Suchergebnisse

OBJECTIVE: We implemented this study to report the prevalence and associated risk factors of hypertension among adult men and women aged >30 years residing in selected urban and rural areas of Dhaka division, Bangladesh. DESIGN: Cross-sectional study. SETTING: Two urban (Dhaka city north and Dhaka city south) and two rural (Narsinghdi and Gazipur district) areas of the Dhaka division. PARTICIPANTS: A total of 4856 male and female participants were included in the final analysis, of whom 2340 (48.2%) were from urban and 2516 (51.8%) were from rural areas. PRIMARY OUTCOME: Hypertension was the dependent variable for this study and was operationally defined as systolic blood pressure >140 mm of Hg and/or diastolic blood pressure >90 mm of Hg, and/or persons with already diagnosed hypertension. RESULTS: The overall prevalence of hypertension was 31.0%, and the prevalence was higher among urban participants (urban: 36.9%, rural: 30.6%). Age (across all categories), female (urban—adjusted OR (AOR): 1.3, 95% CI: 1.0 to 1.5 and rural—AOR: 1.7, 95% CI: 1.4 to 2.1)), higher educational status (urban—AOR: 1.7, 95% CI: 1.3 to 2.2 and rural—AOR: 2.1, 95% CI: 1.5 to 3.1), inadequate physical activity (urban—AOR: 1.3, 95% CI: 1.0 to 1.7 and rural—AOR: 1.5, 95% CI: 1.2 to 1.9) and overweight/obesity (urban—AOR: 2.7, 95% CI: 2.1 to 3.3 and rural—AOR: 2.1, 95% CI: 1.7 to 2.5) were associated with hypertension in both urban and rural areas. Women who were not currently married during the survey had higher odds of hypertension only in the rural areas (rural—AOR: 1.8, 95% CI: 1.3 to 2.4), and respondents who were not working during the survey had higher odds of hypertension only in the urban areas (AOR: 1.7, 95% CI: 1.0 to 2.6). CONCLUSION: Since the prevalence of hypertension was high in urban and rural areas, the government of Bangladesh should consider implementing hypertension prevention programmes focusing young population of Dhaka division. In addition, early screening programmes and management of hypertension need to ...

OBJECTIVES: Minimum Dietary Diversity (MDD) is an indicator to assess feeding practices of children aged 6–23 months. The WHO and UNICEF have recently revised the definition of MDD, replacing '≥4 out of 7 food groups (MDD-7FG)' with '≥5 out of 8 food groups (MDD-8FG)'. In the new definition, breast milk was considered as a separate food group. We aimed to estimate the implications of this change on the prevalence of MDD at the national and regional levels of Bangladesh. METHODS: We analyzed data from the national food security and nutrition surveillance round 2018–2019. MDD was defined and calculated according to the WHO-UNICEF guidelines. The prevalence of MDD-7FG and MDD-8FG was estimated and stratified by gender, age groups, place of residence, division, and wealth index. The difference between the prevalence between MDD-7FG and MDD-8FG was presented as percentages. RESULTS: Compared to the older definition, the overall prevalence of MDD was lower among 6 to 23 months old children in Bangladesh (46.2% vs. 54.7%). The absolute percentage point difference between the estimates (MDD-8FG vs. MDD-7FG) was higher among the boys (44.0% vs. 53.2%), 12–23 months aged old children (53.4% vs. 63.4%), children living in the non-slum urban areas (30.2% vs. 42.4%) and Dhaka division (42.0% vs. 56.3%), and among the children of middle-class families (40.3% vs. 57.6%). CONCLUSIONS: The new definition and the inclusion of breast milk intake as a new food group led to a decrease in the prevalence of minimum dietary diversity in Bangladesh. The country program needs to emphasize the continuation of breastfeeding until two years of age of the children. Moreover, the changes in the definition of MDD and the resultant consequence should be kept in mind while performing trend analysis of dietary diversity in Bangladesh and elsewhere. FUNDING SOURCES: Ministry of Health and Family Welfare, Government of Bangladesh.

OBJECTIVES: Though Bangladesh is passing through demographic, epidemiologic and nutritional transitions, national estimates on nutrition and health status of the elderly population are largely unknown. We aimed to determine the status of selected health and nutrition indicators among the elderly population in Bangladesh. METHODS: For the first time in Bangladesh, we included elderly population (≥60 years old females and males) as a separate population group in the national food security and nutrition surveillance round 2018–2019. We collected data on dietary diversity, nutritional status, behavioral risk factors of non-communicable diseases, blood pressure, and self-reported chronic diseases from 4,818 elderly people (48% female) living in 82 clusters (57 rural, 15 non-slums urban, and 10 slums) randomly selected from eight administrative division of Bangladesh. RESULTS: Majority (59% in rural, 53% in non-slum urban, and 69% in slums) of elderly people were consuming an inadequately diverse (4 or less food groups out of 10) diet. Overall, 89% of elderly people were malnourished (20%) or at risk of malnutrition (69%). The highest prevalence of malnutrition was in Mymensingh division (37%) followed by Sylhet division (27%). The prevalence of obesity was 5%, 16%, and 11%, in rural, non-slum urban, and slums, respectively. The national prevalence of smoking, smokeless tobacco consumption, physical inactivity was 18%, 52%, and 38%, respectively. There was a high burden of hypertension (49% in rural, 53% in non-slum urban, and 39% in slums). Overall, 16% of elderly people had heart diseases, 14% had chronic respiratory diseases, 3% had kidney diseases, 9% had diabetes, 8% had stroke, 0.5% had cancer and 1.4% had mental health problems. CONCLUSIONS: The government of Bangladesh should design and implement health and nutrition programs among the elderly population. The regional differences in the prevalence of health and nutrition indicators should be considered while designing such programs. FUNDING SOURCES: Ministry ...

AbstractThe World Health Organization set a target of a 15% relative reduction in the prevalence of insufficient physical activity (IPA) by 2025 among adolescents and adults globally. In Bangladesh, there are no national estimates of the prevalence of IPA among adolescents. The aim of this study was to estimate the prevalence of and risk factors associated with IPA among adolescent girls and boys. Data for 4865 adolescent girls and 4907 adolescent boys, collected as a part of a National Nutrition Surveillance in 2018–19, were analysed for this study. A modified version of the Global Physical Activity Questionnaire (GPAQ) was used to collect physical activity data. The World Health Organization recommended cut-off points were used to estimate the prevalence of IPA. Bivariate and multivariable logistic regression was performed to identify factors associated with IPA. Prevalences of IPA among adolescent girls and boys were 50.3% and 29.0%, respectively, and the prevalence was significantly higher among early adolescents (10–14 years) than late adolescents (15–19 years) among both boys and girls. The IPA prevalence was highest among adolescents living in non-slum urban areas (girls: 77.7%; boys: 64.1%). For both boys and girls, younger age, non-slum urban residence, higher paternal education and increased television viewing time were significantly associated with IPA. Additionally, residing in slums was significantly associated with IPA only among the boys. Higher maternal education was associated with IPA only among the girls. This study identified several modifiable risk factors associated with IPA among adolescent boys and girls in Bangladesh. These factors should be addressed through comprehensive public health interventions to promote physical activity among adolescent girls and boys.

OBJECTIVES: To assess the prevalence of noncommunicable disease (NCD) risk factors and the factors associated with the coexistence of multiple risk factors (≥ 2 risk factors) among adolescent boys and girls in Bangladesh. METHODS: Data on selected NCD risk factors collected from face to face interviews of 4,907 boys and 4,865 girls in the national Nutrition Surveillance round 2018–2019, was used. Descriptive analysis and multivariable logistic regression were performed. RESULTS: The prevalence of insufficient fruit and vegetable intake, inadequate physical activity, tobacco use, and being overweight/obese was 90.72%, 29.03%, 4.57%, and 6.04%, respectively among boys; and 94.32%, 50.33%, 0.43%, and 8.03%, respectively among girls. Multiple risk factors were present among 34.87% of boys and 51.74% of girls. Younger age (p < 0.001), non-slum urban (p < 0.001) and slum residence (p < 0.001), higher paternal education (p = 0.001), and depression (p < 0.001) were associated with the coexistence of multiple risk factors in both boys and girls. Additionally, higher maternal education (p < 0.001) and richest wealth quintile (p = 0.023) were associated with the coexistence of multiple risk factors in girls. CONCLUSION: The government should integrate specific services into the existing health and non-health programs which are aimed at reducing the burden of NCD risk factors.

CONTEXT AND OBJECTIVES: Non-communicable diseases and injuries (NCDIs) comprise a large share of mortality and morbidity in low-income countries (LICs), many of which occur earlier in life and with greater severity than in higher income settings. Our objective was to assess availability of essential equipment and medications required for a broad range of acute and chronic NCDI conditions. DESIGN: Secondary analysis of existing cross-sectional survey data. SETTING: We used data from Service Provision Assessment surveys in Bangladesh, the Democratic Republic of the Congo, Ethiopia, Haiti, Malawi, Nepal, Senegal and Tanzania, focusing on public first-referral level hospitals in each country. OUTCOME MEASURES: We defined sets of equipment and medications required for diagnosis and management of four acute and nine chronic NCDI conditions and determined availability of these items at the health facilities. RESULTS: Overall, 797 hospitals were included. Medication and equipment availability was highest for acute epilepsy (country estimates ranging from 40% to 95%) and stage 1–2 hypertension (28%–83%). Availability was low for type 1 diabetes (1%–70%), type 2 diabetes (3%–57%), asthma (0%–7%) and acute presentations of diabetes (0%–26%) and asthma (0%–4%). Few hospitals had equipment or medications for heart failure (0%–32%), rheumatic heart disease (0%–23%), hypertensive emergencies (0%–64%) or acute minor surgical conditions (0%–5%). Data for chronic pain were limited to only two countries. Availability of essential medications and equipment was lower than previous facility-reported service availability. CONCLUSIONS: Our findings demonstrate low availability of essential equipment and medications for diverse NCDIs at first-referral level hospitals in eight LICs. There is a need for decentralisation and integration of NCDI services in existing care platforms and improved assessment and monitoring to fully achieve universal health coverage.