| Outline of Annual Research Achievements |
Studies from developed countries have shown that, probability of developing diabetes was higher among the people belonging to low socioeconomic group. However, there is a dearth of evidence from developing countries on social epidemiology of diabetes. These studies are typically based on local or regional samples or strength of the associations was found to be inconsistent. We are going to expand our work as a large scale epidemiological data analysis considering 25 developing countries to address the association between socioeconomic status (SES) with prevalence, awareness, and control of diabetes. Further, through a field survey, by using multicenter, prospective, longitudinal cohort study design, we attempt to identify the factors associated with barriers to and determinants of poor glycemic control in relation to SES among the diabetics in Bangladesh.
During this period, we have reviewed the scientific literatures, applied for secondary data access to MEASURE DHS authority, and developed survey protocol in collaboration with diabetic centers in Dhaka for our primary data collection. To improving my researching skills, under the supervision of my Professor, I also analyzed the UNICEF MICS data of Lao PDR.
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| Current Status of Research Progress |
Current Status of Research Progress
2: Research has progressed on the whole more than it was originally planned.
Reason
Our research has progressed smoothly. For secondary data analyses, we already have accessed the DHS data from 25 developing countries. We already shortened the variables from the secondary data sources, which are required for our analysis. Now we are in a stage of analyzing these data. For primary data analyses, we already developed our study protocol. We are now in a stage to submit the documents for ethical approval from the Ethical Committee of University of Rajshahi, Bangladesh and Ethical Review Board, Tokyo Medical and Dental University, Japan. We also developed the questionnaires, reviewed the instruments for collection of data, estimated the budget, and the number of interviewers required for our data collection as well as their qualification to carry out the field work. We already contacted to the directors of the diabetic centers in Bangladesh from where we will recruit the participants.
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| Strategy for Future Research Activity |
For secondary data analyses, we planned to consider hypertension, diabetes, prostate cancer, breast cancer, and cervical cancer as a proxy of noncommunicable disease. We considered the following countries Albania, Armenia, Azerbaijan, Bangladesh, Benin Bolivia Brazil. Burkina Faso. Colombia. Cote d’Ivore, Dominican Republic, Egypt, Guatemala, Honduras, Jordan, Kyrgyz Republic, Lesotho, Namibia, Peru. Philippines, South Africa, Tajikistan, Tanzania, Ukraine ad Uzbekistan. These countries are chosen based on availability of NCDs data in DHS surveys. Currently, we are planning to analyze these data sets, to see whether socioeconomic variation exists in NCDs among those countries.
For primary data analyses, to identifying barriers to and determinants of poor glycemic control, we planned to consider 500 type 2 diabetes patients aged 21 years and older and reporting a diagnosis of diabetes for at least 1 year before their index date from three diabetes centers located in three divisional cities of Bangladesh. We will assess each participant prospectively at 3 and 6 months. We will collect data on glycemic level, health related quality of life, diabetes complications, out of pocket expenses due to care of diabetes, adherence to treatment visit, medication, diet, and physical exercise. Descriptive statistics and multivariate analyses will be used to analyze the data.
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