Prevalence, awareness, treatment, and control of hypertension in Bangladesh: Findings from National Demographic and Health Survey, 2017-18

AbstractObjectiveTo estimate the age-standardised prevalence, awareness, treatment and control of hypertension; and to identify their risk factors in Bangladeshi adults 18 years and above using the Bangladesh Demographic and Health Survey (BDHS) 2017-18 data.MethodsData from 12, 904 Bangladeshi adults aged 18 years and older available from the most recent nationally representative BDHS 2017-18 were used. Hypertension was defined as having systolic blood pressure ≥140 mmHg and/or a diastolic blood pressure ≥90 mmHg, and/or taking anti-hypertensive drugs to control blood pressure. Age-standardised prevalence of hypertension and control were estimated with direct standardisation, and a multilevel mixed-effects Poisson regression model with a robust variance was used to identify factors associated with hypertension and its awareness, treatment, and control.ResultsThe overall age-standardised prevalence of hypertension was 40.0% (95% CI, 38.9-42.2); (men: 37.1%, women: 42.0%). Among those with hypertension (n=3531), 44.3% were aware that they had the condition and 39.1% were taking anti-hypertensive medication. Among those treated for hypertension (n=1306), only 41% had controlled hypertension. Factors independently associated with hypertension were increasing age, higher body mass index, being women, having diabetes, and residing in selected administrative divisions. A declining trend of hypertension control was observed with increasing age and those not being educated.ConclusionHypertension is highly prevalent (4 out of 10) in Bangladeshi adults, while awareness, treatment, and control are low. Irrespective of risks associated with hypertension and its management, awareness and control programmes should be given high priority in reducing hypertension, and improving hypertension control in Bangladesh.

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Socioeconomic inequalities in the use of caesarean section delivery in Ghana: a cross-sectional study using nationally representative data

International Journal for Equity in Health ◽

10.1186/s12939-019-1063-6 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 3

Author(s):

Emmanuel Dankwah ◽

Shelley Kirychuk ◽

Wu Zeng ◽

Cindy Feng ◽

Marwa Farag

Keyword(s):

Caesarean Section ◽

Health Survey ◽

Maternal Age ◽

Wealth Quintile ◽

Socioeconomic Inequalities ◽

Demographic And Health Survey ◽

Wealth Status ◽

Cross Sectional ◽

Factors Associated ◽

Nationally Representative

Abstract Background Inappropriate use of Caesarean Section (CS) delivery is partly to blame for Ghana’s high maternal mortality rate. However, previous research offered mixed findings about factors associated with CS use. The goal of this study is to examine use of CS in Ghana and the socioeconomic factors associated with it. Methods Data from the nationally representative 2014 Ghana Demographic and Health Survey (GDHS) was used after permission from the Monitoring and Evaluation to Assess and Use Results (MEASURE) Demographic and Health Survey (DHS) program. Univariable and multivariable logistic regression models were fitted to examine the socioeconomic inequalities in CS use. The independent variables included maternal age, marital status, religion, ethnicity, education, place of residence, wealth quintile, and working status. Concentration index (CI) and rate-ratios were computed to ascertain the level of CS inequalities. Results Out of the 4294 women, 11.4% had CS delivery. However, the percentage of CS delivery ranged from 5% of women in the poorest quintile to 27.5% of women in the richest qunitle. Significant associations were detected between CS delivery and maternal age, parity, education, and wealth quintile . Conclusions This study revealed that first, even though Ghana has achieved an aggregate CS rate consistent with WHO recommendations, it still suffers from inequities in the use of CS. Second, both underuse of CS among poorer women in Ghana and overuse among rich and educated women are public health concerns that need to be addressed. Third, the results show in spite of Ghana’s free maternal care services policies, wealth status of women continues to be strongly and signtificantly associated with CS delivery, indicating that there are indirect health care costs and other reasons preventing poorer women from having access to CS which should be understood better and addressed with appropriate policies.

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Factors associated with blood pressure check-up during pregnancy among women of reproductive age in Tanzania: an analysis of data from 2015—16 Tanzania Demographic and Health Survey and Malaria Indicators Survey

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03963-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fabiola V. Moshi ◽

Maximilian Tungaraza

Keyword(s):

Blood Pressure ◽

Pregnant Women ◽

Health Survey ◽

Wealth Index ◽

Reference Population ◽

Education Level ◽

Demographic And Health Survey ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Factors Associated

Abstract Background Hypertensive Disorder of Pregnancy (HDP) is one of the leading causes of maternal mortality and morbidity amongst pregnant women in the world. Blood pressure check-ups during pregnancy are one of the strategies used to identify hypertensive disorders, hence timely management. Little is known about the factors associated with blood pressure check-ups in Tanzania. Method The study used data from 2015—16 Tanzania Demographic and Health Survey and Malaria Indicators Survey (2015—16 TDHS—MIS). A total of 6924 women of active reproductive age from 15 to 49 were included in the analysis. Both univariate and multiple regression analyses were used to determine the association between early antenatal booking and maternal services utilization. Results The prevalence of blood pressure checkups during pregnancy was 72.17% at 95% confidence interval of 71.1–73.2%. Factors associated with uptake of blood pressure check-ups were; timely antenatal booking, AOR = 1.496, CI = 1.297–1.726, p < 0.001, late booking was a reference population, age group [> 34 years, (AOR = 1.518, CI = 1.149–2.006, p = 0.003)] with < 20 years used as a reference population, wealth index [middle income, (AOR = 1.215, CI = 1.053–1.468, p = 0.008) and rich, (AOR = 2.270, CI = 1.907–2.702, p < 0.001)] reference population being poor; education level [primary education, (AOR = 1.275, CI = 1.107–1.468, p = 0.001); secondary education, (AOR = 2.163, CI = 1.688–2.774, p < 0.001) and higher education, (AOR = 9.929, CI = 1.355–72.76, p = 0.024)] reference population being no formal education; parity [para 2–4, (AOR = 1.190, CI = 1.003–1.412, p = 0.046) with para one used as a reference population and zones [Unguja Island, (AOR = 3.934, CI = 1.568–9.871, p = 0.004), Pemba Island, (AOR = 5.308, CI = 1.808–15.58, p = 0.002)] and Mainland Urban being the reference population. Conclusion The study revealed that rural dwelling pregnant women had higher chance of not getting their BP checked. It was also revealed that maternal age, education level, place of residence, wealth index and timing of ANC services were significantly associated with blood pressure check-ups. The study recommends the need to explore significant factors associated with utilization of available free reproductive health services across all public health facilities. It also recommends the need to address prioritized intensive awareness programs and behavioral change interventions on the significance of BP check-ups among pregnant women of reproductive age.

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Factors Associated with Blood Pressure Checkup During Pregnancy Among Women of Reproductive Age in Tanzania; An Analysis of Data from the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicators Survey

10.21203/rs.3.rs-44299/v2 ◽

2020 ◽

Author(s):

Fabiola Vincent Moshi ◽

Maximilian Tungaraza

Keyword(s):

Blood Pressure ◽

Pregnant Women ◽

Health Survey ◽

Wealth Index ◽

Reference Population ◽

Education Level ◽

Demographic And Health Survey ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Factors Associated

Abstract Background: Hypertensive Disorder of Pregnancy (HDP) is one of the leading causes of maternal mortality and morbidity amongst pregnant women in the world. Blood pressure check-ups during pregnancy constitute one of the strategies used to identify hypertensive disorders, hence timely management. Little is known about the factors associated with blood pressure check-ups in Tanzania.Method: The study used data from 2015 - 16 Tanzania Demographic and Health Survey and Malaria Indicators Survey (2015 - 16 TDHS - MIS). A total of 6924 women of active reproductive age from 15 to 49 were included in the analysis. Both univariate and multiple regression analyses were used to determine the association between early antenatal booking and maternal services utilization.Results: A total of 4997(72.17%) interviewed women were checked for blood pressure at least once. Having been adjusted for the confounders, the factors which influenced an uptake of blood pressure check-ups during pregnancy were timed for antenatal booking within first 12 weeks, AOR=1.496 at 95% CI= 1.297-1.726, p<0.001, age group [more than 34 years, (AOR=1.518 at 95% CI=1.149-2.006, p=0.003)], wealth index [middle income, (AOR=1.215 at 95% CI=1.053-1.468, p=0.008) and rich, (AOR=2.270 at 95% CI=1.907-2.702, p<0.001)] reference population being poor; education level [primary education, (AOR=1.275 at 95% CI=1.107-1.468, p=0.001); secondary education, (AOR=2.163 at 95% CI=1.688-2.774, p<0.001) and higher education, (AOR=9.929 at 95%CI=1.355-72.76, p=0.024)] reference population being no formal education; parity [para 2-4, (AOR=1.190 at 95% CI=1.003-1.412, p=0.046) and zones [Unguja Island, (AOR=3.934 at 95% CI=1.568-9.871, p=0.004), Pemba Island, (AOR=5.308 at 95%CI=1.808-15.58, p=0.002)] and Mainland Urban being the reference population.Conclusion: Blood pressure check-ups during pregnancy offer the opportunity for early detection, hence timely management of HDP. The study revealed that rural dwelling pregnant women had higher chance of not getting their BP checked. It was also revealed that maternal age, education level, place of residence, wealth index and timing of ANC services were significantly associated with blood pressure check-ups. The study recommends the need to explore significant factors associated with utilization of available free reproductive health services across all public health facilities. It also recommends the need to address prioritized intensive awareness programs and behavioral change interventions on the significance of BP check-ups among pregnant women of reproductive age.

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Prevalence, awareness, and control of hypertension among Bangladeshi adults: an analysis of demographic and health survey 2017–18

Clinical Hypertension ◽

10.1186/s40885-021-00174-2 ◽

2021 ◽

Vol 27 (1) ◽

Author(s):

Gulam Muhammed Al Kibria ◽

Rajat Das Gupta ◽

Jannatun Nayeem

Keyword(s):

Health Survey ◽

Descriptive Analysis ◽

Female Gender ◽

Cross Sectional Study ◽

Older Age ◽

Demographic And Health Survey ◽

Cross Sectional ◽

Factors Associated ◽

Control Programs ◽

And Control

Abstract Background The prevalence of hypertension is increasing in Bangladesh, however, few recent studies investigated the proportion of people and factors associated with prevalence, awareness, and control of this condition in this country. This study investigated these among Bangladeshi adults. Methods Using Bangladesh Demographic and Health Survey 2017–18 data, a cross-sectional study was conducted. Multilevel logistic regression analysis was employed after descriptive analysis and prevalence estimation. Results Among 12,926 persons (mean age: 40 years, 57% women), the prevalence of hypertension was 27.4% (n = 3551), it was 28.4 and 26.2% among females and males, respectively. Among hypertensive people, about 42.4% (n = 1508) people were aware of having it, 48.7% among females and 33.5% among males. Of the 1313 people who were taking antihypertensive medication, only 33.8% (n = 443) had controlled hypertension, 34.7 and 31.7% among females and males, respectively. Among the studied factors associated with hypertension, people with older age, female gender, overweight/obesity, diabetes, richer wealth quintiles, and residence in some administrative divisions had higher odds of hypertension (p < 0.05). However, the odds of awareness was lower among younger people, males, and people without overweight/obesity, diabetes, or richer wealth quintiles. Odds of controlled hypertension was also lower among people with older age and higher among college-educated people. Conclusion This study identified several important factors associated with prevalence, awareness, and control of hypertension. It is important to address these factors with nationwide prevention and control programs.

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Prevalence of diabetes and prediabetes among Bangladeshi adults and associated factors: Evidence from the Demographic and Health Survey, 2017-18

10.1101/2021.01.26.21250519 ◽

2021 ◽

Author(s):

Rakibul M. Islam ◽

Md. Nuruzzaman Khan ◽

John C. Oldroyd ◽

Juwel Rana ◽

Dianna J. Magliago ◽

...

Keyword(s):

Health Survey ◽

Adult Population ◽

Fasting Blood Glucose ◽

Wealth Quintile ◽

Normal Weight ◽

Demographic And Health Survey ◽

Control Measures ◽

Effective Prevention ◽

Factors Associated ◽

Nationally Representative

AbstractAimTo estimate the age-standardised prevalence of diabetes and prediabetes, and to identify factors associated with these conditions at individual, household, and community levels.MethodsData from 11, 952 Bangladeshi adults aged 18+ available from the most recent nationally representative 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-standardised with direct standarisation, and risk factors were identified using multilevel mix-effects Poisson regression models with robust variance.ResultsThe overall age-standardised prevalence of diabetes was 12.8% (95%CI 11.2-14.3) (men: 12.8%, women: 12.7%), and prediabetes was 14.0% (95%CI 12.6-15.4) (men: 12.1%, women: 16.5%). Among people with diabetes, 61.5% were unaware that they had the condition. 35.2% were taking 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. Compared with normal weight and currently unemployed, individuals who were underweight or currently employed were less likely to develop diabetes.ConclusionDiabetes and prediabetes affect a substantial proportion (over one-quarter) of the Bangladeshi adult population. Continuing surveillance and effective prevention and control measures, with a particular focus on obesity reduction and hypertension management, are urgently needed.

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Factors Associated with Blood Pressure Checkup During Pregnancy Among Women of Reproductive Age in Tanzania; An Analysis of Data from the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicators Survey

10.21203/rs.3.rs-44299/v1 ◽

2020 ◽

Author(s):

Fabiola Vincent Moshi ◽

Maximilian Tungaraza

Keyword(s):

Blood Pressure ◽

Pregnant Women ◽

Health Survey ◽

Wealth Index ◽

Reference Population ◽

Education Level ◽

Demographic And Health Survey ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Factors Associated

Abstract Background: Hypertensive Disorder of Pregnancy (HDP) is one of the leading causes of maternal mortality and morbidity amongst pregnant women in the world. Blood pressure checkups during pregnancy are on of strategies to identify hypertensive disorders and hence timely management. Little is known on factors associated with blood pressure checkups in Tanzania.Method: The study used data from the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicators Survey (2015-16 TDHS-MIS). A total of 6924women of active reproductive age from 15 to 49 were included in the analysis. Both univariate and multiple regression analyses were used to determine the association between early antenatal booking and maternal services utilization.Results: A total of 4997(72.17%) of interviewed women were checked for blood pressure at least once. After adjusted for the confounders, factors which influenced uptake of blood pressure checkups during pregnancy were timing for antenatal booking within first 12 weeks, AOR=1.496 at 95% CI= 1.297-1.726, p<0.001, age group [ more than 34 years, (AOR=1.518 at 95% CI=1.149-2.006,p=0.003)], wealth index [ middle income, (AOR=1.215 at 95% CI=1.053-1.468, p=0.008) and rich, (AOR=2.270 at 95% CI=1.907-2.702, p<0.001)] reference population being poor; education level [ primary education, (AOR=1.275 at 95%CI=1.107-1.468, p=0.001); secondary, (AOR=2.163 at 95% CI=1.688-2.774, p<0.001) and higher, (AOR= 9.929 at 95%CI=1.355-72.76, p=0.024)] reference population being no formal education; parity[para 2-4, (AOR=1.190 at 95% CI=1.003-1.412, p=0.046) and zones [Unguja Island, (AOR=3.934 at 95% CI=1.568-9.871, p=0.004) and Pemba Island, (AOR=5.308 at 95%CI=1.808-15.58, p=0.002)] Mainland urban being the reference populationConclusion: Blood pressure checkups during pregnancy offer the opportunity for early detection timely management of HDP. The study revealed that rural dwelling pregnant women had higher chance not to get their BP checked. It was also revealed that maternal age, education level, place of residence, wealth index and timing of ANC services significantly associated with blood pressure check-ups. The study identifies the need to explore significant factors associated with utilization of the available free reproductive health services across all public health facilities and to address prioritized intensive awareness programs and behavioral change interventions on the significance of BP checkups among pregnant women of reproductive age.

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Awareness, treatment, and control of diabetes in Bangladesh: evidence from the Bangladesh Demographic and Health Survey 2017/18

10.1101/2021.07.09.21260274 ◽

2021 ◽

Author(s):

Md Nuruzzaman Khan ◽

John C. Oldroyd ◽

Mohammad Bellal Hossain ◽

Rakibul M. Islam

Keyword(s):

Health Survey ◽

Diabetes Management ◽

Demographic And Health Survey ◽

Structural Factors ◽

Cross Sectional ◽

Factors Associated ◽

Control Of Diabetes ◽

Lower Education ◽

The Government ◽

And Control

Background The prevalence of diabetes is increasing in Bangladesh; however, the management of diabetes assessed by diabetes awareness, treatment, and control, remains poor. We aimed to estimate the age-standardised prevalence of awareness, treatment, and control of diabetes and its associated factors. Methods In this cross-sectional study, data from 1,174 Bangladeshi adults aged 18 years and older available from the most recent nationally representative Bangladesh Demographic and Health Survey (BDHS) 2017-18 were analysed. Awareness, treatment, and control of diabetes were our outcomes of interest. Crude and age-stadarised prevalence of awareness, treatment, and control were estimated using the survey weight and direct standardisation, respectively. Multilevel mixed-effects Poisson regression models were used to identify factors associated with awareness, treatment, and control of diabetes. Results Among those with diabetes (n=1,174), only 41.6% (95% CI, 38.3-45.0) were aware that they had the condition, and 39.3% (95% CI, 35.9-42.6) were taking treatment. Among those treated for diabetes, only 33.3% (95% CI, 28.9-37.6) had controlled diabetes. Factors positively associated with awareness and treatment were increasing age and hypertension while factors negatively associated with awareness and treatment were being men and having lower education. Factors associated with poor control were secondary education and residing in Rajshahi and Rangpur divisions. Conclusion This study provides evidence of poor management of diabetes in Bangladesh, especially in men. Less than half of the people with diabetes were aware of their condition, and only one-third had controlled diabetes. Interventions targeting younger people, in particular men and those with lower education, are urgently needed. The government needs to strengthen diabetes management programs within primary health care and address structural factors including the costs of diabetes care to improve awareness, treatment, and control of diabetes in Bangladesh.

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Social and individual factors associated with condom use among single youths: an analysis of the 2018 Cameroon Demographic and Health Survey

Journal of Biosocial Science ◽

10.1017/s0021932021000055 ◽

2021 ◽

pp. 1-27

Author(s):

Jean-Robert Mburano Rwenge ◽

Franklin Bouba Djourdebbe ◽

Emmanuel Ekambi Ekambi

Keyword(s):

Risk Factor ◽

Condom Use ◽

Sexual Intercourse ◽

Health Survey ◽

Protective Factor ◽

Multivariate Logistic Regression Analysis ◽

Demographic And Health Survey ◽

Main Risk Factor ◽

Factors Associated ◽

Service Sectors

Abstract In Cameroon, two-fifths of the population is between the age of 15 and 24. Adolescents and youths are an important social group for the development of the country and the realization of the demographic dividend. The promotion of sexual and reproductive health will enable youth to transform their potential into development. This study aimed to identify the determinants of condom use at last sexual intercourse among single youths, highlight gender differences in the factors associated with condom use and identify the characteristics of youths who were less likely to use condoms. Data were taken from the 2018 Cameroon Demographic and Health Survey. The study sample comprised 1464 single females and 989 single males age 15–24. Multivariate logistic regression analysis was used to test the study hypotheses. Overall, 51% of the female and 66% of the male youths reported using condoms at last sexual intercourse. For both sexes, the protective factor was not having children. Among the females, belonging to the Bamileke or Mbo ethnic groups and delaying first sexual intercourse were also protective, while working in the modern or service sectors was the main risk factor. Among male youths, residing in households whose heads had a higher educational level was protective and household poverty was the main risk factor. These findings support Cameroon’s multi-sectoral approach to HIV/AIDS prevention among youths, and emphasize the importance of involving parents, teachers and youths in prevention strategies.

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Individual and contextual factors associated with barriers to accessing healthcare among women in Papua New Guinea: insights from a nationwide demographic and health survey

International Health ◽

10.1093/inthealth/ihaa097 ◽

2020 ◽

Author(s):

Abdul-Aziz Seidu ◽

Ebenezer Agbaglo ◽

Louis Kobina Dadzie ◽

Bright Opoku Ahinkorah ◽

Edward Kwabena Ameyaw ◽

...

Keyword(s):

Papua New Guinea ◽

Health Survey ◽

Rural Areas ◽

Contextual Factors ◽

Statistical Significance ◽

New Guinea ◽

Wealth Quintile ◽

Demographic And Health Survey ◽

Outcome Variable ◽

Factors Associated

Abstract Background This study sought to assess the individual and contextual factors associated with barriers to accessing healthcare among women in Papua New Guinea. Methods The study was conducted among 14 653 women aged 15–49 y using data from the 2016–2018 Papua New Guinea Demographic and Health Survey. The outcome variable was barriers to accessing healthcare. Descriptive and multilevel logistic regression analyses were conducted. Statistical significance was declared at P < 0.05. Results Women aged 15–19 y were more likely to experience at least one barrier compared with those aged 40–49 y (adjusted OR [AOR]=1.48; 95% CI 1.18 to 1.86). Women with secondary/higher education (AOR=0.68; 95% CI 0.57 to 0.81), women in the richest wealth quintile (AOR=0.36; 95% CI 0.28 to 0.46) and those in the least disadvantaged socioeconomic status (AOR=0.46; 95% CI 0.33 to 0.64) had lower odds of having challenges with at least one barrier to healthcare. However, living in rural areas increased the odds of facing at least one barrier to healthcare (AOR=1.87; 95% CI 1.27 to 2.77). Conclusions This study has demonstrated that both individual and contextual factors are associated with barriers to healthcare accessibility among women in Papua New Guinea. To enhance the achievement of the Sustainable Development Goals 3.1, 3.7 and 3.8, it is critical to deem these factors necessary and reinforce prevailing policies to tackle barriers to accessing healthcare among women in Papua New Guinea.

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