Knowledge, attitude and practice regarding diabetes and hypertension among school students of Nepal: A rural vs. urban study

Abstract

Background The burden of non-communicable diseases like diabetes and hypertension is increasing worldwide including low-and middle-income countries. Good knowledge of such diseases among young people will make them adopt a healthy lifestyle from an early age, which will, in turn, prevent them from developing such non-communicable diseases. This study aimed to assess the knowledge, attitude, and practice of rural and urban school students regarding diabetes and hypertension. We also aimed to see the differences in the knowledge, attitude, and practice of students from rural vs. urban communities. Methods A school-based cross-sectional study was conducted from May 1 2021 to June 30, 2021, in four schools in Nepal (1 from a metropolitan city, 2 from an urban municipality, and 1 from a rural municipality). The study was conducted among the secondary-level students of classes 9 and 10 in each school. The data were collected from the participants via pre-tested questionnaires and analyzed in the Statistical Packages for Social Sciences (SPSS) version 20.0. Logistic regression analysis was carried out to determine the determinants of knowledge and attitude regarding diabetes and hypertension. Results Of 380 respondents, 35.5% were residents of metropolitan city, 37.4% were from the urban municipality and 27.1% were from the rural municipality. The mean age of respondents was 15.61±0.99 years and 51.1% were male. Respondents having a family history of diabetes and hypertension were 21.1% and 37.9% respectively. Respondents from the metropolitan city had significantly higher mean knowledge scores than the respondents from the urban and rural municipality (p<0.001) while there was no significant difference in mean attitude scores. There was significantly higher daily consumption of fruits and vegetables among the participants from rural municipality (p<0.01) while no significant difference was seen in salt consumption and time spent on physical activity. In univariate regression analysis, place of residence, family occupation, parental education, and family history of diabetes and hypertension were significantly associated with good knowledge level. In multivariate analysis, only a higher grade of study (grade 10 in comparison to grade 9) was an independent predictor of a student’s good attitude level. Conclusion In general, there was a good attitude towards diabetes and hypertension despite poor knowledge. The mean knowledge scores were lower in urban municipality and rural municipality compared to metropolitan city. Low knowledge scores on diabetes and hypertension among the students show an urgent need for school-based interventional programs focusing on non-communicable diseases and lifestyle modification with more emphasis on rural communities.

Assessement of Diabetes Related-Knowledge and Practice Among Algerian University Students: A Cross-sectional Study

“…These results joined different published results among non-diabetic adults in different countries including Jordan [14], Ethiopia [4,20], India [21] and Saudi Arabia [22]. However, lower rates were reported in Kenya [23], Pakistan [17], Philippines [24], Bangladesh [25], Qatar [12] and Saudi Arabia [26] while higher rates of knowledge were also reported in other countries citing Sri Lanka [15] and Bangladesh [27]. These variations in the level of knowledge in different countries are to be treated with some care due to the difference in the target population (students, general public…) or in the measurement systems (difference in the used items and cut-off points) [14].…”

“…In this study, some factors including the level of education, sex, marital status, living area, smoking, sports practice and having a family history of diabetes were not associated with the level of knowledge about this disease. Consistent results were obtained for some of these factors [15,24,27]. Contrarily, other studies found that that living area [24,27], family history of diabetes [16,24], sex [3,12,16,33], educational level [16], and physical activity [16] are significantly associated with diabetes related knowledge.…”

“…Consistent results were obtained for some of these factors [15,24,27]. Contrarily, other studies found that that living area [24,27], family history of diabetes [16,24], sex [3,12,16,33], educational level [16], and physical activity [16] are significantly associated with diabetes related knowledge. At last, our study showed a positive correlation between knowledge and lifestyle practice.…”

“…Having a father with middle and secondary school level increase 2.261 and 2.455 fold the level of knowledge about diabetes. Sitaula et al [24] in Nepal found that higher level of parental education, in association with other factors, were significantly associated with good knowledge levels on both diabetes and hypertension. In this study, some factors including the level of education, sex, marital status, living area, smoking, sports practice and having a family history of diabetes were not associated with the level of knowledge about this disease.…”

Assessment of Diabetes Related-Knowledge and Practice Among Algerian University Students: A Cross- sectional Survey

“…Having a father with middle and secondary school educational level increases 2.261 and 2.455 folds the level of knowledge about diabetes respectively. Sitaula et al [23] in Nepal found that a higher degree of parental education, in association with other factors, were signi cantly associated with good knowledge levels on both diabetes and hypertension.…”