Psychometric evaluation of the modified 19-item Bengali version of WHOQOL scale using Rasch analysis: a cross-sectional study of a rural district in Bangladesh.

BACKGROUND: This investigation aims to validate the psychometric properties of the modified 19-item Bengali version World Health Organization Quality of Life (WHOQOL) instrument in a typical healthy rural population in Bangladesh. METHOD: The cross-sectional investigation collected 300 adults aged 18-85 years from Narail, a rural district of Bangladesh using a multi-stage cluster random sampling technique. Face-to-face interviews were conducted between July and August 2018 using an Android phone installed with a mobile data collection application CommCare. SPSS version 25; IBM. and a Rasch analysis software RUMM2030 were used for analyses. RESULTS: Results showed good overall fit, as indicated by a significant item-trait interaction with Bonferroni corrected p values, for physical ([Formula: see text] =32.13, p = 0.041), psychological ([Formula: see text] =14.93, p = 0.529), social ([Formula: see text] =12.62, p = 0.397), and environmental ([Formula: see text] =22.01, p = 0.339) domains. Item fit residual (IFR) values for all domains were within the desired limits, indicating no deviation from the expected relationship between the individual items and the rest of the items of the scale. Person fit residual (PFR) values also showed no person misfit among the samples, indicating item threshold are suitable for Rasch analysis. Reliability of the three domains of the 19-item WHOQOL scale was very good as indicated by a person separation index (PSI) = 0.873 and Cronbach's Alpha (CA) = 0.881 for physical domain, PSI = 0.739 and CA = 0.746 for psychological domain, and PSI = 0.753 and CA = 0.781 for environmental domain. The social domain (PSI = 0.650 and CA = 0.669) had below acceptable reliability. All items in each domain had ordered thresholds except one item of the environmental domain. All four domains of the 19-item WHOQOL scale showed unidimensionality and was free from local dependency. Each domain also showed similar functioning for adults and older adults, males and females, no education and at least primary level of education, low and high socio-economic conditions. CONCLUSION: The 19-item modified WHOQOL scale is confirmed as an efficient screening tool for measuring QoL among healthy rural Bangladeshi people. The scale could be implemented more widely. In particular, validations are required for diseases-specific population in Bangladesh to measure the Health Related Quality of life (HR-QoL) assessments for people suffering from chronic or other diseases

Factors associated with antihypertensive medication use and blood pressure control in a rural area in Bangladesh: baseline data from a cluster randomised control trial

Background The use of antihypertensive medications is critical for controlling high blood pressure. We aimed to investigate associations between socio-demographic factors and antihypertensive medications use, and antihypertensive medications use with different types of drugs use with levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP). Methods For the present report we derived data from the baseline measurements of a cluster randomised control trial on 307 participants with previously diagnosed hypertension from the rural district of Narial in Bangladesh. We measured the participant’s current blood pressure levels and recorded antihypertensive medications uses. Associated factors included socio-economic status, diabetes, antihypertensive medications use, and types of drugs and doses used for controlling blood pressure. We applied analysis of variance and logistic regression techniques to identify factors associated with blood pressure. Results Of the total participants, 144 (46.9%) were on antihypertensive medications. After multivariate adjustment, binary logistic regression revealed that employees (odds ratio, (95% confidence interval (CI)) (OR 3.58, 95%CI 1.38-9.28) compared to farmers, and people with diabetes (OR 2.43, 95%CI 1.13-5.26) compared to people without diabetes were associated with a higher proportion of antihypertensive medications use. Of 144 participants on antihypertensive medications, 7 (5%) had taken two doses, 114 (79%) had taken one dose per day and the rest were irregular in medication use. The mean (standard deviation) [min, max] SBP and DBP were 149 (19) mmHg [114, 217] and 90 (10) mmHg [75, 126], respectively. Overall, there was no significant difference in SBP (p = 0.10) or DBP (p = 0.67) between participants with or without antihypertensive medications or using any type of medications (p = 0.54 for SBP and 0.76 for DBP). There was no significant association between antihypertensive medications use and elevated BP levels SBP/DBP≥140/90 mmHg (p = 0.42) Conclusion Less than half of the people with hypertension were on medication. Irrespective of the antihypertensive medications use, most of the participant’s blood pressure was high. Further study is needed with a large sample to understand the factors and aetiology of unmanaged hypertension in rural areas of Bangladesh where the prevalence of hypertension is very high

Functional presbyopia in a rural Kenyan population: the unmet presbyopic need.

BACKGROUND: Presbyopia is the most common reason for requiring spectacles in low-income regions, although the unmet need for presbyopic spectacles in these regions is very high. The aim of this study was to estimate the prevalence of presbyopia, and the functional impairment and spectacle use among persons with presbyopia in a rural Kenyan population. METHODS: A cross-sectional study was carried out in the Rift Valley, Kenya. Clusters were selected through probability-proportionate to size sampling, and people aged >/=50 years within the clusters were identified through compact segment sampling. Within the context of this survey, 130 eligible participants were selected for interview and underwent near-vision testing. Functional presbyopia was defined as requiring at least +1.00 dioptre in order to read the N8 optotype at a distance of 40 cm in the participant's usual visual state. Participants were corrected to the nearest 0.25 dioptre in order to see N8. Unmet and met presbyopic need, and presbyopic correction coverage were calculated. RESULTS: Functional presbyopia was found in 111 participants (85.4%). Mean age was lower in those with presbyopia (64.1 years vs. 71.5 years, P = 0.004). Increasing degree of addition required to see N8 was significantly associated with increased difficulty with reading (P = 0.04), sewing (P = 0.03), recognizing small objects (P = 0.02) and harvesting grains (P = 0.05). Among participants with functional presbyopia, 5.4% wore reading glasses and 25.2% had prior contact with an eye care professional. The unmet presbyopic need was 80.0%, met presbyopic need was 5.4% and presbyopic correction coverage was 6.3%. Cost was cited as the main barrier to spectacle use in 62% of participants with presbyopia. CONCLUSION: In low-income regions, there is a high prevalence of uncorrected presbyopia, which is associated with near-vision functional impairment. Provision of spectacles for near vision remains a priority in low-income regions

Knowledge, Attitudes and Practices Regarding Diabetes in the General Population: A Cross-Sectional Study from Pakistan.

Background: Low knowledge about diabetes risk factors coupled with high disease prevalence is common in low-resource countries. This study evaluated diabetes-related knowledge, attitudes, and practices in the general population in Punjab (Pakistan). Methods: A cross-sectional study was conducted in five districts in Punjab from January to March 2017. Data were collected from 2019 adults aged 18⁻90 years through face-to-face interviews using a semi-structured questionnaire. The total knowledge score ranged from 0⁻9; a score ≥6 was considered adequate diabetes awareness. Descriptive statistics, chi-square tests, and linear and binary logistic regression were used for the analyses. Results: Respondents' mean age was 32.92 ± 11.4 years. In total, 85.9% of respondents had heard of diabetes, and 30.1% knew about the glucose tolerance test. We found 2.3% of respondents scored zero for diabetes knowledge, 11.3% scored 9, and 47.4% scored ≥6 (adequate awareness). Being female (β = 0.37, 95% confidence interval [CI]: 0.16, 0.05; p = 0.001), socioeconomic status (β = 0.24, 95% CI: 0.12, 0.36; p < 0.001), being diabetic (β = 0.82, 95% CI: 0.53, 1.10; p < 0.001), and higher education (β = 0.25, 95% CI: 0.17, 0.33; p < 0.001) were significantly associated with knowledge score. Respondents with high socioeconomic status showed significantly higher positive attitudes compared with those with low socioeconomic status (adjusted odds ratio 1.57, 95% CI: 1.12, 2.24). Only 8.7% (30/343) of those diagnosed with diabetes had never undergone blood glucose screening since diagnosis. Conclusions: Knowledge of diabetes risk factors, management, and care is low in Pakistan's general population. Targeted public education programs should be instigated at a national level to increase understanding of diabetes prevention and treatment

Retinal vessel diameters and risk of hypertension: The Multiethnic Study of Atherosclerosis

10.1097/HJH.0b013e3283310f7eJournal of Hypertension27122386-239