Hypertension: adherence to treatment in rural Bangladesh – findings from a population-based study

Figures & data

Table 1 Characteristics of the three study sites

Characteristics	Matlab	Mirsarai	Abhoynagar
Rural/urban	Rural	Rural	Rural
Location	55 km southeast of capital city (nearly central in the country)	Southeastern part of the country	Southwestern part of the country
Average household income	Per capita household income in 2001 approx. 9,000 BDT	8,040 BDT/month Median 6,000 BDT	5,609 BDT/month Median 4,000 BDT
Total surveillance population in 2009	113,186	39,025	34,717
Sample population
Men	1,648	3,584	4,435
Women	4,725	8,410	7,158
Disease profile is predominantly	Fever, digestive disturbance, and respiratory disease	Fever, digestive disturbance, and respiratory disease	Fever, digestive disturbance, and respiratory disease
Population Density	1,100 persons/km^2	1,067 persons/km^2	1,067 persons/km^2
Household size	5.1 persons	5.4 persons	5.4 persons
Primary occupation	Cultivation	Cultivation	Cultivation
Religion	Muslims (90%)	Muslims (>80%)	Muslims (>80%)

Table 2 Characteristics of the study population (n=29,960) by hypertension status

		Hypertension
Characteristics	No. of participants	Present	Absent	p
(n)	29,960	4,097	25,863
Age groups, years (%)
< 40	43.1	5.9	94.1
40–49	23.9	11.8	88.2	<0.001
50–59	16.0	17.3	82.7
60 and above	17.0	23.1	76.9
Mean age (std)	44.6 (15.8)	52.8 (14.3)	43.6 (14.1)	<0.001
Sex (%)
Male	47.4	8.9	91.1	<0.001
Female	52.6	14.8	85.2
Level of education (%)
No education	43.7	12.1	87.9
Primary (1–5 years)	26.9	12.0	88.0
Secondary (6–10 years)	24.5	11.9	88.1	0.727
Higher (11+ years)	4.8	12.8	87.2
Years of education (std)	3.6 (4.4)	3.7 (4.0)	3.6 (4.0)	0.201
Asset Index (%)
Poorest 20%	16.3	6.5	93.5
Poorer 20%	18.2	9.0	91.0
Middle 20%	20.0	10.5	89.5
Less poor 20%	22.0	13.4	76.6	<0.001
Least poor 20%	23.6	18.9	81.1

Fig. 1 Percentage of people non-adherent to treatment by age group and sex, in rural Bangladesh, 2009.

*Absolute numbers of samples are shown in the parenthesis.

Fig. 2 Percentage of people non-adherent to treatment by sex and asset quintile.

*Absolute numbers of samples are shown in the parenthesis.

Table 3 Hypertension diagnosed by type of health care providers and sex in rural Bangladesh

	Diagnosis of hypertension (%)
	Male	Female	Total	p
MBBS doctor	48.8	44.5	46.1	0.007
Specialized doctor	9.1	6.5	7.4	0.002
Nurse	0.0	0.1	0.1	0.168
Health worker	0.3	0.3	0.3	0.858
Paramedic	3.3	4.5	4.1	0.054
Quack/village doctor	37.0	42.7	40.7	0.001
Homeopath	0.6	0.6	0.6	0.931
Kabiraz/spiritual healer	0.1	0.0	0.0	0.418
Pharmacy	0.7	0.7	0.7	0.869

Table 4 Unadjusted and adjusted odds ratio (OR) and 95% confidence intervals (CI) of discontinuation of (non-adherence to) hypertension treatment in rural Bangladesh

	Non-adherence to hypertension treatment
Characteristics (n)	Unadjusted OR (95% CI)	Adjusted OR (95% CI)
Age groups, years
< 40 (363)	1	1
40–49 (252)	0.46 (0.38–0.56)	0.45 (0.36–0.55)
50–59 (205)	0.36 (0.29–0.44)	0.34 (0.27–0.42)
60 and above (248)	0.29 (0.24–0.35)	0.27 (0.22–0.33)
Sex
Female (651)	1	1
Male (417)	1.29 (1.12–1.49)	1.67 (1.42–1.97)
Education
No education (471)	1	1
Primary (1–5 years) (305)	1.08 (0.91–1.27)	1.00 (0.83–1.20)
Secondary (6–10 years) (255)	1.11 (0.84–1.20)	0.80 (0.65–0.99)
Higher secondary (11+ years) (31)	0.52 (0.35–0.78)	0.38 (0.25–0.60)
Asset Index
Poorest 20% (117)	1	1
Poorer 20% (162)	0.83 (0.62–1.10)	0.84 (0.63–1.14)
Middle 20% (192)	0.75 (0.57–0.99)	0.87 (0.65–1.16)
Less poor 20% (277)	0.77 (0.59–1.00)	0.89 (0.68–1.18)
Least poor 20% (297)	0.50 (0.38–0.64)	0.69 (0.52–0.92)
Comorbidity
No (919)	1	1
Yes (149)	0.62 (0.51–0.76)	0.78 (0.64–0.97)
Diagnosing provider
Qualified doctors (461)	1	1
Unqualified providers (605)	1.78 (1.55–2.05)	1.46 (1.31–1.77)