Rural and urban differences in the prevalence and determinants of Type-2 diabetes in Bangladesh

OBJECTIVE

To estimate the prevalence of Type 2 Diabetes (T2D) in urban and rural settings and identify the specific risk factors for each location.

METHOD

We conducted this study using data from the 2017-18 Bangladesh Demographic and Health Survey (BDHS), sourced from the DHS website. The survey employed a stratified two-stage sampling method, which included 7,658 women and 7,048 men aged 18 and older who had their blood glucose levels measured. We utilized chi-square tests and ordinal logistic regression to analyze the association between various selected variables in both urban and rural settings and their relationship with diabetes and prediabetes.

RESULTS

The prevalence of T2D was 10.8% in urban areas and 7.4% in rural areas, while pre-diabetes affected 31.4% and 27% of the populations in these respective settings. The study found significant factors influencing diabetes in both urban and rural regions, particularly in the 55-64 age group (Urban: AOR = 1.88, 95% CI [1.46, 2.42]; Rural: AOR = 1.87, 95% CI [1.54, 2.27]). Highly educated individuals had lower odds of T2D, while wealthier and overweight participants had higher odds in both areas. In rural regions, T2D risk was higher among caffeinated drink consumers and those not engaged in occupation-related physical activity, while these factors did not show significant influence in urban areas. Furthermore, urban participants displayed a significant association between T2D and hypertension.

CONCLUSION

Our study outlines a comprehensive strategy to combat the increasing prevalence of T2D in both urban and rural areas. It includes promoting healthier diets to control BMI level, encouraging regular physical activity, early detection through health check-ups, tailored awareness campaigns, improving healthcare access in rural regions, stress management in urban areas, community involvement, healthcare professional training, policy advocacy like sugary drink taxation, research, and monitoring interventions. These measures collectively address the T2D challenge while accommodating the distinct features of urban and rural settings.

Knowledge, attitudes, and factors determining the willingness for COVID-19 vaccination among students in Bangladesh: An online-based cross-sectional study

Aim

The most effective way to avoid COVID-19 is through immunization against the virus that causes the disease. The primary objective of this study was to assess the extent of knowledge, attitudes, acceptability, and factors influencing COVID-19 vaccination acceptance among higher secondary and university students in Bangladesh.

Subject and methods

A structured questionnaire-based online survey was conducted among 451 students residing in Khulna and Gopalganj cities from February to August, 2022. The willingness to accept the COVID-19 vaccine was compared with a few covariates using the chi-square test, and we then used binary logistic regression to identify the determinants that led Bangladeshi students to receive the COVID-19 vaccine.

Results

During the study period, almost 70% of the students obtained immunizations, with 56% of men and 44% of women reporting having done so. The age range of 26-30 years had the highest percentage of students who had received vaccinations, and 83.9% of students agreed that the COVID-19 vaccine is crucial for students. The results of the binary logistic regression clearly show that gender, degree of education, and respondents' willingness, encouragement, and beliefs have a significant impact on students' eagerness to receive COVID-19 vaccination.

Conclusion

The rising trend in vaccination status among Bangladeshi students is highlighted by this study. Additionally, our results eloquently demonstrate that vaccination status varies by gender, education level, willingness, encouragement, and respondent's viewpoint. The outcomes of this study are essential for health policy makers and other interested parties to successfully organize their immunization program for young adults and children at various levels.

Dynamic changes in prevalence of type 2 diabetes along with associated factors in Bangladesh: Evidence from two national cross-sectional surveys (BDHS 2011 and BDHS 2017-18)

BACKGROUND AND AIMS

Prevalence of type 2 diabetes has been rising rapidly especially in low- and middle-income countries. The purpose of this study is to analyze the prevalence of type 2 diabetes in 2011 and 2017-18, and the risk factors based on the Bangladesh Demographic and Health Surveys (BDHS).

METHODS

The study comprised of data from the BDHS 2011 and the BDHS 2017-18 with 7565 (50.6% female) and 12,299 respondents (56.9% female) respectively. The plasma blood glucose was classified into normal, pre-diabetes, and diabetes categories. While univariate analysis was performed to determine the data, Chi-square and gamma analyses were used for bivariate estimation of the correlation between diabetes status and other comorbidities. Multinomial and ordinal logistic regression were also performed to trace the link between diabetes and various risk factors.

RESULTS

The 2011 BDHS survey indicated that nearly half of the participants (47.6%) had pre-diabetic condition, while 10.2% were diagnosed with diabetes. On the other hand, the BDHS 2017-18 demonstrated that 28.6% and 8.6% of participants had pre-diabetes and diabetes, respectively. Results of inferential statistics showed that gender (p<0.05), age, wealth status, physical activity, BMI (p<0.01), and caffeinated beverages (p<0.05), were significantly linked with diabetes status.

CONCLUSION

According to our findings, older people and people with lower education are more likely to develop diabetes. BMI` Physically active, wealth status, diet and lifestyle were significant predictors of type 2 diabetes. Healthy lifestyle, physical activities, proper knowledge and awareness can reduce the risk of T2D.

Expansion of hay production and marketing in Brazil

In the last decade, advances in Brazilian hay production showed that the country has the potential to produce bulky dehydrated fodder. For many years, the Brazilian hay production scientific knowledge had been based on temperate climate species, even though the best hay material are tropical grasses, as Tifton 85 Bermudagrass. Researches that focused on the comprehension of yield systems, biochemical processes, physiology, composition, and nutritional quality of tropical species under dehydration and conservation have become important to hay yield in Brazil. Therefore, this literature review aimed to discuss the hay research contribution in tropical conditions and its reflex on the production and commercialization of hay in Brazil. This review was based on database research with key-words defined in a period between 1960 and 2021, which resulted in 33 articles. Each article had the strengths and weaknesses, opportunities, and threats classified according to the SWOT matrix. Articles related to the haymaking system with tropical forage and the effects on nutritional value, sanitary quality, and factors that influence the dehydration period in the field and storage were listed in this paper. Based on the literature, the conclusion is that Brazil has elevated hay yield potential with high nutritional and sanitary quality of tropical species due to the weather conditions that allow fast dehydration and, also, the availability of residual wastewater as fertilization and machinery appropriated. Brazilian haymaking and commercialization are in an expansion process with economic return as national and international trade. Further challenges: to obtain a constant annual hay supply and the transport viability to markets distant from the production center.

Erratum to: Elephants also like coffee: Trends and drivers of human-elephant conflicts in coffee agroforestry landscapes of Kodagu, Western Ghats, India

Kodagu district produces 2% of the world's coffee, in complex, multistoried agroforestry systems. The forests of the district harbour a large population of the Asian elephant (Elephas maximus). The combined effects of high elephant density and major landscape changes due to the expansion of coffee cultivation are the cause of human-elephant conflicts (HEC). Mitigation strategies, including electric fences and compensation schemes implemented by the Forest Department have met with limited success. Building on previous studies in the area, we assessed current spatial and temporal trends of conflict, analysed local stakeholders' perceptions and identified factors driving elephants into the estates. Our study, initiated in May 2007, shows that the intensity of HEC has increased over the last 10 years, exhibiting new seasonal patterns. Conflict maps and the lack of correlation between physical features of the coffee plantations and elephant visits suggest elephants move along corridors between the eastern and western forests of the district, opportunistically foraging when crossing the plantations. Dung analyses indicate elephants have selectively included ripe coffee berries in their diet. This is, to our knowledge, the first report of wild elephants feeding on coffee berries. If this new behaviour spreads through the population, it will compound an already severe conflict situation. The behavioural plasticity, the multiplicity of stakeholders involved, the difficulty in defining the problem and the limits of technical solutions already proposed suggest that HEC in Kodagu has the ingredients of a "wicked" problem whose resolution will require more shared understanding and problem solving work amongst the stakeholders.

Elephants also like coffee: trends and drivers of human-elephant conflicts in coffee agroforestry landscapes of Kodagu, Western Ghats, India

Kodagu district produces 2% of the world's coffee, in complex, multistoried agroforestry systems. The forests of the district harbour a large population of the Asian elephant (Elephas maximus). The combined effects of high elephant density and major landscape changes due to the expansion of coffee cultivation are the cause of human-elephant conflicts (HEC). Mitigation strategies, including electric fences and compensation schemes implemented by the Forest Department have met with limited success. Building on previous studies in the area, we assessed current spatial and temporal trends of conflict, analysed local stakeholders' perceptions and identified factors driving elephants into the estates. Our study, initiated in May 2007, shows that the intensity of HEC has increased over the last 10 years, exhibiting new seasonal patterns. Conflict maps and the lack of correlation between physical features of the coffee plantations and elephant visits suggest elephants move along corridors between the eastern and western forests of the district, opportunistically foraging when crossing the plantations. Dung analyses indicate elephants have selectively included ripe coffee berries in their diet. This is, to our knowledge, the first report of wild elephants feeding on coffee berries. If this new behaviour spreads through the population, it will compound an already severe conflict situation. The behavioural plasticity, the multiplicity of stakeholders involved, the difficulty in defining the problem and the limits of technical solutions already proposed suggest that HEC in Kodagu has the ingredients of a "wicked" problem whose resolution will require more shared understanding and problem solving work amongst the stakeholders.