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Okyere J, Ayebeng C, Dickson KS. Burden of non-communicable diseases among women of reproductive age in Kenya: a cross-sectional study. BMJ Open 2024; 14:e078666. [PMID: 39002967 PMCID: PMC11253757 DOI: 10.1136/bmjopen-2023-078666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 06/28/2024] [Indexed: 07/15/2024] Open
Abstract
OBJECTIVE To examine the burden of non-communicable diseases (NCDs) among women of reproductive age in Kenya, highlighting the prevalence and risk factors. DESIGN Cross-sectional design based on the 2022 Kenya Demographic and Health Survey. SETTING Kenya. PRIMARY OUTCOMES Predict the burden of hypertension, diabetes, heart disease, lung disease, arthritis, depression, anxiety, breast and cervical cancer. RESULTS Overall, 15.9% of Kenyan women aged 15-49 years were living with at least one NCD. The most prevalent NCD among this cohort was hypertension (8.7%) followed by arthritis (2.9%) and depression (2.8%). Our findings revealed that increasing age, increasing wealth, being married or formerly married, being overweight or obese, consuming alcohol and some occupations were risk factors of NCDs among women of reproductive age in Kenya. CONCLUSION We conclude that hypertension is the most prevalent NCD among women of reproductive age in Kenya. The findings underscore the multifaceted nature of NCD risk factors in Kenya, emphasising the importance of targeted interventions that consider age, economic status, education, marital status, occupation and lifestyle factors.
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Affiliation(s)
- Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Castro Ayebeng
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
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Talukder A, Sara SS, Hossain MT, Nath CD, Rahman R, Hussain S, Sarma H, Huda MN. Rural and urban differences in the prevalence and determinants of Type-2 diabetes in Bangladesh. PLoS One 2024; 19:e0298071. [PMID: 38603719 PMCID: PMC11008877 DOI: 10.1371/journal.pone.0298071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/18/2024] [Indexed: 04/13/2024] Open
Abstract
OBJECTIVE To estimate the prevalence of Type 2 Diabetes (T2D) in urban and rural settings and identify the specific risk factors for each location. METHOD We conducted this study using data from the 2017-18 Bangladesh Demographic and Health Survey (BDHS), sourced from the DHS website. The survey employed a stratified two-stage sampling method, which included 7,658 women and 7,048 men aged 18 and older who had their blood glucose levels measured. We utilized chi-square tests and ordinal logistic regression to analyze the association between various selected variables in both urban and rural settings and their relationship with diabetes and prediabetes. RESULTS The prevalence of T2D was 10.8% in urban areas and 7.4% in rural areas, while pre-diabetes affected 31.4% and 27% of the populations in these respective settings. The study found significant factors influencing diabetes in both urban and rural regions, particularly in the 55-64 age group (Urban: AOR = 1.88, 95% CI [1.46, 2.42]; Rural: AOR = 1.87, 95% CI [1.54, 2.27]). Highly educated individuals had lower odds of T2D, while wealthier and overweight participants had higher odds in both areas. In rural regions, T2D risk was higher among caffeinated drink consumers and those not engaged in occupation-related physical activity, while these factors did not show significant influence in urban areas. Furthermore, urban participants displayed a significant association between T2D and hypertension. CONCLUSION Our study outlines a comprehensive strategy to combat the increasing prevalence of T2D in both urban and rural areas. It includes promoting healthier diets to control BMI level, encouraging regular physical activity, early detection through health check-ups, tailored awareness campaigns, improving healthcare access in rural regions, stress management in urban areas, community involvement, healthcare professional training, policy advocacy like sugary drink taxation, research, and monitoring interventions. These measures collectively address the T2D challenge while accommodating the distinct features of urban and rural settings.
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Affiliation(s)
- Ashis Talukder
- Statistics Discipline, Science Engineering and Technology School, Khulna University, Khulna, Bangladesh
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Sabiha Shirin Sara
- Statistics Discipline, Science Engineering and Technology School, Khulna University, Khulna, Bangladesh
| | - Md. Tanvir Hossain
- Sociology Discipline, Social Science School, Khulna University, Khulna, Bangladesh
| | - Chuton Deb Nath
- Mass Communication and Journalism Discipline, Social Science School, Khulna University, Khulna, Bangladesh
| | - Riaz Rahman
- Statistics Discipline, Science Engineering and Technology School, Khulna University, Khulna, Bangladesh
| | - Sadiq Hussain
- Examination Branch, Dibrugarh University, Dibrugarh, India
| | - Haribondhu Sarma
- Research Fellow, National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Md. Nazmul Huda
- Translational Health Research Institute, Western Sydney University, Campbell Town, NSW, Australia
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Ahmmed F, Hossain MJ, Khan MTF, Manik MMR, Shahriar S, Nandi DC, Hussain MP. Mediating effect of BMI on the association of economic status and coexistence of hypertension and diabetes in Bangladesh: A counterfactual framework-based weighting approach. Health Sci Rep 2024; 7:e2063. [PMID: 38660004 PMCID: PMC11039488 DOI: 10.1002/hsr2.2063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 03/31/2024] [Accepted: 04/07/2024] [Indexed: 04/26/2024] Open
Abstract
Background and Aims Non-communicable diseases such as hypertension and diabetes are matters of huge concern worldwide, with an increasing trend in prevalence over the previous decade. First of all, this study aimed to evaluate the association between economic status (ES) and body mass index (BMI), ES and comorbidity of hypertension and diabetes, and BMI and comorbidity independently. Second, it explored the mediating role of BMI in the association between ES and comorbidity of hypertension and diabetes. Finally, it investigated whether the mediating effect differs with the place of residence, gender, and education levels. Methods A total of 11,291 complete cases from the Bangladesh demographic and health survey 2017-18 were utilized for this study. Survey-based binary logistic regression or multiple logistic regression was used to find the association among outcome, exposure, and mediator variables, and a counterfactual framework-based weighting approach was utilized for mediation analysis. Results Middle-income (adjusted odds ratio [AOR]: 1.696, 95% confidence interval [CI]: 1.219, 2.360) and rich (AOR: 2.770, CI: 2.054, 3.736) respondents were more likely to have comorbidity of hypertension and diabetes compared to the poor. The odds of comorbidity increased with the increase in BMI. A positive association was observed between ES and BMI. A significant mediating role of BMI in the association between ES and comorbidity was found. We observed that 19.85% (95% CI: 11.50%, 49.6%) and 20.35% (95% CI: 14.9%, 29.3%) of total effect was mediated by BMI for middle and rich respondents, respectively, compared to the poor. Conclusions The mediating role of BMI was greater for female, no or primary educated respondents, and respondents from rural areas. Therefore, the study will facilitate policymakers of Bangladesh and other countries with a similar set-up to decide on health policies regarding hypertension and diabetes.
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Affiliation(s)
- Foyez Ahmmed
- Department of StatisticsComilla UniversityCumillaBangladesh
- Department of Biostatistics & Data ScienceUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Md. Jamal Hossain
- Department of Pharmacy, School of Pharmaceutical SciencesState University of BangladeshDhakaBangladesh
| | | | | | - Saimon Shahriar
- Department of Pharmacy, School of Pharmaceutical SciencesState University of BangladeshDhakaBangladesh
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Gerety MK, Kim DK, Carpenter RM, Ma JZ, Chisholm C, Taniuchi M, Islam MO, Pholwat S, Platts-Mills JA, Siraj MS, Billah SM, Haque R, Petri WA. Systemic inflammation, enteropathogenic E. Coli, and micronutrient insufficiencies in the first trimester as possible predictors of preterm birth in rural Bangladesh: a prospective study. BMC Pregnancy Childbirth 2024; 24:82. [PMID: 38267943 PMCID: PMC10807221 DOI: 10.1186/s12884-024-06266-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/10/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND An incomplete understanding of preterm birth is especially concerning for low-middle income countries, where preterm birth has poorer prognoses. While systemic proinflammatory processes are a reportedly normal component of gestation, excessive inflammation has been demonstrated as a risk factor for preterm birth. There is minimal research on the impact of excessive maternal inflammation in the first trimester on the risk of preterm birth in low-middle income countries specifically. METHODS Pregnant women were enrolled at the rural Bangladesh site of the National Institute of Child Health Global Network Maternal Newborn Health Registry. Serum samples were collected to measure concentrations of the inflammatory markers C-reactive protein (CRP) and Alpha-1-acid glycoprotein (AGP), and stool samples were collected and analyzed for enteropathogens. We examined associations of maternal markers in the first-trimester with preterm birth using logistic regression models. CRP and AGP were primarily modeled with a composite inflammation predictor. RESULTS Out of 376 singleton births analyzed, 12.5% were preterm. First trimester inflammation was observed in 58.8% of all births, and was significantly associated with increased odds of preterm birth (adjusted odds ratio [aOR] = 2.23; 95% confidence interval [CI]: 1.03, 5.16), independent of anemia. Maternal vitamin B12 insufficiency (aOR = 3.33; 95% CI: 1.29, 8.21) and maternal anemia (aOR = 2.56; 95% CI: 1.26, 5.17) were also associated with higher odds of preterm birth. Atypical enteropathogenic E. coli detection showed a significant association with elevated AGP levels and was significantly associated with preterm birth (odds ratio [OR] = 2.36; 95% CI: 1.21, 4.57), but not associated with CRP. CONCLUSIONS Inflammation, anemia, and vitamin B12 insufficiency in the first trimester were significantly associated with preterm birth in our cohort from rural Bangladesh. Inflammation and anemia were independent predictors of premature birth in this low-middle income setting where inflammation during gestation was widespread. Further research is needed to identify if infections such as enteropathogenic E. coli are a cause of inflammation in the first trimester, and if intervention for infection would decrease preterm birth.
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Affiliation(s)
- Meghan K Gerety
- Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Debora K Kim
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA
| | - Rebecca M Carpenter
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA
| | - Jennie Z Ma
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Christian Chisholm
- Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Mami Taniuchi
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Md Ohedul Islam
- The International Centre for Diarrhoeal Disease and Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Suporn Pholwat
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - James A Platts-Mills
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Md Shahjahan Siraj
- The International Centre for Diarrhoeal Disease and Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sk Masum Billah
- The International Centre for Diarrhoeal Disease and Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Rashidul Haque
- The International Centre for Diarrhoeal Disease and Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - William A Petri
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, USA
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Talin IA, Abid MH, Samad MA, Domínguez Azpíroz I, de la Torre Diez I, Ashraf I, Nahid AA. Exploring factors influencing the severity of pregnancy anemia in India: a study using proportional odds model. Sci Rep 2023; 13:22816. [PMID: 38129518 PMCID: PMC10739876 DOI: 10.1038/s41598-023-49872-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
Pregnancy-associated anemia is a significant health issue that poses negative consequences for both the mother and the developing fetus. This study explores the triggering factors of anemia among pregnant females in India, utilizing data from the Demographic and Health Survey 2019-21. Chi-squared and gamma tests were conducted to find out the relationship between anemia and various socioeconomic and sociodemographic elements. Furthermore, ordinal logistic regression and multinomial logistic regression were used to gain deeper insight into the factors that affect anemia among pregnant women in India. According to these findings, anemia affects about 50% of pregnant women in India. Anemia is significantly associated with various factors such as geographical location, level of education, and wealth index. The results of our study indicate that enhancing education and socioeconomic status may serve as viable approaches for mitigating the prevalence of anemia disease developed in pregnant females in India. Employing both Ordinal and Multinominal logistic regression provides a more comprehensive understanding of the risk factors associated with anemia, enabling the development of targeted interventions to prevent and manage this health condition. This paper aims to enhance the efficacy of anemia prevention and management strategies for pregnant women in India by offering an in-depth understanding of the causative factors of anemia.
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Affiliation(s)
- Iffat Ara Talin
- Electronics and Communication Engineering Discipline, Khulna University, Khulna, 9208, Bangladesh
| | - Mahmudul Hasan Abid
- Electronics and Communication Engineering Discipline, Khulna University, Khulna, 9208, Bangladesh
| | - Md Abdus Samad
- Department of Information and Communication Engineering, Yeungnam University, Gyeongsan-si, Gyeongsangbuk-do, 38541, South Korea.
| | - Irma Domínguez Azpíroz
- Universidad Europea del Atlántico, Isabel Torres 21, 39011, Santander, Spain
- Universidad Internacional Iberoamericana, 24560, Campeche, Mexico
- Universidade Internacional do Cuanza, Cuito, Bié, Angola
| | - Isabel de la Torre Diez
- Department of Signal Theory, Communications and Telematics Engineering, Unviersity of Valladolid, Paseo de Belén, 15, 47011, Valladolid, Spain
| | - Imran Ashraf
- Department of Information and Communication Engineering, Yeungnam University, Gyeongsan-si, Gyeongsangbuk-do, 38541, South Korea.
| | - Abdullah-Al Nahid
- Electronics and Communication Engineering Discipline, Khulna University, Khulna, 9208, Bangladesh.
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Shil A, Zhang J, Chichger H. Investigating the use and awareness of artificial sweeteners among diabetic patients in Bangladesh. PLoS One 2023; 18:e0295272. [PMID: 38091359 PMCID: PMC10718416 DOI: 10.1371/journal.pone.0295272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 11/19/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND As with many countries around the world, the incidence of diabetes in Bangladesh is increasing significantly. Whilst there is controversy in the field regarding the health impact of artificial sweeteners in Western communities, the link between sweetener consumption and awareness in Bangladesh has not been established. METHODS In the present study, 260 diabetic patients completed a questionnaire survey to investigate the use and awareness of sweeteners and how this links to demographics and potential co-morbidities. RESULTS Findings show that daily artificial sweetener consumption is significantly associated with hypertension but not other co-morbidities such as kidney disease or obesity. We further demonstrate that there is limited checking of artificial sweeteners in food or drink products by participants. the rurality of diabetic participants was found to significantly correlates with lower awareness of any health impact of artificial sweeteners. CONCLUSIONS The findings from this study demonstrate that there is a need to increase the awareness of artificial sweetener use in diabetic patients in Bangladesh. Combined with a more robust understanding of the health impact of artificial sweeteners, these findings suggest that there is potential to improve outcomes for diabetic patients by improving this awareness.
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Affiliation(s)
- Aparna Shil
- Department of Botany, Jahangirnagar University, Dhaka, Bangladesh
| | - Jufen Zhang
- Clinical Trial Unit, School of Medicine, Anglia Ruskin University, Cambridge, United Kingdom
| | - Havovi Chichger
- Biomedical Research Group, School of Life Science, Anglia Ruskin University, Cambridge, United Kingdom
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Faruque M, Barua L, Rakhshanda S, Banik PC, Shawon RA, Rahman AKMF, Mashreky SR. Baseline prevalence of hyperglycemia and its predictors among community clinic users of a selected rural area of Bangladesh: A cross-sectional study using the WHO PEN Protocol 1. J Diabetes Investig 2023; 14:1368-1377. [PMID: 37610272 PMCID: PMC10688118 DOI: 10.1111/jdi.14074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/30/2023] [Accepted: 08/09/2023] [Indexed: 08/24/2023] Open
Abstract
AIMS/INTRODUCTION Our objective was to estimate the prevalence of hyperglycemia at baseline, and identify its predictors among community clinic (CC) users from a selected rural area of Bangladesh. MATERIALS AND METHODS This cross-sectional study partly used the baseline data of implementation research in which a total of 11,244 adults visited the CC, and their blood glucose, blood pressure and anthropometry were evaluated according to 'Action 2' of the World Health Organization (WHO) Package of Essential Noncommunicable Disease Interventions (PEN) protocol 1. Of these, 11,144 had complete information on demography, chronic diseases and their risk factors, which were collected during the implementation of 'Action 1' of WHO PEN protocol 1 at the household level. Hyperglycemia, prediabetes (PreD) and type 2 diabetes were diagnosed using the WHO criteria. RESULTS Using WHO PEN protocol 1, the estimated baseline prevalence was 12.5% for hyperglycemia, 3.4% for PreD and 9.2% for type 2 diabetes, and was more prevalent among men compared with women. PreD and type 2 diabetes had significantly higher odds ratio (OR >1) of having common risk factors as follows: age ≥40 years (PreD, P < 0.001; type 2 diabetes, P < 0.001), generalized obesity (PreD, P < 0.001; type 2 diabetes, P = 0.005) and hypertension (PreD, P < 0.000; type 2 diabetes, P < 0.001). Furthermore, participants with a family history of diabetes appeared to be a significant predictor of type 2 diabetes (P < 0.001), but not for PreD (P = 0.303). CONCLUSIONS Hyperglycemia, preD and type 2 diabetes showed a comparatively high prevalence among the CC users of the selected rural area. Obesity and hypertension are the key modifiable risk factors that should be reduced using a CC-centered risk reduction strategy.
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Affiliation(s)
- Mithila Faruque
- Department of Noncommunicable DiseasesBangladesh University of Health Sciences (BUHS)DhakaBangladesh
| | - Lingkan Barua
- Department of Noncommunicable DiseasesBangladesh University of Health Sciences (BUHS)DhakaBangladesh
| | | | - Palash Chandra Banik
- Department of Noncommunicable DiseasesBangladesh University of Health Sciences (BUHS)DhakaBangladesh
| | - Riffat Ara Shawon
- Centre for Injury Prevention and Research Bangladesh (CIPRB)DhakaBangladesh
| | - AKM Fazlur Rahman
- Centre for Injury Prevention and Research Bangladesh (CIPRB)DhakaBangladesh
| | - Saidur Rahman Mashreky
- Department of Noncommunicable DiseasesBangladesh University of Health Sciences (BUHS)DhakaBangladesh
- Centre for Injury Prevention and Research Bangladesh (CIPRB)DhakaBangladesh
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Aktar MF, Chowdhury MH, Rahman MS. A quantile regression approach to identify risk factors for high blood glucose levels among Bangladeshi individuals. Health Sci Rep 2023; 6:e1772. [PMID: 38116173 PMCID: PMC10728372 DOI: 10.1002/hsr2.1772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 12/21/2023] Open
Abstract
Background and Aims Diabetes mellitus, characterized by high blood glucose, is an overwhelming public health concern globally, including in Bangladesh. The implication of this trend may pose a significant challenge to the health systems due to the lack of awareness and improper management of this chronic disease. To formulate strategies for public health planning, this study aims to explore the potential risk factors for elevated blood glucose levels among Bangladeshi individuals using advanced statistical methods and a nationally representative data set. Methods This study utilized data from the 2017-18 Bangladesh Demographic and Health Survey and included 11,863 individuals. A nonparametric Kruskal-Wallis test assessed the significant association between fasting plasma glucose levels and various risk factors. Additionally, a robust quantile regression model was applied to examine the net effects of each risk factor at different quantiles of the distribution. Results The prevalence of diabetes is 8.1% among individuals in the study population, with variations observed across different administrative divisions in the country. Respondents from the Dhaka division respondents had a higher likelihood (24.1%) of having elevated plasma glucose and the Rangpur division had a lower risk (10.3%) of developing diabetes disease. This study identified several potential risk factors associated with elevated blood glucose levels, including hypertensive disease, overweight and obese body mass index, higher economic status, reduced physical activities, and older age, significantly contributing to develop diabetes mellitus. Conclusion This study recommends promoting healthy lifestyles, increased physical activity, effective hypertension management, obesity reduction, and nationwide screening programs to control diabetes and noncommunicable diseases in Bangladesh. These preventive measures are crucial for reducing the existing prevalence of diabetes and working toward achieving the Sustainable Development Goals by 2030.
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Affiliation(s)
- Mst. Farjana Aktar
- Department of StatisticsMawlana Bhashani Science and Technology UniversitySantoshBangladesh
| | - Mashfiqul Huq Chowdhury
- Department of StatisticsMawlana Bhashani Science and Technology UniversitySantoshBangladesh
- School of Mathematics and StatisticsVictoria University of WellingtonWellingtonNew Zealand
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Sen KK, Jamee AR, Islam UN, Bari W. Unveiling the effects of living standards on diabetes and hypertension with the mediating role of overweight and obesity: a cross-sectional study in Bangladesh. BMJ Open 2023; 13:e075370. [PMID: 37963706 PMCID: PMC10649606 DOI: 10.1136/bmjopen-2023-075370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 10/26/2023] [Indexed: 11/16/2023] Open
Abstract
OBJECTIVE The purpose of the study was to ascertain how the standard of living is associated with the likelihood of developing diabetes and hypertension directly as well as indirectly through overweight and obesity. STUDY DESIGN The study used 2017-2018 Bangladesh Demographic and Health Survey data. It examined the household living standard (LSD) as the main factor, and body mass index (BMI) as a mediator. Outcomes included diabetes status, hypertension status and their co-occurrence. Structural equation modelling with logistic regression and bootstrapping were used for mediation analysis and computing bias-corrected SEs. SETTING The research was carried out in Bangladesh and included both male and female adults. PARTICIPANTS The study encompassed a total of 11 961 adults (5124 males and 6837 females) aged 18 years or older. RESULTS Among the participants, 10.3% had diabetes, 28.6% had hypertension and 4.9% had both conditions. The prevalence of diabetes, hypertension or both conditions was 18.5%, 33.5% and 9.7%, respectively, among those with a high LSD. Regression analysis demonstrated that individuals with high LSD had significantly elevated risks of these conditions compared with those with low LSD: 133% higher odds for diabetes (OR 2.22; 95% CI 1.97 to 2.76), 25% higher odds for hypertension (OR 1.25; 95% CI 1.10 to 1.42) and 148% higher odds for both conditions (OR 2.48; 95% CI 1.96 to 3.14). Moreover, the indirect effects of high LSD through obesity surpassed its direct effects for developing diabetes, hypertension or both conditions. CONCLUSION This study emphasises that with the enhancement of LSD, individuals often experience weight gain, resulting in elevated BMI levels. This cascade effect significantly amplifies the risks of diabetes, hypertension or both conditions. To counteract this concerning trajectory, policy interventions and targeted awareness campaigns are imperative. These efforts must prioritise the promotion of heightened physical activity and the mitigation of the overweight/obesity surge associated with rising LSD.
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Affiliation(s)
| | | | | | - Wasimul Bari
- Department of Statistics, University of Dhaka, Dhaka, Bangladesh
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Cai A, Zheng C, Qiu J, Fonarow GC, Lip GYH, Feng Y, Wang Z. Prevalence of heart failure stages in the general population and implications for heart failure prevention: reports from the China Hypertension Survey 2012-15. Eur J Prev Cardiol 2023; 30:1391-1400. [PMID: 37410587 DOI: 10.1093/eurjpc/zwad223] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 06/18/2023] [Accepted: 07/04/2023] [Indexed: 07/08/2023]
Abstract
AIMS There are no nationwide epidemiological data on heart failure (HF) stages in China. Knowledge of the prevalence of HF stages is crucial for planning HF prevention and management strategies. We aimed to evaluate the prevalence of HF stages in the general Chinese population and the specific prevalence by age, sex, and urbanity. METHODS AND RESULTS This is a cross-sectional study and national representative general population aged ≥ 35 years (n = 31 494, mean age 57.4 years, women 54.1%) were obtained from the China Hypertension Survey. Participants were divided into Stage A (at-risk for HF), Stage B (pre-HF), and Stage C (symptomatic HF). Survey weights were calculated based on the 2010 China population census data. The prevalence of Stage A was 35.8% (≈245.1 million), Stage B 42.8% (≈293.1 million), and Stage C 1.1% (≈7.5 million). The prevalence of Stages B and C increased with increasing age (P < 0.0001). Women had lower prevalence of Stage A (32.6% vs. 39.3%; P < 0.0001) but higher prevalence of Stage B (45.9% vs. 39.5%; P < 0.0001) than men. People from rural area had lower prevalence of Stage A (31.9% vs. 41.0%; P < 0.0001) but higher prevalence of Stage B (47.8% vs. 36.2%; P < 0.0001) than people from urban. The prevalence of Stage C was similar by sex and urbanity. CONCLUSION The burdens of pre-clinical and clinical HF are high and vary by age, sex, and urbanity in China. Targeted interventions are needed to reduce the high burden of pre-clinical and clinical HF.
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Affiliation(s)
- Anping Cai
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, No.106, Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, China
| | - Congyi Zheng
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 15 (Lin), Fengcunxili, Mentougou District, Beijing 102308, China
| | - Jiayuan Qiu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou 201701, China
| | - Gregg C Fonarow
- Division of Cardiology, Department of Medicine, Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
- Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Yingqing Feng
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, No.106, Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, China
| | - Zengwu Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 15 (Lin), Fengcunxili, Mentougou District, Beijing 102308, China
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Kaombe TM, Hamuza GA. Impact of ignoring sampling design in the prediction of binary health outcomes through logistic regression: evidence from Malawi demographic and health survey under-five mortality data; 2000-2016. BMC Public Health 2023; 23:1674. [PMID: 37653375 PMCID: PMC10469829 DOI: 10.1186/s12889-023-16544-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/16/2023] [Indexed: 09/02/2023] Open
Abstract
The birth and death rates of a population are among the crucial vital statistics for socio-economic policy planning in any country. Since the under-five mortality rate is one of the indicators for monitoring the health of a population, it requires regular and accurate estimation. The national demographic and health survey data, that are readily available to the puplic, have become a means for answering most health-related questions among African populations, using relevant statistical methods. However, many of such applications tend to ignore survey design effect in the estimations, despite the availability of statistical tools that support the analyses. Little is known about the amount of inaccurate information that is generated when predicting under-five mortality rates. This study estimates and compares the bias encountered when applying unweighted and weighted logistic regression methods to predict under-five mortality rate in Malawi using nationwide survey data. The Malawi demographic and health survey data of 2004, 2010, and 2015-16 were used to determine the bias. The analyses were carried out in R software version 3.6.3 and Stata version 12.0. A logistic regression model that included various bio- and socio-demographic factors concerning the child, mother and households was used to estimate the under-five mortality rate. The results showed that accuracy of predicting the national under-five mortality rate hinges on cluster-weighting of the overall predicted probability of child-deaths, regardless of whether the model was weighted or not. Weighting the model caused small positive and negative changes in various fixed-effect estimates, which diffused the result of weighting in the fitted probabilities of deaths. In turn, there was no difference between the overall predicted mortality rate obtained using the weighted model and that obtained in the unweighted model. We recommend considering survey cluster-weights during the computation of overall predicted probability of events for a binary health outcome. This can be done without worrying about the weights during model fitting, whose aim is prediction of the population parameter.
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Affiliation(s)
- Tsirizani M Kaombe
- Department of Mathematical Sciences, School of Natural and Applied Sciences, University of Malawi, Zomba, Malawi.
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Wang X, Ren J, Ren H, Song W, Qiao Y, Zhao Y, Linghu L, Cui Y, Zhao Z, Chen L, Qiu L. Diabetes mellitus early warning and factor analysis using ensemble Bayesian networks with SMOTE-ENN and Boruta. Sci Rep 2023; 13:12718. [PMID: 37543637 PMCID: PMC10404250 DOI: 10.1038/s41598-023-40036-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 08/03/2023] [Indexed: 08/07/2023] Open
Abstract
Diabetes mellitus (DM) has become the third chronic non-infectious disease affecting patients after tumor, cardiovascular and cerebrovascular diseases, becoming one of the major public health issues worldwide. Detection of early warning risk factors for DM is key to the prevention of DM, which has been the focus of some previous studies. Therefore, from the perspective of residents' self-management and prevention, this study constructed Bayesian networks (BNs) combining feature screening and multiple resampling techniques for DM monitoring data with a class imbalance in Shanxi Province, China, to detect risk factors in chronic disease monitoring programs and predict the risk of DM. First, univariate analysis and Boruta feature selection algorithm were employed to conduct the preliminary screening of all included risk factors. Then, three resampling techniques, SMOTE, Borderline-SMOTE (BL-SMOTE) and SMOTE-ENN, were adopted to deal with data imbalance. Finally, BNs developed by three algorithms (Tabu, Hill-climbing and MMHC) were constructed using the processed data to find the warning factors that strongly correlate with DM. The results showed that the accuracy of DM classification is significantly improved by the BNs constructed by processed data. In particular, the BNs combined with the SMOTE-ENN resampling improved the most, and the BNs constructed by the Tabu algorithm obtained the best classification performance compared with the hill-climbing and MMHC algorithms. The best-performing joint Boruta-SMOTE-ENN-Tabu model showed that the risk factors of DM included family history, age, central obesity, hyperlipidemia, salt reduction, occupation, heart rate, and BMI.
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Affiliation(s)
- Xuchun Wang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jiahui Ren
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Hao Ren
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Wenzhu Song
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yuchao Qiao
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Ying Zhao
- Shanxi Centre for Disease Control and Prevention, Taiyuan, 030012, Shanxi, China
| | - Liqin Linghu
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
- Shanxi Centre for Disease Control and Prevention, Taiyuan, 030012, Shanxi, China
| | - Yu Cui
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Zhiyang Zhao
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Limin Chen
- Shanxi Provincial People's Hospital, Taiyuan, Shanxi, China.
| | - Lixia Qiu
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China.
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Mirzaei T, Ravari A, Hosseini F, Hassanshahi E. Comparison of the Effect of Education Using Team-based Learning Method and Lecture Method on Controlling Diabetes in the Elderly: A Quasi-Experimental Study. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2023; 11:201-209. [PMID: 37489223 PMCID: PMC10363271 DOI: 10.30476/ijcbnm.2023.97837.2210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 06/03/2023] [Accepted: 06/26/2023] [Indexed: 07/26/2023]
Abstract
Background Patient education is considered as an essential part of diabetes control. This research is conducted to compare the effect of education using team-based learning (TBL) method and lecture method on blood pressure (BP), serum levels of fasting blood sugar (FBS), glycosylated hemoglobin (HbA1c), and Body mass index (BMI) in the elderly with diabetes. Methods This quasi-experimental study was conducted on 61 elderly patients with type 2 diabetes in diabetes clinics in Rafsanjan, during October 2018 to January 2019. Patients were selected using simple random sampling. They were divided into two groups of TBL and lecture-based learning. For each group, educational content was presented through 2-hour sessions held once a week for 1 months. FBS, HbA1c, BMI, and BP were measured at baseline and 3 months after the intervention. Data were analyzed through SPSS 21, using Chi-square test, independent t-test, and paired t-test; A P-value<0.05 was considered as significant. Results After the intervention, the TBL group had a significant decrease in systolic and diastolic BP compared to the lecture group (P<0.001). Before and 3 months after the intervention in the TBL group, there was a significant decrease between the means of FBS (P=0.01), HbA1c (P<0.001), and systolic and diastolic BP (P<0.001), but in the lecture group, only the systolic BP showed a significant decrease (P<0.001). Conclusion TBL method had more effects on controlling diabetes type 2 in the elderly than the lecture method. It is suggested that health providers should consider TBL for the education of the elderly with diabetes.
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Affiliation(s)
- Tayebeh Mirzaei
- Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Ali Ravari
- Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Fatemeh Hosseini
- Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Community Health Nursing, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Elham Hassanshahi
- Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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Promyos N, Phienluphon PP, Wechjakwen N, Lainampetch J, Prangthip P, Kwanbunjan K. Inverse Correlation of Superoxide Dismutase and Catalase with Type 2 Diabetes among Rural Thais. Nutrients 2023; 15:2071. [PMID: 37432193 DOI: 10.3390/nu15092071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 07/12/2023] Open
Abstract
Oxidative stress contributes to defective antioxidant defenses, which may lead to type 2 diabetes (T2D). This study aimed to elucidate the T2D risks and antioxidant defenses by investigating the superoxide dismutase (SOD), catalase (CAT), vitamin A, and vitamin E status. We observed 102 participants aged 35-66 years from Sung Neon, Nakhon Ratchasima, Thailand. The blood samples were collected to measure the SOD, CAT, vitamin A, and vitamin E concentrations. The SOD and CAT activities were inversely associated with T2D risk. When compared with participants in the highest quartile of SOD and CAT, those in the lowest quartile for T2D risk obtained multivariable-adjusted odds ratios of 4.77 (SOD: 95% confident interval CI, 1.01-22.40; p = 0.047) and 4.22 (CAT: 95% CI, 1.07-16.60; p = 0.039). The possible influencing factors (e.g., physical activity, total cholesterol, and triglyceride) might mediate the association of SOD and CAT with T2D risk. Meanwhile, the relationship between vitamin A and vitamin E concentrations and T2D risk was insignificant. In conclusion, lower concentrations of antioxidant enzyme activity (SOD and CAT) may be an additional risk factor for T2D.
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Affiliation(s)
- Natnicha Promyos
- Department of Tropical Nutrition and Food Science, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | | | - Naruemon Wechjakwen
- Faculty of Public Health, Nakhon Ratchasima Rajabhat University, Nakhon Ratchasima 30000, Thailand
| | - Jirayu Lainampetch
- Department of Nutrition, Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand
| | - Pattaneeya Prangthip
- Department of Tropical Nutrition and Food Science, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Karunee Kwanbunjan
- Department of Tropical Nutrition and Food Science, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
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Khatun MM, Rahman M, Islam MJ, Haque SE, Adam IF, Chau Duc NH, Sarkar P, Haque MN, Islam MR. Socio-economic inequalities in undiagnosed, untreated, and uncontrolled diabetes mellitus in Bangladesh: is there a gender difference? Public Health 2023; 218:1-11. [PMID: 36933353 DOI: 10.1016/j.puhe.2023.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/13/2022] [Accepted: 01/31/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVES We aimed to determine: (1) the prevalence and socio-economic distribution of undiagnosed, untreated, and uncontrolled diabetes mellitus (DM); (2) the relationship between socio-economic status (SES) and undiagnosed, untreated, and uncontrolled DM; and (3) if this relationship is mediated by gender. STUDY DESIGN Cross-sectional nationally representative household-based survey. METHODS We used data from the Bangladesh Demographic Health Survey from 2017 to 18. Our findings were based on the responses of 12,144 individuals aged 18 years and older. As a measure of SES, we focused on standard of living (hereinafter referred to as wealth). The study's outcome variables were prevalence of total (diagnosed + undiagnosed), undiagnosed, untreated, and uncontrolled DM. We used three regression-based approaches-adjusted odds ratio, relative inequality index, and slope inequality index-to assess different aspects of SES differences in the prevalence of total, undiagnosed, untreated, and uncontrolled DM. We used logistic regression analysis to look at the adjusted association between SES and the outcomes after gender stratification to see whether gender status moderates the association between SES and the targeted outcomes. RESULTS In our sample analysis, the age-adjusted prevalence of total, undiagnosed, untreated, and uncontrolled DM was 9.1%, 61.4%, 64.7%, and 72.1%, respectively. Females had a higher prevalence of DM and undiagnosed, untreated, and uncontrolled DM than males. When compared to people in the poor SES group, people in the rich and middle SES groups had 2.60 times (95% confidence interval [CI] 2.05-3.29) and 1.47 times (95% CI 1.18-1.83) higher chance of developing DM. When compared to individuals in the poor SES group, those in the rich SES groups were 0.50 (95% CI 0.33-0.77) and 0.55 times (95% CI 0.36-0.85) less likely to have undiagnosed and untreated DM. CONCLUSIONS In Bangladesh, rich SES groups were more likely than poor SES groups to have DM, whereas poor SES groups with DM were less likely than rich SES groups to be aware of their disease and obtain treatment. The government and other concerned parties are urged by this study to pay more attention to developing suitable policy measures to reduce the risk of DM, particularly among rich SES groups, as well as targeted efforts to screen for and diagnose DM in socio-economically disadvantaged groups.
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Affiliation(s)
- M M Khatun
- Department of Population Science and Human Resource Development University of Rajshahi, Rajshahi 6205, Bangladesh
| | - M Rahman
- Department of Population Science and Human Resource Development University of Rajshahi, Rajshahi 6205, Bangladesh.
| | - M J Islam
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD 4122, Australia
| | - S E Haque
- Uchicago Research Bangladesh, Bangladesh
| | - I F Adam
- Faculty of Public Health, University of Khartoum, Sudan
| | - N H Chau Duc
- Hue University of Medicine and Pharmacy, Hue University, Viet nam
| | - P Sarkar
- Dr. Wazed Research and Training Institute, Begum Rokeya University, Rangpur, Bangladesh
| | - M N Haque
- Department of Population Science and Human Resource Development University of Rajshahi, Rajshahi 6205, Bangladesh
| | - M R Islam
- Department of Population Science and Human Resource Development University of Rajshahi, Rajshahi 6205, Bangladesh
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Shirin Sara S, Talukder A, Lee KY, Basak N, Rahman Razu S, Haq I, Nath CD. Dynamic changes in prevalence of type 2 diabetes along with associated factors in Bangladesh: Evidence from two national cross-sectional surveys (BDHS 2011 and BDHS 2017-18). Diabetes Metab Syndr 2023; 17:102706. [PMID: 36657306 DOI: 10.1016/j.dsx.2023.102706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 01/04/2023] [Accepted: 01/07/2023] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIMS Prevalence of type 2 diabetes has been rising rapidly especially in low- and middle-income countries. The purpose of this study is to analyze the prevalence of type 2 diabetes in 2011 and 2017-18, and the risk factors based on the Bangladesh Demographic and Health Surveys (BDHS). METHODS The study comprised of data from the BDHS 2011 and the BDHS 2017-18 with 7565 (50.6% female) and 12,299 respondents (56.9% female) respectively. The plasma blood glucose was classified into normal, pre-diabetes, and diabetes categories. While univariate analysis was performed to determine the data, Chi-square and gamma analyses were used for bivariate estimation of the correlation between diabetes status and other comorbidities. Multinomial and ordinal logistic regression were also performed to trace the link between diabetes and various risk factors. RESULTS The 2011 BDHS survey indicated that nearly half of the participants (47.6%) had pre-diabetic condition, while 10.2% were diagnosed with diabetes. On the other hand, the BDHS 2017-18 demonstrated that 28.6% and 8.6% of participants had pre-diabetes and diabetes, respectively. Results of inferential statistics showed that gender (p<0.05), age, wealth status, physical activity, BMI (p<0.01), and caffeinated beverages (p<0.05), were significantly linked with diabetes status. CONCLUSION According to our findings, older people and people with lower education are more likely to develop diabetes. BMI` Physically active, wealth status, diet and lifestyle were significant predictors of type 2 diabetes. Healthy lifestyle, physical activities, proper knowledge and awareness can reduce the risk of T2D.
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Affiliation(s)
- Sabiha Shirin Sara
- Statistics Discipline, Science Engineering and Technology School, Khulna University, Khulna, 9208, Bangladesh.
| | - Ashis Talukder
- Statistics Discipline, Science Engineering and Technology School, Khulna University, Khulna, 9208, Bangladesh.
| | - Ka Yiu Lee
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden.
| | - Nayan Basak
- Statistics Discipline, Science Engineering and Technology School, Khulna University, Khulna, 9208, Bangladesh.
| | | | - Iqramul Haq
- Department of Agricultural Statistics, Sher-e-Bangla Agricultural University, Dhaka, 1207, Bangladesh.
| | - Chuton Deb Nath
- Mass Communication and Journalism Discipline, Khulna University, Khulna, 9208, Bangladesh.
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Elekofehinti OO. Computer-aided identification of bioactive compounds from Gongronema latifolium leaf with therapeutic potential against GSK3β, PTB1B and SGLT2. INFORMATICS IN MEDICINE UNLOCKED 2023. [DOI: 10.1016/j.imu.2023.101202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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18
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Diabetes, Hypertension, and Comorbidity among Bangladeshi Adults: Associated Factors and Socio-Economic Inequalities. J Cardiovasc Dev Dis 2022; 10:jcdd10010007. [PMID: 36661902 PMCID: PMC9863699 DOI: 10.3390/jcdd10010007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022] Open
Abstract
Diabetes, hypertension, and comorbidity are still crucial public health challenges that Bangladeshis face. Nonetheless, very few studies have been conducted to examine the associated factors, especially the socioeconomic inequalities in diabetes, hypertension, and comorbidity in Bangladesh. This study explored the prevalence of, factors connected with, and socioeconomic inequalities in diabetes, hypertension, and comorbidity among Bangladeshi adults. We used the Bangladesh Demographic and Health Survey (BDHS) data set of 2017−2018. A total of 12,136 (weighted) Bangladeshi adults with a mean age of 39.5 years (±16.2) participated in this study. Multilevel (mixed-effect) logistic regression analysis was employed to ascertain the determinants of diabetes, hypertension, and comorbidity, where clusters were considered as a level-2 factor. The concentration curve (CC) and concentration index (CIX) were utilized to investigate the inequalities in diabetes, hypertension, and comorbidity. The weighted prevalence of diabetes, hypertension, and comorbidity was 10.04%, 25.70%, and 4.47%, respectively. Age, body mass index, physical activity, household wealth status, and diverse administrative divisions were significantly associated with diabetes, hypertension, and comorbidity among the participants. Moreover, participants’ smoking statuses were associated with hypertension. Women were more prone to hypertension and comorbidity than men. Diabetes (CIX: 0.251, p < 0.001), hypertension (CIX: 0.071, p < 0.001), and comorbidity (CIX: 0.340, p < 0.001) were higher among high household wealth groups. A pro-wealth disparity in diabetes, hypertension, and comorbidity was found. These inequalities in diabetes, hypertension, and comorbidity emphasize the necessity of designing intervention schemes geared towards addressing the rising burden of these diseases.
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Socioeconomic disparities in diabetes prevalence and management among the adult population in Bangladesh. PLoS One 2022; 17:e0279228. [PMID: 36538534 PMCID: PMC9767371 DOI: 10.1371/journal.pone.0279228] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 12/03/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Diabetes, one of the major metabolic disorders, is rising in Bangladesh. Studies indicate there is inequality in prevalence and care-seeking behavior, which requires further exploration to understand the socioeconomic disparities in the pathophysiology of diabetes. This study examined the latest nationally representative estimates of diabetes prevalence, awareness, and management among adults aged 18 years and above in Bangladesh and its association with socioeconomic status in 2017-18. METHODS We used the 2017-18 Bangladesh Demographic and Health Survey data. Diabetic status of 12,092 adults aged 18 years and above was measured in the survey using fasting plasma glucose levels. We applied multivariate logistic regressions to examine the role of socioeconomic status on diabetes prevalence, awareness, and management, after controlling for relevant covariates. RESULTS Overall, 10% of adults had diabetes in Bangladesh in 2017-18, with the highest prevalence of 16% in the age group 55-64 years. Our analyses found statistically significant disparities by socioeconomic status in the prevalence of diabetes as well as the person's awareness of his/her diabetic condition. However, the effect of socioeconomic status on receiving anti-diabetic medication only approached significance (p = 0.07), and we found no significant association between socioeconomic status and control of diabetes. CONCLUSIONS We expect to see an 'accumulation' of the number of people with diabetes to continue in the coming years. The rising prevalence of diabetes is only the tip of an iceberg; a large number of people with uncontrolled diabetes and a lack of awareness of their condition will lead to increased morbidity and mortality, and that could be the real threat. Immediate measures to increase screening coverage and exploration of poor control of diabetes are required to mitigate the situation.
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Akter F, Rashid SMM, Alam N, Lipi N, Qayum MO, Nurunnahar M, Mannan A. Knowledge, attitude and practice of diabetes among secondary school-going children in Bangladesh. Front Public Health 2022; 10:1047617. [PMID: 36466517 PMCID: PMC9713846 DOI: 10.3389/fpubh.2022.1047617] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
Abstract
Diabetes Mellitus (DM) is a global public health concern. DM has been increasing alarmingly among the young people and childhood-onset has now become an emerging issue worldwide. Unlike other chronic diseases, DM requires constant and active attention of the patients, sometimes of their family members for successful management of this disease. Knowledge, attitude, and practices make significant differences at the population level, which largely depend on socioeconomic status, area of residence, level of education, and other socio-demographic attributes. A descriptive cross-sectional study was carried out among secondary school students in grades 6 through 10 attending schools in 18 districts of Bangladesh. A total of 2009 students were enrolled for the study from the selected schools and madrasas from Bengali, English, and Arabic medium. The majority of responders (79.34%) reported that they had heard of diabetes, however, only 45% knew that diabetes can cause blood glucose levels to rise. Among different therapeutic options, only 15% of students had heard the name of metformin, while 56.2% were familiar with insulin. English medium students were significantly more likely to have good knowledge than the Bangla medium students (19.31%, OR: 1. 44; 95% CI: 1.07, 1.95). Respondents of semi-urban (19.66%, OR: 1.7; 95% CI: 1.21, 2.36) and urban (18.47%, OR: 1.48; 95% CI: 1.17, 1.86) areas were more likely to have good knowledge than rural areas. Of the respondents, 20.61% did not know of any diabetic treatment options. Only a small percentage of students (11%) attended any diabetes education classes and 10.7% of students followed any recommended diabetes prevention methods. Knowledge, attitude, and practice related to diabetes were found to have been influenced by socioeconomic factors, societal practices, and behavioral patterns. This is the first nationwide research study in Bangladesh among secondary school students to study knowledge, attitudes, and practices related to diabetes. With a focus on Bangladesh's youthful population, this study sought to provide an informational framework that can be supportive for effective intervention to increase knowledge of diabetes and its implications.
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Affiliation(s)
- Farhana Akter
- Department of Endocrinology, Chittagong Medical College, Chattogram, Bangladesh,Disease Biology & Molecular Epidemiology Research Group, Chattogram, Bangladesh
| | - S. M. Mahbubur Rashid
- Department of Genetic Engineering & Biotechnology, University of Dhaka, Dhaka, Bangladesh,*Correspondence: S. M. Mahbubur Rashid
| | - Nazmul Alam
- Department of Public Health, Asian University for Women, Chittagong, Bangladesh
| | - Nasrin Lipi
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Md. Omar Qayum
- Department of Epidemiology, Institute of Epidemiology, Disease Control & Research (IEDCR), Dhaka, Bangladesh
| | - Mehejabin Nurunnahar
- Department of Epidemiology, Institute of Epidemiology, Disease Control & Research (IEDCR), Dhaka, Bangladesh
| | - Adnan Mannan
- Disease Biology & Molecular Epidemiology Research Group, Chattogram, Bangladesh,Department of Genetic Engineering & Biotechnology, University of Chittagong, Chattogram, Bangladesh
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Roy JR, Janaki CS, Jayaraman S, Periyasamy V, Balaji T, Vijayamalathi M, Veeraraghavan VP. Carica papaya Reduces Muscle Insulin Resistance via IR/GLUT4 Mediated Signaling Mechanisms in High Fat Diet and Streptozotocin-Induced Type-2 Diabetic Rats. Antioxidants (Basel) 2022; 11:antiox11102081. [PMID: 36290804 PMCID: PMC9598374 DOI: 10.3390/antiox11102081] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 10/15/2022] [Accepted: 10/17/2022] [Indexed: 11/19/2022] Open
Abstract
In the management of type 2 diabetes, oral antidiabetic drugs have several side effects, which in turn have led the pharmaceutical industry to search for good therapeutic, non-toxic and reliable drugs. Carica papaya (C. papaya) is one of several plants in nature that have been found to possess anti-diabetic properties. Despite studies being focused on the antidiabetic activity of C. papaya, the molecular mechanism against high fat diet induced insulin resistance is yet to be identified. The role of C. papaya was evaluated on insulin signaling molecules, such as the insulin receptor (IR) and glucose transporter-4 (GLUT4) in high fat, diet-streptozotocin induced type 2 diabetic rats, and analyzed the bioactive compounds of C. papaya against IR and GLUT4 via molecular docking and dynamics. The ethanolic extract of C. papaya leaves (600 mg/kg of body weight) was given daily to male wistar rats for 45 days and we observed the various biochemical parameters, gene expression analysis and histopathology of skeletal muscle. Molecular docking and dynamics were undertaken to understand the bioactive compounds with the greatest hit rate. C. papaya treatment was able to control blood glucose levels, the lipid profile and serum insulin, but it facilitated tissue antioxidant enzymes and IR and GLUT4 levels. The in-silico study showed that kaempferol, quercitin and transferulic acid were the top three ligands with the greatest hit rate against the protein targets. Our preliminary findings, for the first time, showed that C. papaya reinstates the glycemic effect in the diabetic skeletal muscle by accelerating the expression of IR and GLUT4.
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Affiliation(s)
- Jeane Rebecca Roy
- Department of Anatomy, Bhaarath Medical College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai 600 073, Tamil Nadu, India
- Correspondence: (J.R.R.); (S.J.)
| | - Coimbatore Sadagopan Janaki
- Department of Anatomy, Bhaarath Medical College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai 600 073, Tamil Nadu, India
| | - Selvaraj Jayaraman
- Centre of Molecular Medicine and Diagnostics (COMManD), Department of Biochemistry, Saveetha Dental College & Hospitals, Saveetha Institute of Medical & Technical Sciences, Saveetha University, Chennai 600 077, Tamil Nadu, India
- Correspondence: (J.R.R.); (S.J.)
| | - Vijayalakshmi Periyasamy
- Department of Biotechnology and Bioinformatics, Holy Cross College, Trichy 620 002, Tamil Nadu, India
| | - Thotakura Balaji
- Department of Anatomy, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chennai 603 103, Tamil Nadu, India
| | - Madhavan Vijayamalathi
- Department of Physiology, Bhaarath Medical College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai 600 073, Tamil Nadu, India
| | - Vishnu Priya Veeraraghavan
- Centre of Molecular Medicine and Diagnostics (COMManD), Department of Biochemistry, Saveetha Dental College & Hospitals, Saveetha Institute of Medical & Technical Sciences, Saveetha University, Chennai 600 077, Tamil Nadu, India
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Rahman MA. Socioeconomic inequalities in the risk factors of noncommunicable diseases (hypertension and diabetes) among Bangladeshi population: Evidence based on population level data analysis. PLoS One 2022; 17:e0274978. [PMID: 36126087 PMCID: PMC9488802 DOI: 10.1371/journal.pone.0274978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 09/07/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Noncommunicable diseases (NCDs) such as hypertension and diabetes are among the most fatal disease and prevalent among the adult population worldwide, including Bangladesh, and pose a public health threat. Understanding the socioeconomic inequalities linked to NCD risk factors can aid in the development of effective strategies to reduce the disease's recurrence. However, the literature on socioeconomic inequalities in hypertension and diabetes prevalence in Bangladesh is scant. Therefore, this study seeks to assess the inequality in hypertension and diabetes prevalence and to identify factors that may contribute to socioeconomic inequalities in Bangladesh. METHODS The current study incorporated data from a recent round of Bangladesh Demographic and Health Survey (BDHS 2017-18). The age-standardized prevalence rates of hypertension and diabetes were reported, and the log-binomial regression technique was used to identify the relevant confounders. Additionally, socioeconomic inequalities were quantified using a regression-based decomposition technique in which the concentration index (CIX) and Concentration curve were produced to determine the socioeconomic factors contributing to inequality. RESULTS Hypertension and diabetes were shown to have an age-standardized prevalence of (11.29% 95% CI: 11.13-11.69) and (36.98% 95% CI: 36.79-37.16), respectively. Both hypertension and diabetes were shown to be pointedly linked to the respondents' age, wealth status, being overweight or obese, and a variety of respondents' administrative divisions (p <0.001). In Bangladesh, household wealth status accounted for approximately 25.71% and 43.41% of total inequality in hypertension and diabetes, respectively. While BMI played a significant role in the emergence of inequality, the corresponding percentages for diabetes and hypertension are 4.95 and 83.38, respectively. In addition, urban areas contributed 4.56% inequality to increase diabetes among Bangladeshi inhabitants while administrative region contributed 4.76% of the inequality of hypertension. CONCLUSION A large proportion of Bangladesh's adult population suffers from hypertension and diabetes. It is critical to recognize the value of equity-based initiatives in order to optimize the benefit-risk ratio and cost effectiveness of preventive health programmes. Integrating equity considerations into interventions is critical for policies and programmes to achieve their objectives. As a result, these findings can be taken into account when making existing and prospective policy decisions, as well as following its progression with economic development of Bangladesh.
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Affiliation(s)
- Md. Ashfikur Rahman
- Development Studies Discipline, Social Science School, Khulna University, Khulna, Bangladesh
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Rahman MA, Halder HR, Kundu S, Sultana F, Islam SMS. Trends in the prevalence and associated factors of prediabetes and diabetes in Bangladesh: Evidence from population-based cross-sectional surveys. Diabetes Res Clin Pract 2022; 190:109873. [PMID: 35436546 DOI: 10.1016/j.diabres.2022.109873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 03/06/2022] [Accepted: 04/11/2022] [Indexed: 11/03/2022]
Abstract
AIMS Diabetes is a major health problem in Bangladesh, but nationally representative studies on its trends and associated factors are scarce to guide policy formulation. Therefore, the study aims to determine trends in the prevalence and associated factors of prediabetes and diabetes in Bangladesh. METHODS The study included two population-based cross-sectional surveys from Bangladesh Demographic and Health Survey (n = 7,505 in 2011 and n = 11,959 in 2017-18). Chi-square association tests were performed to determine the associated factors. Logistic regression models (univariate and multivariable) were used to estimate unadjusted and adjusted relative risks of having diabetes, reported with odds ratios. Age-adjusted prevalence was also reported for both surveys. RESULTS The overall age-adjusted prevalence of prediabetes and diabetes decreased from 52.77% (95% CI: 52.61-52.92) and 10.43% (95% CI: 10.33-10.53) in 2011 to 34.10% (95% CI: 33.43-34.78) and 8.50% (95% CI: 8.11-8.90) in 2017-18. Compared to males, females had a higher odds of diabetes in 2011, but in 2017-18 a significant inverse result was observed. In both surveys, the odds of prediabetes and diabetes increased with advancing age, obesity, better wealth status, and hypertension. CONCLUSION The study shows that the prevalence of prediabetes and diabetes is high in Bangladesh despite decreasing trends. Therefore, the study recommends promoting healthy lifestyles and regular screening for non-communicable diseases.
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Affiliation(s)
- Md Ashfikur Rahman
- Development Studies Discipline, Social Science School, Khulna University, Khulna 9208, Bangladesh.
| | - Henry Ratul Halder
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba R3E 0W3, Canada; Statistics Discipline, Science, Engineering and Technology School, Khulna University, Khulna 9208, Bangladesh.
| | - Satyajit Kundu
- School of Public Health, Southeast University, Nanjing 210009, China; Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Dumki, Patuakhali 8602, Bangladesh.
| | - Farhana Sultana
- Telstra Health, 222 Lonsdale Street, Melbourne, Victoria 3000, Australia.
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Burwood, Victoria 3125, Australia.
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Socioeconomic Inequalities in the Prevalence of Diabetes in Argentina: A Repeated Cross-Sectional Study in Urban Women and Men. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158888. [PMID: 35897259 PMCID: PMC9331888 DOI: 10.3390/ijerph19158888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023]
Abstract
This study measured the socioeconomic inequalities in the prevalence of diabetes between 2005 and 2018 in an urban Argentinian population. Data were obtained from the repeated cross-sectional surveys “National Survey of Risk Factors” (ENFR is its acronym in Spanish). From 2005 to 2018, four rounds of ENFR were administered to men and women over 18 years of age. Concentration curves (CC) and the Erreygers concentration index (ECI) were used to describe the socioeconomic inequalities in diabetes’ prevalence. A decomposition analysis was performed to determine the contribution of each variable to inequality in diabetes’ prevalence. Data from 41,219 (2005), 34,583 (2009), 32,232 (2013), and 29,094 (2018) individuals were analyzed. Women reported a greater prevalence of diabetes compared with men for all the years included. According to the CC and ECI, we found no evidence of inequality in men throughout all study years. For women, throughout all years, the CCs were above the line of equity, and the ECIs during all the years were negative and different from zero (p < 0.01). For women, we found no evidence of a reduction in inequalities between 2005 and 2018 (p = 0.475). The socioeconomic inequality for women was largely driven by public insurance, primary and secondary education, and employment. Diabetes’ prevalence was not associated with socioeconomic status in men, while the prevalence of diabetes in women was more concentrated among poorer women. During the 13 years, there was no evidence of a reduction of inequality in women, noting that interventions must prioritize and should focus on the main contribution of inequalities, such as education and employment.
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Hossain MB, Khan MN, Oldroyd JC, Rana J, Magliago DJ, Chowdhury EK, Karim MN, Islam RM. Prevalence of, and risk factors for, diabetes and prediabetes in Bangladesh: Evidence from the national survey using a multilevel Poisson regression model with a robust variance. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000461. [PMID: 36962350 PMCID: PMC10021925 DOI: 10.1371/journal.pgph.0000461] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 04/18/2022] [Indexed: 12/25/2022]
Abstract
To estimate the age-standardized prevalence of diabetes and prediabetes and identify factors associated with these conditions at individual, household, and community levels. Data from 11952 Bangladeshi adults aged 18-95 years available from the most recent Bangladesh Demographic and Health Survey 2017-18 were used. Anthropometric measurements and fasting blood glucose samples were taken as part of the survey. Prevalence estimates of diabetes and prediabetes were age-standardized with direct standardization, and risk factors were identified using multilevel mix-effects Poisson regression models with robust variance. The overall age-standardised prevalence of diabetes was 9.2% (95%CI 8.7-9.7) (men: 8.8%, women: 9.6%), and prediabetes was 13.3% (95%CI 12.7-13.9) (men: 13.0%, women: 13.6%). Among people with diabetes, 61.5% were unaware that they had the condition. 35.2% took treatment regularly, and only 30.4% of them had controlled diabetes. Factors associated with an increased prevalence of having diabetes were increasing age, male, overweight/obesity, hypertension, being in the highest wealth quintile, and living in the Dhaka division. People currently employed and living in the Rangpur division were less likely to have diabetes than those currently not employed and living in the Barishal division. Diabetes and prediabetes affect a substantial proportion (over one-quarter) of the Bangladeshi adult population. Continuing surveillance and effective prevention and control measures, focusing on obesity reduction and hypertension management, are urgently needed.
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Affiliation(s)
| | - Md. Nuruzzaman Khan
- Department of Population Sciences, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
| | - John C. Oldroyd
- School of Behavioral and Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Juwel Rana
- Department of Public Health, School of Health and Life Sciences, North South University, Dhaka, Bangladesh
- South Asian Institute for Social Transformation (SAIST), Dhaka, Bangladesh
| | - Dianna J. Magliago
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Enayet K. Chowdhury
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Md Nazmul Karim
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Rakibul M. Islam
- South Asian Institute for Social Transformation (SAIST), Dhaka, Bangladesh
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Amit Jain’s surgical scoring system and its ability in predicting the major amputation in diabetic foot complications. Int J Health Sci (Qassim) 2022. [DOI: 10.53730/ijhs.v6ns3.6221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
There are numerous scoring system used in different parts of the world and most of them are for diabetic foot ulcers only with Amit Jain’s surgical scoring system being the first such scoring for diabetic foot complications. This study aims to validate the Amit Jain’s scoring system in predicting the risk of major amputation in diabetic foot complications. A retrospective analysis was done in Department of General Surgery of Raja Rajeswari medical college, Bengaluru, India. The study period was from January 2018 to December 2019. All the patients who underwent surgeries for diabetic foot complications in our department were included in the study. A total of 47 patients were included in this study. Majority of patients (76.6%) were males 61.7% of patients had diabetes mellitus of less than 10 years duration. Abscess was the most common pathological lesion seen in the foot affecting 36.17%. Most of the patients (59.6%) with diabetic foot complications had Amit Jain’s surgical score of 6-10 and were in low risk category. 12 patients (25.5%) underwent major amputation in this study and a significant association (P<0.001) was noted between Amit Jain’s surgical scoring and major amputation.
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Sarker AR, Khanam M. Socio-economic inequalities in diabetes and prediabetes among Bangladeshi adults. Diabetol Int 2022; 13:421-435. [PMID: 35463862 PMCID: PMC8980187 DOI: 10.1007/s13340-021-00556-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/18/2021] [Indexed: 10/20/2022]
Abstract
Diabetes and prediabetes are overwhelming public health concerns in Bangladesh. However, there is a paucity of the literature examining and measuring socioeconomic inequalities in the prevalence of diabetes in Bangladesh. To provide reliable data and contribute to a nationwide scenario analysis, this study aims to estimate the inequality in prevalence of diabetes and prediabetes and to identify factors potentially contributing to socioeconomic inequalities in Bangladesh. This study used data from the latest Bangladesh Demographic and Health Survey (BDHS) 2017-18, a nationally representative survey. A regression-based decomposition method was applied to assess the socioeconomic contributors to inequality. The prevalence of diabetes and prediabetes were about 10 and 15% among Bangladeshi adults, respectively. Both diabetes and prediabetes were significantly associated with age, wealth status, suffering from overweight or obesity and administrative divisions of the respondents (p < 0.001). Respondents' household wealth status accounted for about 74 and 81% of the total inequality in diabetes and prediabetes in Bangladesh, respectively. Administrative region contributed 24.85% of the inequality in prediabetes and 12.26% of the inequality in diabetes. In addition, overweight or obesity status contributed 11.37% and exposure to television contributed 5.17% of the inequality in diabetes. Diabetes and prediabetes affect a substantial proportion of the Bangladeshi adult population. Therefore, these findings should be considered in the context of current and proposed policy decision making and for tracking its progression with economic development in Bangladesh.
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Affiliation(s)
- Abdur Razzaque Sarker
- Population Studies Division, Bangladesh Institute of Development Studies (BIDS), Dhaka, 1207 Bangladesh
| | - Moriam Khanam
- Institute of Health Economics, University of Dhaka, Dhaka, Bangladesh
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Ali A, Alfajjam S, Gasana J. Diabetes Mellitus and Its Risk Factors among Migrant Workers in Kuwait. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073943. [PMID: 35409622 PMCID: PMC8997920 DOI: 10.3390/ijerph19073943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 03/01/2022] [Accepted: 03/16/2022] [Indexed: 12/14/2022]
Abstract
The prevalence of diabetes mellitus (DM) is growing enormously worldwide, and actions need to be taken in order to minimize the burden of diabetes mellitus and reduce its complications. Since two-thirds of Kuwait's population are expatriates, the prevalence of and factors associated with diabetes among migrant workers was assessed as it has a significant impact on migrant workers' quality of life, health, and productivity. The data used in this study was for all migrant workers who attended Shuaiba Industrial Medical Center (SIMC) for physical examination in the year 2018. Univariate and multivariate regression were used to assess the relationship between diabetes mellitus and the other independent factors where odds ratios with confidence intervals were delineated. Information for a total of 3477 participants was recorded in the dataset for 2018. Of the total participants, 10.1% had diabetes mellitus. About 49% of the participants were overweight. The largest age group of participants was between 31 and 40 years of age. A small percentage of the participants were diagnosed with hypertension at 11.8%. Additionally, 76.1% of the participants reported themselves as non-smokers. Diabetes was positively associated with age, hypertension, and nationalities. However, no association was found between BMI and smoking tobacco. This is the first study in SIMC to assess DM and its associated risk factor among migrants, since migrant workers are neglected subpopulations that need our focus and attention to achieve justice and fairness. The findings revealed that the prevalence of DM among our study population was considerably lower. However, a healthy lifestyle, including a healthy diet and being physically active, need to be introduced to prevent any further damage.
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Affiliation(s)
- Anwar Ali
- Public Health Department, Ministry of Health, P.O. Box 5, Kuwait City 12009, Kuwait;
| | - Shaikhah Alfajjam
- Occupational Health Department, Ministry of Health, P.O. Box 5, Kuwait City 12009, Kuwait;
| | - Janvier Gasana
- Department of Environmental and Occupational Health, Faculty of Public Health, Kuwait University, P.O. Box 24923, Kuwait City 13110, Kuwait
- Correspondence:
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Hassan MM, Uddin S, Bhowmik A, Ashraf A, Islam MM, Rokeya B. Phytochemical screening and antidiabetic effects of fruit rind of Momordica dioica roxb. on streptozocin induced type 2 diabetic rats. Heliyon 2022; 8:e08771. [PMID: 35128091 PMCID: PMC8808062 DOI: 10.1016/j.heliyon.2022.e08771] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/04/2021] [Accepted: 01/11/2022] [Indexed: 12/31/2022] Open
Abstract
Momordica dioica (M. dioica) is a gourd like blooming plant that is readily available in Bangladesh, requiring biological research to discover its therapeutic values. The goal of our research was to see if the ethanolic extract of this plant had any anti-hyperglycemic properties. Water, glibenclamide and M. dioica extracts were fed to Streptozocin induced type-2 diabetic rat models at a dose of 1.25 g/kg body weight (bw) for 28 days to see what kind of effects they had on serum glucose, insulin, liver glycogen and lipid contents. Except for the control group, all the groups followed a pattern of maintaining the body weight. The oral glucose tolerance test was observed to be improved in extract after 14 days of the experiment. When assessed with the control group, the M. dioica extract showed a significant (p = 0.0015) decrease in postprandial serum glucose level (M±SD, mmol/l, 13.23 ± 1.03 control Vs 11.47 ± 2.21 extract) at 120 min. The treatment of diabetic model rats with extract resulted in a 7% (p < 0.0001) reduction in serum cholesterol levels. While subsequent 28 days of treatment, insulin levels were found to be lowered in all groups (from 246.76 to 200.44 pg/dL; p < 0.0001 for standard and from 309.01 to 204.61 pg/dL; p < 0.0001 for sample). The results revealed that prolonged administration of M. dioica improved the glycemic and lipidemic state of type-2 diabetic rats, implying that more research is needed to identify the active ingredient (s).
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Affiliation(s)
- Md. Mynul Hassan
- Department of Biotechnology and Genetic Engineering, Khulna University, Khulna, Bangladesh
| | - Shihab Uddin
- Department of Biochemistry and Molecular Biology, Jahangirnagar University, Savar, Bangladesh
| | - Amrita Bhowmik
- Department of Applied Laboratory Sciences, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Ayesha Ashraf
- Biotechnology and Genetic Engineering Discipline, Khulna University, Khulna, Bangladesh
| | - Md. Mahmodul Islam
- Department of Pharmacy, Daffodil International University, Dhanmondi, Dhaka, Bangladesh
| | - Begum Rokeya
- Department of Pharmacology, Bangladesh University of Health Sciences, Dhaka, Bangladesh
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Amssayef A, Azzaoui B, Bouadid I, Eddouks M. Antihyperglycemic Activity of Aqueous Extract of Euphorbia guyoniana in Streptozotocin-Induced Diabetic Rats. Cardiovasc Hematol Disord Drug Targets 2021; 21:225-234. [PMID: 34906066 DOI: 10.2174/1871529x21666211214161639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/03/2021] [Accepted: 11/26/2021] [Indexed: 11/22/2022]
Abstract
AIMS This work assessed the antihyperglycemic effect of Euphorbia guyoniana. BACKGROUND Euphorbia guyoniana (Boss. and Reut.) is widely used in traditional medicine. OBJECTIVE This study was designed to confirm this traditional use by assessing its antihyperglycemic capacity in vivo. METHODS The effect of the aqueous extract of Euphorbia guyoniana (Boss. and Reut.) (60 mg/kg) on glycemia in both normal and diabetic rats was evaluated. The glycogen content in the liver and skeletal muscles (extensor digitorum longus and soleus) was measured. Furthermore, liver histopathological analysis was performed. RESULTS The findings showed that Euphorbia guyoniana (Boss. and Reut.) exhibited a significant decrease in glycaemia in diabetic rats (from 20±2 mmol/l to 5.5 mmol/l after 6 hours of oral administration; p<0.0001 and from 20±2 mmol/l to 4.5 mmol/l after 7 days of once-daily repeated oral administration of the aqueous Euphorbia guyoniana extract; p<0.0001). In addition, the extract increased the glycogen content in the liver (41±4 mg/g versus 70±5 mg/g in normal and diabetic rats respectively) and extensor digitorum longus (39±4 mg/g versus 60±1 mg/g in normal and diabetic rats, respectively), and partially restored corporal weight in diabetic rats. Furthermore, this aqueous extract has been shown to suppress hyperglycemia induced by glucose load in treated diabetic rats. Additionally, hepatic histology in diabetic rats has been improved. This plant revealed the presence of several phytochemical constituents and possessed antioxidant activity. CONCLUSION The current study evidenced that Euphorbia guyoniana (Boss. and Reut.) has a beneficial effect on improving hyperglycemia and glycogen depletion in the diabetic state.
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Affiliation(s)
- Ayoub Amssayef
- Team of Ethnopharmacology and Pharmacognosy, Faculty of Sciences and Techniques Errachidia, Moulay Ismail University of Meknes, BP 509, Boutalamine, 52000. Errachidia. Morocco
| | - Bouchra Azzaoui
- Team of Ethnopharmacology and Pharmacognosy, Faculty of Sciences and Techniques Errachidia, Moulay Ismail University of Meknes, BP 509, Boutalamine, 52000. Errachidia. Morocco
| | - Ismail Bouadid
- Team of Ethnopharmacology and Pharmacognosy, Faculty of Sciences and Techniques Errachidia, Moulay Ismail University of Meknes, BP 509, Boutalamine, 52000. Errachidia. Morocco
| | - Mohamed Eddouks
- Team of Ethnopharmacology and Pharmacognosy, Faculty of Sciences and Techniques Errachidia, Moulay Ismail University of Meknes, BP 509, Boutalamine, 52000. Errachidia. Morocco
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Al-Zubayer MA, Ahammed B, Sarder MA, Kundu S, Majumder UK, Islam SMS. Short response on "Double and triple burden of noncommunicable diseases and its determinants among adults in Bangladesh: Evidence from a recent demographic and health survey". Int J Clin Pract 2021; 75:e14976. [PMID: 34965658 DOI: 10.1111/ijcp.14976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Benojir Ahammed
- Statistics Discipline, Khulna University, Khulna, Bangladesh
| | | | - Subarna Kundu
- Statistics Discipline, Khulna University, Khulna, Bangladesh
| | | | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
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Hossain MB, Khan JR, Das Gupta R. Role of hypertension in the association of overweight and obesity with diabetes among adults in Bangladesh: a population-based, cross-sectional nationally representative survey. BMJ Open 2021; 11:e050493. [PMID: 34330863 PMCID: PMC8327840 DOI: 10.1136/bmjopen-2021-050493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
AIMS Overweight and obesity (OWOB) is a modifiable risk factor for both hypertension and diabetes. However, the association between OWOB and diabetes among Bangladeshi adults and how hypertension may mediate this relationship are not well explored. This study aimed to examine (1) whether OWOB is independently associated with diabetes among Bangladeshi adults, (2) whether this association is mediated by hypertension, and (3) the effect modification by wealth status and place of residence in the relationships. RESEARCH DESIGN AND METHODS We used data of 9305 adults aged ≥18 years from the most recent nationally representative cross-sectional study of Bangladesh Demographic and Health Survey 2017-2018. Design-based logistic regression was used to assess the association between OWOB and diabetes, and counterfactual framework-based weighting approach was used to evaluate the mediation effect of hypertension in the OWOB-diabetes relationship. We used stratified analyses for the effect modifications. RESULTS The prevalence of OWOB, diabetes and hypertension was 48.5%, 11.7% and 30.3%, respectively. We observed a significant association between OWOB and diabetes and a mediating role of hypertension in the OWOB-diabetes association. The odds of diabetes was 51% higher among adults with OWOB than those without OWOB (adjusted OR: 1.51, 95% CI 1.29 to 1.77). We observed that 18.64% (95% CI 9.84% to 34.07%) of the total effect of OWOB on the higher odds of diabetes was mediated through hypertension, and the mediation effect was higher among adults from non-poor households and from both rural and urban areas. CONCLUSIONS Adult OWOB status is independently associated with diabetes in Bangladesh, and hypertension mediates this association. Therefore, prevention policies should target adults with both OWOB and hypertension, particularly those from non-poor households and from both rural and urban areas, to reduce the growing burden of diabetes and its associated risk.
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Affiliation(s)
- Md Belal Hossain
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jahidur Rahman Khan
- Biomedical Research Foundation, Dhaka, Bangladesh
- Health Research Institute, Faculty of Health, University of Canberra, Bruce, Canberra, Australia
| | - Rajat Das Gupta
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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Duodu PA, Agbadi P, Duah HO, Darkwah E, Nutor JJ. Correlates of blood pressure and blood glucose screenings in Cameroon: insights from the 2018 Demographic and Health Survey. Int Health 2021; 14:201-210. [PMID: 34118153 PMCID: PMC8890807 DOI: 10.1093/inthealth/ihab033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/15/2021] [Accepted: 05/20/2021] [Indexed: 11/28/2022] Open
Abstract
Background Hypertension and diabetes, two major risk factors for cardiometabolic diseases, are associated with high morbidity and mortality rates. Early detection through screening can initiate early treatment to reduce adverse outcomes. The current study sought to investigate the correlates of blood pressure and blood glucose screenings in Cameroon. Methods We used secondary data from the 2018 Cameroon Demographic and Health Survey. Adjusting for a complex sample design, we performed multivariate prevalence ratio estimates of the blood pressure and blood glucose screenings. Results Approximately 60% and 30% of Cameroonians had undergone blood pressure and blood glucose screenings, respectively. More females (68%) had undergone blood pressure screenings compared with their male counterparts (44.1%). In the multivariate model, gender, age, education, marital status, household wealth index and region of residence were significantly associated with both blood pressure and blood glucose screenings in the full sample. Previous blood pressure screening was associated with an increased likelihood of blood glucose screening and vice versa. A modification effect of gender was observed in the association between the correlates and both outcomes. Conclusion Our findings uncovered individuals with a decreased likelihood for blood pressure and blood glucose screenings and this can inform policy decisions to ensure targeted screening aimed at early detection and management.
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Affiliation(s)
- Precious Adade Duodu
- Department of Nursing and Midwifery, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK
| | - Pascal Agbadi
- Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Ernest Darkwah
- Department of Psychology, University of Ghana, P. O. Box LG 84, Legon, Ghana
| | - Jerry John Nutor
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, CA, USA
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Khanam M, Hasan E, Sarker AR. Prevalence and Factors of Hypertension Among Bangladeshi Adults. High Blood Press Cardiovasc Prev 2021; 28:393-403. [PMID: 34018151 DOI: 10.1007/s40292-021-00461-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/14/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Hypertension is one of the leading causes of morbidity and mortality in developing countries, especially in South Asian countries including Bangladesh. AIM This study aimed to assess the prevalence, risk factors, and inequality of hypertension in Bangladesh. METHODS This study analyzed the Bangladesh Demographic and Health Survey data from 2017-2018. A total of 12,863 people aged 18 years and above were included in this study. Both bivariate and multivariate analyses were performed to observe the effects of different factors and reported as adjusted ORs (AORs) with 95% CIs. Concentration index and concentration curve were used to measure the inequality in the distribution of hypertension among people with varying socio-economic status. RESULTS This study found that the prevalence of hypertension was 27.43% while this rate was 28.43% among females and 26.11% among males. The prevalence was the highest (49.26%) among those from the highest age group and among individuals who belonged to the richest households (p < 0.001). The concentration index for hypertension was 0.07. Our study suggests that the risk of having hypertension was higher among respondents who were female, elderly, were overweight or obese; had diabetes; or were from Barisal and Rangpur divisions. CONCLUSION Our study showed that more than one quarter of respondents had hypertension. Early diagnosis and proper management of the risk factors for hypertension are crucial to halt this emerging public health problem. A joint effort involving public, private, and non-governmental organizations is necessary to tackle the burden of hypertension faced by Bangladesh and similar developing countries in South Asia.
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Affiliation(s)
- Moriam Khanam
- Institute of Health Economics, University of Dhaka, Dhaka, Bangladesh
| | - Emran Hasan
- Department of Economics, Bangladesh University of Professionals, Dhaka, Bangladesh
| | - Abdur Razzaque Sarker
- Population Studies Division, Bangladesh Institute of Development Studies (BIDS), Dhaka, 1207, Bangladesh.
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Islam MM, Rahman MJ, Chandra Roy D, Tawabunnahar M, Jahan R, Ahmed NAMF, Maniruzzaman M. Machine learning algorithm for characterizing risks of hypertension, at an early stage in Bangladesh. Diabetes Metab Syndr 2021; 15:877-884. [PMID: 33892404 DOI: 10.1016/j.dsx.2021.03.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/24/2021] [Accepted: 03/31/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS Hypertension has become a major public health issue as the prevalence and risk of premature death and disability among adults due to hypertension has increased globally. The main objective is to characterize the risk factors of hypertension among adults in Bangladesh using machine learning (ML) algorithms. MATERIALS AND METHODS The hypertension data was derived from Bangladesh demographic and health survey, 2017-18, which included 6965 people aged 35 and above. Two most promising risk factor identification methods, namely least absolute shrinkage operator (LASSO) and support vector machine recursive feature elimination (SVMRFE) are implemented to detect the critical risk factors of hypertension. Additionally, four well-known ML algorithms as artificial neural network, decision tree, random forest, and gradient boosting (GB) have been used to predict hypertension. Performance scores of these algorithms were evaluated by accuracy, precision, recall, F-measure, and area under the curve (AUC). RESULTS The results clarify that age, BMI, wealth index, working status, and marital status for LASSO and age, BMI, marital status, diabetes and region for SVMRFE appear to be the top-most five significant risk factors for hypertension. Our findings reveal that the combination of SVMRFE-GB gives the maximum accuracy (66.98%), recall (97.92%), F-measure (78.99%), and AUC (0.669) compared to others. CONCLUSION GB-based algorithm confirms the best performer for prediction of hypertension, at an early stage in Bangladesh. Therefore, this study highly suggests that the policymakers make proper judgments for controlling hypertension using SVMRFE-GB-based combination to save time and reduce cost for Bangladeshi adults.
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Affiliation(s)
- Md Merajul Islam
- Department of Statistics, University of Rajshahi, Rajshahi 6205, Bangladesh.
| | - Md Jahanur Rahman
- Department of Statistics, University of Rajshahi, Rajshahi 6205, Bangladesh.
| | - Dulal Chandra Roy
- Department of Statistics, University of Rajshahi, Rajshahi 6205, Bangladesh.
| | - Most Tawabunnahar
- Department of Statistics, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh 2220, Bangladesh.
| | - Rubaiyat Jahan
- Institution of Education and Research, University of Rajshahi, Rajshahi 6205, Bangladesh.
| | - N A M Faisal Ahmed
- Institution of Education and Research, University of Rajshahi, Rajshahi 6205, Bangladesh.
| | - Md Maniruzzaman
- Statistics Discipline, Khulna University, Khulna 9208, Bangladesh.
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