Cluster analysis of Noncommunicable disease risk factors among adults in Brunei: The National Health and Nutritional Status Survey based on WHO’s STEPwise methodology

Abstract

Abstract Background: Noncommunicable diseases (NCDs) constitute a major global health concern, accounting for 74% of annual deaths worldwide. In Brunei Darussalam, the population faces high prevalence of risk factors for NCDs. To monitor progress of interventions aimed at reducing NCDs, Brunei conducted the third National Health and Nutritional Survey (NHANSS) using WHO STEPs methodology in 2022-2023. Methods: Data from the NHANSS, comprising of 2,832 adults aged 18 to 69 in Brunei Darussalam were extracted and analysed. Clustering analysis was applied to identify naturally occurring clusters in the population based on NCD risk factors. Results: The analysis revealed five distinct clusters. Cluster 1 exhibited highest prevalence (79%) of insufficient fruit and vegetable intake. Clusters 2 and 4, predominantly male, exhibited smoking, low fruit and vegetable intake, and abdominal obesity despite physical activity. Cluster 3, mainly comprised of women and older adults, demonstrated highest physical inactivity. Cluster 5, comprised of non-smokers with lower incidences of diabetes mellitus and cardiovascular diseases among high income group. Conclusions: Effective population-based strategies, in line with the World Health Organization's recommendations, were proposed based on each cluster's characteristics. This underscores the Brunei government's commitment to implementing preventive measures and tailored interventions to mitigate the harmful impact of noncommunicable diseases.