Beyond the Numbers: Underreported Noncommunicable Disease Burden in Nomadic Communities

Dimitris Alexiou¹, Ioanna Kyriazis², James Whitaker³

Abstract

Background:
Nomadic populations are often excluded from routine health surveillance systems, leading to potential underreporting of noncommunicable diseases (NCDs) such as hypertension, diabetes, and respiratory disorders. This data invisibility hampers targeted public health interventions.

Objective:
To estimate the prevalence of selected NCDs in nomadic communities and compare self-reported versus objectively measured health outcomes.

Methods:
A mobile health screening initiative was conducted across four nomadic pastoralist regions in western China and Inner Mongolia between 2022 and 2024. A total of 612 adults were assessed using standardized NCD screening protocols (BP, HbA1c, spirometry). Self-reported health surveys were also collected. Prevalence estimates were compared to regional health database reports.

Results:
Hypertension prevalence based on direct BP measurement was 29.6%, while self-reported diagnosis was only 11.2% (p < 0.001). Diabetes (HbA1c ≥6.5%) was found in 13.4% of participants, with just 3.9% aware of their status. Chronic respiratory symptoms were noted in 26.1%, yet only 7.3% reported any previous evaluation. Compared to national registry data, NCD prevalence in these populations was underreported by 2.5 to 4.8-fold.

Conclusion:
NCDs are significantly underdetected in nomadic communities due to access barriers and reporting gaps. Traditional household survey designs may not capture mobile groups. Integrating mobile clinics with geospatial tracking and culturally sensitive health engagement strategies is essential to ensure equity in NCD surveillance and care.