title: Diagnosis of chronic conditions with modifiable lifestyle risk factors in selected urban and rural areas of Bangladesh and sociodemographic variability therein.
abstract: BACKGROUND
  Bangladesh suffers from a lack of healthcare providers. The growing chronic disease epidemic's demand for healthcare resources will further strain Bangladesh's limited healthcare workforce. Little is known about how Bangladeshis with chronic disease seek care. This study describes chronic disease patients' care seeking behavior by analyzing which providers diagnose these diseases.
  
  
  METHODS
  During 2 month periods in 2009, a cross-sectional survey collected descriptive data on chronic disease diagnoses among 3 surveillance populations within the International Center for Diarrheal Disease Research, Bangladesh (ICDDR, B) network. The maximum number of respondents (over age 25) who reported having ever been diagnosed with a chronic disease determined the sample size. Using SAS software (version 8.0) multivariate regression analyses were preformed on related sociodemographic factors.
  
  
  RESULTS
  Of the 32,665 survey respondents, 8,591 self reported having a chronic disease. Chronically ill respondents were 63.4% rural residents. Hypertension was the most prevalent disease in rural (12.4%) and urban (16.1%) areas. In rural areas chronic disease diagnoses were made by MBBS doctors (59.7%) and Informal Allopathic Providers (IAPs) (34.9%). In urban areas chronic disease diagnoses were made by MBBS doctors (88.0%) and IAP (7.9%). Our analysis identified several groups that depended heavily on IAP for coverage, particularly rural, poor and women.
  
  
  CONCLUSIONS
  IAPs play important roles in chronic disease care, particularly in rural areas. Input and cooperation from IAPs are needed to minimize rural health disparities. More research on IAP knowledge and practices regarding chronic disease is needed to properly utilize this potential healthcare resource.
authors.affiliation: International Center for Diarrheal Disease Research, Bangladesh, Health Systems and Infectious Disease Division, Mohakali, Dhaka, Bangladesh. JohnDP1983@gmail.com
authors.forename: John D
authors.initials: JD
authors.lastname: Parr
authors.forename: Wietze
authors.initials: W
authors.lastname: Lindeboom
authors.forename: Masuma A
authors.initials: MA
authors.lastname: Khanam
authors.forename: Tracey L
authors.initials: TL
authors.lastname: Pérez Koehlmoos
mesh_terms: D000328:Adult; D000368:Aged; D001459:Bangladesh / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006302:Health Services Research; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014504:Urban Health / Q000706:statistics & numerical data*; D019037:Urban Health Services / Q000706:statistics & numerical data
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