A Community-Based Noncommunicable Disease Prevention Intervention in Punjab,

Background: Noncommunicable diseases (NCD) are the leading cause of death in India, with cardiovascular diseases (CVD) in particular accounting for nearly 1 in 3 deaths. The prevention of key CVD risk factors – namely, diabetes and hypertension – is a public health priority.
Objectives: To describe the results of large-scale, community based NCD screening using the Government of India’s Community Based Assessment Checklist (CBAC) scoring system.
Methods: Trained enumerators visited each household in 10 villages in Punjab, India between September 2019 and March 2020. Standardized methods were used to measure blood pressure, blood glucose, waist circumference, family medical history, and lifestyle behaviors.
Results: A total of 11,322 adults (52.1% women; mean age 48.3 years) completed the assessment and 14.4% were classified as high-risk (CBAC>4). Those classified as high-risk were significantly more likely to have hypertension (46.0% versus 20.6% among low-risk, p<0.0001) and diabetes (12.0% versus 7.7%, p<0.0001). Only 26.8% of those with hypertension were diagnosed and only 14.9% treated. Proportions among those with diabetes were similarly low: 29.2% diagnosed and 16.0% treated.
Conclusions: To the best of our knowledge, this is the first study to estimate the prevalence of high-risk CBAC scores in a population-based sample. Given that the Government of India aims to undertake population-based screening of all adults >30 years for NCDs, the results of this study are directly translatable.