Non-communicable diseases (NCDs) are rising rapidly in developing countries including Sub-Saharan
Africa. The increase of NCDs and premature death as a result of major NCDs (cardiovascular diseases,
abbreviated as CVDs, namely, cancer, chronic respiratory diseases, and diabetes) has a strong negative impact,
hindering the rapid economic growth of developing countries. In Zambia, mortality due to NCDs was estimated
to be 23% in 2012, having CVDs accounting for one-third of all NCDs-related deaths. The prevalence of
hypertension is estimated as 32.8%, which exceeds the levels among major developed countries. Despite high
figures of NCDs, related prevention/control measures and researches in Zambia are still limited. Therefore, we
planned to conduct a community-based socio-epidemiological study to investigate the NCDs-related physical
conditions including knowledge, attitude, and behavior in Zambia. This study is a pilot phase to help inform
field work feasibility and planning prior to the main quantitative study. It also facilitates our questionnaire
pretesting, for validity and reliability and to solve language discrepancies, as a part of instrument development
procedure.
Kabwe and Mumbwa districts in Central province, Zambia, were selected as our study sites. The research
team (interviewer, Tateyama, registered nurse and community health worker) visited the selected compound or
village in both districts to recruit eligible individuals. Convenience sampling was used for this pilot phase. The
local male and female residents, ages 25 to 64, were included in the study. The data on socio-demographics,
dietary habits, lifestyle, NCDs-related knowledge, risk perception, behavior, etc. was collected through face-toface
interviews using a structured questionnaire. Anthropometric and biological measurements were also
collected. In consideration of regional characteristics and participant’s comfort, the interview was conducted in
English or two most common local languages (Nyanja and Bemba).
Thirty participants from each Kabwe and Mumbwa district were interviewed with complete measurements
of weight, height, and blood pressure. Blood and urine samples were collected from 20 among the total 60
participants. Eleven participants (18.3%) were previously diagnosed with hypertension; four participants (6.7%)
had diabetes in combination with hypertension. Sixteen participants (26.7%) were overweight (BMI≧25). In
regard to tobacco smoking as a risk factor for cancer (NCDs), more than 65% of both male and female
participants were aware that tobacco smoking and secondhand smoke are hazardous to health. More than 75% of
participants viewed that alcohol can negatively affect their health and over half stated that alcohol use can be
dangerous for their lungs, liver, brain, kidneys and it also promotes family issues and poverty. As for dietary
habit, 16 participants (26.7%) usually add to their food more than 5 grams (g) of salt per day and 14 out of 16
participants felt that the amount of their salt intake is a “right” amount or “a bit too little”. For hypertension, 54
participants (90%) perceived that hypertension is a common disease in Zambia; however, only 66.7%
understood that hypertension can be prevented.
Before conducting this pilot study, our biggest concerns were the feasibility and research acceptability
from the participants. The positive cooperative attitude in the community could imply high interest in their
health status. The findings potentially suggested excessive consumption of cooking oil, salt, and sugar among
the local community. In regards to being overweight, half of participants who have BMI≧25 did not recognize
themselves as being overweight, demonstrating a “gap” between knowledge, attitude and behavior. Through
these results, we emphasize the importance of a subsequent quantitative epidemiological study with
representative sample to help the country develops evidence-based interventions and health education programs
in the future.