A Study to Assess the Validity of Community based Assessment Checklist - The Standard Non-Communicable Diseases Screening Tool of Frontline Health Workers

Abstract

Backgrounds: Around 63% of deaths in India are due to non-communicable diseases (NCD), and 1 in 4 Indians is at risk of premature death between 30 to 70 years of age. Considering this burden, the Government of India has introduced a Community Based Assessment Checklist (CBAC) to be used by frontline health workers for universal screening of populations aged more than 30 years for common NCDs as a part of Health and Wellness Centres under Ayushman Bharat.

Objectives: This study aimed to assess the validity of CBAC in the screening of common NCDs like diabetes mellitus and hypertension.

Methods: A cross-sectional study was done in the rural southern part of India among adults aged more than 30 years. A total of 110 participants were screened using CBAC. Random blood glucose (RBS) and blood pressure were measured. RBS more than 200 mg/dl and blood pressure equal to or more than 140/90 mmHg were considered as operational diagnostic criteria. The CBAC score >;4 was considered to be a risk for these NCDs. Data were collected in MS excel, and analysis was done using R software.

Results: A majority of participants belonged to the age group above 50 years (71%) and male sex (69%). The study participants' median (IQR) CBAC score was 5 (4-6), and 70% had scored more than 4. About 45% of participants had blood pressure equal to or more than 140/90 mmHg, 15% had RBS>200 mg/dl. and 51% had at least one abnormal parameter. The sensitivity of the current CBAC score cut-off was 85.7% and 53.7%, respectively. Analysis showed that if the cut-off score is reduced to equal to or more than 4, sensitivity increases to 98%.

Conclusion: Community based assessment checklist is a valid tool for NCD screening and high-risk behaviour among the community. However, decreasing the cut-off score to equal to or more than four will increase the sensitivity of CBAC.