Prevalence of non-communicable diseases risk factors and their determinants in Malawi: Evidence from 2017 WHO STEPwise Survey

Introduction: By 2030, the non-communicable diseases (NCDs) are expected to overtake communicable, maternal, neonatal, and nutritional (CMNN) diseases combined as the leading cause of mortality in sub-Saharan Africa (SSA). With the increasing trend in NCDs, the NCD risk factors (NCDRF) need to be understood at local level in order 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 was analysed using frequencies, proportions, odds ratios (OR) and their associated 95% confidence intervals (95%CI). We fitted multiple logistic regression of the NCD risk factors on the explanatory variables using 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 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 level of education. Females had lower odds of engaging in harmful alcohol use than males (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 non-paid 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 relatively blood pressure calls for a sound public health approach. The Malawi Ministry of Health should devise multi-sectoral approaches that minimize exposure to modifiable NCD risk factors at population and individual levels.