Changes in non-communicable diseases, diet and exercise in a rural Bangladesh setting before and after the first wave of COVID-19.
Changes in non-communicable diseases, diet and exercise in a rural Bangladesh setting before and after the first wave of COVID-19.
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DOI：
10.1371/journal.pgph.0001110
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发表时间：
2022
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孟加拉国农村地区非传染性疾病 (NCD) 的患病率很高。鉴于非传染性疾病、COVID-19 感染和控制措施之间复杂的多向关系，在这种背景下探讨大流行的影响非常重要。我们于 2020 年 2 月至 3 月（调查 1，COVID-19 之前）和 2021 年 1 月至 3 月（调查 2，封锁后）对孟加拉国法里德普尔地区 30 岁以上的成年人进行了两次横断面调查。每次调查都会随机抽取新的参与者样本。人体测量包括：血压、体重、身高、臀围和腰围以及空腹和血糖负荷后 2 小时血糖。访谈员管理的调查问卷包括：社会人口统计；生活方式和行为风险因素；寻求护理；自评健康、抑郁和焦虑评估。使用chi2检验、逻辑回归和线性回归比较了调查之间非传染性疾病、饮食和运动的差异；按性别、年龄和社会经济三分位数进行了亚组分析。我们在调查 1 中招募了 950 名 (72.0%) 参与者，在调查 2 中招募了 1392 名 (87.9%) 参与者。高血压人口比例从 34.5% (95% CI: 30.7, 38.5) 显着增加到 41.5% (95% CI: 38.2, 45.0; p 值 = 0.011)；男性的增加更为明显。在自我报告的健康和心理健康的所有指标中，调查 1 和 2 之间都有显着改善。对于自我评价的健康，我们观察到增加了 10 个百分点（71.3 vs 81.2，p 值 = 0.005）。抑郁症从 15.3% (95% CI: 8.4, 26.1) 降至 6.0% (95% CI: 2.7, 12.6; p 值 = 0.044)，广泛性焦虑症从 17.9% (95% CI: 11.3, 27.3) 降至 4.0% (95% CI: 2.0, 7.6; p 值 = 0.044)。 p 值<0.001）。未观察到空腹血糖、糖尿病状况、体重指数或腹部肥胖的变化。我们的研究结果表明，在孟加拉国农村地区，COVID-19 封锁后，健康结果既有积极的也有消极的，其中高血压的增加令人担忧。这些发现需要进一步结合实际情况，对身心健康和寻求护理的间接影响进行前瞻性评估。
Prevalence of non-communicable diseases (NCDs) is high in rural Bangladesh. Given the complex multi-directional relationships between NCDs, COVID-19 infections and control measures, exploring pandemic impacts in this context is important. We conducted two cross-sectional surveys of adults ≥30-years in rural Faridpur district, Bangladesh, in February to March 2020 (survey 1, pre-COVID-19), and January to March 2021 (survey 2, post-lockdown). A new random sample of participants was taken at each survey. Anthropometric measures included: blood pressure, weight, height, hip and waist circumference and fasting and 2-hour post-glucose load blood glucose. An interviewer-administered questionnaire included: socio-demographics; lifestyle and behavioural risk factors; care seeking; self-rated health, depression and anxiety assessments. Differences in NCDs, diet and exercise were compared between surveys using chi2 tests, logistic and linear regression; sub-group analyses by gender, age and socio-economic tertiles were conducted. We recruited 950 (72.0%) participants in survey 1 and 1392 (87.9%) in survey 2. The percentage of the population with hypertension increased significantly from 34.5% (95% CI: 30.7, 38.5) to 41.5% (95% CI: 38.2, 45.0; p-value = 0.011); the increase was more pronounced in men. Across all measures of self-reported health and mental health, there was a significant improvement between survey 1 and 2. For self-rated health, we observed a 10-point increase (71.3 vs 81.2, p-value = 0.005). Depression reduced from 15.3% (95% CI: 8.4, 26.1) to 6.0% (95% CI: 2.7, 12.6; p-value = 0.044) and generalised anxiety from 17.9% (95% CI: 11.3, 27.3) to 4.0% (95% CI: 2.0, 7.6; p-value<0.001). No changes in fasting blood glucose, diabetes status, BMI or abdominal obesity were observed. Our findings suggest both positive and negative health outcomes following COVID-19 lockdown in a rural Bangladeshi setting, with a concerning increase in hypertension. These findings need to be further contextualised, with prospective assessments of indirect effects on physical and mental health and care-seeking.