Rates of hypertension and diabetes are rising gradually across rural Bangladesh, revealing a silent but alarming public health crisis.
A recent study shows that one in five rural residents suffers from high blood pressure, while more than eight percent live with diabetes. Even more concerning, over half of the newly diagnosed diabetes patients had already progressed to an advanced stage of the disease even before detection. The most alarming is that the participants were unaware that they had hypertension, diabetes, or chronic kidney disease.
Researchers say that with money equivalent to just one US dollar per person, it is possible to implement a large-scale community-based screening programme capable of identifying major non-communicable diseases (NCDs) early.
A Shift From “Urban Diseases” to Rural Epidemics
Hypertension and diabetes were once considered illnesses linked to urban lifestyles. That assumption no longer holds. The new study, conducted in two northern upazilas, reveals that these conditions have now taken root in rural communities as a “silent epidemic.”
The research carried out between January and October 2023 in Chatmohar (Pabna) and Biral (Dinajpur) screened nearly 2,500 people who had never previously been diagnosed with hypertension, diabetes, or chronic kidney disease. The findings, recently published in the international medical journal Clinical Epidemiology and Global Health, show:
● 20.3% of participants had hypertension
● 8.6% had diabetes
● 3.7% had chronic kidney disease
The study was jointly conducted by a Bangladeshi NGO Alternative Approach and Melbourne-based organisation Social Help Endeavour for Bangladesh (SHEBA). The research team was led by Melbourne-based physician, Bangladesh University of Health Sciences researcher and adjunct Professor of Dhaka Community Medical College Dr Ahmed Sharif, The other members of the research team were Prof Dr Shariful Islam of Texas Tech University USA, Monash University Senior Research Fellow Dr Roslin Botlero, Prof Dr Rahelee Zinnat and Prof Dr Pradip Sen Gupta of Bangladesh University of Health Sciences and Melbourne-based physician Dr Nazmul Hoque.
The One-Dollar Screening Model
The “one-dollar screening” model used in the study offers a low-cost method to detect three major NCDs in rural populations. Among the 2,500 participants:
● 1 in 5 had high blood pressure
● 1 in 11 had diabetes
Two troubling patterns emerged:
Most patients had no symptoms, had never been tested before, and thus were unaware of their condition.
More than half (53%) of the newly diagnosed diabetes patients had glucose in their urine, indicating advanced disease and a high risk of future heart disease, stroke, kidney failure, blindness and other complications.
Researchers also noted that many affected individuals consumed excessive salt or were overweight, both known risk factors of these NCDs.
Unexpectedly Low Rate of Chronic Kidney Disease
While previous studies in Bangladesh and South Asia have reported chronic kidney disease (CKD) prevalence between 17% and 24%, this study found a much lower rate of 3.7% in the two surveyed upazillas. A similar survey in Dharan, eastern Nepal—geographically close to Dinajpur—reported a CKD rate of 5.1%, also far below the regional average.
Researchers suggest that geographical or lifestyle similarities may explain this pattern, but emphasise the need for larger, long-term studies to confirm the findings. If validated, these insights could help shape more effective CKD prevention strategies.
A Call for Policy Action
Lead researcher Dr Ahmed Sharif warns that the high prevalence of undiagnosed hypertension and diabetes in rural communities is deeply concerning. Without timely treatment, these conditions can lead to severe complications and premature deaths.
He argues that the one-dollar screening model could be a powerful tool against the growing NCD burden:
Integrating low-cost, community-based screening into primary healthcare could significantly reduce rates of heart disease, stroke, kidney failure, blindness, and premature death.
Dr Sharif stresses that the study’s findings should serve as a message to health policymakers. Early diagnosis and intervention through large-scale low-cost screening could reduce both the human and economic costs of chronic diseases for families and the state.
However, he also notes that the data comes from a limited, one-time screening effort. To fully understand the scale, causes, and long-term impact of NCDs in rural Bangladesh, larger and longitudinal studies are essential.
Here is the link to the research article:
Writer:
Dr Ahmed Sharif (Lead researcher)
MBBS, M Fam Med, FRACGP, FACRRM
WhatsApp: + 61413124627
Family Physician, Melbourne, Australia
Researcher, Department of Public Health
Bangladesh University of Health Sciences, Dhaka, Bangladesh.