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Presented by: Esther Mwende A56/68041/2011

KNOWLEDGE AND ATTITUDE ON THE RISK FACTORS ASSOCIATED WITH NON COMMUNICABLE DISEASES: A CASE STUDY OF THE KENYA ARMED FORCES PERSONNEL, KAHAWA BARRACKS. Presented by: Esther Mwende A56/68041/2011

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Presented by: Esther Mwende A56/68041/2011

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  1. KNOWLEDGE AND ATTITUDE ON THE RISK FACTORS ASSOCIATED WITH NON COMMUNICABLE DISEASES: A CASE STUDY OF THE KENYA ARMED FORCES PERSONNEL, KAHAWA BARRACKS Presented by: Esther Mwende A56/68041/2011 Supervisor: Prof. Jasper K Imungi Date: 19/04/2012 Venue: ANP Lecture Hall

  2. INTRODUCTION • A Non Communicable Disease (NCD), is a medical condition or disease which is non-infectious. • NCDs are diseases of long duration and generally slow progression. • The dietary NCDs of importance are CVD, Cancer and Diabetes. • Worldwide NCDs currently represent 43% of the burden of disease and are expected to be responsible for 60% of the disease burden and 73% of all deaths by 2020. (WHO NCD Surveillance Strategy ).

  3. STATEMENT OF THE PROBLEM • NCDs are already of major importance in developing countries and are rapidly becoming a major public health threat. • The burden of disease from NCDs is expected to rise by more than 60% by 2020 . • The underlying cause is the increase in lifestyle related risk factors resulting from social and economic changes. (WHO NCD Surveillance)

  4. JUSTIFICATION (reasons) • NCDs develop gradually over a period of time. • Active screening • Diseases are detected when at advanced stages and already chronic. • Develop disease at younger ages, suffer longer and die sooner than those in developing countries. • Undermines countries’ economic development as many of those affected are at the peak of their productive and economic activity.

  5. GENERAL OBJECTIVES To determine the knowledge and attitude on the risk factors that the soldiers are exposed to and that may eventually lead to development of NCDs. SPECIFIC OBJECTIVES 1. To determine the lifestyle risk factors that may expose the soldiers to NCDs. 2. To establish the nutritional knowledge among the soldiers. 3. To determine the blood cholesterol levels of the soldiers 4. To assess the BMI and Waist to hip ratio of the soldiers

  6. HYPOTHESES 1. The soldiers maintain healthy diets 2. The soldiers are physically active. 3. The soldiers are not engaged in behavioral habits that expose them to risks associated with NCDs. 4. The blood cholesterol level of the soldiers are within the normal limits. 5. The blood pressure levels of the soldiers are within the normal limits.

  7. STUDY AIM The aim of this study is to contribute information that will assist in designing appropriate interventions to reduce the risks associated with NCDs. PURPOSE Determine the risk factors that may increase the chances of Kenyan military developing NCD.

  8. RESEARCH QUESTIONS 1. Is there a significant risk among the soldiers of developing NCDs? 2. How much nutritional knowledge do the soldiers have on lifestyle diseases? 3. What are the cholesterol levels among the soldiers? 4. Are the soldiers physically active lifestyle when not attending drills or on mission? 5. Do the anthropometric measurements of the solders reflect normal weight?

  9. LIMITATIONS OF THE STUDY 1. It may be difficult to get a research permit from Kenya Department of Defense. 2. It will be expensive to perform blood cholesterol test on the entire study population.

  10. LITERATURE REVIEW • NCDs are thought to be a problem of the developed world • Only 20% occur in the developed world (WHO 2007) Urbanization and diet Epidemiology transition Nutritional transition Chronic disease mortality Morbidity related to NCDs Risk factors of NCDs Methods of data collection

  11. Figure 1: Risk factors common to major chronic diseases conditions Source: African Health Monitor January to June 2008

  12. KNOWLEDGE GAP • Scanty data is available on prevalence of NCDs from the Ministry of Public Health Department of NCDs • Few studies has been done in the country on NCDs

  13. STUDY DESIGN A cross sectional study will be conducted. Exposure to risk factors, knowledge and attitude will be assesses. It will be both descriptive and analytical in nature STUDY POPULATION The study population will comprise of the Kenya Army Service Branch of the KDF soldiers at the Kahawa Barracks

  14. SAMPLING PROCEDURE

  15. INCLUSION AND EXCLUSION CRITERIA Inclusion Criteria • Soldiers in the senior, mid level and junior officers of the Army Service based at Kahawa Barracks. Exclusion criteria • Pregnant soldiers since they may have lifestyle habits and that could be different from their usual. • Soldiers that have recently been seriously ill. • Any army personnel who refuses to participate in the study

  16. SAMPLE SIZE DETERMINATION The sample size was calculated using Infinite population using the Fisher’s formula (Fisher et. al 1991) n= (Zα/2)²Pq ------------------- (L²) n= (1.96)²(0.5 x 0.5) --------------------------- (0.05)² =384 + 5 % Attrition = 403

  17. DATA COLLECTION TOOLS • A semi structured pre-tested questionnaire will be administered. • Bathroom scale • Pro sport measuring tape • Digital blood pressure machine • Lipid profile kit

  18. DATA COLLECTION PROCESS • Legal permits from National Council for Science & Technology, KNH/UON Ethical clearance committee and DOD • Informed consent from respondents • Guarantee confidentiality • Recruitment and Training of Research Assistants • Form four graduates, fluent in English & Swahili, and assertive • Engage services of a Kenya registered Nurse • Pre testing of questionnaire - DOD

  19. DATA COLLECTION METHODS • Demographic Information • Behavioral information: physical activity, tobacco use, alcohol consumption, food frequency. • Physical measurements: BMI, Hip and Waist ratio, blood pressure • Biochemical measurements: cholesterol DATA QUALITY CONTROL Calibration of scale, Examining questionnaires, Direct field supervision

  20. DATA ANALYSIS Data collected will be analyzed using the Statistical Package for Social Sciences (SPSS) The following analysis will be done: 1. Descriptive Statistics Proportions (%) Counts Frequencies Skewness Kurtosis

  21. Measure of central tendency Mode Median Mean Range Inferential statistics Chi- square (χ²) for comparison of proportions (counts) Man Whitney –U test for ranking t-test compare means of two groups ANOVA- Multi Variant Analysis Regression for confounding variables Correlation

  22. BMI, Hip & Waist Ration cut off points will be done using WHO referencing • Activity profiling using WHO classification.

  23. Quant Chart

  24. Study Budget

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