A community-based cluster randomized survey of noncommunicable disease and risk factors in a peri-urban shantytown in Lima, Peru

Kristen Heitzinger, Silvia M. Montano, Stephen E. Hawes, Jorge O. Alarcón, Joseph R. Zunt

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Background: An estimated 863 million people-a third of the world's urban population-live in slums, yet there is little information on the disease burden in these settings, particularly regarding chronic preventable diseases. Methods. From March to May 2012, we conducted a cluster randomized survey to estimate the prevalence of noncommunicable diseases (NCDs) and associated risk factors in a peri-urban shantytown north of Lima, Peru. Field workers administered a questionnaire that included items from the WHO World Health Survey and the WHO STEPS survey of chronic disease risk factors. We used logistic regression to assess the associations of NCDs and related risk factors with age and gender. We accounted for sampling weights and the clustered sampling design using statistical survey methods. Results: A total of 142 adults were surveyed and had a weighted mean age of 36 years (range 18-81). The most prevalent diseases were depression (12%) and chronic respiratory disease (8%), while lifetime prevalence of cancer, arthritis, myocardial infarction, and diabetes were all less than 5%. Fifteen percent of respondents were hypertensive and the majority (67%) was unaware of their condition. Being overweight or obese was common for both genders (53%), but abdominal obesity was more prevalent in women (54% vs. 10% in men, p < 0.001). Thirty-five percent of men binge drank and 34% reported current smoking; these behaviors were less common among women (4% binge drank, p < 0.001; 8% smoked, p = 0.002). Increasing age was associated with an increased risk of abdominal obesity (Odds Ratio (OR) = 1.04, 95% CI = 1.01, 1.07, p = 0.02), hypertension (OR = 1.06, 95% CI = 1.02, 1.10, p = 0.006), arthritis (OR = 1.07, 95% CI = 1.03, 1.11, p < 0.001) and cancer (OR = 1.13, 95% CI = 1.07, 1.20, p < 0.001) in adjusted models. The prevalences of other NCDs and related risk factors were similar when stratified by age or gender. Conclusions: This study underlines the important burden of noncommunicable disease in informal settlements in Peru and suggests that prevention and treatment interventions could be optimized according to age and gender.

Original languageEnglish
Article number19
JournalBMC International Health and Human Rights
Issue number1
StatePublished - 21 May 2014

Bibliographical note

Funding Information:
We would like to express our gratitude to our study participants and the Lomas de Zapallal community for their support of this study. We would also like to thank the Sociedad Cientifica de San Fernando, Omar and Carlos Maguiña, and José Viñoles for their valuable contributions to data collection and Thanh Ton for her insights regarding study design. This work was supported by the National Institutes of Health Office of the Director, Fogarty International Center, Office of AIDS Research, National Cancer Center, National Eye Institute, National Heart, Blood, and Lung Institute, National Institute of Dental and Craniofacial Research, National Institute On Drug Abuse, National Institute of Mental Health, National Institute of Allergy and Infectious Diseases, and National Institutes of Health Office of Women’s Health and Research through the Fogarty International Clinical Research Scholars and Fellows Program at Vanderbilt University (R24 TW007988) and the American Relief and Recovery Act.


  • Noncommunicable disease
  • Peru
  • Shantytown
  • Slum


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