Prevalence of Non-Communicable Disease (NCD’s) among adults in Barangay Tambacan

Iligan City

A Research Proposal

Presented to the High School Department

Adventist Medical Center College
Brgy. San Miguel, Iligan City

In Partial Fulfillment
Of the Requirements for
PRACTICAL RESEARCH II

Alaine Vence R. Malacaste

Athica Juvel B. Usman
Lorene A. Magada
Mary Jo B. Siarot
Trisha Rose Z. Ojeda

September 2019
 ADVENTIST MEDICAL CENTER COLLEGE – ILIGAN
San Miguel, Iligan City, Philippines

High School Department

APPROVAL SHEET

This Qualitative research proposal, entitled “Prevalence of Non-Communicable Disease

(NCDs) among adults in Barangay Tambacan, Iligan City ”.
Prepared and submitted by:
Alaine Vence R. Malacaste
Athica Juvel B. Usman
Lorene A. Magada
Mary Jo B. Siarot
Trisha Rose Z. Ojeda

In partial fulfilment of the requirements for the subject PRACTICAL RESEARCH II is hereby
recommended for oral defense.

_________________________
Panel Member

GENEVIEVE C. TONOG,RND,MSc
Adviser

This Quantitative research is approved in partial fulfillment of the requirements for Practical
Research II.

GENEVIEVE C. TONOG, RND,MSc

Research Instructor

FEBE LAVADOR, MSBio

Principal, High School Department
 CHAPTER 1

THE PROBLEM AND ITS SCOPE

1.1 INTRODUCTION

Non-communicable Disease (NCD), also known as chronic disease, tend to be of long

duration and are the result of a combination of genetic, physiological, environmental and behaviors

factors. NCD is a disease that is not transmissible from one person to another. The main types of

NCDs are cardiovascular disease like heart attack, stroke, cancer, diabetes, alzheimer’s disease,

cataracts. NCD maybe chronic or acute, most are not infectious although they are some NCD such

as parasitic diseases in which the parasite’s life cycle does not include direct host-to-host

transmission.

Recent times NCD are the top killers in the Philippines. The total deaths in 2008 are 25%

due to fatal four NCDs, namely cardiovascular disease, cancer, diabetes, and chronic respiratory

disease. It is estimated that 35 to 65 presents of NCD deaths occur before age 60 (World Health

Organization 2011).

Modifiable behaviors, such as tobacco use, physical inactivity, unhealthy diet and the

harmful use of alcohol, all increase the risk of NCDs. This make millions of Filipinos vulnerable

in developing NCDs in the future. In past years (2011) current prevalence of NCDs risk factors

among adults are overweight and obesity (27%), hypertension (25%), high blood sugar (5%), and

high total cholesterol (10%).

Non-communicable disease (NCD) are increasing in low and mid income countries

(LMICs).The greatest burden of NCDs is from cardiovascular diseases, diabetes,cancers and

chronic respiratory illness. This four disease group share set of four risk factors: tabacco use,

unhealthy diets, harmful alcohol consumption, and physical in activity.

The purpose of this study is to determine the affected percentage of NCDs among adults

and to discover how people managed these kind of diseases. The importance of this study is not

just to find out the affected in this disease but also to spread awareness in what person may do if

they have this kind of diseases.

1.2 CONCEPTUAL FRAMEWORK

Independent Variable Dependent Variable

Prevalence of NCDs:

Adults in Brgy. Tambacan 1. Cancer 7. Cataracts

2. Cardiovascular disease 8. Strokes
3. Diabetes 9. Alzheimer’s disease
4. Chronic kidney disease 10. Heart disease
5. Chronic respiratory disease 11. Osteoarthritis
6. Parkinson’s disease 12. Osteoporosis

Figure 1. Research Paradigm

The survey will include adults in Brgy. Tambacan and will serve as independent variable.

The researchers will identify the prevalence of NCDs, such as cancer, cardiovascular, diabetes,

chronic kidney disease, chronic respiratory disease, parkinson’s disease, cataracts, strokes,

alzheimer’s disease, heart disease, osteoarthritis and osteoporosis are the dependent variable.
1.3 STATEMENT OF THE PROBLEM

This study aims to evaluate the lifestyle disease (NCD) especially among adults in

barangay Purok 4. Tambacan Iligan City on how they manage this type of disease. The

researchers aims to seek these following questions:

1. What is the socio-demographic profile of the adults?

2. What are the common NCD’s experienced by the adults residents of Tambacan?

3. What’s the prevalence of NCDs between sexes?

4.What are the lifestyle practices of the respondents?

1.4 OBJECTIVE OF THE STUDY

The main objectives of this study is to know how many people have NCD’s in Barangay

Tambacan. The following objectives are defined as follows:

1. To determine the socio-demographic profile that can affect presence of NCDs.

2. To determine the prevalence of NCD among adults.

3. To identify the common lifestyle practices of the respondents that has NCD.

1.4 HYPOTHESIS

Ha1: There is a common lifestyle practice of NCD

Ho1: There is no common lifestyle practice of NCD

1.5 SIGNIFICANCE OF THE STUDY

The findings of the study will be a good benefit to the following:

Adults. This can be a help for them as a reliable source for those who have NCD to know how to

have a healthy lifestyle and to know the possible harmful effects on them.
Students of AMCC. For them to be able to know what is NCD and to know how it can affects to

those people who’s experiencing these kind of disease.

Faculties and Staffs. This study will help them to guide the students and be aware of their

situations.

Future readers. This will have a background on studies related to the topic of this research and

may apply it in the future.

Overall, this study will benefit the teachers, students, and specially the adults who have

these kind of disease, and lastly, the future researchers will also be aware.

1.7 SCOPES AND LIMITATIONS

This study aims to know the lifestyle diseases among adults under the age of 40-60 years

old and to be able to determine the prevalence of NCD using a survey technique. This system will

let the respondents to answer all the questions asked, regardless of their (1) sex, (2) how many

years of residency and their (3) income. Thus, the scope of the study will be limited only among

adults in Purok 4, Tambacan, Iligan City.

1.8 DEFINITION OF TERMS

The following terms will be used in this study:

Bowel Movement. This term refers to the release of the food that was broken down into substances

outside the body.

Digestion. The process of breaking down the food by mechanical and enzymatic action in the

alimentary canal into substances that can be used by the body.

Immune System. The body’s defense against infectious organism and other inavades.

Mental. Relating to the emotional and intellectual response of an individual to external reality.

NCD. Non-communicable Disease such as cancer, cardiovascular disease, diabetes, chronic

respiratory disease, parkinson’s disease, cataracts, strokes, alzheimer’s disease, osteoarthritis and

osteoporosis.

Physical. Relating to the body as opposed to the mind. Condition of your body, taking

consideration from everything to the absence of disease.

Social. Relating to interaction with other people by gatherings and other events.

Spiritual. Sense of connection to something bigger than ourselves, involves searching the meaning

of our lives.

Weight. Refers to a person’s mass or weight that is reduced or increased by physical and mental

activity.

Cataracts. A condition in which part your eye called lense, becomes cloudy and you cannot see.
 CHAPTER 2

REVIEW OF RELATED LITERATURE

This chapter presents the related literature and related study of this research it includes the

different works by the other researchers that are related to this study. Most of this consist of

research studies about the Prevalence of Non-communicable Disease (NCD’s) among adults in

Barangay Tambacan, Iligan City.

RELATED LITERATURE

In most countries, people who have a low socioeconomic status and those who live in poor

or marginalised communities have a higher risk of dying from non-communicable diseases

(NCDs) than do more advantaged groups and communities. Smoking rates, blood pressure, and

several other NCD risk factors are often higher in groups with low socioeconomic status than in

those with high socioeconomic status; the social gradient also depends on the country's stage of

economic development, cultural factors, and social and health policies. Social inequalities in risk

factors account for more than half of inequalities in major NCDs, especially for cardiovascular

diseases and lung cancer. People in low-income countries and those with low socioeconomic status

also have worse access to health care for timely diagnosis and treatment of NCDs than do those in

high-income countries or those with higher socioeconomic status. Reduction of NCDs in

disadvantaged groups is necessary to achieve substantial decreases in the total NCD burden,

making them mutually reinforcing priorities. Effective actions to reduce NCD inequalities include

equitable early childhood development programmers and education; removal of barriers to secure
employment in disadvantaged groups; comprehensive strategies for tobacco and alcohol control

and for dietary salt reduction that target low socioeconomic status groups; universal, financially

and physically accessible, high-quality primary care for delivery of preventive interventions and

for early detection and treatment of NCDs; and universal insurance and other mechanisms to

remove financial barriers to health care (Khang YH, 2013).

Lifestyle is the way humans chose to live their day to day lives which may be related to

social, occupational or environmental factors. A healthy lifestyle is about striving to obtain a

reasonable balance between enhancing one's personal health, the health and well-being of others,

and the health of the community and according to the World Health Organization (WHO), health

is a state of complete physical, mental, and social well-being not merely absence of disease or

infirmity. Promoting healthy lifestyles is a challenge for many primary care practices. Although

most individual understand the importance of physical activity and healthy eating, many seem

unable to change their unhealthy behaviors to reduce weight and improve chronic conditions, and

lifestyle changes have been shown to significantly reduce morbidity and mortality rates for most

chronic diseases (McAndrews JA, McMullen S, Wilson SL, 2011).

Dietary habits and regular practice of physical activities and exercises are important

components of a healthy lifestyle that are associated with decreased risk of chronic

nontransmissible diseases such as Type 2 diabetes, hypertension, obesity, some cancers, and the

metabolic syndrome. Notwithstanding, sedentary behavior (physical inactivity) allied to a lower

intake of fruits, vegetables, cereals, and fibers, as well as higher intake of fatty, fried, salted, caloric

foods, snacks, and soft drinks have been associated with increased chronic disease risk in children

and adults. WHO estimates 2 million deaths/year caused by physical inactivity and unhealthy

eating habits ( Ferrari CK, Ferreira RF, 2011).

 Lifestyle has long been associated with the development of many chronic diseases and

NCDs. WHO has identified four major NCDs, i.e., diabetes, CVDs, cancer and chronic lung

disease/chronic obstructive pulmonary disease (COPD) which share common lifestyle-related

behavioral risk factors. These risk factors are tobacco use (smoking/chewing), physical inactivity,

unhealthy diet, and alcohol use leads to key metabolic and or physiological changes like raised

blood pressure, overweight or obesity, raised blood glucose, and raised cholesterol levels. Many

studies have shown that the prevalence of risk factors of NCDs in the early phase of life, i.e.,

childhood and adolescence bears significant tendency toward development of disease in adulthood.

(Narayan KM, Ali MK, Koplan JP, 2010).

Furthermore, lifestyle-related NCDs are similar in many ways. First, it is difficult to reverse

the state of health of an individual who has acquired any or a combination of these diseases. Unlike

communicable diseases, which have specific causative biologic agents and specific treatment to

cure the disease, lifestyle-related NCDs are caused by a combination of factors that has yet

rendered cure almost impossible. Once acquired, the person affected suffers the disease for the

lifetime and can be alleviated only through a combination of behavioral, clinical, and non-medical

interventions. Second, every individual is bound to experience one of these diseases to a certain

degree after reaching a certain age. The onset and progression of these diseases depend on factors

that are influenced by the person’s socioeconomic and physical environment and by his genetic

predisposition and personal behaviors and practices. Third, the onset and progression of these

diseases are brought by many shared risk factors such as unhealthy diet, stressful and sedentary

lifestyle, smoking and alcohol abuse. Together with the interplay of the individual's genetic and

physical endowment and exposure to environmental hazards and other risks, these factors increase

a person's susceptibility to developing lifestyle-related NCDs (DOH, 2005).

 Additionally, our country is currently in an epidemiologic transition. Although great

progress has been made in the past several decades to control communicable diseases, their burden

as a cause of morbidity is still high. Communicable diseases such as acute respiratory infections,

pneumonia, bronchitis, influenza, diarrhea and tuberculosis remain among the leading causes of

morbidity in our country. On the other hand, chronic noncommunicable diseases (NCDs) have

emerged as the major causes of mortality. The number of deaths arising from non-communicable

causes is steadily rising in the last 35 years, with the greatest increases noted within the last two

decades. From 2000 to 2009, diseases of the heart, cerebrovascular diseases and malignant

neoplasms were the top three leading causes of registered deaths in the country. Chronic lower

respiratory tract diseases, diabetes mellitus, diseases of the kidney (nephritis, nephrosis, and

nephrotic syndrome), and accidents and injuries were also among the top ten causes of registered

deaths in the country for the same period. Collectively, these account for around 70 percent of the

mortalities in the country annually (WHO, 2011).

In low-resource settings, health-care costs for NCDs quickly drain household resources.

The exorbitant costs of NCDs, including often lengthy and expensive treatment and loss of

breadwinners, force millions of people into poverty annually and stifle development (DOH. 2015)

Lastly, Poverty is closely linked with NCDs. The rapid rise in NCDs is predicted to impede

poverty reduction initiatives in low-income countries, particularly by increasing household costs

associated with health care. Vulnerable and socially disadvantaged people get sicker and die

sooner than people of higher social positions, especially because they are at greater risk of being

exposed to harmful products, such as tobacco, or unhealthy dietary practices, and have limited

access to health services (WHO, 2015).

RELATED STUDIES

As our country’s economic development improves, societal challenges similarly increase

and so do health hazards and risk behaviors among our population. Although we are becoming

more aware that some aspects of our modern lifestyle may be detrimental to our health, it is also

becoming difficult for more and more people to make healthy choices in the way they work, play

and live because of their living conditions and socioeconomic circumstances. Like in many other

developing countries, the changing family structures and lifestyle trends in the Philippines have

resulted in a considerable change in our health profile. As more people suffer and die from costly

chronic degenerative diseases, the government is expected to shoulder ballooning expenses on

health care over the years. If nothing is done, a significant portion of our gross domestic product

(GDP) would be spent on health, an overwhelming share going to expensive curative and

rehabilitative care. Upward pressures on health spending would be persistent, reflecting increased

demand brought about by shifting disease patterns. Efficiencies in health have to be found if we

are to improve and sustain our health outcomes in the long run. Now, more than ever, health

reforms must embed health promotion strategies and approaches that deliver greater value for

money, with the multitude of threat reinforcing the need for a multi-sectoral, whole-of-government

and whole-of-society approach to keep our population healthy (US National Library of Medicines,

2019).

In the present study, none of the subjects screened were found to have hypertension as per

API classification on BP. Majority screened were with optimal and normal BP. However, there

were 1.55% of the subjects recorded to have high normal BP (prehypertension) who are at high

risk of developing hypertension later in life and the risk increases by many folds with an unhealthy

lifestyle. In a similar study conducted by Al-Majed and Sadek reported a high proportion of
prehypertension and hypertension among college students in Kuwait and many studies have shown

a high prevalence of prehypertension and hypertension among adolescents. It is remarkable that

not only overweight and obesity but also poor lifestyle practices are important risk factors of

hypertension and other NCDs (Al-Majed HT, Sadek AA., 2012).

In a developing country like India, the present scenario of these diseases is in quite alarming

situation as the profile of these diseases is changing very rapidly. The WHO has identified India

as one of the nations that is going to have most of the lifestyle-related disorders in the near future.

However, the important fact is that not only are the lifestyle disorders becoming more common,

but they are showing a drastic shift toward the younger population. According to the WHO, 53

percent of the deaths in 2008 were due to NCDs in India and CVDs alone account for 24 percent

of all deaths. As of 2005, India experienced the “highest loss in potentially productive years of

life” worldwide, and the leading cause of death was CVD; mostly affecting people aged 35–64

years (Chakma JK, 2014).

There are well-documented key risk factors for non-communicable diseases (NCDs).

These risk factors include unhealthy lifestyle behaviours such as high tobacco and alcohol

consumption, an unhealthy diet, physical inactivity, and raised blood pressure. They define the

occurrence and severity of NCDs such as cancers and cardiovascular diseases which generally

develop from the interaction of multiple risk factors. There is an increase in NCD risk factors in

South Africa, including among elderly South Africans, which may place a heavy burden on the

already constrained healthcare system (Mayosi BM, Flisher AJ, Lalloo UG, Sitas F, Tollman SM,

Bradshaw D, 2009).

Limited studies have been conducted to determine the association between

sociodemographic characteristics and multiple NCD risk factors among the elderly in developing
countries. Most previous studies have concentrated on the significance of one unhealthy behavior

in an individual and focused less on other unhealthy behaviors that may coexist within an

individual. In a cross-sectional study in three rural sites in Malawi, Rwanda, and Tanzania, results

from five risk factors that were examined (alcohol intake, smoking, vigorous physical activity,

hypertension, and overweight) showed that individuals aged 50 years and above were more likely

to have multiple risk factors (Negin J, Cumming R, de Ramirez SS, Abimbola S, Sachs SE., 2011).

Further, by the year 2020, global anticipated NCDs burden will rise to 80% and the

majority of deaths (70%) will occur in low and middle-income countries. Similarly, the magnitude

of NCDs is increasing in Ethiopia. Hypertension and diabetes mellitus (DM) are the two most

common and easily diagnosed forms of NCDs. There are one billion hypertensive cases worldwide

of which one in three patients live in developing countries. In Ethiopia too, the magnitude of

hypertension increased from 18.8% in 2010 to 27.9% in 2015 (Abebe SM, Berhane Y, Worku A,

Getachew A., 2015).

In 2013, globally, 8.3% of adults (382 million people) had diabetes. Among them, 80% of

diabetes cases live in developing countries. Likewise, 6.5% of Ethiopian adults had DM. Diabetes

mellitus is the major risk factor for coronary artery disease, peripheral arterial disease, stroke,

cardiomyopathy, congestive heart failure, diabetic nephropathy, neuropathy, and retinopathy

(Molla M., 2015).

 CHAPTER 3

RESEARCH METHODOLOGY

This chapter represents the research methodology that will be applied in this study. It

includes the research design, research locale, respondents of the study, sampling method, data

gathering procedure and concept map that were used in the study regarding the Prevalence of

lifestyle Disease (NCDs) among adults in Barangay Tambacan, Iligan City.

3.1 RESEARCH DESIGN

The research design of this study is descriptive. This research method aims to know how

many are affected of NCD in Barangay Tambacan, Iligan City. It will collect detailed and

Factual-information to describe existing phenomena. It will systematically describe the situation

or area of interest factually and accurately. It allows the researchers to carefully describe and

understand the behavior. The variables are related to each other using various statistical

instruments.

3.2 RESEARCH LOCALE

The study will be conducted in Barangay Tambacan, Iligan City. The respondents will be

interviewed in their houses or any comfortable places that the respondent will choose to. These

respondents will be interview via questionnaires. The respondents choose the place because it will

give the researchers the needed information for the people with NCDs and majority of the people

are in 30-60 years old.

 Figure 1. Shows the terrain image of Purok 4 Tambacan, Iligan City.

3.3 RESPONDENTS OF THE STUDY

The study will use 20 respondents from Purok 4 Tambacan, Iligan City, especially those

adults have NCD. Regardless of the number of complications. Since the study is focusing on the

affected disease of NCD among adults who is 30-60 years old. The researchers aim to have

different opinions from different respondents suitable for the study.

3.4 RESEARCH INSTRUMENT

The questionnaire that will be used in the study are modified questionnaire. They will be

interviewed individually. The questionnaire that will be used contains questions asking about the

lifestyle disease of the respondents. The respondents will indicate their response by answering the

questions, which will be asked. The data gathered from the answer of the respondents are the bases

for the result and discussion of the study and the conclusion.
3.5 SAMPLING METHOD

This study used purposive sampling. As the study implies the prevalence of lifestyle

disease among adults in Barangay Tambacan, Iligan City, hence respondents who are available for

interview with current NCDs will serve as the respondents of the study. This enable the researchers

to collect significant data essential for this study. It will effectively identify the common lifestyle

disease among adults.

3.6. DATA GATHERING PROCEDURE

The researchers will conduct an individual interview. The respondents will be interviewed

in a comfortable place. The researchers will gather the answers by the respondents. It will be

tabulated and will be analyzed by compiling the answers of the respondents. It will help the

researcher to understand the views of NCDs in Purok 4 Tambacan, Iligan City which can help the

researcher conduct solution of this people.

3.7 ETHICAL CONSIDERATION

We are aware for the respondents feelings, thus sensitive statements will be avoided. Their

background, age, gender, culture, and disability will be respected. The researcher will ask for some

information. The purpose of the research will be explained. Informed consent will be secured

before the conduct of the interview. The researcher will keep any confidential information that is

not intended for other people.

3. 8 STATISTICAL TREATMENT

To interpret the data effectively, the researcher will employ the following statistical

treatment. The Frequency and Percentage, the Mean, and the Chi-square test are the tools use to

interpret data.

1.Frequency & Percentage

A percentage frequency distribution is a display of data that specifies particularly

useful method of expressing the relative frequency of survey responses and other data.

This will employ to determine the frequency counts and percentage distribution of

personal related variable of respondents.

2.Mean

The statistical means refers to the mean or average that is used to derive the central

tendency of the data in question. It is determined by adding all the data points is a population and

then dividing the total by the number of points, The resulting number is known as the average.

This will used to determine the assessment of the respondents with regards to their personal

profile.

3. Chi-square test

The Chi-square statistic is most commonly used to evaluate test of independence when

using a crosstabulation (also known as a bivariate table). Crosstabulation presents the

distribution of two categorical variables simultaneously, with the intersections of the categories

of the variable appearing the cells to the pattern that would be expected if the variable were truly

independent of each other. Calculating the Chi-square statistic and comparing it against critical
value from the Chi-square distribution allows the researchers to assess whether the observed cell

counts are significantly different from the expected cell counts. Chi square analysis is utilized to

understand if there is socio-demographic profile that can affect presence of NCDs

Please indicate a check (√) sign on the underlined portion.

Age:

Gender:__ Female __ Male

Occupational:

Income:

Educational Attainment:

__ Elementary Level

__ Elementary Graduate

__ High School Level

__ High School Graduate

__ Collage Level

__ Collage Graduate

__Others: (please specify) ___________

Number of the people living in the household:____

 DEMOGRAPHIC INFORMATION
NAME:
AGE:
SEX:
OCCUPATION:
INCOME:
1. What is the highest level of education you have complete.
__ no formal school
__ less than primary school
__ primary school complete
__ secondary school complete
__ college/university complete
__ post graduate degree
__ refused

QUESTIONNAIRE
Which non communicable disease you’ve experience.

__Cardiovascular disease

__Diabetes

__Chronic kidney disease

__Chronic respiratory disease

__Parkinson’s disease

__ Cataracts

__Stroke

__Alzheimer’s disease

__Herat disease

__Osteoarthritis

__Osteoporosis

__Parkinson’s disease
QUESTIONNAIRE YES NO
1. Is it important to
focus on primary
health care as an
avenue for the
management of non
communicable
disease.
2. Is the non
communicable can
really affect your
lifestyle.
3. Are people in non
communicable
disease more
vulnerable to the
health impact
emergency.
4. Is the common
lifestyle practice can
really prevent non
communicable
disease
5. Is it really hard to
you to handle non
communicable
disease
6. Is a multisectoral
approach needed to
prevent and control
non-communicable
disease
7. Is socio demographic
profile can really
affect the presence of
non communicable
disease.
8. Are conflicting
interest considered a
barrier for
multisectoral
 planning and action
in preventing and
controlling non
communicable
disease.
9. do you spend doing
sport, fitness or
recreational activity
in a typical day.
10. Is non health sector
could be involved in
the prevention and
control of non
communicable
disease.