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孟加拉国社会经济地位与非传染性疾病风险因素和合并症患病率的关系:一项全国性横断面调查的结果。

Association between socioeconomic status and prevalence of non-communicable diseases risk factors and comorbidities in Bangladesh: findings from a nationwide cross-sectional survey.

机构信息

Universal Health Coverage, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh.

Institute for Social Science Research, The University of Queensland, Queensland, Australia.

出版信息

BMJ Open. 2019 Mar 13;9(3):e025538. doi: 10.1136/bmjopen-2018-025538.

Abstract

OBJECTIVES

This study aimed to examine the prevalence and distribution in the comorbidity of non-communicable diseases (NCDs) among the adult population in Bangladesh by measures of socioeconomic status (SES).

DESIGN

This was a cross-sectional study.

SETTING

This study used Bangladesh Demographic and Health Survey 2011 data.

PARTICIPANTS

Total 8763 individuals aged ≥35 years were included.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome measures were diabetes mellitus (DM), hypertension (HTN) and overweight/obesity. The study further assesses factors (in particular SES) associated with these comorbidities (DM, HTN and overweight/obesity).

RESULTS

Of 8763 adults 12% had DM, 27% HTN and 22% were overweight/obese (body mass index ≥23 kg/m). Just over 1% of the sample had all three conditions, 3% had both DM and HTN, 3% DM and overweight/obesity and 7% HTN and overweight/obesity. DM, HTN and overweight/obesity were more prevalent those who had higher education, were non-manual workers, were in the richer to richest SES and lived in urban settings. Individuals in higher SES groups were also more likely to suffer from comorbidities. In the multivariable analysis, it was found that individual belonging to the richest wealth quintile had the highest odds of having HTN (adjusted OR (AOR) 1.49, 95% CI 1.29 to 1.72), DM (AOR 1.63, 95% CI 1.25 to 2.14) and overweight/obesity (AOR 4.3, 95% CI 3.32 to 5.57).

CONCLUSIONS

In contrast to more affluent countries, individuals with NCDs risk factors and comorbidities are more common in higher SES individuals. Public health approaches must consider this social patterning in tackling NCDs in the country.

摘要

目的

本研究旨在通过社会经济地位(SES)指标,调查孟加拉国成年人群中非传染性疾病(NCD)的共病患病率和分布情况。

设计

这是一项横断面研究。

地点

本研究使用了 2011 年孟加拉国人口与健康调查的数据。

参与者

共纳入 8763 名年龄≥35 岁的个体。

主要和次要结果测量

主要结果测量是糖尿病(DM)、高血压(HTN)和超重/肥胖。本研究进一步评估了与这些共病(DM、HTN 和超重/肥胖)相关的因素(特别是 SES)。

结果

在 8763 名成年人中,有 12%患有糖尿病,27%患有高血压,22%超重/肥胖(体重指数≥23kg/m²)。超过 1%的样本同时存在这三种情况,3%同时患有糖尿病和高血压,3%同时患有糖尿病和超重/肥胖,7%同时患有高血压和超重/肥胖。在受教育程度较高、非体力劳动者、SES 较富裕到最富裕和居住在城市地区的人群中,DM、HTN 和超重/肥胖更为普遍。SES 较高的个体也更有可能患有共病。在多变量分析中,发现属于最富裕财富五分位的个体发生高血压的几率最高(调整后的比值比(AOR)为 1.49,95%置信区间(CI)为 1.29 至 1.72)、糖尿病(AOR 为 1.63,95%CI 为 1.25 至 2.14)和超重/肥胖(AOR 为 4.3,95%CI 为 3.32 至 5.57)。

结论

与较富裕国家相反,孟加拉国 SES 较高的个体中非传染性疾病危险因素和共病更为常见。在解决该国的非传染性疾病问题时,公共卫生方法必须考虑到这种社会模式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf0f/6429850/979294c8ac98/bmjopen-2018-025538f01.jpg

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