Abstracts of NCD & Prevalence of risk factors in Sri Lanka 1990 to 2012

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1. [Type thedocumenttitle]Abstracts of Non Communicable Diseases and prevalence of riskfactors in Sri Lanka, published from 1990 2012Abstracts ofNon CommunicableDiseases and prevalenceof risk factorsin Sri Lanka,published fro m Non CommunicableDisease Unit,Ministry of HealthDr. Anura Jaysasinghe MD, MSc, MBBS 2. AcknowledgementI should thanks for all stakeholders who contributed to accomplish this task. Especially, Iwish to express our deep sense of gratitude to the Japan International Cooperation Agency,Sri Lanka for their invaluable support in providing us with necessary human resource tocomplete this project.Its my pleasure to thanks staff of Postgraduate Institute of Medicine library, Alcohol andDrug Information Centre, Sri Lanka Medical Association Library, National ScienceFoundation, World Health Organization library , University of Colombo and Ministry of HealthLibrary, who gave fullest support to carry out this task.I would also take this opportunity to thank all the authors who made available theirpublications to meet the requirement of this project. I would also like to express my gratitudetowards the colleagues of Ministry of Health Sri Lanka for their fullest support andencouragement in completion of this important project.Lastly on behalf of the NCD unit, my special thanks goes to the research assistant SayuriNakandala, for her effort in making this project a success.Dr. Anura Jayasinghe. MD, MSc, MBBSPrincipal InvestigatorNon Communicable Disease UnitMinistry of HealthSri Lanka. Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,published from 1990 2012 3. ContentsAcknowledgement ......................................................................................................................... 11. Introduction ........................................................................................................................... 32. Objective ............................................................................................................................... 33. Methodology ......................................................................................................................... 4Key words*: ............................................................................................................................... 64. Results ................................................................................................................................... 75. Discussion .............................................................................................................................. 86. Limitations ............................................................................................................................. 97. Conclusion ............................................................................................................................. 9References .................................................................................................................................... 9Group A Publications (Studies which showed the prevalence of NCDs and their risk factors in thegeneral population) ..................................................................................................................... 10Group B Publications (Studies which found under the key words and carried out among specificpopulation) ................................................................................................................................ 101Group C Publications (Studies found under the key words, but unable to meet the criteria forGroup A and B) .......................................................................................................................... 158 Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,published from 1990 2012 4. Abstracts of Non Communicable Diseases and prevalence of riskfactors in Sri Lanka, published from 1990 20121. IntroductionSri Lanka faces escalating health care costs with rising rates of Non CommunicableDiseases (NCDs) such as Cardiovascular Diseases, Cancers, Chronic RespiratoryDiseases, and Diabetes as well as their risk factors such as Obesity, physical inactivity,smoking, High sugar and salt intake, etc.Due to rising levels of urbanization: sedentary lifestyles, unhealthy diet, excessive use ofalcohol and cigarettes, people are increasingly exposed to the risk factors of NCDs and as aresult, create new burden for the health care system to cater for their health needs. Theeffect of reducing risk factors such as cigarette use, alcohol consumption, promoting anactive lifestyle and eating balanced diets, will go a long way in reducing the prevalence ofNCDs in Sri Lanka (1).The Ministry of Health has introduced The National Policy and Strategic Framework forPrevention and Control of Chronic Non- Communicable Diseases with the aim of reducingthe burden due to chronic NCDs by promoting healthy lifestyles, reducing the prevalence ofcommon risk factors, and providing integrated evidence-based treatment options fordiagnosed NCD patients. The Ministry of Health has given priority to certain strategic areasin the effort to achieve the goals such as to implement a cost-effective NCD screeningprogram at community level (2).The aim of this project was to uncover the prevalence of NCD and their risk factors in SriLanka, and to assess the socioeconomic burden they impart on the population. Findings ofstudies conducted by other organizations regarding NCDs would helpful to check thereliability of routine survey of the Ministry. These valuable information will eventually be usedto plan and monitor prevention programme, which conduct by the Ministry of Health.2. ObjectiveTo compile studies and reports on prevalence of Non Communicable Diseases and theirrisk factors in Sri Lanka published from 1990 2012. Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,published from 1990 2012 5. 3. MethodologyIn order to achieve the objective of this project, there was a need to find the all physical andelectronic data published on the topic of NCDs. However, there was no specific studycompiled for this purpose, and so a search was carried out to find the definite locations ofthe publications on different directories such as The Profile Partner in Health, published byWHO Sri Lanka.Initially, the details of different organizations were obtained, which have libraries containingthe relevant publications on NCD, from several directories. Many online databases were alsolooked into for studies carried out in Sri Lanka with regard to NCDs. After preparing a list oforganizations, libraries, research institutions and websites which contained potential data forthis purpose, the relevant personnel in charge of the respective institutions were contacted,either by visiting them personally or over the phone, and gained permission to use theirfacilities. According to a schedule, they were visited during the August to November 2012. Alist of keywords was determined based on the risk factors and prevalence of NCDs.Permission was vested by the Ministry of Health to visit the particular institutions.The first institution visited was the Post Graduate Institute of Medicine (PGIM) Library. ThePGIM is an institute attached to the University of Colombo, which is responsible for thespecialist training of medical officers. It is recognized internationally for its trainingprogrammes, and works in close collaboration with the Ministry of Higher Education, Ministryof Health, Faculties of Medicine and Professional Colleges. It is situated in Norris CanalRoad, Colombo 07. With help of the Senior Librarian, a list of references was found usingthe keywords in their database. The publications identified were mainly theses anddissertations compiled by the postgraduate trainees in Medicine to fulfill the requirement forthe Doctor of Medicine and Master of Science degrees in different fields (3). All of therelevant publications were studied and the essential information was extracted and noteddown on a Microsoft Word document. The Word document was copied on to the softwareprogram EndNote. Certain authors were contacted to obtain clarification on areas of thepublication and to gain further information.Then, information collected from Alcohol and Drug Information Centre (ADIC). ADIC is awell-recognized National Resource Centre, which works to reduce drug demand. It providesa voluntary and charity service for the public by collecting and disseminating information,conducting seminars, training, and workshops on the effects of substance abuse andmobilizes communities through effective strategies. The institution also works in associationwith many international networks such as the Global Alcohol Policy Alliance, etc.(4). TheADIC conducts a variety of surveys designed to determine the trends of alcohol and tobaccoconsumption on selected districts in order to support other programmes of ADIC and theinformation needs of the country. The institution annually evaluates the activities of selectedprogrammes and donor funded projects in order to determine the impact and effectivenessof the activities carried out.The ADIC library compiles data from spot surveys into reports.These surveys along with research evaluations were extracted to the program EndNote andscrutinized.The Sri Lanka Medical Association (SLMA) was visited subsequently. The SLMA is thenational medical professional association in Sri Lanka, which brings together medical Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,published from 1990 2012 6. practitioners of all grades and all branches of medicine. It is in fact the oldest professionalmedical association in Asia and Australasia, with a proud history dating from 1887 (5). Manypublished journals such as Ceylon Medical Journal, Journal of Medical Sciences, BritishMedical Journal and several other local and international journals were examined forrelevant publications. The online databases available at the SLMA library were also utilizedto find data relating to NCDs and their risk factors.The National Science Foundation (NSF) was visited next. The NSF is a state fundedorganization under the Ministry of Technology and Research(6). It promotes research,development and innovation to create knowledge based economy by building public-private,institution-industry partnerships. National Science Library & Resource Centre (NSLRC) ofthe National Science Foundation is the National Focal Point for the dissemination of Science& Technology (S&T) Information in the country. The efficiency of the information service isenhanced through a network (Sri Lanka Science & Technology Information Network)operated among S&T libraries in the country. The NSLRC web site functions as a centralhub which links other S & T related information sources in the country for efficient exchangeof information among the scientific counterparts. NSLRC services extend to the reach &accessibility of resources within & outside the country(7). Electronic online databases wereavailable within the NSF premises, some of which had limited access to the outside. NCDrelevant studies were also found in the studies done under the category of Anthropology andSociology. Eventually, all relevant publications were extracted and later placed onto thesoftware program EndNote.The World Health Organization (WHO) was visited thereafter. The WHO is the directing andcoordinating authority for health within the United Nations system. It is responsible forproviding leadership on global health matters, shaping the health research agenda, settingnorms and standards, articulating evidence-based policy options, providing technical supportto countries and monitoring and assessing health trends(8). The publications and the onlinedatabases were utilized to obtain the necessary data to accumulate the studies onto thesoftware program EndNote.The Ministry of Health Library was also visited. Almost all available publications were in thephysical format, most of which had been previously encountered in prior institutions.Previous publications were also verified as to the validity of the content of the publications, inaddition to gathering new data on publications.Research groups of several universities were also contacted, such as University of Colombo,University of Peradeniya, University of Sri Jayawardenapura, and a number of theirpublications were included into this project.The publications contained within each library were studied along with the key words*, andthe essential data were documented directly onto the software program EndNote. Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,published from 1990 2012 7. Key words*:Cardio vascular diseasesStrokeCerebrovascular diseasesDiabetes MellitusPeripheral vascular diseasesCancerHyperglycemiaHypertensionMyocardial InfarctionHeart failureSmokingAlcoholPhysical Inactivity/ activityHypercholesterolemiaOverweightObesityWastingAsthmaChronic non communicable diseasesThe availability of publications on electronic databases was very helpful in recognizingpotential publications, but many of them were password restricted, so separate visits werenecessary to uncover these restricted electronic databases from their respective institutions.EndNote is a software program which searches, organizes, and sharing researches andbibliographies. Being an online search tool, it provides a simple way to search onlinebibliographic databases and retrieve the references directly into EndNote. This software hasthe capability to make bibliographies and manuscripts; it can format citations, figures, andtables in Microsoft Word with the Cite While You Write feature.The reliability of individual publications was checked twice a week during the study periodand changes were made. After creating a library database on the EndNote softwareprogram, which included all the probable publications relating to NCDs, a grading systemwas implemented on these publications in the order of their relevance to the risk factors andprevalence of NCDs, whether they were carried out as a community based study, etc. Thepublications were placed into one of three categories A, B, or C, based on the followingfeatures. Publications were graded A, if they contained data involving mentioned NCD riskfactors and prevalence rates, and if they were based on a general population. Publications were graded B, if they contained data involving mentioned risk factorsand prevalence rates, but they were from specific group or population which made itdifficult to infer the status of the general population. Publications were graded C, if they contained information matching the keywords,but were unable to meet the criteria for Group A and B. Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,published from 1990 2012 8. Some publications, despite matching the keywords, were excluded as they failed to addressthe issue of NCD or any other component relevant to this project.4. ResultsDuring the period of four months, seven libraries/institutions were visited (PGIM Library,ADIC, SLMA Library, NSF Library, WHO Library, University of Colombo and Ministry ofHealth Library). Publications regarding NCDs and published from January 1st 1990 -November 30th 2012, referred from these libraries were found mainly in Journals ofMedicine and in dissertations and theses of Postgraduate trainees in preparation for theirDoctor of Medicine and Master of Science degrees.The Journals referred were:Ceylon Medical JournalJournal of the Ceylon College of PhysiciansJournal of the College of the Community Physicians of Sri LankaBritish Medical JournalSri Lanka Journal of Population StudiesInternational Journal of Public HealthGalle Medical JournalKandy Medical JournalAnuradhapura Medical JournalSri Lanka Journal of Diabetes, Endocrinology and MetabolismThe electronic databases from which data were gathered included:Sri Lanka Journals Online - http://www.sljol.info/Hinari - www.who.int/hinari/Scopus - www.scopus.com/scopus/home.urlEBSCO - www.ebsco.com/SLSTINET - www.cmb.ac.lk/academic/Science/science-library/networks/slstinetPubMed - www.ncbi.nlm.nih.gov/pubmedSciencedirect - www.sciencedirect.com/From these data sources, after a period of 4 months, a total of 356 publications relating tothe topic of NCDs were gathered. After analyzing and verifying their content, 241publications were deemed to be appropriate for the need of this project.The publicationswere categorized into Groups:A (75 studies);Studies which showed the prevalence of NCDs and their risk factors in thegeneral population, Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,published from 1990 2012 9. B (74 studies); Studies which found under the key words and carried out among specificpopulation (e.g. hospital based or disease specific population) andC (92 studies); Studies found under the key words, but unable to meet the criteria for GroupA and B.Group A was further analyzed to identify the study method, study population, and theprevalence of NCD related risk factors. There were 75 studies in group A, out of which57.6% examined only a single risk factor relating to NCDs and 42.4% studied multiple riskfactors. Table 1 shows the number of studies carried out to determine the prevalence ofeach of NCD risk factors in the general population.Table 1. Number of studies carried out to determine the prevalence of each of NCD riskfactors in the general population, published from January 1st 1990 - November 30th 2012.NCD related risk factor Number of studies foundSmoking 25Alcohol 14Physical Inactivity/ activity 13Hyperglycemia 19Hypertension 17Hypercholesterolemia 4Overweight, Obesity, wasting 20Asthma 4The individual studies of Group A (studies which contain data involving risk factors andprevalence rates, and which were based on the general population: published from January1st 1990 November 30th 2012) can be found Annexure 1.Group B (studies which were based on a specific group or population which made it difficultto infer the status of the general population) can be found in Annexure II and Group C(studies which contain information matching the keywords, but were unable to meet thecriteria for Group A and B) can be found in Annexure III.5. DiscussionRegarding the type of population studied in group A, most of smoking and alcohol relatedstudies have been carried out among the adolescent. Other NCD risk factors such ashyperglycemia, hypertension and hypercholesterolemia were carried out among the adultpopulation.A few studies were carried out among certain group of population such as estate community,urban or rural population, school children and elderly population. Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,published from 1990 2012 10. It was noticed that a large number of these studies targeted the adolescents and middle agegroup ranging up to about 64 years, and relatively few were aimed at the elderly. Severalstudies had not mentioned the age of study population, and most of them were abstractspublication.Among the 75 studies, it was observed that the majority were conducted within the Colombodistrict, and other studies around other urban areas in Sri Lanka, while only a very fewstudies were conducted in the rural areas. Among our study search, hardly any publishedstudies on prevalence of Type I DM were found.6. Limitations A number of studies which were gathered had only the abstract, which limited theamount of information extracted from those publications. In some instances, entering of key words by authors has not exactly reflected thecontent of publication, so they are unable to find by using of our key words searching,and a number of publications may have been missed out. Several authors had published pieces of same study in different journals. So onestudy may be appeared in different publications.7. ConclusionThis project was done in order to fill a large gap existing in the field of NCDs. With the minorlimitation, this document is presented most of local studies (242) on NCD risk factors. Whiletaking possible effort to disseminate this document among needy people, it is suggested tocontinue mapping up NCD researches/publication further more.References (1)http://www.worldbank.org/en/news/2012/05/16/non-communicable-diseases-sri-lanka (2)http://203.94.76.60/NCD/temp/NCD%20Policy%20English.pdf (3) http://www.cmb.ac.lk/pgim/ (4) http://www.adicsrilanka.org/Page_About%20Us.html (5) http://www.slmaonline.info/ (6) http://www.nsf.ac.lk/index.php/the-nsf-/about-us (7) http://www.nsf.ac.lk/index.php/resources-and-publications/library-and-information-centre (8) http://www.who.int/about/en/ Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,published from 1990 2012 11. Group A Publications (Studies which showed the prevalence of NCDs andtheir risk factors in the general population)Alcohol and Drug Information Centre, (1995). Community Survey on substance on substanceabuse 1992/93 preliminary results of a research study carried out in 7 districts in Sri Lanka,1995Colombo, Alcohol and Drug Information Centre (ADIC),Objective:To determine the prevalence and the socio-economic differentials of the use of tobacco, alcohol andthe other drugs (such as heroine)Study method:An interviewed administered questionnaire was used to obtain the data use to tobacco/alcohol andother drugs types and quantity used, age of initiation and environment in which substances wereconsumed.Study Area:The study was carried out in seven districts of Colombo, Gampaha, Kurunegala, Polonnaruwa,Hambantota, Monaragala, and Nuwara-Eliya.Study population:Selected samples of both sexes, irrespective of their age from the seven districtsStudy Instrument:Interviewed administered questionnairesStudy type:A cross sectional studySample size:8257Sampling method:A multistage sampling techniqueRisk Factors Investigated:AlcoholTobaccoDrugs such as heroineResults:Prevalence rates (shown on table 1,2)Ever use (substance was consumed at least once in their lifetime) rates for the three substancesvaried from26% in Kurunegala to 34.8% in Moneragala for tobacco25.1% in Kurunagela to 33.8% in Gampaha for alcohol0.7% in Nuwara Eliya to 5.7% in Moneragala for other drugsThus it was seen that percentage of adults (including women) who had smoked, were slightly higherthan the corresponding rates for alcohol. In contrast, percentage of respondents who had tried anillicit drug was very low, less than 4% in 5 of the 7 districts.Current prevalence rates for the three substances varied from22.6% in Kurunegala to 31.8% in Moneragala for tobacco19.8% in Kurunegala to 31.4% in Gampaha for alcohol0.2% in Nuwara Eliya to 3.1% in Moneragala for other drugsMale prevalence rate, both ever and current was higher than in women in all seven districts. Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,published from 1990 2012 12. Types of substances usedCigarettes were main types of tobacco smoked by males in all districts with over 70% of therespondents in all 6 districts (except Nuwara Eliya), with beedi used (30%) to a lesser degree.Arrack was the most frequently mentioned type of alcohol used by the respondents (over 70% inall districts).0n the other hand, 20% of the study population had used Kassipu, which includes 23.3%Monaragala, 20.3% Kurunegala and 21.5% Polonnaruwa.Over 50% of the users of illicit drugs stated that they had used Ganja in 4 districts (Hambantota,Monaragala, Polonnaruwa, and Kurunegala), with heroine being mentioned by 50% of the users onlyin the Gampaha.Age of InitiationAge of initiation by 60%of smokers was 15 to 24 years with 35% being between 15 to 19 years(except Colombo and Nuwara Eliya)Over 50% of ever users (except in Nuwara Eliya) had initially taken alcohol between the ages of 15 to24 years, with over 30% stating they started using between 20 to 24 years.Of those who had used illicit drugs, over 30% in five districts had not mentioned the age of first use.However in Polonnaruwa and Hambantota, of those who responded, 30% were between 20 to 24years.Enviroment in which substances were consumed- Smoking occured mostly at home ( over 50%) of the respodents in all districts and either alone (>70%) or with friends (45-70%)- Alcohol was mostly consumed at functions (over 60% of users in 6 districts)and with friends (over70% in most districts). In all the districts among 20-35% had consumed at home.- Place of use of illicit drugs varied among the respondents as well as within the districts. At homeand while at travelling werethe places and instances mentioned by few of then drug userscommonly.Alcohol and Drug Information Centre, A. (1995). Substance use among school children in 6distiricts of Sri Lanka. Colombo, Alcohol and Drug Information Centre (ADIC)Objective:To assess the prevalence of smoking, alcohol and the use of other drugs ( such as heroine amongthe the studentsStudy area:Colombo, Hambantota , Badulla, Kandy , Anuradhapura and PuttalamStudy population:School students of 33 different schools in year 7 and above with an age range between 12 to 20years.Type of study:A cross sectional studyStudy instrument:Self administered questionnaireSampling method:A multi stage cluster samplingSample size:4843 males3215 femalestotal 8058Risk Factors investigated:Alcohol Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,published from 1990 2012 13. tobaccoIllicit drugsResults:The number of student subjects in each district is given below-Colombo, 2116Kandy 834Badulla 1332Hambantota 1486Anuradhapura 944Puttalam 1344According to the study, the substance use of the population was divided into ever users and currentusers. Ever users are the students who had used alcohol , tobacco or other illicit drug at least once intheir life time and current users are the students who at present using one of the three substances.The prevalence of the study population of both sexes is shown under table 1. It showed that amongthe ever users highest percentage of alcohol and tobacco user were from Puttlam (38.6% and 19.3%respectively.) and the highest other drug users were from Hambantota (4.6%). Among the currentusers, highest tobacco users were from Colombo 6.0% and the highest alcohol and drug users werefrom Hambantota, 8.0% and 2.8% respectively.The study also revealed that the number of females who were currently using these threesubstances were less than 10 for tobacco and other drugs and less than 20 for alcohol. Thereforefurther detail analysis of the female population on the use of these three substances was not taken.Regarding the type and the quantity of the substance currently used, it was observed that cigaretteswere the main type of tobacco smoked (over 85%) by the students in all districts. Moreover exceptHambantota, over 50% of the students smoked only 1 to 5 tobacco unit (refers to any unit ofsmoking such as cigarette, beedi, cigar etc.) per month. While a regular smoker (a student whosmoked one unit a day or 30 units or more a month) ranged from 5% in Puttlam to 14% inHambantota.Regarding the alcohol use among the study population it showed that, out of different types ofalcohol consumed, Beer was the most common alcohol drunk (35%) by the students in all sixdistricts, while arrack was drunk by 30% and kassipu by 10%.Data of different types of drugs used was not mentioned and the study revealed that the drug usedwas less than 12 % in eac district. The details of the type of alcohol used was not mentioned.Alcohol and Drug Information Centre, A., Kandy Drug Prevention Project (Life), (1995). Survey ofsubstance use among a selected sample of households in an estate community Colombo, Alcoholand Drug Information Centre (ADIC).Objective:To determine the knowledge, attitude and use of substances by workers on this estate, before theinterventions were carried outStudy method:A small sample of the 60 estate workers in the four divisions of the estate was interviewed regardingalcohol and tobacco use. Of the respondents 80% were males. Since the number of femalerespondents were only 12 , the detailed analysis were confined to males.Study Area:In the 4 divisions of St. Claires Estate, Thalawakele, Nuwara Eliya District Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,published from 1990 2012 14. Study population:Selected estate workers from the estate from various agesStudy Instrument:Interviewer administered questionnairesStudy type:A cross sectional studySample size:48 males12 femalesTotal 60Sampling method:Random sampling methodRisk Factors Investigated:AlcoholTobaccoResults:The respondents of this survey were mainly males (80%), Tamil (92%), 95% married and 81.7%estate workers. Furthermore, the majority of the sample had not studied beyond grade 5 (73.4%).Prevalence rate for tobacco and alcoholPrevalence rate for tobacco was 56.7%. Consumption was comparatively higher among males. It wasrevealed that 64.4% (31) males had and 33.3% (3) of the females have smokedCigarettes (32.3%) and beedi ( 29%) were the type of tobacco used by the estate workers . Majoritystated they smoked as a habit.(74.2%).Prevalence rate for alcohol was 60%. Male prevalence rate was higher (65%) when compared to thefemale rate (41.7%).Reasons given for consuming alcohol were gives enjoyment (54.8%), and relieves tiredness(25.8%).The frequency of the alcohol and tobacco use among the estate workers during 1995 is given undertable 1 and 2.Attitudes regarding alcohol and tobacco78% stated that use of alcohol and tobacco leads to relieving tiredness and 71% stated that it leadsto increased happiness.Majority agreed with the statement that people are unware of their behavior when they are underthe influence of alcohol.(50%)Impact of substance use25% of the families who use substances had spent 20% of their total expenditure on alcohol andtobacco.Alcohol and Drug Information Centre, A. (2009). Trends in Alcohol use , spot survey. Colombo,Alcohol and Drug Information Centre.General objectives:1.To find the prevailing alcohol trends in Sri Lanka2.To compare the alcohol trends with the previous year Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,published from 1990 2012 15. Specific Objectives:To find the prevailing alcohol trends in the sampling districtsTo find the prevailing alcohol trends according to age groupsTo find the prevailing attitudes and reasons for alcohol useTo find the age and initiation of alcohol useTo find the trends in the alcohol brands according to age groupsStudy Area:The study was conducted in the following districts; Colombo, Gampaha, Galle, Kegalle,Anuradhapura and Nuwara EliyaStudy population:Male of age fifteen and aboveStudy Instrument:Interviewer administered questionnaireStudy type:A cross sectional studySample size:1414Sampling method:Random sampling methodRisk Factors Investigated:AlcoholResults:The age distribution of the study sample population shows that 41.1% of the sample populationcomprised of the age rand 15-24 years, 35.9% of the study sample population comprised of the agerange 25-39 years and 23.1% in the age range of 40 years and above. The mean age of the samplepopulation was 31 years. The minimum age was 15 years and maximum age was 85 years.When considering the employment status, highest percentage of the study population consisted ofvendors (21.3%).The current users (respondents who used alcohol within the previous month) of alcohol among thestudy population was 46% in July 2009. The highest percentage of alcohol intake from the study areawas in the district of Colombo (49.6%) and the lowest percentage was on the district of Kegalle(44.0%).The study also revealed that most (54.5%) of the alcohol users were belonging to the age group 25-39 years. Most (48%) of the users were occasional users and highest percentage of respondents whowere occasional users were in the age range 15-24 (52.5%) and this was mostly observed in thedistrict of Kegalle (58.1%).Arrack (63.6%) was the most common type of alcohol used ( as shown below) among the studysubjects and it was more prominent among the subject s who belong the age group >/=40 years(77.9%). The highest response on the use of arrack was from the district of Galle (70.6%).The survey showed that the most of the subjects common reason for the use for consuming alcoholwas for fun/enjoyment and to be happy (33%).Regarding the age of initiation of alcohol use, most (55.6%) of the study population started usingalcohol at the age range 16-20 years of age. The initiation of alcohol was mostly at a function(52.4%), and the commonest type of alcohol used was beer (51.7%).In the comparison with the results of July 2009 spot survey and the July spot survey, the alcohol usehas decreased in comparison to the previous year (2008 July -48.6% to 46% in July 2009) Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,published from 1990 2012 16. Alcohol and Drug Information Centre, A. (2009). Trends in Tobacco use. Colombo, Alcohol andDrug Information centre: 32.General objective:1.To find the prevailing tobacco trends in Sri Lanka2.To compare the tobacco trends with the previous yearSpecific Objective:To find the prevailing tobacco trends in the sampling districtsTo find the prevailing tobacco trends according to age groupsTo find the prevailing attitudes and reasons for tobacco useTo find the age and initiation of tobacco useTo find the trends in the tobacco brands according to age groupsStudy Area:The study was conducted in the following districts; Colombo, Gampaha, Galle, Kegalle,Anuradhapura and Nuwara EliyaStudy population:Male of age fifteen and aboveStudy Instrument:Interviewer administered questionnaireStudy type:A cross sectional studySample size:1414Sampling method:Random sampling methodRisk Factors Investigated:TobaccoResults:The age distribution of the study sample population shows that 41.1% of the sample populationcomprised of the age rand 15-24 years, 35.9% of the study sample population comprised of the agerange 25-39 years and 23.1% in the age range of 40 years and above. The mean age of the samplepopulation was 31 years. The minimum age was 15 years and maximum age was 85 years.When considering the employment status, highest percentage of the study population consisted ofvendors (21.3%).37% of the sample population used tobacco. The highest percentage was recorded from the districtof Nuwara Eliya (44.6%) and lowest from the district of Kegalle (31.7%). The highest percentage oftobacco users were found to be among those belonging to the age group of 25-39 years (42%) asshown in table 1.72% of the tobacco users of the study sample were daily users (used of tobacco at least one stick perday). The highest percentage of daily users was from the district of Colombo (78%). The daily usewas mainly seen in the age group of 40 and above (90.1%) and the lowest in the age group 15-24.The main reason for using tobacco in the study population was regarded as Habit of using by 25.8%of the study subject as give in the chart below.The age of initiation of tobacco as told by the subjects was the age of 16-20 years 57.9%of the studypopulation. The highest percentage on the occasion of initiation of tobacco use was with the friends(56.6%). Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,published from 1990 2012 17. Alcohol and Drug Information Centre, R. a. I. p. (2008 ). Spot Survey 2008 December - Alcohol.Colombo, Alcohol and drug Information centreGeneral objective:To find the prevailing alcohol trends in Sri LankaSpecific Objective:To find the prevailing alcohol trends in the sampling districtsTo find the prevailing alcohol trends according to age groupsTo find the prevailing attitudes and reasons for alcohol useTo find the age and initiation of alcohol useTo find the trends in the alcohol types according to age groupsTo find the t types of alcohol use according to the age groupsStudy method:QuestionnairesStudy Area:The study was conducted in the following districts; Colombo, Gampaha, Galle, Kegalle,Anuradhapura and MonaragalaStudy population:Males of age fifteen and aboveStudy Instrument:Interviewer administered QuestionnairesStudy type:A cross sectional studySample size:1179Sampling method:Random sampling methodRisk Factors Investigated:AlcoholResults:The population distribution of the study sample among the districts studies is as follows:Colombo 216Gampaha 195Galle 177Kegalle 207Anuradhapura 213Monaragala 171The age distribution of the study sample 15-24 - 41024-40 - 499>40- 270The alcohol use was based on the respondents alcohol used in the previous week of the study. Thestudy revealed that 48% of the overall study population was consuming alcohol as at December2008. The results were further categorized in obtaining the alcohol use among the study population-Alcohol use age basis15-24 44.9%24-40 - 50.8%>40- 48.6%The highest percentage of alcohol users were among the age group 25-40 (50%) Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,published from 1990 2012 18. Alcohol use district basisColombo 51.9%Kegalle 50.5%Anuradhapura 49.8%Gampaha 48.1%Galle 47.9%Monaragala 39.5%The highest alcohol consumption was recorded was in Colombo 51.9% and the lowest fromMonaragala 39.5%Alcohol use (Ever used- whether they have ever used alcohol even once, in their life until now).From analyzing the ever use of alcohol from the study population, it revealed that 29% of the studysubjects used alcohol at least once in their lifetime while 71 % did not. The ever used population wasfurther analyzed according to their district as follows-Colombo 41%Kegalle 21.8%Anuradhapura 34.3%Gampaha 27.7%Galle 14.7%Monaragala 29.7%Frequency of alcohol useThe frequency of the alcohol use was further analyzed according to daily use (at least a glass ofalcohol), monthly use and occasional basis-The frequency of alcohol use among the overall study population was as follows-Daily basis 11.5%Few times per month 45.5%On special occasion 42.9%With regarding to the age group, highest percentage of daily users of alcohol was found among > 40years (20.5%).Types of alcohol useArrack 68.2%Beer 51.9%Kassippu 11.1%Other (whisky, Brandy, wine) 10%With considering the age of the study population and the type of alcohol used 15-24 ,24-40 and >40,Arrack was the most common type of alcohol used among all three age groups , 60%, 71.5% and73.6% respectively.Reasons of using alcoholFor partying, fun and feel happy was the commonest reason to consume alcohol, given by thestudy population 37.3%Age of initiation of alcoholAmong the alcohol users, 78% have initiated in consuming alcohol at the ages of 21-25 years. 95th percentile for gender, age and height on>3 occasions for this study.. Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,published from 1990 2012 26. Pre hypertension in children was defined as average SBP or DBP levels that are >90th percentile but55%). Consumption of commercially baked foods were was also higher among the males(33.8%) than females (25.9%) students with p200 mg/dL , LDL (Low density lipoproteins) >130 mg/dL andtriglyceride levels >150 mg/dL were taken as High respectively. The mean FBS was significantlyhigher (p 95t h percentile) 18 9 39HDL n=70(< 5t h percentile) 1 1 3HBPn=70(^95'" percentile)SBP 5 3 11DBP 0 3 4Abnormal glucosehomeostasis n=63 9 8 27Metabolic syndromen=63 5 8 21Conclusions:Serious metabolic abnormalities are found in obese Sri Lankan children and the WC is a reliableindicator of these derangements.De Silva S (2008). "The Nutritional Status of Grade Eleven Students in the Medical Officer of HealthArea Kalutara." Journal of the College of Community Physicians of Sri Lanka 13(2).objective:To describe the nutritional status of grade eleven school children in the Medical Officer of Health(MOH) area Kalutara. Abstracts of Non Communicable Diseases and prevalence of risk factors in Sri Lanka,published from 1990 2012 35. Study MethodA descriptive cross-sectional study was carried out among grade eleven school children in Type 1ABand Type 1C state schools in the MOH area Kalutara. Eighteen classes from a total of 14 schools werestudied. Cluster sampling technique, probability proportionate to size was used to select the sample.The heights and weights were measured, and the Body Mass Index (BMI) was calculated for eachchild. The age and sex specific BMI charts developed by the National Centre for Health Statistics2000 were used as standards. A structured, pre-tested self-administered questionnaire was used tocollect the socio-demographic characteristics.Study area:Type 1AB and Type 1C state schools in the MOH area KalutaraStudy population:Grade eleven school childrenType of study:A descriptive cross-sectional studyStudy instrument:A structured, pre-tested self-administered questionnaireHeight and Weight MeasurementsSampling method:Cluster sampling methodSample size:639Female 356 55.7 %Male 283 44.3 %Risk Factors investigated:Nutritional StatusResults:The study included 639 school children where the great majority were Sinhalese (99.5%, n= 636),Buddhists (95%, n=607). There were no Tamils or Hindus. Females accounted for 55.7% (n=356) ofthe sample. Most (84.8%, n=542) of the students were residing in rural areas. The mean age of thestudy sample was 16.1(SD0.4) years. The age range was 15.5 to 18.5 years.Seventy nine percent (n=502) of the children were able to record their monthly family income and265 families had a monthly income of less than 10,000 rupees. Ninety eight percent [n=627] of thestudents were residing in there own homes where as 12 (1.9%) were residing outside home.The prevalence of thinness(