Objectives: To determine the national prevalence of risk factors of non-communicable diseases (NCD) in the adult population of Bangladesh.

Design: The study was a population-based national cross-sectional study.

Setting: This study used 496 primary sampling units (PSUs) developed by the Bangladesh Bureau of Statistics. The PSUs were equally allocated to each division and urban and rural stratum within each division.

Participants: The participants were adults aged 18-69 years, who were usual residents of the households for at least six months, and stayed the night before the survey. Out of 9900 participants, 8185 (82.7%) completed STEP-1 and STEP-2, and 7208 took part in STEP-3.

Primary and secondary outcome: The prevalence of behavioral, physical, and biochemical risk factors of NCD. Data were weighted to generate national estimates.

Results: Tobacco use was significantly (p<0.05) higher in the rural (45.2%) than the urban (38.8%) population. Inadequate fruit/vegetable intake was significantly (P<0.05) higher in the urban (92.1%) than in the rural (88.9%) population. The mean salt intake per day was higher in the rural (9.0 gm) than urban (8.9 gm) population. Among all, 3.0% had no, 70.9% had 1-2, and 26.2% had ≥3 NCD risk factors. The urban population was more likely to have insufficient physical activity (AOR: 1.2, 95% CI: 1.2–1.2), obesity (AOR: 1.5, 95% CI: 1.5–1.5), hypertension (AOR: 1.3, 95% CI: 1.3–1.3), diabetes (AOR: 1.6, 95% CI: 1.6–1.6), and hyperglycemia (AOR: 1.1, 95% CI: 1.1–1.1).

Conclusions: Considering the high prevalence of the behavioral, physical, and biochemical risk factors, diverse population and high-risk group targeted interventions are essential to combat the rising burden of NCDs. 

Data were collected using a standardized pre-tested questionnaire developed considering WHO STEPS questionnaire version 3.2. All the core questions along with some selected expanded questions and country-specific questions were incorporated. Questionnaire was translated in to Bengali. Validation of the translated questionnaire was done by translation and back translation. Data collection techniques included face-to-face interview (STEP 1), physical measurements (STEP 2) and body fluid (blood and urine) collection (STEP 3). Data were collected by android device on spot and were transferred into cloud through ODK software on the PDAs.

Data were sent electronically and stored in ONA data base server. Field team daily uploaded data on the server and data were downloaded at central office for consistency and validity check. Stored data were downloaded into Microsoft Excel® format. Each participant had a unique identifier QR-code and personal identification number (PID) which were used for merging data for steps 1, 2, 3. Data were cleaned and analyzed following WHO STEPS recommended guidelines.