Prevalence of cardiovascular disease among Bangladeshi adult population: a systematic review and meta-analysis of the studies
Received 21 February 2018
Accepted for publication 21 May 2018
Published 21 August 2018 Volume 2018:14 Pages 165—181
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Dr Takashi Kajiya
Mohammad Ziaul Islam Chowdhury,1,2 Md Ashiqul Haque,2 Zaki Farhana,2 Ataul Mustufa Anik,2 Amadul Hoque Chowdhury,2 Sabrina Mahfuja Haque,2 Lu-Lu-Wal Marjana,2 Piali Dey Bristi,2 BM Abu Al Mamun,2 Mohammad Jasim Uddin,3 Jain Fatema,4 Md Meshbahur Rahman,2 Tanjila Akter,2 Tania Akhter Tani,2 Tanvir C Turin1,5
1Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada; 2Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh; 3Department of General Surgery, North East Medical College, Sylhet, Bangladesh; 4Department of Clinical Pathology, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh; 5Department of Family Medicine, University of Calgary, Calgary, AB, Canada
Background: Cardiovascular disease (CVD) is a group of conditions affecting the functioning of the heart or blood vessels and is one of the leading causes of death globally. Like other countries, CVD prevalence is also rising among the adults in Bangladesh. Epidemiological studies have shown not only a high CVD prevalence but also a significant increase in its prevalence in Bangladesh in the last few decades. To have a better understanding of the current CVD prevalence scenario, we conducted this systematic review and meta-analysis. Our objective was to assess the prevalence of CVD among the Bangladeshi adult population using evidence from the published scientific literature.
Methods: Electronic databases such as MEDLINE, Embase and PubMed were searched. We also manually checked the references of all relevant publications that describe the prevalence of CVD in Bangladeshi adults. To pool the CVD prevalence, we used random-effects meta-analysis. We assessed heterogeneity using both the formal tests and the subgroup analyses. We also assessed study quality and examined publication bias.
Results: We retrieved 755 potentially relevant papers through searches of electronic and gray literature, of which only 13 met inclusion criteria after the screening and were included in this review. Of the studies that met inclusion criteria, three were carried out in rural populations, five in both urban and rural populations and two in strictly urban populations. Male and female participation in the studies was almost equal. The weighted pooled prevalence of CVD was 5.0%, regardless of the types of CVD, gender and geographical location of the study participants. There was also a high heterogeneity in the observed CVD prevalence. Weighted pooled prevalence of overall CVD in the Bangladeshi population was higher in urban areas (8%) compared to rural areas (2%). However, no such difference was observed in terms of gender (3% for both males and females). The highest reported prevalence (21%) was for heart disease, while the lowest reported prevalence (1%) was for stroke. Sources of heterogeneity were often unexplained. The criteria used to assess study quality were fulfilled by only a few studies, and adequate sample size criteria was missed by almost all of them. In addition, there was evidence of small-study effects.
Conclusion: A high CVD prevalence along with an upward trend was observed in Bangladeshi adults. Proper strategies are required for primary prevention of CVD so that a further increase can be alleviated and the morbidity and mortality associated with it can be reduced.
Keywords: cardiovascular disease, prevalence, systematic review, Bangladesh
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