Behavioral and biological risk factors of non-communicable diseases: Results of a nationally representative cross-sectional survey in Algeria

INTRODUCTION There is a need to strengthen the evidence base for context-specific heterogeneities in factors that may potentiate or reduce adverse outcomes of non-communicable disease (NCDs). The study aimed to estimate the prevalence of behavioral and biological risk factors for NCDs among adults in Algeria. METHODS We conducted a secondary analysis of nationally representative cross-sectional population-based data from the Algeria STEPS survey 2016–2017 with a sample size of 6989 adults aged 18–69 years. The STEPS instrument comprised three levels: the questionnaire, physical and biochemical measures, which were used to assess the NCDs’ behavioral and biological risk factors, including current tobacco use, inadequate fruit and vegetable (FV) intake, low physical activity (PA), sedentary behavior, overweight/obese, hypertension, diabetes, and elevated total cholesterol. Adjusted binary logistic regressions assessed the associations between sociodemographic and health factors and specific NCD risk factors. Adjusted Poisson regressions were used to assess the predictors of multiple NCD risk factors. RESULTS The proportion of the population with inadequate fruit/vegetable (FV) consumption was 85.2%, followed by overweight/obese (55.6%), low physical activity (PA) (36.6%), hypertension (23.6%), current tobacco use (21.8%), elevated total cholesterol (18.2%), sedentary behavior (8.9%), diabetes (8.8%), and current alcohol use (2.1%). In total, 46.9% of participants had three or more of eight assessed NCD risk factors. Male sex (AOR=109.24; 95% CI: 66.92–178.31) was positively associated, while older age (45–69 years) (AOR=0.63; 95% CI: 0.51–0.78) and higher level of education (≥12 years) (AOR=0.49; 95% CI: 0.38– 0.64) were negatively associated with current tobacco use. Higher level of education (≥12 years) (AOR=0.64; 95% CI: 0.49–0.84) was negatively associated with insufficient FV intake. Older age (45–69 years) (AOR=1.53; 95% CI: 1.27– 1.84), higher level of education (≥12 years) (AOR=1.94; 95% CI: 1.53–2.46), and urban residence (AOR=1.22; 95% CI: 1.02–1.47) were positively associated, while male sex (AOR=0.45; 95% CI: 0.38–0.53) was inversely associated with low PA. Older age, female sex, urban residence, and lower level of education were associated with 2–4 biological NCD risk factors (overweight/obese, hypertension, diabetes, and/or elevated total cholesterol). CONCLUSIONS In the current study, almost half of the participants had three or more risk factors for NCDs. Older age and urban residence increased the risk for a higher degree of NCD risk factors. Therefore, there is a need to develop and strengthen the effectiveness of policies and programs to mitigate the burden of NCDs and related risk factors.