A cross-sectional study on hypertension and diabetes care cascade and prevalence of noncommunicable diseases (NCD) risk factors in Tamil Nadu: rationale and methods

BackgroundNoncommunicable diseases (NCDs) account for over 65% of all deaths in India, as per the Global Burden of Disease Report, 2019. In Tamil Nadu, a southern state in India, more than 75% of all deaths were due to NCDs. To counter the problem, the government of Tamil Nadu launched a flagship project called Makkalai Thedi Maruthuvam (MTM), a scheme that provides a comprehensive range of home-based services and doorstep delivery of drugs for NCDs. We propose to undertake a representative survey suitably designed using the WHO STEP-wise approach to estimate the proportion of individuals with hypertension or diabetes with controlled blood pressure or blood sugar in Tamil Nadu, 2024. ObjectivesThe primary objective is to estimate the proportion of of individuals with hypertension or diabetes with controlled blood pressure or blood sugar control among individuals aged 18-69 years. The secondary objective is to estimate the prevalence of behavioural and biological risk factors for NCDs. Methods and analysisThis cross-sectional study will be conducted in all districts of Tamil Nadu. We will collect data on socioeconomic status, behavioural risk factors, and physical measurements. Data will be collected on the history of screening, diagnosis, and treatment services for diabetes, hypertension, and cancer screening for oral, breast, and cervix adopted from the WHO STEPS questionnaire. Key indicators related to the burden and continuum of care for hypertension and diabetes will be estimated using complex sample wieghted analysis to estimate percentages with 95% confidence intervals. Ethics and disseminationThis study proposal was approved by the institutional ethics committee. The results of our study will be shared through the manuscripts in peer-reviewed journals. Additionally, the findings will be presented to the relevant public health authorities in India for drafting NCD policies and management.