Abstract

Background: Non-communicable diseases (NCDs) such as cardiovascular disease, diabetes, chronic respiratory illnesses, and cancer have emerged as leading causes of morbidity and mortality worldwide, with Central Asia witnessing a rising burden. Kyrgyzstan, a developing country in the heart of the region, faces significant challenges due to limited healthcare infrastructure and socio-economic barriers.

Objective: This study investigates the prevalence, risk factors, and public health implications of NCDs in Jalal-Abad, a region representative of Kyrgyzstan’s broader health trends.

Methods: A cross-sectional, community-based survey was conducted across Jalal-Abad region from July to October 2024. Participants (n=1,200) were selected using stratified random sampling. Data on demographics, lifestyle habits, medical history, and clinical indicators were collected and analyzed.

Results: Of the participants, 32.5% had hypertension, 14.8% had type 2 diabetes, and 9.6% had evidence of chronic respiratory illness. Cardiovascular risk factors such as smoking (29.1%), obesity (23.4%), and physical inactivity (41.2%) were common. Awareness and treatment rates were significantly low, especially among rural populations.

Conclusion: The burden of NCDs in Jalal-Abad is high and growing, necessitating urgent public health interventions. Enhanced screening, education, and access to primary healthcare services are essential to mitigate future complications and mortality.

Keywords: non-communicable diseases, Kyrgyzstan, Jalal-Abad, public health, hypertension, diabetes, epidemiology

Introduction

Non-communicable diseases (NCDs) account for over 70% of global deaths, with low- and middle-income countries (LMICs) experiencing the most rapid increases. The transition from infectious to chronic disease burden is reshaping public health landscapes across Central Asia, including the Kyrgyz Republic. In this context, Jalal-Abad—a diverse and densely populated region in southwestern Kyrgyzstan—serves as a microcosm for examining the growing impact of NCDs.

Despite improvements in healthcare accessibility and reforms supported by international agencies, Kyrgyzstan remains challenged by outdated infrastructure, fragmented services, and inadequate chronic disease management systems. Several studies highlight an emerging epidemiological shift driven by urbanization, aging populations, dietary changes, and sedentary lifestyles. However, limited local data hinders comprehensive planning and policy formation.

This study was initiated to estimate the prevalence of major NCDs and their risk factors in Jalal-Abad, to contribute to the evidence base for regional public health interventions. By profiling disease patterns and associated behaviors, the study aims to inform both local and national strategies aligned with WHO's NCD Global Action Plan.

Methods

Study Design and Setting

A descriptive, cross-sectional study was conducted between July and October 2024 in Jalal-Abad, Kyrgyzstan. The region includes both urban and rural populations, encompassing diverse ethnic and socioeconomic backgrounds.

Sampling Technique

A stratified random sampling method was employed to ensure representative coverage. The sample frame was divided into four strata based on geographic zones (urban, peri-urban, rural plain, rural mountainous). Within each stratum, clusters (villages or neighborhoods) were randomly selected. Households were approached systematically, and one adult (aged ≥18 years) per household was recruited using the Kish grid method. The final sample consisted of 1,200 individuals.

Inclusion and Exclusion Criteria

Inclusion criteria: adults aged 18 years or older, permanent residents of Jalal-Abad for at least 6 months, and willing to provide informed consent. Exclusion criteria included pregnant women, critically ill individuals, and temporary visitors.

Data Collection Tools

Data were collected through face-to-face interviews and clinical examinations. A structured questionnaire adapted from WHO STEPS was used, translated into Kyrgyz and Russian. It covered:

• Demographics (age, sex, education, occupation)
  
  

• Lifestyle factors (smoking, alcohol, diet, physical activity)
  
  

• Medical history (hypertension, diabetes, respiratory diseases)
  
  

• Anthropometric data (weight, height, BMI)
  
  

• Blood pressure measurement (average of two readings)
  
  

• Random blood glucose testing (capillary method)
  
  

Ethical Considerations

Ethical clearance was obtained from the Research Ethics Committee of Jalal-Abad State University. Participants provided informed consent. Privacy and confidentiality were maintained throughout.

Statistical Analysis

Data were entered in SPSS version 26. Descriptive statistics (means, proportions) were used for baseline characteristics. Associations between variables (e.g., smoking and hypertension) were tested using Chi-square tests and logistic regression where appropriate. A p-value <0.05 was considered statistically significant.

Results

Demographic Profile

The study sample included 1,200 participants: 52% female and 48% male. The mean age was 43.6 years (SD ±12.7). Approximately 67% lived in rural settings, and 74% had completed secondary education. Monthly household income was below the national average in 59% of respondents.

Prevalence of NCDs

• Hypertension: 32.5% (n=390)
  
  

• Type 2 Diabetes: 14.8% (n=177)
  
  

• Chronic Respiratory Illnesses (e.g., COPD, asthma): 9.6% (n=115)
  
  

• Ischemic Heart Disease (self-reported diagnosis): 6.1% (n=73)
  
  

Risk Factors

• Smoking (current): 29.1% overall (men 46.5%, women 12.8%)
  
  

• Obesity (BMI ≥30): 23.4%
  
  

• Physical inactivity (self-reported <150 mins/week): 41.2%
  
  

• Low fruit and vegetable intake (≤2 servings/day): 64.7%
  
  

• Harmful alcohol use: 17.6% (higher in men)
  
  

Awareness and Management

Only 51% of hypertensive participants were aware of their condition. Of those aware, just 34% were on regular medication, and only 18% had controlled blood pressure (<140/90 mmHg). Diabetes awareness was similarly low at 44%, with medication adherence at 29%. Rural participants had significantly lower awareness and treatment rates than urban residents (p<0.01).

Discussion

The findings from Jalal-Abad reflect a growing NCD crisis in Kyrgyzstan. The high prevalence of hypertension, diabetes, and behavioral risk factors align with national trends and WHO reports. However, the low levels of disease awareness and treatment suggest that health system responsiveness remains weak.

Hypertension and Diabetes:
With nearly one-third of adults affected, hypertension is the leading NCD concern. The figures are consistent with studies from Kazakhstan and Uzbekistan, suggesting a regional health emergency. Diabetes prevalence, while lower, is expected to rise rapidly with increasing obesity and sedentary behaviors. Community awareness programs remain underutilized, despite global evidence of their efficacy.

Tobacco and Alcohol Use:
Tobacco use remains alarmingly high among males, driven by cultural acceptance and lack of regulatory enforcement. Alcohol misuse, although underreported due to stigma, is a silent contributor to liver disease and accidents. Smoking cessation initiatives and alcohol education programs are urgently needed.

Obesity and Nutrition:
A quarter of participants were obese, and dietary practices were suboptimal. Public health messaging on nutrition and physical activity is sparse in the region. School-based education and community-level campaigns may play a transformative role if supported by the government and NGOs.

Health System Gaps:
The poor rates of treatment and disease control expose the fragility of the primary healthcare system in Jalal-Abad. Resource constraints, drug stockouts, and low health literacy compound the problem. Strategies such as task-shifting, community health workers, and mobile screening units could bridge the accessibility gap.

Conclusion

Non-communicable diseases are becoming the dominant public health challenge in Jalal-Abad and across Kyrgyzstan. This study highlights the urgent need for comprehensive prevention, screening, and management programs. The findings also point toward the necessity of investing in primary care, public awareness, and policy-level changes to counter the NCD epidemic.

Efforts should be multi-sectoral, involving education, agriculture, finance, and health departments. As Kyrgyzstan moves forward with its development goals, addressing the NCD burden must be a national priority.

References

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8. Institute for Health Metrics and Evaluation. NCD Risk Factors by Country. Seattle, WA.