 35 40 45
Malays
Chinese
Indians
OtherBumiputras
Others
Hypercholestrolemia
KnownHypercholestrolemia
UndiagnosedHypercholestrolemia
33.25
26.17 26.4 25.68
27.07
15
20
25
30
35
40
Malay Chinese Indian Other Bumiputra Others
Pre
vale
nce
PREVALENCE UNDIAGNOSED HYPERCHOLESTROLEMIA BY ETHNICITY, NHMS 2011
Burden of Hypercholesterolaemia in Malaysia: Trends & Projections by 2020 (Adults age 18 years and above)
NUTRITIONAL STATUS NON-COMMUNICABLE DISEASES
DEFINITION
BMI STATUS (CPG 2004)
• Underweight ≤ 18.5
• Normal = 18.5 – 22.9
• Pre-obese = 23.0 – 27.4
• Obese ≥ 27.5
BMI STATUS (WHO 1998)
• Underweight ≤ 18.5
• Normal = 18.5 – 24.9
• Overweight = 25.0 – 29.9
• Obese ≥ 30
• Abdominal obesity (aged > 18 years old) =
- Men ≥ 108
- Women ≥ 80
8.3
31.1
27.2
33.3
8.3
47.2
15.1
29.4
0.0
10.0
20.0
30.0
40.0
50.0
60.0
CPG2004
WHO1998
PR
EVA
LEN
CE
(%)
NATIONAL PREVALENCE OF NUTRITIONAL STATUS ≥ 18 YEARS, NHMS 2011
UNDERWEIGHT
NORMAL
OBESITY
PRE-OBESE / OVERWEIGHT
25.2
8.5 8.3
48.4 47.2
16.6
29.1 29.4
4.4
14 15.1
0
10
20
30
40
50
60
NHMS (1996) NHMS (2006) NHMS (2011)
PR
EVA
LEN
CE
(%)
NATIONAL PREVALENCE OF NUTRITIONAL STATUS (WHO, 1998), NHMS II (1996), NHMS
III (2006), NHMS 2011
UNDERWEIGHT
NORMAL
OVERWEIGHT
OBESITY
26.3
33.5
27.2
33.3
0 5 10 15 20 25 30 35 40
OBESITY
OVERWEIGHT
PREVALENCE (%)
PREVALENCE OF NUTRITIONAL STATUS, ≥ 18 YEARS, NHMS III (2006) AND NHMS 2011
(CPG2004)
NHMS 2011
NHMS 2006
PREVALENCE OF PRE-OBESE BY STATES, ≥ 18 YEARS, NHMS 2011 (CPG 2004)
33 34.0
35.2 33.7
31.3 32.2
36.3
31.4
29.1
32.3 32.7 34.5
32.4
36.9 36.3
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
PR
EVA
LEN
CE
(%)
PREVALENCE OF OBESITY BY STATES, ≥ 18 YEARS, NHMS 2011 (CPG 2004)
29 28.2 29.4 29.3
28.2 28.2 26.9
30.1
34.6
28.2 28.1
21.1
26.7
22.8
27.4
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
PR
EVA
LEN
CE
(%)
33.7
32.4
27.3
26.3
0 5 10 15 20 25 30 35 40
Urban
Rural
PREVALENCE (%)
PREVALENCE OF PRE-OBESE/OBESITY BY STRATA, ≥ 18 YEARS NHMS 2011
OBESITY
PRE-OBESE
16.1 18.5
24.2
28.1
31.1 31.6
35.1 32.6
34.4
30.7
27.7
17.8 16.8
15.7
24.5 26.1
35.4 35.7
41.0 38.6
40.3 39.4 40.2 41.0 40.1
36.9
0
5
10
15
20
25
30
35
40
45
18-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79
PR
EVA
LEN
CE
(%
)
PREVALENCE OF PRE-OBESE/OBESITY BY AGE GROUP ≥ 18 YEARS, NHMS 2011
OBESITY
PRE-OBESE
35.80
30.70
24.96
29.61
0.00 5.00 10.00 15.00 20.00 25.00 30.00 35.00 40.00
MALE
FEMALE
PREVALENCE (%)
OBESITY
PRE-OBESE
PREVALENCE OF PRE-OBESE/OBESITY BY SEX ≥ 18 YEARS, NHMS 2011
33.4
35.8
29.8
33.5
28
32
19.7
35.7
25.2
13.8
0 5 10 15 20 25 30 35 40
Malay
Chinese
Indians
Other Bumis
Others
PREVALENCE %
PREVALENCE OF PRE-OBESE/OBESITY BY ETHNICITY, ≥ 18 YEARS NHMS 2011
OBESITY
PRE-OBESE
OBESITY AMONG POPULATION < 18 YEARS
DEFINITION
• Obesity among children is defined as BMI for age ≥+2SD.
PREVALENCE OF OBESITY AMONG CHILDREN <18 YEARS BY STATES, NHMS 2011
5.5 5.8 6.4
4.7 5
7.2
3.4
9 8.8
7.3
5.5
3.2
8
6.3
7.4
6.1
0
2
4
6
8
10
12
14
PR
EVA
LEN
CE
(%)
6.5
5.5
5 5.2 5.4 5.6 5.8 6 6.2 6.4 6.6
Urban
Rural
PREVALENCE %
PREVALENCE OF OBESITY AMONG CHILDREN < 18 YEARS, BY STRATA ,
NHMS 2011
6.5 6.7 6.3
4.9
0
1
2
3
4
5
6
7
8
0-4 5-9 10-14 15-17
PR
EVA
LEN
CE
(%)
PREVALENCE OF OBESITY AMONG CHILDREN < 18 YEARS BY AGE GROUP, NHMS 2011
7.6
4.6
0
1
2
3
4
5
6
7
8
9
10
Male Female
PR
EVA
LEN
CE
(%)
PREVALENCE OF OBESITY AMONG CHILDREN < 18 YEARS BY SEX, NHMS 2011
INTAKE OF FRUITS/VEGETABLES NON-COMMUNICABLE DISEASES
DEFINITION
• Inadequate intake: Intake of less than 5 servings of fruits and/or vegetables per day (based on WHO definition for the prevention of chronic diseases)
92.9 94.8
90.1 95.7 93.6
90.9 92.3 93 95.6 89.8 92 95.1 94.7
90.7 94.2
0
20
40
60
80
100
120Jo
ho
r
Ked
ah
Kel
anta
n
Mel
aka
Ne
geri
Sem
bila
n
Pa
han
g
Pe
nan
g
Pe
rak
Pe
rlis
Sela
ngo
r
Tere
ngg
anu
Sab
ah &
WP
Lab
uan
Sara
wak
WP
Ku
ala
Lum
pu
r
WP
Pu
traj
aya
PR
EVA
LEN
CE
%
PREVALENCE OF VEGE/FRUIT INTAKE <5 SERVINGS BY STATE, ≥ 18 YEARS, NHMS 2011
92.5
92.1
94.2
0 20 40 60 80 100
MALAYSIA
Urban
Rural
PREVALENCE (%)
PREVALENCE OF VEGE/FRUIT INTAKE <5 SERVINGS AMONG ADULTS, ≥ 18 YEARS, NATIONAL AND BY STRATA, NHMS 2011
97.4 95 94.4 91.8 90.6 90.6 91.7 90.4 89 90.1 89.7 93.6 96.2
0
20
40
60
80
100
120
18-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79
PR
EVA
LEN
CE
%
PREVALENCE OF VEGE/FRUIT INTAKE <5 SERVINGS BY AGE GROUP, ≥ 18 YEARS, NHMS
2011
92.8
92.1
0 10 20 30 40 50 60 70 80 90 100
Male
Female
PREVALENCE %
PREVALENCE OF VEGE/FRUIT INTAKE <5 SERVINGS BY SEX, ≥ 18 YEARS, NHMS 2011
92.4
90.9
94.8
94.8
92.6
0 10 20 30 40 50 60 70 80 90 100
Malays
Chinese
Indians
OtherBumis
Others
PREVALENCE %
PREVALENCE OF VEGE/FRUIT INTAKE <5 SERVINGS BY ETHNICITY, ≥ 18 YEARS, NHMS
2011
PHYSICAL ACTIVITY NON-COMMUNICABLE DISEASES
‘Active’ Physical Activity
Combination of walking, moderate-intensity or vigorous-intensity activities achieving a minimum of at least 600 MET-minutes/week.
• IPAQ Short Form ( revised Nov 2005)
DEFINITION
TREND OF ‘ACTIVE’ PHYSICAL ACTIVITY, NHMS III (2006) AND NHMS 2011
56.3
64.8
0
10
20
30
40
50
60
70
NHMS 2006 NHMS 2011
PR
EVA
LEN
CE
(%
)
PREVALENCE OF ‘ACTIVE’ PHYSICAL ACTIVITY BY STATE, NHMS 2011
PREVALENCE OF ‘ACTIVE’ PHYSICAL ACTIVITY BY STRATA, NHMS 2011.
PREVALENCE OF ‘ACTIVE’ PHYSICAL ACTIVITY, BY AGE GROUP, NHMS 2011
PREVALENCE OF ‘ACTIVE’ PHYSICAL ACTIVITY BY SEX, NHMS 2011
PREVALENCE OF ‘ACTIVE’ PHYSICAL ACTIVITY, BY ETHNICITY, NHMS 2011
NON-COMMUNICABLE DISEASES
ALCOHOL
DEFINITION • Alcoholic beverages in this context encompassed any drink
containing ethanol irrespective of its concentration and, inclusive of those consumed for medical purposes such as alcoholic tonic
• Non drinker is a respondent who never consume alcoholic beverages in their life time
• Ever drinker is a respondent who had history of consuming alcoholic beverages at least once in their life time
• Current drinker is a respondent who still consuming alcoholic beverages for the past 12 months
• Ex-drinker is a respondent who had stopped drinking alcoholic beverages for the past 12 months
DEFINITION
• Binge drinking is consumption of ≥ 6 standard drink per-sitting
• Heavy episodic drinking is consumption of ≥ 6 standard drink per-sitting at least once occasion weekly.
• Low risk drinker is a respondent who consumed alcohol according to low risk guideline and is generally indicated when the AUDIT score is between 0 – 7.
• Risky drinker is a respondent who consumed alcohol in excess of low risk guideline and is generally indicated when the AUDIT score is between 8 – 19.
• Probable Alcohol Dependence is a respondent who consumed alcohol beyond the low risk guideline and is generally indicated when the AUDIT score is 20 or above
Validated tool: Alcohol Use Disorder Identification Test (AUDIT)
PREVALENCE OF CURRENT DRINKER, ≥ 13 YEARS, NHMS III (2006) AND NHMS 2011
11.1 11.6
0
2
4
6
8
10
12
2006 2011
PR
EVA
LEN
CE
(%)
YEAR
PREVALENCE OF CURRENT DRINKER, BINGE DRINKER AND HEAVY EPISODIC BY STRATA, ≥ 13 YEARS, NHMS 2011
12.6
6.1
1.1
8.9
4.7
0.8 0
2
4
6
8
10
12
14
16
Urban Rural
PR
EVA
LEN
CE
(%)
binge drinker
current drinker
heavy episodic drinker
PREVALENCE OF CURRENT DRINKER, BINGE DRINKER AND HEAVY EPISODIC DRINKER BY AGE GROUP, ≥ 13 YEARS,
NHMS 2011
1.6
6.9
15.7
13.7
14.7 14.3 13.9
12.4
11 9.7 9.8
8.4
5.4
4.9
0.6
3.5
8.3
7
8.3 6.3 6.4 6.7
5 4 4.1
3.7
1.7 1.5
0.3
0.7 1.4 0.9
1.3 1 1.3 1.2 1.5 0.8 1.6 0.5 0.1
0.9 0
2
4
6
8
10
12
14
16
18
10-14years
15-19years
20-24years
25-29years
30-34years
35-39years
40-44years
45-49years
50-54years
55-59years
60-64years
65-69years
70-74years
75+years
Current drinker
Binge drinker Heavy episodic drinker
PR
EVA
LEN
CE
(%)
PREVALENCE OF CURRENT DRINKER, BINGE DRINKER
AND HEAVY EPISODIC BY SEX, ≥ 13 YEARS, NHMS 2011
17.2
9.1
1.9
5.7
2.2
0.2 0
2
4
6
8
10
12
14
16
18
20
Male Female
PR
EVA
LEN
CE
(%)
binge drinker
current drinker
heavy episodic drinker
PREVALENCE OF CURRENT DRINKER, BINGE DRINKER AND HEAVY EPISODIC DRINKER BY ETHNICITY, ≥ 13 YEARS, NHMS
2011
0.9 0.5 0.1
27.5
12.1
2.4
18.8
8.3
1.1
20.3
12.8
2.2
11.3
6.7
0.9 0
5
10
15
20
25
30
35
Malay Chinese Indian OtherBumiputeras
Others
PR
EVA
LEN
CE
(%)
Current drinker
Binge drinker
Heavy episodic drinker
PATTERN OF DRINKING BY RISK, ≥ 13 YEARS, NHMS 2011
35.6
49.2
14.0
1.2 0
10
20
30
40
50
60
Abstinence Low-risk Risky Probable dependence
PR
EVA
LEN
CE
(%)
COMPARISON OF ‘DRINKING RISKS’ GLOBAL VS NHMS 2011
Babor & Higgins-Biddle, WHO, 2001
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Global NHMS 2011
40 36
35 49
20
14 5
1
Ex drinker
Low (score : 0 - 7)
Risky (score : 8 - 19)
P. Dependence
Conclusion
• Inter-sectoral collaboration with community participation is an important strategy to curb the NCD problems. Preventing the primary risk factors of NCDs, namely tobacco use, poor diets, harmful use of alcohol and physical inactivity, is a top priority to reverse the rising trends in NCDs.
Conclusion
“Research is not a luxury, but an essential
tool to facilitate & improve managerial
decision-making”
WHO Technical Series No. 819
It’s Not What You Know, But What You Do With What You
Know