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MAP OF BANGLADESH

Area : 147570 Sq. Km. 56977 Sq. Miles

National Flag of Bangladesh

BANGLADESH
Population : 143809000 143.8 million

Male/Female Ratio : 105:100


Annual Population Growth : 1.7

Urban Population

: 21.5%
369 USD

Per capita Income :

Adult Literacy Rate : 51%


WHO report: 2004

National Health Indicators

Life Expectancy at birth (Years)

62.6 M/F : 55.3 Male 53.3 Female 71 Male 73 Female 3.0 251 Male 258 Female 58 USD 3.5%

Healthy Life Expectancy at birth (Years) Child mortality/1000 Maternal Mortality Ratio/1000 Adult Mortality/1000 Per Capita Total Health Expenditure : : : :

Total Health : Expenditure as % GDP

Top 20 Causes of Deaths By Sex in 2000


Cause of deaths Total (top 20 causes) 01. Old age complications (senility) 02. Asthma 03. Stroke/Paralysis 04. Fever Both sex 63.38 12.09 6.04 5.71 4.99 Male 62.26 11.07 6.24 6.62 4.35 Female 64.34 13.50 5.77 4.46 5.88

05. Heart disease


06. Pneumonia 07. Diarrhoea 08. Hypertension 09. Gastritis/Peptic ulcer 10. Diabetes 11. Drowning 12. Hepatitis-B 13. Tuberculosis 14. Malnutrition 15. Typhoid 16. Tetanus (after delivery) 17. Accident and injuries 18. Cancer (all types) 19. Tetanus 20. Anaemia

4.89
4.18 3.35 2.91 2.42 2.36 2.20 1.81 1.70 1.65 1.48 1.21 1.15 1.10 1.10 1.04

5.87
3.41 3.12 3.31 2.65 2.65 2.18 1.51 1.42 1.80 1.14 1.70 1.32 1.14 0.76

3.54
5.24 3.67 3.36 2.10 1.97 2.23 2.23 2.10 1.44 1.97 1.21 0.39 0.79 1.05 1.44

Source: Health and Demographic Survey, 2000, Bangladesh Bureau of Statistics.

Leading cause of deaths in the country


1. Respiratory and Infectious Diseases 2. Diarrhoeal and GI diseases 3. Cardiovascular diseases

All types of cardiovascular diseases are seen in Bangladesh.


1. 2. 3. 4. 5. Rheumatic Heart Disease Ischaemic Heart Disease Hypertension Congenital Heart Disease Arrhythmias, Cardiomyopathies, Myocarditis etc.

Pattern of Cardiac Diseases in Bangladesh 1974-1976


Total No. of population surveyed
No. of Heart Disease Detected

:
:

7062
207 (2.9%)

Hypertension

: 83 (1.10%)

Rheumatic Heart Diseases


Ischaemic Heart Diseases Congenital Heart Diseases

: 53 (0.75%)
: 24 (0.33%) : 13 (0.18%)

Arrhythmia
Others
Brig. A. Malik, BMRC Bulletin, 1976; 2:115-119

: 16 (0.22%)
: 18 (0.25%)

Pattern of Cardiac Diseases in Bangladesh 1979-1980


Total No. of population surveyed No. of Heart Disease Detected : : 5000 230 (4.6%)

Hypertension Ischaemic Heart Diseases Rheumatic Heart Diseases Congenital Heart Diseases Others

: 105 (2.1%) : : : : 66 (1.3%) 39 (0.78%) 11 (0.22%) 9 (0.18%)

Akhter Hussain, Bangladesh Heart Journal, 1984.

Pattern of Cardiac Diseases in Bangladesh 1984-1986


Total No. of population surveyed No. of Heart Disease Detected : : 1619 97 (5.9%)

Hypertension Ischaemic Heart Diseases Rheumatic Heart Diseases Congenital Heart Diseases Others

: 43 (2.65%) : 28 (1.72%) : 16 (0.98%) : : 5 (0.30%) 5 (0.30%)

Malik et al. SSMCJ. 1993; 1 (2):35

Prevalence of Cardiac Disease in Bangladesh


Investigators Years Total Population No. of Cardiac Cases Percentage

Malik et al 1974-75 Hossain A 1979-80 Malik et al. 1984-86

7062 5000 1619

207 203 97

2.9 4.6 5.9

Pattern of Cardiovascular Diseases in Bangladesh


Cardiovascular Diseases
Malik et al. 1974-75 n-7062 A.Hossain 1979-80 n-5000 Malik et al. 1984 - 86 n-1619

Hypertension
Ischaemic Heart Disease Rheumatic Heart Disease Congenital Heart Disease

1.10%
0.33% 0.75% 0.18% 0.25%

2.1%
1.3% 0.75% 0.22% 0.25%

2.65%
1.72% 0.98% 0.30% 0.30%

Others

Pattern of Cardiovascular Diseases in Bangladesh


3

2.5

1.5

74-76 79-80 84-86

0.5

0 HTN IHD RHD CHD OTHERS

Prevalence of CHD, sHTN and dHTN in NIDDM subjects at the time of diagnosis by sex and area
Prevalence (%)

Disease events

CHD

(SBP>140mmHg)

sHTN

dHTN

(DBP>90mmHg)

Sex

Men
Women M+W Area Rural Urban

295
398 693

16.6
20.1 18.6

19.3
26.1 23.2

11.2
15.3 13.6

174 519

17.8 18.9

18.4 24.9

5.7 16.2

Diabetic Research and Clinical Practice 39 (1998)

From July1995-1997 4410 Cardiac Patients were Admitted in 13 Regional and Tertiary Hospitals 34% patients were of Ischaemic Heart Diseases
Chest & Heart Diseases of Bangladesh, 2001

Pattern of Cardiovascular Diseases in Sir Salimullah Medical College in last 5 years


No. of Patients Diseases
Ischaemic Heart Diseases Hypertension Rheumatic Heart Diseases Congenital Heart Diseases Others Total

Total
2004
630 213 55 23 210 1131 3247 1403 542 146 900 6238

%
52 22.4 8.6 2.3 14.4 100

2000
596 292 176 33 154 1251

2001
603 248 161 36 169 1217

2002
725 316 66 25 161 1346

2003
693 334 84 29 206 1346

RISK FACTORS PROFILE IN PATIENTS WITH IHD

Smoking
Hypertension Dyslipidaemia Diabetes Mellitus
No major risk factors:
J Bangladesh Coll Phy Surg 1996; 14:94-97 J. Inst. Postgrad. Med. Res. 1998;13:5-8 Chest and Heart Bulletin, 1998;22:49-52

52 - 70%
30 48% 29 51% 23 39%
6% - 9%

Health Sector Research Activities


Government : Bangladesh Medical Research Council
Very few epidemiological survey in cardiovascular diseases

Bangladesh Cardiac Society : Organizationally no epidemiological survey. Individual Members : Mostly clinical research

Bangladesh Cardiac Society

Formed in 1982 Total members : 300

Activities:

Seminars
Publication of Journal (Bangladesh Heart Journal) CME program Conferences International relations : WHF, APSC, SAARC Cardiac Society

Fund :

Membership Fee Conferences

SUMMARY
Cardiovascular diseases are increasing in Bangladesh The Prevalence of the disease raised from 29 per thousand to 59 per thousand by 10 years. Ischaemic Heart Disease most common cardiovascular disease increased from 3.3 per thousand to 17 per thousand indicating 5 fold increase of the disease.

With the decline of the mortality due to Infectious and diarrhoeal diseases and deaths from perinatal cause cardiovascular diseases particularly

Ischaemic Heart Disease will be the major health problem and No. 1 killer disease in our country.

Contd

Socio-economic improvement and changes in life style in respect of increase in tobacco consumption and saturated fat intake, decrease in physical activity, increasing body weight and

consequently increasing rate of diabetes mellitus, hypertension and


dyslipidaemia in the population contribute to this increase in ischaemic heart disease.