Factors Associated with Disability in Rural Bangladesh: Bangladesh Population-Based Diabetes and Eye Study (BPDES)

Abstract

BackgroundTo assess factors associated with disability in a rural district of Bangladesh.MethodsUsing a population-based systematic sampling technique, data were collected from 3104 adults aged ≥ 30 years from the Banshgram union of Narail district. Data collected included an interviewer administered questionnaire to report physical disabilities including impairment that prevents engagement with paid work, visual, hearing, and mobility as well as mental disabilities. Socio-demographic and anthropometric factors including educational attainment and body mass index, as well as clinical factors such as blood pressure, and fasting blood glucose were also collected. Binary and multinomial logistic regression techniques were used to explore the association of various socio-demographic and clinical factors with disability.ResultsThe mean (SD), minimum and maximum ages of the participants were 51 (12), 30 and 89 years. Of total participants, 65% were female. The prevalence of disability varied from 29.1% for visual impairment (highest) to 16.5% for hearing, 14.7% for movement difficulties and 1.6% (lowest) for any other disability that prevented engagement with paid work. Overall, the prevalence of a single disability was 28.6% and that of two or more disabilities was 14.7%. Older age, gender (female), lower socio-economic status (SES), and hypertension were associated with a higher prevalence of most of the disability components. The prevalence of hearing problems (24.5% vs. 13.3%, p<0.001) and movement difficulties (24.9% vs. 13.0%, p<0.001) was significantly higher among lower-income participants than their higher-income counterparts after controlling for age. Prevalence of visual impairment (54.6% vs. 9.2%, p<0.001), hearing (32.2% vs. 6.7%, p<0.001) and movement difficulties (29.2% vs. 5.5%, p<0.001) were significantly higher in people of aged 60 years or older than those aged 30–34 years. After multivariate adjustment, the prevalence of single disability (prevalence risk ratio [PRR] 1.25, 95% CI: 1.09–1.42, p<0.001), and multiple disabilities (PRR 1.41, 95% CI 1.14–1.73, p<0.001) was higher among females than males. The prevalence of single disability and multiple disabilities was respectively 21% (PRR 1.21, 95% CI: 1.02–1.42, p<0.001) and 88% (PRR 1.88, 95% CI: 1.38–2.54, p<0.001) higher among participants with low educational attainment (primary level or less) than those with at least a secondary level of education.ConclusionsIn rural Bangladesh, the prevalence of disability is high. Public health programs should target those of low SES, older age, and female participants and aim to provide necessary supports in order to bridge disability-related inequities.

Prevalence of disability using rapid assessment of disability toolkit among adult residents of rural Delhi, India

“…Some studies across the world have reported a higher prevalence of disability among female but these are mostly limited to the elderly age group. 1,8,10,[12][13][14][15][16][17] A few studies have reported a higher prevalence of disability in males but these used census data, considered all age groups or were outside Asia. 11,[18][19] Education A majority of persons with disability were either illiterate (35.1%) or studied till primary school (29.8%) only.…”

“…Other studies using rapid assessment of disability toolkit or otherwise, in India or abroad have also reported low level of education attainment in persons with disability. 8,11,13,15,[20][21][22] Marital status…”

“…Other studies conducted in India and other countries worldwide also reported the poor level of employment status of persons with disability. 6,15,19,20,[24][25][26][27][28][29][30] Ganesh et al reviewed 32 studies which reveal that occupation plays a major role as a determinant of disability. 26…”

Eye Disorders in Bangladesh: A Hospital-based Descriptive Study

“…Some assessments have been conducted on the incidence of cataract surgeries in Bangladesh (Gogate et al, 2010;Lindfield et al, 2008), as well as causes of blindness and visual impairment in Bangladeshi adults (Dineen et al, 2003), blindness related to smoking (Bidwell et al, 2005) and the Bangladesh Population-Based Diabetes and Eye Study (Islam et al, 2016). However, while there is data on age-related eye disorders and on the incidence of eye disorders that most commonly affect people in Bangladesh (Wong et al, 2006;Dineen et al, 2003) there have been little assessment of how this relates to hospital-based treatment.…”

Coping with natural disasters: A cross-sectional study with people with disabilities in the coastal zone of Bangladesh

“…The cumulative cost (four cost components including costs due to lack of access to employment; costs due to children with disabilities losing out on school; costs due to adults helping people with disabilities; and costs due to children helping a family member with disabilities) of disability in Bangladesh is approximately US $1.18 billion per year (Ali, 2014). The prevalence of disability is higher among the rural community (Islam, Bhowmik, Islam, Renzaho, & Hiller, 2016). Therefore, in rural areas disability has a devastating effect on the quality of life of the disabled people (Hosain, Atkinson & Underwood, 2002).…”