title: Co-occurrence of behavioral risk factors of common non-communicable diseases among urban slum dwellers in Nairobi, Kenya.
abstract: BACKGROUND
  The four common non-communicable diseases (NCDs) account for 80% of NCD-related deaths worldwide. The four NCDs share four common risk factors. As most of the existing evidence on the common NCD risk factors is based on analysis of a single factor at a time, there is a need to investigate the co-occurrence of the common NCD risk factors, particularly in an urban slum setting in sub-Saharan Africa.
  
  
  OBJECTIVE
  To determine the prevalence of co-occurrence of the four common NCDs risk factors among urban slum dwellers in Nairobi, Kenya.
  
  
  METHODS
  This analysis was based on the data collected as part of a cross-sectional survey to assess linkages among socio-economic status, perceived personal risk, and risk factors for cardiovascular and NCDs in a population of slum dwellers in Nairobi, Kenya, in 2008-2009. A total of 5,190 study subjects were included in the analysis. After selecting relevant variables for common NCD risk factors, we computed the prevalence of all possible combinations of the four common NCD risk factors. The analysis was disaggregated by relevant background variables.
  
  
  RESULTS
  The weighted prevalences of unhealthy diet, insufficient physical activity, harmful use of alcohol, and tobacco use were found to be 57.2, 14.4, 10.1, and 12.4%, respectively. Nearly 72% of the study participants had at least one of the four NCD risk factors. About 52% of the study population had any one of the four NCD risk factors. About one-fifth (19.8%) had co-occurrence of NCD risk factors. Close to one in six individuals (17.6%) had two NCD risk factors, while only 2.2% had three or four NCD risk factors.
  
  
  CONCLUSIONS
  One out of five of people in the urban slum settings of Nairobi had co-occurrence of NCD risk factors. Both comprehensive and differentiated approaches are needed for effective NCD prevention and control in these settings.
authors.affiliation: African Population and Health Research Center, Nairobi, Kenya; tharegu@aphrc.org.
authors.forename: Tilahun Nigatu
authors.initials: TN
authors.lastname: Haregu
authors.affiliation: African Population and Health Research Center, Nairobi, Kenya.|Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.|Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
authors.forename: Samuel
authors.initials: S
authors.lastname: Oti
authors.affiliation: African Population and Health Research Center, Nairobi, Kenya.
authors.forename: Thaddaeus
authors.initials: T
authors.lastname: Egondi
authors.affiliation: African Population and Health Research Center, Nairobi, Kenya.
authors.forename: Catherine
authors.initials: C
authors.lastname: Kyobutungi
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus; D004032:Diet / Q000009:adverse effects; D005260:Female; D015438:Health Behavior; D006801:Humans; D007630:Kenya; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D011204:Poverty Areas; D015995:Prevalence; D012140:Respiratory Tract Diseases; D012307:Risk Factors; D057185:Sedentary Behavior; D012907:Smoking / Q000009:adverse effects; D012959:Socioeconomic Factors; D014505:Urban Population; D055815:Young Adult
keywords: co-occurrence; non-communicable diseases; risk factors