Proposal on a cross sectional study on usage of technology in Blood Pressure, SpO2
and Blood Glucose on 200 people in Dhaka, Bangladesh
Introduction
Non-communicable diseases (NCDs) contribute to the highest number of mortalities and morbidities
around the globe. According to the Global Burden of Disease study, 38 million deaths in 2013 were
caused by NCDs of which 71% died at an age below 70 years and 82% belonged to Low and Middle
Income Countries (LMICs). NCDs are thought to exceed the combined burden posed by
communicable, maternal, perinatal and nutritional diseases by 2030 and would cause most number
of deaths if timely and appropriate measures are not taken.
Bangladesh like many other developing countries is facing a steep growth in NCDs which presently
are causing 61% of deaths. Cardiovascular disease, Diabetes Mellitus, Cancer and Chronic Respiratory
diseases being the most prevalent NCDs in Bangladesh. It is feared that the NCDs will impose even
greater burden in near future.(1)
In response to the increasing prevalence of NCDs in Bangladesh, Company X is willing to enhance and
accelerate the use of technology to reduce the health burden imposed by NCDs. For working in this
direction Company X presently focuses on Hypertension, Diabetes Mellitus and Respiratory diseases
and has multidimensional achievements in the field of health.
The onset and progression of Hypertension and Diabetes Mellitus can be controlled by regular
monitoring of Blood Pressure and Blood Glucose Levels respectively.
Impaired respiratory functions may result in lower concentration of oxygen in blood. This can be
regularly monitored using SpO2 values. SpO2 is the peripheral capillary oxygen saturation which
estimates the amount of oxygen in the blood and is measured using pulse oximeter. Less SpO2 levels
in otherwise healthy person may lead to low stamina and therefore less productivity.
Aim of the Project
Hypertension is the third highest cause of disability adjusted life years. According to data published
in BioMed Central in 2016, 26.4% of Bangladeshi population are suffering from Hypertension. (2)
World Health Organization refers patients with systolic pressure between 120-139mmHg and
diastolic pressure between 80-89mmHg as pre-hypertensive. The pre-hypertensive patients are in
the risk zone but can easily return to optimal blood pressure by life style modification upon timely
detection. Once the systolic pressure shoots over 140mmHg and diastolic over 90mmHg, patients are
termed as hypertensive and must start their dose of anti-hypertensive drugs as prescribed by a
registered physician.
Bangladesh has a disproportionately high diabetic population. According to a research published in
WHO bulletin in 2013, 8.4% of the adult Bangladeshi population are diabetic of which nearly half
(51.2%) are unaware. This results in late detection and higher burden on the society. Moreover,
chronic untreated diabetes can lead to many other diseases such as skin diseases, diabetic
retinopathy etc. International Diabetes Federation fears the number of diabetic patients may rise up
to 13% by 2030 in Bangladesh.
In 2014 WHO ranked Bangladesh as the 4th most polluted country among 91 countries. This polluted
environment among other effects can silently damage the respiratory system of the inhabitants
which mostly goes unnoticed. The respiratory diseases, like any other disease is easily controllable at
early stage but could invite many more diseases at its chronic phase.
From the above facts and figures a clear picture can be drawn about the rising prevalence of
hypertension, diabetes and respiratory diseases in Bangladeshi population and disease negligence by
most of the sufferers.
Technology is a part and parcel of the daily life now, be it rural or urban. The extent of its utility in
health sector is yet to unfold. A portion of conscious Bangladeshi population has already started the
use of technology in regularly monitoring their health conditions.
The use of technology could be through owning the specific devices such as the blood glucose
monitor, sphygmomanometer etc., by utilizing some mobile apps or through some common social
platforms such as local clinics.
Company X plans to statistically evaluate the influence of technology intervention on the levels of
blood pressure, blood glucose and SpO2, thereby delaying onset and progression of related diseases
and its contribution in decreasing the health burden and improving the life standard. These findings
can help the society take a step ahead towards achieving the UN millennium goals.
Methodology
Study Population
The study will be conducted on 200 participants selected randomly from different income levels,
education levels and areas of Dhaka city. Of these 200 participants, 100 will be selected who use
technological intervention for their blood pressure, blood glucose and SpO2 monitoring and 100 who
does not. The age of the participants will range from 35-70 years and other factors such as sex, height,
weight will be kept random.
For randomized data collection, small basic health checkup booths will be organized for 1 day in four
different quadrants of Dhaka (North, South, East and West). The health checkup date will be locally
announced to inform the locals. From every quadrant 25 technology user and 25 technology non-
user participants will be included in the study selected randomly after receiving consent from the
participants. The blood glucose level, blood pressure and SpO2 value (referred to as parameters in
later part of this article) of all participants will be noted. An already prepared questionnaire will be
filled up from information provided by them including their age, different parameter levels,
parameters monitoring interval, age at disease onset and rate of disease progression if known and
applicable.
The booth setup will also give a secondary long-term benefit of increasing awareness about health
parameters among the Dhaka city dwellers.
Study Design
For this project, cross-sectional study will be conducted. The data collected from intervention group
(100 technology users) will be compared to the non-intervention group (100 technology non-users)
in context of the health parameters and health conditions to draw a conclusion about the effect of
technology use in blood pressure, blood glucose and SpO2 levels and hence on prevalence of
hypertension, diabetes mellitus and blood oxygen deficiency related disorders using appropriate
statistical tools.
Health Checkup Booth Implementation
Two staffs (1 male and 1 female) for each booth, i.e 8 staffs in total, will be recruited. Blood glucose
meter, Sphygmomanometer and pulse oximeter, one of each, will be provided to each booth. The
staffs will be trained beforehand about how to measure the parameters of interest and fill up the
questionnaire. A written consent from each participant will be obtained before recording their data.
Timeline
Month Activity
November Research proposal, final planning of activities and staff recruitment
December (1st half) Training of the hired staff for measuring the parameters and execution of
health checkup booth activities
December (2nd half) Data entry completion, carrying out statistical evaluation
January Data analysis and report writing
Team of experts conducting the study
Upon approval of the grant the following team will be formed for the conduction of the study
1. Leader: Mr. A (CV attached)
Tasks: Recruitment of the staffs, development and finalization of the study plan, assignment
of tasks, final scrutiny of the written report
2. Coordinator: Mr. B (CV attached)
Tasks: Coordination of the booth setup, ensuring timely accomplishment of participant data
compilation, data analysis and report writing
3. Statistician: Mr. C (CV attached)
Tasks: Data entry and statistical analysis of the data and evaluation
Budget
Sl. Activities Unit description Unit cost No. of Frequency Total (BDT)
units
1. Leader Person days 30,000 1 56 1,680,000
2. Coordinator Person days 20,000 1 56 1,120,000
3. Statistician Person days 5,000 1 14 70,000
4. Booth staff (incl. Person days 1000 1 24 24,000
training)
5. Booth setup Per booth 10,000 1 4 40,000
5. Equipment Blood glucose meter, 9,000 1 4 36,000
Sphygmomanometer,
Pulse oximeter
6. Travel cost Per travel 500 1 8 40,000
7. Miscellaneous Per project 20,000 1 1 20,000
8. Total 3,030,000
References
1. Biswas T, Pervin S, Tanim IA, Niessen L, Islam A. Bangladesh policy on prevention and control
of non-communicable diseases: a policy analysis. BMC Public Health; 2017;111.
2. Chowdhury MAB, Uddin MJ, Haque MR, Ibrahimou B. Hypertension among adults in
Bangladesh: evidence from a national cross-sectional survey. BMC Cardiovasc Disord
[Internet]. 2016 Jan;16(1):22. Available from: https://doi.org/10.1186/s12872-016-0197-3
