Kundu Satyajit, Rahman Md Ashfikur, Kabir Humayun, Al Banna Md Hasan, Hagan John Elvis, Srem-Sai Medina, Wang Lina
Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210096, China.
Development Studies Discipline, Khulna University, Khulna 9208, Bangladesh.
J Cardiovasc Dev Dis. 2022 Dec 23;10(1):7. doi: 10.3390/jcdd10010007.
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.
糖尿病、高血压及共病仍是孟加拉国人面临的重大公共卫生挑战。尽管如此，针对相关因素，尤其是孟加拉国糖尿病、高血压及共病方面的社会经济不平等现象所开展的研究却极少。本研究探讨了孟加拉国成年人中糖尿病、高血压及共病的患病率、相关因素以及社会经济不平等情况。我们使用了2017 - 2018年孟加拉国人口与健康调查（BDHS）数据集。共有12136名（加权后）平均年龄为39.5岁（±16.2）的孟加拉国成年人参与了本研究。采用多水平（混合效应）逻辑回归分析来确定糖尿病、高血压及共病的决定因素，其中群组被视为二级因素。利用浓度曲线（CC）和浓度指数（CIX）来研究糖尿病、高血压及共病方面的不平等情况。糖尿病、高血压及共病的加权患病率分别为10.04%、25.70%和4.47%。年龄、体重指数、身体活动、家庭财富状况以及不同行政区与参与者中的糖尿病、高血压及共病显著相关。此外，参与者的吸烟状况与高血压有关。女性比男性更容易患高血压和共病。高家庭财富组中的糖尿病（CIX：0.251，p < 0.001）、高血压（CIX：0.071，p < 0.001）和共病（CIX：0.340，p < 0.001）情况更为严重。在糖尿病、高血压及共病方面发现了有利于财富阶层的差异。这些糖尿病、高血压及共病方面的不平等现象凸显了设计干预方案以应对这些疾病不断上升负担的必要性。
