Community-based intervention for managing hypertension and diabetes in rural Bangladesh

Abstract Background Approximately 80% of non-communicable diseases (NCDs) have been reported in low- and middle-income countries (LMICs). However, studies on the usefulness of educational interventions run by non-healthcare workers in combating NCDs in resource-limited areas in rural parts of LMICs...

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Main Authors: Yurie Kobashi, Syed Emdadul Haque, Kayako Sakisaka, Isamu Amir, Megumi Kaneko, Mahmuda Mutahara, Sanzida Mubassara, Abul Kashem, Masaharu Tsubokura
Format: Article
Language:English
Published: BMC 2024-01-01
Series:Tropical Medicine and Health
Subjects:
Online Access:https://doi.org/10.1186/s41182-023-00574-0
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author Yurie Kobashi
Syed Emdadul Haque
Kayako Sakisaka
Isamu Amir
Megumi Kaneko
Mahmuda Mutahara
Sanzida Mubassara
Abul Kashem
Masaharu Tsubokura
author_facet Yurie Kobashi
Syed Emdadul Haque
Kayako Sakisaka
Isamu Amir
Megumi Kaneko
Mahmuda Mutahara
Sanzida Mubassara
Abul Kashem
Masaharu Tsubokura
author_sort Yurie Kobashi
collection DOAJ
description Abstract Background Approximately 80% of non-communicable diseases (NCDs) have been reported in low- and middle-income countries (LMICs). However, studies on the usefulness of educational interventions run by non-healthcare workers in combating NCDs in resource-limited areas in rural parts of LMICs are limited. This study aimed to identify the effectiveness of a community-based simple educational program run by non-healthcare trained staff for several outcomes associated with NCDs in a resource-limited area. Methods Six villages in the Narail district in Bangladesh were selected, two each in the first and second intervention and the control groups, in the Narail district in Bangladesh were selected. Pre- and post-intervention survey data were collected. The first intervention group received the “strong” educational intervention that included a checklist poster on the wall, phone call messages, personalized advice papers, seminar videos, and face-to-face seminars. The second intervention group received a “weak” intervention that included only a checklist poster on the wall in their house. The outcome was the proportion of NCDs and changes in systolic blood pressure and blood sugar level. Confidential fixed-effects logistic regression and multiple linear regression were performed to identify the effectiveness of the intervention. Results Overall, 600 participants completed the baseline survey and the follow-up survey. The mean systolic blood pressure reduced by 7.3 mm Hg (95% confidence interval [CI] 4.6–9.9) in the first intervention group, 1.9 mm Hg (95% CI − 0.5–4.2) in the second intervention group, and 4.7 mm Hg (95% CI 2.4–7.0) in the control group. Multiple linear regression analysis showed that the between-group differences in the decline in systolic blood pressure were significant for the first intervention versus control (p = 0.001), but not for the second intervention versus control (p = 0.21). The between-group differences in the reduction in blood glucose after the intervention, were not significant on multiple linear regression analysis. Conclusions Community-based educational interventions for NCDs provided by non-healthcare staff improved the outcomes of hypertension and risk behaviors. Well-designed community-based educational interventions should be frequently implemented to reduce NCDs in rural areas of low- and middle-income countries. Trial registration UMIN Clinical Trials Registry (UMIN-CTR; UMIN000050171) retrospectively registered on January 29, 2023.
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spelling doaj.art-b6e42483eae14b46ae58e2474dfcdf4d2024-03-05T16:43:46ZengBMCTropical Medicine and Health1349-41472024-01-0152111010.1186/s41182-023-00574-0Community-based intervention for managing hypertension and diabetes in rural BangladeshYurie Kobashi0Syed Emdadul Haque1Kayako Sakisaka2Isamu Amir3Megumi Kaneko4Mahmuda Mutahara5Sanzida Mubassara6Abul Kashem7Masaharu Tsubokura8Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima CityUChicago Research BangladeshFaculty of International Liberal Arts, Kaichi International UniversityDepartment of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima CityHealth Equity Research InstituteBridge of Community Development FoundationDepartment of Botany, Jahangirnagar UniversityBridge of Community Development FoundationDepartment of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima CityAbstract Background Approximately 80% of non-communicable diseases (NCDs) have been reported in low- and middle-income countries (LMICs). However, studies on the usefulness of educational interventions run by non-healthcare workers in combating NCDs in resource-limited areas in rural parts of LMICs are limited. This study aimed to identify the effectiveness of a community-based simple educational program run by non-healthcare trained staff for several outcomes associated with NCDs in a resource-limited area. Methods Six villages in the Narail district in Bangladesh were selected, two each in the first and second intervention and the control groups, in the Narail district in Bangladesh were selected. Pre- and post-intervention survey data were collected. The first intervention group received the “strong” educational intervention that included a checklist poster on the wall, phone call messages, personalized advice papers, seminar videos, and face-to-face seminars. The second intervention group received a “weak” intervention that included only a checklist poster on the wall in their house. The outcome was the proportion of NCDs and changes in systolic blood pressure and blood sugar level. Confidential fixed-effects logistic regression and multiple linear regression were performed to identify the effectiveness of the intervention. Results Overall, 600 participants completed the baseline survey and the follow-up survey. The mean systolic blood pressure reduced by 7.3 mm Hg (95% confidence interval [CI] 4.6–9.9) in the first intervention group, 1.9 mm Hg (95% CI − 0.5–4.2) in the second intervention group, and 4.7 mm Hg (95% CI 2.4–7.0) in the control group. Multiple linear regression analysis showed that the between-group differences in the decline in systolic blood pressure were significant for the first intervention versus control (p = 0.001), but not for the second intervention versus control (p = 0.21). The between-group differences in the reduction in blood glucose after the intervention, were not significant on multiple linear regression analysis. Conclusions Community-based educational interventions for NCDs provided by non-healthcare staff improved the outcomes of hypertension and risk behaviors. Well-designed community-based educational interventions should be frequently implemented to reduce NCDs in rural areas of low- and middle-income countries. Trial registration UMIN Clinical Trials Registry (UMIN-CTR; UMIN000050171) retrospectively registered on January 29, 2023.https://doi.org/10.1186/s41182-023-00574-0Non-communicable diseasesCommunity surveyCommunity-based participatory researchGlobal healthBangladesh
spellingShingle Yurie Kobashi
Syed Emdadul Haque
Kayako Sakisaka
Isamu Amir
Megumi Kaneko
Mahmuda Mutahara
Sanzida Mubassara
Abul Kashem
Masaharu Tsubokura
Community-based intervention for managing hypertension and diabetes in rural Bangladesh
Tropical Medicine and Health
Non-communicable diseases
Community survey
Community-based participatory research
Global health
Bangladesh
title Community-based intervention for managing hypertension and diabetes in rural Bangladesh
title_full Community-based intervention for managing hypertension and diabetes in rural Bangladesh
title_fullStr Community-based intervention for managing hypertension and diabetes in rural Bangladesh
title_full_unstemmed Community-based intervention for managing hypertension and diabetes in rural Bangladesh
title_short Community-based intervention for managing hypertension and diabetes in rural Bangladesh
title_sort community based intervention for managing hypertension and diabetes in rural bangladesh
topic Non-communicable diseases
Community survey
Community-based participatory research
Global health
Bangladesh
url https://doi.org/10.1186/s41182-023-00574-0
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