Assessment of prevalence of risk factors for non-communicable diseases in early adolescent age group using Global School Health Survey in Ujjain, Madhya Pradesh, India

Assessment of prevalence of risk factors for non-communicable diseases in early adolescent age group using Global School Health Survey in Ujjain, Madhya Pradesh, India Sharma P.1, Chandra Mandliya J.2*, Dhaneria M.3, Diwan V.4 DOI: https://doi.org/10.17511/ijpr.2020.i06.02 1 Priyanka Sharma, Resident, Department of Pediatrics, R.D Gardi Medical College, Ujjain, Madhya Pradesh, India. 2* Jagdish Chandra Mandliya, Professor, Department of Pediatrics, R.D Gardi Medical College, Ujjain, Madhya Pradesh, India. 3 Mamta Dhaneria, Professor and Head, Department of Pediatrics, R.D Gardi Medical College, Ujjain, Madhya Pradesh, India. 4 Vishal Diwan, Scientist E, National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India.

Appropriate counseling and positive reinforcement during any age including adolescence make a significant difference in morbidity and mortality [4].
Preventive strategy to be formulated before the execution of any intervention in terms of screening and risk factor reduction, require the actual situation in the community has to be estimated [5].
The present study has been carried out to determine the prevalence of these risk factors and the proportion of modifiable risk factors to assess the co-existence of these among school-going adolescents in Ujjain. The study was conducted in the Ujjain district situated in Madhya Pradesh. As per provisional reports of Census India, the population of Ujjain in 2011 was 1,986,864. The study was conducted among students in the adolescent age (12-14 years) group in urban and rural schools of Ujjain, which included both government and private schools.

Material and Methods
The Global School Health Survey was done amongst students enrolled in grades eight and nine. A complete list of the schools was obtained from the district education department. A two-stage cluster sampling technique to obtain samples of students to be included in the study was used, each sampling frame of the identified class and age group of the school in a geographically defined area are selected.
The first level of sample selection is schools i.e. STRATUM. The probability of schools selected is proportional to the number of students enrolled in a specific grade using a random start, twenty schools were sampled which included schools from the urban and rural areas of Ujjain which was further divided into private and government schools.
Following the selected schools were approached one day before the study with the data regarding the study and its details. In case a school refused to participate in the study the next schools were selected based on simple random sampling. At the second stage, systematic equal probability sampling with a random start was used to select students from each of the sampled schools.       [11]. Jain et al reported a prevalence of 4.6%, of which 57.9% were males and 42.1% were females [12].
Mangalore Bukelo et al reported in their study with a similar setting that only one boy admitted to having consumed alcohol [13].
GSHS survey 2006 India did not study alcohol consumption among the risk factors for NCDs. On comparison there is a higher percentage of alcohol consumption noted in this study, a statistical significance noted in males and females could be males have easy accessibility to money for buying alcohol, peer pressure and male parent or guardian consuming alcohol Mahmood SE et al reported in an imitation study that 70.8% consumed fast food daily. 64% consumed fruits 3 days per week and 75.6% of vegetables 3 days per week [13]. There is a higher percentage of children going hungry in the present study could be due to a small sample size of the study. Operational definitions with regard to the adequacy of fruit and vegetable intake were not provided in the study to make a definitive comparison. There was a lower percentage of consumption of carbonated drinks as compared to a similar study this could be explained on the basis of health education being routinely provided in schools and in the community.
During the past 7 days, on how many days did you eat food from a fast-food restaurant What does the study add to the existing knowledge?
This study recommends health promotion practices for prevention of risk factors among school-going adolescents, lifestyle modifications such as restriction of tobacco and alcohol use, high intake of fruits and vegetables and increased physically activity are required to be implemented for a better future of the health care system There is a need for improving the knowledge and awareness regarding NCDs and its related risks along with which we require actions that will help to bridge the knowledge-practice gap for eating and exercise habits. Apart from which early diagnosis with proper treatment facilities must be provided to the already existing population having NCDs. Community participation is essential for the prevention of risk factors. Parents should be educated about the importance of playing games and a balanced diet. students and adequate moderate activity was done by 66.3% students [12]. Ade et al reported similar results in Karnataka with 22.1% of students doing physical activity daily [13]. GSHS has done in Delhi in 2007 reported with similar settings that 23.2% of children spent more than 3 hours a day watching television or playing video games [6]. Ismail et al reported a lack of physical activity in 44.6 % [17]. .The present study participants, the majority fail to meet the WHO recommendation on physical activity, 60 minutes of moderate to vigorous-intensity physical activity daily. The above study cannot be adequately compared to that of other studies due to a lack of operational definitions for adequate moderate or vigorous physical activity. 04. Tobacco Use: Global youth tobacco survey reported that one in 10 students (10%) had used tobacco in any form. Kumar et al in Chennai estimated the prevalence of tobacco use to be 41.1% [11]. Mohammad et al reported a past smoking rate of 5.2%, currently smoking adolescents were 4.8%, 4.8% were also noted to be using smokeless tobacco, 2.4% used smokeless tobacco in the past(11). Puwar et al in Surat reported no adolescent smoking in their study [3]. Jain et al reported 1.2% of students all males to have smoked tobacco, and only 4 students to have smoked about 5 cigarettes three times a week in the past 30 days [12]. The GSHS Delhi in 2006, reported 1.2% of students who smoked cigarettes with 3.7% who have used tobacco in any form other than smoking and 37.1% exposed to secondhand smoking. The present study denotes an increase in smoking, tobacco use of which increase in prevalence was noted to be more in private school's possible reason could be due to peer pressure Pediatric Review -International Journal of Pediatric Research 2020;7(6)