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Barrio-Cortes J, Mateos-Carchenilla MP, Martínez-Cuevas M, Beca-Martínez MT, Herrera-Sancho E, López-Rodríguez MC, Jaime-Sisó MÁ, Ruiz-López M. Comorbidities and use of health services in people with diabetes mellitus according to risk levels by adjusted morbidity groups. BMC Endocr Disord 2024; 24:115. [PMID: 39010042 PMCID: PMC11251131 DOI: 10.1186/s12902-024-01634-0] [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: 10/23/2022] [Accepted: 06/25/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND People with diabetes mellitus frequently have other comorbidities and involve greater use of primary and hospital care services. The aim of this study was to describe the comorbidities and use of primary and hospital care services of people with diabetes according to their risk level by adjusted morbidity groups (AMG) and to analyse the factors associated with the utilisation of these services. METHODS Cross-sectional study. People with diabetes were identified within the population of patients with chronic conditions of an urban health care centre by the AMG stratification tool integrated into the primary health care electronic clinical record of the Community of Madrid. Sociodemographic, functional, clinical characteristics and annual health care services utilisation variables were collected. Univariate, bivariate and Poisson regression analyses were performed. RESULTS A total of 1,063 people with diabetes were identified, representing 10.8% of patients with chronic conditions within the health centre. A total of 51.4% were female, the mean age was 70 years, 94.4% had multimorbidity. According to their risk level, 17.8% were high-risk, 40.6% were medium-risk and 41.6% were low-risk. The most prevalent comorbidities were hypertension (70%), dyslipidaemia (67%) and obesity (32.4%). Almost 50% were polymedicated. Regarding health services utilisation, 94% were users of primary care, and 59.3% were users of hospital care. Among the main factors associated with the utilisation of both primary and hospital care services were AMG risk level and complexity index. In primary care, utilisation was also associated with the need for primary caregivers, palliative care and comorbidities such as chronic heart failure and polymedication, while in hospital care, utilisation was also associated with comorbidities such as cancer, chronic obstructive pulmonary disease or depression. CONCLUSIONS People with diabetes were older, with important needs for care, many associated comorbidities and polypharmacy that increased in parallel with the patient's risk level and complexity. The utilisation of primary and hospital care services was very high, being more frequent in primary care. Health services utilization were principally associated with functional factors related to the need of care and with clinical factors such as AMG medium and high-risk level, more complexity index, some serious comorbidities and polymedication.
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Affiliation(s)
- Jaime Barrio-Cortes
- Foundation for Biosanitary Research and Innovation in Primary Care, Madrid, Spain.
- Primary Care Investigation Unit, Gerencia Asistencial de Atención Primaria, Madrid, Spain.
- Faculty of Health, Universidad Camilo José Cela, Madrid, Spain.
| | - María Pilar Mateos-Carchenilla
- Faculty of Health, Universidad Camilo José Cela, Madrid, Spain
- V Centenario Healthcare Centre, Gerencia Asistencial de Atención Primaria, San Sebastián de los Reyes, Madrid, Spain
| | | | | | - Elvira Herrera-Sancho
- Ciudad Jardín Healthcare Centre, Gerencia Asistencial de Atención Primaria, Madrid, Spain
| | | | | | - Montserrat Ruiz-López
- Nursing School, Fundación Jiménez Diaz Hospital, Universidad Autónoma de Madrid, Madrid, Spain
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Ghammari F, Heidari K, Jalilian H. Financial protection and equity in the healthcare financing system in Iran: a cross-sectional study among slum dwellers with type 2 diabetes. BMJ Open 2024; 14:e081989. [PMID: 38702082 PMCID: PMC11086487 DOI: 10.1136/bmjopen-2023-081989] [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: 11/11/2023] [Accepted: 04/19/2024] [Indexed: 05/06/2024] Open
Abstract
OBJECTIVES This study was conducted to assess financial protection and equity in the healthcare financing system among slum dwellers with type 2 diabetes (T2D) in Iran in 2022. DESIGN Cross-sectional study. SETTING Primary care centres in Iran were selected from slums. PARTICIPANTS Our study included 400 participants with T2D using a systematic random sampling method. Patients were included if they lived in slums for at least five consecutive years, were over 18 years old and did not have intellectual disabilities. PRIMARY AND SECONDARY MEASURES A self-report questionnaire was used to assess cost-coping strategies vis-à-vis T2D expenditures and factors influencing them, as well as forgone care among slum dwellers. RESULTS Of the 400 patients who participated, 53.8% were female. Among the participants, 27.8% were illiterate, but 30.3% could read and write. 75.8% had income below 40 million Rial. There was an association between age, education, income, basic insurance, supplemental insurance and cost-coping strategies (p<0.001). 88.2% of those with first university degree used health insurance and 34% of illiterate people used personal savings. 79.8% of people with income over 4 million Rial reported using insurance to cope with healthcare costs while 55% of those with income under 4 million Rial reported using personal savings and a combination of health insurance and personal savings to cope with healthcare costs. As a result of binary logistic regression, illiterate people (adjusted OR=16, 95% CI 3.65 to 70.17), individuals with low income (OR 5.024, 95% CI 2.42 to 10.41) and people without supplemental insurance (OR 1.885, 95% CI 0.03 to 0.37) are more likely to use other forms of cost-coping strategies than health insurance. CONCLUSIONS As a result of insufficient use of insurance, cost-coping strategies used by slum dwellers vis-à-vis T2D expenditures do not protect them from financial risks. Expanding universal health coverage and providing supplemental insurance for those with T2D living in slums are recommended. Iran Health Insurance should adequately cover the costs of T2D care for slum dwellers so that they do not need to use alternative strategies.
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Affiliation(s)
- Fawzieh Ghammari
- Department of Health Policy and Management School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
| | - Kousar Heidari
- Department of Education Development, Faculty Medical School, Ahvaz Jondishapour University of Medical Sciences, Ahvaz, Khuzestan, Iran (the Islamic Republic of)
| | - Habib Jalilian
- Department of Health Services Management, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran (the Islamic Republic of)
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Ahmed MNQ, Lalin SAA, Ahmad S. Factors affecting knowledge, attitude, and practice of COVID-19: A study among undergraduate university students in Bangladesh. Hum Vaccin Immunother 2023; 19:2172923. [PMID: 36748107 PMCID: PMC10012897 DOI: 10.1080/21645515.2023.2172923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The global expansion of the COVID-19 outbreak is one of the worst disasters the world has faced in recent decades. This study explored various factors of knowledge, attitude, and practice regarding COVID-19 among Bangladeshi undergraduate university students. In addition, we also look at how COVID-19 based knowledge, attitude, and practice influence each other. Using a random sampling technique and a self-administered structured questionnaire survey, this study collected data from 167 private university students in Bangladesh from 1st October to 30th October 2020. Data were analyzed using descriptive statistics (including frequencies, percentages, and means), binary logistic regression, bivariate regression analysis, and factor analysis. The findings suggest that most of the students learned about COVID-19 from various sources, including news media (TV, radio, newspapers, etc.), international organizations (WHO, UN, etc.), various government programs, or from their friends, family members, or neighbors. Most of the students were concerned about becoming sick, keeping social distance, and family members' job insecurity, followed by the university shutdown and the subsequent quarantine. Many students believe Bangladesh's media, government, medical sector, and religious organizations played a significant role during COVID-19. Binary logistic regression demonstrates that students' gender, department, and residency significantly explained their COVID-19 knowledge. In addition, students' attitudes significantly vary with their religion and place of residence. Students' departments and semesters found significant in explaining their practice regarding COVID-19. Moreover, factor analysis results also identified several crucial factors in explaining students' overall knowledge, attitude, and practice of COVID-19. Finally, we found a statistically significant relationship between knowledge, attitude, and practice.
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Affiliation(s)
| | - Shamim Al Aziz Lalin
- Department of Business Administration, North East University Bangladesh, Sylhet, Bangladesh
| | - Saeed Ahmad
- Department of Sociology and Anthropology, Utah State University, Logan, UT, USA
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Eseadi C, Amedu AN, Ilechukwu LC, Ngwu MO, Ossai OV. Accessibility and utilization of healthcare services among diabetic patients: Is diabetes a poor man's ailment? World J Diabetes 2023; 14:1493-1501. [PMID: 37970126 PMCID: PMC10642413 DOI: 10.4239/wjd.v14.i10.1493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/03/2023] [Accepted: 09/06/2023] [Indexed: 10/09/2023] Open
Abstract
Diabetes is a non-communicable ailment that has adverse effects on the individual's overall well-being and productivity in society. The main objective of this study was to examine the empirical literature concerning the association between diabetes and poverty and the accessibility and utilization of medical care services among diabetic patients. The diabetes literature was explored using a literature review approach. This review revealed that diabetes is an ailment that affects all individuals irrespective of socioeconomic status; however, its pre-valence is high in low-income countries. Hence, despite the higher prevalence of diabetes in developing countries compared with developed countries, diabetes is not a poor man's ailment because it affects individuals of all incomes. While the number of diabetic patients that access and utilize diabetes medical care services has increased over the years, some personal and institutional factors still limit patients' access to the use of diabetes care. Also, there is a lacuna in the diabetes literature concerning the extent of utilization of available healthcare services by diabetic patients.
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Affiliation(s)
- Chiedu Eseadi
- Department of Educational Psychology, University of Johannesburg, Johannesburg 2006, Gauteng, South Africa
| | - Amos Nnaemeka Amedu
- Department of Educational Psychology, University of Johannesburg, Johannesburg 2006, Gauteng, South Africa
| | | | - Millicent O Ngwu
- Department of Sociology and Anthropology, University of Nigeria, Nsukka 41001, Enugu, Nigeria
| | - Osita Victor Ossai
- Department of Childhood Education, University of Johannesburg, Johannesburg 2006, Gauteng, South Africa
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Lovelina L, Mukherjee P, Kumar V, Abraham S, Rahman S, Pricilla RA. A Survey on Factors Affecting Knowledge and Satisfaction with Care Among Persons with Diabetes Mellitus in an Urban Health Centre and its Outreach Clinics in South India. J ASEAN Fed Endocr Soc 2023; 38:41-49. [PMID: 38045659 PMCID: PMC10692441 DOI: 10.15605/jafes.038.02.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 12/16/2022] [Indexed: 12/05/2023] Open
Abstract
Objective To determine the level of knowledge and factors affecting knowledge and satisfaction with diabetes care among persons with diabetes at urban health centre (UHC) and community health worker (CHW)-led outreach clinics (ORC) in South India. Methodology A cross-sectional study was carried out using a structured questionnaire. One hundred patients at the UHC and 200 patients at the ORC were included. Results Patients with DM of more than eight years, with co-morbidities and maintained on insulin had good knowledge at the UHC. At the ORC, participants who received education beyond the primary level and belonging to non - Hindu religion had higher knowledge. Patients at the ORC experienced better satisfaction in terms of waiting time for appointments, consultation, registration system and counselling. At the UHC, those who received primary education or those with lower educational attainment had better satisfaction. Overall, knowledge (p = 0.03) and satisfaction (p = 0.00001) of diabetes care was better at the ORC than at the UHC. Conclusions Our study found better knowledge and satisfaction with diabetes care at the ORC than at the UHC. Whether or not the difference can be attributed to CHW-based clinics in the community needs to be further elucidated.
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Affiliation(s)
- Lerisha Lovelina
- Department of Family Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Pavan Mukherjee
- Low Cost Effective Care Unit, Christian Medical College, Vellore, Tamil Nadu, India
| | - Vijaya Kumar
- Low Cost Effective Care Unit, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sunil Abraham
- Department of Family Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sajitha Rahman
- Department of Family Medicine, Christian Medical College, Vellore, Tamil Nadu, India
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Ghammari F, Jalilian H, Khodayari‐zarnaq R, Gholizadeh M. Health care utilization and its association with sociodemographic factors among slum-dwellers with type 2 diabetes in Tabriz, Iran: A cross-sectional study. Health Sci Rep 2023; 6:e1272. [PMID: 37251526 PMCID: PMC10213483 DOI: 10.1002/hsr2.1272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/18/2023] [Accepted: 05/03/2023] [Indexed: 05/31/2023] Open
Abstract
Background and Aims Slums are known as growing underprivileged areas. One of the health adverse effects of slum-dwelling is health care underutilization. Management of type 2 diabetes mellitus (T2DM) requires an appropriate utilization. This study aimed to investigate the extent of health care utilization among slum-dwellers with T2DM in Tabriz, Iran, in 2022. Methods We conducted a cross-sectional study on 400 patients with T2DM living in slum areas of Tabriz, Iran. Sampling was conducted using a systematic random sampling method. A researcher-made questionnaire was used for data collection. To develop the questionnaire, we used Iran's Package of Essential Noncommunicable (IraPEN) diseases, in which potential needs and essential health care for patients with diabetes and the appropriate time intervals for use are specified. Data were analyzed using SPSS version 22. Results Although 49.8% of patients needed outpatient services, only 38.3% were referred to health centers and utilized health services. The results of the binary logistic regression model showed that women (OR = 1.871, CI 1.170-2.993), those with higher income levels (OR = 1.984, CI 1.105-3.562), and those with diabetes complications (Adjusted OR = 1.7, CI 0.2-0.603) were almost 1.8 times more likely to utilize outpatient services. Additionally, those with diabetes complications (OR = 1.93, CI 0.189-2.031) and those taking oral medication (OR = 3.131, CI 1.825-5.369) were respectively 1.9 and 3.1 times more likely to utilize inpatient care services. Conclusions Our study showed that, although slum-dwellers with type 2 diabetes needed outpatient services, a small percentage were referred to health centers and utilized health services. Multispectral cooperation is necessary for improving the status quo. There is a need to take appropriate interventions to strengthen health care utilization among residents with T2DM living in slum sites. Also, insurance organizations should cover more health expenditures and provide a more comprehensive benefits package for these patients.
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Affiliation(s)
- Fawzieh Ghammari
- Department of Health Policy and Management, School of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
| | - Habib Jalilian
- Department of Health Services Management, School of HealthAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Rahim Khodayari‐zarnaq
- Department of Health Policy and Management, School of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
| | - Masumeh Gholizadeh
- Department of Health Policy and Management, School of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
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Saadeh R, Alsmadi H, Batieha A, Khader Y, Jaddou H, El-Khateeb M, Allouh MZ, Ajlouni K. Quality of care for type 2 diabetes in Jordan: A national study. MEDICINE INTERNATIONAL 2023; 3:27. [PMID: 37323128 PMCID: PMC10265394 DOI: 10.3892/mi.2023.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 05/25/2023] [Indexed: 06/17/2023]
Abstract
The present study aimed to describe the quality of healthcare delivered to patients with type 2 diabetes in Jordan in 2017. Another objective was to identify the factors related to glycemic control and hospital admission due to type 2 diabetes. This was a national population-based household study. Aspects of care quality were evaluated in relation to outcomes, such as glycemic control [hemoglobin A1c; glycated hemoglobin (HbA1c) level <7%] and hospital admission owing to diabetes. A total of 754 patients previously diagnosed with type 2 diabetes and aged ≥25 years were recruited. The number of annual visits was >10 for 48.5% and 1-4 for 38.2% of patients. The proportion of patients achieving glycemic control was 33.0%. In total, 4 of 5 patients reported easy access to health facilities and good health team support. Foot and eye examinations were performed for 24.9 and 55.0% of the patients, respectively. Dietary advice was delivered to 87.5% of the patients. Glycemic control exhibited a significant inverse association with the duration of diabetes and the number of annual visits. Following a specific diet for managing diabetes and the cessation of medication after an improved well-being were independently associated with a higher likelihood of glycemic control (HbA1c <7%). On the whole, the present study demonstrates that a number of indicators for the quality of diabetes care in Jordan were relatively satisfactory; however, others require improvement. The findings demonstrate that numerous patients with diabetes in Jordan require education about the treatment and management of, and complications associated with diabetes, especially those who are recently diagnosed.
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Affiliation(s)
- Rami Saadeh
- Department of Public Health and Community Medicine, College of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Haya Alsmadi
- Jerash Medical Center, Dental Department, Jerash Governorate, Jordan Ministry of Health, Amman 11118, Jordan
| | - Anwar Batieha
- Department of Public Health and Community Medicine, College of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Yousef Khader
- Department of Public Health and Community Medicine, College of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Hashem Jaddou
- Department of Public Health and Community Medicine, College of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Mohammed El-Khateeb
- The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), University of Jordan, Amman 11942, Jordan
| | - Mohammed Z. Allouh
- Department of Anatomy, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Kamel Ajlouni
- The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), University of Jordan, Amman 11942, Jordan
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Abebe G, Hailu T, Fikadu T, Gebremickael A, Temesgen R, Shibru T, Kefelew E, Dawit F, Atnafu K, Wale Tesega W, Bekele A. Magnitude and factors associated with musculoskeletal disorder among patients with diabetes attending chronic care at Arba Minch General Hospital, Arba Minch, southern Ethiopia, 2021: a cross-sectional study. BMJ Open 2022; 12:e059218. [PMID: 36343989 PMCID: PMC9644307 DOI: 10.1136/bmjopen-2021-059218] [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] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE This study aimed to assess the prevalence and determinants of musculoskeletal disorders (MSDs) among patients with diabetes in southern Ethiopia. DESIGN Facility-based cross-sectional study. SETTING Data collected from 1 March 2021 to 30 August 2021 at Arba Minch General Hospital. PARTICIPANTS Three hundred and sixty-five patients with diabetes attending care at Arba Minch General Hospital. MAIN OUTCOME MEASURES The magnitude and determinants of the MSDs. RESULTS The prevalence of MSDs among patients with diabetes was 23.29% (95% CI 19.00 to 27.76). The likelihood of developing MSDs was 6.8 times higher among women than men (AOR=6.787, 95% CI 2.08 to 22.19). Rural participants were about 2.4 times (AOR=2.38, 95% CI 1.06 to 5.33) more likely to develop MSDs as compared with urban participants. Participants aged >50 years were 5.9 times more likely to develop MSDs as compared with those aged ≤50 years (AOR=5.864, 95% CI 2.663 to 12.914). The odds of developing MSDs was 6.2 times (AOR=6.247, 95% CI 1.158 to 33.702) and 5.5 times (AOR=5.451 95% CI 1.174 to 25.312) higher among participants who attended primary and secondary education as compared with those who attended college and above, respectively. Participants with cardiovascular disease were 3.9 times more likely to develop MSDs as compared with their counterparts (AOR=3.854, 95% CI 1.843 to 8.063). CONCLUSIONS This study showed that age, sex, educational status, place of residence and cardiovascular disease were found to be determinants of MSDs. Thus, clinical and public health interventions working on diabetes mellitus should consider these determinants.
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Affiliation(s)
- Getachew Abebe
- Department of Anatomy, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Tadiwos Hailu
- Department of Internal Medicine, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Teshale Fikadu
- Department of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
- Department of nutrition and dietetics, Faculty of Public Health, Institute of Health, Jimma Jniversity, Jimma, Ethiopia
| | - Abinet Gebremickael
- Department of Anatomy, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Rodas Temesgen
- Department of Internal Medicine, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Tamiru Shibru
- Department of Internal Medicine, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Etenesh Kefelew
- Department of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Firehiwot Dawit
- Department of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Kaleb Atnafu
- Department of Medical Laboratory, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Wondwossen Wale Tesega
- Department of Biomedical Science, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Alehegn Bekele
- Department of Anatomy, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
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de Siqueira ISL, Guimarães RA, Pagotto V, Rosso CFW, Batista SRR, Barbosa MA. Access and Use of Health Services by People with Diabetes from the Item Response Theory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14612. [PMID: 36361491 PMCID: PMC9656273 DOI: 10.3390/ijerph192114612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/03/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
The objective of this study was to analyze the indicators of access and use of health services in people with diabetes mellitus. This study used data from the National Health Survey, conducted in Brazil in 2013. The National Health Survey was carried out with adults aged 18 years or older residing in permanent private households in Brazil. Indicators from 492 individuals with self-reported diabetes mellitus living in the Central-West region of the country were analyzed. Item response theory was used to estimate the score for access to and use of health services. Multiple linear regression was used to analyze factors associated with scores of access and use of health services by people with diabetes mellitus. The mean score of access estimated by the item response theory and use estimated was 51.4, with the lowest score of zero (lowest access and use) and the highest 100 (highest access and use). Among the indicators analyzed, 74.6% reported having received medical care in the last 12 months and 46.4% reported that the last visit occurred in primary care. Only 18.9% had their feet examined and 29.3% underwent eye examinations. Individuals of mixed-race/skin color and those residing outside capital and metropolitan regions had lower access and use scores when compared to white individuals and residents of state capitals, respectively. The study shows several gaps in the indicators of access and use of health services by people with diabetes. People of mixed race/skin color and residents outside the capitals and metropolitan regions had lower scores for access and use, suggesting the need to increase health care in these groups.
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Affiliation(s)
- Isabela Silva Levindo de Siqueira
- School of Social and Health Sciences, Pontifical Catholic University of Goiás, Avenida Universitária, número 1.440, Setor Leste Universitário, Goiânia 74605-010, Brazil
- Faculty of Nursing, Postgraduate Program in Nursing, Federal University of Goiás (UFG), Rua 227, Viela quadra 68, Setor Leste Universitário, Goiânia 74605-080, Brazil
| | - Rafael Alves Guimarães
- Faculty of Nursing, Postgraduate Program in Nursing, Federal University of Goiás (UFG), Rua 227, Viela quadra 68, Setor Leste Universitário, Goiânia 74605-080, Brazil
- Institute of Tropical Pathology and Public Health, Postgraduate Program in Tropical Medicine and Public Health, Federal University of Goiás, Rua 235, Setor Leste Universitário, Goiânia 74605-050, Brazil
| | - Valéria Pagotto
- Faculty of Nursing, Postgraduate Program in Nursing, Federal University of Goiás (UFG), Rua 227, Viela quadra 68, Setor Leste Universitário, Goiânia 74605-080, Brazil
| | - Claci Fátima Weirich Rosso
- Faculty of Nursing, Postgraduate Program in Nursing, Federal University of Goiás (UFG), Rua 227, Viela quadra 68, Setor Leste Universitário, Goiânia 74605-080, Brazil
| | - Sandro Rogério Rodrigues Batista
- Faculty of Medicine, Postgraduate Program in Health Sciences, Federal University of Goiás, Rua 235, Setor Leste Universitário, Goiânia 74605-050, Brazil
- Goiás State Health Department, Avanida SC 1, número 299, Parque Santa Cruz, Goiânia 74860-260, Brazil
| | - Maria Alves Barbosa
- Faculty of Nursing, Postgraduate Program in Nursing, Federal University of Goiás (UFG), Rua 227, Viela quadra 68, Setor Leste Universitário, Goiânia 74605-080, Brazil
- Faculty of Medicine, Postgraduate Program in Health Sciences, Federal University of Goiás, Rua 235, Setor Leste Universitário, Goiânia 74605-050, Brazil
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Hakim S, Chowdhury MAB, Ahmed NU, Uddin MJ. The availability of essential medicines for diabetes at health facilities in Bangladesh: evidence from 2014 and 2017 national surveys. BMC Health Serv Res 2022; 22:377. [PMID: 35317808 PMCID: PMC8941751 DOI: 10.1186/s12913-022-07738-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 03/01/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Bangladesh ranks among the world's top ten countries in the number of diabetic patients. The prevention of this disease requires treating patients with essential medicines, and the first crucial step in the uptake of these medicines is availability. We aimed to assess the availability of essential medicines for diabetes (EM-Diabetes) and to explore health facility characteristics associated with the availability of those medicines. METHODS We performed the analysis using nationally representative data from the two waves of the cross-sectional Bangladesh Health Facility Survey (BHFS) in 2014 and 2017. Data are available for 1548 and 1524 health facilities in the 2014 and 2017 BHFS. Study samples of this study were 217 facilities (73 from 2014 and 144 from 2017) that offer diabetes diagnosis and treatment services. The outcome variable 'EM-Diabetes availability' was calculated as a counting score of the tracer medicines: metformin, glibenclamide, injectable insulin, and injectable glucose solution. A multivariable Poisson regression model was used to identify the health facility characteristics (such as, managing authority, location, external supervision, regular quality assurance activities, national guidelines for diagnosis and management of diabetes, etc.) associated with EM-Diabetes availability. RESULTS Since 2014, there have been minimal increases in Bangladeshi health facilities that provide diabetes screening and treatment services (from 4.7% to 9.4%). Among facilities offering diabetes services, 64.5% (BHFS 2014) and 55.7% (BHFS 2017) facilities had no EM-Diabetes on-site at all. Between 2014 and 2017, the availability of metformin increased (from 27.5% to 40.1%), but there was a decrease in the availability of glibenclamide (from 16.5% to 9.1%), injectable insulin (from 20.4% to 11.4%), and injectable glucose solution (from 20.4% to 19.2%). Furthermore, publicly owned facilities [relative risk (RR) = 0.44, 95% confidence interval (CI): 0.25-0.78 for 2014 and RR= 0.54, 95% CI: 0.41-0.71 for 2017] and facilities in rural settings [RR= 0.26, 95% CI: 0.12-0.55 for 2014 and RR= 0.60, 95% CI: 0.44-0.81 for 2017] were significantly associated with decreased availability of EM-Diabetes in both survey years. Moreover, routine user fees [RR=3.70, 95% CI: 1.86-7.38] and regular quality assurance activities [RR= 1.62, 95% CI: 1.12-2.34] were also significantly associated with increased EM-Diabetes availability in 2017 only. CONCLUSIONS Overall, the health facilities in Bangladesh had insufficient essential medicines for treating diabetes. In general, the availability of EM-Diabetes declined from 2014 to 2017, except for metformin. Policymakers should consider a wide range of policy implications, focusing on the management of public facilities, rural facilities, routine user fees, and quality assurance activities to improve the availability of EM-Diabetes at health facilities in Bangladesh.
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Affiliation(s)
- Shariful Hakim
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, 3114, Bangladesh
- Chander Hat Degree College, Nilphamari, Bangladesh
| | | | - Nasar U Ahmed
- Department of Epidemiology, Florida International University, Miami, FL, USA
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, 3114, Bangladesh.
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Mwangasha FM, Nyamu DG, Tirop LJ. Factors impacting on diabetes knowledge, medication adherence and glycemic control among adult diabetics visiting a county teaching and referral hospital in Kenya: a cross-sectional study. Pan Afr Med J 2021; 40:5. [PMID: 34650655 PMCID: PMC8490163 DOI: 10.11604/pamj.2021.40.5.21848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 06/17/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction optimal management of diabetes involves interplay between patients’ understanding of their disease and medication adherence, which would eventually influence glycemic control. However, there is scant published literature on the interconnection of patient related factors that impact on optimal management of diabetes in resource-limited settings such as Kenya. Methods a hospital based cross-sectional survey involving 270 freely consenting adult diabetics investigated the interconnection between diabetes knowledge, medication adherence and glycemic control. Data on the patient´s knowledge and medication adherence was collected using validated tools whilst glycemic control was evaluated using the patients' glycated haemoglobin values. Data analysis was carried out using STATA version 13 statistical software, employing the chi square test for association and simple linear regression for prediction, with p ≤0.05 considered significant. Results participants´ level of knowledge on diabetes was significantly associated with the academic achievement (p=0.001), while their medication adherence was significantly associated with family support (p=0.001) and duration of disease since diagnosis (p=0.019). On linear regression, family support occasioned by the nature of participants’ household setup, had a strong positive correlation [r=0.99 (CI 0.60-1.00)] with optimal glycemic control. Conclusion family support is an important determinant of medication adherence and optimal glycemic control among diabetic patients. Clinicians should team up with family members of diabetic patients for optimal glycemic control.
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Affiliation(s)
| | - David Gitonga Nyamu
- School of Pharmacy, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya
| | - Lucy Jemutai Tirop
- School of Pharmacy, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya
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Islam SMS, Islam MT, Uddin R, Tansi T, Talukder S, Sarker F, Mamun KAA, Adibi S, Rawal LB. Factors associated with low medication adherence in patients with Type 2 diabetes mellitus attending a tertiary hospital in Bangladesh. LIFESTYLE MEDICINE 2021. [DOI: 10.1002/lim2.47] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition Deakin University Melbourne Victoria Australia
- Cardiovascular Division The George Institute for Global Health University of Sydney Sydney Australia
- Sydney Medical School The University of Sydney Sydney Australia
| | | | - Riaz Uddin
- Institute for Physical Activity and Nutrition Deakin University Melbourne Victoria Australia
| | - Tania Tansi
- Bangladesh College of Home Economics University of Dhaka Dhaka Bangladesh
| | | | - Farhana Sarker
- Department of CSE University of Liberal Arts Bangladesh (ULAB) Dhaka Bangladesh
| | | | - Sasan Adibi
- School of IT Deakin University Melbourne Victoria Australia
| | - Lal B Rawal
- School of Health Medical and Applied Sciences Central Queensland University Rockhampton Queensland Australia
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Knowledge, Attitude, Practice, and Fear of COVID-19: an Online-Based Cross-cultural Study. Int J Ment Health Addict 2021; 21:1025-1040. [PMID: 34483782 PMCID: PMC8404540 DOI: 10.1007/s11469-021-00638-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
The study aimed to measure Knowledge, Attitude, and Practice (KAP) and fear level towards COVID-19 and explore its cross-cultural variances in knowledge by sociodemographic factors among the general population of 8 different countries over 5 continents. It was a cross-sectional online survey. This survey was conducted in April 2020 among 1296 participants using the “Google Form” platform. Considering the social distancing formula and pandemic situation, we collect data using popular social media networks. Univariate and bivariate analyses were used to explore the collected data on KAP, fear, and sociodemographic factors. Overall knowledge score was 9.7 ± 1.7 (out of 12), and gender differences (female vs male: 9.8 ± 1.6 vs 9.5 ± 1.9) were significant (p = 0.008) in the bivariate analysis. Knowledge score variances were found significant in some regions by gender, marital status, and education qualification. The highest and lowest mean knowledge scores were recorded in the Middle East (10.0 ± 1.7) and Europe (9.3 ± 2.0). Despite having a high fear score (22.5 ± 5.6 out of 35), 78.35% of respondents were positively and 81.7% in a good practice level. Fear score rankings: Middle East (1st; 23.8 ± 5.5), Europe (2nd; 23.2 ± 5.8), Africa (3rd; 22.7 ± 5.0), South Asia (4th; 22.1 ± 5.7), Oceania (5th; 21.9 ± 5.8), and North America (6th; 21.7 ± 5.5). Fear and knowledge were not correlated. KAP and fear variation exist among geographical regions. Gender, marital status, and education qualification are factors in knowledge variances for some regions. KAP and fear measures can help health education programs consider some sociodemographic factors and regions during an outbreak of highly contagious disease and uplift a positive attitude and good practice.
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Alloh F, Hemingway A, Turner-Wilson A. The Role of Finding Out in Type 2 Diabetes Management among West-African Immigrants Living in the UK. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6037. [PMID: 34199708 PMCID: PMC8199992 DOI: 10.3390/ijerph18116037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 05/29/2021] [Accepted: 05/31/2021] [Indexed: 01/29/2023]
Abstract
Type 2 diabetes (T2DM) prevalence is three times higher among West African Immigrants compared to the general population in the UK. The challenges of managing T2DM among this group have resulted in complications. Reports have highlighted the impact of migration on the health of the immigrant population, and this has contributed to the need to understand the influence of living in West Africa, and getting diagnosed with T2DM, in the management of their condition in the UK. Using a qualitative constructivist grounded theory approach, thirty-four West African immigrants living in the UK were recruited for this study. All participants were interviewed using Semi-structured interviews. After coding transcripts, concepts emerged including noticing symptoms, delayed diagnosis, affordability of health services, beliefs about health, feelings at diagnosis, and emotions experienced at diagnosis all contribute to finding out about diagnosis T2DM. These factors were linked to living in West Africa, among participants, and played significant roles in managing T2DM in the UK. These concepts were discussed under finding out as the overarching concept. Findings from this study highlight important aspects of T2DM diagnosis and how lived experiences, of living in West Africa and the UK, contribute to managing T2DM among West African immigrants. The findings of this study can be valuable for healthcare services supporting West African immigrants living in the UK.
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Affiliation(s)
- Folashade Alloh
- Department of Allied and Public Health Professions, School of Health, Sport and Bioscience, University of East London, London E15 4LZ, UK
| | - Ann Hemingway
- Department of Public Health and Human Sciences, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth BH1 3LH, UK; (A.H.); (A.T.-W.)
| | - Angela Turner-Wilson
- Department of Public Health and Human Sciences, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth BH1 3LH, UK; (A.H.); (A.T.-W.)
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Ortiz-Rodríguez MA, Aldaz-Rodríguez MV, González-Robledo LM, Villa A, Bouzas C, Pastor R, Tur JA. Association between the Use of Health Services, Cardiovascular Risk Factors and Metabolic Syndrome in Mexican Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5336. [PMID: 34067845 PMCID: PMC8156833 DOI: 10.3390/ijerph18105336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/13/2021] [Accepted: 05/13/2021] [Indexed: 11/16/2022]
Abstract
Background: The use of health services is a complex behavioral phenomenon affected by multiple factors (availability, distance, cost, quality, attitudes, cultural beliefs, socioeconomic characteristics, and individuals' self-perception of health). Mexico has a segmented health system, and the access to it depends on the labor insertion and the population's ability to pay. Objective: To assess association between use of health services and cardiovascular and metabolic syndrome risk factors among Mexican adults. Methods: Analytical cross-sectional nationally representative study carried out on Mexican adults (≥20-year-old adults of both sexes; n = 4595). Socioeconomic factors, geographic area, health care coverage, information about the use of health services, previous medical diagnoses of diabetes and hypertension, and smoking were assessed. Anthropometrics, triglyceride, total cholesterol, HDL-cholesterol, and glucose plasma levels were measured. Metabolic syndrome (MetS) and cardiovascular risk factors were assessed. Prevalences were expressed in terms of percentages, and significant differences were calculated using χ2 test. Univariate and multivariate analysis was performed to evaluate the association between the use of health services and cardiovascular risk factors and sociodemographic variables. Results: The probability of using health services is higher and more significant in subjects with obesity, diabetes (OR (95% CI): 1.73 (1.49-2.00; p < 0.001), hypertension (OR (95% CI): 1.29 (1.14-1.45; p < 0.001), hypertriglyceridemia (OR (95% CI): 1.30 (1.15-1.46; p < 0.001), and in those with hypercholesterolemia (OR (95% CI): 1.23 (1.03-1.39; p = 0.001). Conclusions: Among health service users, there is a positive significant association between the use of health services and the presence of metabolic syndrome, obesity, diabetes, hypertension, hypertriglyceridemia, and hypercholesterolemia.
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Affiliation(s)
- María Araceli Ortiz-Rodríguez
- Faculty of Nutrition, Autonomous University of the State of Morelos, Cuernavaca 62350, Mexico; (M.A.O.-R.); (L.M.G.-R.)
| | | | - Luz María González-Robledo
- Faculty of Nutrition, Autonomous University of the State of Morelos, Cuernavaca 62350, Mexico; (M.A.O.-R.); (L.M.G.-R.)
| | - Antonio Villa
- Faculty of Medicine, National Autonomous University of Mexico, México City 04360, Mexico; (M.V.A.-R.); (A.V.)
| | - Cristina Bouzas
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS & IDISBA, 07122 Palma de Mallorca, Spain; (C.B.); (R.P.)
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain
| | - Rosario Pastor
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS & IDISBA, 07122 Palma de Mallorca, Spain; (C.B.); (R.P.)
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain
| | - Josep A. Tur
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS & IDISBA, 07122 Palma de Mallorca, Spain; (C.B.); (R.P.)
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain
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Haq MEU, Akash MSH, Sabir S, Mahmood MH, Rehman K. Human exposure to bisphenol A through dietary sources and development of diabetes mellitus: a cross-sectional study in Pakistani population. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:26262-26275. [PMID: 32361967 DOI: 10.1007/s11356-020-09044-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 04/23/2020] [Indexed: 05/27/2023]
Abstract
Bisphenol A (BPA) is considered as xenoestrogen, a crucial component utilized for the manufacturing of plastic products. It has a potential to disrupt the endocrine system and induces endocrine-related metabolic disorders. We aimed to investigate the exposure of BPA in Pakistani population and its association with sociodemographic features, dietary habits, and risk factors of diabetes mellitus (DM). This cross-sectional study was conducted on 400 participants among which 61.75% participants were diabetic and 38.25% were non-diabetic. We developed a structured questionnaire, gathered sociodemographic data, and collected their urine and blood samples for the estimation of BPA and various biomarkers as risk factors of DM, respectively. Pearson correlation coefficient was determined for urinary BPA levels and DM risk factors. Urinary BPA values were adjusted for confounders. Sociodemographic data shown that urinary BPA level was significantly higher (p < 0.05) in obese people (BMI > 27) living in semi-urban and industrial areas. BPA was detectable in 75% of study participants. Urinary BPA level was found to be higher in diabetic participants compared with that of non-diabetics. A significant correlation is observed between BPA exposure and DM risk factors. We found that urinary BPA level was correlated with elevated levels of HbA1c (r = 0.6028), HOMA-IR (r = 0.5356), CRP (r = 0.6946), BUN (r = 0.6077), AST (r = 0.5151), FFA (r = 0.5759), TGs (r = 0.5608), and MDA (r = 0.6908). Hence, our study adds to the growing body of evidence supporting the role of BPA exposure as a risk factor for DM and may be associated with higher glycemic index, increased pro-inflammatory and oxidative stress biomarkers, dyslipidemia, and impaired functioning of the liver and kidney. Heating food in plastic containers and consumption of packed food items are the main sources of BPA exposure which are positively associated with DM.
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Affiliation(s)
- Muhammad Ejaz Ul Haq
- Department of Pharmaceutical Chemistry, Government College University, Faisalabad, Pakistan
- Department of Pharmacology, Government College University, Faisalabad, Pakistan
| | | | - Shakila Sabir
- Department of Pharmaceutical Chemistry, Government College University, Faisalabad, Pakistan
| | | | - Kanwal Rehman
- Department of Pharmacy, University of Agriculture, Faisalabad, Pakistan.
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Determinants of diabetes in Bangladesh using two approaches: an analysis of the Demographic and Health Survey 2011. J Biosoc Sci 2019; 52:585-595. [PMID: 31630691 DOI: 10.1017/s002193201900066x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This cross-sectional study analysed data from the Bangladesh Demographic and Health Survey 2011 to investigate factors associated with diabetes in Bangladesh. Data were analysed using logistic and log-binomial regressions to estimate odds ratios (ORs) and prevalence ratios (PRs), respectively. Among the 7544 respondents aged ≥35 years, the estimated prevalence of diabetes was 11.0%. In the adjusted analysis, survey participants in the age group 55-64 years (adjusted PR [APR]: 1.8, 95% Confidence Interval (CI): 1.4, 2.2; adjusted OR [AOR]: 1.9, 95% CI: 1.5, 2.5) and those with at least secondary education level (APR: 1.3, 95% CI: 1.0, 1.6; AOR: 1.3, 95% CI: 1.0, 1.7) were more likely to have diabetes than those in the age group 35-44 years and those with no education. Furthermore, respondents living in Khulna (APR: 0.5, 95% CI: 0.4, 0.6; AOR: 0.4, 95% CI: 0.3, 0.6) were less likely to have diabetes than people living in Barisal. While adjusted estimates of PR and OR were similar in terms of significance of association, the magnitude of the point estimate was attenuated in PR compared with the OR. Nevertheless, the measured factors still had a significant association with diabetes in Bangladesh. The results of this study suggest that Bangladeshi adults would benefit from increased education on, and awareness of, the risk factors for diabetes. Focused public health intervention should target these high-risk populations.
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Islam JY, Zaman MM, Bhuiyan MR, Haq SA, Ahmed S, Al-Qadir AZ. Prevalence and determinants of hyperglycaemia among adults in Bangladesh: results from a population-based national survey. BMJ Open 2019; 9:e029674. [PMID: 31345979 PMCID: PMC6661587 DOI: 10.1136/bmjopen-2019-029674] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES With the increasing burden of non-communicable diseases in low-income and middle-income countries, biological risk factors, such as hyperglycaemia, are a major public health concern in Bangladesh. Hyperglycaemia is an excess of glucose in the bloodstream and is often associated with type 2 diabetes mellitus. Nationally representative data of hyperglycaemia prevalence starting from age ≥18 years are currently unavailable for Bangladeshi adults. The objective of this study was to assess the prevalence and determinants of hyperglycaemia among adults in Bangladesh aged ≥18 years. STUDY DESIGN Cross-sectional, population-based study. SETTING AND PARTICIPANTS Data for this analysis were collected in November to December 2015, from a population-based nationally representative sample of 1843 adults, aged ≥18 years, from both urban and rural areas of Bangladesh. Demographic information, capillary blood glucose, blood pressure, height, weight, waist circumference and treatment history were recorded. PRIMARY OUTCOME MEASURES Hyperglycaemia was defined as a random capillary blood glucose level of ≥11.1 mmol/L (ie, in the diabetic range) or currently taking medication to control type 2 diabetes, based on self-report. RESULTS Overall, the prevalence of hyperglycaemia was 5.5% (95% CI 4.5% to 6.6%) and was significantly higher among urban (9.8%, 95% CI 7.7% to 12.2%) than rural residents (2.8%, 95% CI 1.9% to 3.9%). The age-standardised prevalence of hyperglycaemia was 5.6% (95% CI 4.6% to 6.8%). Among both urban and rural residents, the associated determinants of hyperglycaemia included hypertension and abdominal obesity. About 5% of the total population self-reported have been previously diagnosed with type 2 diabetes; among these adults, over 25% were not taking medications to control their diabetes. CONCLUSIONS Our study found that about 1 in 20 Bangladeshi adults aged ≥18 years have hyperglycaemia. To control and prevent the development of type 2 diabetes, data from this study can be used to inform public health programming and provide descriptive information on surveillance of progress towards controlling diabetes in Bangladesh.
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Affiliation(s)
- Jessica Yasmine Islam
- Non-Communicable Disease Unit, World Health Organization Country Office for Bangladesh, Dhaka, Bangladesh
- Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Mohammad Mostafa Zaman
- Non-Communicable Disease Unit, World Health Organization Country Office for Bangladesh, Dhaka, Bangladesh
| | - Mahfuz Rahman Bhuiyan
- Non-Communicable Disease Unit, World Health Organization Country Office for Bangladesh, Dhaka, Bangladesh
| | - Syed Atiqul Haq
- Rheumatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Shamim Ahmed
- Rheumatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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