The second NDSP was conducted from February 2016 to August 2017 in all four provinces of Pakistan, that is, Punjab, Sindh, Khyber Pakhtunkhwa and Baluchistan.
Pakistani nationals aged 20 years or more were included in the survey, whereas pregnant women and those not residents of the selected households were excluded. An estimated sample size of 10 800 was calculated using probability sampling and multistage stratified sampling techniques.17 Sample size was calculated based on an expected prevalence of 18% (based on previous surveys), level of significance 97%, margin of error 1% with a design effect of 2, considering complex multistage design.
Stratification of population was done on the basis of urban and rural domains for all four provinces as defined in the latest available census.18 Each province was considered as a stratum and the districts (geographical subdivision of provinces legally described by government) considered as clusters were selected from each stratum. Tehsils or towns (further bifurcation of districts legally described by government) considered as subclusters were selected from each identified cluster for the survey.
Clusters and subclusters were randomly selected using probability proportional to size technique, and number of clusters were selected from each province using the ‘rule of thumb’ number of clusters (k)=(sample size of stratum/2)0.5.19 Twenty-seven clusters were selected out of a total 213 clusters from all over Pakistan. A total of 46 subclusters (21 from urban and 25 from rural) were selected (figure 1 ).
Seventeen teaching hospitals and/or diabetes centres participated in the second NDSP. The training sessions of these 17 teams were conducted from February 2016 to July 2016. The teams were trained to identify households, to fill the questionnaire, to take anthropometric and clinical measurements and to collect blood samples. The questionnaire was adopted from the WHO Questionnaire used in the 1st NDSP.8 (link) Each team was led by a physician as provincial coordinator of that cluster and each team comprised laboratory technicians, paramedical staff and survey officers.
Door-to-door assessment was done following systematic sampling technique. The first household in the lane was selected randomly and afterwards every 10th house was identified. In case residents of the identified household were not present or if they refused to participate, the next consecutive household was taken. Teams marked the houses and informed the adult residents. The selected household members were requested to come after an overnight fast (at least 8 hours) to the camp on the specific day. Two hundred and fourteen camps were conducted to recruit the required number of study subjects. Each participant was expected to stay within the screening facility for at least 2 hours, that is, for the post 75 g anhydrous glucose load. Meanwhile, the anthropometric and clinical data were collected by the trained paramedic staff under the supervision of the provincial coordinator.
Pakistani nationals aged 20 years or more were included in the survey, whereas pregnant women and those not residents of the selected households were excluded. An estimated sample size of 10 800 was calculated using probability sampling and multistage stratified sampling techniques.17 Sample size was calculated based on an expected prevalence of 18% (based on previous surveys), level of significance 97%, margin of error 1% with a design effect of 2, considering complex multistage design.
Stratification of population was done on the basis of urban and rural domains for all four provinces as defined in the latest available census.18 Each province was considered as a stratum and the districts (geographical subdivision of provinces legally described by government) considered as clusters were selected from each stratum. Tehsils or towns (further bifurcation of districts legally described by government) considered as subclusters were selected from each identified cluster for the survey.
Clusters and subclusters were randomly selected using probability proportional to size technique, and number of clusters were selected from each province using the ‘rule of thumb’ number of clusters (k)=(sample size of stratum/2)0.5.19 Twenty-seven clusters were selected out of a total 213 clusters from all over Pakistan. A total of 46 subclusters (21 from urban and 25 from rural) were selected (
Seventeen teaching hospitals and/or diabetes centres participated in the second NDSP. The training sessions of these 17 teams were conducted from February 2016 to July 2016. The teams were trained to identify households, to fill the questionnaire, to take anthropometric and clinical measurements and to collect blood samples. The questionnaire was adopted from the WHO Questionnaire used in the 1st NDSP.8 (link) Each team was led by a physician as provincial coordinator of that cluster and each team comprised laboratory technicians, paramedical staff and survey officers.
Door-to-door assessment was done following systematic sampling technique. The first household in the lane was selected randomly and afterwards every 10th house was identified. In case residents of the identified household were not present or if they refused to participate, the next consecutive household was taken. Teams marked the houses and informed the adult residents. The selected household members were requested to come after an overnight fast (at least 8 hours) to the camp on the specific day. Two hundred and fourteen camps were conducted to recruit the required number of study subjects. Each participant was expected to stay within the screening facility for at least 2 hours, that is, for the post 75 g anhydrous glucose load. Meanwhile, the anthropometric and clinical data were collected by the trained paramedic staff under the supervision of the provincial coordinator.
