Exploring socioeconomic inequality in caries experience in an adult Norwegian population; the HUNT4 Oral Health Study.

OBJECTIVES: To investigate socioeconomic inequality in caries experience in an adult Norwegian population. METHODS: This population-based study included 4549 dentate participants aged 25-94 years from the cross-sectional HUNT4 Oral Health Study conducted in Central Norway in 2017-2019. Participants were randomly sampled from the larger HUNT4 Survey and answered questionnaires and underwent clinical and radiographic examinations. Caries experience was measured as numbers of decayed, missing and filled teeth (DMFT index) and socioeconomic position was denoted by education and household income. Negative binomial regression models were used to estimate associations between caries experience and socioeconomic position. RESULTS: Lower levels of both education and income were associated with higher caries experience, particularly pronounced for missing teeth. Socioeconomic gradients were observed for all outcomes DMFT, DT, MT and FT (p-value linear trends <.001). Gradients were similar for both income and education and were apparent for all age groups but were most evident in middle-aged and older individuals. High level of education was associated with a 50% lower mean number of missing teeth compared with basic level education, whereas high income was associated with a 24% lower mean number of decayed teeth and a 15% higher mean number of filled teeth than low income. CONCLUSIONS: There was a socioeconomic gradient for caries experience in the study population that was present from early adulthood and increased with age. The gradient was particularly pronounced for missing teeth. Findings indicate that inequality was more associated with treatment given than with untreated disease.

Vulnerability of NCDs and Mediating Effect of Risk Behaviors Among Tuberculosis Patients and Their Household Contacts Compared to the General Population in the Yangon Region, Myanmar.

Purpose: We investigated the association of TB patients and their household contacts with diabetes mellitus (DM) and hypertension compared to the general population, and the mediating effects of risk behaviors including current smoking, alcohol drinking, and poor diet quality. Patients and Methods: A cross-sectional study on screening for DM, hypertension, and risk behaviors among newly diagnosed TB patients (n = 221) and their household contacts (n = 257) aged 25-74 years in Yangon in 2018. Health data of the general population (n = 755) were obtained from an NCD risk factor survey in Yangon. A directed acyclic graph is used to identify possible pathways of association between variables. Associations are presented as adjusted odds ratios (aOR). Results: Compared to the general population, both TB patients and their household contacts were associated with current smoking and drinking, and TB patients were more likely to be underweight. Without considering mediating effects, TB patients had higher odds of DM (aOR = 6.3, 95% CI: 3.8-10.6), but both TB patients and household contacts had lower odds of hypertension (aOR = 0.54; 95% CI: 0.33-0.87) and (aOR = 0.68; 95% CI: 0.47-0.98), respectively. The body mass index-mediated pathway reduced the odds of DM and hypertension among TB patients (aOR = 3.4; 95% CI: 2.2-5.3) and (aOR = 0.3; 95% CI: 0.2-0.5), respectively. Conclusion: The shared risk behaviors among TB patients and household contacts with high burden of DM in TB patients endorse screening of risk behaviors and strengthening the integration of NCD services among TB patients and household contacts in this dual-burden country.

Widening the knowledge of non-employment as a risk factor for suicide: a Norwegian register-based population study.

BACKGROUND: There is a known association between employment status and suicide risk. However, both reason for non-employment and the duration affects the relationship. These factors are investigated to a lesser extent. About one third of the Norwegian working age population are not currently employed. Due to the share size of this population even a small increase in suicide risk is of importance, and hence increased knowledge about this group is needed. METHODS: We used discrete time event history analysis to examine the relationship between suicide risk and non-employment due to either unemployment or health-problems, and the duration of these non-employment periods. We analyze data from the Norwegian population registry from 2004 to 2014, which includes all Norwegian residents in the ages 19-58 born between 1952 and 1989. In total the data consists of 1 063 052 men and 1 024 238 women, and 2 039 suicides. RESULTS: The suicide risk among the non-employed men and women is significantly higher than that of the employed. For the unemployed men, the suicide risk is significantly higher than the employed within the first 18 months. For the unemployed women we only find a significant association with suicide risk among those unemployed for six to twelve months. The suicide risk is especially increased among those with temporary health-related benefits. In the second year of health-related non-employment men have eightfold and women over twelvefold the OR for suicide, compared to the employed. CONCLUSION: There is an association between non-employment and suicide risk. Compared to the employed both unemployed men and men and women with health-related non-employment have elevated suicide risk, and the duration of non-employment may be the driving force. Considering the large share of the working age population that are not employed, non-employment status should be considered in suicide risk assessment by health care professionals and welfare providers.

Dental caries in a Norwegian adult population, the HUNT4 oral health study; prevalence, distribution and 45-year trends.

OBJECTIVE: To investigate dental caries prevalence amongst adults in Central Norway and assess changes over the last 45 years. MATERIALS AND METHODS: The cross-sectional HUNT4 Oral Health Study was conducted in 2017-2019. A random sample of 4913 participants aged ≥19 years answered questionnaires and underwent clinical and radiographic examinations. Data were compared to findings from previous studies in the same region conducted from 1973 to 2006. RESULTS: Mean number of decayed, missing and filled teeth (D3-5MFT) was 14.9 (95% CI 14.7, 15.1), 56% of adults had one or more carious teeth (D3-5T) and 11.8% had ≥4 D3-5T, with the mean number of 1.4 (95% CI 1.32, 1.42). For initial caries, mean D1-2S was 3.8 (95% CI 3.7, 3.9), being the highest for 19-24-year-olds at 8.6 (95% CI 7.9, 9.3). Comparisons with earlier studies showed a decline in mean D3-5MFT for 35-44-year-olds from 26.5 in 1973 to 10.8 in 2019. In 1973, 4.8% of 35-44-year-olds were edentulous, while in present study edentulousness was found only in individuals >65 years. CONCLUSIONS: Despite a substantial reduction in caries experience over the last 45 years, untreated dentine caries was common, evenly distributed across all age groups. Initial caries particularly affected younger individuals, indicating a need to evaluate prevention strategies and access to dental services.

Childhood abuse and its association with adults' mental health problems: a cross-sectional study among men and women in the Yangon Region of Myanmar.

OBJECTIVES: To estimate the prevalence of emotional, physical and sexual childhood abuse, and symptoms of post-traumatic stress disorder (PTSD) and to examine the association between childhood abuse and adult mental health problems, including mental distress and PTSD symptoms. DESIGN: A community-based cross-sectional study was conducted. Childhood abuse was assessed with the NorVold Abuse Questionnaire, and mental distress and symptoms of PTSD were measured using the Hopkins Symptom Checklist 10 and the Impact of Event Scale-Revised, respectively. The Wald test and multiple linear regression analysis were applied for testing differences between proportions and the association between childhood abuse and adult mental health outcomes, respectively. SETTING: Urban and rural areas of the Yangon Region, Myanmar. PARTICIPANTS: A total of 2377 men and women aged 18-49 years were included. Institutionalised people, monks, nuns and individuals deemed too ill physically and/or mentally to participate were excluded. RESULTS: Overall, 21.1% (95% CI 18.8 to 23.6) reported any form of childhood abuse, 10.4% (95% CI 8.9 to 12.4) physical abuse, 10.4% (95% CI 8.8 to 12.2) emotional abuse and 7.3% (95% CI 5.7 to 9.3) sexual abuse. Childhood abuse was more common in women (29.8%) than in men (12.4%). The prevalence of PTSD symptoms in the total sample was 6.6%. After adjusting for confounding variables, positive associations were found between childhood abuse with adult mental distress and PTSD symptoms among women and older men. CONCLUSIONS: Childhood abuse is prevalent among both men and women in the Yangon Region of Myanmar and associated with adult mental health problems. Approximately 7% of people report PTSD symptoms. It should prompt local health professionals and policy makers to establish prevention programmes to eliminate violence against children and to organise services for victims of childhood abuse. Care should be taken in generalising findings for less populated areas.

Associations between stressful working conditions and psychosomatic symptoms among Palestinian nurses: a cross-sectional survey.

BACKGROUND: Stressful working conditions among nurses have adverse effects on their physical and mental health. We investigated associations between self-reported stressful working conditions and psychosomatic symptoms among nurses in the Hebron district, occupied Palestinian Territory, and whether there are differences the sexes in the perceptions of working conditions and psychosomatic symptoms. METHODS: We did a cross-sectional survey between Oct 7 and Dec 10, 2012, among registered nurses in all health sectors in Hebron district. A nine-point ordinal scale of working conditions was used to categorise perception of stress as low, medium, or high, and seven psychosomatic symptoms were recorded on a checklist coded as never (0), seldom (1), occasionally (2), or often (3), allowing for a total score between 0 and 21. All analyses were done with STATA (version 10). P values of less than 0·05 were significant. Participation in the study was voluntary, and written informed consent was obtained from each participant. The study was approved by the Regional Committee for Medical and Health Research Ethics, Norway. Permission to do the study was obtained from the Palestinian Ministry of Health. FINDINGS: Among 372 eligible nurses, ten were on extended leave from work, 16 declined to participate, and four had incomplete data, giving a final sample of 342 nurses (92% response rate). 212 (62%) were women and 130 (38%) were men. Low levels of stress were reported by 42 (12%) nurses, medium levels by 206 (60%), and high levels by 94 (28%). The mean score of psychosomatic symptoms for the group was 10·4 (SD 4·02, range 0-21). Scores did not differ significantly between men and women. Mean symptom scores differed between nurses with self-reported highly stressful working conditions and those with low levels of stress (12.6 vs 8.4, difference 4·1, 95% CI 2·7-5·5; p<0·001). Among male nurses, those with self-reported highly stressful working conditions had a mean psychosomatic symptom score of 13.0, compared with that was 7.7 among those working in low-stress conditions (difference 5·3 units, p<0·001). This effect remained significant after adjustment for the covariates age, education, number of children, work schedule, and years of experience (12·6 vs 7·7, difference 4·9 units, 95% CI 2·6-7·2). Among female nurses, the scores among those with high-stress working conditions was 12.4 and for those with low-stress working conditions was 9.0 (difference 3·4 units, p<0·001). After adjustment the difference remained similar (12·4 vs 9·0, difference 3·5 units, 95% CI 1·7-5·3, p<0·001). INTERPRETATION: We found that psychosomatic symptoms increased as self-reported perception of stressful working conditions increased, irrespective of sex. The study had a cross-sectional design and both exposure and outcomes were measured using self-report and, therefore, interpretation of the results should be made with caution. Longitudinal epidemiological studies are recommended. Future studies should investigate whether stressful working conditions affect the quality of patients' care in health services. FUNDING: Norwegian Programme for Development, Research and Education.

Urban-rural differences in overweight and obesity among 25-64 years old Myanmar residents: a cross-sectional, nationwide survey.

OBJECTIVES: To investigate whether urban-rural location and socioeconomic factors (income, education and employment) are associated with body mass index (BMI) and waist-hip ratio (W/H-ratio), and to further explore if the associations between urban-rural location and BMI or W/H-ratio could be mediated through variations in socioeconomic factors. DESIGN: Cross-sectional, WHO STEPS survey of non-communicable disease risk factors. SETTING: Urban and rural areas of Myanmar. PARTICIPANTS: A total of 8390 men and women aged 25 to 64 years included during the study period from September to December 2014. Institutionalised people (Buddhist monks and nuns, hospitalised patients) and temporary residents were excluded. RESULTS: The prevalence of overweight and obesity was higher in the urban areas and increased with increasing socioeconomic status (SES) score. Mean BMI was higher among urban residents (ß=2.49 kg/m2; 95% CI 2.28 to 2.70; p<0.001), individuals living above poverty line, that is, ≥US$1.9/day (ß=0.74 kg/m2; 95% CI 0.43 to 1.05; p<0.001), and those with high education attainment (ß=1.48 kg/m2; 95% CI 1.13 to 1.82; p<0.001) when adjusting for potential confounders. Similarly, greater W/H-ratio was observed in participants living in an urban area, among those with earnings above poverty line, and among unemployed individuals. The association between urban-rural location and BMI was found to be partially mediated by a composite SES score (9%), income (17%), education (16%) and employment (16%), while the association between urban-rural location and W/H-ratio was found to be partially mediated by income (12%), education (6%) and employment (6%). CONCLUSION: Residents living in urban locations had higher BMI and greater W/H-ratio, partially explained by differences in socioeconomic indicators, indicating that socioeconomic factors should be emphasised in the management of overweight and obesity in the Myanmar population. Furthermore, new national or subnational STEPS surveys should be conducted in Myanmar to observe the disparity in trends of the urban-rural differential.

Time from dementia diagnosis to nursing-home admission and death among persons with dementia: A multistate survival analysis.

OBJECTIVES: To estimate transition times from dementia diagnosis to nursing-home (NH) admission or death and to examine whether sex, education, marital status, level of cognitive impairment and dementia aetiology are associated with transition times. DESIGN: Markov multistate survival analysis and flexible parametric models. SETTING: Participants were recruited from the Norwegian Registry of Persons Assessed for Cognitive Symptoms (NorCog) in specialist healthcare between 2008 and 2017 and followed until August 2019, a maximum of 10.6 years follow-up time (mean 4.4 years, SD 2.2). Participants' address histories, emigration and vital status were retrieved from the National Population Registry from time of diagnosis and linked to NorCog clinical data. PARTICIPANTS: 2,938 home-dwelling persons with dementia, ages 40-97 years at time of diagnosis (mean 76.1, SD 8.5). RESULTS: During follow-up, 992 persons (34%) were admitted to nursing-homes (NHs) and 1,556 (53%) died. Approximately four years after diagnosis, the probability of living in a NH peaked at 19%; thereafter, the probability decreased due to mortality. Median elapsed time from dementia diagnosis to NH admission among those admitted to NHs was 2.28 years (IQR 2.32). The probability of NH admission was greater for women than men due to women´s lower mortality rate. Persons living alone, particularly men, had a higher probability of NH admission than cohabitants. Age, dementia aetiology and severity of cognitive impairment at time of diagnosis did not influence the probability of NH admission. Those with fewer than 10 years of education had a lower probability of NH admission than those with 10 years or more, and this was independent of the excess mortality in the less-educated group. CONCLUSION: Four years after diagnosis, half of the participants still lived at home, while NH residency peaked at 19%. Those with fewer than 10 years of education were less often admitted to NH.

Domestic violence victimisation and its association with mental distress: a cross-sectional study of the Yangon Region, Myanmar.

OBJECTIVES: To estimate the prevalence of domestic violence, with subgroups of physical, sexual and emotional violence, among men and women and to assess the association between any lifetime domestic violence (DV) and mental distress among ever-married men and women. DESIGN: We conducted a cross-sectional study from October to November 2016 using a multistage sampling design. DV questionnaire was adopted from the Demographic and Health Survey programme. Mental distress was estimated using the Hopkins Symptom Checklist-10 (HSCL-10). HSCL-score and DV were the outcome and exposure variables, respectively, in multiple linear regression. Prevalence estimates and associations were presented with a 95% CI and the Wald test. SETTING: Urban and rural areas of the Yangon region, Myanmar. PARTICIPANTS: Men and women ages 18 to 49 years were included. Institutionalised people, monks, nuns and individuals deemed too ill physically and/or mentally to participate were excluded. RESULTS: A random sample of 2383 people was included in the analyses. Among ever-married participants, lifetime (LT) and past-12-month (12M) prevalence of any domestic violence victimisation was higher in women compared with men: LT women: 61.8% (95% CI: 54.3 to 68.9) versus LT men: 42.4% (95% CI: 37.5 to 47.5) and 12M women: 51.2% (95% CI: 44.9 to 57.5) versus 12M men: 37.7% (95% CI: 32.9 to 42.7). Among never-married participants, lifetime physical and sexual violence victimisation rates was higher in men (34.3% and 7.9%) compared with women (19.1% and 6.4%). Mental distress was significantly associated with lifetime DV in women who were afraid of their husbands and men who had wives who exhibited controlling behaviours. CONCLUSIONS: Domestic violence is prevalent among both men and women and is associated with mental distress. The findings highlight an urgent need to prevent domestic violence in both sexes, including through legal and policy reform and improved mental health services for DV victims.

Dynamics of contraceptive use among married women in North and South Yangon, Myanmar: findings from a cross-sectional household survey.

OBJECTIVE: The objective was to explore the sociodemographic factors associated with contraceptive use, the variation in prevalence and duration of contraceptive use across the age groups and parity among 18-49-year-old married women in North and South Yangon. STUDY DESIGN: We conducted a cross-sectional study regarding contraceptive use among married women aged 18-49 in North and South Yangon from September to November 2016. We used a questionnaire based on the Demographic and Health Surveys Program, with additional questions on the duration of contraception along the life-course. Associations between contraceptive prevalence and sociodemographic factors were tested by χ 2. We describe the percentages of contraceptive use and nonuse across the age and parity subgroups, and the mean duration of contraception. We compared the contraceptive prevalence ratios across the parity using logistic regression. RESULTS: The contraceptive prevalence of modern methods was 66% (95% confidence interval: 61.5%-69.9%) with better coverage in rural (69.6%) than in urban women (61.5%). Contraceptive use varied by age and parity, demonstrating lower prevalence in the oldest age group (45-49) and high parity (parity five and above). The mean duration of contraceptive use rose with increased age and parity, except in the oldest-age and high-parity groups. CONCLUSIONS: The findings called for greater attention to improve the contraceptive coverage of married women living in urban areas around Yangon city (periurban women). IMPLICATIONS: The study identified the pockets of low contraceptive coverage in a region with the highest contraceptive prevalence in Myanmar. Women above the age of 40 and women who had high parity had low contraceptive prevalence. Women living near the city showed lower contraceptive coverage compared to their rural counterparts.

The prevalence of mental distress and the association with education: a cross-sectional study of 18-49-year-old citizens of Yangon Region, Myanmar.

BACKGROUND: Poor mental health is an important contributor to the global burden of disease. Mental health problems are often neglected in communities, and are scarcely studied in developing countries, including Myanmar. This study estimates the prevalence of mental distress by socio-demographic and health related factors, and the association between education and mental distress. As far as the authors are aware, this is the first population-based study in Myanmar estimating the prevalence of mental distress. METHODS: Between October and November 2016, a cross sectional study was conducted using a multi-stage sampling design with face-to-face interviews using the Hopkins Symptom Checklist (HSCL-10) for mental distress (symptoms of depression and anxiety). The multivariable analysis strategy was based on Directed Acyclic Graphs (DAGs), to identify confounders, mediators and colliders. Pearson's chi-square was used for testing differences between proportions and multiple linear regression analysis was applied to explore the association between education (years at school) and mental distress (HSCL score). RESULTS: A random sample of 2391 (99.6% response) men and women aged 18-49 years participated in the study. The prevalence of mental distress was 18.0% (95% confidence interval (CI): 14.7-21.9), being higher among women (21.2%; 95% (CI): 16.6-26.6) than men (14.9%; 95% (CI): 11.4-19.2). Older-age, being separated or divorced and having a higher number of children were associated with increased mental distress. In linear regression analyses, adjusted for confounders (age, marital status and income), there was a significant negative association between years at school and mental distress among women and older men (> 30 years), but not among the youngest men. CONCLUSIONS: The prevalence of mental distress is high, and there is an association between HSCL-10 score and education. Due to the scarcity of mental health services in Myanmar, the findings indicate a need for a mental health policy to handle the burden of mental health problems in Yangon, a burden which is probably high within the country.

Association of anthropometry and weight change with risk of dementia and its major subtypes: A meta-analysis consisting 2.8 million adults with 57 294 cases of dementia.

Uncertainty exists regarding the relation of body size and weight change with dementia risk. As populations continue to age and the global obesity epidemic shows no sign of waning, reliable quantification of such associations is important. We examined the relationship of body mass index, waist circumference, and annual percent weight change with risk of dementia and its subtypes by pooling data from 19 prospective cohort studies and four clinical trials using meta-analysis. Compared with body mass index-defined lower-normal weight (18.5-22.4 kg/m2 ), the risk of all-cause dementia was higher among underweight individuals but lower among those with upper-normal (22.5-24.9 kg/m2 ) levels. Obesity was associated with higher risk in vascular dementia. Similarly, relative to the lowest fifth of waist circumference, those in the highest fifth had nonsignificant higher vascular dementia risk. Weight loss was associated with higher all-cause dementia risk relative to weight maintenance. Weight gain was weakly associated with higher vascular dementia risk. The relationship between body size, weight change, and dementia is complex and exhibits non-linear associations depending on dementia subtype under scrutiny. Weight loss was associated with an elevated risk most likely due to reverse causality and/or pathophysiological changes in the brain, although the latter remains speculative.

Unmet Need for Family Planning among Urban and Rural Married Women in Yangon Region, Myanmar-a Cross-Sectional Study.

Despite increasing contraceptive use and prevalence, many women who want to avoid or delay pregnancy are not using contraceptives. This results in unintended pregnancies, which increases the risk of unsafe abortions. This study aimed to explore the extent of the unmet need for family planning (FP) among urban and rural married women in Myanmar and their demand for and satisfaction with FP. A cross-sectional survey using adapted Demographic and Health surveys questions was conducted in south and north Yangon from September 2016 to November 2016. A total of 1100 currently married women of 18-49 years participated. The contraceptive prevalence was 67.2% in total, 63% urban, and 70% rural. About 19.4% (95% CI: 16.7%-22.4%) of the studied women had an unmet need for FP, significantly higher in urban than rural women (22.6% versus 16.6%). Rural women also showed significant lesser odds (adjusted OR: 0.63; 95% CI: 0.461-0.849) of unmet need than the urban counterparts. About 86% of the women had demand for contraception and 77% of them satisfied their demand. The study population revealed a fairly good contraceptive coverage; however, a considerable proportion of women had an unmet need for FP, especially the urban women. The demand for contraception is increasing, and contraceptive services need to expand coverage to marginalized groups in order to reduce the risk of unsafe abortions.

Trends in Diabetes Prevalence, Awareness, Treatment and Control in Yangon Region, Myanmar, Between 2004 and 2014, Two Cross-Sectional Studies.

Myanmar is currently facing the burden of non-communicable diseases due to changes in lifestyle and dietary patterns linked to socio-economic development. However, evidence is scarce about changes in the prevalence of diabetes mellitus (DM) over time. We aimed to investigate changes in the prevalence, awareness, treatment and control of DM from 2004 to 2014, among adults aged 25-74 years, in the Yangon region. Two cross-sectional household-based studies, according to World Health Organization STEPwise approach to surveillance (WHO STEPS) methodology, were conducted in 2004 (n = 4448) and 2014 (n = 1372). The overall age-standardized prevalence of DM was 8.3% (95% CI 6.5-10.6) in 2004 and 10.2% (7.6-13.6) in 2014 (p = 0.296). The DM prevalence increased between the study years among elderly participants only, from 14.6% (11.7-18.1) to 31.9% (21.1-45.0) (p = 0.009). Awareness of having DM increased from 44.3% (39.2, 49.6) to 69.4% (62.9-75.2) (p < 0.001). Among participants who were aware of having DM, the proportion under treatment increased from 55.1% (46.8-63.1) to 68.6% (61.5-74.8) (p = 0.015). There was no change in proportion with controlled DM. Adjusted for age, sex and education, mean fasting plasma glucose levels in 2014 were 0.56 mmol/L (0.26-0.84) higher than in 2004. Preventive measures to halt future increases in DM prevalence and to increase the detection of undiagnosed DM cases are needed.

Comparison of Cardiovascular Risk Factors among Somalis Living in Norway and Somaliland.

OBJECTIVE: We aimed to assess and compare cardiovascular disease (CVD) risk factors and predict the future risk of CVD among Somalis living in Norway and Somaliland. METHOD: We included participants (20-69 years) from two cross-sectional studies among Somalis living in Oslo (n = 212) and Hargeisa (n = 1098). Demographic data, history of CVD, smoking, alcohol consumption, anthropometric measures, blood pressure, fasting serum glucose, and lipid profiles were collected. The predicted 10-year risk of CVD was calculated using Framingham risk score models. RESULTS: In women, systolic and diastolic blood pressure were significantly higher in Hargeisa compared to Oslo (p < 0.001), whereas no significant differences were seen in men. The ratio of total cholesterol to high-density lipoprotein (HDL) cholesterol was significantly higher in Hargeisa compared to Oslo among both men (4.4 versus 3.9, p = 0.001) and women (4.1 versus 3.3, p < 0.001). Compared to women, men had higher Framingham risk scores, but there were no significant differences in Framingham risk scores between Somalis in Oslo and Hargeisa. CONCLUSION: In spite of the high body mass index (BMI) in Oslo, most CVD risk factors were higher among Somali women living in Hargeisa compared to those in Oslo, with similar patterns suggested in men. However, the predicted CVD risks based on Framingham models were not different between the locations.

The prevalence of selected risk factors for non-communicable diseases in Hargeisa, Somaliland: a cross-sectional study.

BACKGROUND: Non-communicable diseases (NCDs), particularly cardiovascular diseases, diabetes, respiratory conditions and cancers, are the most common causes of morbidity and mortality globally. Information on the prevalence estimates of NCD risk factors such as smoking, low fruit & vegetable intake, physical inactivity, raised blood pressure, overweight, obesity and abnormal blood lipid are scarce in Somaliland. The aim of this study was to determine the prevalence of these selected risk factors for NCDs among 20-69 year old women and men in Hargeisa, Somaliland. METHODS: A cross-sectional study was conducted in five districts of Hargeisa (Somaliland), using the STEPwise approach to noncommunicable disease risk factor surveillance (STEPS) to collect data on demographic and behavioral characteristics and physical measurements (n = 1100). The STEPS approach is a standardized method for collecting, analysing and disseminating data on NCD risk factor burden. Fasting blood sugar, serum lipids (total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides) were collected in half of the participants. RESULTS: The vast majority of participants had ≤1 serving of fruits daily (97.7%) and ≤ 1 serving of vegetables daily (98.2%). The proportion of participants with low physical activity levels was 78.4%. The overall prevalence of high salt intake was 18.5%. The prevalence of smoking and khat chewing among men was 27 and 37% respectively, and negligible among women. In women, the prevalence of hypertension increased from 15% in the age group 20-34 years to 67% in the age group 50-69 years, the prevalence of overweight and obesity (BMI ≥ 25 kg/m2) from 51 to 73%, and the prevalence of diabetes from 3 to 22%. Similar age-trends were seen in men. CONCLUSION: Most of the selected risk factors for noncommunicable diseases were high and increased by age in both women and men. Overweight and obesity and low physical activity needs intervention in women, while hypertension and low fruit and vegetable consumption needs intervention in both men and women. Somaliland health authorities should develop and/or strengthen health services that can help in treating persons with hypertension and hyperlipidaemia, and prevent a future burden of NCDs resulting from a high prevalence of NCD risk factors.