NCDs SOLO
Questionnaire code
Sex of interviewee
How old are you? Adults age in years
What is the highest education level you completed
What is your current marital status?
What is your religion?
What ethnic group do you belong to?
What is your current occupation?
How much did you earn, before taxes and other deductions, during the past 12
How many people are currently living in your household, including yourself?
Functioning radio/tape
Functioning television
Stove (kerosene/electric)
Motorcycle
Watch (hand /wall)
Mobile phone
Local mattress
Solar energy
Bajaj
Bicycle
Chair
Bed
Shelf
Land (in hectare)
Cattles like cow, ox
Chicken
Horse, mule, donkey
Other (specify)
Did you ever smoked any tobacco products (egg. cigarette), shisha, Ganja?
Do you currently smoke any tobacco products (egg. cigarette), shisha, Ganja?
For how long did you smoke?
Average of consumption per a day
During the past 12 months, have you tried to stop smoking?
Have you ever consumed any alcohol such as beer, wine, tella, areqe, teji an
For how long did you consume any alcohol?
Have you consumed any alcohol within the past 12 months?
Have you stopped drinking due to health reasons, or on the advice of your do
During the past 12 months, how frequently have you had at least one standard
How often do you add salt or a salty sauce such as soya sauce to your food r
What type of oil or fat is most often used for meal preparation in your hous
Other
Breakfast
Snack between breakfast and lunch
Lunch
Snack between lunch and dinner
Dinner
Snack after dinner
Cereals
how many days did you or others in your HH consume any
Roots and tubers
Vitamin A rich vegetables and tubers, dark green leafy vegetables and other
Vitamin A rich fruits and other fruits
Flesh meats and organ meat
Eggs
Fish and sea foods
Legumes, nuts and seeds
Milk and milk Products
Oils and fats
Sweets
Spices, condiments, beverages
Does your work involve vigorous-intensity activity
In a typical week, on how many days do you do vigorous intensity activities
How much time (IN MINUTES ) do you spend doing vigorous-intensity activities
Does your work involve moderate-intensity activity
In a typical week, frequency of moderate intensity activities as part of you
How much time (IN MINUTES ) do you spend doing moderate-intensity activities
Do you walk or use a bicycle (pedal cycle) for at least 10 minutes continuou
In a typical week, on how many days do you walk or bicycle for at least 10 m
How much time (IN MINUTES ) do you spend walking or bicycling for travel on
Do you do any vigorous-intensity sports, fitness or recreational (Leisure)
In a typical week, on how many days do you do vigorous intensity sports, fi
How much time (IN MINUTES ) do you spend doing vigorous-intensity sports, f
Do you do any moderate-intensity sports, fitness or recreational activities
In a typical week, on how many days do you do moderate intensity sports, fi
How much time (IN MINUTES ) do you usually spend sitting or reclining on a
Have you ever had your blood pressure measured by a doctor or other health w
Have you ever been told by a doctor or other health worker that you have rai
Have you ever had your blood sugar measured by a doctor or other health work
Have you ever been told by a doctor or other health worker that you have blo
Have you ever had your cholesterol (fat levels in your blood) measured by a
Feeling nervous, anxious or on edge
Not being able to stop or control worrying
Worrying too much about different things
Trouble relaxing
Being so restless that it is hard to sit still
Becoming easily annoyed or irritable
Feeling afraid as if something awful might happen
If you checked off any problems, how difficult have these problems made it f
You drank alcohol even though a doctor suggested that you stop drinking beca
You drank alcohol, were high from alcohol, or hung over while you were work
You missed or were late for work, school, or other activities because you w
You had a problem getting along with other people while you were drinking
You drove a car after having several drinks or after drinking too much
If you checked off any problems, how difficult have these problems made it
Have you used drugs other than those required for medical reasons
Do you abuse more than one drug at a time
Are you unable to stop abusing drugs when you want to
Have you ever had blackouts or flashbacks as a result of drug use?
Do you ever feel bad or guilty about your drug use?
Do your spouse (parents) ever complain about your connection with drugs?
Have you neglected your family because of your use of drugs?
Have you engaged in illegal activities in order to obtain drugs?
Have you ever experienced felt sick when you stopped taking drugs?
Have you had medical problems as a result of your drug use (e.g. Memory los
Little interest or pleasure in doing things
Feeling down, depressed, or hopeless
Trouble falling or staying asleep, or sleeping too much
Feeling tired or having little energy
Poor appetite or overeating
Feeling bad about yourself
Trouble concentrating on things, such as reading the newspaper or watching
Moving or speaking so slowly that other people could have noticed
Thoughts that you would be better off dead or of hurting yourself in some w
HEIGHT IN CENTIMETER
WEIGHT IN KILOGRAM
Waist circumference
Hip circumference
Random blood glucose mg/dl
Total cholesterol mg/dl
Triglycerides mg/dl
HDL Cholesterol mg/dl
LDL cholesterol mg/dl
FIRST VISIT systolic mmHg
FIRST VISIT diastolic mmHg
Height in Meter
Categorized LDL
Categorized HDL
Body Mass Index
Categorized BMI
Categorized Random blood glucose level
Categorized Total Cholestrol
Categorized Triglyceride
Categorized Systolic blood pressure
Categorized Diastolic Blood pressure
waist to Hip ratio
Categorized waist to Hip ratio
Categorized waist Circumference
Rank of DDS_SUM
Percentile Group of DDS_SUM
REGR factor score 1 for analysis 1
REGR factor score 2 for analysis 1
REGR factor score 3 for analysis 1
REGR factor score 4 for analysis 1
REGR factor score 5 for analysis 1
REGR factor score 6 for analysis 1
REGR factor score 7 for analysis 1
Rank of FAC1_1
Percentile Group of FAC1_1
wc = 1 (FILTER)
Do you know FGIDs?
what is your sources of knowledge?
Do you have functional dyspepsia?
Which kind of functional dyspepsia (FD) symptoms you are under existing?
How long you are existing under such disorders in months ?
How long this symptoms onset in Month?
Do you have irritable bowel syndrome (IRB)?
kind Of irritable bowl syndrome you are under existing ?
How long you are existing under such disorders in months?
How long this symptoms onset in months?
Which kind of subtype IRB you are under existing in monthes?
How long you are existing under such subtype disorders in months?
Which kind of functional constipation (FC) you are under existing?
How long you are existing functional constipation disorders in months?
How long functional constipation symptoms onset in months?
hot drink of teas
hot drink of coffe
Health seeking practice
Risk of the the quantity of treated surface water avaliability in the next three weeks
Risk of the the quantity of unprotected well/s,bore hole/s ,spring/swater avaliability in the next three weeks
Risk of the the quantity of protected well/s,bore hole/s ,spring/s water avaliability in the next three weeks
Risk of the the quantity of tanker water avaliability in the next three weeks
Risk of the the quantity of traditional water sellers avaliability in the next three weeks
Risk of the the contamination of treated surface water at source it self or b/n the source the water collection point in the next three weeks
Risk of the the contamination of untreated surface water at source it self or b/n the source the water collection point in the next three weeks
Risk of the the contamination of unprotected well/s,bore hole/s ,spring/swater at source it self or b/n the source the water collection point in the next three weeks
Risk of the the contamination of protected well/s,bore hole/s ,spring/swaterat source it self or b/n the source the water collection point in the next three weeks
Risk of the the contamination of tanker water at source it self or b/n the source the water collection point in the next three weeks
Risk of the the contamination of water sellers at source it self or b/n the source the water collection point in the next three weeks
Open on ground, not in a defined defecation area
Open buried, not in a defecation area
Defecation area
Communal pit latrine /pour-flush latrine
Male/femalepit latrine / pour-flush latrine
Family pit latrine/pour-flush latrine
Sewage/ septic tank
estimated number of people/toilet
Is there significant presence of human faeces in and around toilets
Is there significant presence of general solid waste in and around toilets
Is there significant presence of animal faeces in and around toilets
Is there significant presence of animal carcasses in and around toilets
Is there significant presence of stagnant wast water/rain water in and around toilets
Are there any flies present in significant number in and aroind toilet
Are there any rodents present in significant number in and aroind toilet
Are there any body lice present in significant number in and aroind toilet
Safe use of toilets
Hand washing with soap after defecation
Hand washing with soap after dealing with babies’ faeces
Hand washing with soap before food preparation
Hand washing with soap before eating
Covering water in the household
Water treatment in the household
Covering food
Clean water
Suitable and accessible toilets
Suitable water containers
Anal cleansing materials
Soap
Sanitary cloths/items for women
Nappies/diapers for babies
In general, would you say your health is
Compared to one year ago, how would you rate your health in general now?
Vigorous activities, such as running, lifting heavy objects, participating in strenuous sports.
Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf
Lifting or carrying groceries
Climbing several flights of stairs
Climbing one flight of stairs
Bending, kneeling, or stooping
Walking more than a mile
Walking several blocks
Walking one block
Bathing or dressing yourself
The past 4 weeks,due physical problem , have you Cut down the amount of time you spent on work or other activities
The past 4 weeks,due physical problem ,have you Accomplished less than you would like
The past 4 weeks,due physical problem, have you limited in the kind of work or other activities
The past 4 weeks,due physical problem, have you difficulty in performing the work or other activities
The past 4 weeks,due emotional problem have you Cut down the amount of time you spent on work or other activities
The past 4 weeks,due emotional problem have you Accomplished less than you would like
The past 4 weeks,due emotional problem didn't do work/other activities as carfully as usual
Emotional problems interfered with your normal social activities with family, friends, neighbors, or groups?
How much bodily pain have you had during the past 4 weeks?
During the past 4 weeks, how much did pain interfere with your normal work?
Did you feel full of pep?energy and high spritis?
Have you been a very nervous person?
Have you felt so down in the dumps that nothing could cheer you up?
Have you felt calm and peaceful?
Did you have a lot of energy?
Have you felt downhearted and blue?
Did you feel worn out?
Have you been a happy person?
Did you feel tired?
During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting with friends, relatives, etc.)?