Persons In Rural Bangladesh Research Articles

Quality of Life of Older Persons in Rural Bangladesh

The proportion of older persons in Bangladesh is significantly increasing due to demographic transition. This will bring new demands related to older persons’ health and social needs. Expeditious development of initiatives to face these coming challenges is required. The aim of this study was to assess older persons’ quality of life in southern Bangladesh, and the relationship between quality of life and various socio-demographic characteristics in this region. Data were collected from 280 older persons from 10 villages. The Bengali version of WHOQOL-BREF questionnaire was used to measure the quality of life. Descriptive statistics were used to analyze demographic and quality of life data. One way classification of analysis of variance (ANOVA) was used to compare two groups of older persons with different socio-demographic characteristics. The study found that older persons reported a moderate quality of life score (M = 73.82, SD = 9.35). Results also showed that being male, married, literate, living in an extended family, and having a medium family income, significantly contributed to a higher quality of life score. There is a need to identify the psychological and social problems that affect older persons’ quality of life in order to prepare strategies to improve their quality of life. The authors believe that this study’s findings will contribute to this process.

Depression of Older Persons in Rural Bangladesh

The proportion of older persons in Bangladesh is gradually increasing due to declining mortality rates and increased life expectancy. Bangladesh faces significant challenges around older persons’ health and well-being. The aim of this study was to assess older persons’ depression in two southern districts of Bangladesh and the relationship between depression and several socio-demographic characteristics. Data were collected from 280 older persons using Geriatric Depression Scale (GDS-10). Descriptive statistics were used to analyze demographic and depression data. One way classification of analysis of variance (ANOVA) was used to compare different groups of older persons with different socio-demographic characteristics. A large majority (84.3%) of participants reported having depression. Being widowed, being illiterate, the presence of disease(s), living in a nuclear family, and having a low income were found to be significant factors contributing to older persons’ depression. The identification of internal and external factors that affect older persons’ depression may inform screening and intervention programs and reduce the consequences of depression.

Social and economic inclusion of people with disabilities: practical lessons from Bangladesh

People with disabilities remain one of the most excluded minorities, often deprived of the benefits of mainstream development programmes. This practical note reports on lessons learnt in delivering a programme combining a community based rehabilitation (CBR) and self-help group approach with disabled persons in rural Bangladesh. Our findings demonstrate how targeted programmes can bring about the social and economic inclusion of disabled persons. We also highlight the greater effectiveness of CBR programmes when targeting a more diverse client base, when not based on debt recovery, and how targeted programmes can even benefit the wider community.

Prevalence of depressive symptoms and suicidal thoughts among elderly persons in rural Bangladesh.

Depression, if broadly defined, is the commonest late-life mental disorder. We examined the distribution of depressive symptoms and suicidal thoughts, across age, sex, literacy, and marital status, among elderly individuals residing in rural Bangladesh and participating in a population-based study on health and aging. Prevalence figures of depressive symptoms were assessed with SRQ20 (n = 625), and possible social network and economic associations were examined. Morbidity accounts of depressive symptoms and suicidal thoughts were examined for a subsample that also underwent complete medical examination (n = 471). We selected for analyses the items that corresponded to DSM-IV criteria and constructed a dichotomous variable. The prevalence was 45%, and most pronounced among the oldest women (70%). The overall prevalence of suicidal thoughts was 23%. Being a woman, illiterate or single were all risk factors for depressive symptoms and suicidal thoughts. These associations remained unaccounted for by the social network and economic variables. Co-residing with a child and having a high quality of contact were protective of both depressive symptoms and suicidal thoughts. The main findings were replicated in the subsample, where it was found that morbidities were also associated with the outcomes, independently of the four main predictors. Prevalence figures for depressive symptoms among elderly in rural Bangladesh are high. Demographic, social network, and morbidity factors are independently associated with both depressive symptoms and suicidal thoughts. This is the first study to report prevalence figures for depressive symptoms in this population.

The Metabolic Syndrome: Prevalence, Associated Factors, and Impact on Survival among Older Persons in Rural Bangladesh

ObjectivesTo describe the prevalence of the metabolic syndrome (MetS) among older persons in rural Bangladesh, to investigate whether the prevalence varies by age, sex, literacy, marital status, nutritional status and socio-economic status, and to assess the impact of MetS on survival.MethodsThe study consisted of 456 persons who were aged ≥60 years living in a rural area of Bangladesh during July 2003–March 2004. Data were collected through interview, clinical examination, and laboratory tests, and their survival status until 30th June 2009 was ascertained through the Matlab surveillance system. We defined MetS following the NCEP ATP III criteria, with minor modifications, i.e., presence of any three of the following: hypertension (BP ≥130/85 mm Hg); random blood glucose (RBG) level ≥7.0 mmol/L; hyper-triglyceridemia (≥2.28 mmol/L); low level of HDL-cholesterol (<1.04 mmol/L for men and <1.29 mmol/L for women); and BMI ≥25.0 kg/m2. Data were analysed with logistic regressions for the influential factors of MetS, and with Cox models for the association of MetS with the survival status.FindingsThe overall prevalence of MetS was 19.5%, 20.8% in women, and 18.0% in men. Asset-index and nutritional status were independently associated with MetS. During 4.93 years of follow-up, 18.2% died. In the presence of high RBG, MetS has a significant negative effect on survival (69.4% vs 95.2%, log rank p = 0.02).ConclusionThis study highlights the importance of the metabolic syndrome in rural Bangladesh. Our findings suggest that there is a need for screening programmes involving the metabolic syndrome to prevent diabetes and cardiovascular diseases.

Nutritional status and self-reported and performance-based evaluation of physical function of elderly persons in rural Bangladesh

To investigate the impact of nutritional status on self-reported as well as performance-based indicators of physical function in a rural elderly population in Bangladesh. A cross-sectional study conducted in Matlab, Bangladesh, included 457 randomly selected community-living elderly persons aged 60 years or more (60-92 years; 69 +/- 7 years). Mobility, activities of daily living (ADL), performance tests, handgrip strength, the Mini Nutritional Assessment (MNA) and a structured questionnaire were used to assess physical function, nutritional status, socioeconomic status and health status, respectively. Descriptive and linear hierarchical regression analyses were applied. Seven per cent of the participants reported limitations in mobility, and 8% reported limitations in ADL. However, more than half of the participants had difficulties in performing one or more items in the performance tests. According to the MNA, 26% of the participants were undernourished and 62% were at risk of malnutrition. More undernourished participants than well-nourished participants reported limited mobility, impaired ADL and difficulties in the performance tests. A corresponding reduction in grip strength was observed in the undernourished group. Accordingly, higher MNA scores, indicating better nutritional status, were significantly associated with higher mobility index, higher ADL index, higher performance tests index, and higher scores in handgrip strength. These associations remained after adjusting for demographic, socioeconomic and health status differences. Good nutritional status is important for the physical function of elderly people, even after controlling for possible confounders. Performance tests indicated a higher degree of functional impairment than that observed by self-reported estimation.

The impact of health education in managing self-reported arthritis-related illness among elderly persons in rural Bangladesh

This study examines the impact of health education on prevalence of and expenditure on treatment of self-reported arthritis-related illness among elderly persons in rural Bangladesh. An intervention study was conducted, including 1135 elderly persons (>or=60 years) from eight randomly selected villages, four each of an intervention and a control area. The analyses include 839 elderly persons who participated in both pre- and post-intervention surveys (intervention area: n = 425, control area: n = 414). Participants of the intervention area were further categorized as compliant (n = 315) and non-compliant (n = 110) based on adherence to the intervention instructions. The intervention that lasted for 15 months comprised home-based physical exercise, dietary instructions and other aspects of management. Results show that although there was no significant difference in self-reported arthritis-related illness between the compliant and non-compliant groups at baseline, it was significantly lower in the compliant group (71%) at post-intervention compared with the non-compliant (81%). Related monthly expenditure on treatment was significantly reduced in the compliant group (from Taka 104 to Taka 52) but not in the other two groups. Logistic regressions further showed that the control group had a higher probability of increased treatment-related expenditure compared with the compliant group (OR 2.0, 95% CI 1.4-2.8).

Health-care utilization by disabled persons: A survey in rural Bangladesh

The purpose of the present study was to examine the utilization of health services by disabled persons in rural Bangladesh and to identify associated factors to inform the development of appropriate health services. Household surveys were conducted in two villages of Bangladesh by a trained primary-care specialist who lived in the study area for 4 months. About 81% of the sample had utilized some form of health care with more than half consulting unqualified practitioners of modern medicine. Disabled persons whose families perceived they were disabled were 14 times more likely than others to seek treatment. Being male and in the economically productive age group, having an acquired disability and having some form of belief about disability causation were associated with utilization. The conclusions of the study are that social and cultural barriers prevent certain groups, notably women and demographically dependent age groups, from accessing health care. Those who are economically beneficial to the family usually utilize health services. A combination of educational and economic initiatives such as a disability benefits allowance would strongly promote the health of disabled persons and create a general awareness of disability in Bangladesh. A long-term programme which includes disability training for health-care workers and use of financial institutions and existing local government infrastructure for intensive rehabilitation will improve quality of life for disabled persons and is proposed for urgent implementation.