https://repository.auw.edu.bd/handle/123456789/816 2026-06-09T23:33:26Z https://repository.auw.edu.bd/handle/123456789/1005 Healthcare seeking behavior and glycemic control in patients with type 2 diabetes attending a tertiary hospital Biswas, Tuhin Purpose To assess the relationship between healthcare seeking behaviors and glycemic control in patients with type 2 diabetes. Methods A secondary data analysis was conducted among patients with type 2 diabetes from a randomized controlled trial conducted in a tertiary hospital, Bangladesh. Data on health center use, healthcare providers visited, self-monitoring of blood glucose, blood pressure, foot care, and physical activity were collected through structured questionnaires. Uncontrolled diabetes was defined as HbA1c ≥ 7%. Multivariable logistic regression models were performed. Result Of the 265 patients (mean age 50.3 ± 9.9 years; 49.8% females), the majority (71.3%) had uncontrolled diabetes. More than one-third (34.9%) of the participants did not visit their physician or a healthcare center during the previous 3-months. Only 12.4% of participants checked their blood glucose, and 35.8% checked their blood pressure during the last week. Participants who did not visit a physician or a healthcare center during the past 3 months had twice the odds of having uncontrolled diabetes, compared with those who visited during the same period [OR 2.12, 95% CI (1.02–5.14), p = 0.04]. Conclusion Regular consultation with a physician or visiting a healthcare center might help to improve glycemic control in patients with type 2 diabetes in Bangladesh. 2021-01-01T00:00:00Z https://repository.auw.edu.bd/handle/123456789/1004 The risk and protective factors for suicidal burden among 251 763 school-based adolescents in 77 low- and middle-income to high-income countries: assessing global, regional and national variations‡ Biswas, Tuhin Background. Adolescent suicide is a global public health concern and the second leading cause of adolescent death worldwide. This study aimed to estimate the burden of adolescent suicidal behaviours and its association with violence and unintentional injury, psychosocial, protective, lifestyle and food security-related factors amongst school-based adolescents across 77 countries in the six World Health Organization (WHO) regions. Methods. This study comprised a sample of 251 763 adolescents drawn from the latest Global School-based Student Health Survey of school-based adolescents, aged 11–17 years, across 77 countries. Logistic regression analyses were employed to estimate the adjusted effect of independent factors on adolescent suicidal behaviours. Results. The population-weighted 12-month prevalence of suicidal ideation (SI), suicidal planning (SP) and suicidal attempts (SA) amongst school-based adolescents was 18, 18 and 16%, respectively. Adolescent suicidal behaviours (i.e. SI, SP and SA) were respectively asso- ciated with being physically attacked, physical fighting, high levels of anxiety, feeling lonely, being bullied, lack of parental support, poor peer support, not having close friends and high levels of sedentary behaviours. Overall, these associations also extended to the context of food insecurity across regions and country income groups, where the magnitude of asso- ciation slightly varied from odds ratios of 1.25 times to 3.13. Conclusions. The burden of school-going adolescent suicidal thoughts, suicide planning and suicide attempts is of particular concern in low-resource countries. Comprehensive suicide prevention programmes for school-going adolescents in LMICs are needed that address socio-cultural inequities related to violence and unintentional injury, social support and psychological factors, protective, and lifestyle-related factors. 2021-01-01T00:00:00Z https://repository.auw.edu.bd/handle/123456789/1003 Factors associated with low adherence to medication among patients with type 2 diabetes at different healthcare facilities in southern Bangladesh Biswas, Tuhin Background: Diabetic individuals must adhere to their medications to control their glucose levels and prevent diabetes-related complications. However, there is limited evidence of medication adherence in patients with type 2 diabetes in Bangladesh. Objectives: We assessed the level of adherence and factors associated with low adherence to anti-diabetic medication among patients with type 2 diabetes at different health facilities in southern Bangladesh. Methods: This cross-sectional study included 2,070 patients with type 2 diabetes who presented at five health facilities in the Chittagong Division between November 2018 and June 2019. We assessed medication adherence using a self-reported, structured, eight-item questionnaire and performed multiple logistic regression to investigate the factors associated with low medication adherence. Results: The overall prevalence of low medication adherence was 46.3% (95% CI: 41.4–55.8%) of our study population. Multiple logistic regression analysis revealed that males (OR: 1.37; 95% CI: 1.13–1.67), those with a family income of < 233 USD (OR: 1.54, 95% CI: 1.17–2.03), and those with a diabetic ulcer (OR: 1.42, 95% CI: 1.04–1.94) showed low adherence. Diabetic ulcers, retinopathy, and obesity were relatively more elevated among diabetic patients with low medication adherence. Conclusion: Low medication adherence among patients with type 2 diabetes in southern Bangladesh is a key public health challenge. Factors such as male sex, low annual family income, and diabetic ulcers were associated with low medication adherence. Patient counsel- ing and awareness programs may enhance medication adherence among people with type 2 diabetes. Our findings will help physicians and public health workers to develop targeted strategies to increase awareness of the same among their patients. 2021-01-01T00:00:00Z https://repository.auw.edu.bd/handle/123456789/1002 Prevalence and associated factors of metabolic syndrome among Bangladeshi adults: Evidence from a nation-wide survey Biswas, Tuhin Background: Metabolic syndrome is an important risk factor for cardiovascular disease and premature mor- tality. This study aimed to determine the prevalence and associated factors of metabolic syndrome among Bangladeshi adults (aged 18−69 years) using a nationally representative survey: Stepwise Approach to Sur- veillance (STEPS). Methods: Metabolic syndrome was defined according to Adult Treatment Panel III (ATP III) and International Diabetes Federation (IDF) criteria. Design based multivariable log-binomial regression was conducted to explore the associated factors. The adjusted prevalence ratio (APR) was reported along with a 95% confidence interval (CI). Findings: In total, 6851 samples were included. Overall, 15.5% and 16.6% of the participants had metabolic syndrome according to ATP III and IDF criteria, respectively. According to ATP III criteria, the prevalence of metabolic syndrome was higher among those aged 30−49 years (APR: 2.4; 95% CI: 1.8−3.2) and 50−69 years (APR: 3.5; 95% CI: 2.5−4.5) compared to those aged 18−29 years, being educated up to college and higher (APR: 1.6; 95% CI: 1.2−2.0) compared to those who did not receive any formal education, residence in the urban area (APR: 1.2; 95% CI: 1.0−1.4) compared to rural residents, having an abnormal waist-hip ratio (APR: 2.0; 95% CI: 1.6−2.6) compared to having normal waist-hip ratio, being overweight (APR: 1.8; 95% CI: 1.4 −2.3), and obese (APR: 3.5; 95% CI: 2.8−4.4) compared to those who had normal BMI/underweight. Com- pared to the residents in the Dhaka Rural, residents in Mymensingh, and Rangpur division had lower odds of having metabolic syndrome. Except for the place of residence, the associated factors were similar according to IDF criteria. Conclusion: As approximately every one in six adults are suffering from the metabolic syndrome in Bangla- desh, the public health prevention and promotion programs should target the high-risk groups to curtail the high burden. 2021-01-01T00:00:00Z