A Mobile Phone-based Cross-Sectional National Survey of Risk Factors for Non-Communicable Diseases Risk Factors in Bangladesh

Background Non-communicable diseases (NCDs) are the leading cause of mortality in Bangladesh, yet the high cost of traditional face-to-face surveys limits frequent data collection. Mobile phone surveys (MPS) offer a potentially cost-effective and timely alternative for monitoring NCD risk factors. We aimed to determine the prevalence of key NCD risk factors in Bangladesh using a national mobile phone survey. Methods We conducted a nationwide cross-sectional survey using computer-assisted telephone interviews (CATI) with random digit dialing (RDD) between November 2023 and March 2024. We utilized a shortened version of the WHO STEPS tool to collect data on behavioral and metabolic risk factors. Complex quota sampling was employed to recruit participants across 48 strata based on age, sex, residence, and education. Iterative proportional fitting (IPF) weighting was used to ensure the representativeness of national estimates. Results A total of 7,757 participants were included in the analysis (weighted: 50.5% female; 68.5% rural). The weighted prevalence of current smoking was 20.5% (95% CI: 19.6%–21.5%), while 23.7% (95% CI: 22.6%–24.8%) used smokeless tobacco. Alcohol consumption was low at 1.3% (95% CI: 0.9%–1.6%). Inadequate fruit and vegetable intake was prevalent at 58.1% (95% CI: 56.8%–59.5%), and 54.0% (95% CI: 52.7%–55.4%) of respondents reported adding salt to food while eating. Approximately 20.1% (95% CI: 19.1%–21.0%) and 9.7% (95% CI: 8.9%–10.4%) of participants reported a known diagnosis of hypertension and diabetes, respectively. Multivariable analysis revealed that older age groups had significantly higher odds of hypertension (AOR: 27.0 for age 60+) and diabetes (AOR: 14.9 for age 60+) compared to those aged 18–29. Additionally, females had higher odds of inadequate fruit and vegetable intake (AOR: 2.0), hypertension (AOR: 1.9), and diabetes (AOR: 1.8) compared to males. Conclusion The high prevalence of clustered NCD risk factors underscores the urgent need for targeted public health interventions in Bangladesh. Our findings demonstrate that CATI-based surveillance is a feasible and effective method for providing timely, population-level NCD data in low- and middle-income countries.