VULNERABILITY OF LOW-ARSENIC AQUIFERS TO MUNICIPAL PUMPING IN BANGLADESH

PubMed Central

Knappett, P. S. K.; Mailloux, B. J.; Choudhury, I.; Khan, M. R.; Michael, H. A.; Barua, S.; Mondal, D. R.; Steckler, M. S.; Akhter, S. H.; Ahmed, K. M.; Bostick, B.; Harvey, C. F.; Shamsudduha, M.; Shuai, P.; Mihajlov, I.; Mozumder, R.; van Geen, A.

2017-01-01

Sandy aquifers deposited >12,000 years ago, some as shallow as 30 m, have provided a reliable supply of low-arsenic (As) drinking water in rural Bangladesh. This study concerns the potential risk of contaminating these aquifers in areas surrounding the city of Dhaka where hydraulic heads in aquifers >150 m deep have dropped by 70 m in a few decades due to municipal pumping. Water levels measured continuously from 2012 to 2014 in 12 deep (>150m), 3 intermediate (90–150 m) and 6 shallow (<90 m) community wells, 1 shallow private well, and 1 river piezometer show that the resulting drawdown cone extends 15–35 km east of Dhaka. Water levels in 4 low-As community wells within the 62–147 m depth range closest to Dhaka were inaccessible by suction for up to a third of the year. Lateral hydraulic gradients in the deep aquifer system ranged from 1.7×10−4 to 3.7×10−4 indicating flow towards Dhaka throughout 2012–2014. Vertical recharge on the edge of the drawdown cone was estimated at 0.21±0.06 m/yr. The data suggest that continued municipal pumping in Dhaka could eventually contaminate some relatively shallow community wells. PMID:28966395

Epidemiology of Hepatitis E Virus in an Urban Community in Dhaka City

PubMed Central

Rahman, Salimur; Jahan, Munira; Tabassum, Shahina; Fazle Akbar, Sheikh Mohammad

2014-01-01

ABSTRACT Introduction Hepatitis E virus (HEV) is endemic in Bangladesh and sporadic and epidemic outbreaks of acute hepatitis E occur in this country almost regularly. Although the real magnitude of HEV prevalence has not been documented in Bangladesh, HEV infections and HEV-related acute hepatitis of Bangladeshi origin have been reported from different parts of the world. Methods The study was conducted in Mirpur area of Dhaka city, which is a major residential area of the capital of Bangladesh. Three hundred adults were randomly included in the study. None had any history of jaundice or complains of liver diseases. Results The study revealed 30% prevalence of HEV in this population. The prevalence increased with age, but there was no gender difference. Conclusion HEV is a highly prevalent disease in Bangladesh as elsewhere in the developing world. Since there is no specific treatment for HEV, improvement of personal hygiene and ensuring supply of safe food and drinking water remain most important approach to sustain the virus. How to cite this article: Rahman S, Mahtab MA, Jahan M, Tabassum S, Akbar SMF. Epidemiology of Hepatitis E Virus in an Urban Community in Dhaka City. Euroasian J Hepato-Gastroenterol 2014; 4(1):4-6. PMID:29264310

Patterns of Use and Perceptions of Harm of Smokeless Tobacco in Navi Mumbai, India and Dhaka, Bangladesh

PubMed Central

Mutti, Seema; Reid, Jessica L.; Gupta, Prakash C.; Pednekar, Mangesh S.; Dhumal, Gauri; Nargis, Nigar; Hussain, AKM Ghulam; Hammond, David

2016-01-01

Background: Globally, smokeless tobacco use is disproportionately concentrated in low-income and middle-income countries like India and Bangladesh. Objectives: The current study examined comparative patterns of use and perceptions of harm for different smokeless tobacco products among adults and youth in Navi Mumbai, India, and Dhaka, Bangladesh. Methods: Face-to-face interviews were conducted on tablets with adult (19 years and older) smokeless tobacco users and youth (16–18 years) users and non-users in Navi Mumbai (n = 1002), and Dhaka (n = 1081). Results: A majority (88.9%) of smokeless tobacco users reported daily use. Approximately one-fifth (20.4%) of the sample were mixed-users (used both smoked and smokeless tobacco), of which about half (54.4%) reported that they primarily used smokeless over smoked forms like cigarettes or bidis. The proportion of users planning to quit was higher in India than in Bangladesh (75.7% vs. 49.8%, p < 0.001). Gutkha was the most commonly used smokeless product in India, and pan masala in Bangladesh. Among users in Bangladesh, the most commonly reported reason for using their usual product was the belief that it was “less harmful” than other types. Perceptions of harm also differed with respect to a respondent's usual product. Bangladeshi respondents reported more negative attitudes toward smokeless tobacco compared to Indian respondents. Conclusions: The findings highlight the high daily use of smokeless tobacco, and the high prevalence of false beliefs about its harms. This set of findings reinforces the need to implement effective tobacco control strategies in low and middle-income countries like India and Bangladesh. PMID:27890978

A Bayesian approach for estimating under-reported dengue incidence with a focus on non-linear associations between climate and dengue in Dhaka, Bangladesh.

PubMed

Sharmin, Sifat; Glass, Kathryn; Viennet, Elvina; Harley, David

2018-04-01

Determining the relation between climate and dengue incidence is challenging due to under-reporting of disease and consequent biased incidence estimates. Non-linear associations between climate and incidence compound this. Here, we introduce a modelling framework to estimate dengue incidence from passive surveillance data while incorporating non-linear climate effects. We estimated the true number of cases per month using a Bayesian generalised linear model, developed in stages to adjust for under-reporting. A semi-parametric thin-plate spline approach was used to quantify non-linear climate effects. The approach was applied to data collected from the national dengue surveillance system of Bangladesh. The model estimated that only 2.8% (95% credible interval 2.7-2.8) of all cases in the capital Dhaka were reported through passive case reporting. The optimal mean monthly temperature for dengue transmission is 29℃ and average monthly rainfall above 15 mm decreases transmission. Our approach provides an estimate of true incidence and an understanding of the effects of temperature and rainfall on dengue transmission in Dhaka, Bangladesh.

Migration of female construction labourers to Dhaka City, Bangladesh.

PubMed

Ahsan, R M

1997-03-01

The author analyzes migration patterns and processes of female construction workers in Dhaka City, Bangladesh, and considers the impact of this migration. "Interviews...reveal that the major goal of these female migrants, whose mobility and employment have traditionally been restricted, is to take responsibility in the struggle for livelihood.... Success of many migrations is linked with participation in construction work in the city. Employment in such activities is largely by women from male-headed households, indicating male support in the work, followed by females heading their own households." excerpt

Presence of enterotoxigenic Escherichia coli in biofilms formed in water containers in poor households coincides with epidemic seasons in Dhaka.

PubMed

Ahmed, D; Islam, M S; Begum, Y A; Janzon, A; Qadri, F; Sjöling, A

2013-04-01

The objective of this study was to investigate if biofilms may be potential reservoirs for the waterborne pathogen enterotoxigenic Escherichia coli (ETEC) in household water in Dhaka, Bangladesh. Biofilms formed on submerged glass slides. Mature biofilms were found significantly more often on glass slides collected in the monsoon period between the two annual ETEC peaks in Bangladesh, that is, between May and August than the rest of the year (P < 0.03). Sixty-four per cent (49/77) of all biofilms analysed by quantitative real-time PCR were positive for ETEC. Significantly more ETEC-PCR positive biofilms were found during the epidemic peaks and during flooding periods than the rest of the year (P < 0.008). Planktonic ETEC was present in the household water during all seasons, but there was no correlation between presence or numbers of ETEC in water and the epidemic peaks. We conclude that ETEC is continuously present in water and biofilms in household water reservoirs in Dhaka, which has a high prevalence of ETEC diarrhoea. The frequency of biofilms with ETEC was significantly associated (P < 0.008) with seasonal epidemic peaks of ETEC diarrhoea. We show for the first time that enterotoxigenic Escherichia coli (ETEC), the causative agent of acute watery diarrhoea and travellers' diarrhoea is present in biofilms in household water tanks in Dhaka, Bangladesh. © 2012 The Society for Applied Microbiology.

Free-Roaming Dog Population Estimation and Status of the Dog Population Management and Rabies Control Program in Dhaka City, Bangladesh

PubMed Central

Tenzin, Tenzin; Ahmed, Rubaiya; Debnath, Nitish C.; Ahmed, Garba; Yamage, Mat

2015-01-01

Beginning January 2012, a humane method of dog population management using a Catch-Neuter-Vaccinate-Release (CNVR) program was implemented in Dhaka City, Bangladesh as part of the national rabies control program. To enable this program, the size and distribution of the free-roaming dog population needed to be estimated. We present the results of a dog population survey and a pilot assessment of the CNVR program coverage in Dhaka City. Free-roaming dog population surveys were undertaken in 18 wards of Dhaka City on consecutive days using mark-resight methods. Data was analyzed using Lincoln-Petersen index-Chapman correction methods. The CNVR program was assessed over the two years (2012–2013) whilst the coverage of the CNVR program was assessed by estimating the proportion of dogs that were ear-notched (processed dogs) via dog population surveys. The free-roaming dog population was estimated to be 1,242 (95 % CI: 1205–1278) in the 18 sampled wards and 18,585 dogs in Dhaka City (52 dogs/km2) with an estimated human-to-free-roaming dog ratio of 828:1. During the two year CNVR program, a total of 6,665 dogs (3,357 male and 3,308 female) were neutered and vaccinated against rabies in 29 of the 92 city wards. A pilot population survey indicated a mean CNVR coverage of 60.6% (range 19.2–79.3%) with only eight wards achieving > 70% coverage. Given that the coverage in many neighborhoods was below the WHO-recommended threshold level of 70% for rabies eradications and since the CNVR program takes considerable time to implement throughout the entire Dhaka City area, a mass dog vaccination program in the non-CNVR coverage area is recommended to create herd immunity. The findings from this study are expected to guide dog population management and the rabies control program in Dhaka City and elsewhere in Bangladesh. PMID:25978406

JPRS Report, Near East & South Asia

DTIC Science & Technology

1992-06-25

Text] Myanmar military government has finally agreed to take back thousands of Rohingya Muslim refugees who crossed over to Bangladesh since...A.S.M. Mustafizur Rahman hoped that 2,23.000 Rohingya Muslim refugees who crossed over to Bangladesh so far would be repatriated to their home- lands...intensive negotiations on the repatriation of the Rohingya refu- gees. Refugees’ Reluctance 92AS1019B Dhaka THE BANGLADESH OBSERVER in English 30

Demographic Correlates of Constant Condom Use among Sex Workers in Tangail, Dhaka, Bangladesh

ERIC Educational Resources Information Center

Eva, Nilufar Akter; Munakata, Tsunetsugu; Onuoha, Francis N.

2007-01-01

Consistent condom use, particularly by promiscuous individuals, is a major safeguard against sexually transmitted diseases, including HIV/AIDS. This study examines some demographic factors that may affect such use among Bangladeshi female commercial sex workers at a brothel in Tangail (n = 196; mean age = 23.44 years), and the streets of Dhaka (n…

Migration, health, and socioenvironmental safety net among children of Dhaka, Bangladesh.

PubMed

Molla, Neelima Afroz; Ali, Ghaffar; Mollah, Kabirul Ahsan; Wongwit, Waranya; Shipin, Oleg; Ramasoota, Pongrama; Nur, Husna Parvin

2017-11-02

This study quantifies the diarrhea burden among migrant children under age 5 (who have migrated due to environmental degradation) in Dhaka. We used a multifactor socioepidemiological as well as environmental approach with pretested questionnaires and observations. It was found that 52% of the children were affected by diarrhea. Disability-adjusted life years (DALYs) lost was reduced manifold with the increase of mothers' behavioral determinants. Health losses were 1,718 fold with significant coefficient (β) in the migrant group. DALYs lost were significantly associated with socioenvironmental factors such as mother's illiteracy (β = .18; p < .001), no hand wash before eating (β = .08; p = .004), and no hand wash after defecation (β = .10; p < .001). This puts emphasis clearly on the awareness at household level, especially of mothers and children under age 5 in Dhaka, Bangladesh, in formulating migration-related policies.

Anaemia and vitamin A status among adolescent schoolboys in Dhaka City, Bangladesh.

PubMed

Ahmed, Faruk; Rahman, Ataur; Noor, Adeba Nazma; Akhtaruzzaman, Mohammad; Hughes, Robert

2006-05-01

To investigate the prevalence of anaemia and subclinical vitamin A deficiency among adolescent schoolboys in Dhaka City, Bangladesh, and to identify factors related to anaemia and vitamin A status. A cross-sectional study. Government high schools in Dhaka City, Bangladesh. A total of 381 boys, aged 11-16 years, from 10 schools in Dhaka City participated in the study. Socio-economic, anthropometric and dietary data were collected. Haemoglobin and serum retinol (vitamin A) concentrations were determined. Seven per cent of the boys were anaemic and 22% had serum vitamin A levels below the adequate level of 1.05 micromol l(-1), with only 1.5% having subclinical vitamin A deficiency (<0.70 micromol l(-1)). Food frequency data revealed poor dietary habits. Multiple regression analysis showed that age, body mass index (BMI), parents' occupation, serum vitamin A level and frequency of intakes of meat and fruit were significantly independently related to haemoglobin level. The overall F-ratio (13.1) was highly significant (P<0.000) and the adjusted R(2) was 0.192. For serum vitamin A, BMI, father's education, per capita expenditure on food, haemoglobin concentration and frequency of intake of vitamin A-rich fruit were found to be significantly independently related. The overall F-ratio (14.5) was highly significant (P<0.000) and the adjusted R(2) was 0.186. The data show that adolescent schoolboys in Dhaka City have anaemia and inadequate vitamin A status, although the extent of the problems is lower than in other population groups in the country. Sociodemographic and dietary factors appear to have important relationships with anaemia and vitamin A status of these boys.

Current state of traffic pollution in Bangladesh and metropolitan Dhaka

DOE Office of Scientific and Technical Information (OSTI.GOV)

Karim, Masud; Matsui, Hiroshi; Ohno, Takashi

1997-12-31

Limited resources, invested for the development of transport facilities, such as infrastructure and vehicles, coupled with the rapid rise in transport demand, existence of a huge number of non-motorized vehicles on roads, lack of application of adequate and proper traffic management schemes are producing severe transport problems in almost all the urban areas of Bangladesh. Worsening situation of traffic congestion in the streets and sufferings of the inhabitants from vehicle emissions demand extensive research in this field. However, no detailed study concerning traffic congestion and pollution problems for urban areas of Bangladesh has yet been done. Therefore, it has becomemore » increasingly important to examine the present state of the problem. This research is a preliminary evaluation of the current situation of traffic pollution problem in Bangladesh. The daily total emissions of NO{sub x}, HC, CO, PM, and SO{sub x} are estimated using the daily fuel consumption and total traffic flows in Dhaka city. Estimated daily emissions are 42, 39, 314, 14, and 42 t/d for NO{sub x}, HC, CO, PM, and SO{sub x}, respectively. The emissions estimated using two different methods revealed good correlation. Daily average concentration of NO{sub x} (NO{sub 2}, NO) were measured at 30 street locations in Dhaka city during September and November, 1996. The results showed extremely high concentrations of NO{sub 2} and NO in these locations.« less

Creating a sustainable, participatory palliative care programme in an urban slum in Dhaka, Bangladesh.

PubMed

Ahmad, Nezamuddin

2018-01-01

The Centre for Palliative Care, based at the only medical university [Bangabandhu Sheikh Mujib Medical University (BSMMU)] in Dhaka, Bangladesh, in collaboration with Worldwide Hospice Palliative Care Alliance, piloted a one-year project focussed on improving the quality of life of 100 older people and their families in two slum settings in Dhaka. This project was developed following the identification of significant palliative care needs of older people in the slum settings. In addition, the project was formed in response to the absence of programmes delivering palliative care to the poorest and most marginalised in poor urban settings, in a sustainable manner within the context of the low development of palliative care and the human and financial resource limitations in Bangladesh. The programme was developed using a participatory approach which focussed on engaging members of the community in the delivery of the project through the identification and training of 8 palliative care assistants from the slum setting itself, who delivered basic care supported by health professionals, the development of palliative care activists within the community and the engagement of the slum community leadership. The impact of the project showed improved quality of life for the target population and the potential for further development as a sustainable, community owned model over a further 2 years, which could be translated into other urban settings. This presentation will highlight lessons learned from the development and implementation of the project, and findings from the independent evaluation completed in December 2016, overseen by Glasgow University. The presentation will outline the successes and challenges of developing a participatory, community owned palliative care service within a slum in Dhaka, Bangladesh for older people and their families.

Water, climate change and society in Bangladesh

NASA Astrophysics Data System (ADS)

Thiele-Eich, Insa; Aßheuer, Tibor; Simmer, Clemens

2017-04-01

Due to its location in the extensive Ganges-Brahmaputra-Meghna river delta, Bangladesh faces multiple natural hazards, in particular flooding, droughts and sea-level rise. In addition to climate change, transboundary water sharing issues resulting from dam structures such as Farakka Barrage complicate a prognosis on how the rapidly growing population will be affected in the 21st century. This is particularly important as our previous research suggests that the Greater Dhaka population already experiences a significant increase in mortality during droughts (Thiele-Eich et al., 2015). We attempt to explore the complex interactions between the hydrological system under climate change and anthropogenic impacts due to dams as well as a growing population. Our approach consists of a quantitative assessment of climate change using over fourty years of meteorological data (Bangladesh Meteorological Department) and hydrological data (Bangladesh Water Development Board), and CCSM4 climate model output (NCAR, 1950-2100). In addition to an extensive literature review, we also conducted qualitative interviews with slum dwellers in the megacity Dhaka, the capital of Bangladesh. Results show that significant changes in flood characteristics are expected for the later part of the 21st century, although they are difficult to quantify down to exact numbers due to large uncertainties. These changes take place over longer stretches of time and thus enable the population of Bangladesh to adapt slowly. Resources such as social capital, which is one of the main tools for slum dwellers to be able to cope with flooding can be altered over time, and as such the system can be considered overall stable and resilient. The presented results will also focus on how the riparian and coastal population is impacted by the interplay of natural changes such as sea-level rise and anthropogenic changes such as Farakka Barrage and the associated reduction in dry season flow. Thiele-Eich, I.; Burkart, K.; Simmer, C. Trends in Water Level and Flooding in Dhaka, Bangladesh and Their Impact on Mortality. Int. J. Environ. Res. Public Health 2015, 12, 1196-1215.

A regional groundwater-flow model for sustainable groundwater-resource management in the south Asian megacity of Dhaka, Bangladesh

NASA Astrophysics Data System (ADS)

Islam, Md Bayzidul; Firoz, A. B. M.; Foglia, Laura; Marandi, Andres; Khan, Abidur Rahman; Schüth, Christoph; Ribbe, Lars

2017-05-01

The water resources that supply most of the megacities in the world are under increased pressure because of land transformation, population growth, rapid urbanization, and climate-change impacts. Dhaka, in Bangladesh, is one of the largest of 22 growing megacities in the world, and it depends on mainly groundwater for all kinds of water needs. The regional groundwater-flow model MODFLOW-2005 was used to simulate the interaction between aquifers and rivers in steady-state and transient conditions during the period 1981-2013, to assess the impact of development and climate change on the regional groundwater resources. Detailed hydro-stratigraphic units are described according to 150 lithology logs, and a three-dimensional model of the upper 400 m of the Greater Dhaka area was constructed. The results explain how the total abstraction (2.9 million m3/d) in the Dhaka megacity, which has caused regional cones of depression, is balanced by recharge and induced river leakage. The simulated outcome shows the general trend of groundwater flow in the sedimentary Holocene aquifers under a variety of hydrogeological conditions, which will assist in the future development of a rational and sustainable management approach.

Risk factors for the presence of dengue vector mosquitoes, and determinants of their prevalence and larval site selection in Dhaka, Bangladesh.

PubMed

Paul, Kishor Kumar; Dhar-Chowdhury, Parnali; Haque, C Emdad; Al-Amin, Hasan Mohammad; Goswami, Doli Rani; Kafi, Mohammad Abdullah Heel; Drebot, Michael A; Lindsay, L Robbin; Ahsan, Gias Uddin; Brooks, W Abdullah

2018-01-01

Dengue viruses are responsible for over 100 million infections a year worldwide and are a public health concern in Bangladesh. Although risk of transmission is high, data on vector population characteristics are scanty in Bangladesh; therefore, a comprehensive prediction of the patterns of local virus transmission is not possible. Recognizing these gaps, multi-year entomological surveys were carried out in Dhaka, where the disease is most frequently reported. The specific objectives of the present study are threefold: i) to determine the risk factors for the presence of Aedes mosquitoes; ii) to identify the types of most productive and key containers; and iii) to estimate the effects of climatic factors on Aedes abundance in the city of Dhaka, Bangladesh. Entomological surveys were conducted in 12 out of 90 wards in Dhaka. These wards were selected using a probability proportional sampling procedure during the monsoon seasons in 2011, 2012 and 2013 and in the dry season in 2012. All containers inside and around sampled households were inspected for mosquito larvae and pupae, and containers were classified according to their relative size, use pattern, and materials of construction. During the study period (2011-2013), 12,680 larvae and pupae were collected. About 82% of the identified immature mosquitoes were Aedes aegypti, while the remainder were Ae. albopictus and other mosquito species. The largest number of immature mosquitoes was collected from tires and refrigerator trays during 2011 and 2012 monsoon seasons. Conversely, plastic drums were the most productive during the 2012 dry and 2013 monsoon season. Vehicle parts and discarded construction materials were the most efficient producers of Aedes mosquitoes in all surveys. The presence of Aedes mosquitoes was significantly (p < 0.05) higher in low socio-economic zones of Dhaka. Container location, presence of vegetation, and availability of shade for containers were also significantly associated with finding immature Aedes mosquitoes, based on multivariable analysis after confounder adjustment. Rainfall, temperature, and relative humidity also significantly affected the mean abundance of mosquitoes. Proper use, disposal, and recycling of the containers that effectively produce large numbers of Aedes vector mosquitoes may decrease the risk of arboviral transmission.

Pregnant Women's and Community Health Workers' Perceptions of Root Causes of Malnutrition Among Infants and Young Children in the Slums of Dhaka, Bangladesh

PubMed Central

Faiz, Sabina; Bogin, Barry A.; Griffiths, Paula L.

2011-01-01

Research in Bangladesh shows that malnutrition among infants and young children is most severe in urban slums. We examined the root causes of malnutrition as perceived by pregnant women and community health workers. We conducted 10 focus group discussions in the slums of Dhaka in 2008 and 2009. Participants accurately perceived inappropriate care, inappropriate environment, inappropriate food, and flooding to be major causes. Recurrent flooding has not traditionally been identified by experts as a cause of malnutrition. We recommend further research to address the nutritional risks flooding creates for vulnerable slum populations. PMID:21653248

Prevalence of Tobacco Smoking and Factors Associated with the Initiation of Smoking among University Students in Dhaka, Bangladesh.

PubMed

Hossain, Sahadat; Hossain, Shakhaoat; Ahmed, Fahad; Islam, Rabiul; Sikder, Tajuddin; Rahman, Abdur

2017-01-01

Tobacco smoking is considered to be the key preventable risk factor for morbidity and mortality at the global level. The aim of this study was to determine the prevalence of tobacco smoking and factors associated with the initiation of smoking among university students in Dhaka, Bangladesh. A cross-sectional survey study was conducted with 264 students of Jahangirnagar University, Dhaka, Bangladesh in 2015. A standard, self-administered questionnaire consisting of questions on socio-demographic variables, tobacco smoking status, family and peer tobacco smoking history, attitudes and beliefs about tobacco smoking, as well as knowledge about the negative health consequences of tobacco smoking was administered to participants. Data were analyzed using logistic regression models, chi square, and Fisher exact tests. The overall prevalence of tobacco smoking was 60.2%, where males smoked at higher rates than females (68.81% and 19.56%, respectively). The influence of friends was the most significant reason for initiating tobacco smoking (OR: 0.862; CI: 0.810-0.917). Perception regarding tobacco smoking was significantly related to continuing tobacco use. Logistic regression models identified that smoking-related attitudes, potential health problems, and family members dying from cardiovascular disease and cancer were significantly associated with tobacco smoking. The current tobacco smoking prevalence among university students in Bangladesh is over 60%. We suggest adopting WHO Framework Convention on Tobacco Control (FCTC) policies, especially for university students.

Analysis of transport eco-efficiency scenarios to support sustainability assessment: a study on Dhaka City, Bangladesh.

PubMed

Iqbal, Asif; Allan, Andrew; Afroze, Shirina

2017-08-01

The study focused to assess the level of efficiency (of both emissions and service quality) that can be achieved for the transport system in Dhaka City, Bangladesh. The assessment technique attempted to quantify the extent of eco-efficiency achievable for the system modifications due to planning or strategy. The eco-efficiency analysis was facilitated with a detailed survey data on Dhaka City transport system, which was conducted for 9 months in 2012-2013. Line source modelling (CALINE4) was incorporated to estimate the on-road emission concentration. The eco-efficiency of the transport systems was assessed with the 'multi-criteria analysis' (MCA) technique that enabled the valuation of systems' qualitative and quantitative parameters. As per the analysis, driving indiscipline on road can alone promise about 47% reductions in emissions, which along with the number of private vehicles were the important stressors that restrict achieving eco-efficiency in Dhaka City. Detailed analysis of the transport system together with the potential transport system scenarios can offer a checklist to the policy makers enabling to identify the possible actions needed that can offer greater services to the dwellers against lesser emissions, which in turn can bring sustainability of the system.

Observational study on the concentration distributions of SO{sub 2} and NO{sub 2} in Dhaka, Bangladesh under severe air pollution condition in winter

DOE Office of Scientific and Technical Information (OSTI.GOV)

Azad, A.K.; Kitada, T.

1996-12-31

Dhaka is the capital and the biggest city of Bangladesh, and is expanding very rapidly. Emissions from heavy traffic and many small industries and commercial complexes, newly developed in and around the city, are polluting the air of Dhaka city. The air pollution is severe especially in winter due to adverse meteorological conditions such as low wind speed and dry, stably-stratified air, which restricts the mixing height to low levels and prevent dispersion of pollutants. But so far no study of air pollution of Dhaka city has been done. We have first measured SO{sub 2} and NO{sub 2} concentrations inmore » Dhaka city in a large scale and derived their spatial distributions over Dhaka. Molecular diffusion tubes, which do not require power sources and are produced at low cost, have been used to measure the concentration distributions of SO{sub 2} and NO{sub 2} at 64 sites in Dhaka city and its suburbs during the period of December-January of 1995-96. The diffusion tube samplers were calibrated using 6 automated air pollution monitoring stations in Aichi-prefecture, Japan. The calibration curve and the distribution of the concentration data acquired by automatic measurement instrument at each location showed that the error range of measurements with the molecular diffusion tube samplers was 2-27%. The samples were analyzed using ion-chromatography and spectrophotometer to determine the concentrations of SO{sub 2} and NO{sub 2} respectively. The contamination of unexposed tubes under field conditions was determined and the value of the blank test was subtracted from the measurements of the diffusion tube samplers. The effects of wind turbulence and temperature were reduced using polyflon filters.« less

Perception and attitude of medical doctors in Dhaka, Bangladesh, with regard to Ayurvedic medicine.

PubMed

Yoshida, Yoshitoku; Alim, Md Abdul; Alam, Zakia; Asaduzzaman, Mohammad; Yoshida, Yasuko; Manikdrs, Shahabuddin

2017-02-01

The World Health Organization (WHO) Traditional Medicine Strategy (2014-2023) aimed to help member states promote the safe and effective use of traditional medicine. While economic conditions have markedly improved in Bangladesh, the country is experiencing significant public health problems. Because of limited medical resources, there is a strong incentive to enhance complementary and alternative medicine usage in Bangladesh. Therefore, this study aimed to confirm the perceptions and attitudes of medical doctors (MDs) in Dhaka, Bangladesh, with regard to Ayurvedic medicine (AM). A total number of 159 MDs in Dhaka were interviewed by face-to-face between February and June 2015. The study revealed that 62.0% of MDs had treated patients with AM and 55.3% believed that AM should be regarded as its own specialty, whereas 39.7% of MDs believed that AM should be part of the conventional medical curriculum and 32.7% thought that AM did not seem scientific. In terms of gender, 45.3% of male MDs agreed or strongly agreed that AM only had a placebo effect. On the other hand, 65.8% of female MDs disagreed or strongly disagreed it. In terms of age, 77.0% of MDs aged 36 or elder (elder MDs) believed they were more likely to recommend AM use and 80.3% of elder MDs believed that the government should encourage more initiatives to promote AM. To enhance AM use, scientifically robust information on the efficacy, safety and scientific basis of AM should be more effectively conveyed to male MDs.

First record of the fruit fly Bactrocera (Bactrocera) nigrofemoralis White & Tsuruta(Diptera: Tephritidae) in Bangladesh

USDA-ARS?s Scientific Manuscript database

The presence of the fruit fly Bactrocera (Bactrocera) nigrofemoralis White & Tsuruta was recorded in Bangladesh for the first time. B.nigrofemoralis was captured in traps baited with sweet orange oil and cue-lure at the Atomic Energy Research Establishment campus, Ganak bari, Savar, Dhaka, Banglades...

Analysis of urban land use in the megacity of Dhaka, Bangladesh: Roof-top detection in the context of assessing solar photovoltaic potential

NASA Astrophysics Data System (ADS)

Jaegermeyr, J.; Kabir, H.; Endlicher, W.

2009-12-01

The megacity of Dhaka, Bangladesh is considered to be one of the world’s fastest growing urban centers. With nearly 14 million people Dhaka currently faces tremendous power crisis. The available power supply of Dhaka Megacity is currently 1000-1200 MW against the maximum demand of nearly 2000 MW. The objective of this study is to classify land cover of Dhaka to locate roof-top areas which are adequate for solar photovoltaic applications. Usually this task is performed with additional building-heights data. With lack of that, we present an object-based classification approach which is based on high resolution Quickbird data only. Extensive formal buildings in Dhaka mostly have flat roof-tops made from concrete which are well suited for PV applications. The classification is focused to detect these ‘Bright Roof-Tops’ to assess a lower limit for potential PV areas. With that conservative approach bright roof-top areas of 10.554 km2 out of the city’s 134.282 km2 could be found. The overall classification accuracy is 0.918, the producer’s accuracy of ‘Bright Roof-Tops’ is 0.833. Preliminary result of the PhD work of Humayun Kabir indicates that the application of only 75 Wp stand-alone solar modules on these available bright roof-tops can generate nearly 1,000 MW of electricity. The application of solar modules with high capacity (i.e., >200 Wp) preferably through grid-connected PV systems can substantially meet-up the city’s power demand, although several techno-economic and socio-political factors are certainly involved.

Cross-sectional study exploring barriers to adverse drug reactions reporting in community pharmacy settings in Dhaka, Bangladesh

PubMed Central

Amin, Mohammad Nurul; Khan, Tahir Mehmood; Dewan, Syed Masudur Rahman; Islam, Mohammad Safiqul; Moghal, Mizanur Rahman

2016-01-01

Objectives To assess community pharmacists'/pharmacy technicians' knowledge and perceptions about adverse drug reactions (ADRs) and barriers towards the reporting of such reactions in Dhaka, Bangladesh. Method A cross-sectional study was planned to approach potential respondents for the study. A self-administered questionnaire was delivered to community pharmacists/pharmacy technicians (N=292) practising in Dhaka, Bangladesh. Results The overall response to the survey was 69.5% (n=203). The majority of the sample was comprised of pharmacy technicians (152, 74.9%) who possessed a diploma in pharmacy, followed by pharmacists (37, 18.2%) and others (12, 5.9%). Overall, 72 (35.5%) of the respondents disclosed that they had experienced an ADR at their pharmacy, yet more than half (105, 51.7%) were not familiar with the existence of an ADR reporting body in Bangladesh. Exploring the barriers to the reporting of ADRs, it was revealed that the top four barriers to ADR reporting were ‘I do not know how to report (Relative Importance Index (RII)=0.998)’, ‘reporting forms are not available (0.996)’, ‘I am not motivated to report (0.997)’ and ‘Unavailability of professional environment to discuss about ADR (RII=0.939)’. In addition to these, a majority (141, 69.46%) were not confident about the classification of ADRs (RII=0.889) and were afraid of legal liabilities associated with reporting ADRs (RII=0.806). Moreover, a lack of knowledge about pharmacotherapy and the detection of ADRs was another major factor hindering their reporting (RII=0.731). Conclusions The Directorate of Drug Administration in Bangladesh needs to consider the results of this study to help it improve and simplify ADR reporting in Bangladeshi community pharmacy settings. PMID:27489151

Rapid and Accurate Idea Transfer: Presenting Ideas with Concept Maps

DTIC Science & Technology

2008-07-30

AndolanerAncholik Itihas (Regional Histor of the State Language Movement), Dhaka: Bangla Academy. Muhith. A.M.A. (1978) Bangladesh. Emergence qf a Nation, Dhaka...The incidental learning paradigm presumes that information processed at deeper (i.e., more conceptually connected) levels will result in superior...consideration dovetails with Kinchen and Cabot’s (2007) results showing that Concept Maps enable deeper levels of information processing over PowerPoint

Middle East Respiratory Syndrome Coronavirus Antibodies in Dromedary Camels, Bangladesh, 2015

PubMed Central

Islam, Ariful; Rostal, Melinda K.; Islam, Shariful; Rahman, Mohammed Ziaur; Hossain, Mohammed Enayet; Uzzaman, Mohammed Salim; Munster, Vincent J.; Peiris, Malik; Flora, Meerjady Sabrina; Rahman, Mahmudur; Daszak, Peter

2018-01-01

Dromedary camels are bred domestically and imported into Bangladesh. In 2015, of 55 camels tested for Middle East respiratory syndrome coronavirus in Dhaka, 17 (31%) were seropositive, including 1 bred locally. None were PCR positive. The potential for infected camels in urban markets could have public health implications and warrants further investigation. PMID:29664373

Construction Material-Based Methodology for Military Contingency Base Construction: Case Study of Dhaka, Bangladesh

DTIC Science & Technology

2016-08-01

of the operational environment to anticipate the impacts that siting and operating CBs will have on the local context, and to consider the effects ...17 Figure 7. Density and effective proximity factor (McNulty 2009b...Area-wise consumption of cement, FY2010 (Nahar 2011). ...............................44 Figure 23. Overview of Bangladesh [green: office, orange

Inclusive Education at a BRAC School--Perspectives from the Children

ERIC Educational Resources Information Center

Mahbub, Tahiya

2008-01-01

Tahiya Mahbub is a lecturer in English studies at North South University located in Dhaka, Bangladesh. In this article, she presents some of the data on which her MPhil thesis, completed at the University of Cambridge Faculty of Education, was based. This research was carried out in Bangladesh, focusing on a primary school run by the…

Access to and Exclusion from Primary Education in Slums of Dhaka, Bangladesh. CREATE Pathways to Access. Research Monograph No. 45

ERIC Educational Resources Information Center

Cameron, Stuart

2010-01-01

Bangladesh's urban population is rising fast. In the capital, Dhaka, some 4 million people live in slums. They are lacking in wealth, power and social connections; probably under-counted in national surveys; and under-served by both government and non-government organisations, many of whom still see poverty as a rural issue or see the urban poor…

Hydrogeological analysis of the upper Dupi Tila Aquifer, towards the implementation of a managed aquifer-recharge project in Dhaka City, Bangladesh

NASA Astrophysics Data System (ADS)

Rahman, Mohammad Azizur; Wiegand, Bettina A.; Badruzzaman, A. B. M.; Ptak, Thomas

2013-08-01

A preliminary feasibility assessment of managed aquifer-recharge (MAR) techniques was undertaken for Dhaka City, Bangladesh. Considering the top impermeable-layer (TIL) thickness and the land-use classification, four primary MAR techniques have been suggested: (1) soil-aquifer treatment (SAT) for TIL thickness 0-8 m, (2) cascade-type recharge trenches/pits for TIL thickness 9-30 m, (3) aquifer storage, transfer and recovery (ASR/ASTR) for TIL thickness 31-52 m, and (4) use of natural wetlands to recharge water collected from open spaces. The study suggests that recharge trenches and pits will be the most appropriate MAR techniques, which can be implemented in most parts of the recharge area (ca. 277 km2). In case of a recharge trench, the lower parts (15-20 m) that are in direct contact with the aquifer can be backfilled with biosand filters with a reactive layer containing metallic iron (Fe0) to offer pre-treatment of the infiltrated water. In addition to the suggested four techniques, the regional groundwater flow direction, from the northwest and northeast towards Dhaka City, may allow use of the aquifer as a natural treatment and transport medium for groundwater, if spreading basins are installed in the greater Dhaka area.

Patterns and Predictors of Smokeless Tobacco Use among Adults in Bangladesh: Findings from the International Tobacco Control (ITC) Bangladesh Survey

PubMed Central

Abdullah, Abu S.; Driezen, Pete; Ruthbah, Ummul H.; Nargis, Nigar; Quah, Anne C. K.; Fong, Geoffrey T.

2014-01-01

Background Although smokeless tobacco (SLT) use is prevalent in South Asian countries including Bangladesh, information about the pattern and correlates of SLT use is scarce. This study described the pattern and predictors of SLT use among Bangladeshi adults. Methods The data for this study were derived from the International Tobacco Control Policy Evaluation Bangladesh (ITC BD) Survey, a prospective cohort survey of a nationally representative sample of smokers and non-smokers, conducted during November 2011 and May 2012. The study included 5522 adults aged 15 or above. We used multiple logistic regression models to identify predictors of SLT use. Results Of the respondents (N = 5522), 20% were SLT users. In general, SLT use was significantly higher among women, the illiterate and residents of the Dhaka slums or non-tribal/non-border areas outside Dhaka; SLT use increased with age. Several attitudinal factors were also associated with SLT use. Multivariable logistic regression analyses revealed several predictors of SLT use: being female (OR = 1.96, 95% confidence interval, CI: 1.18–3.24), an increasing age, being a resident of a Dhaka slum (OR = 5.86; 95% CI: 3.73–9.21) or non-tribal/non-border areas outside Dhaka (OR = 3.42; 95% CI: 1.94–6.03), being illiterate (OR = 3.37; 95% CI: 1.99–5.71), holding positive opinion towards societal approval of SLT use (OR = 5.84; 95% CI: 3.38–10.09), holding positive opinion towards SLT use by women (OR = 2.63; 95% CI: 1.53–4.54), believing that SLT is addictive (OR = 2.96; 95% CI: 1.51–5.81), and believing SLT is less harmful than bidi (OR = 2.22; 95% CI: 1.36–3.62). Conclusion The findings suggest that coordinated efforts of governmental and non-governmental organizations, targeting both smoked tobacco and SLT use reduction and cessation, could be modified to reach each level of population including those who are marginalized, female, less educated and elderly. As most tobacco control programs in Bangladesh target mainly cigarette or bidi smoking, coordinated programs are needed that will also include SLT use within the tobacco control policy and prevention strategies. PMID:25007266

Patterns and predictors of smokeless tobacco use among adults in Bangladesh: findings from the International Tobacco Control (ITC) Bangladesh survey.

PubMed

Abdullah, Abu S; Driezen, Pete; Ruthbah, Ummul H; Nargis, Nigar; Quah, Anne C K; Fong, Geoffrey T

2014-01-01

Although smokeless tobacco (SLT) use is prevalent in South Asian countries including Bangladesh, information about the pattern and correlates of SLT use is scarce. This study described the pattern and predictors of SLT use among Bangladeshi adults. The data for this study were derived from the International Tobacco Control Policy Evaluation Bangladesh (ITC BD) Survey, a prospective cohort survey of a nationally representative sample of smokers and non-smokers, conducted during November 2011 and May 2012. The study included 5522 adults aged 15 or above. We used multiple logistic regression models to identify predictors of SLT use. Of the respondents (N = 5522), 20% were SLT users. In general, SLT use was significantly higher among women, the illiterate and residents of the Dhaka slums or non-tribal/non-border areas outside Dhaka; SLT use increased with age. Several attitudinal factors were also associated with SLT use. Multivariable logistic regression analyses revealed several predictors of SLT use: being female (OR = 1.96, 95% confidence interval, CI: 1.18-3.24), an increasing age, being a resident of a Dhaka slum (OR = 5.86; 95% CI: 3.73-9.21) or non-tribal/non-border areas outside Dhaka (OR = 3.42; 95% CI: 1.94-6.03), being illiterate (OR = 3.37; 95% CI: 1.99-5.71), holding positive opinion towards societal approval of SLT use (OR = 5.84; 95% CI: 3.38-10.09), holding positive opinion towards SLT use by women (OR = 2.63; 95% CI: 1.53-4.54), believing that SLT is addictive (OR = 2.96; 95% CI: 1.51-5.81), and believing SLT is less harmful than bidi (OR = 2.22; 95% CI: 1.36-3.62). The findings suggest that coordinated efforts of governmental and non-governmental organizations, targeting both smoked tobacco and SLT use reduction and cessation, could be modified to reach each level of population including those who are marginalized, female, less educated and elderly. As most tobacco control programs in Bangladesh target mainly cigarette or bidi smoking, coordinated programs are needed that will also include SLT use within the tobacco control policy and prevention strategies.

Poverty, violence, and family disorganization: Three "Hydras" and their role in children's street movement in Bangladesh.

PubMed

Reza, Md Hasan

2016-05-01

The increasing number of children running away from home in Bangladesh is a major concern, and in need of critical attention. This yearlong study explores why children leave home with a sample of street children in Dhaka, Bangladesh. Purposive sampling from three locations in Dhaka yielded a sample of 75 homeless children aged 10-17. For each participant, a 60-90min in-depth qualitative interview was conducted multiple times. While the dominant explanations rely on poverty or abuse, the findings of this study reveal that the cause is actually three heads of a Hydra monster: poverty, abuse, and family disorganization and their interactions. It shows that the primary reasons for children breaking from their family are all interrelated. The findings from this study are likely to add knowledge regarding the issues and may lead to preventative interventions for street children and their families. Copyright © 2016 Elsevier Ltd. All rights reserved.

Economic and Environmental Assessment of a 1 MW Grid Connected Rooftop Solar PV System for Energy Efficient Building in Bangladesh

NASA Astrophysics Data System (ADS)

Chakraborty, Sanjib; Hosain, Rubayet; Rahman, Toufiqur; Rabbi, Ahmead Fazle

This paper evaluates the potentiality of a 1 MW grid connected rooftop solar PV system for an Energy Efficient Building in Bangladesh, which was estimated by utilizing NASA SSE solar radiation data, PVsyst simulation software and RETScreen simulation software. Economic and environmental viability for a ten-storied building with roof area of 6,500 m2 in the Capital City of Bangladesh, Dhaka was assessed by using the RETScreen simulation software. The yearly electricity production of the proposed system was 1,581 MWh estimated by PVsyst where the technical prospective of gird-connected solar PV in Bangladesh was calculated as about 50,174 MW. The economic assessments were determined the simple payback in such a way that the generated electricity first fulfills the demand of the building, and then the rest of the energy is supplied to the grid. The result indicates that the roof top solar PV system for an Energy efficient building in Dhaka city has a favorable condition for development both in economic and environmental point of view.

Airborne volatile organic compounds in urban and industrial locations in four developing countries

NASA Astrophysics Data System (ADS)

Do, Duc Hoai; Walgraeve, Christophe; Amare, Abebech Nuguse; Barai, Krishna Rani; Parao, Amelia Estigoy; Demeestere, Kristof; van Langenhove, Herman

2015-10-01

Volatile organic compounds (VOCs) represent an important class of air pollutants, however their concentration levels in developing countries have scarcely been reported in literature. Therefore, concentration levels of 60 VOCs were determined at 27 urban and industrial locations in seven different cities in Ethiopia, Vietnam, the Philippines and Bangladesh between 2011 and 2014. Active sampling using Tenax TA as a sorbent was employed followed by TD-GC-MS analysis using internal standard calibration. It was found that TVOCs concentration levels in Dhaka, Bangladesh (arithmetic mean: 343 and 399 μg/m3 for urban and industrial campaign, respectively) were more than 10 times higher when compared to TVOCs levels observed in Mekelle, Ethiopia. ∑BTEX concentration at street sites ranges from 36 μg/m3 in Mekelle, to 100 and 250 μg/m3 in Hanoi, Vietnam and Dhaka, Bangladesh, respectively. The indoor to outdoor concentration ratios were found to be dependent on the country, type of environment, VOC compound and outdoor reference location. The highest Ozone Formation Potential (OFP, 2150 μg/m3), calculated from the same set of seven aromatic VOCs, was obtained at the street site in Dhaka. This OFP value is a factor three and four times higher than the OFP value observed at the street sites in Hanoi, and Manila, respectively. Finally, the Cumulative Cancer Risk (CCR) calculated for four carcinogenic VOCs ranged from 97 × 10-6 in urban Mekelle to 299 × 10-6 in urban Dhaka. This work provides for the first time comparisons of CCR in urban and industrial environments in the selected developing countries.

Measurement of the atmospheric aerosol particle size distribution in a highly polluted mega-city in Southeast Asia (Dhaka-Bangladesh)

NASA Astrophysics Data System (ADS)

Salam, Abdus; Mamoon, Hassan Al; Ullah, Md. Basir; Ullah, Shah M.

2012-11-01

Aerosol particle size distribution was measured with an aerodynamic particle sizer (APS) spectrometer continuously from January 21 to April 24, 2006 in Dhaka, Bangladesh. Particles number, surface and mass distributions data were stored automatically with Aerosol Instrument Manager (AIM) software on average every half an hour in a computer attached to the APS. The grand total average of number, surface and mass concentrations were 8.2 × 103 ± 7.8 × 103 particles cm-3, 13.3 × 103 ± 11.8 × 103 μm2 cm-3 and 3.04 ± 2.10 mg m-3, respectively. Fine particles with diameter smaller than 1.0 μm aerodynamic diameter (AD) dominated the number concentration, accounted for 91.7% of the total particles indicating vehicular emissions were dominating in Dhaka air either from fossil fuel burning or compressed natural gas (CNGs). The surface and mass concentrations between 0.5 and 1.0 μm AD were about 56.0% and 26.4% of the total particles, respectively. Remarkable seasonal differences were observed between winter and pre-monsoon seasons with the highest monthly average in January and the lowest in April. Aerosol particles in winter were 3.79 times higher for number, 3.15 times for surface and 2.18 times for mass distributions than during the pre-monsoon season. Weekends had lower concentrations than weekdays due to less vehicular traffic in the streets. Aerosol particles concentrations were about 15.0% (ranging from 9.4% to 17.3%) higher during traffic peak hours (6:00am-8:00pm) than off hours (8:00pm-6:00am). These are the first aerosol size distribution measurements with respect to number, surface and mass concentrations in real time at Dhaka, Bangladesh.

Shifting Prevalence of Major Diarrheal Pathogens in Patients Seeking Hospital Care during Floods in 1998, 2004, and 2007 in Dhaka, Bangladesh

PubMed Central

Harris, Aaron M.; Chowdhury, Fahima; Begum, Yasmin Ara; Khan, Ashraful Islam; Faruque, Abu S. G.; Svennerholm, Ann-Mari; Harris, Jason B.; Ryan, Edward T.; Cravioto, Alejandro; Calderwood, Stephen B.; Qadri, Firdausi

2009-01-01

Bangladesh experienced severe flooding and diarrheal epidemics in 2007. We compared flood data from 2007 with 2004 and 1998 for diarrheal patients attending the ICDDR,B hospital in Dhaka. In 2007, Vibrio cholerae O1 (33%), rotavirus (12%), and enterotoxigenic Escherichia coli (ETEC) (12%) were most prevalent. More severe dehydration was seen in 2007 compared with 2004 and 1998 (P < 0.001). In 2007, V. cholerae O1 Inaba (52%) and Ogawa (48%) were seen, whereas in 2004 and 1998 it was primarily Inaba and the Ogawa types, respectively (P < 0.001). In 2007, 51% of ETEC produced the heat labile toxin (LT) (P < 0.001 compared with 2004), 22% expressed the heat stable (ST) (P < 0.001), and 27% were ST/LT positive (P = 0.231). The CS7 colonization factor (CF) was the most prevalent in 2007 (20% compared with 6% in 2004; P = 0.05). Our findings demonstrate alterations in clinical features and phenotypic changes of major bacterial pathogens in the recent Bangladesh flood. PMID:18981509

Factors affecting waste generation: a study in a waste management program in Dhaka City, Bangladesh.

PubMed

Afroz, Rafia; Hanaki, Keisuke; Tudin, Rabaah

2011-08-01

Information on waste generation, socioeconomic characteristics, and willingness of the households to separate waste was obtained from interviews with 402 respondents in Dhaka city. Ordinary least square regression was used to determine the dominant factors that might influence the waste generation of the households. The results showed that the waste generation of the households in Dhaka city was significantly affected by household size, income, concern about the environment, and willingness to separate the waste. These factors are necessary to effectively improve waste management, growth and performance, as well as to reduce the environmental degradation of the household waste.

Coping with changing conditions: alternative strategies for the delivery of maternal and child health and family planning services in Dhaka, Bangladesh.

PubMed Central

Routh, S.; el Arifeen, S.; Jahan, S. A.; Begum, A.; Thwin, A. A.; Baqui, A. H.

2001-01-01

The door-to-door distribution of contraceptives and information on maternal and child health and family planning (MCH-FP) services, through bimonthly visits to eligible couples by trained fieldworkers, has been instrumental in increasing the contraceptive prevalence rate and immunization coverage in Bangladesh. The doorstep delivery strategy, however, is labour-intensive and costly. More cost-effective service delivery strategies are needed, not only for family planning services but also for a broader package of reproductive and other essential health services. Against this backdrop, operations research was conducted by the Centre for Health and Population Research at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) from January 1996 to May 1997, in collaboration with government agencies and a leading national nongovernmental organization, with a view to developing and field-testing alternative approaches to the delivery of MCH-FP services in urban areas. Two alternative strategies featuring the withdrawal of home-based distribution and the delivery of basic health care from fixed-site facilities were tested in two areas of Dhaka. The clinic-based service delivery strategy was found to be a feasible alternative to the resource-intensive doorstep system in urban Dhaka. It did not adversely affect programme performance and it allowed the needs of clients to be addressed holistically through a package of essential health and family planning services. PMID:11242821

Evidence of a Dominant Lineage of Vibrio cholerae-Specific Lytic Bacteriophages Shed by Cholera Patients over a 10-Year Period in Dhaka, Bangladesh

PubMed Central

Seed, Kimberley D.; Bodi, Kip L.; Kropinski, Andrew M.; Ackermann, Hans-Wolfgang; Calderwood, Stephen B.; Qadri, Firdausi; Camilli, Andrew

2011-01-01

Lytic bacteriophages are hypothesized to contribute to the seasonality and duration of cholera epidemics in Bangladesh. However, the bacteriophages contributing to this phenomenon have yet to be characterized at a molecular genetic level. In this study, we isolated and sequenced the genomes of 15 bacteriophages from stool samples from cholera patients spanning a 10-year surveillance period in Dhaka, Bangladesh. Our results indicate that a single novel bacteriophage type, designated ICP1 (for the International Centre for Diarrhoeal Disease Research, Bangladesh cholera phage 1) is present in all stool samples from cholera patients, while two other bacteriophage types, one novel (ICP2) and one T7-like (ICP3), are transient. ICP1 is a member of the Myoviridae family and has a 126-kilobase genome comprising 230 open reading frames. Comparative sequence analysis of ICP1 and related isolates from this time period indicates a high level of genetic conservation. The ubiquitous presence of ICP1 in cholera patients and the finding that the O1 antigen of lipopolysaccharide (LPS) serves as the ICP1 receptor suggest that ICP1 is extremely well adapted to predation of human-pathogenic V. cholerae O1. PMID:21304168

Temporal variations and spatial distribution of ambient PM2.2 and PM10 concentrations in Dhaka, Bangladesh.

PubMed

Begum, Bilkis A; Biswas, Swapan K; Hopke, Philip K

2006-04-01

Concentrations and characteristics of airborne particulate matter (PM(10), PM(2.2) and BC) on air quality have been studied at two air quality-monitoring stations in Dhaka, the capital of Bangladesh. One site is at the Farm Gate area, a hot spot with very high pollutant concentrations because of its proximity to major roadways. The other site is at a semi-residential area located at the Atomic Energy Centre, Dhaka Campus, (AECD) with relatively less traffic. The samples were collected using a 'Gent' stacked filter unit in two fractions of 0-2.2 mum and 2.2-10 mum sizes. Samples of fine (PM(2.2)) and coarse (PM(2.2-10)) airborne particulate matter fractions collected from 2000 to 2003 were studied. It has been observed that fine particulate matter has a decreasing trend, from prior year measurements, because of Government policy interventions like phase-wise plans to take two-stroke three-wheelers off the roads in Dhaka and finally banned from January 1, 2003. Other policy interventions were banning of old buses and trucks to ply on Dhaka city promotion of the using compressed natural gas (CNG), introducing air pollution control devices in vehicles, etc. It was found that both local (mostly from vehicular emissions) and possibly some regional emission sources are responsible for high PM(2.2) and BC concentrations in Dhaka. PM(2.2), PM(2.2-10) and black carbon concentration levels depend on the season, wind direction and wind speed. Transport related emissions are the major source of BC and long-range transportation from fossil fuel related sources and biomass burning could be another substantial source of BC.

Influence of extensive compressed natural gas (CNG) usage on air quality

NASA Astrophysics Data System (ADS)

Suthawaree, Jeeranut; Sikder, Helena Akhter; Jones, Charlotte Emily; Kato, Shungo; Kunimi, Hitoshi; Mohammed Hamidul Kabir, Abu Naser; Kajii, Yoshizumi

2012-07-01

Compressed Natural Gas (CNG) is an inexpensive, indigenous energy resource which currently accounts for the majority of automobile and domestic energy consumption in Bangladesh. This extensive CNG usage, particularly within the capital city, Dhaka, heavily influences the atmospheric composition (and hence air quality), yet to date measurements of trace gases in regions dominated by CNG emissions are relatively limited. Here we report continuous observations of the atmospherically important trace gases O3, CO, SO2, NOx and volatile organic compounds (VOC), in ambient air in Dhaka City, Bangladesh, during May 2011. The average mixing ratios of O3, CO, SO2, and NOx for the measurement period were 18.9, 520.9, 7.6 and 21.5 ppbv, respectively. The ratios of CO to NO reveal that emissions from gasoline and CNG-fuelled vehicles were dominant during the daytime (slope of ˜26), while in contrast, owing to restrictions imposed on diesel fuelled vehicles entering Dhaka City, emissions from these vehicles only became significant during the night (slope of ˜10). The total VOC mixing ratio in Dhaka was ˜5-10 times higher than the levels reported in more developed Asian cities such as Tokyo and Bangkok, which consequently gives rise to a higher ozone formation potential (OFP). However, the most abundant VOC in Dhaka were the relatively long-lived ethane and propane (with mean mixing ratios of ˜115 and ˜30 ppbv, respectively), and as a consequence, the ozone formation potential per ppb carbon (ppbC) was lower in Dhaka than in Tokyo and Bangkok. Thus the atmospheric composition of air influenced by extensive CNG combustion may be characterized by high VOC mixing ratios, yet mixing ratios of the photochemical pollutant ozone do not drastically exceed the levels typical of Asian cities with considerably lower VOC levels.

Modeling of urban solid waste management system: The case of Dhaka city

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sufian, M.A.; Bala, B.K.

2007-07-01

This paper presents a system dynamics computer model to predict solid waste generation, collection capacity and electricity generation from solid waste and to assess the needs for waste management of the urban city of Dhaka, Bangladesh. Simulated results show that solid waste generation, collection capacity and electricity generation potential from solid waste increase with time. Population, uncleared waste, untreated waste, composite index and public concern are projected to increase with time for Dhaka city. Simulated results also show that increasing the budget for collection capacity alone does not improve environmental quality; rather an increased budget is required for both collectionmore » and treatment of solid wastes of Dhaka city. Finally, this model can be used as a computer laboratory for urban solid waste management (USWM) policy analysis.« less

Near East/South Asia Report

DTIC Science & Technology

1987-03-09

of HYVs and yield rates, they remarked. There is a general tendency among the farmers to harvest crop when it is too mature and this also causes...Harness Oil Resources Planned (THE BANGLADESH OBSERVER, 29 Dec 86) iUÖ Dhaka’s First Marine Fishing Policy Announced (THE BANGLADESH OBSERVER, 2 Jan...factor and a mediator to remove differences among the fraternal Arab countries. He asserted that relations between Egypt and the Arabs have recently

Extensively drug-resistant New Delhi metallo-β-lactamase-encoding bacteria in the environment, Dhaka, Bangladesh, 2012.

PubMed

Toleman, Mark A; Bugert, Joachim J; Nizam, Syed A

2015-06-01

Carriage of the New Delhi metallo-β-lactamase variant 1 (NDM-1) enables drug resistance to move between communities and hospitals. In Bangladesh, we found the blaNDM-1 gene in 62% of environmental waters and in fermentative and nonfermentative gram-negative bacteria. Escherichia coli sequence type (ST) 101 was most commonly found, reflecting a common global relationship between ST101 and NDM-1.

All That Glitters Is Not Gold: The Quality of Low-Fee Private Schools in Dhaka, Bangladesh

ERIC Educational Resources Information Center

Richardson, Emily Elisabeth

2017-01-01

Bangladesh, home to one of the world's largest and most diverse education sectors, has witnessed rapid growth in its private education sector in recent decades. The majority of this growth has been within the low-fee private school (LFPS) sector, which now accounts for more than 25 percent of total school enrollment. However, the reliability of…

JPRS Report Nuclear Developments

DTIC Science & Technology

1988-06-21

Radio Nacional da Amazonia Network] 23 NEAR EAST & SOUTH ASIA BANGLADESH Energy Minister Addresses Atomic Energy Officials [Dhaka THE BANGLADESH...SATURDAY WINDSOR STAR in English 23 May 88pA5 [Text] Ottawa—MP Herb Gray (L-Windsor West) is asking an affiliate of the UN to investigate the safety of...nuclear power plants at a cost of $7.7 billion. Seabra submitted this proposal to the Senate CPI [Congressional Investigating Commission] that is

Launching automated rotary parking system: Towards traffic congestion free Dhaka city

NASA Astrophysics Data System (ADS)

Islam, Mohummad Shariful; Tithi, Afshana Morshed; Hossain, Farzad; Shetu, Rifat Sultana; Amin, S. M. Abdullah Al; Chowdhury, Shakia Zannatul Ferdous

2017-12-01

Bangladesh is the most densely populated city in the whole world, which is visible more in the capital city Dhaka. People have to suffer and valuable times are being wasted for this chronic quandary. Lack of proper planning of the city, different speed vehicles on the same road, over population, inadequate road space, unplanned stoppage or parking etc. are responsible for causing the traffic congestion in Dhaka City. Among those insufficient/unplanned parking system is one of the main reasons for causing traffic congestion. The automated rotary car parking system is the best and suitable because of its less utilization of space compared to other systems. It is a friendly parking system due to the non-utilization of noise/pollution related mechanism. The aim of this paper is to develop an automated car parking system with a minimum cost for reducing congestion in Dhaka city.

Key issues in controlling air pollutants in Dhaka, Bangladesh

NASA Astrophysics Data System (ADS)

Begum, Bilkis A.; Biswas, Swapan K.; Hopke, Philip K.

2011-12-01

Particulate matter (PM) sampling for both coarse and fine fractions was conducted in a semi-residential site (AECD) in Dhaka from February 2005 to December 2006. The samples were analyzed for mass, black carbon (BC), and elemental compositions. The resulting data set were analyzed for sources by Positive Matrix Factorization (EPA-PMF). From previous studies, it is found that, the air quality became worse in the dry winter period compared to the rainy season because of higher particulate matter concentration in the ambient air. Therefore, seasonal source contributions were determined from seasonally segregated data using EPA-PMF modeling so that further policy interventions can be undertaken to improve air quality. From the source apportionment results, it is observed that vehicular emissions and emission from brick kiln are the major contributors to air pollution in Dhaka especially in the dry seasons, while contribution from emissions from metal smelters increases during rainy seasons. The Government of Bangladesh is considering different interventions to reduce the emissions from those sources by adopting conversion of diesel/petrol vehicles to CNG, increasing traffic speed in the city and by introducing green technologies for brick production. However, in order to reduce the transboundary effect it is necessary to take action regionally.

Injecting drug users and their health seeking behavior: a cross-sectional study in dhaka, bangladesh.

PubMed

Shariful Islam, Sheikh Mohammed; Biswas, Tuhin; Bhuiyan, Faiz Ahmed; Islam, Md Serajul; Rahman, Mohammad Mizanur; Nessa, Hurun

2015-01-01

Introduction and Aim. Injecting drug users (IDUs) are amongst the most vulnerable people to acquisition of HIV/AIDS. This study aims to collect information on IDUs and their health seeking behavior in Bangladesh. Design and Methods. A cross-sectional study was conducted among 120 IDUs attending a drug rehabilitation center in Dhaka, Bangladesh. Data were collected on sociodemographics, drug use, health seeking behavior, knowledge of injecting drugs, and sexual behavior. Results. The mean ± SD and median (IQR) age of the participants were 32.5 ± 21.3 and 33 (27-38) years, respectively, with only 9.2% females. Injection buprenorphine was the drug of choice for 40% of participants, and 58% of the participants first started drug use with smoking cannabis. 73.3% of participants shared needles sometimes and 57.5% were willing to use the needle exchange programs. 60% of the participants had no knowledge about the diseases spread by injection. Condom use during the last intercourse with regular partners was 11.7% and with any partners 15.8%. Conclusion. IDUs in Bangladesh are a high-risk group for HIV/AIDS due to lack of knowledge and risky behaviors. Education and interventions specifically aimed at IDUs are needed, because traditional education may not reach IDUs or influence their behavior.

Subsurface information for risk-sensitive urban spatial planning in Dhaka Metropolitan City, Bangladesh

NASA Astrophysics Data System (ADS)

Günther, Andreas; Aziz Patwary, Mohammad Abdul; Bahls, Rebecca; Asaduzzaman, Atm; Ludwig, Rüdiger; Ashraful Kamal, Mohammad; Nahar Faruqa, Nurun; Jabeen, Sarwat

2016-04-01

Dhaka Metropolitan City (including Dhaka and five adjacent municipal areas) is one of the fastest developing urban regions in the world. Densely build-up areas in the developed metropolitan area of Dhaka City are subject to extensive restructuring as common six- or lower storied buildings are replaced by higher and heavier constructions. Additional stories are built on existing houses, frequently exceeding the allowable bearing pressure on the subsoil as supported by the foundations. In turn, newly developing city areas are projected in marshy terrains modified by extensive, largely unengineered landfills. In most areas, these terrains bear unfavorable building ground conditions within 30 meters. Within a collaborative technical cooperation project between Bangladesh and Germany, BGR supports GSB in the provision of geo-information for the Capital Development Authority (RAJUK). For general urban planning, RAJUK successively develops a detailed area plan (DAP) at scale 1 : 50000 for the whole Dhaka Metropolitan City area (approx. 1700 km2). Geo-information have not been considered in the present DAP. Within the project, geospatial information in form of a geomorphic map, a digital terrain model and a 3-D subsurface model covering the whole city area have been generated at a scale of 1 : 50000. An extensive engineering geological data base consisting of more than 2200 borehole data with associated Standard Penetration Testing (SPT) and lab data has been compiled. With the field testing (SPT) and engineering geological lab data, the 3-D subsurface model can be parameterized to derive important spatial subsurface information for urban planning like bearing capacity evaluations for different foundation designs or soil liquefaction potential assessments for specific earthquake scenarios. In conjunction with inundation potential evaluations for different flooding scenarios, comprehensive building ground suitability information can be derived to support risk-sensitive urban planning in Dhaka Metropolitan City area at the DAP scale

A New Species of Frog (Anura: Dicroglossidae) Discovered from the Mega City of Dhaka.

PubMed

Howlader, Mohammad Sajid Ali; Nair, Abhilash; Merilä, Juha

2016-01-01

We describe a new species of frog of the genus Zakerana discovered from the urban core of Dhaka, Bangladesh, one of the most densely populated cities in the world. Although the new species is morphologically similar to the geographically proximate congeners in the Bangladeshi cricket frog group, we show that it can be distinguished from all congeners on the basis of morphological characters, advertisement calls and variation in two mitochondrial DNA genes (12S rRNA and 16S rRNA). Apart from several diagnostic differences in body proportions, the new species differs from other Zakerana species in having a flattened snout (from ventral view) projecting over the lower jaw, and diagnostic trapezoid-shaped red markings on the vocal sac in males. Molecular genetic analyses show that the new species is highly divergent (3.1-20.1% sequence divergence) from all congeneric species, and forms a well-supported clade with its sister species, Zakerana asmati. The discovery of a new amphibian species from the urban core of Dhaka together with several recent descriptions of new amphibian species from Bangladesh may indicate that more amphibian species remain to be discovered from this country.

Investigation of severe water problem in urban areas of a developing country: the case of Dhaka, Bangladesh.

PubMed

Nahar, Mst Shamsun; Zhang, Jing; Ueda, Akira; Yoshihisa, Fujishiro

2014-12-01

The present study evaluated water supply geochemistry in Dhaka City, Bangladesh, to provide detailed trace level (subppb) water quality data that include major ions, low dissolved oxygen (DO) and toxic trace metals for sustainable development. Dhaka Groundwater, which almost uniformly meets the World Health Organization guideline, has become the preferred source. Due to groundwater depletion and an ever-increasing need to meet water demands by city residents, Dhaka water supply and sewerage authority has initiated the treatment of river water, despite the fact that very little is known about the geochemical structure, and trace metal content in the Dhaka water supply. Major ion composition of water samples was determined, and the results used to generate Stiff diagrams. The diagrams served to visually compare water from different sources based on units of mass/volume. Hydrochemical facies analysis showed supply ground and surface waters are comprised predominately of Ca-Na-Mg-HCO3 and Ca-Na-Mg-HCO3-Cl types. Spatial distribution of ions, and Na/Cl and Na/SiO2 molar ratio indicated that silicate weathering is the dominant geochemical process. Chemical data revealed that toxic Cr metal mobilization is associated with chemical hazards from the leather industry. The vulnerability of deep wells to contamination by As is governed by the geometry of induced groundwater flow paths and the geochemical conditions encountered between the shallow and deep regions of the aquifer. Quantifying total arsenic (As) and As from interlocking geochemical cycles (Fe, Mn) may assist in interpreting As dynamics in Dhaka well water. The surface source water was hypoxic to anoxic low DO associated with very high concentrations of biological oxygen demands, and electrical conductivity compared to industrial and non-industrial urban processes and standard activity guidelines. The results of this study should be applied to future research focused on the potential to improve water quality in urban and surrounding areas.

The effect of intrapartum antibiotics on early-onset neonatal sepsis in Dhaka, Bangladesh: a propensity score matched analysis

PubMed Central

2014-01-01

Background We estimate the effect of antibiotics given in the intrapartum period on early-onset neonatal sepsis in Dhaka, Bangladesh using propensity score techniques. Methods We followed 600 mother-newborn pairs as part of a cohort study at a maternity center in Dhaka. Some pregnant women received one dose of intravenous antibiotics during labor based on clinician discretion. Newborns were followed over the first seven days of life for early-onset neonatal sepsis defined by a modified version of the World Health Organization Young Infants Integrated Management of Childhood Illnesses criteria. Using propensity scores we matched women who received antibiotics with similar women who did not. A final logistic regression model predicting sepsis was run in the matched sample controlling for additional potential confounders. Results Of the 600 mother-newborn pairs, 48 mothers (8.0%) received antibiotics during the intrapartum period. Seventy-seven newborns (12.8%) were classified with early-onset neonatal sepsis. Antibiotics appeared to be protective (odds ratio 0.381, 95% confidence interval 0.115–1.258), however this was not statistically significant. The results were similar after adjusting for prematurity, wealth status, and maternal colonization status (odds ratio 0.361, 95% confidence interval 0.106–1.225). Conclusions Antibiotics administered during the intrapartum period may reduce the risk of early-onset neonatal sepsis in high neonatal mortality settings like Dhaka. PMID:24742087

High mortality from Guillain-Barré syndrome in Bangladesh.

PubMed

Ishaque, Tanveen; Islam, Mohammad B; Ara, Gulshan; Endtz, Hubert P; Mohammad, Quazi D; Jacobs, Bart C; Islam, Zhahirul

2017-06-01

Although Guillain-Barré syndrome (GBS) has higher incidence and poor outcome in Bangladesh, mortality from GBS in Bangladesh has never been explored before. We sought to explore the frequency, timing, and risk factors for deaths from GBS in Bangladesh. We conducted a prospective study on 407 GBS patients who were admitted to Dhaka Medical College Hospital, Dhaka, Bangladesh from 2010 to 2013. We compared deceased and alive patients to identify risk factors. Cox regression model was used to adjust for confounders. Of the 407 GBS patients, 50 (12%) died, with the median time interval between the onset of weakness and death of 18 days. Among the fatal cases, 24 (48%) were ≥40 years, 36 (72%) had a Medical Research Council sum score ≤20 at entry, 33 (66%) had a progressive phase <8 days, and 27 (54%) required ventilation support. Ten patients (20%) died due to unavailability of ventilator. The strongest risk factor for deaths was lack of ventilator support when it was required (HR: 11.9; 95% confidence interval [CI]: 4.6-30.7). Other risk factors for death included age ≥40 years (HR: 5.9; 95% CI: 2.1-16.7), mechanical ventilation (HR: 2.3; 95% CI: 1.02-5.2), longer progressive phase (>8 days) (HR: 2.06; 95% CI: 1.1-3.8), autonomic dysfunction (HR: 1.9; 95% CI: 1.05-3.6), and bulbar nerve involvement (HR: 5.4; 95% CI: 1.5-19.2). In Bangladesh, GBS is associated with higher mortality rates, which is related to lack of ventilator support, disease severity, longer progressive phase of the disease, autonomic dysfunction, and involvement of the bulbar nerves. © 2017 Peripheral Nerve Society.

Chemical Composition and Emission Sources of the Fine Particulate Matters in a Southeast Asian Mega City (Dhaka, Bangladesh)

NASA Astrophysics Data System (ADS)

Salam, Abdus

2016-04-01

Air pollution has significant impact on human health, climate change, agriculture, visibility reduction, and also on the atmospheric chemistry. There are many studies already reported about the direct relation of the human mortality and morbidity with the increase of the atmospheric particulate matters. Especially, fine particulate matters can easily enter into the human respiratory system and causes many diseases. Particulate matters have the properties to absorb the solar radiation and impact on the climate. Dhaka, Bangladesh is a densely populated mega-city in the world. About 16 million inhabitants are living within an area of 360 square kilometers. Air quality situation has been degrading due to unplanned growth, increasing vehicles, severe traffic jams, brick kilns, industries, construction, and also transboundary air pollution. A rapidly growing number of vehicles has worsen the air quality in spite of major policy interventions, e.g., ban of two-stroke and three-wheeled vehicles, phase out of 20 years old vehicles, conversion to compressed natural gas (CNGs), etc. Introduction of CNGs to reduce air pollution was not the solution for fine particles at all, as evidence shows that CNGs and diesel engines are the major sources of fine particles. High concentration of the air pollutants in Dhaka city such as PM, carbonaceous species (black and organic carbon), CO, etc. has already been reported. PM2.5 mass, chemical composition (e.g., BC, OC, SO42-, NO3-, trace elements, etc.), aerosol Optical Depth (AOD) and emission sources of our recent measurements at the highly polluted south East Asian Mega city (Dhaka) Bangladesh will be presented in the conference. PM2.5 samples were collected on filters with Digital PM2.5 sampler (Switzerland) and Air photon, USA. BC was measured from filters (with thermal and optical method) and also real time with an Aethalometer AE42 (Magee Scitific., USA). Water soluble ions were determined from filters with ion chromatogram. AOD was continuously monitor with NASA AERONET sunphotometer. Carbon monoxide (CO) was measured continuously with Horiba CO monitor, Japan.

Empirically Derived Dehydration Scoring and Decision Tree Models for Children With Diarrhea: Assessment and Internal Validation in a Prospective Cohort Study in Dhaka, Bangladesh

PubMed Central

Glavis-Bloom, Justin; Modi, Payal; Nasrin, Sabiha; Rege, Soham; Chu, Chieh; Schmid, Christopher H; Alam, Nur H

2015-01-01

Introduction: Diarrhea remains one of the most common and most deadly conditions affecting children worldwide. Accurately assessing dehydration status is critical to determining treatment course, yet no clinical diagnostic models for dehydration have been empirically derived and validated for use in resource-limited settings. Methods: In the Dehydration: Assessing Kids Accurately (DHAKA) prospective cohort study, a random sample of children under 5 with acute diarrhea was enrolled between February and June 2014 in Bangladesh. Local nurses assessed children for clinical signs of dehydration on arrival, and then serial weights were obtained as subjects were rehydrated. For each child, the percent weight change with rehydration was used to classify subjects with severe dehydration (>9% weight change), some dehydration (3–9%), or no dehydration (<3%). Clinical variables were then entered into logistic regression and recursive partitioning models to develop the DHAKA Dehydration Score and DHAKA Dehydration Tree, respectively. Models were assessed for their accuracy using the area under their receiver operating characteristic curve (AUC) and for their reliability through repeat clinical exams. Bootstrapping was used to internally validate the models. Results: A total of 850 children were enrolled, with 771 included in the final analysis. Of the 771 children included in the analysis, 11% were classified with severe dehydration, 45% with some dehydration, and 44% with no dehydration. Both the DHAKA Dehydration Score and DHAKA Dehydration Tree had significant AUCs of 0.79 (95% CI = 0.74, 0.84) and 0.76 (95% CI = 0.71, 0.80), respectively, for the diagnosis of severe dehydration. Additionally, the DHAKA Dehydration Score and DHAKA Dehydration Tree had significant positive likelihood ratios of 2.0 (95% CI = 1.8, 2.3) and 2.5 (95% CI = 2.1, 2.8), respectively, and significant negative likelihood ratios of 0.23 (95% CI = 0.13, 0.40) and 0.28 (95% CI = 0.18, 0.44), respectively, for the diagnosis of severe dehydration. Both models demonstrated 90% agreement between independent raters and good reproducibility using bootstrapping. Conclusion: This study is the first to empirically derive and internally validate accurate and reliable clinical diagnostic models for dehydration in a resource-limited setting. After external validation, frontline providers may use these new tools to better manage acute diarrhea in children. PMID:26374802

Causes of Early Childhood Deaths in Urban Dhaka, Bangladesh

PubMed Central

Halder, Amal K.; Gurley, Emily S.; Naheed, Aliya; Saha, Samir K.; Brooks, W. Abdullah; Arifeen, Shams El; Sazzad, Hossain M. S.; Kenah, Eben; Luby, Stephen P.

2009-01-01

Data on causes of early childhood death from low-income urban areas are limited. The nationally representative Bangladesh Demographic and Health Survey 2007 estimates 65 children died per 1,000 live births. We investigated rates and causes of under-five deaths in an urban community near two large pediatric hospitals in Dhaka, Bangladesh and evaluated the impact of different recall periods. We conducted a survey in 2006 for 6971 households and a follow up survey in 2007 among eligible remaining households or replacement households. The initial survey collected information for all children under five years old who died in the previous year; the follow up survey on child deaths in the preceding five years. We compared mortality rates based on 1-year recall to the 4 years preceding the most recent 1 year. The initial survey identified 58 deaths among children <5 years in the preceding year. The follow up survey identified a mean 53 deaths per year in the preceding five years (SD±7.3). Under-five mortality rate was 34 and neonatal mortality was 15 per thousand live births during 2006–2007. The leading cause of under-five death was respiratory infections (22%). The mortality rates among children under 4 years old for the two time periods (most recent 1-year recall and the 4 years preceding the most recent 1 year) were similar (36 versus 32). The child mortality in urban Dhaka was substantially lower than the national rate. Mortality rates were not affected by recall periods between 1 and 5 years. PMID:19997507

The hidden cost of 'free' maternity care in Dhaka, Bangladesh.

PubMed

Nahar, S; Costello, A

1998-12-01

We studied the cost and affordability of 'free' maternity services at government facilities in Dhaka, Bangladesh, to assess whether economic factors may contribute to low utilization. We conducted a questionnaire survey and in-depth interviews among 220 post-partum mothers and their husbands, selected from four government maternity facilities (three referral hospitals and one Mother and Child Health hospital) in Dhaka. Mothers with serious complications were excluded. Information was collected on the costs of maternity care, household income, the sources of finance used to cover the costs, and the family's willingness to pay for maternity services. The mean cost for normal delivery was 1275 taka (US$31.9) and for caesarean section 4703 taka (US$117.5). Average monthly household income was 4933 taka (US$123). Twenty-one per cent of families were spending 51-100% of monthly income, and 27% of families 2-8 times their monthly income for maternity care. Overall, 51% of the families (and 74% of those having a caesarean delivery) did not have enough money to pay; of these, 79% had to borrow from a money lender or relative. Surprisingly, 72% of the families said they were willing to pay a government-levied user charge, though this was less popular among low-income families (61%). 'Free' maternity care in Bangladesh involves considerable hidden costs which may be a major contributor to low utilization of maternity services, especially among low-income groups. To increase utilization of safer motherhood services, policy-makers might consider introducing fixed user charges with clear exemption guidelines, or greater subsidies for existing services, especially caesarean section.

Naturally acquired picornavirus infections in primates at the Dhaka zoo.

PubMed

Oberste, M Steven; Feeroz, Mohammed M; Maher, Kaija; Nix, W Allan; Engel, Gregory A; Begum, Sajeda; Hasan, Kamrul M; Oh, Gunwha; Pallansch, Mark A; Jones-Engel, Lisa

2013-01-01

The conditions in densely populated Bangladesh favor picornavirus transmission, resulting in a high rate of infection in the human population. Data suggest that nonhuman primates (NHP) may play a role in the maintenance and transmission of diverse picornaviruses in Bangladesh. At the Dhaka Zoo, multiple NHP species are caged in close proximity. Their proximity to other species and to humans, both zoo workers and visitors, provides the potential for cross-species transmission. To investigate possible interspecies and intraspecies transmission of picornaviruses among NHP, we collected fecal specimens from nine NHP taxa at the Dhaka Zoo at three time points, August 2007, January 2008, and June 2008. Specimens were screened using real-time PCR for the genera Enterovirus, Parechovirus, and Sapelovirus, and positive samples were typed by VP1 sequencing. Fifty-two picornaviruses comprising 10 distinct serotypes were detected in 83 fecal samples. Four of these serotypes, simian virus 19 (SV19), baboon enterovirus (BaEV), enterovirus 112 (EV112), and EV115, have been solely associated with infection in NHP. EV112, EV115, and SV19 accounted for 88% of all picornaviruses detected. Over 80% of samples from cages housing rhesus macaques, olive baboons, or hamadryas baboons were positive for a picornavirus, while no picornaviruses were detected in samples from capped langurs or vervet monkeys. In contrast to our findings among synanthropic NHP in Bangladesh where 100% of the picornaviruses detected were of human serotypes, in the zoo population, only 15% of picornaviruses detected in NHP were of human origin. Specific serotypes tended to persist over time, suggesting either persistent infection of individuals or cycles of reinfection.

Injecting Drug Users and Their Health Seeking Behavior: A Cross-Sectional Study in Dhaka, Bangladesh

PubMed Central

Biswas, Tuhin; Bhuiyan, Faiz Ahmed; Islam, Md. Serajul; Rahman, Mohammad Mizanur; Nessa, Hurun

2015-01-01

Introduction and Aim. Injecting drug users (IDUs) are amongst the most vulnerable people to acquisition of HIV/AIDS. This study aims to collect information on IDUs and their health seeking behavior in Bangladesh. Design and Methods. A cross-sectional study was conducted among 120 IDUs attending a drug rehabilitation center in Dhaka, Bangladesh. Data were collected on sociodemographics, drug use, health seeking behavior, knowledge of injecting drugs, and sexual behavior. Results. The mean ± SD and median (IQR) age of the participants were 32.5 ± 21.3 and 33 (27–38) years, respectively, with only 9.2% females. Injection buprenorphine was the drug of choice for 40% of participants, and 58% of the participants first started drug use with smoking cannabis. 73.3% of participants shared needles sometimes and 57.5% were willing to use the needle exchange programs. 60% of the participants had no knowledge about the diseases spread by injection. Condom use during the last intercourse with regular partners was 11.7% and with any partners 15.8%. Conclusion. IDUs in Bangladesh are a high-risk group for HIV/AIDS due to lack of knowledge and risky behaviors. Education and interventions specifically aimed at IDUs are needed, because traditional education may not reach IDUs or influence their behavior. PMID:25692067

Impact of flooding on feeding practices of infants and young children in Dhaka, Bangladesh Slums: what are the coping strategies?

PubMed

Goudet, Sophie M; Griffiths, Paula L; Bogin, Barry A; Selim, Nasima

2011-04-01

Previous research has shown that urban slums are hostile environments for the growth of infants and young children (IYC). Flooding is a hazard commonly found in Dhaka slums (Bangladesh) which negatively impacts IYC's nutritional and health status. This paper aims 1) to identify the impact of flooding on IYC's feeding practices, and 2) to explore the coping strategies developed by caregivers. Qualitative data (participant observation and semi-structured interviews) and quantitative data (household questionnaire and anthropometric measurements) collected in slums in Dhaka (n=18 mothers, n=5 community health workers, and n=55 children) were analysed. The subjects of the interviews were mothers and Bangladesh Rural Advancement Committee (BRAC) community health workers living and working in the slums. Research findings showed that breastfeeding and complementary feeding practices for IYC were poor and inappropriate due to lack of knowledge, time, and resources in normal times and worse during flooding. One coping strategy developed by mothers purposely to protect their IYC's nutritional status was to decrease their personal food intake. Our research findings suggest that mothers perceived the negative impact of flooding on their IYC's nutritional health but did not have the means to prevent it. They could only maintain their health through coping strategies which had other negative consequences. The results suggests a holistic approach combining 1) provision of relief for nutritionally vulnerable groups during flooding, 2) support to mothers in their working role, 3) breastfeeding counseling and support to lactating mothers with difficulties, and 4) preventing malnutrition in under 2 year old children. © 2010 Blackwell Publishing Ltd.

The use of vouchers in HIV prevention, referral treatment, and care for young MSM and young transgender people in Dhaka, Bangladesh: experience from ‘HIM’ initiative

PubMed Central

Oyewale, Tajudeen O.; Ahmed, Shale; Ahmed, Farid; Tazreen, Mona; Uddin, Ziya; Rahman, Anisur; Oyediran, Kola A.

2016-01-01

Introduction The study described the effectiveness of a voucher scheme to access sexual and reproductive health and HIV services among young MSM and transgender people aged 15–24 years in Dhaka, Bangladesh, a country with HIV prevalence of less than 0.1%. Methods Descriptive and analytical methods were used to assess the net effects of biodemographic factors of the respondents on the voucher scheme. Effectiveness of the scheme was contextualized as target population coverage, and turnaround time of voucher redemption to access services. Results and discussion A total of 210 (87.9%) out of the 239 vouchers distributed were redeemed. The mean age of the identified young people was 19.6 years (SD = +2.6 years). The coverage of the scheme against the target population of 200 young MSM and 936 young transgender people was 88% (n = 175) and 4% (n = 35) respectively, with P < 0.001. The median turnaround time for voucher redemption was 7 days. The predictors of voucher turnaround time were age, education, and population group (P < 0.001). HIV testing and counselling was accessed by 160 (76%) respondents, one was positive and linked to antiretroviral treatment and 110 (52%) were diagnosed and treated for sexually transmitted infections. Conclusion The voucher scheme was effective in linking young MSM with sexual and reproductive health and HIV services in Dhaka, Bangladesh. The findings are consistent with the low HIV prevalence in the country. The scheme is, however, not optimal for linking young transgender people with services. PMID:26945145

A New Species of Frog (Anura: Dicroglossidae) Discovered from the Mega City of Dhaka

PubMed Central

Howlader, Mohammad Sajid Ali; Nair, Abhilash; Merilä, Juha

2016-01-01

We describe a new species of frog of the genus Zakerana discovered from the urban core of Dhaka, Bangladesh, one of the most densely populated cities in the world. Although the new species is morphologically similar to the geographically proximate congeners in the Bangladeshi cricket frog group, we show that it can be distinguished from all congeners on the basis of morphological characters, advertisement calls and variation in two mitochondrial DNA genes (12S rRNA and 16S rRNA). Apart from several diagnostic differences in body proportions, the new species differs from other Zakerana species in having a flattened snout (from ventral view) projecting over the lower jaw, and diagnostic trapezoid-shaped red markings on the vocal sac in males. Molecular genetic analyses show that the new species is highly divergent (3.1–20.1% sequence divergence) from all congeneric species, and forms a well-supported clade with its sister species, Zakerana asmati. The discovery of a new amphibian species from the urban core of Dhaka together with several recent descriptions of new amphibian species from Bangladesh may indicate that more amphibian species remain to be discovered from this country. PMID:26934699

Epidemiology and Etiology of Sexually Transmitted Infection among Hotel-Based Sex Workers in Dhaka, Bangladesh

PubMed Central

Nessa, Khairun; Waris, Shama-A; Sultan, Zafar; Monira, Shirajum; Hossain, Maqsud; Nahar, Shamsun; Rahman, Habibur; Alam, Mahbub; Baatsen, Pam; Rahman, Motiur

2004-01-01

The prevalence of sexually transmitted infections (STIs) and reproductive tract infections (RTIs) among hotel-based sex workers (HBSWs) in Dhaka, Bangladesh, was studied. A total of 400 HBSWs were enrolled in the study during April to July 2002. Endocervical swabs, high vaginal swabs, and blood samples from 400 HBSWs were examined for Neisseria gonorrhoeae (by culture), Chlamydia trachomatis (by PCR), Trichomonas vaginalis (by microscopy), antibody to Treponema pallidum (by both rapid plasma reagin and Treponema pallidum hemagglutination tests), and antibody to herpes simplex virus type 2 (HSV-2) (by enzyme-linked immunosorbent assay). Sociodemographic information as well as gynecological and obstetric information was collected. Among the HBSWs, 228 women (57%) were symptomatic and 172 (43%) were asymptomatic, 35.8% were positive for N. gonorrhoeae, 43.5% were positive for C. trachomatis, and 4.3% were positive for T. vaginalis. A total of 8.5% had syphilis, 34.5% were positive for HSV-2, and 86.8% were positive for at least one RTI or STI. There was no significant difference between the prevalences of STIs among the symptomatic and asymptomatic HBSWs. These data suggested a high prevalence of STIs, particularly gonorrhea and chlamydia, among HBSWs in Dhaka. PMID:14766825

Using lot quality assurance sampling to improve immunization coverage in Bangladesh.

PubMed Central

Tawfik, Y.; Hoque, S.; Siddiqi, M.

2001-01-01

OBJECTIVE: To determine areas of low vaccination coverage in five cities in Bangladesh (Chittagong, Dhaka, Khulna, Rajshahi, and Syedpur). METHODS: Six studies using lot quality assurance sampling were conducted between 1995 and 1997 by Basic Support for Institutionalizing Child Survival and the Bangladesh National Expanded Programme on Immunization. FINDINGS: BCG vaccination coverage was acceptable in all lots studied; however, the proportion of lots rejected because coverage of measles vaccination was low ranged from 0% of lots in Syedpur to 12% in Chittagong and 20% in Dhaka's zones 7 and 8. The proportion of lots rejected because an inadequate number of children in the sample had been fully vaccinated varied from 11% in Syedpur to 30% in Dhaka. Additionally, analysis of aggregated, weighted immunization coverage showed that there was a high BCG vaccination coverage (the first administered vaccine) and a low measles vaccination coverage (the last administered vaccine) indicating a high drop-out rate, ranging from 14% in Syedpur to 36% in Dhaka's zone 8. CONCLUSION: In Bangladesh, where resources are limited, results from surveys using lot quality assurance sampling enabled managers of the National Expanded Programme on Immunization to identify areas with poor vaccination coverage. Those areas were targeted to receive focused interventions to improve coverage. Since this sampling method requires only a small sample size and was easy for staff to use, it is feasible for routine monitoring of vaccination coverage. PMID:11436470

Greenhouse gas footprint and the carbon flow associated with different solid waste management strategy for urban metabolism in Bangladesh.

PubMed

Islam, K M Nazmul

2017-02-15

Greenhouse gas (GHG) emissions from municipal solid waste (MSW) and associated climate change consequences are gripping attention globally, while MSW management as a vital subsystem of urban metabolism significantly influences the urban carbon cycles. This study evaluates the GHG emissions and carbon flow of existing and proposed MSW management in Bangladesh through scenario analysis, including landfill with landfill gas (LFG) recovery, waste to energy (WtE), and material recovery facility (MRF). The analysis indicates that, scenario H 2 and H 5 emitted net GHGs -152.20kg CO 2 eq. and -140.32kg CO 2 eq., respectively, in comparison with 420.88kg CO 2 eq. of scenario H 1 for managing per ton of wastes during the reference year 2015. The annual horizontal carbon flux of the waste input was 319Gg and 158Gg during 2015 in Dhaka and Chittagong, respectively. An integrated strategy of managing the wastes in the urban areas of Bangladesh involving WtE incineration plant and LFG recovery to generate electricity as well as MRF could reverse back 209.46Gg carbon and 422.29Gg carbon to the Chittagong and Dhaka urban system, respectively. This study provides valuable insights for the MSW policy framework and revamp of existing MSW management practices with regards to reduction of GHGs emissions from the waste sector in Bangladesh. Copyright © 2016 Elsevier B.V. All rights reserved.

Newborn care practices among slum dwellers in Dhaka, Bangladesh: a quantitative and qualitative exploratory study.

PubMed

Moran, Allisyn C; Choudhury, Nuzhat; Uz Zaman Khan, Nazib; Ahsan Karar, Zunaid; Wahed, Tasnuva; Faiz Rashid, Sabina; Alam, M Ashraful

2009-11-17

Urbanization is occurring at a rapid pace, especially in low-income countries. Dhaka, Bangladesh, is estimated to grow to 50 million by 2015, with 21 million living in urban slums. Although health services are available, neonatal mortality is higher in slum areas than in urban non-slum areas. The Manoshi program works to improve maternal, newborn, and child health in urban slums in Bangladesh. This paper describes newborn care practices in urban slums in Dhaka and provides program recommendations. A quantitative baseline survey was conducted in six urban slum areas to measure newborn care practices among recently delivered women (n = 1,256). Thirty-six in-depth semi-structured interviews were conducted to explore newborn care practices among currently pregnant women (n = 18) and women who had at least one delivery (n = 18). In the baseline survey, the majority of women gave birth at home (84%). Most women reported having knowledge about drying the baby (64%), wrapping the baby after birth (59%), and cord care (46%). In the in-depth interviews, almost all women reported using sterilized instruments to cut the cord. Babies are typically bathed soon after birth to purify them from the birth process. There was extensive care given to the umbilical cord including massage and/or applying substances, as well as a variety of practices to keep the baby warm. Exclusive breastfeeding was rare; most women reported first giving their babies sweet water, honey and/or other foods. These reported newborn care practices are similar to those in rural areas of Bangladesh and to urban and rural areas in the South Asia region. There are several program implications. Educational messages to promote providing newborn care immediately after birth, using sterile thread, delaying bathing, and ensuring dry cord care and exclusive breastfeeding are needed. Programs in urban slum areas should also consider interventions to improve social support for women, especially first time mothers. These interventions may improve newborn survival and help achieve MDG4.

Delivery practices of traditional birth attendants in Dhaka slums, Bangladesh.

PubMed

Fronczak, N; Arifeen, S E; Moran, A C; Caulfield, L E; Baqui, A H

2007-12-01

This paper describes associations among delivery-location, training of birth attendants, birthing practices, and early postpartum morbidity in women in slum areas of Dhaka, Bangladesh. During November 1993-May 1995, data on delivery-location, training of birth attendants, birthing practices, delivery-related complications, and postpartum morbidity were collected through interviews with 1,506 women, 489 home-based birth attendants, and audits in 20 facilities where the women from this study gave birth. Associations among maternal characteristics, birth practices, delivery-location, and early postpartum morbidity were specifically explored. Self-reported postpartum morbidity was associated with maternal characteristics, delivery-related complications, and some birthing practices. Dais with more experience were more likely to use potentially-harmful birthing practices which increased the risk of postpartum morbidity among women with births at home. Postpartum morbidity did not differ by birth-location. Safe motherhood programmes must develop effective strategies to discourage potentially-harmful home-based delivery practices demonstrated to contribute to morbidity.

Antimicrobial susceptibility pattern of clinical isolates of Burkholderia pseudomallei in Bangladesh.

PubMed

Dutta, Subarna; Haq, Sabah; Hasan, Mohammad Rokibul; Haq, Jalaluddin Ashraful

2017-07-20

Melioidosis an infectious disease, caused by a Gram negative bacterium called Burkholderia pseudomallei, is endemic in Bangladesh. This organism is sensitive to limited number of antimicrobial agents and need prolonged treatment. There is no comprehensive data on the antimicrobial susceptibility profile of B. pseudomallei isolated in Bangladesh over last several years. The present study aimed to determine the antimicrobial susceptibility pattern of B. pseudomallei isolated in a tertiary care hospital of Dhaka city from 2009 to 2015. All B. pseudomallei isolated from melioidosis patients over a period of 7 years (2009-2015) in the Department of Microbiology of a 725-bed tertiary care referral hospital in Dhaka city, Bangladesh were included in the study. B. pseudomallei was identified by Gram stain, culture, specific biochemical tests, serology and PCR using specific primers constructed from 16s rRNA region of B. pseudomallei. Antimicrobial susceptibility to specific agents was determined by disk diffusion and minimum inhibitory concentration methods. A total of 20 isolates of B. pseudomallei which were isolated from patients coming from different geographic locations of Bangladesh were included in the study. All the isolates were uniformly sensitive (100%) to ceftazidime, imipenem, piperacillin-tazobactam, amoxicillin-clavulanic acid and tetracycline by both disk diffusion and MIC methods. Two strains were resistant to trimethoprim-sulfamethoxazole by disk diffusion method but were sensitive by MIC method. The MIC 50 and MIC 90 values of the above antimicrobial agents were almost similar. All the isolates were resistant to amikacin by both MIC and disk diffusion methods. The results of the study suggest that B. pseudomallei prevalent in Bangladesh were still susceptible to all recommended antimicrobial agents used for the treatment of melioidosis. However, regular monitoring is needed to detect any emergence of resistance and shifting of MIC 50 and MIC 90 values.

Patterns and correlates of physical activity in adolescents in Dhaka city, Bangladesh.

PubMed

Khan, A; Burton, N W; Trost, S G

2017-04-01

Despite the widely acknowledged public health importance of physical activity (PA), few studies have examined levels of PA in Bangladesh. The purpose of this study was to investigate the patterns and correlates of PA in adolescents in Bangladesh. Cross-sectional survey. A total of 798 students, aged 13-17 years; 48% girls, from eight purposively selected secondary schools in Dhaka city, Bangladesh completed a self-administered questionnaire including the 3-Day PA Recall. Parents completed a separate questionnaire to provide household/family-level data. Multilevel generalized linear modelling was used to identify the correlates of PA for boys and girls. Two-thirds (66%) of the adolescents met the recommendations of 60 min/day of moderate to vigorous PA (MVPA) daily, with more boys than girls (76% and 55%, respectively). The most common activities reported were walking for travel (42%), cricket (33%) and household chores (30%). Multivariable modelling showed that girls' PA was positively associated with mother's education level, walking to school, involvement in school sports and having home sports equipment. Boys' PA was positively associated with mother's employment, having home sports equipment, having a playground at school and walking to school. One third of adolescents in Bangladesh were insufficiently active with girls less active than boys. Walking to school and access to sports facilities including playgrounds and home equipment may be important to promote activity among Bangladeshi adolescents, with special attention to the girls. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Empirically Derived Dehydration Scoring and Decision Tree Models for Children With Diarrhea: Assessment and Internal Validation in a Prospective Cohort Study in Dhaka, Bangladesh.

PubMed

Levine, Adam C; Glavis-Bloom, Justin; Modi, Payal; Nasrin, Sabiha; Rege, Soham; Chu, Chieh; Schmid, Christopher H; Alam, Nur H

2015-08-18

Diarrhea remains one of the most common and most deadly conditions affecting children worldwide. Accurately assessing dehydration status is critical to determining treatment course, yet no clinical diagnostic models for dehydration have been empirically derived and validated for use in resource-limited settings. In the Dehydration: Assessing Kids Accurately (DHAKA) prospective cohort study, a random sample of children under 5 with acute diarrhea was enrolled between February and June 2014 in Bangladesh. Local nurses assessed children for clinical signs of dehydration on arrival, and then serial weights were obtained as subjects were rehydrated. For each child, the percent weight change with rehydration was used to classify subjects with severe dehydration (>9% weight change), some dehydration (3-9%), or no dehydration (<3%). Clinical variables were then entered into logistic regression and recursive partitioning models to develop the DHAKA Dehydration Score and DHAKA Dehydration Tree, respectively. Models were assessed for their accuracy using the area under their receiver operating characteristic curve (AUC) and for their reliability through repeat clinical exams. Bootstrapping was used to internally validate the models. A total of 850 children were enrolled, with 771 included in the final analysis. Of the 771 children included in the analysis, 11% were classified with severe dehydration, 45% with some dehydration, and 44% with no dehydration. Both the DHAKA Dehydration Score and DHAKA Dehydration Tree had significant AUCs of 0.79 (95% CI = 0.74, 0.84) and 0.76 (95% CI = 0.71, 0.80), respectively, for the diagnosis of severe dehydration. Additionally, the DHAKA Dehydration Score and DHAKA Dehydration Tree had significant positive likelihood ratios of 2.0 (95% CI = 1.8, 2.3) and 2.5 (95% CI = 2.1, 2.8), respectively, and significant negative likelihood ratios of 0.23 (95% CI = 0.13, 0.40) and 0.28 (95% CI = 0.18, 0.44), respectively, for the diagnosis of severe dehydration. Both models demonstrated 90% agreement between independent raters and good reproducibility using bootstrapping. This study is the first to empirically derive and internally validate accurate and reliable clinical diagnostic models for dehydration in a resource-limited setting. After external validation, frontline providers may use these new tools to better manage acute diarrhea in children. © Levine et al.

Using remote sensing and GIS to detect and monitor land use and land cover change in Dhaka Metropolitan of Bangladesh during 1960-2005.

PubMed

Dewan, Ashraf M; Yamaguchi, Yasushi

2009-03-01

This paper illustrates the result of land use/cover change in Dhaka Metropolitan of Bangladesh using topographic maps and multi-temporal remotely sensed data from 1960 to 2005. The Maximum likelihood supervised classification technique was used to extract information from satellite data, and post-classification change detection method was employed to detect and monitor land use/cover change. Derived land use/cover maps were further validated by using high resolution images such as SPOT, IRS, IKONOS and field data. The overall accuracy of land cover change maps, generated from Landsat and IRS-1D data, ranged from 85% to 90%. The analysis indicated that the urban expansion of Dhaka Metropolitan resulted in the considerable reduction of wetlands, cultivated land, vegetation and water bodies. The maps showed that between 1960 and 2005 built-up areas increased approximately 15,924 ha, while agricultural land decreased 7,614 ha, vegetation decreased 2,336 ha, wetland/lowland decreased 6,385 ha, and water bodies decreased about 864 ha. The amount of urban land increased from 11% (in 1960) to 344% in 2005. Similarly, the growth of landfill/bare soils category was about 256% in the same period. Much of the city's rapid growth in population has been accommodated in informal settlements with little attempt being made to limit the risk of environmental impairments. The study quantified the patterns of land use/cover change for the last 45 years for Dhaka Metropolitan that forms valuable resources for urban planners and decision makers to devise sustainable land use and environmental planning.

Naturally Acquired Picornavirus Infections in Primates at the Dhaka Zoo

PubMed Central

Feeroz, Mohammed M.; Maher, Kaija; Nix, W. Allan; Engel, Gregory A.; Begum, Sajeda; Hasan, Kamrul M.; Oh, Gunwha; Pallansch, Mark A.; Jones-Engel, Lisa

2013-01-01

The conditions in densely populated Bangladesh favor picornavirus transmission, resulting in a high rate of infection in the human population. Data suggest that nonhuman primates (NHP) may play a role in the maintenance and transmission of diverse picornaviruses in Bangladesh. At the Dhaka Zoo, multiple NHP species are caged in close proximity. Their proximity to other species and to humans, both zoo workers and visitors, provides the potential for cross-species transmission. To investigate possible interspecies and intraspecies transmission of picornaviruses among NHP, we collected fecal specimens from nine NHP taxa at the Dhaka Zoo at three time points, August 2007, January 2008, and June 2008. Specimens were screened using real-time PCR for the genera Enterovirus, Parechovirus, and Sapelovirus, and positive samples were typed by VP1 sequencing. Fifty-two picornaviruses comprising 10 distinct serotypes were detected in 83 fecal samples. Four of these serotypes, simian virus 19 (SV19), baboon enterovirus (BaEV), enterovirus 112 (EV112), and EV115, have been solely associated with infection in NHP. EV112, EV115, and SV19 accounted for 88% of all picornaviruses detected. Over 80% of samples from cages housing rhesus macaques, olive baboons, or hamadryas baboons were positive for a picornavirus, while no picornaviruses were detected in samples from capped langurs or vervet monkeys. In contrast to our findings among synanthropic NHP in Bangladesh where 100% of the picornaviruses detected were of human serotypes, in the zoo population, only 15% of picornaviruses detected in NHP were of human origin. Specific serotypes tended to persist over time, suggesting either persistent infection of individuals or cycles of reinfection. PMID:23097447

Dengue seroprevalence, seroconversion and risk factors in Dhaka, Bangladesh

PubMed Central

Dhar-Chowdhury, Parnali; Paul, Kishor Kumar; Hossain, Shakhawat; Lindsay, L. Robbin; Dibernardo, Antonia; Brooks, W. Abdullah; Drebot, Michael A.

2017-01-01

Background Dengue virus (DENV) activity has been reported in Dhaka, Bangladesh since the early 1960s with the greatest burden of dengue fever and dengue hemorrhagic fever cases observed in 2000. Since this time, the intensity of dengue activity has varied from year to year, and its determining factors remained relatively unknown. In light of such gaps in knowledge, the main objectives of this study were to determine the magnitude of seroprevalence and seroconversion among the surveyed population, and establish the individual/household level risk factors for the presence of DENV antibodies among all age groups of target populations in the city of Dhaka. Methodology/Principal findings Considering the lack of fine scale investigations on the factors driving dengue activity in Bangladesh, a prospective cohort study involving serological surveys was undertaken with participant interviews and blood donation across the city of Dhaka in 2012. Study participants were recruited from 12 of 90 wards and blood samples were collected during both the pre-monsoon (n = 1125) and post-monsoon (n = 600) seasons of 2012. The findings revealed that the seroprevalence in all pre-monsoon samples was 80.0% (900/1125) while the seropositivity in the pre-monsoon samples that had paired post-monsoon samples was 83.3% (503/600). Of the 97 paired samples that were negative at the pre-monsoon time point, 56 were positive at the post-monsoon time point. This resulted in a seroprevalence of 93.2% (559/600) among individuals tested during the post-monsoon period. Seroprevalence trended higher with age with children exhibiting a lower seropositivity as compared to adults. Results from this study also indicated that DENV strains were the only flaviviruses circulating in Dhaka in 2012. A multivariate analysis revealed that age, possession of indoor potted plants, and types of mosquito control measures were significant factors associated with DENV seroprevalence; while attendance in public/mass gatherings, and use of mosquito control measures were significantly associated with DENV seroconversion after adjusting for all other variables. Conclusions/Significance Our study suggests that there is a high level of endemic dengue virus circulation in the city of Dhaka which has resulted in significant DENV seroprevalence among its residents. Seropositivity increased with age, however, a substantial proportion of children are at risk for DENV infections. Our serological analysis also documents considerable DENV seroconversion among study participants which indicates that a large proportion of the population in the city of Dhaka were newly exposed to DENV during the study period (pre-and post-monsoon 2012). High levels of seroconversion suggest that there was an intense circulation of DENV in 2012 and this may have resulted in a significant risk for viral associated illness. Findings of our study further indicated that home-based interventions, such as removing indoor potted plants and increased bed net use, in addition to vector control measures in public parks, would reduce exposure to DENV and further decrease risk of viral associated disease. PMID:28333935

Dengue seroprevalence, seroconversion and risk factors in Dhaka, Bangladesh.

PubMed

Dhar-Chowdhury, Parnali; Paul, Kishor Kumar; Haque, C Emdad; Hossain, Shakhawat; Lindsay, L Robbin; Dibernardo, Antonia; Brooks, W Abdullah; Drebot, Michael A

2017-03-01

Dengue virus (DENV) activity has been reported in Dhaka, Bangladesh since the early 1960s with the greatest burden of dengue fever and dengue hemorrhagic fever cases observed in 2000. Since this time, the intensity of dengue activity has varied from year to year, and its determining factors remained relatively unknown. In light of such gaps in knowledge, the main objectives of this study were to determine the magnitude of seroprevalence and seroconversion among the surveyed population, and establish the individual/household level risk factors for the presence of DENV antibodies among all age groups of target populations in the city of Dhaka. Considering the lack of fine scale investigations on the factors driving dengue activity in Bangladesh, a prospective cohort study involving serological surveys was undertaken with participant interviews and blood donation across the city of Dhaka in 2012. Study participants were recruited from 12 of 90 wards and blood samples were collected during both the pre-monsoon (n = 1125) and post-monsoon (n = 600) seasons of 2012. The findings revealed that the seroprevalence in all pre-monsoon samples was 80.0% (900/1125) while the seropositivity in the pre-monsoon samples that had paired post-monsoon samples was 83.3% (503/600). Of the 97 paired samples that were negative at the pre-monsoon time point, 56 were positive at the post-monsoon time point. This resulted in a seroprevalence of 93.2% (559/600) among individuals tested during the post-monsoon period. Seroprevalence trended higher with age with children exhibiting a lower seropositivity as compared to adults. Results from this study also indicated that DENV strains were the only flaviviruses circulating in Dhaka in 2012. A multivariate analysis revealed that age, possession of indoor potted plants, and types of mosquito control measures were significant factors associated with DENV seroprevalence; while attendance in public/mass gatherings, and use of mosquito control measures were significantly associated with DENV seroconversion after adjusting for all other variables. Our study suggests that there is a high level of endemic dengue virus circulation in the city of Dhaka which has resulted in significant DENV seroprevalence among its residents. Seropositivity increased with age, however, a substantial proportion of children are at risk for DENV infections. Our serological analysis also documents considerable DENV seroconversion among study participants which indicates that a large proportion of the population in the city of Dhaka were newly exposed to DENV during the study period (pre-and post-monsoon 2012). High levels of seroconversion suggest that there was an intense circulation of DENV in 2012 and this may have resulted in a significant risk for viral associated illness. Findings of our study further indicated that home-based interventions, such as removing indoor potted plants and increased bed net use, in addition to vector control measures in public parks, would reduce exposure to DENV and further decrease risk of viral associated disease.

Non-communicable disease (NCD) risk factors and diabetes among adults living in slum areas of Dhaka, Bangladesh.

PubMed

Rawal, Lal B; Biswas, Tuhin; Khandker, Nusrat Nausheen; Saha, Shekhar Ranjan; Bidat Chowdhury, Mohammed Mahiul; Khan, Abdullah Nurus Salam; Chowdhury, Enamul Hasib; Renzaho, Andre

2017-01-01

Despite one-third of the urban population in Bangladesh living in urban slums and at increased risk of non-communicable diseases (NCDs), little is known about the NCD risk profile of this at-risk population. The aim of the study was to identify the prevalence of the NCD risk factors and the association of NCD risk factors with socio-demographic factors among the adults of urban slums in Dhaka, Bangladesh. A cross-sectional study was conducted among adult slum dwellers (aged 25 and above) residing in three purposively selected urban slums of Dhaka for at least six months preceding the survey. The risk factors assessed were- currently smoking, fruit and vegetable intake, physical activity, hypertension and body mass index (BMI). Information on self-reported diabetes was also taken. A total of 507 participants (252 females; 49.7%) were interviewed and their physical measures were taken using the WHO NCD STEPS instrument. The overall prevalence of NCD risk factors was: 36.0% (95% CI: 31.82-40.41) for smoking; 95.60% (95% CI: 93.60-97.40) for insufficient fruit and vegetable intake; 15.30% (95% CI:12.12-18.71) for low physical activity;13.70% (95% CI: 10.71-16.92) for hypertension; 22.70% (95% CI: 19.31-26.02) for overweight or obesity; and 5.00% (95%: 3.20-7.00) for self-reported diabetes. In the logistic regression model, the clustering of three or more NCD risk factors was positively associated with younger age groups (p = 0.02), no formal education (p <0.001) and primary education level (p = 0.01), but did not differ by sex of the participants, monthly income and occupation. All NCD risk factors are markedly high among the urban slum adults. These findings are important to support the formulation and implementation of NCD-related polices and plan of actions that recognize urban slum populations in Bangladesh as a priority sub-population.

NASA/NOAA implementation of the USAID-sponsored satellite ground station and data processing facility for Bangladesh

NASA Technical Reports Server (NTRS)

Dodge, J. C.; Vermillion, C. H.

1983-01-01

A description is given of a project to transfer multiple environmental satellite data reception, processing, and interpretation capabilities from the U.S. to Bangladesh. The goal of the project is to improve the management of resources related primarily to agriculture, water development, forestry, and fisheries. It is also hoped to improve the existing cyclone/storm surge warning system. An account is given of the interagency and international cooperation underlying the project. The remote-sensing installation in Dhaka, Bangladesh, is described, and the most likely system applications are summarized. Attention is also given to the special requirements concerning this type of technology transfer, and an assessment is made of the project's practical value to Bangladesh.

A Differential Effect of Indian Ocean Dipole and El Niño on Cholera Dynamics in Bangladesh

PubMed Central

Hashizume, Masahiro; Chaves, Luis Fernando; Faruque, A. S. G.; Yunus, Md; Streatfield, Kim; Moji, Kazuhiko

2013-01-01

Background A stationary (i.e., constant through time) association between El Niño Southern Oscillation (ENSO), the Indian Ocean Dipole (IOD) and epidemics of cholera in Bangladesh has been widely assumed. However, whether or not elements of the local climate that are relevant for cholera transmission have stationary signatures of the IOD on their dynamics over different time scales is still not clear. Here we report results on the time-varying relationships between the various remote and local environmental drivers and cholera incidence in Bangladesh. Methodology/Principal Findings We performed a cross wavelet coherency analysis to examine patterns of association between monthly cholera cases in the hospitals in Dhaka and Matlab (1983–2008) and indices for both IOD and ENSO. Our results showed that the strength of both the IOD and ENSO associations with cholera hospitalizations changed across time scales during the study period. In Dhaka, 4-year long coherent cycles were observed between cholera and the index of IOD in 1988–1997. In Matlab, the effect of ENSO was more dominant while there was no evidence for an IOD effect on cholera hospitalizations. Conclusions/Significance Our results call for the consideration of non-stationary, possibly non-linear, patterns of association between cholera hospitalizations and climatic factors in cholera epidemic early warning systems. PMID:23555861

Understanding the Broader Sexual and Reproductive Health Needs of Female Sex Workers in Dhaka, Bangladesh.

PubMed

Katz, Karen R; McDowell, Misti; Green, Mackenzie; Jahan, Shamim; Johnson, Laura; Chen, Mario

2015-12-01

Little is known about the sexual and reproductive health care needs of female sex workers in Dhaka, Bangladesh. Survey data were collected from 354 hotel-based and 323 street-based female sex workers using a venue-based stratified cluster sampling approach. In addition, in-depth interviews were conducted with 20 female sex workers recruited from drop-in centers. We calculated unmet need for family planning and examined fertility desires, use of condoms and other contraceptive methods, experiences with gender-based violence, sexual and reproductive health service needs, and preferences on where to receive services. The prevalence of unmet need was 25% among hotel-based female sex workers and 36% among street-based female sex workers. Almost all participants reported having used condoms in the past 30 days, and 44% of hotel-based sex workers and 30% of street-based sex workers reported dual method use during that period. Condom use was inconsistent, however, and condom breakage and nonuse for extra money were common. Many women reported experiencing gender-based violence. Sexual and reproductive health services had been obtained by 64% of hotel-based and 89% of street-based sex workers in the past six months; drop-in centers were their preferred site for receiving health services. Female sex workers in Dhaka need family planning and other sexual and reproductive health services and prefer receiving them from drop-in centers.

Renewable energy and rural development activities experience in Bangladesh

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barua, D.C.

1997-12-01

The per capita per year fuel consumption in Bangladesh is only 56 kg oil equivalent. The supply of electricity by Bangladesh power development board (BPDB) and Dhaka electricity supply authority (DESA) is mainly confined to cities and towns. Rural Electrification Board (REB) distributes electricity to the rural people through cooperatives. The rural cooperatives cover only 10% of the total population. Only about 15% of the total population is directly connected to the electricity. In order to meet the increasing energy demand for development of agriculture and industry and for the generation of better employment opportunities, it will be necessary tomore » harness all the available alternative sources of energy immediately.« less

Fecal Contamination on Produce from Wholesale and Retail Food Markets in Dhaka, Bangladesh.

PubMed

Harris, Angela R; Islam, Mohammad Aminul; Unicomb, Leanne; Boehm, Alexandria B; Luby, Stephen; Davis, Jennifer; Pickering, Amy J

2018-01-01

Fresh produce items can become contaminated with enteric pathogens along the supply chain at the preharvest (e.g., irrigation water, soil, fertilizer) or postharvest (e.g., vendor handling or consumer handling) stages. This study assesses the concentrations of fecal indicator bacteria Escherichia coli , enterococci (ENT), and Bacteriodales on surfaces of carrots, eggplants, red amaranth leaves, and tomatoes obtained from both a wholesale market (recently harvested) and neighborhood retail markets in Dhaka, Bangladesh. We detected E. coli in 100% of carrot and red amaranth rinses, 92% of eggplant rinses, and 46% of tomato rinses. Using a molecular microbial source tracking assay, we found that 32% of produce samples were positive for ruminant fecal contamination. Fecal indicator bacteria were more likely to be detected on produce collected in retail markets compared with that in the wholesale market; retail market produce were 1.25 times more likely to have E. coli detected ( P = 0.03) and 1.24 times more likely to have ENT detected ( P = 0.03) as compared with wholesale market produce. Bacteriodales was detected in higher concentrations in retail market produce samples compared with wholesale market produce samples (0.40 log 10 gene copies per 100 cm 2 higher, P = 0.03). Our results suggest that ruminant and general fecal contamination of produce in markets in Dhaka is common, and suggest that unsanitary conditions in markets are an important source of produce fecal contamination postharvest.

Community perspectives on dengue transmission in the city of Dhaka, Bangladesh.

PubMed

Dhar-Chowdhury, Parnali; Emdad Haque, C; Michelle Driedger, S; Hossain, Shakhawat

2014-12-01

The recurrence of dengue has become a growing public health threat. This research examines the knowledge, beliefs, attitudes and practice of local community members regarding dengue transmission in the city of Dhaka, Bangladesh. It also investigates explanatory demographic and socioeconomic factors that affect community knowledge, beliefs and practices. In July-August 2011, a random sample of household heads or alternatives (n=300) was surveyed in 12 wards of Dhaka. This survey was supplemented by 12 focus group discussions (n=107) and 18 key informant interviews in three selected wards. Most community members had heard about dengue (91.3%; 274/300) and knew (93.7%; 281/300) that mosquitoes act as the primary vector of its transmission. In contrast, most (87.3%; 262/300) was unaware that Aedes mosquitoes prefer to lay their eggs in water containers. Multivariate logistic regression modeling revealed that the respondents in age group 45-60 years were 2.83 times more likely to have positive attitudes towards undertaking precautionary measures to prevent dengue than the respondents aged <25 years. These findings confirm the presence in local communities of misconceptions and considerable knowledge gaps about dengue transmission that could be improved by formulating interventions targeting specific subgroups of the population. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Acceptability of the rainwater harvesting system to the slum dwellers of Dhaka City.

PubMed

Islam, M M; Chou, F N-F; Kabir, M R

2010-01-01

Urban area like Dhaka City, in Bangladesh, has scarcity of safe drinking water which is one of the prominent basic needs for human kind. This study explored the acceptability of harvested rainwater in a densely populated city like Dhaka, using a simple and low cost technology. A total of 200 random people from four slums of water-scarce Dhaka City were surveyed to determine the dwellers' perception on rainwater and its acceptability as a source of drinking water. The questionnaire was aimed at finding the socio-economic condition and the information on family housing, sanitation, health, existing water supply condition, knowledge about rainwater, willingness to accept rainwater as a drinking source etc. A Yield before Spillage (YBS) model was developed to know the actual rainwater availability and storage conditions which were used to justify the effective tank size. Cost-benefit analysis and feasibility analysis were performed using the survey results and the research findings. The survey result and overall study found that the low cost rainwater harvesting technique was acceptable to the slum dwellers as only the potential alternative source of safe drinking water.

Changing Emergence of Shigella Sero-Groups in Bangladesh: Observation from Four Different Diarrheal Disease Hospitals

PubMed Central

Das, Sumon Kumar; Ahmed, Shahnawaz; Ferdous, Farzana; Farzana, Fahmida Dil; Chisti, Mohammod Jobayer; Leung, Daniel T.; Malek, Mohammad Abdul; Talukder, Kaisar Ali; Bardhan, Pradip Kumar; Salam, Mohammed Abdus; Faruque, Abu Syed Golam; Raqib, Rubhana

2013-01-01

Background Shigellosis continues to be a public health challenge for developing countries, including Bangladesh. The aim of the study is to demonstrate recent changes in Shigella sero-groups and their geographical diversity. Methods Data were extracted from data archive of four diarrheal disease surveillance systems. A 2% sub sample from urban Dhaka Hospital (2008–2011; n = 10,650), and 10% from urban Mirpur Treatment Centre (2009–2011; n = 3,585), were enrolled systematically; whereas, all patients coming from the Health and Demographic Surveillance System area in rural Matlab (2008–2011; n = 6,399) and rural Mirzapur (2010–2011; n = 2,812) were included irrespective of age, sex, and disease severity. A fresh stool specimen was collected for identification of Shigella spp. Of them, 315 (3%) were positive for Shigella in Dhaka, 490 (8%) from Matlab, 109 (3%) from Mirpur and 369 (13%) from Mirzapur and considered as analyzable sample size. Results Among all Shigella isolates regardless of age, significant decreases in percentage of S. flexneri over time was observed in Mirpur (55→29%; p value of χ2-for trend = 0.019) and Mirzapur (59→47%; p = 0.025). A non-significant decrease was also seen in Dhaka (58→48%), while in Matlab there was a non-significant increase (73→81%). Similar patterns were observed among under-5 children at all sites. Emergence of S. sonnei was found in Dhaka (8→25%; p<0.001) and Mirpur (10→33%; p = 0.015), whereas it decreased in Mirzapur (32→23%; p = 0.056). The emergence of S. boydii was seen in all ages in Mirzapur [(3→28%; p<0.001); (3→27%; p<0.001)]. On the other hand, we saw non-significant percent reductions in S. boydii in Dhaka [overall (25→16%); under-5 (16→9%)]. Decreasing rates of Shigella dysenteriae were observed in Matlab, Mirpur and Mirzapur; whereas, in Dhaka it remained unchanged. Conclusion and Significance Emergence of S. sonnei and S. boydii as important infectious diarrhea etiologies and variations in geographical diversity underscore the need for monitoring, with possible implications for vaccine development. PMID:23658619

HIV and AIDS in Bangladesh

PubMed Central

Azim, Tasnim; Khan, Sharful Islam; Haseen, Fariha; Huq, Nafisa Lira; Henning, Lars; Pervez, Md. Moshtaq; Chowdhury, Mahbub Elahi; Sarafian, Isabelle

2008-01-01

Bangladesh initiated an early response to the HIV epidemic starting in the mid-1980s. Since then, the res-ponse has been enhanced considerably, and many HIV-prevention interventions among the most at-risk populations and the general youth are being undertaken. Alongside prevention activities, gathering of data has been a key activity fostered by both the Government and individual development partners. This paper reviews available sources of data, including routine surveillance (HIV and behavioural among most at-risk populations), general population surveys, and various research studies with the aim to understand the dynamics of the HIV epidemic in Bangladesh. Available data show that the HIV epidemic is still at relatively low levels and is concentrated mainly among injecting drug users (IDUs) in Dhaka city. In addition, when the passively-reported cases were analyzed, another population group that appears to be especially vulnerable is migrant workers who leave their families and travel abroad for work. However, all sources of data confirm that risk behaviours that make individuals vulnerable to HIV are high—this is apparent within most at-risk populations and the general population (adult males and youth males and females). Based on the current activities and the sources of data, modelling exercises of the future of the HIV epidemic in Dhaka suggest that, if interventions are not enhanced further, Bangladesh is likely to start with an IDU-driven epidemic, similar to other neighbouring countries, which will then move to other population groups, including sex workers, males who have sex with males, clients of sex workers, and ultimately their families. This review reiterates the often repeated message that if Bangladesh wants to be an example of how to avert an HIV epidemic, it needs to act now using evidence-based programming. PMID:18831227

Aerosol Optical Depth (AOD) Trends Over Bangladesh

NASA Astrophysics Data System (ADS)

Salam, A.

2016-12-01

An important omission in the Southeast Asian observing network is the border region with the Indian subcontinent. Significant amounts of pollution are generated and transported down the Indo-Gangenic Plain into the Bay of Bengal. High population density in a semi-arid region leads to the development of a complex mixture of absorbing pollution coupled with dust. Transport patterns of this mixture takes pollutants into Bangladesh, where more pollution is added to the atmosphere-leading to what is one of the highest non urban emission loading in the world (AOD500= 0.75 during the premonsoon season). Bangladesh is essentially a riverine country, and atmospheric outflow is over delta regions fed by over 500 rivers, including the Ganges, Bramaputra, Jamuna, and Padma systems forming the massive Meghna river. This combination of atmospheric and riverine components makes for an optically complex littoral region which challenges a host of environmental sensors and modeling systems. Data is needed to understand the sources, transport and optical characteristics of aerosol particles in the region. Dhaka (23.8103° N, 90.4125° E) is the capital of Bangladesh with a population of about 16 million. It has been growing rapidly with all the problem of a mega city. We have installed a sun photometer with NASA Aeronet project at the roof of the Chemistry Department, Dhaka University with other aerosol particles and gas measuring instruments. Bhola is an Island of the Bay of Bengal. It is surrounded by the Meghna River on the north and east, the Tatulia River on the west and the Bay of Bengal on the south. The observatory is located at Charfashion Bazar, Bhola (N 22o10´01″, E 90o45´00″, 3m asl). There is very little influence from traffic and industrial emissions. A Cimel sunphotometer (NASA AERONET) was installed for AOD measurements at this locations since 2013. Aerosol optical depth (AOD) trends between 2012 and 2016 at two different locations (Dhaka and Bhola) will be presented including seasonal variations. Size distribution, single scattering albedo (SSA) and other physical properties of the aerosol particles will also be presented There is a good correlation between black carbon (BC) and brown carbon (BrC) derived from sun photometer AOD (870 and 380nm) and Aethalometer based BC and BrC measurements.

Fighting poverty: the economic adjustment of female migrants in Dhaka.

PubMed

Huq-hussain, S

1995-10-01

Data from a field survey of slum and squatter settlements in Dhaka, Bangladesh, are used to examine the social adjustment of poor, female migrants to work, occupational choice, work satisfaction, income, control over income, and women's role in the family economy. A "poor household," defined in terms of nutritional intake, included those families receiving under 2122 cal/person/day. 44% of the urban population in Bangladesh do not obtain the daily nutritional requirement. Findings indicate that 61% of all female migrants expected to find work on arrival in the city. 44% of female migrants were willing to take any kind of work available at the time of arrival. Over 66% of all females found work in less than 6 months. Almost 25% took 6 months to a year to find a job, and 15% found work after a year's time. Recent migrants, who were older, found work quicker. 16% of female migrants found their job with help from relatives and friends (23% of recent migrants and 14% of long-term migrants). Among female migrants who sought a job on their own, 14% found work within 6 months. 3% found work between 6 months and a year. The rest were engaged in family and home-based work or found a job much later. In Dhaka, most women migrants worked in the service or informal sector. 40% of the sample worked as domestics, 38% worked in the informal sector, 16% worked in other informal work, and 5% worked in export-based garment industries. Most female migrants lived in the British Dhaka zone and the post-British Dhaka zone. Those living in the Mughal Dhaka zone tended to work in home-based informal activities. Garment industry workers tended to have more education. Women in the informal sector did not receive cash income. Just over 33% received income in kind, about 25% received a low income, and another 25% received a moderate income. In 71% of cases, husbands or fathers handled the money. 29% handled income on their own. Their own earnings went mostly for survival needs. Over 70% changed jobs more than once. 44% were satisfied with their work. Women were unhappy with low wages, tiring and hard work, and long working hours.

Dengue Disease Risk Mental Models in the City of Dhaka, Bangladesh: Juxtapositions and Gaps Between the Public and Experts.

PubMed

Dhar-Chowdhury, Parnali; Haque, C Emdad; Driedger, S Michelle

2016-05-01

Worldwide, more than 50 million cases of dengue fever are reported every year in at least 124 countries, and it is estimated that approximately 2.5 billion people are at risk for dengue infection. In Bangladesh, the recurrence of dengue has become a growing public health threat. Notably, knowledge and perceptions of dengue disease risk, particularly among the public, are not well understood. Recognizing the importance of assessing risk perception, we adopted a comparative approach to examine a generic methodology to assess diverse sets of beliefs related to dengue disease risk. Our study mapped existing knowledge structures regarding the risk associated with dengue virus, its vector (Aedes mosquitoes), water container use, and human activities in the city of Dhaka, Bangladesh. "Public mental models" were developed from interviews and focus group discussions with diverse community groups; "expert mental models" were formulated based on open-ended discussions with experts in the pertinent fields. A comparative assessment of the public's and experts' knowledge and perception of dengue disease risk has revealed significant gaps in the perception of: (a) disease risk indicators and measurements; (b) disease severity; (c) control of disease spread; and (d) the institutions responsible for intervention. This assessment further identifies misconceptions in public perception regarding: (a) causes of dengue disease; (b) dengue disease symptoms; (c) dengue disease severity; (d) dengue vector ecology; and (e) dengue disease transmission. Based on these results, recommendations are put forward for improving communication of dengue risk and practicing local community engagement and knowledge enhancement in Bangladesh. © 2015 Society for Risk Analysis.

Trends in Water Level and Flooding in Dhaka, Bangladesh and Their Impact on Mortality

PubMed Central

Thiele-Eich, Insa; Burkart, Katrin; Simmer, Clemens

2015-01-01

Climate change is expected to impact flooding in many highly populated coastal regions, including Dhaka (Bangladesh), which is currently among the fastest growing cities in the world. In the past, high mortality counts have been associated with extreme flood events. We first analyzed daily water levels of the past 100 years in order to detect potential shifts in extremes. A distributed lag non-linear model was then used to examine the connection between water levels and mortality. Results indicate that for the period of 2003–2007, which entails two major flood events in 2004 and 2007, high water levels do not lead to a significant increase in relative mortality, which indicates a good level of adaptation and capacity to cope with flooding. However, following low water levels, an increase in mortality could be found. As our trend analysis of past water levels shows that minimum water levels have decreased during the past 100 years, action should be taken to ensure that the exposed population is also well-adapted to drought. PMID:25648177

Chemical speciation of trace metals in the industrial sludge of Dhaka City, Bangladesh.

PubMed

Islam, Md Saiful; Al-Mamun, Md Habibullah; Feng, Ye; Tokumura, Masahiro; Masunaga, Shigeki

2017-07-01

The objective of this study was to assess total concentration and chemical fractionation of trace metals in the industrial wastewater and sludge collected from seven different types of industries in Dhaka City, Bangladesh. The sludge from industries is either dumped on landfills or reused as secondary resources in order to preserve natural resources. Metals were analyzed using inductively coupled plasma mass spectrometry (ICP-MS). The ranges of Cr, Ni, Cu, As, Cd, and Pb in the sludges were 1.4-9,470, 4.8-994, 12.8-444, 2.2-224, 1.9-46.0 and 1.3-87.0 mg/kg, respectively. As a whole, the average concentrations of trace metals in samples were in the decreasing order of Cr > Ni > Cu > As > Pb > Cd. The results of the Community Bureau of Reference (BCR) sequential extraction showed that the studied metals were predominantly associated with the residual fraction followed by the oxidizable fraction. The study revealed that the mobile fractions of trace metals are poorly predictable from the total content, and bioavailability of all fractions of elements tends to decrease.

A cluster randomized controlled trial to assess the impact of SAFE on spousal violence against women and girls in slums of Dhaka, Bangladesh.

PubMed

Naved, Ruchira Tabassum; Mamun, Mahfuz Al; Mourin, Sanjida Akhter; Parvin, Kausar

2018-01-01

Bangladesh reports one of the highest rates of intimate partner violence (IPV) in the world. Despite wide recognition of IPV as an important public health and human rights issue, evidence for IPV prevention is still inadequate. Lack of guidance on effective IPV prevention in Bangladesh resulted in targeting only women in most of the programmes. This paper assesses impact of SAFE, a 20-month intervention (March 2012 to October 2013) in slums of Dhaka on IPV and tests effectiveness of female only groups vs. no groups; and female + male groups vs. female only groups on IPV in the community using a three-arm cluster randomized controlled trial. SAFE's core activities included interactive group sessions, community mobilisation, and services. The last two activities were common across arms. Regression analyses (female survey: baseline n = 2,666; endline n = 2,670) showed no effect of SAFE on IPV against women aged 15-29. However, sub-group analyses demonstrated 21% risk reduction of physical IPV against adolescent girls aged 15-19 in the female + male group intervention arm. A consistent reduction in sexual violence was observed in both female and female + male arms for both groups of women, but the results were not statistically significant. The findings emphasise the importance of combining male and female interventions for reducing physical IPV against adolescent girls. Implications for future research have been discussed.

Work stress: its components and its association with self-reported health outcomes in a garment factory in Bangladesh-Findings from a cross-sectional study.

PubMed

Steinisch, Maria; Yusuf, Rita; Li, Jian; Rahman, Omar; Ashraf, Hasan M; Strümpell, Christian; Fischer, Joachim E; Loerbroks, Adrian

2013-11-01

Bangladesh is one of the leading exporters of ready-made garments (RMG) worldwide producing at very low cost almost exclusively for Western markets. Empirical evidence on psychologically adverse working conditions and their association with health in the RMG setting remains sparse. Drawing on insights from previous ethnographic research, we conducted a cross-sectional epidemiological study among 332 RMG workers in Dhaka, Bangladesh. High work-related demands and poor interpersonal resources represented key components of work stress and were important determinants of poor health. The key work stress components observed in this study partly differed from those identified in Western work place settings. © 2013 The Authors. Published by Elsevier Ltd. All rights reserved.

Groundwater arsenic contamination in Bangladesh-21 Years of research.

PubMed

Chakraborti, Dipankar; Rahman, Mohammad Mahmudur; Mukherjee, Amitava; Alauddin, Mohammad; Hassan, Manzurul; Dutta, Rathindra Nath; Pati, Shymapada; Mukherjee, Subhash Chandra; Roy, Shibtosh; Quamruzzman, Quazi; Rahman, Mahmuder; Morshed, Salim; Islam, Tanzima; Sorif, Shaharir; Selim, Md; Islam, Md Razaul; Hossain, Md Monower

2015-01-01

Department of Public Health Engineering (DPHE), Bangladesh first identified their groundwater arsenic contamination in 1993. But before the international arsenic conference in Dhaka in February 1998, the problem was not widely accepted. Even in the international arsenic conference in West-Bengal, India in February, 1995, representatives of international agencies in Bangladesh and Bangladesh government attended the conference but they denied the groundwater arsenic contamination in Bangladesh. School of Environmental Studies (SOES), Jadavpur University, Kolkata, India first identified arsenic patient in Bangladesh in 1992 and informed WHO, UNICEF of Bangladesh and Govt. of Bangladesh from April 1994 to August 1995. British Geological Survey (BGS) dug hand tube-wells in Bangladesh in 1980s and early 1990s but they did not test the water for arsenic. Again BGS came back to Bangladesh in 1992 to assess the quality of the water of the tube-wells they installed but they still did not test for arsenic when groundwater arsenic contamination and its health effects in West Bengal in Bengal delta was already published in WHO Bulletin in 1988. From December 1996, SOES in collaboration with Dhaka Community Hospital (DCH), Bangladesh started analyzing hand tube-wells for arsenic from all 64 districts in four geomorphologic regions of Bangladesh. So far over 54,000 tube-well water samples had been analyzed by flow injection hydride generation atomic absorption spectrometry (FI-HG-AAS). From SOES water analysis data at present we could assess status of arsenic groundwater contamination in four geo-morphological regions of Bangladesh and location of possible arsenic safe groundwater. SOES and DCH also made some preliminary work with their medical team to identify patients suffering from arsenic related diseases. SOES further analyzed few thousands biological samples (hair, nail, urine and skin scales) and foodstuffs for arsenic to know arsenic body burden and people sub-clinically affected. SOES and DCH made a few follow-up studies in some districts to know their overall situations after 9 to 18 years of their first exposure. The overall conclusion from these follow-up studies is (a) villagers are now more aware about the danger of drinking arsenic contaminated water (b) villagers are currently drinking less arsenic contaminated water (c) many villagers in affected village died of cancer (d) arsenic contaminated water is in use for agricultural irrigation and arsenic exposure from food chain could be future danger. Since at present more information is coming about health effects from low arsenic exposure, Bangladesh Government should immediately focus on their huge surface water management and reduce their permissible limit of arsenic in drinking water. Copyright © 2015 Elsevier GmbH. All rights reserved.

Microneurosurgical management of temporal lobe epilepsy by amygdalohippocampectomy (AH) plus standard anterior temporal lobectomy (ATL): a report of our initial five cases in Bangladesh

PubMed Central

Chowdhury, F H; Haque, M R; Islam, M S; Sarker, MH; Kawsar, KA; Sarker, AC

2010-01-01

Patient presenting as a case of Temporal Lobe Epilepsy (TLE) are usually resistant to antiepileptic drugs and surgery is the treatment of choice. This type of epilepsy may be due to Mesial Temporal Sclerosis (MTS), tumors [i.e. low grade glioma, Arterio-Venous Malformation (AVM) etc], trauma, infection (Tuberculosis) etc. Here we report five cases of surgically treated TLE that were due to a MTS, MTS with arachnoid cyst, low grade ganglioglioma, high grade ganglioglioma and a tuberculoma in the department of neurosurgery, Dhaka Medical College Hospital and Islami Bank Central Hospital, Dhaka, Bangladesh from August 2009 to February 2010. In all cases the only presenting symptoms was complex partial seizures (psychomotor epilepsy) for which all underwent scalp EEG (Electro Encephalogram) and MRI (Magnetic Resonance Imaging) of Brain. All patients were managed by amygdalohippocampectomy plus standard anterior lobectomy. One patient with high grade ganglioglioma recurred within two months of operation and expired within five months. The rest of the cases are seizure and disease free till the last follow up. PMID:22028754

Quantitative assessment of medical waste generation in the capital city of Bangladesh

DOE Office of Scientific and Technical Information (OSTI.GOV)

Patwary, Masum A.; O'Hare, William Thomas; Street, Graham

2009-08-15

There is a concern that mismanagement of medical waste in developing countries may be a significant risk factor for disease transmission. Quantitative estimation of medical waste generation is needed to estimate the potential risk and as a basis for any waste management plan. Dhaka City, the capital of Bangladesh, is an example of a major city in a developing country where there has been no rigorous estimation of medical waste generation based upon a thorough scientific study. These estimates were obtained by stringent weighing of waste in a carefully chosen, representative, sample of HCEs, including non-residential diagnostic centres. This studymore » used a statistically designed sampling of waste generation in a broad range of Health Care Establishments (HCEs) to indicate that the amount of waste produced in Dhaka can be estimated to be 37 {+-} 5 ton per day. The proportion of this waste that would be classified as hazardous waste by World Health Organisation (WHO) guidelines was found to be approximately 21%. The amount of waste, and the proportion of hazardous waste, was found to vary significantly with the size and type of HCE.« less

Perceived effectiveness of text and pictorial health warnings for smokeless tobacco packages in Navi Mumbai, India, and Dhaka, Bangladesh: findings from an experimental study.

PubMed

Mutti, Seema; Reid, Jessica L; Gupta, Prakash C; Pednekar, Mangesh S; Dhumal, Gauri; Nargis, Nigar; Hussain, Akm Ghulam; Hammond, David

2016-07-01

To examine the perceived effectiveness of text and pictorial smokeless tobacco health warnings in India and Bangladesh, including different types of message content. An experimental study was conducted in Navi Mumbai, India (n=1002), and Dhaka, Bangladesh (n=1081). Face-to-face interviews were conducted on tablets with adult (≥19 years) smokeless tobacco users and youth (16-18 years) users and non-users. Respondents viewed warnings depicting five health effects, within one of the four randomly assigned warning label conditions (or message themes): (1) text-only, (2) symbolic pictorial, (3) graphic pictorial or (4) personal testimonial pictorial messages. Text-only warnings were perceived as less effective than all of the pictorial styles (p<0.001 for all). Graphic warnings were given higher effectiveness ratings than symbolic or testimonial warnings (p<0.001). No differences were observed in levels of agreement with negative attitudes and beliefs across message themes, after respondents had viewed warnings. Pictorial warnings are more effective than text-only messages. Pictorial warnings depicting graphic health effects may have the greatest impact, consistent with research from high-income countries on cigarette warnings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Monitoring of metal pollution in waterways across Bangladesh and ecological and public health implications of pollution.

PubMed

Kibria, Golam; Hossain, Md Maruf; Mallick, Debbrota; Lau, T C; Wu, Rudolf

2016-12-01

Using innovative artificial mussels technology for the first time, this study detected eight heavy metals (Cd, Cu, Fe, Mn, Ni, Pb, U, Zn) on a regular basis in waterways across Bangladesh (Chittagong, Dhaka and Khulna). Three heavy metals, viz. Co, Cr and Hg were always below the instrumental detection levels in all the sites during the study period. Through this study, seven metal pollution "hot spots" have been identified, of which, five "hot spots" (Cu, Fe, Mn, Ni, Pb) were located in the Buriganga River, close to the capital Dhaka. Based on this study, the Buriganga River can be classified as the most polluted waterway in Bangladesh compared to waterways monitored in Khulna and Chittagong. Direct effluents discharged from tanneries, textiles are, most likely, reasons for elevated concentrations of heavy metals in the Buriganga River. In other areas (Khulna), agriculture and fish farming effluents may have caused higher Cu, U and Zn in the Bhairab and Rupsa Rivers, whereas untreated industrial discharge and ship breaking activities can be linked to elevated Cd in the coastal sites (Chittagong). Metal pollution may cause significant impacts on water quality (irrigation, drinking), aquatic biodiversity (lethal and sub-lethal effects), food contamination/food security (bioaccumulation of metals in crops and seafood), human health (diseases) and livelihoods of people associated with wetlands. Copyright © 2016 Elsevier Ltd. All rights reserved.

Sexually Transmitted Infections and Associated Risk Factors Among Street-Based and Residence-Based Female Sex Workers in Dhaka, Bangladesh.

PubMed

Khanam, Rasheda; Reza, Masud; Ahmed, Dilruba; Rahman, Mustafizur; Alam, M Shah; Sultana, Salima; Alam, Anadil; Khan, Sharful I; Mayer, Kenneth H; Azim, Tasnim

2017-01-01

Female sex workers (FSWs) in Bangladesh remain at elevated risk of sexually transmitted infections (STIs) although the human immunodeficiency virus (HIV) prevalence among them is low. Recent information on the burden and etiological diagnosis of STIs among them has been lacking. This study examines prevalence and risk behaviors of selected STIs among FSWs in Dhaka in 2014. Between August and October 2014, a cross-sectional study was conducted among street-based and residence-based FSWs receiving HIV prevention services at 24 drop in centers in Dhaka. Participants underwent behavioral interview, clinical examination, and laboratory testing for selected STIs using cervical swabs and blood. The sample consisted of 371 streets and 329 residence FSWs. Prevalence of gonorrhea, chlamydia, and active syphilis were 5.1%, 4.6%, 1.3% in street FSWs and were 5.8%, 8.2%, and 0.6% for residence FSWs which are lower compared with the previously reported rates. The following factors were associated with having any STI: being ≤5 years in sex trade (odds ratio, 2.2; 95% confidence interval, 1.2-3.9; P < 0.01), and having a cervical discharge (odds ratio, 2.6, 95% confidence interval, 1.5-4.6; P < 0.01). Resistance to cefixime and azithromycin was observed for 1 and 3 Neisseria gonorrhoeae strains, respectively. Despite receiving HIV/STI prevention services, bacterial STIs remain prevalent among FSWs suggesting the need for more effective management of STIs. The guidelines for management of STIs need revision in view of the emerging resistance.

Chlorination of Household Drinking Water among Cholera Patients' Households to Prevent Transmission of Toxigenic Vibrio cholerae in Dhaka, Bangladesh: CHoBI7 Trial

PubMed Central

Rashid, Mahamud-ur; George, Christine Marie; Monira, Shirajum; Mahmud, Toslim; Rahman, Zillur; Mustafiz, Munshi; Saif-Ur-Rahman, K. M.; Parvin, Tahmina; Bhuyian, Sazzadul Islam; Zohura, Fatema; Begum, Farzana; Biswas, Shwapon Kumar; Akhter, Shamima; Zhang, Xiaotong; Sack, David; Sack, R. Bradley; Alam, Munirul

2016-01-01

Household members of cholera patients are at a 100 times higher risk of cholera infections than the general population because of shared contaminated drinking water sources and secondary transmission through poor household hygiene practices. In this study, we investigated the bactericidal concentration of free chlorine required to inactivate Vibrio cholerae in household drinking water in Dhaka, Bangladesh. In laboratory experiments, we found that the concentrations of free chlorine required to inactivate 105 colony-forming units (CFU)/mL of V. cholerae serogroups O1 and O139 were 0.1 mg/L and 0.2 mg/L, respectively. The concentration of free chlorine generated by a single chlorine tablet (sodium dichloroisocyanurate [33 mg]) after a 30-minute reaction time in a 10-L sealed vessel containing Dhaka city municipal supply water was 1.8 mg/L; and the concentration declined to 0.26 mg/L after 24 hours. In field measurements, water collected from 165 households enrolled in a randomized controlled trial (RCT) of a chlorine and handwashing with soap intervention (Cholera-Hospital-Based-Intervention-for-7-Days[CHoBI7]), we observed significantly higher free chlorine concentrations in the 82 intervention arm households (mean = 1.12 mg/L, standard deviation [SD] = 0.52, range = 0.07–2.6 mg/L) compared with the 83 control households (0.017 mg/L, SD = 0.01, range = 0–0.06 mg/L) (P < 0.001) during spot check visits. These findings suggest that point-of-use chlorine tablets present an effective approach to inactivate V. cholerae from drinking water in households of cholera patients in Dhaka city. This result is consistent with the findings from the RCT of CHoBI7 which found that this intervention led to a significant reduction in symptomatic cholera infections among household members of cholera patients and no stored drinking water samples with detectable V. cholerae. PMID:27698273

Water, climate change and society in Bangladesh

NASA Astrophysics Data System (ADS)

Thiele-Eich, I.; Simmer, C.

2017-12-01

Dhaka, the capital of Bangladesh with a population of over 17 million people, is among the top five coastal cities most vulnerable to climate change, with over 30 % of the population living in slums. Effective disaster mitigation and adaptation requires an understanding how hazards such as flooding impact the population. The impacts of climate change on flooding and thus livelihoods in the complex delta of the Ganges-Brahmaputra-Meghna rivers can not be treated isolated from other anthropogenic impacts due to e.g. the construction of dams as well as a growing population. We illustrate this by setting up a conceptual socio-hydrological causal network using the enhanced Driving force - Pressure - State - Impact - Response framework. The constructed socio-hydrological framework includes both natural and anthropogenic processes and their two-way feedbacks, allowing policy makers to know where available resources can be used effectively to increase resilience and reduce vulnerability. We conclude that climate change takes place over long stretches of time and thus enable the population of Bangladesh to adapt slowly. Resources such as social capital, which is one of the main tools for slum dwellers to be able to cope with flooding can be altered over time, and as such the system can be considered overall stable and resilient. However, transboundary water sharing issues during the dry season and other implications resulting from dam structures such as Farakka Barrage complicate a prognosis on how the rapidly growing population will be affected in the 21st century. This is particularly important in connection with previous findings, which suggest that the Greater Dhaka population already experience a significant increase in mortality during droughts. Climate change can thus be seen as an anthropogenic amplification of the socio-hydrological challenges already faced by Bangladesh today.

Modernization of the migrant women in Dhaka, Bangladesh: analysis of some demographic variables.

PubMed

Huq-hussain, S

1995-04-01

This study examines demographic factors as signs of change among female rural migrants who settled in the slums of Dhaka, Bangladesh, in 1988. Data are obtained from structured and open-ended interviews among 399 migrant women working in selected clusters of Dhaka in 1988. Short-term migrants lived in Dhaka city for 6 months to 5 years. Long-term migrants lived longer than 5 years in Dhaka city. Findings indicate that 81% of all migrant families were nuclear, 18% were joint, and only 1% were extended. A greater proportion of recent migrants had nuclear families (89%) compared to long-term migrants (78%). 90% of recent migrants and 81% of long-term migrants favored nuclear families. Migrant women indicated that small nuclear families were preferred due to economic hardship and the shortage of housing. Interpersonal quarrels were another reason for their preference for nuclear families. Women who desired joint families found their domestic burdens relieved with more people to share responsibilities. 17% of all migrant households were headed by women (15% among recent migrants and 18% among long-term migrants). Female heads reported that their family structure was due to the death of or divorce from their spouse and the preference of independence from family dependency. 43% of families had 4 members, 36% had 5-7 members, and 21% had over 7 members. 52% of recent migrants and 40% of long-term migrants had small families under 4 members. 39% of long-term migrants and 26% of recent migrants had families with 5-7 members. Recent female migrants were characterized as primarily aged 11-30 years compared to long-term female migrants who were aged mainly under 10 years. A distinctive feature of marriage among migrant women was the larger proportion of women marrying at early ages. 43% were married at ages 11-14 years. 29% of recent migrants and only 11% of long-term migrants supported early age at marriage, but over 50% supported a marriage age of 18-20 years. It is argued that the long-term migrants support for lower fertility and modern values was an adjustment to urban life.

Development of liquid larval diet with modified rearing system for Bactrocera dorsalis (Hendel) (Diptera:Tephritidae) for the application of sterile insect technique

USDA-ARS?s Scientific Manuscript database

A liquid larval diet and its rearing system have been developed for mass rearing of Bactrocera dorsalis (Hendel) in Hawaii. Rearing facility in Institute of Food and Radiation Biology, Atomic Energy Research Establishment, Dhaka, Bangladesh, modified protein source from brewer's yeast to a combinat...

Prevalence and Determinants of Chronic Malnutrition among Preschool Children: A Cross-sectional Study in Dhaka City, Bangladesh

PubMed Central

Jesmin, Aklima; Yamamoto, Shelby Suzanne; Malik, Ahmad Azam

2011-01-01

Chronic malnutrition is one of the major causes of morbidity and mortality among preschool children and the future productivity of nations. To understand the prevalence of chronic malnutrition and to identify the factors affecting height-for-age z-score (HAZ) among preschool children, a cross-sectional study was conducted among 380 randomly-selected children aged less than five years in Dhaka city, Bangladesh. Results of analysis of this study data revealed that the prevalence of stunting among preschool children in Dhaka city was 39.5%, with 25% severely stunted and 14% moderately stunted (p<0.001). Results of bivariate analysis revealed that socioeconomic and demographic factors were most significantly associated with the stunting of children. Children were found to be well-nourished if their parents had a tertiary-level education or higher and if the mother held a job and had good knowledge of nutrition. Well-nourishment of the children were also associated with the height of mothers (above 148 cm), good family educational background, normal birthweight, greater frequency of food intake (more than six times/day), and fewer fever episodes in the last six months. Results of multivariate linear regression models showed that height of mothers, birthweight of children, education of fathers, knowledge of mothers on nutrition, and frequency of feeding were the most significant factors that had an independent and direct influence on the stunting of children. To achieve the Millennium Development Goal target of 34% malnutrition prevalence by 2015, it is important to have specific government intervention to focus on the causes that directly influence the stunting of children. PMID:22106755

Determinants of infant and young child feeding practices in Bangladesh: secondary data analysis of Demographic and Health Survey 2004.

PubMed

Mihrshahi, Seema; Kabir, Iqbal; Roy, S K; Agho, Kingsley E; Senarath, Upul; Dibley, Michael J

2010-06-01

In Bangladesh, poor infant and young child feeding practices are contributing to the burden of infectious diseases and malnutrition. Objective. To estimate the determinants of selected feeding practices and key indicators of breastfeeding and complementary feeding in Bangladesh. The sample included 2482 children aged 0 to 23 months from the Bangladesh Demographic and Health Survey of 2004. The World Health Organization (WHO)-recommended infant and young child feeding indicators were estimated, and selected feeding indicators were examined against a set of individual-, household-, and community-level variables using univariate and multivariate analyses. Only 27.5% of mothers initiated breastfeeding within the first hour after birth, 99.9% had ever breastfed their infants, 97.3% were currently breastfeeding, and 22.4% were currently bottle-feeding. Among infants under 6 months of age, 42.5% were exclusively breastfed, and among those aged 6 to 9 months, 62.3% received complementary foods in addition to breastmilk. Among the risk factors for an infant not being exclusively breastfed were higher socioeconomic status, higher maternal education, and living in the Dhaka region. Higher birth order and female sex were associated with increased rates of exclusive breastfeeding of infants under 6 months of age. The risk factors for bottle-feeding were similar and included having a partner with a higher educational level (OR = 2.17), older maternal age (OR for age > or = 35 years = 2.32), and being in the upper wealth quintiles (OR for the richest = 3.43). Urban mothers were at higher risk for not initiating breastfeeding within the first hour after birth (OR = 1.61). Those who made three to six visits to the antenatal clinic were at lower risk for not initiating breastfeeding within the first hour (OR = 0.61). The rate of initiating breastfeeding within the first hour was higher in mothers from richer households (OR = 0.37). Most breastfeeding indicators in Bangladesh were below acceptable levels. Breastfeeding promotion programs in Bangladesh need nationwide application because of the low rates of appropriate infant feeding indicators, but they should also target women who have the main risk factors, i.e., working mothers living in urban areas (particularly in Dhaka).

Diagnosis and management of febrile children using the WHO/UNICEF guidelines for IMCI in Dhaka, Bangladesh.

PubMed Central

Factor, S. H.; Schillinger, J. A.; Kalter, H. D.; Saha, S.; Begum, H.; Hossain, A.; Hossain, M.; Dewitt, V.; Hanif, M.; Khan, N.; Perkins, B.; Black, R. E.; Schwartz, B.

2001-01-01

OBJECTIVE: To determine whether the fever module in the WHO/UNICEF guidelines for the integrated management of childhood illness (IMCI) identifies children with bacterial infections in an area of low malaria prevalence. METHODS: Physicians assessed a systematic sample of 669 sick children aged 2-59 months who presented to the outpatient department of Dhaka Shishu Hospital, Bangladesh. FINDINGS: Had IMCI guidelines been used to evaluate the children, 78% of those with bacterial infections would have received antibiotics: the majority of children with meningitis (100%), pneumonia (95%), otitis media (95%) and urinary tract infection (83%); and 50% or less of children with bacteraemia (50%), dysentery (48%), and skin infections (30%). The current fever module identified only one additional case of meningitis. Children with bacteraemia were more likely to be febrile, feel hot, and have a history of fever than those with dysentery and skin infections. Fever combined with parental perception of fast breathing provided a more sensitive fever module for the detection of bacteraemia than the current IMCI module. CONCLUSIONS: In an area of low malaria prevalence, the IMCI guidelines provide antibiotics to the majority of children with bacterial infections, but improvements in the fever module are possible. PMID:11799441

Differences in Field Effectiveness and Adoption between a Novel Automated Chlorination System and Household Manual Chlorination of Drinking Water in Dhaka, Bangladesh: A Randomized Controlled Trial

PubMed Central

Pickering, Amy J.; Crider, Yoshika; Amin, Nuhu; Bauza, Valerie; Unicomb, Leanne; Davis, Jennifer; Luby, Stephen P.

2015-01-01

The number of people served by networked systems that supply intermittent and contaminated drinking water is increasing. In these settings, centralized water treatment is ineffective, while household-level water treatment technologies have not been brought to scale. This study compares a novel low-cost technology designed to passively (automatically) dispense chlorine at shared handpumps with a household-level intervention providing water disinfection tablets (Aquatab), safe water storage containers, and behavior promotion. Twenty compounds were enrolled in Dhaka, Bangladesh, and randomly assigned to one of three groups: passive chlorinator, Aquatabs, or control. Over a 10-month intervention period, the mean percentage of households whose stored drinking water had detectable total chlorine was 75% in compounds with access to the passive chlorinator, 72% in compounds receiving Aquatabs, and 6% in control compounds. Both interventions also significantly improved microbial water quality. Aquatabs usage fell by 50% after behavioral promotion visits concluded, suggesting intensive promotion is necessary for sustained uptake. The study findings suggest high potential for an automated decentralized water treatment system to increase consistent access to clean water in low-income urban communities. PMID:25734448

MICROBIAL CONTAMINATION OF STREET VENDED FOODS FROM A UNIVERSITY CAMPUS IN BANGLADESH.

PubMed

Islam, Sufia; Nasrin, Nishat; Rizwan, Farhana; Nahar, Lutfun; Bhowmik, Adity; Esha, Sayma Afrin; Talukder, Kaisar Ali; Akter, Mahmuda; Roy, Ajoy; Ahmed, Muniruddin

2015-05-01

The microbiological quality of street vended food samples from Dhaka, Bangladesh was evaluated. The objective of the study was to identify the presence of common pathogens (Escherichia coli, Shigella spp, Salmonella and Vibrio spp) and to describe the molecular characterization of E coli, a commonly found pathogen in various street foods. Fifty food samples were collected from fixed and mobile vendors from two sampling locations (Mohakhali and Aftabnagar) in Dhaka city, Bangladesh. The tested samples included deep fried and fried snacks; quick lunch items; pickles; fruit chutney; baked items; spicy, sour and hot snacks etc: Juices, tamarind water and plain drinking water were also tested. Sterile polythene bags were used for collecting 200 g of each category of samples. They were tested for the presence of microorganisms following conventional microbiological processes. Biochemical tests followed by serology were done for the confirmation of Shigella and Salmonella. Serological reaction was carried out for confirmation of Vibrio spp. DNA was isolated for the molecular characterization to detect the pathogenic E. coli by polymerase chain reaction (PCR). Out of 50 food samples, six (12%) were confirmed to contain different species of E. coli and Shigella. Molecular characterization of E. coli revealed that three samples were contaminated with enteroaggregative E. coli (EAEC) and one was contaminated with enterotoxigenic E. coli (ETEC). Shigellaflexneri X variant was detected in one food item and Shigella flexneri 2a was found in drinking water. All these enteric pathogens could be the potential cause for foodborne illnesses.

Evaluation of knowledge, practices, and possible barriers among healthcare providers regarding medical waste management in Dhaka, Bangladesh.

PubMed

Sarker, Mohammad Abul Bashar; Harun-Or-Rashid, Md; Hirosawa, Tomoya; Abdul Hai, Md Shaheen Bin; Siddique, Md Ruhul Furkan; Sakamoto, Junichi; Hamajima, Nobuyuki

2014-12-09

Improper handling of medical wastes, which is common in Bangladesh, could adversely affect the hospital environment and community at large, and poses a serious threat to public health. We aimed to assess the knowledge and practices regarding medical waste management (MWM) among healthcare providers (HCPs) and to identify possible barriers related to it. A cross-sectional study was carried out during June to September, 2012 including 1 tertiary, 3 secondary, and 3 primary level hospitals in Dhaka division, Bangladesh through 2-stage cluster sampling. Data were collected from 625 HCPs, including 245 medical doctors, 220 nurses, 44 technologists, and 116 cleaning staff who were directly involved in MWM using a self-administered (researcher-administered for cleaning staff), semi-structured questionnaire. Nearly one-third of medical doctors and nurses and two-thirds of technologists and cleaning staff had inadequate knowledge, and about half of medical doctors (44.0%) and cleaning staff (56.0%) had poor practices. HCPs without prior training on MWM were more likely to have poor practices compared to those who had training. Lack of personal protective equipment, equipment for final disposal, MWM-related staff, proper policy/guideline, and lack of incinerator were identified as the top 5 barriers. Strengthening and expansion of ongoing educational programs/training is necessary to improve knowledge and practices regarding MWM. The government should take necessary steps and provide financial support to eliminate the possible barriers related to proper MWM.

Extreme Environment Basing:Contingency Basing in Dense Urban and Megacity Environments

DTIC Science & Technology

2016-05-24

the placement of a U.S. military contingency base. As stated above, the consideration given to the volume of displaced people caused by the base camp...population density , Dhaka, Bangladesh ........................... 29 B-1 The base camp development planning process...urban areas are not incredibly dense, a great many are. These places represent the extreme end of the urban spectrum for population density and city

Housing Satisfaction Related to Health and Importance of Services in Urban Slums: Evidence from Dhaka, Bangladesh

ERIC Educational Resources Information Center

Zanuzdana, Arina; Khan, Mobarak; Kraemer, Alexander

2013-01-01

Quality of housing plays one of the key roles in a public health research, since inadequate housing may have direct or indirect negative impact on health. Higher satisfaction with housing was shown to be associated with higher income, higher age, a smaller family, higher education, being female and being an owner of a dwelling. The aim of our…

Trace metals accumulation in soil irrigated with polluted water and assessment of human health risk from vegetable consumption in Bangladesh.

PubMed

Islam, Md Atikul; Romić, Davor; Akber, Md Ali; Romić, Marija

2018-02-01

Trace metals accumulation in soil irrigated with polluted water and human health risk from vegetable consumption was assessed based on the data available in the literature on metals pollution of water, soil, sediment and vegetables from the cites of Bangladesh. The quantitative data on metal concentrations, their contamination levels and their pollution sources have not been systematically gathered and studied so far. The data on metal concentrations, sources, contamination levels, sample collection and analytical tools used were collected, compared and discussed. The USEPA-recommended method for health risk assessment was used to estimate human risk from vegetable consumption. Concentrations of metals in water were highly variable, and the mean concentrations of Cd, Cr, Cu and As in water were found to be higher than the FAO irrigation water quality standard. In most cases, mean concentrations of metals in soil were higher than the Bangladesh background value. Based on geoaccumulation index (I geo ) values, soils of Dhaka city are considered as highly contaminated. The I geo shows Cd, As, Cu, Ni, Pb and Cr contamination of agricultural soils and sediments of the cities all over the Bangladesh. Polluted water irrigation and agrochemicals are identified as dominant sources of metals in agricultural soils. Vegetable contamination by metals poses both non-carcinogenic and carcinogenic risks to the public. Based on the results of the pollution and health risk assessments, Cd, As, Cr, Cu, Pb and Ni are identified as the priority control metals and the Dhaka city is recommended as the priority control city. This study provides quantitative evidence demonstrating the critical need for strengthened wastewater discharge regulations in order to protect residents from heavy metal discharges into the environment.

Chlorination of Household Drinking Water Among Cholera Patients' Households to Prevent Transmission of Toxigenic Vibrio cholerae in Dhaka, Bangladesh: CHoBI7 Trial.

PubMed

Rashid, Mahamud-Ur; George, Christine Marie; Monira, Shirajum; Mahmud, Toslim; Rahman, Zillur; Mustafiz, Munshi; Saif-Ur-Rahman, K M; Parvin, Tahmina; Bhuyian, Sazzadul Islam; Zohura, Fatema; Begum, Farzana; Biswas, Shwapon Kumar; Akhter, Shamima; Zhang, Xiaotong; Sack, David; Sack, R Bradley; Alam, Munirul

2016-12-07

Household members of cholera patients are at a 100 times higher risk of cholera infections than the general population because of shared contaminated drinking water sources and secondary transmission through poor household hygiene practices. In this study, we investigated the bactericidal concentration of free chlorine required to inactivate Vibrio cholerae in household drinking water in Dhaka, Bangladesh. In laboratory experiments, we found that the concentrations of free chlorine required to inactivate 10 5 colony-forming units (CFU)/mL of V. cholerae serogroups O1 and O139 were 0.1 mg/L and 0.2 mg/L, respectively. The concentration of free chlorine generated by a single chlorine tablet (sodium dichloroisocyanurate [33 mg]) after a 30-minute reaction time in a 10-L sealed vessel containing Dhaka city municipal supply water was 1.8 mg/L; and the concentration declined to 0.26 mg/L after 24 hours. In field measurements, water collected from 165 households enrolled in a randomized controlled trial (RCT) of a chlorine and handwashing with soap intervention (Cholera-Hospital-Based-Intervention-for-7-Days [CHoBI7]), we observed significantly higher free chlorine concentrations in the 82 intervention arm households (mean = 1.12 mg/L, standard deviation [SD] = 0.52, range = 0.07-2.6 mg/L) compared with the 83 control households (0.017 mg/L, SD = 0.01, range = 0-0.06 mg/L) (P < 0.001) during spot check visits. These findings suggest that point-of-use chlorine tablets present an effective approach to inactivate V. cholerae from drinking water in households of cholera patients in Dhaka city. This result is consistent with the findings from the RCT of CHoBI7 which found that this intervention led to a significant reduction in symptomatic cholera infections among household members of cholera patients and no stored drinking water samples with detectable V. cholerae. © The American Society of Tropical Medicine and Hygiene.

External validation of the DHAKA score and comparison with the current IMCI algorithm for the assessment of dehydration in children with diarrhoea: a prospective cohort study

PubMed Central

Levine, Adam C; Glavis-Bloom, Justin; Modi, Payal; Nasrin, Sabiha; Atika, Bita; Rege, Soham; Robertson, Sarah; Schmid, Christopher H; Alam, Nur H

2016-01-01

Summary Background Dehydration due to diarrhoea is a leading cause of child death worldwide, yet no clinical tools for assessing dehydration have been validated in resource-limited settings. The Dehydration: Assessing Kids Accurately (DHAKA) score was derived for assessing dehydration in children with diarrhoea in a low-income country setting. In this study, we aimed to externally validate the DHAKA score in a new population of children and compare its accuracy and reliability to the current Integrated Management of Childhood Illness (IMCI) algorithm. Methods DHAKA was a prospective cohort study done in children younger than 60 months presenting to the International Centre for Diarrhoeal Disease Research, Bangladesh, with acute diarrhoea (defined by WHO as three or more loose stools per day for less than 14 days). Local nurses assessed children and classified their dehydration status using both the DHAKA score and the IMCI algorithm. Serial weights were obtained and dehydration status was established by percentage weight change with rehydration. We did regression analyses to validate the DHAKA score and compared the accuracy and reliability of the DHAKA score and IMCI algorithm with receiver operator characteristic (ROC) curves and the weighted κ statistic. This study was registered with ClinicalTrials.gov, number NCT02007733. Findings Between March 22, 2015, and May 15, 2015, 496 patients were included in our primary analyses. On the basis of our criterion standard, 242 (49%) of 496 children had no dehydration, 184 (37%) of 496 had some dehydration, and 70 (14%) of 496 had severe dehydration. In multivariable regression analyses, each 1-point increase in the DHAKA score predicted an increase of 0·6% in the percentage dehydration of the child and increased the odds of both some and severe dehydration by a factor of 1·4. Both the accuracy and reliability of the DHAKA score were significantly greater than those of the IMCI algorithm. Interpretation The DHAKA score is the first clinical tool for assessing dehydration in children with acute diarrhoea to be externally validated in a low-income country. Further validation studies in a diverse range of settings and paediatric populations are warranted. Funding National Institutes of Health Fogarty International Center. PMID:27567350

External validation of the DHAKA score and comparison with the current IMCI algorithm for the assessment of dehydration in children with diarrhoea: a prospective cohort study.

PubMed

Levine, Adam C; Glavis-Bloom, Justin; Modi, Payal; Nasrin, Sabiha; Atika, Bita; Rege, Soham; Robertson, Sarah; Schmid, Christopher H; Alam, Nur H

2016-10-01

Dehydration due to diarrhoea is a leading cause of child death worldwide, yet no clinical tools for assessing dehydration have been validated in resource-limited settings. The Dehydration: Assessing Kids Accurately (DHAKA) score was derived for assessing dehydration in children with diarrhoea in a low-income country setting. In this study, we aimed to externally validate the DHAKA score in a new population of children and compare its accuracy and reliability to the current Integrated Management of Childhood Illness (IMCI) algorithm. DHAKA was a prospective cohort study done in children younger than 60 months presenting to the International Centre for Diarrhoeal Disease Research, Bangladesh, with acute diarrhoea (defined by WHO as three or more loose stools per day for less than 14 days). Local nurses assessed children and classified their dehydration status using both the DHAKA score and the IMCI algorithm. Serial weights were obtained and dehydration status was established by percentage weight change with rehydration. We did regression analyses to validate the DHAKA score and compared the accuracy and reliability of the DHAKA score and IMCI algorithm with receiver operator characteristic (ROC) curves and the weighted κ statistic. This study was registered with ClinicalTrials.gov, number NCT02007733. Between March 22, 2015, and May 15, 2015, 496 patients were included in our primary analyses. On the basis of our criterion standard, 242 (49%) of 496 children had no dehydration, 184 (37%) of 496 had some dehydration, and 70 (14%) of 496 had severe dehydration. In multivariable regression analyses, each 1-point increase in the DHAKA score predicted an increase of 0·6% in the percentage dehydration of the child and increased the odds of both some and severe dehydration by a factor of 1·4. Both the accuracy and reliability of the DHAKA score were significantly greater than those of the IMCI algorithm. The DHAKA score is the first clinical tool for assessing dehydration in children with acute diarrhoea to be externally validated in a low-income country. Further validation studies in a diverse range of settings and paediatric populations are warranted. National Institutes of Health Fogarty International Center. Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

Knowledge of, attitudes toward, and preventive practices relating to cholera and oral cholera vaccine among urban high-risk groups: findings of a cross-sectional study in Dhaka, Bangladesh

PubMed Central

2013-01-01

Background In endemic countries such as Bangladesh, consequences of cholera place an enormous financial and social burden on patients and their families. Cholera vaccines not only provide health benefits to susceptible populations but also have effects on the earning capabilities and financial stability of the family. Community-based research and evaluations are necessary to understand perceptions about and practices of the community relating to cholera and oral cholera vaccines. This may help identify the ways in which such vaccines may be successfully introduced, and other preventive measures can be implemented. The present study assessed the knowledge of, attitudes toward, and preventive practices relating to cholera and oral cholera vaccine among an urban population residing in a high cholera-prone setting in Dhaka, Bangladesh. Methods This cross-sectional study was conducted in an area of high cholera prevalence in 15 randomly-selected clusters in Mirpur, Dhaka city. A study team collected data through a survey and in-depth interviews during December 2010–February 2011. Results Of 2,830 families included in the final analysis, 23% could recognize cholera as acute watery diarrhea and 16% had ever heard of oral cholera vaccine. About 54% of the respondents had poor knowledge about cholera-related issues while 97% had a positive attitude toward cholera and oral cholera vaccine. One-third showed poor practice relating to the prevention of cholera. The findings showed a significant (p < 0.05) association between the respondents’ knowledge and sex, education, occupation, monthly overall household expenditure, attitudes and practice. In the adjusted model, male sex, having a lower monthly overall household expenditure, and having a less positive attitude toward cholera were the significant predictors to having poor knowledge. Conclusions The findings suggest the strengthening of health education activities to improve knowledge on cholera, its prevention and treatment and information on cholera vaccination among high-risk populations. The data also underscore the potential of mass cholera vaccination to prevent and control cholera. PMID:23509860

Factors associated with relapse into drug use among male and female attendees of a three-month drug detoxification–rehabilitation programme in Dhaka, Bangladesh: a prospective cohort study

PubMed Central

2013-01-01

Background To determine relapse rates and associated factors among people who use drugs (PWUDs) attending abstinence-oriented drug treatment clinics in Dhaka, Bangladesh. Methods A cohort of male and female PWUDs admitted to the 3-month drug detoxification-rehabilitation treatment programmes of three non-governmental organisation-run drug treatment clinics in Dhaka, Bangladesh were interviewed on admission and over the following 5 months, which included the first 2 months after discharge. The study subjects comprised 150 male and 110 female PWUDs who had been taking opiates/opioids, cannabis or other drugs (including sedatives) before admission, had provided informed consent and were aged ≥16 years. Interviews were conducted using semi-structured questionnaires at four time points; on admission, at discharge and at 1 and 2 months after discharge. Relapse rates were assessed by the Kaplan–Meier method. Factors associated with relapse on enrolment and after discharge were determined using the Cox proportional hazards regression model. Results A greater proportion of female than male subjects relapsed over the study period (71.9% versus 54.5%, p < 0.01). For men, baseline factors associated with relapse were living with other PWUDs (relative hazard ratio [RHR] = 2.27), living alone (RHR = 2.35) and not having sex with non-commercial partners (RHR = 2.27); whereas for women these were previous history of drug treatment (RHR = 1.94), unstable housing (RHR = 2.44), higher earnings (RHR = 1.89), preferring to smoke heroin (RHR = 3.62) and injecting buprenorphine/pethidine (RHR = 3.00). After discharge, relapse for men was associated with unstable housing (RHR = 2.78), living alone (RHR = 3.69), higher earnings (RHR = 2.48) and buying sex from sex workers (RHR = 2.29). Women’ relapses were associated with not having children to support (RHR = 3.24) and selling sex (RHR = 2.56). Conclusions The relapse rate was higher for female PWUDs. For both male and female subjects the findings highlight the importance of stable living conditions. Additionally, female PWUDs need gender-sensitive services and active efforts to refer them for opioid substitution therapy, which should not be restricted only to people who inject drugs. PMID:24004685

Differences in field effectiveness and adoption between a novel automated chlorination system and household manual chlorination of drinking water in Dhaka, Bangladesh: a randomized controlled trial.

PubMed

Pickering, Amy J; Crider, Yoshika; Amin, Nuhu; Bauza, Valerie; Unicomb, Leanne; Davis, Jennifer; Luby, Stephen P

2015-01-01

The number of people served by networked systems that supply intermittent and contaminated drinking water is increasing. In these settings, centralized water treatment is ineffective, while household-level water treatment technologies have not been brought to scale. This study compares a novel low-cost technology designed to passively (automatically) dispense chlorine at shared handpumps with a household-level intervention providing water disinfection tablets (Aquatab), safe water storage containers, and behavior promotion. Twenty compounds were enrolled in Dhaka, Bangladesh, and randomly assigned to one of three groups: passive chlorinator, Aquatabs, or control. Over a 10-month intervention period, the mean percentage of households whose stored drinking water had detectable total chlorine was 75% in compounds with access to the passive chlorinator, 72% in compounds receiving Aquatabs, and 6% in control compounds. Both interventions also significantly improved microbial water quality. Aquatabs usage fell by 50% after behavioral promotion visits concluded, suggesting intensive promotion is necessary for sustained uptake. The study findings suggest high potential for an automated decentralized water treatment system to increase consistent access to clean water in low-income urban communities.

Fuel properties and engine performance of biodiesel from waste cooking oil collected in Dhaka city

NASA Astrophysics Data System (ADS)

Islam, R. B.; Islam, R.; Uddin, M. N.; Ehsan, Md.

2016-07-01

Waste cooking oil can be a potential source of biodiesel that has least effect on the edible oil consumption. Increasing number of hotel-restaurants and more active monitoring by health authorities have increased the generation of waste cooking oil significantly in densely populated cities like Dhaka. If not used or disposed properly, waste cooking oil itself may generate lot of environmental issues. In this work, waste cooking oils from different restaurants within Dhaka City were collected and some relevant properties of these waste oils were measured. Based on the samples studied one with the highest potential as biodiesel feed was identified and processed for engine performance. Standard trans-esterification process was used to produce biodiesel from the selected waste cooking oil. Biodiesel blends of B20 and B40 category were made and tested on a single cylinder direct injection diesel engine. Engine performance parameters included - bhp, bsfc and exhaust emission for rated and part load conditions. Results give a quantitative assessment of the potential of using biodiesel from waste cooking oil as fuel for diesel engines in Bangladesh.

Diarrhoea in slum children: observation from a large diarrhoeal disease hospital in Dhaka, Bangladesh.

PubMed

Ferdous, Farzana; Das, Sumon Kumar; Ahmed, Shahnawaz; Farzana, Fahmida Dil; Malek, Mohammad Abdul; Das, Jui; Latham, Jonathan Ross; Faruque, Abu Syed Golam; Chisti, Mohammod Jobayer

2014-10-01

To determine and compare socio-demographic, nutritional and clinical characteristics of children under five with diarrhoea living in slums with those of children who do not live in slums of Dhaka, Bangladesh. From 1993 to 2012, a total of 28 948 under fives children with diarrhoea attended the Dhaka Hospital of icddr,b. Data were extracted from the hospital-based Diarrhoea Disease Surveillance System, which comprised 17 548 under fives children from slum and non-slum areas of the city. Maternal illiteracy [aOR = 1.57; 95% confidence interval (1.36, 1.81), P-value <0.001], paternal illiteracy [1.37 (1.21, 1.56) <0.001], mother's employment [1.59 (1.37, 1.85) <0.001], consumption of untreated water [2.73 (2.26, 3.30) <0.001], use of non-sanitary toilets [3.48 (3.09, 3.93) <0.001], 1st wealth quintile background [3.32 (2.88, 3.84) <0.001], presence of fever [1.14 (1.00, 1.29) 0.047], some or severe dehydration [1.21 (1.06, 1.40) 0.007], stunting [1.14 (1.01, 1.29) 0.030] and infection with Vibrio cholerae [1.21 (1.01, 1.45) 0.039] were significantly associated with slum-dwelling children after controlling for co-variates. Measles immunisation [0.52 (0.47, 0.59) P < 0.001] and vitamin A supplementation rates [0.36 (0.31, 0.41) P < 0.001] amongst children 12-59 months were lower for slum dwellers than other children in univarate analysis only. Slum-dwelling children are more malnourished, have lower immunisation rates (measles vaccination and vitamin A supplementation) and higher rates of measles, are more susceptible to diarrhoeal illness due to V. cholerae and suffer from severe dehydration more often than children from non-slum areas. Improved health and nutrition strategies should give priority to children living in urban slums. © 2014 John Wiley & Sons Ltd.

Dietary pattern, nutritional status, anaemia and anaemia-related knowledge in urban adolescent college girls of Bangladesh.

PubMed

Kabir, Yearul; Shahjalal, Hussain Mohammad; Saleh, Farzana; Obaid, Wahida

2010-08-01

To examine dietary pattern and nutritional status of adolescent college girls of Dhaka, Bangladesh with a particular focus on the prevalence of anaemia and appropriate knowledge about it among them. A cross sectional study was conducted. Sixty-five adolescent girls aged 15-19 years were selected randomly from Home Economics college of Dhaka. A 7-day food frequency questionnaire was used to investigate the dietary pattern. Nutrient intake of the participants was assessed by 24h recall method. Habitual dietary pattern indicated poor consumption of milk, liver and leafy vegetables. Food intake data revealed a deficit of 473 kcal/day in energy. Mean intake of carbohydrate and fat were lower than RDA; while protein, iron, vitamin A and vitamin C intakes were much higher. Anthropometric data indicated that 63% of the girls were stunted (height-for-age < 95% of NCHS reference values) and 45% were underweight (weight-for-age < 75% of NCHS reference values). The prevalence of anaemia (Hb < 12 g/dl) among the participants was 23%. About 17% had low serum iron (< 40 microg/dl), 23% showed evidence of iron-deficient erythropoiesis (Transferrin Saturation < 15%) and only 8% had vitamin C deficiency (< 0.29 mg/dl). About 65% of the participants had correct knowledge about the causes of anaemia; while 72.3% and 80% respectively, knew about the prevention and treatment of anaemia. Surprisingly, 73.8% of the participants were not aware about the sources of iron-rich foods. Results indicate an overall poor nutritional status of the urban adolescent college girls in Bangladesh and need for appropriate nutrition interventions to overcome the problem.

Infection with influenza A(H1N1)pdm09 during the first wave of the 2009 pandemic: Evidence from a longitudinal seroepidemiologic study in Dhaka, Bangladesh.

PubMed

Nasreen, Sharifa; Rahman, Mustafizur; Hancock, Kathy; Katz, Jacqueline M; Goswami, Doli; Sturm-Ramirez, Katharine; Holiday, Crystal; Jefferson, Stacie; Branch, Alicia; Wang, David; Veguilla, Vic; Widdowson, Marc-Alain; Fry, Alicia M; Brooks, W Abdullah

2017-09-01

We determined influenza A(H1N1)pdm09 antibody levels before and after the first wave of the pandemic in an urban community in Dhaka, Bangladesh. We identified a cohort of households by stratified random sampling. We collected baseline serum specimens during July-August 2009, just prior to the initial wave of the 2009 pandemic in this community and a second specimen during November 2009, after the pandemic peak. Paired sera were tested for antibodies against A(H1N1)pdm09 virus using microneutralization assay and hemagglutinin inhibition (HI) assay. A fourfold increase in antibody titer by either assay with a titer of ≥40 in the convalescent sera was considered a seroconversion. At baseline, an HI titer of ≥40 was considered seropositive. We collected information on clinical illness from weekly home visits. We tested 779 paired sera from the participants. At baseline, before the pandemic wave, 1% overall and 3% of persons >60 years old were seropositive. After the first wave of the pandemic, 211 (27%) individuals seroconverted against A(H1N1)pdm09. Children aged 5-17 years had the highest proportion (37%) of seroconversion. Among 264 (34%) persons with information on clinical illness, 191 (72%) had illness >3 weeks prior to collection of the follow-up sera and 73 (38%) seroconverted. Sixteen (22%) of these 73 seroconverted participants reported no clinical illness. After the first pandemic wave in Dhaka, one in four persons were infected by A(H1N1)pdm09 virus and the highest burden of infection was among the school-aged children. Seroprevalence studies supplement traditional surveillance systems to estimate infection burden. © 2017 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Genetic characteristics of drug-resistant Vibrio cholerae O1 causing endemic cholera in Dhaka, 2006–2011

PubMed Central

Rashed, Shah M.; Mannan, Shahnewaj B.; Johura, Fatema-tuz; Islam, M. Tarequl; Sadique, Abdus; Watanabe, Haruo; Sack, R. Bradley; Huq, Anwar; Colwell, Rita R.; Cravioto, Alejandro

2012-01-01

Vibrio cholerae O1 biotype El Tor (ET), causing the seventh cholera pandemic, was recently replaced in Bangladesh by an altered ET possessing ctxB of the Classical (CL) biotype, which caused the first six cholera pandemics. In the present study, V. cholerae O1 strains associated with endemic cholera in Dhaka between 2006 and 2011 were analysed for major phenotypic and genetic characteristics. Of 54 representative V. cholerae isolates tested, all were phenotypically ET and showed uniform resistance to trimethoprim/sulfamethoxazole (SXT) and furazolidone (FR). Resistance to tetracycline (TE) and erythromycin (E) showed temporal fluctuation, varying from year to year, while all isolates were susceptible to gentamicin (CN) and ciprofloxacin (CIP). Year-wise data revealed erythromycin resistance to be 33.3 % in 2006 and 11 % in 2011, while tetracycline resistance accounted for 33, 78, 0, 100 and 27 % in 2006, 2007, 2008, 2009 and 2010, respectively; interestingly, all isolates tested were sensitive to TE in 2011, as observed in 2008. All V. cholerae isolates tested possessed genetic elements such as SXT, ctxAB, tcpAET, rstRET and rtxC; none had IntlI (Integron I). Double mismatch amplification mutation assay (DMAMA)-PCR followed by DNA sequencing and analysis of the ctxB gene revealed a point mutation at position 58 (C→A), which has resulted in an amino acid substitution from histidine (H) to asparagine (N) at position 20 (genotype 7) since 2008. Although the multi-resistant strains having tetracycline resistance showed minor genetic divergence, V. cholerae strains were clonal, as determined by a PFGE (NotI)-based dendrogram. This study shows 2008–2010 to be the time of transition from ctxB genotype 1 to genotype 7 in V. cholerae ET causing endemic cholera in Dhaka, Bangladesh. PMID:22977073

Persistent organohalogen contaminants in plasma from groups of humans with different occupations in Bangladesh.

PubMed

Zamir, R; Athanasiadou, M; Nahar, N; Mamun, M I R; Mosihuzzaman, M; Bergman, A

2009-01-01

The present study is aimed to assess persistent organic halogenated pollutants in humans living in Bangladesh. The results are compared to other similar studies in the region and globally. Human blood plasma were collected from groups of men and women with different occupations, i.e. being students, garment industry workers, employees at the Power Development Board (PDB), all groups in Dhaka, fishermen and fishermen wife's from Dhaka and another group from Barisal district. The plasma was analysed for hexachlorobenzene (HCB), the hexachlorocyclohexane isomers, alpha-HCH, beta-HCH, gamma-HCH and delta-HCH, the DDT group of chemicals, chlordane compounds, trans-chlordane, cis-chlordane, oxychlordane, trans-nonachlor, trans-heptachlorepoxide, methoxychlor and mirex. The most abundant contaminant, in all groups studied, p,p'-DDE is dominating, with p,p'-DDT/Sigma DDT ratios indicating recent and ongoing DDT exposure. Among the other pesticides analysed beta-HCH is the most abundant indicating the use of technical HCH products instead of Lindane (gamma-HCH). While the Sigma DDT is present in the low ppm range the beta-HCH is detected in up to approx. 400 ppb, lipid basis. The beta-HCH is most abundant in the groups of students. In contrast to the pesticides analysed very low concentrations of polychlorinated biphenyls (PCB) are present in all study groups, with e.g. CB-153 in the range of 5-30 ng g(-1) fat. The concentrations of the DDT group of chemical differ significantly between fishermen and fishermen's wives living and working in the Dhaka area versus those living and working in Barisal. Also, fishermen and their wives had significantly different concentrations of DDT compared to garment industry workers.

Social-epidemiological study for evaluation of water supply and sanitation systems of low-income urban community in Dhaka, Bangladesh.

PubMed

Mollah, Kabirul A; Aramaki, Toshiya

2010-03-01

This study aims at quantification of health losses, considering social and environmental factors. Morbidity and mortality cases of diarrhoea for children under five years old were used to estimate the disability adjusted life years (DALYs) lost for the target households in low-income communities in Dhaka, Bangladesh. Water supply facilities and sanitation systems, along with hygiene practices and their health outcomes, were studied at community level. Demographic, socio-economic and socio-cultural aspects were also studied to support the research findings and give a better understanding of the local conditions. The four selected communities, Ward 60 (W60), Ward 61 (W61), Ward 62 (W62) and Ward 65 (W65), all had different existing urban services such as water supply, sanitation, garbage management and drainage facilities. All of these services existed in W62, but W60 did not have any of the services; W61 had sanitation and drainage coverage, whereas W65 had only a water supply facility. The results conclusively showed that, compared with the null (absence of services) scenario (W60), the other three scenarios (W61, W62 and W65) showed a substantial decrease of diarrhoea (1.219, 1.284 and 2.052 DALYs/household/year, respectively) reported for children under five years old. Besides urban services, other socio-economic characteristics might also influence the prevalence of diseases.

Process assessment of a peer education programme for HIV prevention among sex workers in Dhaka, Bangladesh : a social support framework.

PubMed

Sarafian, Isabelle

2012-08-01

This study evaluated the process of a peer education program for hotel-based sex workers in Dhaka, Bangladesh, with social support proposed as an organizing framework. Programme outcomes were examined through baseline and follow-up assessments. Sex workers naïve to peer education were assessed on socio-cognitive and behavioural variables; a subsample was reassessed at follow-up 23 weeks later on average. Process was assessed in terms of the content of peer education sessions. These sessions were recorded and coded into percentages of social support types provided by the peer educator to her audience: informational, instrumental, appraisal, emotional, companionship, non-support. Peer educators were classified into three "social support profiles" based on average proportions of emotional and informational support they provided. Seeing more peer educators with a high informational support profile was related to higher sex worker self-efficacy, self-reported STI symptoms, and self-reported condom use at follow-up; the same was true for the high emotional support profile and treatment seeking. Social support constituted a useful framework, but needs further exploration. This study provided a direct, in-depth examination of the process of peer education based on a comprehensive theoretical framework. Copyright © 2011 Elsevier Ltd. All rights reserved.

Increased severity in patients presenting to hospital with diarrhea in Dhaka, Bangladesh Since emergence of the hybrid strain of Vibrio cholerae O1 is not unique to cholera patients

PubMed Central

Chowdhury, Fahima; Kuchta, Alison; Khan, Ashraful Islam; Faruque, ASG; Calderwood, Stephen B.; Ryan, Edward T.; Qadri, Firdausi

2015-01-01

In 2001, a hybrid strain of Vibrio cholerae O1 El Tor that expresses a classical cholera toxin (CT) emerged and this hybrid variant rapidly replaced the previous El Tor strain around the world. The global emergence of this variant coincided with anecdotal reports that cholera patients were presenting with more severe dehydration and disease in many locations. We compared severity of disease in cholera patients from before and after emergence of the hybrid strain at a diarrheal hospital in Dhaka, Bangladesh. We did indeed find that cholera patients presented with more severe dehydration and severe disease in the latter period; however, this was also true for “all non-cholera patients” as well. In addition, in sub-analyses of patients who presented with rotavirus and enterotoxigenic E. coli (ETEC), we found similar results. Comparing the two periods for differences in patient characteristics, nutritional status, vaccination status and income, we were unable to detect a plausible cause for patients presenting with more severe disease in the latter period. Because we observed a shift in severity for both cholera and non-cholera, our results indicate that the altered El Tor strain cannot fully explain the differences in cholera severity before and after 2001 PMID:26409202

Impact of tannery effluents on the aquatic environment of the Buriganga River in Dhaka, Bangladesh.

PubMed

Asaduzzaman, Mohammad; Hasan, Imtiaj; Rajia, Sultana; Khan, Nazneen; Kabir, Kazi Ahmed

2016-06-01

This study presents an overview of the existence and effects of six heavy metals, chromium (Cr), lead (Pb), cadmium (Cd), mercury (Hg), manganese (Mn), and aluminum (Al), in tannery effluents released to the Buriganga River in Dhaka, Bangladesh. The pollutants were found in three different sources, such as effluents from tanneries, contaminated river water and three species of fish-climbing perch (Anabas testudineus), spotted snakehead (Channa punctata), and Black tilapia (Oreochromis mossambicus) caught from the river. Tannery effluents, water, and fish samples were collected from three different factories, five sample stations, and three different harvesting points, respectively. Effluents from all three factories contained significant amounts of heavy metals, especially Cr (374.19 ppm in average), whereas lesser amounts were found in the tissues of the three fish species studied. The trends in tissue elemental concentrations of fish were Cr > Pb > Al > Hg > Mn > Cd. In most cases (Cr, Cd, Mn, and Al), heavy metal concentrations were found to be greater in climbing perch than in Black tilapia and spotted snakehead. Although the river water contained high concentrations of harmful heavy metals, the fish species under study had concentrations well below the permissible Food and Agriculture Organization/World Health Organization levels for those metals and seemed to be safe for human consumption. © The Author(s) 2014.

A survey on the faunal diversity of Savar Upazila, Dhaka, Bangladesh.

PubMed

Hossain, Eftekhar; Chowdhury, Mohammad Mamun; Iqubal, Kazi Farhed

2008-02-01

A survey was conducted during January to December 2006 to assess the status of faunal diversity of Savar Upazila, Dhaka, Bangladesh. A total of 30 species of birds, 24 species of winter birds, 7 species of reptiles, 3 species of amphibians, 15 species of mammalians and 32 species of fishes were recorded. Relative abundance of those species were determined. Of the birds, House Sparrow (Passer domesticus) was abundant while Blyth's Kingfisher (Alcedo hercules), Rock Eagle Owl (Bubo bengalensis), Hooded Pitta (Pitta sordida), Black-headed Oriole (Oriolus xanthornus), White-winged Duck (Cairina seululala) and Duck (Anser indicus) were rare. The relative abundance of winter bird could not be assessed because of their migratory habit. Striped keelback (Amphiesma stolata) and Common Smooth Water Snake (Enhydris enhydris) were very common while Black pond turtle (Geoclyms hamiltonii) and Pond tortoise (Melanochelys trijuga) were recorded as endangered. Common Toad (Bufo melanostictus) were abundant but Bull Frog (Rana tigrina) was rare. Asiatic Wild Dog (Cuon alpinus) and House Mouse (Mus musculus) were abundant while Common Otter, Large Indian Civet, Irrawaddy River Dolphin, Indian Hare were rare. Carpu, Silver carp, Tilapia, Nilotica were abundant while, Freshwater Garfish, One stripe spinyeel and Grey Featherback were rare. Landfilling, deforestation, poaching, industrial effluents and current jal were identified as major threats to the faunal diversity of Savar area.

Treatment referral system for tuberculosis patients in Dhaka, Bangladesh

PubMed Central

Hirayama, T.; Islam, A.; Ishikawa, N.; Afsana, K.

2015-01-01

Objective: To evaluate the referral system in an urban DOTS-based programme in Dhaka, Bangladesh, including the peri-urban area, and to identify opportunities to strengthen the system. Design: This was a retrospective cohort study in which diagnosed tuberculosis (TB) patients and health providers from DOTS centres were interviewed. Research tools included pre-tested structured questionnaires and the TB patients' referral records. Results: Of 4974 TB patients who were referred to the different treatment centres, only 1756 (35%) of the counterfoils of the referral slips were returned. Of 250 patients randomly selected for interview, 165 reported to a DOTS centre, 69 did not and 16 could not be traced. Variations in educational qualification, residence and the identification of DOTS centres after counselling were statistically significant (P < 0.05). Lower monthly income (RR = 7.84, RR = 5.03), distance from the centre (RR = 36.21) and those receiving treatment from pharmacies (RR = 3) or non-governmental organisations (RR = 28.48) have more risk of irregular treatment. Conclusion: A high proportion of referred patients were registered and initiated treatment, but many did not report to the referral treatment centre. Proper counselling and taking into account the patients' preferences during referral are essential to address access barriers to treatment adherence and improved treatment outcome. PMID:26767176

Mental health, quality of life, and nutritional status of adolescents in Dhaka, Bangladesh: comparison between an urban slum and a non-slum area.

PubMed

Izutsu, Takashi; Tsutsumi, Atsuro; Islam, Akramul Md; Kato, Seika; Wakai, Susumu; Kurita, Hiroshi

2006-09-01

This study aims to clarify the quality of life (QOL), mental health, and nutritional status of adolescents in Dhaka city, Bangladesh by comparing non-slum areas and slums, and to find the factors associated with their mental health problems. A sample of 187 boys and 137 girls from non-slum areas, and 157 boys and 121 girls from slums, between 11-18 years old were interviewed with a questionnaire consisting of a Bangla translation of the World Health Organization Quality of Life Assessment Instrument (WHOQOL-BREF), Self Reporting Questionnaire (SRQ), Youth Self-Report (YSR) and other questions. The height and weight of the respondents were measured. All significant differences in demographic characteristics, anthropometric measures, and WHOQOL-BREF were found to reflect worse conditions in slum than in non-slum areas. Contrarily, all differences in SRQ and YSR were worse in non-slum areas for both genders, except that the "conduct problems" score for YSR was worse for slum boys. Mental states were mainly associated with school enrollment and working status. Worse physical environment and QOL were found in slums, along with gender and area specific mental health difficulties. The results suggest gender specific needs and a requirement for area sensitive countermeasures.

The Prevalence of Mixed Helicobacter pylori Infections in Symptomatic and Asymptomatic Subjects in Dhaka, Bangladesh.

PubMed

Kibria, Khandoker Mohammad K; Hossain, Md Enayet; Sultana, Jinath; Sarker, Shafiqul A; Bardhan, Pradip Kumar; Rahman, Motiur; Nahar, Shamsun

2015-10-01

Helicobacter pylori is a highly genetically diverse bacterial species, which can persist in the gastric environment for decades. Recent studies have shown that single infections predominate in developed countries, whereas mixed infections are more prevalent in developing countries. Mixed infections of this bacterium may be important for adaptation to the hostile gastric environment and may facilitate dyspeptic symptoms. To calculate the prevalence of mixed infections in symptomatic and asymptomatic subjects, 2010 H. pylori isolates collected from 83 symptomatic and 91 asymptomatic subjects from Dhaka, Bangladesh, were analyzed by (i) random amplified polymorphic DNA fingerprinting (RAPD) and (ii) multiplex PCR amplification for cagA and vacA virulence gene alleles. The overall prevalence of mixed H. pylori infection was 60.15% (77/128), indicating substantial co-colonization in this population. We additionally found that symptomatic subjects (53%) had a significantly higher rate of mixed infection than asymptomatic individuals (36.3%) (p = .016) and that the prevalence of the cagA and vacA and vacA m1/s1 and vacA m2/s1 alleles were higher in subjects with mixed infection. Our findings suggest that an increased diversity of the H. pylori strains in the gastric environment may contribute to the development of disease symptoms. © 2015 John Wiley & Sons Ltd.

Socioeconomic and Ecological Factors Influencing Aedes aegypti Prevalence, Abundance, and Distribution in Dhaka, Bangladesh.

PubMed

Dhar-Chowdhury, Parnali; Haque, C Emdad; Lindsay, Robbin; Hossain, Shakhawat

2016-06-01

This study examined household risk factors and prevalence, abundance, and distribution of immature Aedes aegypti and Aedes albopictus, and their association with socioeconomic and ecological factors at urban zonal and household levels in the city of Dhaka, Bangladesh. During the 2011 monsoon, 826 households in 12 randomly selected administrative wards were surveyed for vector mosquitoes. Results revealed that the abundance and distribution of immature Ae. aegypti and Ae. albopictus, and pupae-per-person indices did not vary significantly among the zones with varied socioeconomic status. Of 35 different types of identified wet containers, 30 were infested, and among the 23 pupae-positive container types, nine were defined as the "most productive" for pupae including: disposable plastic containers (12.2% of 550), sealable plastic barrels (12.0%), tires (10.4%), abandoned plastic buckets (9.6%), flower tub and trays (8.5%), refrigerator trays (6.5%), plastic bottles (6.4%), clay pots (4.9%), and water tanks (1.6%). When the function of the containers was assessed, ornamental, discarded, and household repairing and reconstruction-related container categories were found significantly associated with the number of pupae in the households. The purpose of storing water and income variables were significant predictors of possession of containers that were infested by vector mosquitoes. © The American Society of Tropical Medicine and Hygiene.

Strategies for providing healthcare services to street-dwellers in Dhaka city: evidence from an operations research.

PubMed

Uddin, Jasim; Koehlmoos, Tracey P; Saha, Nirod C; Islam, Ziaul; Khan, Iqbal A; Quaiyum, M A

2012-06-13

In almost every major urban city, thousands of people live in overcrowded slums, streets, or other public places without any health services. Bangladesh has experienced one of the highest rates of urban population growth in the last three decades compared to the national population growth rate. The numbers of the urban poor and street-dwellers are likely to increase at least in proportion to the overall population growth of the country. The street-dwellers in Bangladesh are extremely vulnerable in terms of their health needs and healthcare-seeking behaviours. In Bangladesh, there is no health service-delivery mechanism targeting this marginalized group of people. This study, therefore, assessed the effectiveness of two models to provide primary healthcare (PHC) services to street-dwellers. This study of experimental pre-post design tested two models, such as static clinic and satellite clinics, for providing PHC services to street-dwellers in the evening through paramedics in Dhaka city during May 2009-April 2010. Both quantitative and qualitative techniques were used for collecting data. Data were analyzed comparing before and after the implementation of the clinics for the assessment of selected health and family-planning indicators using the statistical t-test. Services received from the model l and model 2 clinics were also compared by calculating the absolute difference to determine the relative effectiveness of one model over another. The use of healthcare services by the street-dwellers increased at endline compared to baseline in both the model clinic areas, and the difference was highly significant (p < 0.001). Institutional delivery among the female street-dwellers increased at endline compared to baseline in both the clinic areas. The use of family-planning methods among females also significantly (p < 0.001) increased at endline compared to baseline in both the areas. As the findings of the study showed the promise of this approach, the strategies could be implemented in all other cities of Bangladesh and in other countries which encounter similar problems.

Correlates of exposure to secondhand smoke (SHS) at home among non-smoking adults in Bangladesh: findings from the ITC Bangladesh survey.

PubMed

Abdullah, Abu S; Driezen, Pete; Sansone, Genevieve; Nargis, Nigar; Hussain, Ghulam Akm; Quah, Anne Ck; Fong, Geoffrey T

2014-07-16

Exposure to secondhand smoke (SHS) is a serious global public health problem. Understanding the correlates of SHS exposure could guide the development of evidence based SHS exposure reduction interventions. The purpose of this study is to describe the pattern of and factors associated with SHS exposure among non-smoking adults in Bangladesh. Data come from adult non-smokers who participated in the second wave (2010) of the International Tobacco Control Policy (ITC) Evaluation Bangladesh Survey conducted in all six administrative divisions of Bangladesh. A structured questionnaire gathered information on participants' demographic characteristics, pattern of SHS exposure, SHS knowledge, and attitudes towards tobacco control. Exposure to SHS at home was defined as non-smokers who lived with at least one smoker in their household and who reported having no home smoking ban. The data were analyzed using chi-square tests and logistic regression procedures. The SHS exposure rate at home among the participants (N=2813) was 43%. Several sociodemographic and attitudinal factors were associated with SHS exposure. Logistic regression analyses identified eight predictors of SHS exposure: being female (OR=2.35), being aged 15-24 (OR=2.17), being recruited from Dhaka slums (OR=5.19) or non-tribal/non-border areas outside Dhaka (OR=2.19) or tribal/border area (OR=4.36), having lower education (1-8 years: OR=2.45; illiterate: OR=3.00, having higher monthly household income (5000 to <10,000 Taka: OR=2.34; 10,000 Taka or more: OR=2.28), having a father who smoked in the past or currently smokes (OR=2.09), having lower concern about the harms of tobacco on children (unconcerned OR=3.99; moderate concern OR=2.26), and not knowing the fact that SHS causes lung cancer in non-smokers (OR=2.04). Almost half of non-smoking Bangladeshi adults are exposed to SHS at home. The findings suggest the need for comprehensive tobacco control measures that would improve public understanding about health hazards of SHS exposure at home and encourage educational initiatives to promote smoke-free homes. Interventions should deliver targeted messages to reach those in the low socioeconomic status group.

An Evaluation of the Result of Fenestration and Discectomy for the Treatment of Prolapsed Lumber Intervertrebal Disc (PLID).

PubMed

Islam, M A; Akon, S I; Shamsuzzaman, M; Asaduzzaman, M; Akter, S; Awal, M A; Mahboob, A H; Islam, M S; Rahman, M M; Ara, R; Alam, M K; Ali, M R

2017-10-01

The aim of this study is to asses the result of fenestration and discectomy for the treatment of PLID. This Prospective quasi experimental study was conducted on 29 Patient of PLID with different ages at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh from July 2014 to June 2016. Post Operative outcome was assessed through Modified Macnab Criteria & Visual Analogue Score (VAS). The mean age of patient were 38.14±9.20 years and ranging from 24 to 55 years. The mean age of male was 37.21±9.72 years and female patient was 39.90±8.32 years. Overall subjective assessment of this study revealed that 79.2% patients had excellent functional outcome, 13.8% good and 6.9% fair and there was no poor functional outcome a according to modified Macnab criteria.

Risk factors associated with overweight and obesity among urban school children and adolescents in Bangladesh: a case-control study.

PubMed

Bhuiyan, Mejbah Uddin; Zaman, Shahaduz; Ahmed, Tahmeed

2013-05-08

Childhood obesity has become an emerging urban health problem in urban cities in Bangladesh, particularly in affluent families. Risk factors for obesity in this context have not been explored yet. The objective of this study was to identify the risk factors associated with overweight and obesity among school children and adolescents in Dhaka, Bangladesh. From October through November 2007, we conducted a case-control study among children aged 10-15 years in seven schools in Dhaka. We assessed body mass index (weight in kg/height in sq. meter) to identify the cases (overweight/obese) and controls (healthy/normal weight) following the Centers for Disease Control and Prevention age and sex specific growth chart. We used a structured questionnaire to collect demographic information and respondent's exposure to several risk factors such as daily physical activity at home and in school, hours spent on computer games and television watching, maternal education level and parents' weight and height. We enrolled 198 children: 99 cases, 99 controls. Multiple logistic regression analysis revealed that having at least one overweight parent (OR = 2.8, p = 0.001) and engaging in sedentary activities for >4 hours a day (OR = 2.0, p = 0.02) were independent risk factors for childhood overweight and/or obesity while exercising ≥ 30 minutes a day at home was a protective factor (OR = 0.4, p = 0.02). There were no significant associations between childhood overweight and sex, maternal education or physical activity at school. Having overweight parents along with limited exercise and high levels of sedentary activities lead to obesity among school children in urban cities in Bangladesh. Public health programs are needed to increase awareness on risk factors for overweight and obesity among children and adolescents in order to reduce the future burden of obesity-associated chronic diseases.

State and the Low Cost Housing for the Poor: Fall of Bashentek Rehabilitation Project (BRP) in Dhaka City--Bangladesh

ERIC Educational Resources Information Center

Hussain, Rasel; Saha, Amit Kumar; Rabbani, Golam; Pervin, Irin; Shamma, Wasifa Tasnim; Khan, Sazzad Hossain

2015-01-01

In the era of neoliberalism now the people especially the lower income group of people is suffering a lot for the scarcity of housing. After migrating from the rural areas for a better life they discovered themselves in the slum like areas of the city as they are not capable to afford housing in the influential areas of the city due to higher…

Developing a Non-Formal Education and Literacy Database in the Asia-Pacific Region. Final Report of the Expert Group Consultation Meeting (Dhaka, Bangladesh, December 15-18, 1997).

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Bangkok (Thailand). Regional Office for Education in Asia and the Pacific.

The objectives of the Expert Group Consultation Meeting for Developing a Non-Formal Education and Literacy Database in the Asia-Pacific Region were: to exchange information and review the state-of-the-art in the field of data collection, analysis and indicators of non-formal education and literacy programs; to examine and review the set of…

CFD Simulations to Improve Ventilation in Low-Income Housing

NASA Astrophysics Data System (ADS)

Ho, Rosemond; Gorle, Catherine

2017-11-01

Quality of housing plays an important role in public health. In Dhaka, Bangladesh, the leading causes of death include tuberculosis, lower respiratory infections, and chronic obstructive pulmonary disease, so improving home ventilation could potentially mitigate these negative health effects. The goal of this project is to use computational fluid dynamics (CFD) to predict the relative effectiveness of different ventilation strategies for Dhaka homes. A Reynolds-averaged Navier-Stokes CFD model of a standard Dhaka home with apertures of different sizes and locations was developed to predict air exchange rates. Our initial focus is on simulating ventilation driven by buoyancy-alone conditions, which is often considered the limiting case in natural ventilation design. We explore the relationship between ventilation rate and aperture area to determine the most promising configurations for optimal ventilation solutions. Future research will include the modeling of wind-driven conditions, and extensive uncertainty quantification studies to investigate the effect of variability in the layout of homes and neighborhoods, and in local wind and temperature conditions. The ultimate objective is to formulate robust design recommendations that can reduce risks of respiratory illness in low-income housing.

Peptic Ulcer Disease in Bangladesh: A Multi-centre Study.

PubMed

Ghosh, C K; Khan, M R; Alam, F; Shil, B C; Kabir, M S; Mahmuduzzaman, M; Das, S C; Masud, H; Roy, P K

2017-01-01

The incidence of peptic ulcer has steadily declined through out the world. This decreasing trend is also noticeable in this subcontinent. The point prevalence of peptic ulcer (PUD) in Bangladesh was around 15% in eighties. The aim of this study was to see the present prevalence of peptic ulcer at endoscopy and to identify changing trends in the occurrence of peptic ulcer in Bangladesh. This retrospective analysis of the endoscopic records of multiple tertiary referral centres of Dhaka city were done from January 2012 to July 2013. A total of 5608 subjects were the study samples. We included those patients having peptic ulcer in the form of duodenal ulcer, benign gastric ulcer including pre-pyloric ulcer and gastric outlet obstruction due to peptic ulcer. Duodenal ulcer and benign gastric ulcer were found in 415(7.4%) and 184(3.28%) patients respectively and gastric outlet obstruction due to peptic ulcer was found in 23(0.40%) patients.

Prevalence of Hepatitis B Virus, Hepatitis C Virus, and HIV in Overseas Job Seekers of Bangladesh with the Possible Routes of Transmission.

PubMed

Jobayer, M; Chowdhury, S S; Shamsuzzaman, S M; Islam, M S

2016-07-01

Hepatitis and AIDS are major public health problem globally. The aim of this study was to determine the sero-prevalence of hepatitis B, C virus and HIV infection among Bangladeshi overseas job seekers. This cross sectional study was carried out in the Department of Microbiology of Dhaka Medical College, Dhaka, Bangladesh from February 2013 to August 2013. A total of 2254 adult (18-45 years) male job seekers to Malaysia attending for health check up were enrolled. HBsAg, Anti-HCV, Anti-HIV were detected from venous blood by ELISA method using commercial kits. From the positive people, further history and information were collected by predesigned questionnaire. Prevalence of HBV was 2.35%, HCV was 0.13% and none was found positive for HIV. Prevalence of hepatitis was higher in the age group of 21-30 year and infection was more prevalent in married group. No significant relationship was found between hepatitis infection and religion, localities, profession. Only a few cases had history of possible major known route of transmission of virus. But most of them had history of taking injection or sharing blades in barber shop and history of circumcision. About 96% population had no history of hepatitis B vaccination. None was co-infected with HBV and HCV. Prevalence of hepatitis B virus infection in adult population appears to be on decline and hepatitis C and HIV infection is still low in Bangladesh. In majority of the positive person, routes of transmission of viruses were not well established.

Prevalence of Type 2 Diabetes Mellitus Among Urban Bihari Communities in Dhaka, Bangladesh: A Cross-sectional Study in a Minor Ethnic Group

PubMed Central

Chowdhury, Shahanaz; Shahed, Jahid Hossen; Kafi, Mohammad Abdullah Heel; Uzzaman, Md. Nazim; Flowra, Mahfuza Talukder; Ahmed, MSA Mansur

2018-01-01

Introduction The prevalence, disease progression, and treatment outcomes for patients with type 2 diabetes vary significantly between ethnic groups. The Bihari community constitutes one of the most vulnerable populations in Bangladesh on the basis of access to health services and other fundamental rights. Our study aimed at finding out the prevalence and risk factors of type 2 diabetes among the Bihari adults in Dhaka city. Methods This cross-sectional community-based study was carried out among stranded Pakistanis (known as Bihari) living in camps in the Mirpur area from July 2014 to June 2015. Laboratory-based oral glucose tolerance test (OGTT) was the basis for the diagnosis of type 2 diabetes mellitus (DM). Anthropometric measurements, blood pressure, biochemical tests, family history, and socioeconomic information were obtained to determine the risk factors. Results The prevalence of diabetes mellitus (DM), impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) were estimated at 10.11%, 8.74%, and 4.55%, respectively. Increased diastolic blood pressure, serum triglyceride, and cholesterol level were observed to be significantly (p < 0.05) associated with diabetes. Also, the presence of diabetes, high blood pressure, and obesity among relatives significantly increased the probability of diabetes. Conclusions To the best of our knowledge, this is the first study on diabetes prevalence among the Bihari community in Bangladesh. The prevalence of type 2 diabetes mellitus was found to be higher among the Bihari community compared to the general population in Bangladesh. Health planners and policymakers should realize the alarming situation and identified risk factors and consider the minor ethnic groups during decision-making regarding prevention and control of diabetes and other noncommunicable diseases. PMID:29593946

Medication taking behavior of students attending a private university in Bangladesh.

PubMed

Chowdhury, Nishat; Matin, Fatema; Chowdhury, Sk Feroz Uddin Ahmed

2009-01-01

The objective of this study was to investigate the patterns of self-reported medication use, including both prescription and OTC drugs, and to assess the possible predictors of self-medication and medication non-compliance (non-adherence), for 929 non-medical undergraduate students of the American International University, a private university situated in Dhaka city, Bangladesh. Although a high proportion (69%, n = 644) of students of this university had fallen sick in the last six months before the study, the rate of visiting qualified health practitioners was much lower (53%). A good proportion of the sick students were reported to have practiced self-medication (16%, n = 100) and medication non-adherence (15%, n = 98). The average treatment cost involved in self medication was much lower than that offered by a qualified physician (Tk 463 vs Tk 2546 per case). Those students living with parents were more likely to have visited qualified health practitioners (56%, p < .05), and students whose families kept a well-stocked medicine cabinet at home were more likely to have completed the full course (39%, p < .05) of prescribed medicine. No significant difference was found in the rates of self medication and medication compliance incidence for variables like age groups, gender, residence status, financial level, engagement in part-time jobs etc. The study also showed that antimicrobials are widely available (170 incidents) in the home medicine cabinets of the Dhaka City population. The storage of leftover antibiotics in the home constitutes an alternative potential source of self-medication that can have untoward consequences. Further elaborate studies are required to reveal the true pattern of antibiotic usage in Bangladesh.

Surface water pollution in three urban territories of Nepal, India, and Bangladesh.

PubMed

Karn, S K; Harada, H

2001-10-01

In South Asian countries such as Nepal, India, and Bangladesh, pollution of rivers is more severe and critical near urban stretches due to huge amounts of pollution load discharged by urban activities. The Bagmati River in the Kathmandu valley, the Yamuna River at Delhi, and peripheral rivers (mainly Buriganga River) of Dhaka suffer from severe pollution these days. The observed dry season average of biochemical oxygen demand (BOD) in all these rivers is in the range of 20-30 mg/liter and total coliform are as high as 104-105 MPN/100 ml. Per capita pollution load discharge of urban areas has been estimated to be about 31, 19, and 25 g BOD/capita/day in Bagmati, Yamuna, and the rivers of Dhaka, respectively. Regression analysis reveals pollution loads steadily increasing nearly in step with the trend in urbanization. The dissolved oxygen (DO) level of the Bagmati and Buriganga rivers is declining at an average annual rate of nearly 0.3 mg/liter/year. Unplanned urbanization and industrialization occurring in these cities may be largely responsible for this grave situation. Inadequate sewerage, on-site sanitation, and wastewater treatment facilities in one hand, and lack of effective pollution control measures and their strict enforcement on the other are the major causes of rampant discharge of pollutants in the aquatic systems.

Socioeconomic and Ecological Factors Influencing Aedes aegypti Prevalence, Abundance, and Distribution in Dhaka, Bangladesh

PubMed Central

Dhar-Chowdhury, Parnali; Haque, C. Emdad; Lindsay, Robbin; Hossain, Shakhawat

2016-01-01

This study examined household risk factors and prevalence, abundance, and distribution of immature Aedes aegypti and Aedes albopictus, and their association with socioeconomic and ecological factors at urban zonal and household levels in the city of Dhaka, Bangladesh. During the 2011 monsoon, 826 households in 12 randomly selected administrative wards were surveyed for vector mosquitoes. Results revealed that the abundance and distribution of immature Ae. aegypti and Ae. albopictus, and pupae-per-person indices did not vary significantly among the zones with varied socioeconomic status. Of 35 different types of identified wet containers, 30 were infested, and among the 23 pupae-positive container types, nine were defined as the “most productive” for pupae including: disposable plastic containers (12.2% of 550), sealable plastic barrels (12.0%), tires (10.4%), abandoned plastic buckets (9.6%), flower tub and trays (8.5%), refrigerator trays (6.5%), plastic bottles (6.4%), clay pots (4.9%), and water tanks (1.6%). When the function of the containers was assessed, ornamental, discarded, and household repairing and reconstruction-related container categories were found significantly associated with the number of pupae in the households. The purpose of storing water and income variables were significant predictors of possession of containers that were infested by vector mosquitoes. PMID:27022149

Kal Dristi , Stolen Babies and 'Blocked Uteruses': Poverty and Infertility Anxieties among Married Adolescent Women Living in a Slum in Dhaka, Bangladesh.

PubMed

Rashid, Sabina Faiz

2007-08-01

The paper is about the neglect of infertility and women's interests in the health policy of developing countries, and how this shapes married adolescent women's understandings and practices surrounding infertility. Ethnographic fieldwork among married adolescent girls, aged 15-19, was carried out in a slum in Dhaka, Bangladesh from December 2001 to January 2003, including 50 in-depth interviews and eight case studies from 153 married adolescent girls, and observations and discussions with family and community members. There are newer understandings with the re-labelling of infertility from spirit world afflictions to something that is also attributed to family planning and 'build up of fat' in the uterus and stomach. Corrective practices range from not using or discontinuing a contraceptive method, dilatation and curettage (D&C) and visiting traditional healers. The absence of state services to address infertility concerns has implications for contraceptive use, with unintended pregnancies and unsafe abortions. Local beliefs continue to largely attribute the primary cause of infertility to the spirit world, but the emergence of newer infertility understandings reveal the influence of Western cultural beliefs (family planning campaigns, health practices influenced by biomedicine) and highlight the gender politics in the harsh environment of urban slums.

Molecular Analysis of Glucose-6-Phosphate Dehydrogenase Gene Mutations in Bangladeshi Individuals

PubMed Central

Sarker, Suprovath Kumar; Hossain, Mohammad Amir; Qadri, Syeda Kashfi; Muraduzzaman, A. K. M.; Bhuyan, Golam Sarower; Shahidullah, Mohammod; Mannan, Mohammad Abdul; Tahura, Sarabon; Hussain, Manzoor; Akhter, Shahida; Nahar, Nazmun; Shirin, Tahmina; Qadri, Firdausi; Mannoor, Kaiissar

2016-01-01

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common X-linked human enzyme defect of red blood cells (RBCs). Individuals with this gene defect appear normal until exposed to oxidative stress which induces hemolysis. Consumption of certain foods such as fava beans, legumes; infection with bacteria or virus; and use of certain drugs such as primaquine, sulfa drugs etc. may result in lysis of RBCs in G6PD deficient individuals. The genetic defect that causes G6PD deficiency has been identified mostly as single base missense mutations. One hundred and sixty G6PD gene mutations, which lead to amino acid substitutions, have been described worldwide. The purpose of this study was to detect G6PD gene mutations in hospital-based settings in the local population of Dhaka city, Bangladesh. Qualitative fluorescent spot test and quantitative enzyme activity measurement using RANDOX G6PDH kit were performed for analysis of blood specimens and detection of G6PD-deficient participants. For G6PD-deficient samples, PCR was done with six sets of primers specific for G6PD gene. Automated Sanger sequencing of the PCR products was performed to identify the mutations in the gene. Based on fluorescence spot test and quantitative enzyme assay followed by G6PD gene sequencing, 12 specimens (11 males and one female) among 121 clinically suspected patient-specimens were found to be deficient, suggesting a frequency of 9.9% G6PD deficiency. Sequencing of the G6PD-deficient samples revealed c.C131G substitution (exon-3: Ala44Gly) in six samples, c.G487A substitution (exon-6:Gly163Ser) in five samples and c.G949A substitution (exon-9: Glu317Lys) of coding sequence in one sample. These mutations either affect NADP binding or disrupt protein structure. From the study it appears that Ala44Gly and Gly163Ser are the most common G6PD mutations in Dhaka, Bangladesh. This is the first study of G6PD mutations in Bangladesh. PMID:27880809

Impacts of policy and market incentives for solid waste recycling in Dhaka, Bangladesh.

PubMed

Matter, Anne; Ahsan, Mehedi; Marbach, Michelle; Zurbrügg, Christian

2015-05-01

Solid waste mismanagement in Dhaka, Bangladesh, illustrates a well-known market failure which can be summarized as: waste is a resource in the wrong place. Inorganic materials such as plastic or paper can be used to feed the demand for recycled materials in the industrial sector. Organic materials can be converted and used in the nutrient-starved agricultural sector which is currently heavily depending on chemical fertilizers. They are also a feedstock to generate renewable energy in the form of biogas for this energy-starved country relying on diminishing natural gas reserves and increasing import of coal. Reality however does not capitalize on this potential; instead the waste is a burden for municipal authorities who spend large portions of their budgets attempting to transport it out of the city for discharge into landfills. The major part of these materials still remains uncollected in the residential areas and is discarded indiscriminately in open spaces, polluting the residents' living environment including water, soil and air resources, in the city and beyond. Bangladeshi authorities have, to some extent, recognized this market failure and have developed policies to encourage the development of waste recycling activities. It is also important to note that this market failure is only partial: a large, mostly informal recycling sector has developed in Bangladesh, focusing on inorganic recyclables of market value. The fact that this sector remains largely informal means that these actors perceive significant barriers to formalization. Comparatively, the organic waste recycling sector is less driven by market mechanisms. Competition from chemical fertilizers and fossil fuels is fierce and hinders the development of market opportunities for compost and renewable energy. Nevertheless commercial production of compost and biogas from organic municipal waste is formalized and benefiting from policy incentives. Copyright © 2015 Elsevier Ltd. All rights reserved.

Prenatal folic acid use associated with decreased risk of myelomeningocele: A case-control study offers further support for folic acid fortification in Bangladesh.

PubMed

Kancherla, Vijaya; Ibne Hasan, Md Omar Sharif; Hamid, Rezina; Paul, Ligi; Selhub, Jacob; Oakley, Godfrey; Quamruzzaman, Quazi; Mazumdar, Maitreyi

2017-01-01

Neural tube defects contribute to severe morbidity and mortality in children and adults; however, they are largely preventable through maternal intake of folic acid before and during early pregnancy. We examined the association between maternal prenatal folic acid supplement intake and risk of myelomeningocele (a severe and common type of neural tube defect) in the offspring. We performed secondary analysis using data from a case-control study conducted at Dhaka Community Hospital, Bangladesh between April and November of 2013. Cases and controls included children with and without myelomeningocele, respectively, and their mothers. Cases were identified from local hospitals and rural health clinics served by Dhaka Community Hospital. Controls were selected from pregnancy registries located in the same region as the cases, and matched (1:1) to cases by age and sex. Myelomeningocele in the offspring was confirmed by a pediatrician with expertise in classifying neural tube defects. Maternal prenatal folic acid supplement intake was the main exposure of interest. We estimated crude and adjusted odds ratios (OR) and 95% confidence intervals (CI) using conditional logistic regression analysis. There were 53 pairs of matched cases and controls in our study. Overall, 51% of case mothers reported using folic acid supplements during pregnancy compared to 72% of control mothers (p = 0.03). Median plasma folate concentrations at the time of study visit were 2.79 ng/mL and 2.86 ng/mL among case and control mothers, respectively (p = 0.85). Maternal prenatal folic acid use significantly decreased the odds of myelomeningocele in the offspring (unadjusted OR = 0.42, 95% CI = 0.18-0.96). The association was slightly attenuated after adjusting for maternal age at the time of pregnancy (adjusted OR = 0.43, 95% CI = 0.18-1.02). Our study confirms the protective association between maternal prenatal folic acid supplement use and myelomeningocele among children born in Bangladesh. Our findings point to an overall low folic acid supplement use and low plasma folate concentrations among women of reproductive age in Bangladesh. Mandatory fortification of staple foods with folic acid can address low folate status among women of child-bearing age, and prevent child morbidity and mortality associated with myelomeningocele in Bangladesh.

Molecular Analysis of Glucose-6-Phosphate Dehydrogenase Gene Mutations in Bangladeshi Individuals.

PubMed

Sarker, Suprovath Kumar; Islam, Md Tarikul; Eckhoff, Grace; Hossain, Mohammad Amir; Qadri, Syeda Kashfi; Muraduzzaman, A K M; Bhuyan, Golam Sarower; Shahidullah, Mohammod; Mannan, Mohammad Abdul; Tahura, Sarabon; Hussain, Manzoor; Akhter, Shahida; Nahar, Nazmun; Shirin, Tahmina; Qadri, Firdausi; Mannoor, Kaiissar

2016-01-01

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common X-linked human enzyme defect of red blood cells (RBCs). Individuals with this gene defect appear normal until exposed to oxidative stress which induces hemolysis. Consumption of certain foods such as fava beans, legumes; infection with bacteria or virus; and use of certain drugs such as primaquine, sulfa drugs etc. may result in lysis of RBCs in G6PD deficient individuals. The genetic defect that causes G6PD deficiency has been identified mostly as single base missense mutations. One hundred and sixty G6PD gene mutations, which lead to amino acid substitutions, have been described worldwide. The purpose of this study was to detect G6PD gene mutations in hospital-based settings in the local population of Dhaka city, Bangladesh. Qualitative fluorescent spot test and quantitative enzyme activity measurement using RANDOX G6PDH kit were performed for analysis of blood specimens and detection of G6PD-deficient participants. For G6PD-deficient samples, PCR was done with six sets of primers specific for G6PD gene. Automated Sanger sequencing of the PCR products was performed to identify the mutations in the gene. Based on fluorescence spot test and quantitative enzyme assay followed by G6PD gene sequencing, 12 specimens (11 males and one female) among 121 clinically suspected patient-specimens were found to be deficient, suggesting a frequency of 9.9% G6PD deficiency. Sequencing of the G6PD-deficient samples revealed c.C131G substitution (exon-3: Ala44Gly) in six samples, c.G487A substitution (exon-6:Gly163Ser) in five samples and c.G949A substitution (exon-9: Glu317Lys) of coding sequence in one sample. These mutations either affect NADP binding or disrupt protein structure. From the study it appears that Ala44Gly and Gly163Ser are the most common G6PD mutations in Dhaka, Bangladesh. This is the first study of G6PD mutations in Bangladesh.

Diabetes knowledge and utilization of healthcare services among patients with type 2 diabetes mellitus in Dhaka, Bangladesh.

PubMed

Siddique, Md Kaoser Bin; Islam, Sheikh Mohammed Shariful; Banik, Palash Chandra; Rawal, Lal B

2017-08-22

Diabetes is a significant global public health concern. Poor knowledge of disease and healthcare utilization is associated with worse health outcomes, leading to increasing burden of diabetes in many developing countries. This study aimed to determine diabetes related knowledge and factors affecting utilization of healthcare services among patients with type 2 diabetes mellitus in Bangladesh. This analytical study was conducted among 318 patients with type 2 diabetes (T2DM) attending two large tertiary hospitals in Dhaka, Bangladesh between August 2014 and January 2015. Interviewer assisted semi-structured survey questionnaire was used to collect data on diabetes knowledge (measured by a validated Likert scale) and self-reported utilization of service for diabetes. Univariate and bivariate analyses were conducted to determine the factors associated with diabetes knowledge and healthcare utilization. The mean (±SD) age of participants was 52 (±10) years. Majority of the participants were females (58%) and urban residents (74%). Almost two-third (66%) of the participants had an average level of knowledge of T2DM. One-fifth (21%) of the participants had poor knowledge which was significantly associated with gender (P < 0.002), education (P < 0 .001) and income (P < 0.001). The median travel and waiting time at the facility was 30 and 45 min respectively. More than one-third (37%) of the participants checked their blood glucose monthly. Most patients were satisfied regarding the family (55%) and hospital (67%) support. T2DM patients had average knowledge of diabetes which might affect the utilization of healthcare services for diabetes management. Innovations in increasing diabetes knowledge and health behavior change are recommended specially for females, those with lower education and less income.

Accumulation of heavy metals in soil and their transfer to leafy vegetables in the region of Dhaka Aricha Highway, Savar, Bangladesh.

PubMed

Aktaruzzaman, M; Fakhruddin, A N M; Chowdhury, M A Z; Fardous, Z; Alam, M K

2013-04-01

Accumulation of heavy metals in environmental matrices is a potential risk to living system due to their uptake by plants and subsequent introduction into the food chain. A study was conducted to investigate the heavy metals concentration in soils and leafy vegetables samples along the Dhaka Aricha Road to assess their potential ecological risk. Heavy metals concentration was analyzed by Atomic Absorption Spectroscopy. Concentrations ofallthetestedheavy metals except Cd in soil samples were below the permissible level. The mean concentration of Cd was found 3.99 +/- 1.85 mg kg(-1). Concentrations of all the tested heavy metals except Cd and Cr in vegetables samples were lower than recommended level. Mean concentration of Cd and Cr were found 1.00 +/- 0.68 mg kg(-1) and 2.32 +/- 0.84 mg kg(-1), respectively. Based on the Potential Ecological Risk Index, Cd posed very high risk to the local ecosystem due to its higher Risk Factor, > 320 and based on Transfer Factor of Pb and Cd were found higher accumulator among the tested metals. The results of present study revealed that the bioconcentration of heavy metals along the Dhaka Aricha Road posed high risk to the ecosystem. Considering the Transfer Factor of Cd and Pb it can be suggested that plants and leafy vegetables grow in the soil near Dhaka Aricha Road should not be used as food or feed.

Durbolota (weakness), chinta rog (worry illness), and poverty: explanations of white discharge among married adolescent women in an urban slum in Dhaka, Bangladesh.

PubMed

Rashid, Sabina Faiz

2007-03-01

I carried out ethnographic fieldwork among 153 married adolescent girls, aged 15-19, in a Dhaka slum from December 2001 to January 2003, including 50 in-depth interviews and eight case studies. I also held discussions with family and community members. In this article, I focus on popular understandings of vaginal discharge being caused by durbolota (weakness) and chinta rog (worry illness), as mentioned by young women. Eighty-eight young women reported that they had experienced white discharge, blaming it on a number of factors such as stress and financial hardships, tensions in the household, marital instability, hunger anxiety, and reproductive burdens. For married adolescent women in the urban slum, white discharge has many levels of meaning linked to the broader social, political, and material inequalities in their everyday lives.

The increased severity in patients presenting to hospital with diarrhea in Dhaka, Bangladesh since the emergence of the hybrid strain of Vibrio cholerae O1 is not unique to cholera patients.

PubMed

Chowdhury, Fahima; Kuchta, Alison; Khan, Ashraful Islam; Faruque, A S G; Calderwood, Stephen B; Ryan, Edward T; Qadri, Firdausi

2015-11-01

A hybrid strain of Vibrio cholerae O1 El Tor that expresses a classical cholera toxin (CT) emerged in 2001. This hybrid variant rapidly replaced the previous El Tor strain around the world. The global emergence of this variant coincided with anecdotal reports that cholera patients were presenting with more severe dehydration and disease in many locations. A comparison was made of the severity of disease before and after the emergence of the hybrid strain in cholera patients attending an icddr,b hospital in Dhaka, Bangladesh. It was found that cholera patients presented with more severe dehydration and severe disease in the later period. However, this was also true for all non-cholera patients as well. In addition, in sub-analyses of patients who presented with rotavirus and enterotoxigenic Escherichia coli (ETEC), similar results were found. Comparing the two periods for differences in patient characteristics, nutritional status, vaccination status, and income, no plausible cause for patients presenting with more severe disease was identified in the later period. As a shift in severity for both cholera and non-cholera was observed, these results indicate that the altered El Tor strain cannot fully explain the difference in cholera severity before and after 2001. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Hydrogeochemical Analysis of an Overexploited Aquifer In Bangladesh Toward Managed Aquifer Recharge Project Implementation

NASA Astrophysics Data System (ADS)

Rahman, M. A.; Wiegand, B. A.; Pervin, M.; Sauter, M.

2012-12-01

In most parts of the upper Dupitila aquifer (Dhaka City, Bangladesh) the average groundwater depletion reaches 2-3 m/year due to increasing water demands of the growing population. To counteract overexploitation of the aquifer, a more sustainable water management is required. The analysis of the local water resources system suggests that Managed Aquifer Recharge (MAR) would help to restore groundwater resources to strengthen water supply of Dhaka City, e.g., by using collected urban monsoon runoff and excess surface water from rivers. To assess possible effects of surface water or rainwater injection on groundwater quality, a comprehensive hydrogeochemical survey of the Dupitila aquifer is required. This paper presents hydrogeochemical data to document the current status of groundwater quality and to evaluate potential groundwater pollution by mobilization of hazardous chemicals as a result of changes in the hydrochemical equilibria. We performed a comprehensive review of available secondary data sources and will present new results from hydrochemical and Sr isotope investigations of water samples that were conducted within this study. Currently, groundwater quality in the upper Dupitila aquifer is characterized by variations in the electrical conductivity in the range of 200 to 1100 μS/cm, which may indicate some anthropogenic contamination by leakage from waste disposal including the sewage network and from surface water infiltration into the groundwater aquifer. Dissolved oxygen concentrations range from 1.0 to 4.9 mg/L (average 2.5 mg/L) in the upper Dupitila aquifer, while the lower Dupilita aquifer shows dissolved oxygen concentrations in the range 0 to 0.7 mg/L. Concentrations of major ions show some variation primarily due to a sedimentologically/mineralogically heterogeneous aquifer composition (sand, gravel, clay horizons), but may also be affected by anthropogenic processes. The groundwater composition is predominated by Ca-Mg-HCO3 and saturation values with respect to calcite are between -0.1 and -2.0. Trace elements are generally below WHO and Bangladesh standard values, except for higher iron and manganese concentrations in some wells. Groundwater from the Dupitila aquifer is not contaminated by arsenic, but mobilisation of arsenic from the aquifer sediments may occur when iron (III) oxides are dissolved in the storage zone. Based on the evaluation of hydrogeochemical data the major challenges and uncertainties of a MAR project implementation in Dhaka City will be discussed.

Influence of Health Warnings on Beliefs about the Health Effects of Cigarette Smoking, in the Context of an Experimental Study in Four Asian Countries

PubMed Central

Mutti-Packer, Seema; Gupta, Prakash C.; Li, Qiang; Yuan, Jiang; Nargis, Nigar; Hussain, A. K. M. Ghulam; Hammond, David

2017-01-01

Cigarette package health warnings can be an important and low-cost means of communicating the health risks of smoking. We examined whether viewing health warnings in an experimental study influenced beliefs about the health effects of smoking, by conducting surveys with ~500 adult male smokers and ~500 male and female youth (age 16–18) in Beijing, China (n = 1070), Mumbai area, India (n = 1012), Dhaka, Bangladesh (n = 1018), and Republic of Korea (n = 1362). Each respondent was randomly assigned to view and rate pictorial health warnings for 2 of 15 different health effects, after which they reported beliefs about whether smoking caused 12 health effects. Respondents who viewed relevant health warnings (vs. other warnings) were significantly more likely to believe that smoking caused that particular health effect, for several health effects in each sample. Approximately three-quarters of respondents in China (Beijing), Bangladesh (Dhaka), and Korea (which had general, text-only warnings) thought that cigarette packages should display more health information, compared to approximately half of respondents in the Mumbai area, India (which had detailed pictorial warnings). Pictorial health warnings that convey the risk of specific health effects from smoking can increase beliefs and knowledge about the health consequences of smoking, particularly for health effects that are lesser-known. PMID:28767068

Emerging changes in reproductive behaviour among married adolescent girls in an urban slum in Dhaka, Bangladesh.

PubMed

Rashid, Sabina Faiz

2006-05-01

Structural and social inequalities, a harsh political economy and neglect on the part of the state have made married adolescent girls an extremely vulnerable group in the urban slum environment in Bangladesh. The importance placed on newly married girls' fertility results in high fertility rates and low rates of contraceptive use. Ethnographic fieldwork among married adolescent girls, aged 15-19, was carried out in a Dhaka slum from December 2001-January 2003, including 50 in-depth interviews and eight case studies from among 153 married adolescent girls, and observations and discussions with family and community members. Cultural and social expectations meant that 128 of the girls had borne children before they were emotionally or physically ready. Twenty-seven had terminated their pregnancies, of whom 11 reported they were forced to do so by family members. Poverty, economic conditions, marital insecurity, politics in the household, absence of dowry and rivalry among family, co-wives and in-laws made these young women acquiesce to decisions made by others in order to survive. Young married women's status is changing in urban slum conditions. When their economical productivity takes priority over their reproductive role, the effects on reproductive decision-making within families may be considerable. This paper highlights the vulnerability of young women as they pragmatically make choices within the social and structural constraints in their lives.

Environmental Spread of New Delhi Metallo-β-Lactamase-1-Producing Multidrug-Resistant Bacteria in Dhaka, Bangladesh

PubMed Central

Islam, Moydul; Hasan, Rashedul; Hossain, M. Iqbal; Nabi, Ashikun; Rahman, Mahdia; Goessens, Wil H. F.; Endtz, Hubert P.; Faruque, Shah M.

2017-01-01

ABSTRACT Resistance to carbapenem antibiotics through the production of New Delhi metallo-β-lactamase-1 (NDM-1) constitutes an emerging challenge in the treatment of bacterial infections. To monitor the possible source of the spread of these organisms in Dhaka, Bangladesh, we conducted a comparative analysis of wastewater samples from hospital-adjacent areas (HAR) and from community areas (COM), as well as public tap water samples, for the occurrence and characteristics of NDM-1-producing bacteria. Of 72 HAR samples tested, 51 (71%) samples were positive for NDM-1-producing bacteria, as evidenced by phenotypic tests and the presence of the blaNDM-1 gene, compared to 5 of 41 (12.1%) samples from COM samples (P < 0.001). All tap water samples were negative for NDM-1-producing bacteria. Klebsiella pneumoniae (44%) was the predominant bacterial species among blaNDM-1-positive isolates, followed by Escherichia coli (29%), Acinetobacter spp. (15%), and Enterobacter spp. (9%). These bacteria were also positive for one or more other antibiotic resistance genes, including blaCTX-M-1 (80%), blaCTX-M-15 (63%), blaTEM (76%), blaSHV (33%), blaCMY-2 (16%), blaOXA-48-like (2%), blaOXA-1 (53%), and blaOXA-47-like (60%) genes. Around 40% of the isolates contained a qnr gene, while 50% had 16S rRNA methylase genes. The majority of isolates hosted multiple plasmids, and plasmids of 30 to 50 MDa carrying blaNDM-1 were self-transmissible. Our results highlight a number of issues related to the characteristics and source of spread of multidrug-resistant bacteria as a potential public health threat. In view of the existing practice of discharging untreated liquid waste into the environment, hospitals in Dhaka city contribute to the potential dissemination of NDM-1-producing bacteria into the community. IMPORTANCE Infections caused by carbapenemase-producing Enterobacteriaceae are extremely difficult to manage due to their marked resistance to a wide range of antibiotics. NDM-1 is the most recently described carbapenemase, and the blaNDM-1 gene, which encodes NDM-1, is located on self-transmissible plasmids that also carry a considerable number of other antibiotic resistance genes. The present study shows a high prevalence of NDM-1-producing organisms in the wastewater samples from hospital-adjacent areas as a potential source for the spread of these organisms to community areas in Dhaka, Bangladesh. The study also examines the characteristics of the isolates and their potential to horizontally transmit the resistance determinants. The significance of our research is in identifying the mode of spread of multiple-antibiotic-resistant organisms, which will allow the development of containment measures, leading to broader impacts in reducing their spread to the community. PMID:28526792

Safety of the oral cholera vaccine in pregnancy: Retrospective findings from a subgroup following mass vaccination campaign in Dhaka, Bangladesh.

PubMed

Khan, Ashraful Islam; Ali, Mohammad; Chowdhury, Fahima; Saha, Amit; Khan, Iqbal Ansary; Khan, Arifuzzaman; Akter, Afroza; Asaduzzaman, Muhammad; Islam, Md Taufiqul; Kabir, Alamgir; You, Young Ae; Saha, Nirod Chandra; Cravioto, Alejandro; Clemens, John D; Qadri, Firdausi

2017-03-13

Pregnant women are vulnerable to complications of cholera. Killed oral cholera vaccines (OCV) are not recommended for pregnant women though there is no evidence of harmful effects during pregnancy. We evaluated the effect of a killed OCV, Shanchol™, on pregnancy outcomes during an effectiveness trial of the vaccine in urban Bangladesh. Individuals ⩾1year were invited to participate in the trial, conducted in 2011 in Dhaka, Bangladesh. Pregnancy by history was an exclusion criterion and all women of reproductive age (15-49years) were verbally questioned about pregnancy at enrollment and prior to vaccination. Out of 48,414 women of reproductive age 286 women received the OCV unknowingly while pregnant. Out of these, we could recruit 69 women defined as exposed to OCV. Accordingly, we selected 69 pregnant women randomly from those who did not take the OCV (non-exposed to OCV). We evaluated adverse pregnancy outcome (spontaneous miscarriages, still births, or congenital malformations) between those who were exposed to OCV and those who were not exposed to OCV. About 16% of pregnant women exposed to OCV had pregnancy loss, as compared to 12% of unvaccinated pregnant women (P=0.38). One congenital anomaly was observed and occurred in women non-exposed to OCV group. Models that adjusted for baseline characteristics that were unbalanced between the exposed and non-exposed groups, revealed a no elevation of risk of adverse pregnancy outcomes in vaccinees versus non-vaccinees (Adj. OR (95% CI): 0.45 (0.11-1.88). No excess of adverse fetal outcomes associated with receipt of OCV was observed in this study. Clinical Trials.gov number NCT01339845. Copyright © 2017. Published by Elsevier Ltd.

Attitude towards diabetes and social and family support among type 2 diabetes patients attending a tertiary-care hospital in Bangladesh: a cross-sectional study.

PubMed

Shawon, Md Shajedur Rahman; Hossain, Fariha Binte; Adhikary, Gourab; Das Gupta, Rajat; Hashan, Mohammad Rashidul; Rabbi, Md Fazla; Ahsan, G U

2016-05-26

Bangladesh has been suffering from an epidemiological transition from infectious and maternal diseases to non-communicable lifestyle-related diseases like diabetes, cardiovascular diseases, cancers etc. The burden of diabetes has been increasing rapidly due to high incidence as well as poor glycemic control leading to various macro and micro-vascular complications. In this study, we aim to assess the attitude towards diabetes and social and family support among the Bangladeshi type 2 diabetic mellitus (T2DM) patients. This was a cross-sectional study among 144 patients with T2DM at the medicine outpatient department of Dhaka Medical College Hospital (DMCH) in Dhaka, Bangladesh between 1 July and 31 July 2014. Data collection was done by interviewing patients using structured questionnaire. Understanding diabetes, education/advice received, attitude towards diabetes, family and friend support were measured by validated scales adapted from diabetes care profile. This study includes a total of 144 patients (101 males and 43 females) with type 2 diabetes aged between 20 and 84 years. 87 % of the patients had inadequate blood glucose control (fasting blood sugar >7.2 mmol/L or >130 mg/dl). Statistically significant differences were observed in the mean scores of various attitude scales (i.e. positive, negative, care ability and self-care adherence scale) among patients with adequate and inadequate blood glucose control (p < 0.05). Statistically significant positive correlations were found between these three categories of social and family support. Self-satisfaction with diabetic care was significantly associated with adequate blood glucose control (p = 0.05). Positive attitude towards diabetes management and support from friends and family were associated with adequate diabetes management. Appropriate public health interventions should be designed to educate and motivate the family members to offer greater support to the diabetes patients.

Sociodemographic and geographical inequalities in under- and overnutrition among children and mothers in Bangladesh: a spatial modelling approach to a nationally representative survey.

PubMed

Mia, Mohammad Nahid; Rahman, M Shafiqur; Roy, Paritosh K

2018-05-02

To investigate the sociodemographic and geographical variation in under- and overnutrition prevalence among children and mothers. Data from the 2014 Bangladesh Demographic and Health Survey were analysed. Stunting and wasting for children and BMI<18·5 kg/m2 for mothers were considered as undernutrition; overweight was considered as overnutrition for both children and mothers. We estimated the prevalence and performed simple logistic regression analyses to assess the associations between outcome variables and predictors. Bayesian spatial models were applied to estimate region-level prevalence to identify the regions (districts) prone to under- and overnutrition.Settings/SubjectsChildren aged<5 years and their mothers aged 15-49 years in Bangladesh. A significant difference (P<0·001) was observed in both under- and overnutrition prevalence between poor and rich. A notable regional variation was also observed in under- and overnutrition prevalence. Stunting prevalence ranged from 20·3 % in Jessore to 56·2 % in Sunamgonj, wasting from 10·6 % in Dhaka to 19·2 % in Bhola, and overweight from 0·8 % in Shariatpur to 2·6 % in Dhaka. Of the sixty-four districts, twelve had prevalence of stunting and thirty-two districts had prevalence of wasting higher than the WHO critical threshold levels. Similarly, fifty-three districts had prevalence of maternal underweight higher than the national level. In contrast, the prevalence of overweight was comparatively high in the industrially equipped metropolitan districts. Observed sociodemographic and geographical inequalities imply slow progress in the overall improvement of both under- and overnutrition. Therefore, effective intervention programmes and policies need to be designed urgently targeting the grass-roots level of such regions.

Factors driving customers to seek health care from pharmacies for acute respiratory illness and treatment recommendations from drug sellers in Dhaka city, Bangladesh.

PubMed

Chowdhury, Fahmida; Sturm-Ramirez, Katharine; Mamun, Abdullah Al; Iuliano, A Danielle; Bhuiyan, Mejbah Uddin; Chisti, Mohammod Jobayer; Ahmed, Makhdum; Haider, Sabbir; Rahman, Mahmudur; Azziz-Baumgartner, Eduardo

2017-01-01

Pharmacies in Bangladesh serve as an important source of health service. A survey in Dhaka reported that 48% of respondents with symptoms of acute respiratory illness (ARI) identified local pharmacies as their first point of care. This study explores the factors driving urban customers to seek health care from pharmacies for ARI, their treatment adherence, and outcome. A cross-sectional study was conducted among 100 selected pharmacies within Dhaka from June to December 2012. Study participants were patients or patients' relatives aged >18 years seeking care for ARI from pharmacies without prescription. Structured interviews were conducted with customers after they sought health service from drug sellers and again over phone 5 days postinterview to discuss treatment adherence and outcome. We interviewed 302 customers patronizing 76 pharmacies; 186 (62%) sought care for themselves and 116 (38%) sought care for a sick relative. Most customers (215; 71%) were males. The majority (90%) of customers sought care from the study pharmacy as their first point of care, while 18 (6%) had previously sought care from another pharmacy and 11 (4%) from a physician for their illness episodes. The most frequently reported reasons for seeking care from pharmacies were ease of access to pharmacies (86%), lower cost (46%), availability of medicine (33%), knowing the drug seller (20%), and convenient hours of operation (19%). The most commonly recommended drugs were acetaminophen dispensed in 76% (228) of visits, antihistamine in 69% (208), and antibiotics in 42% (126). On follow-up, most (86%) of the customers had recovered and 12% had sought further treatment. People with ARI preferred to seek care at pharmacies rather than clinics because these pharmacies were more accessible and provided prompt treatment and medicine with no service charge. We recommend raising awareness among drug sellers on proper dispensing practices and enforcement of laws and regulations for drug sales.

Correlates of exposure to secondhand smoke (SHS) at home among non-smoking adults in Bangladesh: findings from the ITC Bangladesh survey

PubMed Central

2014-01-01

Background Exposure to secondhand smoke (SHS) is a serious global public health problem. Understanding the correlates of SHS exposure could guide the development of evidence based SHS exposure reduction interventions. The purpose of this study is to describe the pattern of and factors associated with SHS exposure among non-smoking adults in Bangladesh. Methods Data come from adult non-smokers who participated in the second wave (2010) of the International Tobacco Control Policy (ITC) Evaluation Bangladesh Survey conducted in all six administrative divisions of Bangladesh. A structured questionnaire gathered information on participants’ demographic characteristics, pattern of SHS exposure, SHS knowledge, and attitudes towards tobacco control. Exposure to SHS at home was defined as non-smokers who lived with at least one smoker in their household and who reported having no home smoking ban. The data were analyzed using chi-square tests and logistic regression procedures. Results The SHS exposure rate at home among the participants (N = 2813) was 43%. Several sociodemographic and attitudinal factors were associated with SHS exposure. Logistic regression analyses identified eight predictors of SHS exposure: being female (OR = 2.35), being aged 15–24 (OR = 2.17), being recruited from Dhaka slums (OR = 5.19) or non-tribal/non-border areas outside Dhaka (OR = 2.19) or tribal/border area (OR = 4.36), having lower education (1–8 years: OR = 2.45; illiterate: OR = 3.00, having higher monthly household income (5000 to <10,000 Taka: OR = 2.34; 10,000 Taka or more: OR = 2.28), having a father who smoked in the past or currently smokes (OR = 2.09), having lower concern about the harms of tobacco on children (unconcerned OR = 3.99; moderate concern OR = 2.26), and not knowing the fact that SHS causes lung cancer in non-smokers (OR = 2.04). Conclusions Almost half of non-smoking Bangladeshi adults are exposed to SHS at home. The findings suggest the need for comprehensive tobacco control measures that would improve public understanding about health hazards of SHS exposure at home and encourage educational initiatives to promote smoke-free homes. Interventions should deliver targeted messages to reach those in the low socioeconomic status group. PMID:25027238

An empirical study of mHealth adoption in a developing country: the moderating effect of gender concern.

PubMed

Hoque, Md Rakibul

2016-05-03

mHealth has become a valuable tool for providing health care services in developing countries. Despite the potential benefits of mHealth, its adoption remains a very challenge in developing countries like Bangladesh. The aim of this study is to investigate the factors that affect the adoption of mHealth services in Bangladesh using Extended Technology Acceptance Model (TAM). Data were collected from over 250 respondents in Dhaka, Bangladesh. The data were analyzed using the Partial Least Squares (PLS) method, a statistical analysis technique based on the Structural Equation Modeling (SEM). The study found that perceived ease of use, perceived usefulness and subjective norm (p < 0.05) had significant positive impact on the intention to adopt mHealth services. Surprisingly, the effects of personal innovativeness in IT (p > 0.05) on mHealth adoption were insignificant. This study also revealed that gender was strongly associated with the adoption and use of mHealth in developing countries. The findings of this study can be used by government, policy makers, and mobile phone Company to maximize the acceptance of mHealth services in Bangladesh. The paper concludes with a discussion of research results and draws several implications for future research.

Meso-scale on-road vehicle emission inventory approach: a study on Dhaka City of Bangladesh supporting the 'cause-effect' analysis of the transport system.

PubMed

Iqbal, Asif; Allan, Andrew; Zito, Rocco

2016-03-01

The study aims to develop an emission inventory (EI) approach and conduct an inventory for vehicular sources in Dhaka City, Bangladesh. A meso-scale modelling approach was adopted for the inventory; the factors that influence the emissions and the magnitude of emission variation were identified and reported on, which was an innovative approach to account emissions unlike the conventional inventory approaches. Two techniques for the emission inventory were applied, viz. (i) a combined top-down and bottom-up approach that considered the total vehicle population and the average diurnal on-road vehicle speed profile in the city and (ii) a bottom-up approach that accounted for road link-specific emissions of the city considering diurnal traffic volume and speed profiles of the respective roads. For the bottom-up approach, road link-specific detailed data were obtained through field survey in 2012, where mid-block traffic count of the day, vehicle speed profile, road network and congestion data were collected principally. The emission variances for the change in transport system characteristics (like change in fuel type, AC usage pattern, increased speed and reduced congestion/stopping) were predicted and analysed in this study; congestion influenced average speed of the vehicles, and fuel types in the vehicles were identified as the major stressors. The study performance was considered reasonable when comparing with the limited number of similar studies conducted earlier. Given the increasing trend of private vehicles each year coupled with increasing traffic congestion, the city is under threat of increased vehicular emissions unless a good management strategy is implemented. Although the inventory is conducted for Dhaka and the result may be important locally, the approach adopted in this research is innovative in nature to be followed for conducting research on other urban transport systems.

Traditional medicinal plants used for the treatment of diabetes in rural and urban areas of Dhaka, Bangladesh--an ethnobotanical survey.

PubMed

Ocvirk, Soeren; Kistler, Martin; Khan, Shusmita; Talukder, Shamim Hayder; Hauner, Hans

2013-06-24

The usage of medicinal plants is traditionally rooted in Bangladesh and still an essential part of public healthcare. Recently, a dramatically increasing prevalence brought diabetes mellitus and its therapy to the focus of public health interests in Bangladesh. We conducted an ethnobotanical survey to identify the traditional medicinal plants being used to treat diabetes in Bangladesh and to critically assess their anti-diabetic potentials with focus on evidence-based criteria. In an ethnobotanical survey in defined rural and urban areas 63 randomly chosen individuals (health professionals, diabetic patients), identified to use traditional medicinal plants to treat diabetes, were interviewed in a structured manner about their administration or use of plants for treating diabetes. In total 37 medicinal plants belonging to 25 families were reported as being used for the treatment of diabetes in Bangladesh. The most frequently mentioned plants were Coccinia indica, Azadirachta indica, Trigonella foenum-graecum, Syzygium cumini, Terminalia chebula, Ficus racemosa, Momordica charantia, Swietenia mahagoni. Traditional medicinal plants are commonly used in Bangladesh to treat diabetes. The available data regarding the anti-diabetic activity of the detected plants is not sufficient to adequately evaluate or recommend their use. Clinical intervention studies are required to provide evidence for a safe and effective use of the identified plants in the treatment of diabetes.

Megacity pumping and preferential flow threaten groundwater quality

PubMed Central

Khan, Mahfuzur R.; Koneshloo, Mohammad; Knappett, Peter S. K.; Ahmed, Kazi M.; Bostick, Benjamin C.; Mailloux, Brian J.; Mozumder, Rajib H.; Zahid, Anwar; Harvey, Charles F.; van Geen, Alexander; Michael, Holly A.

2016-01-01

Many of the world's megacities depend on groundwater from geologically complex aquifers that are over-exploited and threatened by contamination. Here, using the example of Dhaka, Bangladesh, we illustrate how interactions between aquifer heterogeneity and groundwater exploitation jeopardize groundwater resources regionally. Groundwater pumping in Dhaka has caused large-scale drawdown that extends into outlying areas where arsenic-contaminated shallow groundwater is pervasive and has potential to migrate downward. We evaluate the vulnerability of deep, low-arsenic groundwater with groundwater models that incorporate geostatistical simulations of aquifer heterogeneity. Simulations show that preferential flow through stratigraphy typical of fluvio-deltaic aquifers could contaminate deep (>150 m) groundwater within a decade, nearly a century faster than predicted through homogeneous models calibrated to the same data. The most critical fast flowpaths cannot be predicted by simplified models or identified by standard measurements. Such complex vulnerability beyond city limits could become a limiting factor for megacity groundwater supplies in aquifers worldwide. PMID:27673729

Strategies for providing healthcare services to street-dwellers in Dhaka city: Evidence from an operations research

PubMed Central

2012-01-01

Background In almost every major urban city, thousands of people live in overcrowded slums, streets, or other public places without any health services. Bangladesh has experienced one of the highest rates of urban population growth in the last three decades compared to the national population growth rate. The numbers of the urban poor and street-dwellers are likely to increase at least in proportion to the overall population growth of the country. The street-dwellers in Bangladesh are extremely vulnerable in terms of their health needs and healthcare-seeking behaviours. In Bangladesh, there is no health service-delivery mechanism targeting this marginalized group of people. This study, therefore, assessed the effectiveness of two models to provide primary healthcare (PHC) services to street-dwellers. Methods This study of experimental pre-post design tested two models, such as static clinic and satellite clinics, for providing PHC services to street-dwellers in the evening through paramedics in Dhaka city during May 2009-April 2010. Both quantitative and qualitative techniques were used for collecting data. Data were analyzed comparing before and after the implementation of the clinics for the assessment of selected health and family-planning indicators using the statistical t-test. Services received from the model l and model 2 clinics were also compared by calculating the absolute difference to determine the relative effectiveness of one model over another. Results The use of healthcare services by the street-dwellers increased at endline compared to baseline in both the model clinic areas, and the difference was highly significant (p < 0.001). Institutional delivery among the female street-dwellers increased at endline compared to baseline in both the clinic areas. The use of family-planning methods among females also significantly (p < 0.001) increased at endline compared to baseline in both the areas. Conclusions As the findings of the study showed the promise of this approach, the strategies could be implemented in all other cities of Bangladesh and in other countries which encounter similar problems. PMID:22694892

Long-term impact of changing childhood malnutrition on rotavirus diarrhoea: Two decades of adjusted association with climate and socio-demographic factors from urban Bangladesh.

PubMed

Das, Sumon Kumar; Chisti, Mohammod Jobayer; Sarker, Mohammad Habibur Rahman; Das, Jui; Ahmed, Shawnawaz; Shahunja, K M; Nahar, Shamsun; Gibbons, Nora; Ahmed, Tahmeed; Faruque, Abu Syed Golam; Rahman, Mustafizur; J Fuchs, George; Al Mamun, Abdullah; John Baker, Peter

2017-01-01

There is strong association between childhood rotavirus, diarrhoea, climate factors and malnutrition. Conversely, a significant nutritional transition (reduced under-nutrition) with a concurrent increasing trend of rotavirus infection in last decade was also observed among under 5 children, especially in developing countries including Bangladesh. Considering the pathophysiology of rotavirus, there might be an interaction of this nutrition transition which plays a pivotal role in increasing rotavirus infection in addition to climate and other man-made factors in urban areas such as Dhaka, Bangladesh. Relevant monthly data from 1993-2012 were extracted from the archive of the Diarrhoeal Disease Surveillance System of icddr, b and linked with data collected from the Dhaka station of the Bangladesh Meteorological Department (mean temperature, rainfall, sea level pressure and humidity). Seasonal autoregressive integrated moving average time series models were deployed to determine the association between the monthly proportion of rotavirus infection and underweight, stunting and wasting adjusting for climate, socio-demographic and sanitation factors. The proportion of rotavirus cases among all causes diarrhoea increased from 20% in 1993 to 43% in 2012 (Chi squared for trend p = 0.010). In contrast, underweight, stunting and wasting decreased from 59%-29% (p<0.001); 53%-21% (p<0.001) and 32%-22% (p<0.001) respectively over the same period. Mean ambient temperature increased from 25.76°C-26.62°C (p = 0.07); mean rainfall, sea level pressure and mean humidity decreased from 234.92-111.75 mm (p = 0.5), 1008.30-1006.61 mm of hg (p = 0.02) and 76.63%-70.26% (p<0.001), respectively. In the adjusted model, a decrease in monthly proportion of underweight [coef.: -0.189 (95% CI:-0.376, -0.003)] and wasting [-0.265 (-0.455, -0.075)] were significantly and inversely associated with rotavirus infection. However, an inverse but insignificant association was observed for stunting [-0.070 (-0.249, 0.109)]. The reduction of acute childhood malnutrition is significantly associated with increasing rotavirus diarrhoea among under-5 children. Thus mass vaccination in addition to interventions directed at man-made modifiable predictors for prevention and control is warranted.

Air quality and climate impacts due to CNG conversion of motor vehicles in Dhaka, Bangladesh.

PubMed

Wadud, Zia; Khan, Tanzila

2013-12-17

Dhaka had recently experienced rapid conversion of its motor vehicle fleet to run on compressed natural gas (CNG). This paper quantifies ex-post the air quality and climate benefits of the CNG conversion policy, including monetary valuations, through an impact pathway approach. Around 2045 (1665) avoided premature deaths in greater Dhaka (City Corporation) can be attributed to air quality improvements from the CNG conversion policy in 2010, resulting in a saving of around USD 400 million. Majority of these health benefits resulted from the conversion of high-emitting diesel vehicles. CNG conversion was clearly detrimental from climate change perspective using the changes in CO2 and CH4 only (CH4 emissions increased); however, after considering other global pollutants (especially black carbon), the climate impact was ambiguous. Uncertainty assessment using input distributions and Monte Carlo simulation along with a sensitivity analysis show that large uncertainties remain for climate impacts. For our most likely estimate, there were some climate costs, valued at USD 17.7 million, which is an order of magnitude smaller than the air quality benefits. This indicates that such policies can and should be undertaken on the grounds of improving local air pollution alone and that precautions should be taken to reduce the potentially unintended increases in GHG emissions or other unintended effects.

Long-term impact of changing childhood malnutrition on rotavirus diarrhoea: Two decades of adjusted association with climate and socio-demographic factors from urban Bangladesh

PubMed Central

Das, Sumon Kumar; Chisti, Mohammod Jobayer; Sarker, Mohammad Habibur Rahman; Das, Jui; Ahmed, Shawnawaz; Shahunja, K. M.; Nahar, Shamsun; Gibbons, Nora; Ahmed, Tahmeed; Faruque, Abu Syed Golam; Rahman, Mustafizur; J Fuchs, George; Al Mamun, Abdullah; John Baker, Peter

2017-01-01

Background There is strong association between childhood rotavirus, diarrhoea, climate factors and malnutrition. Conversely, a significant nutritional transition (reduced under-nutrition) with a concurrent increasing trend of rotavirus infection in last decade was also observed among under 5 children, especially in developing countries including Bangladesh. Considering the pathophysiology of rotavirus, there might be an interaction of this nutrition transition which plays a pivotal role in increasing rotavirus infection in addition to climate and other man-made factors in urban areas such as Dhaka, Bangladesh. Methods Relevant monthly data from 1993–2012 were extracted from the archive of the Diarrhoeal Disease Surveillance System of icddr, b and linked with data collected from the Dhaka station of the Bangladesh Meteorological Department (mean temperature, rainfall, sea level pressure and humidity). Seasonal autoregressive integrated moving average time series models were deployed to determine the association between the monthly proportion of rotavirus infection and underweight, stunting and wasting adjusting for climate, socio-demographic and sanitation factors. Finding The proportion of rotavirus cases among all causes diarrhoea increased from 20% in 1993 to 43% in 2012 (Chi squared for trend p = 0.010). In contrast, underweight, stunting and wasting decreased from 59%-29% (p<0.001); 53%-21% (p<0.001) and 32%-22% (p<0.001) respectively over the same period. Mean ambient temperature increased from 25.76°C-26.62°C (p = 0.07); mean rainfall, sea level pressure and mean humidity decreased from 234.92–111.75 mm (p = 0.5), 1008.30–1006.61 mm of hg (p = 0.02) and 76.63%-70.26% (p<0.001), respectively. In the adjusted model, a decrease in monthly proportion of underweight [coef.: -0.189 (95% CI:-0.376, -0.003)] and wasting [-0.265 (-0.455, -0.075)] were significantly and inversely associated with rotavirus infection. However, an inverse but insignificant association was observed for stunting [-0.070 (-0.249, 0.109)]. Interpretation The reduction of acute childhood malnutrition is significantly associated with increasing rotavirus diarrhoea among under-5 children. Thus mass vaccination in addition to interventions directed at man-made modifiable predictors for prevention and control is warranted. PMID:28877163

Influence of Health Warnings on Beliefs about the Health Effects of Cigarette Smoking, in the Context of an Experimental Study in Four Asian Countries.

PubMed

Reid, Jessica L; Mutti-Packer, Seema; Gupta, Prakash C; Li, Qiang; Yuan, Jiang; Nargis, Nigar; Hussain, A K M Ghulam; Hammond, David

2017-08-02

Cigarette package health warnings can be an important and low-cost means of communicating the health risks of smoking. We examined whether viewing health warnings in an experimental study influenced beliefs about the health effects of smoking, by conducting surveys with ~500 adult male smokers and ~500 male and female youth (age 16-18) in Beijing, China ( n = 1070), Mumbai area, India ( n = 1012), Dhaka, Bangladesh ( n = 1018), and Republic of Korea ( n = 1362). Each respondent was randomly assigned to view and rate pictorial health warnings for 2 of 15 different health effects, after which they reported beliefs about whether smoking caused 12 health effects. Respondents who viewed relevant health warnings (vs. other warnings) were significantly more likely to believe that smoking caused that particular health effect, for several health effects in each sample. Approximately three-quarters of respondents in China (Beijing), Bangladesh (Dhaka), and Korea (which had general, text-only warnings) thought that cigarette packages should display more health information, compared to approximately half of respondents in the Mumbai area, India (which had detailed pictorial warnings). Pictorial health warnings that convey the risk of specific health effects from smoking can increase beliefs and knowledge about the health consequences of smoking, particularly for health effects that are lesser-known.

Influence of gender roles and rising food prices on poor, pregnant women's eating and food provisioning practices in Dhaka, Bangladesh.

PubMed

Levay, Adrienne V; Mumtaz, Zubia; Faiz Rashid, Sabina; Willows, Noreen

2013-09-26

Maternal malnutrition in Bangladesh is a persistent health issue and is the product of a number of complex factors, including adherence to food 'taboos' and a patriarchal gender order that limits women's mobility and decision-making. The recent global food price crisis is also negatively impacting poor pregnant women's access to food. It is believed that those who are most acutely affected by rising food prices are the urban poor. While there is an abundance of useful quantitative research centered on maternal nutrition and food insecurity measurements in Bangladesh, missing is an understanding of how food insecurity is experienced by people who are most vulnerable, the urban ultra-poor. In particular, little is known of the lived experience of food insecurity among pregnant women in this context. This research investigated these lived experiences by exploring food provisioning strategies of urban, ultra-poor, pregnant women. This knowledge is important as discussions surrounding the creation of new development goals are currently underway. Using a focused-ethnographic approach, household food provisioning experiences were explored. Data from participant observation, a focus group discussion and semi-structured interviews were collected in an urban slum in Dhaka, Bangladesh. Interviews were undertaken with 28 participants including 12 pregnant women and new mothers, two husbands, nine non-pregnant women, and five health care workers. The key findings are: 1) women were aware of the importance of good nutrition and demonstrated accurate, biomedically-based knowledge of healthy eating practices during pregnancy; 2) the normative gender rules that have traditionally constrained women's access to nutritional resources are relaxing in the urban setting; however 3) women are challenged in accessing adequate quality and quantities of food due to the increase in food prices at the market. Rising food prices and resultant food insecurity due to insufficient incomes are negating the recent efforts that have increased women's knowledge of healthy eating during pregnancy and their gendered empowerment. In order to maintain the gains in nutritional knowledge and women's increased mobility and decision-making capacity; policy must also consider the global political economy of food in the creation of the new development goals.

Prevalence and Associated Factors of Depressive Symptoms Among Disadvantaged Adolescents: Results from a Population-Based Study in Bangladesh.

PubMed

Nasreen, Hashima E; Alam, Mohammad Ariful; Edhborg, Maigun

2016-08-01

Few studies have examined the adolescents' depression in low-income countries and no research has yet been carried out in Bangladesh. This study estimated the prevalence of depressive symptoms and explored the associated factors and help seeking behavior among adolescents in Bangladesh. Data originated from a cross section of 2,440 randomly selected boys and girls aged 13-19 years in a rural district and urban slums of Dhaka city, Bangladesh, during October-November 2012. Beck Depression Inventory (BDI), a 21-item scale, measured the prevalence of depressive symptoms using a cut-off 16 or higher. The prevalence of depressive symptoms among adolescents was 14%, with predominance in urban slums and among girls. Older age (15-19 years), poverty, and poor parental relation were found to be associated with depressive symptoms of both sexes; family history of depressive symptoms for boys; and reproductive illness and sexual abuse for girls. More than 80% of depressed adolescents sought no help. Adolescent depressive symptoms are common and largely undetected public health problem in Bangladesh. Policies aimed at concerted efforts for implementing a school-based counseling program with components of cognitive behavioral therapy and developing referral systems for those who scored at least 30 at BDI may ameliorate the potential harmful consequences of depressive symptoms in adolescents. © 2016 Wiley Periodicals, Inc.

Factors driving customers to seek health care from pharmacies for acute respiratory illness and treatment recommendations from drug sellers in Dhaka city, Bangladesh

PubMed Central

Chowdhury, Fahmida; Sturm-Ramirez, Katharine; Mamun, Abdullah Al; Iuliano, A Danielle; Bhuiyan, Mejbah Uddin; Chisti, Mohammod Jobayer; Ahmed, Makhdum; Haider, Sabbir; Rahman, Mahmudur; Azziz-Baumgartner, Eduardo

2017-01-01

Background Pharmacies in Bangladesh serve as an important source of health service. A survey in Dhaka reported that 48% of respondents with symptoms of acute respiratory illness (ARI) identified local pharmacies as their first point of care. This study explores the factors driving urban customers to seek health care from pharmacies for ARI, their treatment adherence, and outcome. Methods A cross-sectional study was conducted among 100 selected pharmacies within Dhaka from June to December 2012. Study participants were patients or patients’ relatives aged >18 years seeking care for ARI from pharmacies without prescription. Structured interviews were conducted with customers after they sought health service from drug sellers and again over phone 5 days postinterview to discuss treatment adherence and outcome. Results We interviewed 302 customers patronizing 76 pharmacies; 186 (62%) sought care for themselves and 116 (38%) sought care for a sick relative. Most customers (215; 71%) were males. The majority (90%) of customers sought care from the study pharmacy as their first point of care, while 18 (6%) had previously sought care from another pharmacy and 11 (4%) from a physician for their illness episodes. The most frequently reported reasons for seeking care from pharmacies were ease of access to pharmacies (86%), lower cost (46%), availability of medicine (33%), knowing the drug seller (20%), and convenient hours of operation (19%). The most commonly recommended drugs were acetaminophen dispensed in 76% (228) of visits, antihistamine in 69% (208), and antibiotics in 42% (126). On follow-up, most (86%) of the customers had recovered and 12% had sought further treatment. Conclusion People with ARI preferred to seek care at pharmacies rather than clinics because these pharmacies were more accessible and provided prompt treatment and medicine with no service charge. We recommend raising awareness among drug sellers on proper dispensing practices and enforcement of laws and regulations for drug sales. PMID:28293104

A community-randomised controlled trial promoting waterless hand sanitizer and handwashing with soap, Dhaka, Bangladesh.

PubMed

Luby, Stephen P; Kadir, Mohammad Abdul; Yushuf Sharker, M A; Yeasmin, Farzana; Unicomb, Leanne; Sirajul Islam, M

2010-12-01

To pilot two intensive hand hygiene promotion interventions, one using soap and one using a waterless hand sanitizer, in low-income housing compounds in Dhaka, Bangladesh and assess subsequent changes in handwashing behaviour and hand microbiology. Fieldworkers randomized 30 housing compounds: 10 received handwashing promotion with free soap, 10 received handwashing promotion with free waterless hand sanitizer and 10 were non-intervention controls. Fieldworkers assessed handwashing behaviour by structured observation and collected hand rinse specimens. At baseline, compound residents washed their hands with soap 26% of the time after defecation and 30% after cleaning a child's anus but <1% at other times. Compared with baseline, residents of soap intervention compounds were much more likely to wash their hands with soap after faecal contact (85-91%), before preparing food (26%) and before eating (26%). Compounds that received waterless hand sanitizer cleansed their hands more commonly than control compounds that used soap (10.4%vs. 2.3%), but less commonly than soap intervention compounds used soap (25%). Post-intervention hand rinse samples from soap and sanitizer compounds had lower concentrations of faecal indicator bacteria compared with baseline and control compounds. Waterless hand sanitizer was readily adopted by this low-income community and reduced hand contamination but did not improve the frequency of handwashing compared with soap. Future deployments of waterless hand sanitizers may improve hand hygiene more effectively by targeting settings where soap and water is unavailable. © 2010 Blackwell Publishing Ltd.

Species composition and habitat characterization of mosquito (Diptera: Culicidae) larvae in semi-urban areas of Dhaka, Bangladesh

PubMed Central

Bashar, Kabirul; Rahman, Md. Sayfur; Nodi, Ila Jahan; Howlader, Abdul Jabber

2016-01-01

Mosquito larvae are purely aquatic and develop in water bodies, the type of which is more or less specific to each species. Therefore, a study was carried out to identify the habitat characters of different mosquito species along with their species composition in semi-urban area of Dhaka in Bangladesh during the month of May and June 2012. A total of 6088 mosquito larvae belonging to 12 species (Aedes aegypti, Aedes albopictus, Anopheles barbirostris, Anopheles peditaeniatus, Anopheles vagus, Culex gelidus, Culex hutchinsoni, Culex quinquefasciatus, Culex tritaeniorhynchus, Mansonia annulifera, Mansonia uniformis, and Toxorhynchites splendens) under 5 genera were collected from 14 different types of habitats. Culex quinquefsciatus was the dominant (21.7/500 ml) species followed by Cx. tritaeniorhynchus (10.53/500 ml). Dissolved oxygen and chlorophyll a were the preeminent predictors for the abundance of all collected mosquito larvae except Ae. aegypti. Water temperature was positively associated with the breeding of An. vagus (r = 0.421, p = <0.001), An. barbirostris (r = 0.489, p = <0.001) and An. peditaeniatus (r = 0.375, p = <0.001). Water depth, distance from nearest house, emergent plant coverage, and alkalinity were found as the basis of larval abundance. Every Culex species and Tx. splendens (r = 0.359, p = 0.001) were found positively associated with chemical oxygen demand, while Mn. annulifera showed negative association (r = −0.115, p = 0.0297). This study also highlighted that various physicochemical factors affect the presence or abundance of mosquito larvae. PMID:27241953

Pattern of medical waste management: existing scenario in Dhaka City, Bangladesh

PubMed Central

Hassan, M Manzurul; Ahmed, Shafiul Azam; Rahman, K Anisur; Biswas, Tarit Kanti

2008-01-01

Background Medical waste is infectious and hazardous. It poses serious threats to environmental health and requires specific treatment and management prior to its final disposal. The problem is growing with an ever-increasing number of hospitals, clinics, and diagnostic laboratories in Dhaka City, Bangladesh. However, research on this critical issue has been very limited, and there is a serious dearth of information for planning. This paper seeks to document the handling practice of waste (e.g. collection, storage, transportation and disposal) along with the types and amount of wastes generated by Health Care Establishments (HCE). A total of 60 out of the existing 68 HCE in the study areas provided us with relevant information. Methods The methodology for this paper includes empirical field observation and field-level data collection through inventory, questionnaire survey and formal and informal interviews. A structured questionnaire was designed to collect information addressing the generation of different medical wastes according to amount and sources from different HCE. A number of in-depth interviews were arranged to enhance our understanding of previous and existing management practice of medical wastes. A number of specific questions were asked of nurses, hospital managers, doctors, and cleaners to elicit their knowledge. The collected data with the questionnaire survey were analysed, mainly with simple descriptive statistics; while the qualitative mode of analysis is mainly in narrative form. Results The paper shows that the surveyed HCE generate a total of 5,562 kg/day of wastes, of which about 77.4 per cent are non-hazardous and about 22.6 per cent are hazardous. The average waste generation rate for the surveyed HCE is 1.9 kg/bed/day or 0.5 kg/patient/day. The study reveals that there is no proper, systematic management of medical waste except in a few private HCE that segregate their infectious wastes. Some cleaners were found to salvage used sharps, saline bags, blood bags and test tubes for resale or reuse. Conclusion The paper reveals that lack of awareness, appropriate policy and laws, and willingness are responsible for the improper management of medical waste in Dhaka City. The paper also shows that a newly designed medical waste management system currently serves a limited number of HCE. New facilities should be established for the complete management of medical waste in Dhaka City. PMID:18221548

Risk Factors of Tendo-Achilles Injury in Football, Cricket and Badminton Players at Dhaka, Bangladesh.

PubMed

Khan, M J; Giasuddin, A S M; Khalil, M I

2015-04-01

Achilles tendon is the tendon connecting the heel with the calf muscles. Tendo-achilles injury (TAI) in players is common in games. The frequency of TAI is unknown and aetiology is controversial: The present descriptive cross-sectional study was done to determine the prevalence of TAI and associated factors contributing to it in football, cricket and badminton. From January to June 2012, male players (n = 131), age -17-35 years, were selected by purposive sampling technique from renowned sporting clubs at Dhaka, Bangladesh. TAI was diagnosed through structured questionnaire and interviewing the respondents. The analysis by Statistical Package for Social Sciences (SPSS) programme revealed that 11.5% players suffered from TAI, i.e. prevalence was 115 per 1000 respondents. Most injuries (70/131; 53.4%) occurred in the playground and (59/131; 45.3%) happened in practice field. Injuries among the players of third division were higher, i.e. about 36% (p = 0.000). TAI was significantly dependent on occupation (p = 0.046), BMI (p = 0.008), divisional status (p = 0.023), game type (p = 0.043), ground condition (p = 0.05) and injury severity (p = 0.000). The injured players referred for treatment to the physiotherapist was highest (9/15, i.e. 60%) followed by the physicians (5/15, i.e. 33%) (p = 0.000). The associations of TAI with various factors were discussed suggesting effective measures be taken and treatment, particularly physiotherapy, be given to injured players. However, there is a need of team work with sports medicine specialist also to enable the injured players to continue their professional games.

Study on the flood simulation techniques for estimation of health risk in Dhaka city, Bangladesh

NASA Astrophysics Data System (ADS)

Hashimoto, M.; Suetsugi, T.; Sunada, K.; ICRE

2011-12-01

Although some studies have been carried out on the spread of infectious disease with the flooding, the relation between flooding and the infectious expansion has not been clarified yet. The improvement of the calculation precision of inundation and its relation with the infectious disease, surveyed epidemiologically, are therefore investigated in a case study in Dhaka city, Bangladesh. The inundation was computed using a flood simulation model that is numerical 2D-model. The "sensitivity to inundation" of hydraulic factors such as drainage channel, dike, and the building occupied ratio was examined because of the lack of digital data set related to flood simulation. Each element in the flood simulation model was incorporated progressively and results were compared with the calculation result as inspection materials by the inundation classification from the existing study (Mollah et al., 2007). The results show that the influences by ''dyke'' and "drainage channel" factors are remarkable to water level near each facility. The inundation level and duration have influence on wide areas when "building occupied ratio" is also considered. The correlation between maximum inundation depth and health risk (DALY, Mortality, Morbidity) was found, but the validation of the inundation model for this case has not been performed yet. The flood simulation model needs to be validated by observed inundation depth. The drainage facilities such as sewer network or the pumping system will be also considered in the further research to improve the precision of the inundation model.

Chikungunya: an emerging viral infection with varied clinical presentations in Bangladesh: Reports of seven cases.

PubMed

Rahim, Muhammad Abdur; Uddin, Khwaja Nazim

2017-08-15

Chikungunya is an emerging and rapidly spreading viral infection in many parts of the world including Bangladesh. It shares many epidemiological and clinical characteristics with dengue. So, a sound knowledge is required for its detection and differentiation from dengue, specially in endemic regions. We present seven confirmed cases of chikungunya having different clinical presentations occurring among middle aged males and females from different socio-economic background in Dhaka city, the capital of Bangladesh. All patients had fever and aches and pains. Less common features were rash, diarrhea, vomiting and altered liver biochemistry. Dengue was excluded in six patients. Paracetamol remained the mainstay of treatment during febrile periods, but over 50% of the patients had prolonged joint symptoms requiring non-steroidal anti-inflammatory drugs. In spite of being a self-limiting disease, chikungunya may have different presentations and a protracted clinical course. During the febrile episode, exclusion of dengue is equally important. Physicians should be aware of the condition and public health initiatives are necessary to break the disease transmission.

Prevalence of non-communicable disease risk factors among poor shantytown residents in Dhaka, Bangladesh: a community-based cross-sectional survey

PubMed Central

Khalequzzaman, Md; Chiang, Chifa; Choudhury, Sohel Reza; Yatsuya, Hiroshi; Al-Mamun, Mohammad Abdullah; Al-Shoaibi, Abubakr Ahmed Abdullah; Hirakawa, Yoshihisa; Hoque, Bilqis Amin; Islam, Syed Shariful; Matsuyama, Akiko; Iso, Hiroyasu; Aoyama, Atsuko

2017-01-01

Objectives This study aims to describe the prevalence of non-communicable disease (NCD) risk factors among the urban poor in Bangladesh. Design We conducted a community-based cross-sectional epidemiological study. Setting The study was conducted in a shantytown in the city of Dhaka. There were 8604 households with 34 170 residents in the community. Those households were categorised into two wealth strata based on the housing structure. Participants The study targeted residents aged 18–64 years. A total of 2986 eligible households with one eligible individual were selected by simple random sampling stratified by household wealth status. A total of 2551 residents completed the questionnaire survey, and 2009 participated in the subsequent physical and biochemical measurements. Outcome measures A modified WHO survey instrument was used for assessing behavioural risk factors and physical and biochemical measurements, including glycated haemoglobin (HbA1c). The prevalence of NCD risk factors, such as tobacco use, fruit and vegetable intake, overweight/obesity, hypertension, diabetes (HbA1c ≥6.5%) and dyslipidaemia, was described according to household wealth status and gender differences. Results The prevalence of current tobacco use was 60.4% in men and 23.5% in women. Most of them (90.8%) consumed more than 1 serving of fruits and vegetables per day; however, only 2.1% consumed more than 5 servings. Overweight/obesity was more common in women (39.2%) than in men (18.9%), while underweight was more common in men (21.0%) than in women (7.1%). The prevalence of hypertension was 18.6% in men and 20.7% in women. The prevalence of diabetes was 15.6% in men and 22.5% in women, which was much higher than the estimated national prevalence (7%). The prevalence of raised total cholesterol (≥190 mg/dL) was 25.7% in men and 34.0% in women. Conclusion The study identified that tobacco use, both overweight and underweight, diabetes, hypertension and dyslipidaemia were prevalent among the urban poor in Bangladesh. PMID:29138190

Cholera forecast for Dhaka, Bangladesh, with the 2015-2016 El Niño: Lessons learned

PubMed Central

Martinez, Pamela P.; Reiner, Robert C.; Cash, Benjamin A.; Rodó, Xavier; Shahjahan Mondal, Mohammad; Roy, Manojit; Yunus, Mohammad; Faruque, A. S. G.; Huq, Sayeeda; King, Aaron A.; Pascual, Mercedes

2017-01-01

A substantial body of work supports a teleconnection between the El Niño-Southern Oscillation (ENSO) and cholera incidence in Bangladesh. In particular, high positive anomalies during the winter (Dec-Feb) in sea surface temperatures (SST) in the tropical Pacific have been shown to exacerbate the seasonal outbreak of cholera following the monsoons from August to November. Climate studies have indicated a role of regional precipitation over Bangladesh in mediating this long-distance effect. Motivated by this previous evidence, we took advantage of the strong 2015–2016 El Niño event to evaluate the predictability of cholera dynamics for the city in recent times based on two transmission models that incorporate SST anomalies and are fitted to the earlier surveillance records starting in 1995. We implemented a mechanistic temporal model that incorporates both epidemiological processes and the effect of ENSO, as well as a previously published statistical model that resolves space at the level of districts (thanas). Prediction accuracy was evaluated with “out-of-fit” data from the same surveillance efforts (post 2008 and 2010 for the two models respectively), by comparing the total number of cholera cases observed for the season to those predicted by model simulations eight to twelve months ahead, starting in January each year. Although forecasts were accurate for the low cholera risk observed for the years preceding the 2015–2016 El Niño, the models also predicted a high probability of observing a large outbreak in fall 2016. Observed cholera cases up to Oct 2016 did not show evidence of an anomalous season. We discuss these predictions in the context of regional and local climate conditions, which show that despite positive regional rainfall anomalies, rainfall and inundation in Dhaka remained low. Possible explanations for these patterns are given together with future implications for cholera dynamics and directions to improve their prediction for the city. PMID:28253325

Sexuality, rights and personhood: tensions in a transnational world.

PubMed

Siddiqi, Dina M

2011-12-16

This article discusses what happens when normative 'global' discourses of rights and individuated sexual identity confront the messiness of 'local' realities. It considers the tensions that emerge when the relationship between sexual and social identities is not obvious and the implications of such tensions for public health and sexual rights activism. These questions are addressed through debates over the naming of male-to-male sexualities and desires in the context of globalization and the growth of a large NGO (non-governmental organization) sector in urban Bangladesh. The material in the paper draws on a research project undertaken in 2008-9 in Dhaka, Bangladesh. A fundamental objective was to produce a contextualized understanding of sexuality in Dhaka city. Methods used included structured interviews, focus group discussions and informal conversations with a range of participants (students, factory workers, public health professionals and sexual minorities). The aim was to generate a conceptual and analytical framework around sexuality and rights rather than to undertake an empirical survey of any one population. As descriptors, globalized identity categories such as Men who have Sex with Men (MSM), used by public health providers, the state and donors; and gay/lesbian, invoked by human rights activists and transnational NGOs, are too narrow to capture the fluid and highly context-specific ways in which gender and sexually nonconforming persons understand themselves in Bangladesh. Further, class position mediates to a significant degree the reception, appropriation or rejection of transnational categories such as MSM and Lesbian, Gay, Bisexual, Transgender (LGBT). The tension is reflected in the sometimes fraught relations between service providers to MSM, the people they serve and an emerging group who identify as LGBT. A simple politics of recognition will be inadequate to the task of promoting health and human rights for all; such a strategy would effectively exclude individuals who do not necessarily connect their sexual practices with a specific sexual or social identity.

Geo-information for sustainable urban development of Greater Dhaka City, Bangladesh

NASA Astrophysics Data System (ADS)

Günther, Andreas; Asaduzzaman, Atm; Bahls, Rebecca; Ludwig, Rüdiger; Ashraful Kamal, Mohammad; Nahar Faruqa, Nurun

2015-04-01

Greater Dhaka City (including Dhaka and five adjacent municipal areas) is one of the fastest developing urban regions in the world. Densely build-up areas in the developed metropolitan area of Dhaka City are subject to extensive restructuring as common six-storied buildings are replaced by higher and heavier constructions. Additional stories are built on existing houses, frequently exceeding the allowable bearing pressure on the subsoil as supported by the foundations. In turn, newly developing areas are projected in marshy areas modified by extensive, largely unengineered landfills. In many areas, these terrains bear unfavorable building ground conditions, and reliable geospatial information is a major prerequisite for risk-sensitive urban planning. Within a collaborative technical cooperation project between Bangladesh and Germany, BGR supports GSB in the provision of geo-information for the Capital Development authority (RAJUK). For general urban planning, RAJUK successively develops a detailed area plan (DAP) at scale 1 : 50000 for the whole Greater Dhaka City area. Geospatial information have not been considered in the present DAP. Within the project, GSB prepared a detailed geomorphologic map matching the DAP both in areal extent and scale. The geomorphological setting can be used as an important spatial proxy for the characterization of the subsurface since highly segmented, elevated terraces consisting of consolidated sandy Pliocene deposits overlain by stiff Plio-Pleistocene sediments are sharply bordered by low lying-areas. The floodplain and marsh areas are consisting of thick, mechanically weak Holocene fluvial sandy-silty sediments that are sometimes alternated by organic layers. A first expert-based engineering geological reclassification of the geomorphological map resulting in five building ground suitability classes is highly supported by the spatial analysis of extensive archive borehole information consisting of depth-continuous standard penetration test (SPT) observations, engineering geological sample analyses and lithological profiles. The database compiled within the project currently contains more than 1600 locations. The joining of the spatial geomorphological information with the borehole data allows a specific characterization of the building ground classes in terms of bearing capacities for different foundation designs, earthquake-induced subsoil liquefaction potentials and depth-to-engineering rock head considerations. First-order hazard and cost scenarios for several general types of projected settlements can already be broadly evaluated with the data presented in a small scale (DAP scale). However, detailed building ground surveys have to be performed at larger spatial scales (1 : 10000 - 1 : 5000) in areas assigned for new settlements. These involve regular spaced borehole observations, 3-D modeling of the subsurface and geophysical loggings. Within the project, specific representative pilot areas in different geomorphological settings are defined where detailed geospatial building ground investigations are conducted, providing a robust basis for sustainable urban planning related to natural and technological hazards and their associated risks.

Availability and provision of misoprostol and other medicines for menstrual regulation among pharmacies in Bangladesh via mystery client survey.

PubMed

Huda, Fauzia A; Ngo, Thoai D; Ahmed, Anisuddin; Alam, Anadil; Reichenbach, Laura

2014-02-01

To explore the availability and provision of misoprostol and other medicines for menstrual regulation (MR) among pharmacies in Bangladesh. Between March and November 2011, a cross-sectional study using mystery client visits was conducted among pharmacy workers in Dhaka and Gazipur Districts, Bangladesh. Mystery clients were trained to present 1 of 4 pre-developed situations to pharmacy workers to elicit information on the regimen, adverse effects, and complications of misoprostol use. Mystery clients visited 331 pharmacies. Among the 331 pharmacy workers, 45.8% offered the mystery clients misoprostol and/or other medicines for MR; 25.7% referred them to private clinics or hospitals. Only 7% recommended an effective regimen of misoprostol for MR; 65% suggested administering vaginal and oral misoprostol together. Overall, 72.4% did not provide any advice on complications; the remainder suggested visiting trained providers for complications. Counseling on excessive bleeding as a danger sign was provided by 46% of pharmacy workers. Most (94%) did not provide or refer for post-MR family planning. Pharmacy workers in urban Bangladesh are providing ineffective drugs and regimens for MR. A training package is needed to strengthen service delivery by providing accurate information, high-quality products, and referral mechanisms for women seeking MR through pharmacies. © 2013.

Beliefs and practices during pregnancy and childbirth in urban slums of Dhaka, Bangladesh.

PubMed

Choudhury, Nuzhat; Moran, Allisyn C; Alam, M Ashraful; Ahsan, Karar Zunaid; Rashid, Sabina F; Streatfield, Peter Kim

2012-09-17

Worldwide urbanization has become a crucial issue in recent years. Bangladesh, one of the poorest and most densely-populated countries in the world, has been facing rapid urbanization. In urban areas, maternal indicators are generally worse in the slums than in the urban non-slum areas. The Manoshi program at BRAC, a non governmental organization, works to improve maternal, newborn, and child health in the urban slums of Bangladesh. This paper describes maternal related beliefs and practices in the urban slums of Dhaka and provides baseline information for the Manoshi program. This is a descriptive study where data were collected using both quantitative and qualitative methods. The respondents for the quantitative methods, through a baseline survey using a probability sample, were mothers with infants (n = 672) living in the Manoshi program areas. Apart from this, as part of a formative research, thirty six in-depth semi-structured interviews were conducted during the same period from two of the above Manoshi program areas among currently pregnant women who had also previously given births (n = 18); and recently delivered women (n = 18). The baseline survey revealed that one quarter of the recently delivered women received at least four antenatal care visits and 24 percent women received at least one postnatal care visit. Eighty-five percent of deliveries took place at home and 58 percent of the deliveries were assisted by untrained traditional birth attendants. The women mostly relied on their landladies for information and support. Members of the slum community mainly used cheap, easily accessible and available informal sectors for seeking care. Cultural beliefs and practices also reinforced this behavior, including home delivery without skilled assistance. Behavioral change messages are needed to increase the numbers of antenatal and postnatal care visits, improve birth preparedness, and encourage skilled attendance at delivery. Programs in the urban slum areas should also consider interventions to improve social support for key influential persons in the community, particularly landladies who serve as advisors and decision-makers.

Cross-sectional test of the Fama-French three-factor model: Evidence from Bangladesh stock market

NASA Astrophysics Data System (ADS)

Hasan, Md. Zobaer; Kamil, Anton Abdulbasah

2014-09-01

Stock market is an important part of a country's economy. It supports the country's economic development and progress by encouraging the efficiency and profitability of firms. This research was designed to examine the risk-return association of companies in the Dhaka Stock Exchange (DSE) market of Bangladesh by using the Fama-French three-factor model structure. The model is based on three factors, which are stock beta, SMB (difference in returns of the portfolio with small market capitalisation minus that with big market capitalisation) and HML (difference in returns of the portfolio with high book-to-market ratio minus that with low book-to-market ratio). This study focused on the DSE market as it is one of the frontier emerging stock markets of South Asia. For this study, monthly stock returns from 71 non-financial companies were used for the period of January 2002 to December 2011. DSI Index was used as a proxy for the market portfolio and Bangladesh government 3-Month T-bill rate was used as the proxy for the risk-free asset. It was found that large capital stocks outperform small capital stocks and stocks with lower book-to-market ratios outperform stocks with higher book-to-market ratios in the context of Bangladesh stock market.

Sociodemographic Factors on Contraceptive Use among Ever-Married Women of Reproductive Age: Evidence from Three Demographic and Health Surveys in Bangladesh.

PubMed

Haq, Iqramul; Sakib, Saifullah; Talukder, Ashis

2017-12-06

Contraceptive use among married women of reproductive age has showed a substantial progress over the last few decades in Bangladesh. This study explores the sociodemographic factors associated with contraceptive use among ever-married women of reproductive age in Bangladesh by utilizing the information extracted from three of the Bangladesh Demographic and Health Surveys (BDHSs) in 1993-1994, 2004 and 2014. Bivariate analysis was conducted by performing chi-squared test of independence to explore the relationship between selected sociodemographic factors and dependent variables. To know the adjusted effects of covariates, a popular binary logistic regression model was considered. Respondents' current age, place residence, division religion, education, age at first marriage, family planning (FP) media exposure, ideal number of children and fertility preferences are the significant determinants according to the most recent survey, BDHS 2014. However, wealth index and a respondent's current working status were found to be significant factors only in BDHS 2004. The results of the study strongly recommend efforts to increase the education level among poor people, particularly among women in Bangladesh. Program interventions, including health behavior education and family planning services and counselling, are especially needed for some categories of the population, including those living in rural areas, Sylhet, Chittagong and Dhaka divisions, as well as illiterate and Muslim ever-married women.

Tribal formulations for treatment of pain: a study of the Bede community traditional medicinal practitioners of Porabari Village in Dhaka District, Bangladesh.

PubMed

Seraj, Syeda; Jahan, Farhana Israt; Chowdhury, Anita Rani; Monjur-Ekhuda, Mohammad; Khan, Mohammad Shamiul Hasan; Aporna, Sadia Afrin; Jahan, Rownak; Samarrai, Walied; Islam, Farhana; Khatun, Zubaida; Rahmatullah, Mohammed

2012-01-01

The Bedes form one of the largest tribal or indigenous communities in Bangladesh and are popularly known as the boat people or water gypsies because of their preference for living in boats. They travel almost throughout the whole year by boats on the numerous waterways of Bangladesh and earn their livelihood by selling sundry items, performing jugglery acts, catching snakes, and treating village people by the various riversides with their traditional medicinal formulations. Life is hard for the community, and both men and women toil day long. As a result of their strenuous lifestyle, they suffer from various types of pain, and have developed an assortment of formulations for treatment of pain in different parts of the body. Pain is the most common reason for physician consultation in all parts of the world including Bangladesh. Although a number of drugs are available to treat pain, including non-steroidal, steroidal, and narcotic drugs, such drugs usually have side-effects like causing bleeding in the stomach over prolonged use (as in the case of rheumatic pain), or can be addictive. Moreover, pain arising from causes like rheumatism has no proper treatment in allopathic medicine. It was the objective of the present study to document the formulations used by the Bede traditional practitioners for pain treatment, for they claim to have used these formulations over centuries with success. Surveys were conducted among a large Bede community, who reside in boats on the Bangshi River by Porabari village of Savar area in Dhaka district of Bangladesh. Interviews of 30 traditional practitioners were conducted with the help of a semi-structured questionnaire and the guided field-walk method. It was observed that the Bede practitioners used 53 formulations for treatment of various types of pain, the main ingredient of all formulations being medicinal plants. Out of the 53 formulations, 25 were for treatment of rheumatic pain, either exclusively, or along with other types of body pain. A total of 65 plants belonging to 39 families were used in the formulations. The Fabaceae family provided 7 plants followed by the Solanaceae family with 4 plants. 47 out of the 53 formulations were used topically, 5 formulations were orally administered, and 1 formulation had both topical and oral uses. 8 formulations for treatment of rheumatic pain contained Calotropis gigantea, suggesting that the plant has strong potential for further scientific studies leading to discovery of novel efficacious compounds for rheumatic pain treatment.

Species composition and habitat characterization of mosquito (Diptera: Culicidae) larvae in semi-urban areas of Dhaka, Bangladesh.

PubMed

Bashar, Kabirul; Rahman, Md Sayfur; Nodi, Ila Jahan; Howlader, Abdul Jabber

2016-03-01

Mosquito larvae are purely aquatic and develop in water bodies, the type of which is more or less specific to each species. Therefore, a study was carried out to identify the habitat characters of different mosquito species along with their species composition in semi-urban area of Dhaka in Bangladesh during the month of May and June 2012. A total of 6088 mosquito larvae belonging to 12 species (Aedes aegypti, Aedes albopictus, Anopheles barbirostris, Anopheles peditaeniatus, Anopheles vagus, Culex gelidus, Culex hutchinsoni, Culex quinquefasciatus, Culex tritaeniorhynchus, Mansonia annulifera, Mansonia uniformis, and Toxorhynchites splendens) under 5 genera were collected from 14 different types of habitats. Culex quinquefsciatus was the dominant (21.7/500 ml) species followed by Cx. tritaeniorhynchus (10.53/500 ml). Dissolved oxygen and chlorophyll a were the preeminent predictors for the abundance of all collected mosquito larvae except Ae. aegypti. Water temperature was positively associated with the breeding of An. vagus (r = 0.421, p = <0.001), An. barbirostris (r = 0.489, p = <0.001) and An. peditaeniatus (r = 0.375, p = <0.001). Water depth, distance from nearest house, emergent plant coverage, and alkalinity were found as the basis of larval abundance. Every Culex species and Tx. splendens (r = 0.359, p = 0.001) were found positively associated with chemical oxygen demand, while Mn. annulifera showed negative association (r = -0.115, p = 0.0297). This study also highlighted that various physicochemical factors affect the presence or abundance of mosquito larvae.

Toxicity assessment of ash and dust from handmade gold jewelry manufacturing workshops in Bangladesh.

PubMed

Sikder, Arif M; Hossain, Tanvir; Khan, Manzurul H; Aziz Hasan, M; Fakhruzzaman, M; Turner, Joseph B; Pestov, Dmitry; McCallister, Leigh S; Maudood Elahi, K

2017-06-01

Traditionally, handmade gold jewelry played a very important role in the cultural heritage of Bangladesh. Goldsmiths still are partially using ancient manufacturing process with coal fire, candle flame blowing, and nitric and sulfuric acid treatments. Such process leads to the contamination of workplace with the dust of toxic metals, acidic vapors, and particles of different natures. To evaluate contamination by particulate matter (PM), the passive particle collectors were installed in different manufacturing units for a period of 85 days at Tanti Bazar, Dhaka, Bangladesh. The laser diffraction analysis of the samples collected at the soldering units showed significant amounts of particulates, both PM10 and PM 2.5, and also nanoparticles in both nucleation and accumulation mode. SEM/EDS analysis revealed partially melted micro blebs that contain a very high concentration of Fe along with Cu. The toxic elements were detected with ICP analysis and include higher concentrations of cadmium (Cd), chromium (Cr), lead (Pb), and arsenic (As). It is notable that detection of arsenic contamination was unexpected since raw materials used for jewelry making should not have any arsenic.

Peer Smoking and Smoking-related Beliefs Among College Students in Bangladesh

PubMed Central

Ahmmad, Zobayer; Pye, Mu

2018-01-01

Objectives Smoking is a significant public health issue in Bangladesh. The purpose of this study was to examine peer smoking and smoking-related beliefs among college students in Bangladesh. Methods College students at two universities in Dhaka, Bangladesh participated in a self-administered survey in May and June 2017. Results First, being a current or former smoker is associated with lower levels of beliefs among respondents that they would not smoke even with smoker friends or nervousness, and lower levels of intentions that they would not smoke, while current smokers and former smokers have different smoking-related beliefs. Second, having smoker friends is associated with lower levels of intentions that they would not smoke. Third, higher levels of normative beliefs that it is important not to smoke are associated with higher levels of beliefs that they would not smoke even with smoker friends or nervousness, higher levels of intentions that they would not smoke, and higher levels of avoidance of smoking. Conclusions Smoking-related beliefs and perceived norms in individuals’ social networks are important components in promoting tobacco cessation in Bangladesh. But it is challenging to prevent or intervene in smoking because of the high rates of smoking in this country and the high prevalence of smokers in individuals’ social networks. Future studies should examine the most effective interventions to combat smoking in high-smoking social networks, such as using mobile apps or social media, and evaluate the effectiveness of such interventions. PMID:29397641

Peer Smoking and Smoking-related Beliefs Among College Students in Bangladesh.

PubMed

Kamimura, Akiko; Ahmmad, Zobayer; Pye, Mu; Gull, Bethany

2018-01-01

Smoking is a significant public health issue in Bangladesh. The purpose of this study was to examine peer smoking and smoking-related beliefs among college students in Bangladesh. College students at two universities in Dhaka, Bangladesh participated in a self-administered survey in May and June 2017. First, being a current or former smoker is associated with lower levels of beliefs among respondents that they would not smoke even with smoker friends or nervousness, and lower levels of intentions that they would not smoke, while current smokers and former smokers have different smoking-related beliefs. Second, having smoker friends is associated with lower levels of intentions that they would not smoke. Third, higher levels of normative beliefs that it is important not to smoke are associated with higher levels of beliefs that they would not smoke even with smoker friends or nervousness, higher levels of intentions that they would not smoke, and higher levels of avoidance of smoking. Smoking-related beliefs and perceived norms in individuals' social networks are important components in promoting tobacco cessation in Bangladesh. But it is challenging to prevent or intervene in smoking because of the high rates of smoking in this country and the high prevalence of smokers in individuals' social networks. Future studies should examine the most effective interventions to combat smoking in high-smoking social networks, such as using mobile apps or social media, and evaluate the effectiveness of such interventions.

Sexuality, rights and personhood: tensions in a transnational world

PubMed Central

2011-01-01

Background This article discusses what happens when normative ‘global’ discourses of rights and individuated sexual identity confront the messiness of ‘local’ realities. It considers the tensions that emerge when the relationship between sexual and social identities is not obvious and the implications of such tensions for public health and sexual rights activism. These questions are addressed through debates over the naming of male-to-male sexualities and desires in the context of globalization and the growth of a large NGO (non-governmental organization) sector in urban Bangladesh. Methods The material in the paper draws on a research project undertaken in 2008-9 in Dhaka, Bangladesh. A fundamental objective was to produce a contextualized understanding of sexuality in Dhaka city. Methods used included structured interviews, focus group discussions and informal conversations with a range of participants (students, factory workers, public health professionals and sexual minorities). The aim was to generate a conceptual and analytical framework around sexuality and rights rather than to undertake an empirical survey of any one population. Results As descriptors, globalized identity categories such as Men who have Sex with Men (MSM), used by public health providers, the state and donors; and gay/lesbian, invoked by human rights activists and transnational NGOs, are too narrow to capture the fluid and highly context-specific ways in which gender and sexually nonconforming persons understand themselves in Bangladesh. Further, class position mediates to a significant degree the reception, appropriation or rejection of transnational categories such as MSM and Lesbian, Gay, Bisexual, Transgender (LGBT). The tension is reflected in the sometimes fraught relations between service providers to MSM, the people they serve and an emerging group who identify as LGBT. Conclusion A simple politics of recognition will be inadequate to the task of promoting health and human rights for all; such a strategy would effectively exclude individuals who do not necessarily connect their sexual practices with a specific sexual or social identity. PMID:22376124

Cholera forecast for Dhaka, Bangladesh, with the 2015-2016 El Niño: Lessons learned.

PubMed

Martinez, Pamela P; Reiner, Robert C; Cash, Benjamin A; Rodó, Xavier; Shahjahan Mondal, Mohammad; Roy, Manojit; Yunus, Mohammad; Faruque, A S G; Huq, Sayeeda; King, Aaron A; Pascual, Mercedes

2017-01-01

A substantial body of work supports a teleconnection between the El Niño-Southern Oscillation (ENSO) and cholera incidence in Bangladesh. In particular, high positive anomalies during the winter (Dec-Feb) in sea surface temperatures (SST) in the tropical Pacific have been shown to exacerbate the seasonal outbreak of cholera following the monsoons from August to November. Climate studies have indicated a role of regional precipitation over Bangladesh in mediating this long-distance effect. Motivated by this previous evidence, we took advantage of the strong 2015-2016 El Niño event to evaluate the predictability of cholera dynamics for the city in recent times based on two transmission models that incorporate SST anomalies and are fitted to the earlier surveillance records starting in 1995. We implemented a mechanistic temporal model that incorporates both epidemiological processes and the effect of ENSO, as well as a previously published statistical model that resolves space at the level of districts (thanas). Prediction accuracy was evaluated with "out-of-fit" data from the same surveillance efforts (post 2008 and 2010 for the two models respectively), by comparing the total number of cholera cases observed for the season to those predicted by model simulations eight to twelve months ahead, starting in January each year. Although forecasts were accurate for the low cholera risk observed for the years preceding the 2015-2016 El Niño, the models also predicted a high probability of observing a large outbreak in fall 2016. Observed cholera cases up to Oct 2016 did not show evidence of an anomalous season. We discuss these predictions in the context of regional and local climate conditions, which show that despite positive regional rainfall anomalies, rainfall and inundation in Dhaka remained low. Possible explanations for these patterns are given together with future implications for cholera dynamics and directions to improve their prediction for the city.

Prevention and control of sexually transmissible infections among hotel-based female sex workers in Dhaka, Bangladesh.

PubMed

McCormick, Duncan F; Rahman, Motiur; Zadrozny, Sabrina; Alam, Anadil; Ashraf, Lutfa; Neilsen, Graham A; Kelly, Robert; Menezes, Prema; Miller, William C; Hoffman, Irving F

2013-12-01

Hotel-based sex workers in Bangladesh have high rates of sexually transmissible infections (STIs), high client turnover and low condom use. Two monthly clinic-based strategies were compared: periodic presumptive treatment (PPT) and enhanced syndromic management (ESM) - one round of presumptive treatment followed by treatment based on assessment and laboratory tests. A randomised controlled trial compared PPT and ESM by prevalence and incidence, behaviour, retention, cost and STI incidence and prevalence. Demographic, behavioural and clinical data were collected from women at two clinics in Dhaka. All women received presumptive treatment and were randomised to receive PPT or ESM at nine monthly visits. In total, 549 women (median age: <20 years) were enrolled. At baseline, the prevalence of chlamydia (Chlamydia trachomatis) and gonorrhoea (Neisseria gonorrhoeae) was 41% (ESM: 41%; PPT: 42%). After 9 months, chlamydia and gonorrhoea decreased to 7% overall, (ESM: 7.4%; PPT: 6.8%). At each visit, 98% of women receiving ESM met the therapy criteria and were treated. Retention was low (50%). Total costs were 50% lower per visit for each woman for PPT (ESM: $11.62 v. PPT: $5.80). The number of sex work sessions was reduced from 3.3 to 2.5 (P<0.001), but income did not change. Coercion was reduced but condom use at last sex did not change significantly. Monthly PPT and ESM were effective approaches for STI control. PPT offered a feasible, low-cost alternative to ESM. Educational aspects led to a reduction in coercion and fewer sessions. Implementation studies are needed to improve condom use and retention.

Influence of gender roles and rising food prices on poor, pregnant women’s eating and food provisioning practices in Dhaka, Bangladesh

PubMed Central

2013-01-01

Background Maternal malnutrition in Bangladesh is a persistent health issue and is the product of a number of complex factors, including adherence to food 'taboos’ and a patriarchal gender order that limits women’s mobility and decision-making. The recent global food price crisis is also negatively impacting poor pregnant women’s access to food. It is believed that those who are most acutely affected by rising food prices are the urban poor. While there is an abundance of useful quantitative research centered on maternal nutrition and food insecurity measurements in Bangladesh, missing is an understanding of how food insecurity is experienced by people who are most vulnerable, the urban ultra-poor. In particular, little is known of the lived experience of food insecurity among pregnant women in this context. This research investigated these lived experiences by exploring food provisioning strategies of urban, ultra-poor, pregnant women. This knowledge is important as discussions surrounding the creation of new development goals are currently underway. Methods Using a focused-ethnographic approach, household food provisioning experiences were explored. Data from participant observation, a focus group discussion and semi-structured interviews were collected in an urban slum in Dhaka, Bangladesh. Interviews were undertaken with 28 participants including 12 pregnant women and new mothers, two husbands, nine non-pregnant women, and five health care workers. Results The key findings are: 1) women were aware of the importance of good nutrition and demonstrated accurate, biomedically-based knowledge of healthy eating practices during pregnancy; 2) the normative gender rules that have traditionally constrained women’s access to nutritional resources are relaxing in the urban setting; however 3) women are challenged in accessing adequate quality and quantities of food due to the increase in food prices at the market. Conclusions Rising food prices and resultant food insecurity due to insufficient incomes are negating the recent efforts that have increased women’s knowledge of healthy eating during pregnancy and their gendered empowerment. In order to maintain the gains in nutritional knowledge and women’s increased mobility and decision-making capacity; policy must also consider the global political economy of food in the creation of the new development goals. PMID:24069937

A qualitative exploration of parental experiences of stigma while living with HIV in Bangladesh.

PubMed

Islam, Md Shahidul; Scott, John; Minichiello, Victor

2016-01-01

With much of the focus on the "risk" groups, families have often been less studied in HIV research. Further, because of a focus on the aetiology and epidemiology of HIV, the social impacts associated with HIV on families and neighbours are sometimes overlooked. This study examined parental experiences of stigma and discrimination while living with HIV within a family context in Bangladesh. A qualitative research design using a grounded theory approach was used for this research. Data was collected through in-depth interviews with 19 HIV-positive parents, recruited with the support of two self-help groups of HIV-positive people, in two settings namely Khulna and Dhaka in Bangladesh. The findings indicate that HIV-positive parents held the view that they continue to experience significant stigma and their narratives clearly show how this affected them and their children. A range of informal practices were enacted in everyday contexts by extended family and community members to identify, demarcate and limit the social interaction of HIV-positive parents. Parents highlighted a number of factors including negative thoughts and behaviours, rejection, isolation and derogatory remarks as manifestations of stigma and discrimination, impacting upon them and their children because of their association with HIV.

Tuberculosis in the workplace: developing partnerships with the garment industries in Bangladesh.

PubMed

Zafar Ullah, A N; Huque, R; Husain, A; Akter, S; Akter, H; Newell, J N

2012-12-01

To implement and evaluate a public-private partnership model involving garment factories to reduce the tuberculosis (TB) burden in this workforce. We used operational research to develop and evaluate a mechanism for effective and sustainable TB control in workplaces in three areas of Dhaka, Bangladesh. Strategies, protocols, guides and tools were developed with stakeholders. We assessed the impact of the project using quantitative and qualitative measures: changes in TB outcomes were calculated using standard indicators based on factory and DOTS centre records; changes in TB care-seeking behaviour were assessed using qualitative in-depth interviews with factory managers and medical personnel, and focus group discussions with factory workers, including TB patients. The project brought positive changes in knowledge, attitudes and practices of managers, workers and health care providers on TB care and control. During 2008-2010, a total of 3372 workers from a workforce of 69,000 were referred for sputum microscopy and 598 were diagnosed with smear-positive TB, 145 of whom received care at their workplace. The overall treatment success rate was 100%. It is feasible to engage factories in TB control activities in Bangladesh, and thereby increase case notifications and improve treatment outcomes.

Influence of maternal and socioeconomic factors on breast milk fatty acid composition in urban, low‐income families

PubMed Central

Nayak, Uma; Kanungo, Suman; Zhang, Dadong; Ross Colgate, E.; Carmolli, Marya P.; Dey, Ayan; Alam, Masud; Manna, Byomkesh; Nandy, Ranjan Kumar; Kim, Deok Ryun; Paul, Dilip Kumar; Choudhury, Saugato; Sahoo, Sushama; Harris, William S.; Wierzba, Thomas F.; Ahmed, Tahmeed; Kirkpatrick, Beth D.; Haque, Rashidul; Petri, William A.

2017-01-01

Abstract The lipid composition of breast milk may have a significant impact on early infant growth and cognitive development. Comprehensive breast milk data is lacking from low‐income populations in the Indian subcontinent impeding assessment of deficiencies and limiting development of maternal nutritional interventions. A single breast milk specimen was collected within 6 weeks postpartum from two low‐income maternal cohorts of exclusively breastfed infants, from Dhaka, Bangladesh (n = 683) and Kolkata, India (n = 372) and assayed for percentage composition of 26 fatty acids. Mature milk (>15 days) in Dhaka (n = 99) compared to Kolkata (n = 372) was higher in total saturated fatty acid (SFA; mean 48% vs. 44%) and disproportionately lower in ω3‐polyunsaturated fatty acid (PUFA), hence the ω6‐ and ω3‐PUFA ratio in Dhaka were almost double the value in Kolkata. In both sites, after adjusting for days of lactation, increased maternal education was associated with decreased SFA and PUFA, and increasing birth order or total pregnancies was associated with decreasing ω6‐PUFA or ω3‐PUFA by a factor of 0.95 for each birth and pregnancy. In Dhaka, household prosperity was associated with decreased SFA and PUFA and increased ω6‐ and ω3‐PUFA. Maternal height was associated with increased SFA and PUFA in Kolkata (1% increase per 1 cm), but body mass index showed no independent association with either ratio in either cohort. In summary, the socioeconomic factors of maternal education and household prosperity were associated with breast milk composition, although prosperity may only be important in higher cost of living communities. Associated maternal biological factors were height and infant birth order, but not adiposity. Further study is needed to elucidate the underlying mechanisms of these effects. PMID:28198164

Healthcare use and expenditure for diabetes in Bangladesh

PubMed Central

Lechner, Andreas; Ferrari, Uta; Laxy, Michael; Seissler, Jochen; Brown, Jonathan; Niessen, Louis W; Holle, Rolf

2017-01-01

Background Diabetes imposes a huge social and economic impact on nations. However, information on the costs of treating and managing diabetes in developing countries is limited. The aim of this study was to estimate healthcare use and expenditure for diabetes in Bangladesh. Methods We conducted a matched case–control study between January and July 2014 among 591 adults with diagnosed diabetes mellitus (DMs) and 591 age-matched, sex-matched and residence-matched persons without diabetes mellitus (non-DMs). We recruited DMs from consecutive patients and non-DMs from accompanying persons in the Bangladesh Institute of Health Science (BIHS) hospital in Dhaka, Bangladesh. We estimated the impact of diabetes on healthcare use and expenditure by calculating ratios and differences between DMs and non-DMs for all expenses related to healthcare use and tested for statistical difference using Student's t-tests. Results DMs had two times more days of inpatient treatment, 1.3 times more outpatient visits, and 9.7 times more medications than non-DMs (all p<0.005). The total annual per capita expenditure on medical care was 6.1 times higher for DMs than non-DMs (US$635 vs US$104, respectively). Among DMs, 9.8% reported not taking any antidiabetic medications, 46.4% took metformin, 38.7% sulfonylurea, 40.8% insulin, 38.7% any antihypertensive medication, and 14.2% took anti-lipids over the preceding 3 months. Conclusions Diabetes significantly increases healthcare use and expenditure and is likely to impose a huge economic burden on the healthcare systems in Bangladesh. The study highlights the importance of prevention and optimum management of diabetes in Bangladesh and other developing countries, to gain a strong economic incentive through implementing multisectoral approach and cost-effective prevention strategies. PMID:28588991

Seasonal and Interannual Trends in Largest Cholera Endemic Megacity: Water Sustainability - Climate - Health Challenges in Dhaka, Bangladesh

NASA Astrophysics Data System (ADS)

Akanda, Ali S.; Jutla, Antarpreet; Faruque, Abu S. G.; Huq, Anwar; Colwell, Rita R.

2014-05-01

The last three decades of surveillance data shows a drastic increase of cholera prevalence in the largest cholera-endemic city in the world - Dhaka, Bangladesh. Emerging megacities in the region, especially those located in coastal areas also remain vulnerable to large scale drivers of cholera outbreaks. However, there has not been any systematic study on linking long-term disease trends with related changes in natural or societal variables. Here, we analyze the 30-year dynamics of urban cholera prevalence in Dhaka with changes in climatic or anthropogenic forcings: regional hydrology, flooding, water usage, changes in distribution systems, population growth and density in urban settlements, as well as shifting climate patterns and frequency of natural disasters. An interesting change is observed in the seasonal trends of cholera prevalence; while an endemic upward trend is seen in the dry season, the post-monsoon trend is epidemic in nature. In addition, the trend in the pre-monsoon dry season is significantly stronger than the post-monsoon wet season; and thus spring is becoming the dominant cholera season of the year. Evidence points to growing urbanization and rising population in unplanned settlements along the city peripheries. The rapid pressure of growth has led to an unsustainable and potentially disastrous situation with negligible-to-poor water and sanitation systems compounded by changing climatic patterns and increasing number of extreme weather events. Growing water scarcity in the dry season and lack of sustainable water and sanitation infrastructure for urban settlements have increased endemicity of cholera outbreaks in spring, while record flood events and prolonged post-monsoon inundation have contributed to increased epidemic outbreaks in fall. We analyze our findings with the World Health Organization recommended guidelines and investigate large scale water sustainability challenges in the context of climatic and anthropogenic changes in the region. Our findings may prove to be useful in both water sustainability and disaster management perspectives as the dry and wet seasonal trends are affecting both endemic and epidemic outbreaks, respectively, and are influenced by distinctly different seasonal and interannual drivers.

Effects of education and other socioeconomic factors on middle age mortality in rural Bangladesh.

PubMed

Hurt, L S; Ronsmans, C; Saha, S

2004-04-01

To examine socioeconomic gradients in mortality in adult women and their husbands in Bangladesh, paying particular attention to the independent effects of the educational status of each spouse. Historical cohort study. Matlab, a rural area 60 km south east of Dhaka, the capital of Bangladesh. 14803 married women aged 45 or over and their husbands who were resident in the Matlab Demographic Surveillance area between 30 June 1982 and 31 December 1998. Mortality was lower in women with formal or Koranic education compared with those with none (adjusted rate ratio for formal education = 0.68, 95% CI 0.53 to 0.86; adjusted rate ratio for Koranic schooling = 0.82, 95% CI 0.66 to 1.00). After adjusting for her own education, the husband's level of education or occupation did not have an independent effect on a woman's survival. Men who had attended formal education had lower mortality than those without any education (adjusted rate ratio = 0.84, 95% CI 0.75 to 0.93), but men whose wives had been educated had an additional survival advantage independent of their own education and occupation (adjusted rate ratio = 0.76, 95% CI 0.67 to 0.87). Mortality in both sexes was also significantly associated with marital status and the percentage of surviving children, and in men was associated with the man's occupation, religion, area of residence. The data suggest that socioeconomic status has a strong influence on mortality in adults in Bangladesh. They also illustrate how important the continued promotion of education, particularly for women, may be for the survival of both women and men in rural Bangladesh.

Natural hazards and climate change in Dhaka: future trends, social adaptation and informal dynamics

NASA Astrophysics Data System (ADS)

Thiele-Eich, I.; Aßheuer, T.; Simmer, C.; Braun, B.

2009-04-01

Similar to many megacities in the world, Dhaka is regularly threatened by natural hazards. Risks associated with floods and cyclones in particular are expected to increase in the years to come because of global climate change and rapid urbanization. Greater Dhaka is expected to grow from 13.5 million inhabitants in 2007 to 22 million inhabitants by 2025. The vast majority of this growth will take place in informal settlements. Due to the setting of Greater Dhaka in a deltaic plain, the sprawl of slums is primarily taking place in wetlands, swamps and other flood-prone areas. Slum dwellers and informal businesses are vulnerable, but have somehow learned to cope with seasonal floods and developed specific adaptation strategies. An increase of precipitation extremes and tropical cyclones, however, would put considerable stress on the adaptability of the social and economic system. DhakaHazard, a joint research project of the Department of Meteorology at the University of Bonn and the Department of Geography at the University of Cologne, takes up these issues in an interdisciplinary approach. The project, which begun in November 2008, aims to achieve two main objectives: To link analyses of informal social and economic adaptation strategies to models on future climate change and weather extremes. To estimate more accurately the future frequency and magnitude of weather extremes and floods which are crucial for the future adaptability of informal systems. To fulfill these objectives, scientists at the Meteorological Institute are studying the evolution of natural hazards in Bangladesh, while researchers at the Department of Geography are undertaking the task of assessing these hazards from a social point of view. More specifically, the meteorologists are identifying global and regional weather conditions resulting in flooding of the Greater Dhaka region, while possible variations in flood-inducing weather patterns are analyzed by evaluating their frequency and magnitude. Findings are then applied to future global climate scenario runs to obtain a first estimate of trends for the frequency and magnitude of weather extremes and their impact on spatial and temporal characteristics of floods in the Greater Dhaka region. From this estimate, a prediction method for the spatial patterns of flooding within the Dhaka area will be developed. The social part of the project analyzes the vulnerability and resilience of economic and social systems within high-risk areas by utilizing methods such as e.g. quantitative household surveys in Dhaka and qualitative expert interviews. Geographers are hoping to identify adaptation and recovery strategies of slum dwellers and informal businesses (e.g. brickfields, tanneries), analyze the role of social capital as well as formal and informal institutions for building up resilience, and analyze possibilities and limits of adaptation strategies under conditions of further urban growth and climate change. By paying attention to the important behavioral patterns of the informal sector, a meteorological early warning system can then be developed to make better use of weather predictions to mitigate weather-related risks for Greater Dhaka. If successful, this project poses as an exemplary intersection of social science and natural hazards research.

Evaluation of aquifer environment under Hazaribagh leather processing zone of Dhaka city

NASA Astrophysics Data System (ADS)

Zahid, Anwar; Balke, K.-D.; Hassan, M. Qumrul; Flegr, Matthias

2006-07-01

Hazaribagh is a densely populated area of Dhaka city where about 185 leather processing industries have been operating and discharging solid and liquid wastes directly to the low-lying areas, river and natural canals without proper treatment. The area is covered by alluvial deposits of Holocene age and is underlain by Pleistocene Madhupur clay. The Dupi Tila Formation of Mio-Pliocene age underlain by this yellowish gray to brick red clay bed serves as the main water-bearing aquifer of Dhaka city. To assess the environmental degradation as well as the groundwater environment, major anions, cations and heavy metals of water samples, heavy metals and organic carbon content of sediment samples were analyzed in this study. Analyses of tannery effluent detect high concentration of Na+, Mg2+, Cl- and SO{4/2-} followed by Ca2+, NH{4/+} and K+ with remarkable contents of some trace elements, mainly Cr, Fe, Mn, S, Ni and Pb. Higher accumulations of Cr, Al and Fe are observed in topsoil samples with significant amounts of Mn, Zn, Ni and Cu. Concentrations of ions and all the investigated trace elements of sampled groundwater were within the maximum allowable limit for drinking water of the Department of Environment, Bangladesh (DoE), and World Health Organization (WHO). However, excessive concentrations of Cr, Pb, etc., have already been reported in the shallow groundwater (10-20 m) of the area. Due to excessive withdrawal the vulnerability of groundwater contamination in deeper parts cannot be avoided for the future.

Restoring water quality in the polluted Turag-Tongi-Balu river system, Dhaka: Modelling nutrient and total coliform intervention strategies.

PubMed

Whitehead, Paul; Bussi, Gianbattista; Hossain, Mohammed Abed; Dolk, Michaela; Das, Partho; Comber, Sean; Peters, Rebecca; Charles, Katrina J; Hope, Rob; Hossain, Md Sarwar

2018-08-01

River water quality in rapidly urbanising Asian cities threatens to damage the resource base on which human health, economic growth and poverty reduction all depend. Dhaka reflects the challenges and opportunities for balancing these dynamic and complex trade-offs which goals can be achieved through effective policy interventions. There is a serious problem of water pollution in central Dhaka, in the Turag-Tongi-Balu River system in Bangladesh with the river system being one of the most polluted in the world at the moment. A baseline survey of water chemistry and total coliforms has been undertaken and shows dissolved oxygen close to zero in the dry season, high organic loading together with extreme levels of Ammonium-N and total coliform in the water. Models have been applied to assess hydrochemical processes in the river and evaluate alternative strategies for policy and the management of the pollution issues. In particular models of flow, Nitrate-N, Ammonium-N and indicator bacteria (total coliforms) are applied to simulate water quality in the river system. Various scenarios are explored to clean up the river system, including flow augmentation and improved effluent treatment. The model results indicate that improved effluent treatment is likely to have a more significant impact on reducing Ammonium-N and total coliforms than flow augmentation, but a combined strategy would greatly reduce the pollution problems in the Turag-Tongi-Balu River System. Copyright © 2018. Published by Elsevier B.V.

Beliefs and practices during pregnancy and childbirth in urban slums of Dhaka, Bangladesh

PubMed Central

2012-01-01

Background Worldwide urbanization has become a crucial issue in recent years. Bangladesh, one of the poorest and most densely-populated countries in the world, has been facing rapid urbanization. In urban areas, maternal indicators are generally worse in the slums than in the urban non-slum areas. The Manoshi program at BRAC, a non governmental organization, works to improve maternal, newborn, and child health in the urban slums of Bangladesh. This paper describes maternal related beliefs and practices in the urban slums of Dhaka and provides baseline information for the Manoshi program. Methods This is a descriptive study where data were collected using both quantitative and qualitative methods. The respondents for the quantitative methods, through a baseline survey using a probability sample, were mothers with infants (n = 672) living in the Manoshi program areas. Apart from this, as part of a formative research, thirty six in-depth semi-structured interviews were conducted during the same period from two of the above Manoshi program areas among currently pregnant women who had also previously given births (n = 18); and recently delivered women (n = 18). Results The baseline survey revealed that one quarter of the recently delivered women received at least four antenatal care visits and 24 percent women received at least one postnatal care visit. Eighty-five percent of deliveries took place at home and 58 percent of the deliveries were assisted by untrained traditional birth attendants. The women mostly relied on their landladies for information and support. Members of the slum community mainly used cheap, easily accessible and available informal sectors for seeking care. Cultural beliefs and practices also reinforced this behavior, including home delivery without skilled assistance. Conclusions Behavioral change messages are needed to increase the numbers of antenatal and postnatal care visits, improve birth preparedness, and encourage skilled attendance at delivery. Programs in the urban slum areas should also consider interventions to improve social support for key influential persons in the community, particularly landladies who serve as advisors and decision-makers. PMID:22978705

Child care hygiene practices of women migrating from rural to urban areas of bangladesh.

PubMed

Begum, Housne Ara; Moneesha, Shanta Shyamolee; Sayem, Amir Mohammad

2013-07-01

Children's hygiene is very important for better health but there is a paucity of studies in this area. This questionnaire study examined the child care hygiene practices of mothers of young children. A total of 354 women from slum areas of Dhaka city, Bangladesh, who migrated from rural to urban areas were selected for this study. The mean score on hygiene practice was 6.21 of 10 items (SD = 2.113). Low (score = 3) and high hygiene practice (score = 7-10) were practiced by 12.4% and 45.8% of participants, respectively. Multivariate regression analysis indicated that independent variables explained 39.9% of variance in hygiene practices. Eight variables have significant effect: participant's education (0.108; P < .05), time spent since marriage to first birth (0.030; P < .05), number of children (-0.105; P < .05), number of antenatal visits (0.319; P < .001), microcredit status (0.214; P < .001), breastfeeding (0.224; P < .001), husband's monthly income (0.146; P < .001), and household economic status (-0.0114; P < .05). The overall hygiene practice indicates the necessity of awareness building initiatives.

Prevalence of depression and its associated factors in patients with type 2 diabetes: A cross-sectional study in Dhaka, Bangladesh.

PubMed

Islam, Sheikh Mohammed Shariful; Rawal, Lal B; Niessen, Louis W

2015-10-01

Depression is a common feature in patients with type 2 diabetes and often remains undetected and untreated, causing increased morbidity and mortality. We explored the prevalence of co-morbid depression and its associated factors, including major life-events among patients with type 2 diabetes in Bangladesh. We conducted a cross-sectional study among 515 patients with type 2 diabetes between September 2013 and July 2014 in a tertiary hospital in Dhaka city. We assessed depression using Patient Health Questionnaire-9 (PHQ-9) with predefined cut-off scores of 5, 10, 15 and 20 to indicate minimal, mild, moderate, moderately-severe, and severe depression. Associations between depression and its associated factors were explored using univariate and multivariate regression. Overall, 61.9% participants had depressive symptoms, and the prevalence was higher among females (70.9%) compared to males (50.6%). One-third (35.7%) of participants had mild depression and 36.2% had moderate to severe depression. In the multivariate analysis, factors significantly associated with depression were: age≤60 years (OR: 2.1, 95% CI=1.2-3.6; p≤0.006), female gender (OR=1.9, 95% CI=1.3-3.0; p≤0.002), those having 1-3 complications (OR=2.3, 95% CI=1.2-4.3; p=0.010), experienced loss of business or crop failure (OR=2.1, 95% CI=1.2-3.6; p=0.006), major family conflicts (OR=2.2, 95% CI=1.4-3.5; p≤0.001), separation or deaths of family members or divorce (OR=2.2, 95% CI=1.4-3.5; p≤0.001), and those who experienced unavailability of food or medicines (OR=2.2, 95% CI=1.0-4.5; p=0.038). Patients with diabetes, especially females, those having other complications, and major life-events should routinely be screened for symptoms of depression with adequate management of these conditions. Copyright © 2015 Elsevier B.V. All rights reserved.

Cost and sustainability of a successful package of interventions to improve vaccination coverage for children in urban slums of Bangladesh.

PubMed

Hayford, K; Uddin, M J; Koehlmoos, T P; Bishai, D M

2014-04-25

To estimate the incremental economic costs and explore satisfaction with a highly effective intervention for improving immunization coverage among slum populations in Dhaka, Bangladesh. A package of interventions based on extended clinic hours, vaccinator training, active surveillance, and community participation was piloted in two slum areas of Dhaka, and resulted in an increase in valid fully immunized children (FIC) from 43% pre-intervention to 99% post-intervention. Cost data and stakeholder perspectives were collected January-February 2010 via document review and 10 key stakeholders interviews to estimate the financial and opportunity costs of the intervention, including uncompensated time, training and supervision costs. The total economic cost of the 1-year intervention was $18,300, comprised of external management and supervision (73%), training (11%), coordination costs (1%), uncompensated staff time and clinic costs (2%), and communications, supplies and other costs (13%). An estimated 874 additional children were correctly and fully immunized due to the intervention, at an average cost of $20.95 per valid FIC. Key stakeholders ranked extended clinic hours and vaccinator training as the most important components of the intervention. External supervision was viewed as the most important factor for the intervention's success but also the costliest. All stakeholders would like to reinstate the intervention because it was effective, but additional funding would be needed to make the intervention sustainable. Targeting slum populations with an intensive immunization intervention was highly effective but would nearly triple the amount spent on immunization per FIC in slum areas. Those committed to increasing vaccination coverage for hard-to-reach children need to be prepared for substantially higher costs to achieve results. Copyright © 2014. Published by Elsevier Ltd.

Pilot Intervention Study of Household Ventilation and Fine Particulate Matter Concentrations in a Low-Income Urban Area, Dhaka, Bangladesh.

PubMed

Weaver, Anne M; Parveen, Shahana; Goswami, Doli; Crabtree-Ide, Christina; Rudra, Carole; Yu, Jihnhee; Mu, Lina; Fry, Alicia M; Sharmin, Iffat; Luby, Stephen P; Ram, Pavani K

2017-08-01

Fine particulate matter (PM 2.5 ) is a risk factor for pneumonia; ventilation may be protective. We tested behavioral and structural ventilation interventions on indoor PM 2.5 in Dhaka, Bangladesh. We recruited 59 good ventilation (window or door in ≥ 3 walls) and 29 poor ventilation (no window, one door) homes. We monitored baseline indoor and outdoor PM 2.5 for 48 hours. We asked all participants to increase ventilation behavior, including opening windows and doors, and operating fans. Where permitted, we installed windows in nine poor ventilation homes, then repeated PM 2.5 monitoring. We estimated effects using linear mixed-effects models and conducted qualitative interviews regarding motivators and barriers to ventilation. Compared with poor ventilation homes, good ventilation homes were larger, their residents wealthier and less likely to use biomass fuel. In multivariable linear mixed-effects models, ventilation structures and opening a door or window were inversely associated with the number of hours PM 2.5 concentrations exceeded 100 and 250 μg/m 3 . Outdoor air pollution was positively associated with the number of hours PM 2.5 concentrations exceeded 100 and 250 μg/m 3 . Few homes accepted window installation, due to landlord refusal and fear of theft. Motivators for ventilation behavior included cooling of the home and sunlight; barriers included rain, outdoor odors or noise, theft risk, mosquito entry, and, for fan use, perceptions of wasting electricity or unavailability of electricity. We concluded that ventilation may reduce indoor PM 2.5 concentrations but, there are barriers to increasing ventilation and, in areas with high ambient PM 2.5 concentrations, indoor concentrations may remain above recommended levels.

High prevalence of type 2 diabetes among the urban middle class in Bangladesh

PubMed Central

2013-01-01

Background The prevalence of type-2 diabetes and metabolic syndrome are increasing in the developing world; we assessed their prevalence among the urban middle class in Bangladesh. Methods In this cross-sectional survey (n = 402), we randomly selected consenting adults (≥ 30 years) from a middle-income neighborhood in Dhaka. We assessed demography, lifestyle, and health status, measured physical indices and blood pressure and obtained blood samples. We evaluated two primary outcomes: (1) type-2 diabetes (fasting blood glucose ≥ 7.0 mmol/L or hemoglobin A1C ≥ 6.5% (48 mmol/mol) or diabetes medication use) and (2) insulin resistance (type-2 diabetes or metabolic syndrome using International Diabetes Federation criteria). Results Mean age and Quételet’s (body mass) index were 49.4 ± 12.6 years and 27.0 ± 5.1 kg/m2; 83% were married, 41% had ≥12 years of education, 47% were employed, 47% had a family history of diabetes. Thirty-five percent had type-2 diabetes and 45% had metabolic syndrome. In multivariate models older age and family history of diabetes were significantly associated with type-2 diabetes. Older age, female sex, overweight or obese, high wealth index and positive family history of diabetes were significantly associated with insulin resistance. Participants with type-2 diabetes or insulin resistance had significantly poorer physical health only if they had associated cardiovascular disease. Conclusions The prevalence of type-2 diabetes and metabolic syndrome among the middle class in Dhaka is alarmingly high. Screening services should be implemented while researchers focus on strategies to lessen the incidence and morbidity associated with these conditions. PMID:24172217

Estimation of the herd protection of Haemophilus influenzae type b conjugate vaccine against radiologically confirmed pneumonia in children under 2 years old in Dhaka, Bangladesh.

PubMed

Chen, Wei-Ju; Moulton, Lawrence H; Saha, Samir K; Mahmud, Abdullah Al; Arifeen, Shams El; Baqui, Abdullah H

2014-02-12

Herd protection of Haemophilus influenzae type b (Hib) conjugate vaccine has been associated with excessive decrease of invasive Hib diseases, i.e., pneumonia and meningitis, with increased national or regional Hib vaccine coverage. Only a few studies have examined herd protection at the individual level and even less evidence is available from Asia. We examined Hib vaccine herd protection against radiologically confirmed pneumonia among children less than 2 years old. We incorporated data from a matched case-control study and a vaccine coverage survey in Dhaka, Bangladesh. Pneumonia cases (n=343) were confirmed by radiology. For each case, two controls with conditions other than pneumonia or meningitis were selected from the same hospital. Hib vaccine coverage was calculated as percentages of children who received at least 2 doses of Hib vaccine from a survey in the neighborhood centered on each case and control. Conditional logistic regression was fit to examine the association between vaccine coverage and risk of radiologically confirmed pneumonia. Neighborhood Hib vaccine coverage varied from 0% to 63.5% for cases and from 8.7% to 61.5% for controls, respectively. Cases were less likely to have neighborhood coverage higher than 20% (OR=0.49, 0.52, 0.55, and 0.69 for coverage 20-29%, 30-39%, 40-49%, and ≥50%, respectively) than coverage <20%, compared to controls, although the estimates for coverage 40-49% and ≥50% were not statistically significant. The study indicates that Hib vaccine may provide herd protection, even when the coverage is as low as 20-39%, in a low-income country. Asian countries should consider herd protection in implementing effective vaccine policy with limited resources. Copyright © 2014 Elsevier Ltd. All rights reserved.

The urban poor in Dhaka City: their struggles and coping strategies during the floods of 1998.

PubMed

Rashid, S F

2000-09-01

Bangladesh experienced one of the worst floods in recorded history in 1998. This paper focuses on the needs and coping strategies of the urban poor in Dhaka City, which had been very badly affected. The city's roads were completely under water, and most areas were water-logged with drainage and sewage systems blocked. Rising water levels compelled many slum dwellers to move to temporary shelters and relief camps. Women and children were the worst affected. The lack of sanitation facilities and privacy forced women and children to defecate in their own homes. There was an acute scarcity of safe drinking-water, and food prices rose dramatically. Diarrhoea, fever and colds were the most common illnesses affecting the poor. The floods left many of them unemployed, and in some families, the result was increased tension and incidents of domestic violence. In some areas, members felt pressured to repay micro-credit loans. Most NGOs, however, suspended loan repayments. During this period, a committee was set up to co-ordinate and work towards addressing some of the main post-flood problems.

Influence of maternal and socioeconomic factors on breast milk fatty acid composition in urban, low-income families.

PubMed

Nayak, Uma; Kanungo, Suman; Zhang, Dadong; Ross Colgate, E; Carmolli, Marya P; Dey, Ayan; Alam, Masud; Manna, Byomkesh; Nandy, Ranjan Kumar; Kim, Deok Ryun; Paul, Dilip Kumar; Choudhury, Saugato; Sahoo, Sushama; Harris, William S; Wierzba, Thomas F; Ahmed, Tahmeed; Kirkpatrick, Beth D; Haque, Rashidul; Petri, William A; Mychaleckyj, Josyf C

2017-10-01

The lipid composition of breast milk may have a significant impact on early infant growth and cognitive development. Comprehensive breast milk data is lacking from low-income populations in the Indian subcontinent impeding assessment of deficiencies and limiting development of maternal nutritional interventions. A single breast milk specimen was collected within 6 weeks postpartum from two low-income maternal cohorts of exclusively breastfed infants, from Dhaka, Bangladesh (n = 683) and Kolkata, India (n = 372) and assayed for percentage composition of 26 fatty acids. Mature milk (>15 days) in Dhaka (n = 99) compared to Kolkata (n = 372) was higher in total saturated fatty acid (SFA; mean 48% vs. 44%) and disproportionately lower in ω3-polyunsaturated fatty acid (PUFA), hence the ω6- and ω3-PUFA ratio in Dhaka were almost double the value in Kolkata. In both sites, after adjusting for days of lactation, increased maternal education was associated with decreased SFA and PUFA, and increasing birth order or total pregnancies was associated with decreasing ω6-PUFA or ω3-PUFA by a factor of 0.95 for each birth and pregnancy. In Dhaka, household prosperity was associated with decreased SFA and PUFA and increased ω6- and ω3-PUFA. Maternal height was associated with increased SFA and PUFA in Kolkata (1% increase per 1 cm), but body mass index showed no independent association with either ratio in either cohort. In summary, the socioeconomic factors of maternal education and household prosperity were associated with breast milk composition, although prosperity may only be important in higher cost of living communities. Associated maternal biological factors were height and infant birth order, but not adiposity. Further study is needed to elucidate the underlying mechanisms of these effects. © 2017 The Authors. Maternal & Child Nutrition Published by John Wiley & Sons Ltd.

Nutritional status of children <5 years of age who have a working mother: an epidemiological perspective of diarrhoeal children in urban Bangladesh.

PubMed

Ferdous, Farzana; Das, Jui; Ahmed, Shahnawaz; Malek, Mohammad Abdul; Das, Sumon Kumar; Faruque, Abu Syed Golam; Chisti, Mohammod Jobayer; Ma, Enbo; Wagatsuma, Yukiko

2016-10-01

The present analysis aimed to observe nutritional impacts among children <5 years of age by mother's engagement in paid employment. Between 1996 and 2012, 21 443 children <5 years of age with diarrhoea attended the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka Hospital. They were enrolled in the hospital-based Diarrhoeal Disease Surveillance System and their relevant information was extracted from the electronic database. The icddr,b, Bangladesh. The analytic sample was 19 597 children aged <5 years who had a mother aged ≤35 years with or without engagement in paid employment. Eleven per cent of the mothers (n 2051) were currently engaged in paid employment on behalf of the family. Univariate analysis showed that children with mothers engaged in paid employment had a 1·14 times higher risk of being undernourished, a 1·20 times of higher risk of being stunted, a 1·21 times higher risk of being wasted and a 1·31 times higher risk of being underweight (risk ratios) than were children with mothers not likewise engaged. Multivariate analysis showed that such associations remained significant for stunting (1·08; 95 % CI 1·00, 1·16), wasting (1·15; 95 % CI 1·06, 1·25) and underweight (1·09; 95 % CI 1·02, 1·17) after controlling for covariates. Mothers' engagement in income-generating employment was associated with undernutrition in children <5 years of age in urban Bangladesh.

Impact of introduction of the Haemophilus influenzae type b conjugate vaccine into childhood immunization on meningitis in Bangladeshi infants.

PubMed

Sultana, Nadira K; Saha, Samir K; Al-Emran, Hassan M; Modak, Joyanta K; Sharker, M A Yushuf; El-Arifeen, Shams; Cohen, Adam L; Baqui, Abdullah H; Luby, Stephen P

2013-07-01

Some Asian countries have been reluctant to adopt Haemophilus influenzae type b (Hib) conjugate vaccination because of uncertainty over disease burden. We assessed the impact of introduction of Hib conjugate vaccine into the Expanded Program on Immunization in Bangladesh on purulent and laboratory-confirmed H influenzae meningitis. Within a well-defined catchment area around 2 surveillance hospitals in Dhaka, Bangladesh, we compared the incidence of Hib meningitis confirmed by culture, latex agglutination, and polymerase chain reaction assay among infants 1 year before and 1 year after introduction of Hib conjugate vaccine. We adjusted the incidence rate for the proportion of children who sought care at the surveillance hospitals. Among infants, the incidence of confirmed Hib meningitis decreased from 92-16 cases per 100,000 within 1 year of vaccine introduction (vaccine preventable incidence = 76; 95% CI 18, 135 per 100,000). The incidence of purulent meningitis decreased from 1659-1159 per 100,000 (vaccine preventable incidence = 500; 95% CI: 203, 799 per 100,000). During the same time period, there was no significant difference in the incidence of meningitis due to Streptococcus pneumoniae. Introduction of conjugate Hib conjugate vaccine into Bangladesh Expanded Program on Immunization markedly reduced the burden of Hib and purulent meningitis. Copyright © 2013. Published by Mosby, Inc.

Hydrogeological evaluation of an over-exploited aquifer in Dhaka, Bangladesh towards the implementation of groundwater artificial recharge

NASA Astrophysics Data System (ADS)

Azizur Rahman, M.; Rusteberg, Bernd; Sauter, Martin

2010-05-01

The population of Dhaka City is presently about 12 million and according to present trends in population growth, that number will most likely increase to 17.2 million by the year 2025. A serious water crisis is expected due to the extremely limited quality and quantity of water resources in the region. Previous studies have shown that the current trend in groundwater resource development is non-sustainable due to over-exploitation of the regional aquifer system, resulting in rapidly decreasing groundwater levels of about 2 to 3 meters per year. Today, annual groundwater extraction clearly exceeds natural groundwater recharge. New water management strategies are needed to guarantee future generations of Dhaka City a secured and sustained water supply as well as sustainable development of the city. The implementation of groundwater artificial recharge (AR) is one potential measure. As the first step towards a new water management strategy for Dhaka City, the authors report on the hydrogeological conditions of the greater Dhaka region and from this are able to present the location of potential recharge sites and identify appropriate recharge technologies for AR implementation. The aquifers of greater Dhaka can be grouped in three major categories: Holocene Deposit, Pleistocene Deposit and Plio-Pleistocene Deposit. The aquifers are generally thick and multilayered with relatively high transmissivity and storage coefficients. AR is considered feasible due to the fact these aquifers are alluvium deposit aquifers which characteristically have moderate to high hydraulic conductivity. Low costs for recovery of recharged water and large recharge volume capacity are generally associated with aquifers of unconsolidated sediments. Spatial analysis of the region has shown that Karaniganj, Kotoali, Savar, Dhamrai, Singair upazila, which are situated in greater Dhaka region and close to Dhaka City, could serve as recharge sites to the subsurface by pond infiltration technique. A study involving the use of a 3-D mathematical model shows that the abstraction or recharge in the area within and around Dhaka City does not affect the groundwater level below the city. Therefore, in order to improve the groundwater level, artificial groundwater recharge directly at the city area would be mostly appropriate. As the thickness of the surface impermeable layer varies from 5 m to 45 m, the combination of infiltration and injection technology would be a proper choice. Detailed studies are required using the most appropriate state of the art spatial analysis to support the final selection and ranking of suitable locations for the AR facilities, according to flood risk, urbanization, underground characteristics, water sources, AR technology and later use of the recovered water. Groundwater quality data reveal that the upper aquifer below Dhaka City contains relatively high concentrations of dissolved ions, quite variable in space. The ground water is predominantly of Ca-Mg-HCO3 type. Cation exchange and oxidation may enhance the biogeochemical processes in the aquifer under the existing prevailing conditions. Many reports conclude that that the groundwater chemistry of the upper aquifer has been influenced by various anthropogenic processes, showing wide variations of groundwater quality depending on the area, which would complicate the implementation of AR projects. The preliminary evaluation of the potential for AR implementation, considering environmental and social impacts, as well as the available water sources for infiltration and injection (conventional or non-conventional), AR may be considered a viable response measure with regards to the problems Dhaka City is facing. Without the implementation of groundwater artificial recharge or similar measures, groundwater availability and groundwater quality will further decrease and serious water crisis are to be expected. Measures to avoid groundwater contamination must also be taken to complement the benefits provided by AR implementation.

Factors affecting nutritional status in female adults in Dhaka slums, Bangladesh.

PubMed

Pryer, Jane A; Rogers, Stephen; Rahman, Ataur

2003-01-01

This study looks at women from the slums in Mohammadpur, Dhaka, Bangladesh, where 54 percent of women's BMI was less than 18.5. Fifty percent of the Dhaka slum population lived below the poverty line. Logistic regression showed that women with income above 1,500 taka per capita were 1.78 times more likely to have a higher BMI (odds ratio 1.7863; CI = 0.671-3.639). Women with their own savings were 1.89 times more likely to have higher BMI (odds ratio 1.879; CI = 0.01163-1.6431). Women were 4.5 times more likely to have a higher BMI when food expenditure per capita above 559 taka per month (odds ratio 4.55; CI = 1.0302-8.0799). Women were 1.82 times more likely to have higher BMI when there was a break even situation in financial status (odds ratio 1.8212; CI = -015709-3.6285). Female headed households were 3.3 times more likely to have a higher BMI compared to women living in male headed households (odds ratio 3.2966; CI = 0.33711-6.25620). Women who work 15-23 days per month were 2.3 times more likely to have a higher BMI (odds ratio 2.33; CI = 0.1133-4.5600). Women who are the budget manager are 1.12 times more likely to have a higher BMI (odds ratio 1.125; CI = 0.29296-2.0966). Where as a husband who beats his wife is 1.83 more likely to have a poorer BMI (odds ratio 1.8312; CI = -3.72596-0.17508). Women who have no marriage documents and women who take days off due to illness less than 11 days per month were more likely to have a poorer BMI (odds ratio 0.5567; CI = -0.049339-2.8379; odds ratio 0.7569; CI = 0.183167-2.0002). Women's nutritional status and well being can influence their ability to provide for themselves and their families and the demonstration of a relationship between measures of women's autonomy and control in the household and women's nutritional status is an important indication of the importance of these sociological constructs. Women's participation in work outside the home may be a factor increasing their autonomy. The identification of relationships between women's autonomy and control and their physical well being should provide further leverage for policy change that will enable women to escape some traditional roles and to contribute as more equal partners with men in the future of Bangladeshi society.

Pediatric surgery in Bangladesh.

PubMed

Bagwell, C E; Shandling, B

1986-09-01

Bangladesh, although a small country of only 55,000 square miles, is the world's eighth most populous nation, and its 90 million inhabitants occupy a land of harsh economic conditions. One half of this dense population is children, 90% of whom suffer from parasitic infestations, 10% are affected with neonatal tetanus, and one half are severely malnourished. Health care resources are scarce with one physician and hospital bed for about every 10,000 persons. A 1-month stay in Bangladesh at the Dhaka Shishu Hospital, made possible by the Canadian Association of Paediatric Surgeons, afforded an invaluable opportunity to be involved in Pediatric Surgery in such a setting. During the month, over 40 major pediatric surgical procedures were performed, including sequestrectomy, drainage of parietal wall abscess, and resection of massive neoplasms. Many unusual pathologic conditions, not commonly seen in Western countries, were encountered including canker otis, tuberculous ileitis, and ascaris-induced small bowel obstruction. In the setting of widespread malnutrition and limited diagnostic aids, appropriate surgical treatment remains crucial in many serious childhood conditions. Awareness of some of the more unusual infections and parasites seen in Third World nations is of great importance to Western surgeons due to increased travel and immigration and for a perspective on diseases rarely seen in more affluent countries.

Sexually transmitted infections and sexual behaviour among youth clients of hotel-based female sex workers in Dhaka, Bangladesh.

PubMed

Haseen, F; Chawdhury, F A H; Hossain, M E; Huq, M; Bhuiyan, M U; Imam, H; Rahman, D M M; Gazi, R; Khan, S I; Kelly, R; Ahmed, J; Rahman, M

2012-08-01

A cross-sectional study was conducted among youth clients of hotel-based female sex workers (YCHBFSWs) in nine randomly selected hotels in Bangladesh to examine sexual-risk behaviour, condom use and determinants of condom use in last sex, knowledge of HIV, sexually transmitted infection (STI) prevalence and STI care-seeking behaviour. A prestructured questionnaire was used to collect sociodemographic, behavioural, clinical information; urine specimens (before sex) and blood were collected for diagnosis of Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, syphilis and herpes simplex virus 2 (HSV2) infection. One thousand and thirteen participants were enroled in the study. Approximately half of them reported visiting female sex workers (FSWs) at least once a month and 25% visited FSWs at least once a week. Only 12% of participants reported regular condom use. The prevalence of N. gonorrhoeae, C. trachomatis, T. vaginalis, syphilis and HSV2 was 2.2%, 3.9%, 7.2%, 2.6% and 12.9%, respectively. Only 15.3% of the YCHBFSW sought STI care in the past year. Negotiation of condom use with FSWs was the main determinant (odds ratio = 17.95) for condom use at last sex. Male clients of FSWs, including YCHBFSW, are an important bridge population for HIV transmission in Bangladesh and HIV interventions should be designed and implemented for them.

Operational feasibility of using whole blood in the rapid HIV testing algorithm of a resource-limited settings like Bangladesh.

PubMed

Munshi, Saif U; Oyewale, Tajudeen O; Begum, Shahnaz; Uddin, Ziya; Tabassum, Shahina

2016-03-01

Serum-based rapid HIV testing algorithm in Bangladesh constitutes operational challenge to scaleup HIV testing and counselling (HTC) in the country. This study explored the operational feasibility of using whole blood as alternative to serum for rapid HIV testing in Bangladesh. Whole blood specimens were collected from two study groups. The groups included HIV-positive patients (n = 200) and HIV-negative individuals (n = 200) presenting at the reference laboratory in Dhaka, Bangladesh. The specimens were subjected to rapid HIV tests using the national algorithm with A1 = Alere Determine (United States), A2 = Uni-Gold (Ireland), and A3 = First Response (India). The sensitivity and specificity of the test results, and the operational cost were compared with current serum-based testing. The sensitivities [95% of confidence interval (CI)] for A1, A2, and A3 tests using whole blood were 100% (CI: 99.1-100%), 100% (CI: 99.1-100%), and 97% (CI: 96.4-98.2%), respectively, and specificities of all test kits were 100% (CI: 99.1-100%). Significant (P < 0.05) reduction in the cost of establishing HTC centre and consumables by 94 and 61%, respectively, were observed. The cost of administration and external quality assurance reduced by 39 and 43%, respectively. Overall, there was a 36% cost reduction in total operational cost of rapid HIV testing with blood when compared with serum. Considering the similar sensitivity and specificity of the two specimens, and significant cost reduction, rapid HIV testing with whole blood is feasible. A review of the national HIV rapid testing algorithm with whole blood will contribute toward improving HTC coverage in Bangladesh.

Cost of behavior change communication channels of Manoshi -a maternal, neonatal and child health (MNCH) program in urban slums of Dhaka, Bangladesh

PubMed Central

2013-01-01

Background The cost of behavior change communication (BCC) interventions has not been rigorously studied in Bangladesh. This study was conducted to assess the implementation costs of a BCC intervention in a maternal, neonatal and child health program (Manoshi) run by BRAC, which has been operating in the urban slums of Dhaka since 2007. The study estimates the costs of BCC tools per exposure among the different types of BCC channels: face-to-face, group counseling, and mass media. Methods The study was conducted from November 2010 to April 2011 in the Dhaka urban slum area. A micro-costing approach was applied using primary and secondary data sources to estimate the cost of BCC tools. Primary data were collected through interviews with service-providers and managers from the Manoshi program, observations of group counseling, and mass media events. Results Per exposure, the cost of face-to-face counseling was found to be 3.08 BDT during pregnancy detection, 3.11 BDT during pregnancy confirmation, 12.42 BDT during antenatal care, 18.96 BDT during delivery care and 22.65 BDT during post-natal care. The cost per exposure of group counseling was 22.71 BDT (95% CI 21.30-24.87) for Expected Date of Delivery (EDD) meetings, 14.25 BDT (95% CI 12.37-16.12) for Women Support Group meetings, 17.83 BDT (95% CI 14.90-20.77) for MNCH committee meetings and 6.62 BDT (95% CI 5.99-7.26) for spouse forum meetings. We found the cost per exposure for mass media interventions was 9.54 BDT (95% CI 7.30-12.53) for folk songs, 26.39 BDT (95% CI 23.26-32.56) for street dramas, 0.39 BDT for TV-broadcasting and 7.87 BDT for billboards. Considering all components reaching the target audience under each broader type of channel, the total cost per exposure was found to be 60.22 BDT (0.82 USD) for face-to-face counseling, 61.40 BDT (0.82 USD) for group counseling and 44.19 BDT (0.61 USD) for mass media. Conclusions The total cost for group counseling was the highest per exposure, followed by face-to-face counseling and mass media. The cost per exposure varied substantially across BCC channels due to differences in cost drivers such as personnel, materials and refreshments. The cost per exposure can be valuable for planning and resource allocation related to the implementation of BCC interventions in low resource settings. PMID:24228844

Prevalence and determinants of the gender differentials risk factors of child deaths in Bangladesh: evidence from the Bangladesh demographic and health survey, 2011.

PubMed

Hossain, Md Mosharaf; Mani, Kulanthayan K C; Islam, Md Rafiqul

2015-03-01

The number of child deaths is a potential indicator to assess the health condition of a country, and represents a major health challenge in Bangladesh. Although the country has performed exceptionally well in decreasing the mortality rate among children under five over the last few decades, mortality still remains relatively high. The main objective of this study is to identify the prevalence and determinants of the risk factors of child mortality in Bangladesh. The data were based on a cross-sectional study collected from the Bangladesh Demographic and Health Survey (BDHS), 2011. The women participants numbered 16,025 from seven divisions of Bangladesh - Rajshahi, Dhaka, Chittagong, Barisal, Khulna, Rangpur and Sylhet. The 2 test and logistic regression model were applied to determine the prevalence and factors associated with child deaths in Bangladesh. In 2011, the prevalence of child deaths in Bangladesh for boys and girls was 13.0% and 11.6%, respectively. The results showed that birth interval and birth order were the most important factors associated with child death risks; mothers' education and socioeconomic status were also significant (males and females). The results also indicated that a higher birth order (7 & more) of child (OR=21.421 & 95%CI=16.879-27.186) with a short birth interval ≤ 2 years was more risky for child mortality, and lower birth order with longer birth interval >2 were significantly associated with child deaths. Other risk factors that affected child deaths in Bangladesh included young mothers of less than 25 years (mothers' median age (26-36 years): OR=0.670, 95%CI=0.551-0.815), women without education compared to those with secondary and higher education (OR =0 .711 & .628, 95%CI=0.606-0.833 & 0.437-0.903), mothers who perceived their child body size to be larger than average and small size (OR= 1.525 & 1.068, 95%CI=1.221-1.905 & 0.913-1.249), and mothers who delivered their child by non-caesarean (OR= 1.687, 95%CI=1.253-2.272). Community-based educational programs or awareness programs are required to reduce the child death in Bangladesh, especially for younger women should be increase the birth interval and decrease the birth order. The government should apply the strategies to enhance the socioeconomic conditions, especially in rural areas, increase the awareness program through media and expand schooling, particularly for girls.

Prevalence and Determinants of the Gender Differentials Risk Factors of Child Deaths in Bangladesh: Evidence from the Bangladesh Demographic and Health Survey, 2011

PubMed Central

Hossain, Md. Mosharaf; Mani, Kulanthayan K. C.; Islam, Md. Rafiqul

2015-01-01

Background The number of child deaths is a potential indicator to assess the health condition of a country, and represents a major health challenge in Bangladesh. Although the country has performed exceptionally well in decreasing the mortality rate among children under five over the last few decades, mortality still remains relatively high. The main objective of this study is to identify the prevalence and determinants of the risk factors of child mortality in Bangladesh. Methods The data were based on a cross-sectional study collected from the Bangladesh Demographic and Health Survey (BDHS), 2011. The women participants numbered 16,025 from seven divisions of Bangladesh – Rajshahi, Dhaka, Chittagong, Barisal, Khulna, Rangpur and Sylhet. The 𝟀2 test and logistic regression model were applied to determine the prevalence and factors associated with child deaths in Bangladesh. Results In 2011, the prevalence of child deaths in Bangladesh for boys and girls was 13.0% and 11.6%, respectively. The results showed that birth interval and birth order were the most important factors associated with child death risks; mothers’ education and socioeconomic status were also significant (males and females). The results also indicated that a higher birth order (7 & more) of child (OR=21.421 & 95%CI=16.879-27.186) with a short birth interval ≤ 2 years was more risky for child mortality, and lower birth order with longer birth interval >2 were significantly associated with child deaths. Other risk factors that affected child deaths in Bangladesh included young mothers of less than 25 years (mothers’ median age (26-36 years): OR=0.670, 95%CI=0.551-0.815), women without education compared to those with secondary and higher education (OR =0 .711 & .628, 95%CI=0.606-0.833 & 0.437-0.903), mothers who perceived their child body size to be larger than average and small size (OR= 1.525 & 1.068, 95%CI=1.221-1.905 & 0.913-1.249), and mothers who delivered their child by non-caesarean (OR= 1.687, 95%CI=1.253-2.272). Conclusion Community-based educational programs or awareness programs are required to reduce the child death in Bangladesh, especially for younger women should be increase the birth interval and decrease the birth order. The government should apply the strategies to enhance the socioeconomic conditions, especially in rural areas, increase the awareness program through media and expand schooling, particularly for girls. PMID:25747178

Social and economic impact of diabetics in Bangladesh: protocol for a case–control study

PubMed Central

2013-01-01

Background Diabetes affects both individuals and their families and has an impact on economic and social development of a country. Information on the availability, cost, and quality of medical care for diabetes is mostly not available for many low- and middle-income countries including Bangladesh. Complications from diabetes, which can be devastating, could largely be prevented by wider use of several inexpensive generic medicines, simple tests and monitoring and can be a cost saving intervention. This study will provide an in-depth and comprehensive picture of social and economic impacts of diabetes in Bangladesh and propose clear recommendations for improving prevention and management of diabetes. The objectives of the study are: 1) To study the association between diabetes and other health problems and its social impacts 2) To estimate the economic impact of diabetes including total direct and indirect costs 3) To measure the impact of diabetes on quality of life among diabetes patients in Bangladesh 4) To study the impact of diabetes on the health care system Methods This is a case–control study comparing cases with type 2 diabetes to controls without diabetes matched on age, sex and place of residence. 564 cases and 564 controls will be selected from the outpatient department of a tertiary hospital in Dhaka, Bangladesh. Data on socioeconomic status, health utility index, direct and indirect costs for diabetes, medication adherence, quality of life, treatment satisfaction, diet, physical activity, mental state examination, weight, height, hip and waist circumference, blood pressure, pulse, medication history, laboratory data and physical examination will be conducted. Outcome measures: The primary outcome measures will be association between diabetes and other health problems, cost of diabetes, impact of diabetes on quality of life and secondary outcome measures are impact of diabetes on healthcare systems in Bangladesh. Discussion This study will provide an in-depth and comprehensive picture of social and economic impacts of diabetics in Bangladesh and propose clear recommendations for improving prevention and management of diabetics. It will help to develop programs and policies for better management of Diabetics and cost effective strategies in Bangladesh context. PMID:24359558

Safer sex negotiation and its association with condom use among clients of female sex workers in Bangladesh.

PubMed

Kamal, S M Mostafa; Hassan, Che Hashim; Salikon, Roslan Hj

2015-03-01

This study examines safer sex negotiation and its association with condom use among clients of female sex workers (FSWs) in Bangladesh. Data were collected from 484 FSWs living in Dhaka city following a convenient sampling procedure. Overall, 47% of the clients were suggested to use condom during last sexual intercourse and 21% did so. Both bivariate and multivariable binary logistic regression analyses yielded significantly increased risk of negotiation for safer sex with clients among FSWs with higher education. The power bargaining significantly (P < .001) increased the risk of condom use by 2.15 times (95% confidence interval = 1.28-3.59). The odds of condom use were significantly higher among the FSWs with higher education, unmarried, hotel-based, and among those with higher level of HIV/AIDS-related knowledge. The Bangladeshi FSWs have little control over their profession. HIV prevention programs should aim to encourage FSWs through information, education, and communication program to insist on condom use among clients. © 2013 APJPH.

Effects of education and other socioeconomic factors on middle age mortality in rural Bangladesh

PubMed Central

Hurt, L; Ronsmans, C; Saha, S

2004-01-01

Study objective: To examine socioeconomic gradients in mortality in adult women and their husbands in Bangladesh, paying particular attention to the independent effects of the educational status of each spouse. Design: Historical cohort study. Setting: Matlab, a rural area 60 km south east of Dhaka, the capital of Bangladesh. Participants: 14 803 married women aged 45 or over and their husbands who were resident in the Matlab Demographic Surveillance area between 30 June 1982 and 31 December 1998. Main results: Mortality was lower in women with formal or Koranic education compared with those with none (adjusted rate ratio for formal education = 0.68, 95% CI 0.53 to 0.86; adjusted rate ratio for Koranic schooling = 0.82, 95% CI 0.66 to 1.00). After adjusting for her own education, the husband's level of education or occupation did not have an independent effect on a woman's survival. Men who had attended formal education had lower mortality than those without any education (adjusted rate ratio = 0.84, 95% CI 0.75 to 0.93), but men whose wives had been educated had an additional survival advantage independent of their own education and occupation (adjusted rate ratio = 0.76, 95% CI 0.67 to 0.87). Mortality in both sexes was also significantly associated with marital status and the percentage of surviving children, and in men was associated with the man's occupation, religion, area of residence. Conclusions: The data suggest that socioeconomic status has a strong influence on mortality in adults in Bangladesh. They also illustrate how important the continued promotion of education, particularly for women, may be for the survival of both women and men in rural Bangladesh. PMID:15026446

Impacts of policy and market incentives for solid waste recycling in Dhaka, Bangladesh

DOE Office of Scientific and Technical Information (OSTI.GOV)

Matter, Anne; Swisscontact: Swiss Foundation for Technical Cooperation, South Asian Regional Office, House No. 19, Road No. 11, Baridhara, Dhaka 1212; Ahsan, Mehedi

Highlights: • Bangladesh’s industry and population are growing rapidly, producing more urban waste. • Recycling reduces the solid waste management burden of Municipalities. • A wide array of informal and formal actors is involved in collection and recycling. • Demand for recycled materials and renewable energy creates market incentives. • Policy incentives exist, but they only reach the formal industry. - Abstract: Solid waste mismanagement in Dhaka, Bangladesh, illustrates a well-known market failure which can be summarized as: waste is a resource in the wrong place. Inorganic materials such as plastic or paper can be used to feed the demandmore » for recycled materials in the industrial sector. Organic materials can be converted and used in the nutrient-starved agricultural sector which is currently heavily depending on chemical fertilizers. They are also a feedstock to generate renewable energy in the form of biogas for this energy-starved country relying on diminishing natural gas reserves and increasing import of coal. Reality however does not capitalize on this potential; instead the waste is a burden for municipal authorities who spend large portions of their budgets attempting to transport it out of the city for discharge into landfills. The major part of these materials still remains uncollected in the residential areas and is discarded indiscriminately in open spaces, polluting the residents’ living environment including water, soil and air resources, in the city and beyond. Bangladeshi authorities have, to some extent, recognized this market failure and have developed policies to encourage the development of waste recycling activities. It is also important to note that this market failure is only partial: a large, mostly informal recycling sector has developed in Bangladesh, focusing on inorganic recyclables of market value. The fact that this sector remains largely informal means that these actors perceive significant barriers to formalization. Comparatively, the organic waste recycling sector is less driven by market mechanisms. Competition from chemical fertilizers and fossil fuels is fierce and hinders the development of market opportunities for compost and renewable energy. Nevertheless commercial production of compost and biogas from organic municipal waste is formalized and benefiting from policy incentives.« less

Understanding Climate Change Impacts in a Cholera Endemic Megacity: Disease Trends, Hydroclimatic Indicators and Near Future-Term Projections

NASA Astrophysics Data System (ADS)

Akanda, A. S. S.; Hasan, M. A.; Serman, E. A.; Jutla, A.; Huq, A.; Colwell, R. R.

2015-12-01

The last three decades of surveillance data shows a drastic increase of cholera prevalence in the largest cholera-endemic city in the world - Dhaka, Bangladesh. While an endemic trend is getting stronger in the dry season, the post-monsoon season shows increased variability and is epidemic in nature. The pre-monsoon dry season is becoming the dominant cholera season of the year, followed by monsoon flood related propagation in later months of the year. Although the heavily populated and rapidly urbanizing Dhaka region has experienced noticeable shifts in pre monsoon temperature and precipitation patterns and subsequent monsoon variations, to date, there has not been any systematic study on linking the long-term disease trends with observed changes in hydroclimatic indicators. Here, we focus on the past 30-year dynamics of urban cholera prevalence in Dhaka with changes in climatic or anthropogenic forcings to develop projections for the next 30-year period. We focus on the dry and the wet season indicators individually, and develop trends of maximum rainfall intensity, lowest rainfall totals in the pre-monsoon period, number of consecutive dry days, number of wet days, and number of rainy days with greater than 500mm rainfall using a recently developed gridded data product - and compare with regional hydrology, flooding, water usage, changes in distribution systems, population growth and density in urban settlements, and frequency of natural disasters. We then use a bias correction method to develop the next 30 years projections of CMIP5 Regional Climate Model outputs and impacts on cholera prevalence using a probabilistic forecasting approach.

Infant growth patterns in the slums of Dhaka in relation to birth weight, intrauterine growth retardation, and prematurity.

PubMed

Arifeen, S E; Black, R E; Caulfield, L E; Antelman, G; Baqui, A H; Nahar, Q; Alamgir, S; Mahmud, H

2000-10-01

Relations between size and maturity at birth and infant growth have been studied inadequately in Bangladesh, where the incidence of low birth weight is high and most infants are breast-fed. This study was conducted to describe infant growth patterns and their relations to birth weight, intrauterine growth retardation, and prematurity. A total of 1654 infants born in selected low-socioeconomic areas of Dhaka, Bangladesh, were enrolled at birth. Weight and length were measured at birth and at 1, 3, 6, 9, and 12 mo of age. The infants' mean birth weight was 2516 g, with 46.4% weighing <2500 g; 70% were small for gestational age (SGA) and 17% were premature. Among the SGA infants, 63% had adequate ponderal indexes. The mean weight of the study infants closely tracked the -2 SD curve of the World Health Organization pooled breast-fed sample. Weight differences by birth weight, SGA, or preterm categories were retained throughout infancy. Mean z scores based on the pooled breast-fed sample were -2.38, -1. 72, and -2.34 at birth, 3 mo, and 12 mo. Correlation analysis showed greater plasticity of growth in the first 3 mo of life than later in the first year. Infant growth rates were similar to those observed among breast-fed infants in developed countries. Most study infants experienced chronic intrauterine undernourishment. Catch-up growth was limited and weight at 12 mo was largely a function of weight at birth. Improvement of birth weight is likely to lead to significant gains in infant nutritional status in this population, although interventions in the first 3 mo are also likely to be beneficial.

Household-level risk factors for influenza among young children in Dhaka, Bangladesh: a case-control study.

PubMed

Doshi, Saumil; Silk, Benjamin J; Dutt, Dhiman; Ahmed, Moshtaq; Cohen, Adam L; Taylor, Thomas H; Brooks, W Abdullah; Goswami, Doli; Luby, Stephen P; Fry, Alicia M; Ram, Pavani K

2015-06-01

To identify household-level factors associated with influenza among young children in a crowded community in Dhaka, Bangladesh. We conducted a case-control study using existing active surveillance for respiratory illness. Cases were children aged 12-59 months with laboratory-confirmed influenza. Controls were children frequency-matched by age group with no respiratory illness in the prior 6 months. We interviewed caregivers and observed household handwashing behaviour. Soap consumption was estimated by summing weight differences of three bars of soap sequentially left in each household. We measured concentrations of airborne particulate matter <2.5 μg in diameter (PM2.5) in a subset of households. We used logistic regression to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI). We enrolled 145 cases and 341 controls between March 2009 and April 2010. Case and control household members were observed to wash hands with similar frequency during a 5-h period (mean, 0.64 events vs. 0.63, P = 0.87), and similar daily soap consumption per capita (mean 2.92 grams vs. 2.93, P = 0.92). Case households were more likely than controls to have crowded (≥4 persons) sleeping areas (aOR = 1.67, CI: 1.06-2.63) and cross-ventilated cooking spaces (aOR = 1.75, CI: 1.16-2.63). Case and control households had similar median 24-h geometric mean PM2.5 concentrations in the cooking (69.2 vs. 69.6 μg/m(3), P = 0.45) and sleeping (65.4 vs. 67.4 μg/m(3), P = 0.19) spaces. Handwashing with soap was practiced infrequently and was not associated with paediatric influenza in this community. Interventions aimed at crowded households may reduce influenza incidence in young children. © 2015 John Wiley & Sons Ltd.

Epidemiology, Risk Factors and Tumor Profiles of Breast Cancer in Bangladeshi underprivileged women.

PubMed

Rahman, M; Ahsan, A; Begum, F; Rahman, K

2015-01-01

Similar to cancer statistics in developed countries, breast cancer is also the leading cause of cancer-related death in the women population of Bangladesh particularly the poor and underprivileged. The objective of this study was to study the socio-demography, tumor patterns and risk factors that affect these women from Dhaka and Bangladesh in general. This cross-sectional study involved 250 patients who presented to NICRH, Dhaka for treatment. These patients were interviewed, physically examined and vital information were gathered using approved questionnaires. Various personal, social, reproductive and tumor related factors were recorded and analyzed. The mean age of the study group was 44.7 years, standard deviation (SD) was 9.82 (range: 21-67), 87% have children, 57.2% were postmenopausal, 92% were housewives, 51.4% were illiterate, 62% attended 6 months after initiation of symptoms, 72% of the patients' yearly family income were less than US$1000/year. Almost 100% of the patients gave history of cooking from wooden fire source in the rural areas. In our study group, 79.7 percent women were within the group of BMI 20 kg/m2or more. Locally advanced breast cancer patients (T3 and T4) were 52.6%, axillary lymph node involvement was present in 80% of cases, 61.6 % patient received neoadjuvant chemotherapy. In the elderly group (above 40 years) Estrogen receptor was positive in 53.2% cases, 26.6% were Triple negative breast cancer patients. Women with poor socio-economic status and have none or low educational level are often victims of late presentation and tend to have a higher stage at diagnosis. Poverty, literacy and assorted risk factors have influenced the outcome of breast cancer cases among Bangladeshi women.

Teacher Perceptions of Inquiry and STEM Education in Bangladesh

NASA Astrophysics Data System (ADS)

Shahidullah, Kazi K.

This dissertation reports lower secondary science teachers perceptions of current practice in Dhaka, Bangladesh concerning inquiry and STEM Education in order to establish a baseline of data for reform of science education in Bangladesh. Bangladesh has been trying to incorporate inquiry-based science curricula since the 1970s. Over time, the science curricula also aligned with different international science education movements such as Science for All, Scientific Literacy, Science, Technology, and Society. Science, Technology, Engineering, and Mathematics (STEM) is the most recent science education movement in international science education. This study explored current practices and perceptions of lower secondary science teachers in order to establish a baseline of current practice so that future reform recommendations may be pursued and recommendations made for Bangladesh to overcome the inquiry-based challenges and to incorporate new STEM-based science education trends happening in the US and throughout the world. The study explored science teachers perceptions and readiness to transform their science classrooms based on self-reported survey. The survey utilized Likert-type scale with range 1 (very strongly disagree) to 6 (very strongly agree) among four hundred lower secondary science teachers, teacher training college faculty, and university faculty. The data is presented in four different categories: curriculum, instruction, assessment, and professional development. Results indicated that the participants understand and practice a certain level of inquiry in their science classrooms, though they do not have adequate professional development. Participants also stated that they do not have sufficient instructional materials and the curriculum is not articulated enough to support inquiry. On the other hand, the participants reported that they understand and practice a certain degree of inquiry and STEM-based science education, but they also state that the current curriculum and instructional materials are not sufficient to practice inquiry nor to integrate more than one or two disciplines with science as is required in STEM integrated teaching. Finally, this study recommends a framework for science education reform for Bangladesh based upon a combination of successful international science education reformation practices.

Social and economic impact of diabetics in Bangladesh: protocol for a case-control study.

PubMed

Shariful Islam, Sheikh Mohammed; Lechner, Andreas; Ferrari, Uta; Froeschl, Guenter; Niessen, Louis W; Seissler, Jochen; Alam, Dewan Shamsul

2013-12-21

Diabetes affects both individuals and their families and has an impact on economic and social development of a country. Information on the availability, cost, and quality of medical care for diabetes is mostly not available for many low- and middle-income countries including Bangladesh. Complications from diabetes, which can be devastating, could largely be prevented by wider use of several inexpensive generic medicines, simple tests and monitoring and can be a cost saving intervention. This study will provide an in-depth and comprehensive picture of social and economic impacts of diabetes in Bangladesh and propose clear recommendations for improving prevention and management of diabetes. The objectives of the study are: 1) To study the association between diabetes and other health problems and its social impacts. 2) To estimate the economic impact of diabetes including total direct and indirect costs. 3) To measure the impact of diabetes on quality of life among diabetes patients in Bangladesh. 4) To study the impact of diabetes on the health care system This is a case-control study comparing cases with type 2 diabetes to controls without diabetes matched on age, sex and place of residence. 564 cases and 564 controls will be selected from the outpatient department of a tertiary hospital in Dhaka, Bangladesh. Data on socioeconomic status, health utility index, direct and indirect costs for diabetes, medication adherence, quality of life, treatment satisfaction, diet, physical activity, mental state examination, weight, height, hip and waist circumference, blood pressure, pulse, medication history, laboratory data and physical examination will be conducted. The primary outcome measures will be association between diabetes and other health problems, cost of diabetes, impact of diabetes on quality of life and secondary outcome measures are impact of diabetes on healthcare systems in Bangladesh. This study will provide an in-depth and comprehensive picture of social and economic impacts of diabetics in Bangladesh and propose clear recommendations for improving prevention and management of diabetics. It will help to develop programs and policies for better management of Diabetics and cost effective strategies in Bangladesh context.

Reasons and remedies of inland passenger vessels accidents in Bangladesh

NASA Astrophysics Data System (ADS)

Rashid, Cdr Kaosar; Islam, Muhammad Rabiul

2017-12-01

The waterways are very important means of communication in Bangladesh. Every year over 95 million passengers are carried through this route. But, this important mode of transport is ridden with tragic disasters every year, incurring a heavy toll of human lives. In last twenty years (1994 to 2014), around 5,500 people have died and 1,500 gone missing in 658 launch disasters. The inland routes of Barisal, Bhola, Chandpur and Patuakhali and their connected water ways to Dhaka and Chittagong are found to be more accident prone. Lack of Awareness, boundless operation of unfit vessels, overloading of passengers, recruitment of unskilled crews, poor capacity of relevant bodies and low standard maintenance of Inland Water Transport (IWT) channels, poor weather forecasting, profit centered attitude of vessel owners and corruption are initiating these deadly accidents. Despite of a number of initiatives by the government, concerned departments and foreign consultants, the safety aspect of the inland passenger vessels still remains in dark. Combined effort of Department of Shipping, BIWTA, and the attitude of vessels owners as well as passengers are very essential in this respect.

Prevalence and characterization of multidrug-resistant zoonotic Enterobacter spp. in poultry of Bangladesh.

PubMed

Nandi, Shuvro Prokash; Sultana, Munawar; Hossain, M Anwar

2013-05-01

Poultry and poultry products are major contributors of zoonotic pathogens. Limited data are available on Enterobacter spp. as a potent zoonotic pathogen in poultry. The present study is a first endeavor on the emergence of multidrug-resistant zoonotic Enterobacter spp. and its prevalence arising from poultry in Bangladesh. Cloacal swabs from poultry samples of five different farms at Savar, Dhaka, Bangladesh were collected and from 106 isolates, 18 presumptive Enterobacter spp. were obtained. Antibiogram using 19 used antibiotics belonging to 15 major groups revealed that all of the 18 isolates were completely resistant to penicillin and rifampicin, but differed in their drug resistance pattern against ampicillin (94.4%), clindamycin (94.4%), erythromycin (94.4%), vancomycin (88.9%), sulfonamides (72.2%), imipenem (66.6%), streptomycin (55.6%), nitrofurantoin (33.3%), doxycycline (33.3%), tetracyclines (33.3%), cefepime (11.1%), and gentamicin (5.6%). All Enterobacter spp. were found to be plasmid free, implying that multidrug-resistant properties are chromosomal borne. The vanA and sulI were detected by polymerase chain reaction assay in 17 and 13 isolates, respectively. Amplified ribosomal DNA restriction analysis and randomly amplified polymorphic DNA distributed the 18 multidrug-resistant Enterobacter spp. into three genotypes. Phylogenetic analysis of the representatives of the three genotypes using partial 16S rRNA gene sequence (approximately 900 bp) showed that the genotypically diverse groups belonged to Enterobacter hormaechei, E. cloacae, and E. cancerogenus, respectively. The clinical significance of the close relative Enterobacter spp. is indicative of their zoonotic potential. Therefore, urgent intervention is required to limit the emergence and spread of these bacteria in poultry feed as well as prudent use of antibiotics among poultry farmers in Bangladesh.

The coexistence of other micronutrient deficiencies in anaemic adolescent schoolgirls in rural Bangladesh.

PubMed

Ahmed, F; Khan, M R; Banu, C P; Qazi, M R; Akhtaruzzaman, M

2008-03-01

To investigate the prevalence of selected micronutrient deficiencies amongst anaemic adolescent schoolgirls in rural Bangladesh and to examine their relationship with haemoglobin (Hb) levels. A cross-sectional study. Girls' high schools in rural areas of Dhaka District in Bangladesh. Three hundred and ten anaemic adolescent girls aged 14-18 years from eight schools participated in the study. Information on personal characteristics and food habits were collected by interview. Parents were asked about their socio-economic conditions. Anthropometric data and blood samples were collected following the interview. Twenty-eight per cent of the girls had depleted iron stores (serum ferritin <12.0 microg/l), 25% had folic acid deficiency (red blood cell folic acid <317 nmol/l), 89% had vitamin B(2) (erythrocyte glutathione reductase activity coefficient > or =1.4) and 7% had vitamin B(12) deficiencies (serum vitamin B(12) <150 pmol/l). Although the prevalence of vitamins A and C deficiency was very low, a significant proportion had low vitamin A (serum retinol between 0.70 and <1.05 micromol/l) and vitamin C status (plasma ascorbic acid between 11.4-23.0 micromol/l). Frequency of consumption of meat, serum ferritin and vitamin B(2) status were found to be strongly related to Hb by multiple regression analysis. For 1 microg/l change in serum ferritin, there was a 0.13 g/l change in Hb when adjusted for other factors. There is coexistence of micronutrient deficiencies among anaemic adolescent girls in rural Bangladesh, although they do not suffer from energy deficiency. Of all micronutrients, only iron and vitamin B(2) concentrations were found to be related to the Hb concentration.

Enhanced detection rate of typhoid fever among clinically suspected patients in a tertiary referral hospital in Dhaka, Bangladesh using nested polymerase chain reaction technology.

PubMed

Khan, S; Miah, M R; Khatun, S

2015-12-01

A nested polymerase chain reaction (PCR) specific for Salmonella enterica subspecies enteric serovar Typhi was used for the detection of the pathogen, in blood. This study was done during the period of March 2013 to February 2014. A total of 80 clinically suspected cases of typhoid fever were included in the study. Blood was collected from all participating individuals. Nested PCR targeting the flagellin gene (fliC) of Salmonella Typhi & blood culture were done for each of the cases. The positivity rate of PCR & blood culture was 70%& 20% respectively. The positivity rate of PCR was significantly higher than blood culture (P< 0.05). With the nested PCR, S. Typhi DNAs were detected from blood specimens of 67.2% (43/64) patients among the suspected typhoid fever cases on the basis of clinical features but with negative cultures. We conclude that the PCR technique could be used as a novel diagnostic method of typhoid fever, particularly in culture-negative cases in an endemic country like Bangladesh.

Estimating the cost of cholera-vaccine delivery from the societal point of view: A case of introduction of cholera vaccine in Bangladesh.

PubMed

Sarker, Abdur Razzaque; Islam, Ziaul; Khan, Iqbal Ansary; Saha, Amit; Chowdhury, Fahima; Khan, Ashraful Islam; Cravioto, Alejandro; Clemens, John David; Qadri, Firdausi; Khan, Jahangir A M

2015-09-11

Cholera is a major global public health problem that causes both epidemic and endemic disease. The World Health Organization recommends oral cholera vaccines as a public health tool in addition to traditional prevention practices and treatments in both epidemic and endemic settings. In many developing countries like Bangladesh, the major issue concerns the affordability of this vaccine. In February 2011, a feasibility study entitled, "Introduction of Cholera Vaccine in Bangladesh (ICVB)", was conducted for a vaccination campaign using inactivated whole-cell cholera vaccine (Shanchol) in a high risk area of Mirpur, Dhaka. Empirical data obtained from this trial was used to determine the vaccination cost for a fully immunized person from the societal perspective. A total of 123,661 people were fully vaccinated receiving two doses of the vaccine, while 18,178 people received one dose of the same vaccine. The total cost for vaccine delivery was US$ 492,238 giving a total vaccination cost per fully-vaccinated individual of US$ 3.98. The purchase cost of the vaccine accounted for 58% of the overall cost of vaccination. Attempts to reduce the per-dose cost of the vaccine are likely to have a large impact on the cost of similar vaccination campaigns in the future. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cholera and shigellosis in Bangladesh: similarities and differences in population dynamics under climate forcing

NASA Astrophysics Data System (ADS)

Pascual, M.; Cash, B.; Reiner, R.; King, A.; Emch, M.; Yunus, M.; Faruque, A. S.

2012-12-01

The influence of climate variability on the population dynamics of infectious diseases is considered a large scale, regional, phenomenon, and as such, has been previously addressed for cholera with temporal models that do not incorporate fine-scale spatial structure. In our previous work, evidence for a role of ENSO (El Niño Southern Oscillation) on cholera in Bangladesh was elucidated, and shown to influence the regional climate through precipitation. With a probabilistic spatial model for cholera dynamics in the megacity of Dhaka, we found that the action of climate variability (ENSO and flooding) is localized: there is a climate-sensitive urban core that acts to propagate risk to the rest of the city. Here, we consider long-term surveillance data for shigellosis, another diarrheal disease that coexists with cholera in Bangladesh. We compare the patterns of association with climate variables for these two diseases in a rural setting, as well as the spatial structure in their spatio-temporal dynamics in an urban one. Evidence for similar patterns is presented, and discussed in the context of the differences in the routes of transmission of the two diseases and the proposed role of an environmental reservoir in cholera. The similarities provide evidence for a more general influence of hydrology and of socio-economic factors underlying human susceptibility and sanitary conditions.

Immunoproteomic analysis of antibody in lymphocyte supernatant in patients with typhoid fever in Bangladesh.

PubMed

Charles, Richelle C; Liang, Li; Khanam, Farhana; Sayeed, M Abu; Hung, Chris; Leung, Daniel T; Baker, Stephen; Ludwig, Albrecht; Harris, Jason B; Larocque, Regina C; Calderwood, Stephen B; Qadri, Firdausi; Felgner, Philip L; Ryan, Edward T

2014-03-01

We have previously shown that an assay based on detection of anti-Salmonella enterica serotype Typhi antibodies in supernatant of lymphocytes harvested from patients presenting with typhoid fever (antibody in lymphocyte supernatant [ALS] assay) can identify 100% of patients with blood culture-confirmed typhoid fever in Bangladesh. In order to define immunodominant proteins within the S. Typhi membrane preparation used as antigen in these prior studies and to identify potential biomarkers unique to S. Typhi bacteremic patients, we probed microarrays containing 2,724 S. Typhi proteins with ALS collected at the time of clinical presentation from 10 Bangladeshis with acute typhoid fever. We identified 62 immunoreactive antigens when evaluating both the IgG and IgA responses. Immune responses to 10 of these antigens discriminated between individuals with acute typhoid infection and healthy control individuals from areas where typhoid infection is endemic, as well as Bangladeshi patients presenting with fever who were subsequently confirmed to have a nontyphoid illness. Using an ALS enzyme-linked immunosorbent assay (ELISA) format and purified antigen, we then confirmed that immune responses against the antigen with the highest immunoreactivity (hemolysin E [HlyE]) correctly identified individuals with acute typhoid or paratyphoid fever in Dhaka, Bangladesh. These observations suggest that purified antigens could be used with ALS and corresponding acute-phase activated B lymphocytes in diagnostic platforms to identify acutely infected patients, even in areas where enteric fever is endemic.

Barriers to Increasing Use of Peritoneal Dialysis in Bangladesh: A Survey of Patients and Providers.

PubMed

Savla, Dipal; Ahmed, Sweety; Yeates, Karen; Matthew, Anna; Anand, Shuchi

2017-01-01

Despite a lower requirement for technology and equipment than hemodialysis (HD), peritoneal dialysis (PD) is an underutilized modality in low- and middle-income countries (LMICs). Bangladesh has the lowest use of PD in the world (fewer than 2% of prevalent patients). We evaluated nephrologists' attitudes toward PD and examined differences between patients on HD and PD in Dhaka. We asked nephrologists to fill out an English-language questionnaire. Using convenience sampling but targeting both public and private hospitals in Dhaka, we asked trained nurses to administer a Bangla-language questionnaire to patients on HD ( n = 116) and PD ( n = 41). We validated the questionnaires on a sub-sample ( n = 10 for each group). Of the 43 nephrologists surveyed, 27 (63%) had patients on PD. When compared with nephrologists without patients on PD, those with patients on PD were less likely to believe that survival and quality of life on PD was worse than on HD (odds ratio [OR] = 0.21, 95% confidence interval [CI] 0.05 - 0.83 and OR = 0.11, 95% CI 0.02 - 0.67 respectively) but were not more likely to have received training for PD. Nephrologists named cost of PD as the predominant barrier to increasing use of PD, followed by concerns about patient hygiene and lack of trained nurses. Fifty-two HD patients (45%) did not know about a home-based modality. When compared with patients on HD, patients on PD were more likely to have been educated by non-nephrologists about dialysis, to be "forewarned" about the need for dialysis, to be paying fully, and to be living in a permanent home with a non-communal water source. Some barriers to increasing access to PD-i.e., patient living conditions and cost-are unique to LMICs. Our study also highlights that issues encountered in high-income countries-i.e., nephrologists' subjective preference and lack of patient knowledge about an alternate modality to HD-may play a role as well. Copyright © 2017 International Society for Peritoneal Dialysis.

Impact of adding hand-washing and water disinfection promotion to oral cholera vaccination on diarrhoea-associated hospitalization in Dhaka, Bangladesh: evidence from a cluster randomized control trial.

PubMed

Najnin, Nusrat; Leder, Karin; Qadri, Firdausi; Forbes, Andrew; Unicomb, Leanne; Winch, Peter J; Ram, Pavani K; Leontsini, Elli; Nizame, Fosiul A; Arman, Shaila; Begum, Farzana; Biswas, Shwapon K; Clemens, John D; Ali, Mohammad; Cravioto, Alejandro; Luby, Stephen P

2017-12-01

Information on the impact of hygiene interventions on severe outcomes is limited. As a pre-specified secondary outcome of a cluster-randomized controlled trial among >400 000 low-income residents in Dhaka, Bangladesh, we examined the impact of cholera vaccination plus a behaviour change intervention on diarrhoea-associated hospitalization. Ninety neighbourhood clusters were randomly allocated into three areas: cholera-vaccine-only; vaccine-plus-behaviour-change (promotion of hand-washing with soap plus drinking water chlorination); and control. Study follow-up continued for 2 years after intervention began. We calculated cluster-adjusted diarrhoea-associated hospitalization rates using data we collected from nearby hospitals, and 6-monthly census data of all trial households. A total of 429 995 people contributed 500 700 person-years of data (average follow-up 1.13 years). Vaccine coverage was 58% at the start of analysis but continued to drop due to population migration. In the vaccine-plus-behaviour-change area, water plus soap was present at 45% of hand-washing stations; 4% of households had detectable chlorine in stored drinking water. Hospitalization rates were similar across the study areas [events/1000 person-years, 95% confidence interval (CI), cholera-vaccine-only: 9.4 (95% CI: 8.3-10.6); vaccine-plus-behaviour-change: 9.6 (95% CI: 8.3-11.1); control: 9.7 (95% CI: 8.3-11.6)]. Cholera cases accounted for 7% of total number of diarrhoea-associated hospitalizations. Neither cholera vaccination alone nor cholera vaccination combined with behaviour-change intervention efforts measurably reduced diarrhoea-associated hospitalization in this highly mobile population, during a time when cholera accounted for a small fraction of diarrhoea episodes. Affordable community-level interventions that prevent infection from multiple pathogens by reliably separating faeces from the environment, food and water, with minimal behavioural demands on impoverished communities, remain an important area for research. © The Author 2017. Published by Oxford University Press on behalf of the International Epidemiological Association

Effect of active case finding on prevalence and transmission of pulmonary tuberculosis in Dhaka Central Jail, Bangladesh.

PubMed

Banu, Sayera; Rahman, Md Toufiq; Uddin, Mohammad Khaja Mafij; Khatun, Razia; Khan, Md Siddiqur Rahman; Rahman, Md Mojibur; Uddin, Syed Iftekhar; Ahmed, Tahmeed; Heffelfinger, James D

2015-01-01

Understanding tuberculosis (TB) transmission dynamics is essential for establishing effective TB control strategies in settings where the burden and risk of transmission are high. The objectives of this study were to evaluate the effect of active screening on controlling TB transmission and also to characterize Mycobacterium tuberculosis strains for investigating transmission dynamics in a correctional setting. The study was carried out in Dhaka Central Jail (DCJ), from October 2005 to February 2010. An active case finding strategy for pulmonary TB was established both at the entry point to the prison and inside the prison. Three sputum specimens were collected from all pulmonary TB suspects and subjected to smear microscopy, culture, and drug susceptibility testing as well as genotyping which included deletion analysis, spoligotyping and analysis of mycobacterial interspersed repetitive units (MIRU). A total of 60,585 inmates were screened during the study period. We found 466 inmates with pulmonary TB of whom 357 (77%) had positive smear microscopy results and 109 (23%) had negative smear microscopy results but had positive results on culture. The number of pulmonary TB cases declined significantly, from 49 cases during the first quarter to 8 cases in the final quarter of the study period (p=0.001). Deletion analysis identified all isolates as M. tuberculosis and further identified 229 (70%) strains as 'modern' and 100 (30%) strains as 'ancestral'. Analysis of MIRU showed that 347 strains (85%) exhibited unique patterns, whereas 61 strains (15%) clustered into 22 groups. The largest cluster comprised eight strains of the Beijing M. tuberculosis type. The rate of recent transmission was estimated to be 9.6%. Implementation of active screening for TB was associated with a decline in TB cases in DCJ. Implementation of active screening in prison settings might substantially reduce the national burden of TB in Bangladesh.

Nutrition: Basis for Healthy Children and Mothers in Bangladesh

PubMed Central

Faruque, A.S.G.; Ahmed, A.M. Shamsir; Ahmed, Tahmeed; Islam, M. Munirul; Hossain, Md. Iqbal; Roy, S.K.; Alam, Nurul; Kabir, Iqbal; Sack, David A.

2008-01-01

Recent data from the World Health Organization showed that about 60% of all deaths, occurring among children aged less than five years (under-five children) in developing countries, could be attributed to malnutrition. It has been estimated that nearly 50.6 million under-five children are malnourished, and almost 90% of these children are from developing countries. Bangladesh is one of the countries with the highest rate of malnutrition. The recent baseline survey by the National Nutrition Programme (NNP) showed high rates of stunting, underweight, and wasting. However, data from the nutrition surveillance at the ICDDR, B hospital showed that the proportion of children with stunting, underweight, and wasting has actually reduced during 1984–2005. Inappropriate infant and young child-feeding practices (breastfeeding and complementary feeding) have been identified as a major cause of malnutrition. In Bangladesh, although the median duration of breastfeeding is about 30 months, the rate of exclusive breastfeeding until the first six months of life is low, and practice of appropriate complementary feeding is not satisfactory. Different surveys done by the Bangladesh Demographic and Health Survey, United Nations Children's Fund (UNICEF), and Bangladesh Breastfeeding Foundation (BBF) showed a rate of exclusive breastfeeding to be around 32-52%, which have actually remained same or declined over time. The NNP baseline survey using a strict definition of exclusive breastfeeding showed a rate of exclusive breastfeeding (12.8%) until six months of age. Another study from the Abhoynagar field site of ICDDR, B reported the prevalence of exclusive breastfeeding to be 15% only. Considerable efforts have been made to improve the rates of exclusive breastfeeding. Nationally, initiation of breastfeeding within one hour of birth, feeding colostrum, and exclusive breastfeeding have been promoted through the Baby-Friendly Hospital Initiative (BFHI) implemented and supported by BBF and UNICEF respectively. Since most (87-91%) deliveries take place in home, the BFHI has a limited impact on the breastfeeding practices. Results of a few studies done at ICDDR, B and elsewhere in developing countries showed that the breastfeeding peer-counselling method could substantially increase the rates of exclusive breastfeeding. Results of a study in urban Dhaka showed that the rate of exclusive breastfeeding was 70% among mothers who were counselled compared to only 6% who were not counselled. Results of another study in rural Bangladesh showed that peer-counselling given either individually or in a group improved the rate of exclusive breastfeeding from 89% to 81% compared to those mothers who received regular health messages only. This implies that scaling up peer-counselling methods and incorporation of breastfeeding counselling in the existing maternal and child heath programme is needed to achieve the Millennium Development Goal of improving child survival. The recent data showed that the prevalence of starting complementary food among infants aged 6-9 months had increased substantially with 76% in the current dataset. However, the adequacy, frequency, and energy density of the complementary food are in question. Remarkable advances have been made in the hospital management of severely-malnourished children. The protocolized management of severe protein-energy malnutrition at the Dhaka hospital of ICDDR, B has reduced the rate of hospital mortality by 50%. A recent study at ICDDR, B has also documented that home-based management of severe protein-energy malnutrition without follow-up was comparable with a hospital-based protocolized management. Although the community nutrition centres of the NNP have been providing food supplementation and performing growth monitoring of children with protein-energy malnutrition, the referral system and management of complicated severely-malnourished children are still not in place. PMID:18831228

Identification of Essential Containers for Aedes Larval Breeding to Control Dengue in Dhaka, Bangladesh.

PubMed

Ferdousi, Farhana; Yoshimatsu, Shoji; Ma, Enbo; Sohel, Nazmul; Wagatsuma, Yukiko

2015-12-01

Dengue fever (DF), one of the most important emerging arboviral diseases, is transmitted through the bite of container breeding mosquitoes Aedes aegypti and Aedes albopictus. A household entomological survey was conducted in Dhaka from August through October 2000 to inspect water-holding containers in indoor, outdoor, and rooftop locations for Aedes larvae. The objective of this study was to determine mosquito productivity of each container type and to identify some risk factors of households infested with Aedes larvae. Of 9,222 households inspected, 1,306 (14.2%) were positive for Aedes larvae. Of 38,777 wet containers examined, 2,272 (5.8%) were infested with Aedes larvae. Containers used to hold water, such as earthen jars, tanks, and drums were the most common containers for larval breeding. Tires in outdoor and rooftop locations of the households were also important for larval breeding. Although present in abundance, buckets were of less importance. Factors such as independent household, presence of a water storage system in the house, and fully/partly shaded outdoors were found to be significantly associated with household infestation of Aedes larvae. Identification and subsequent elimination of the most productive containers in a given area may potentially reduce mosquito density to below a level at which dengue transmission may be halted.

Socio-demographic characteristics of children infested with scabies in densely populated communities of residential madrashas (Islamic education institutes) in Dhaka, Bangladesh.

PubMed

Karim, S A; Anwar, K S; Khan, M A H; Mollah, M A H; Nahar, N; Rahman, H E M R; Al Mamun, M; Goni, N; Hossain, M M; Rahman, M S; Begum, H-A; Das, S K

2007-12-01

Outbreaks of scabies in institutions and the socio-economic consequences have not been reported from overpopulated countries such as Bangladesh. A community-based study among children from six residential Islamic education institutes (madrashas) in Dhaka. Multistage random sampling was used. To study the socio-economic profile, water-sanitation facilities, personal hygiene and living conditions of these children. Direct interviews were used to collect the data and clinical check up was performed in all children. In total, 492 children received clinical check-ups; 92.5% were boys (mean age: 11.2+/-2.4 years). 63.4% of fathers and 98.5% of mothers were either illiterate or had only received primary education, 55.1% of fathers were in low-paid labouring jobs, and 99% of mothers were housewives. Of the 98% of children who had scabies, 71% had been re-infected (96% during the winter). Randomly assigned anti-scabies drugs revealed an average cure rate of 85.5%. Seventy-four percent of children were living in poorly ventilated buildings with overcrowded sleeping arrangements. They had poor personal hygiene: 21% shared towels; 8% shared undergarments; 30% shared bed linen; and 81% kept their used clothes on a communal line or shelf. Sanitation was also poor: 39% bathed infrequently, although 97% carried out mandatory ablution. Most children (61%) washed their clothes (including undergarments) two or three times a fortnight, 35% did so every 2-3 days, and 3.7% washed their clothes on alternative days. Disease severity and re-infection were associated with infrequent washing of clothes (P<0.001) and bed linen (P<0.001), overcrowded sleeping arrangements (P<0.001) and infrequent bathing (P<0.001) with soap (P<0.001). This was further related to household income (P<0.001 for both). The study findings have potentially dangerous implications for public health. Immediate attention should be given to developing a sustainable long-term intervention programme to combat scabies hyperendemicity, and to save thousands of children from impending complications.

Coverage and cost of a large oral cholera vaccination program in a high-risk cholera endemic urban population in Dhaka, Bangladesh.

PubMed

Khan, Iqbal Ansary; Saha, Amit; Chowdhury, Fahima; Khan, Ashraful Islam; Uddin, Md Jasim; Begum, Yasmin A; Riaz, Baizid Khoorshid; Islam, Sanjida; Ali, Mohammad; Luby, Stephen P; Clemens, John D; Cravioto, Alejandro; Qadri, Firdausi

2013-12-09

A feasibility study of an oral cholera vaccine was carried out to test strategies to reach high-risk populations in urban Mirpur, Dhaka, Bangladesh. The study was cluster randomized, with three arms: vaccine, vaccine plus safe water and hand washing practice, and no intervention. High risk people of age one year and above (except pregnant woman) from the two intervention arms received two doses of the oral cholera vaccine, Shanchol™. Vaccination was conducted between 17th February and 16th April 2011, with a minimum interval of fourteen days between two doses. Interpersonal communication preceded vaccination to raise awareness amongst the target population. The number of vaccine doses used, the population vaccinated, left-out, drop out, vaccine wastage and resources required were documented. Fixed outreach site vaccination strategy was adopted as the mode of vaccine delivery. Additionally, mobile vaccination sites and mop-up activities were carried out to reach the target communities. Of the 172,754 target population, 141,839 (82%) and 123,666 (72%) received complete first and second doses of the vaccine, respectively. Dropout rate from the first to the second dose was 13%. Two complete doses were received by 123,661 participants. Vaccine coverage in children was 81%. Coverage was significantly higher in females than in males (77% vs. 66%, P<0.001). Vaccine wastage for delivering the complete doses was 1.2%. The government provided cold-chain related support at no cost to the project. Costs for two doses of vaccine per-person were US$3.93, of which US$1.63 was spent on delivery. Cost for delivering a single dose was US$0.76. We observed no serious adverse events. Mass vaccination with oral cholera vaccine is feasible for reaching high risk endemic population through the existing national immunization delivery system employed by the government. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Living on the Edge of Stagnant Water: An Assessment of Environmental Impacts of Construction-Phase Drainage Congestion Along Dhaka City Flood Control Embankment, Bangladesh

NASA Astrophysics Data System (ADS)

Rasid, Harun; Mallsk, Azim U.

1996-01-01

Environmental impacts of the construction-phase drainage congestion along the Dhaka City Flood Control Embankment were assessed by a pilot questionnaire survey (in 1991) among the target population adjacent to the embankment. The results of the survey indicated that, despite significant alleviation of river flooding, the majority of the respondents experienced a new type of flood problem in the form of stagnant water inside the embankment, immediately following its construction. Not only had this stagnant water flooded and damaged their property, it had exposed them to a number of other environmental problems, such as accumulation of municipal sewage, foul odors, mosquitoes, and growth of water hyacinth. The study found that the respondents’ assessments of these environmental problems differed significantly according to the magnitude of the impact of stagnant water upon two subgroups within the target population. A postsurvey follow-up in 1994 indicated that this problem of drainage congestion had largely been alleviated by completing the construction of a number of drainage regulators. The study concludes by stressing the importance of synchronizing the construction of drainage structures with that of the embankment systems and by underlining policy implications for flood-vulnerable land use adjacent to embankments.

Knowledge, attitudes, beliefs and practices about HIV/AIDS among the overseas job seekers in Bangladesh.

PubMed

Rahman, M; Shimu, T A; Fukui, T; Shimbo, T; Yamamoto, W

1999-01-01

A study of the knowledge, attitudes, beliefs and practices (KABP) relating to HIV/AIDS was conducted among people from Bangladesh seeking work overseas (N = 300), during February, 1997 and March, 1997. Only 26% of the respondents knew of AIDS and out of 13 basic facts concerning HIV/AIDS the mean score of the sample was 1.63 correct responses. Most of those who knew of HIV had some false beliefs about the mode of HIV transmission, for example, believing that HIV could be contracted by touching an AIDS patient, or sharing bathing facilities or eating utensils. Sex with brothel-based commercial sex workers (100%), sharing contaminated needles (93.6%) and blood transfusion from infected individuals (93.6%) were seen as the main route of HIV transmission. Printed media (69%) was the main source of AIDS information. Multiple logistic regression analysis showed that having a non-agricultural occupation (P < 0.04), being resident in Dhaka, Chandpur, Noakhali, Comilla, and Chittagong (P < 0.01), being in the habit of reading newspapers (P < 0.05), using condoms (P < 0.04), having heard about condoms (P < 0.003), having seen condoms (P < 0.005) and knowing where to buy condoms (P < 0.0005) were significantly associated with AIDS awareness. There is insufficient AIDS awareness among overseas job seekers which calls for public initiatives to provide AIDS information to them before they leave Bangladesh to work abroad.

Private providers' knowledge, attitudes and misconceptions related to long-acting and permanent contraceptive methods: a case study in Bangladesh.

PubMed

Ugaz, Jorge; Banke, Kathryn; Rahaim, Stephen; Chowdhury, Wahiduzzaman; Williams, Julie

2016-11-01

In Bangladesh, use of long-acting and permanent methods of contraception (LAPMs) remains stagnant. Providers' limited knowledge and biases may be a factor. We assessed private providers' knowledge, misconceptions and general attitudes towards LAPM in two urban areas. The ultimate goal is to shape programs and interventions to overcome these obstacles and improve full method choice in Bangladesh. Trained data collectors interviewed a convenience sample of 235 female doctors (obstetricians-gynecologists and general practitioners) and 150 female nurses from 194 commercial (for-profit) health care facilities in Chittagong City Corporation and Dhaka district. Data were collected on the nature of the practice, training received, knowledge about modern contraceptives and attitudes towards LAPM [including intrauterine device (IUDs), implants, female and male sterilization]. All providers, and especially doctors, lacked adequate knowledge regarding side effects for all LAPMs, particularly female and male sterilization. Providers had misconceptions about the effectiveness and convenience of LAPMs compared to short-acting contraceptive methods. Implants and IUDs were generally perceived more negatively than other methods. The majority of providers believed that husbands favor short-acting methods rather than LAPMs and that women should not use a method that their husbands do not approve of. Our findings document knowledge and attitudinal barriers among private for-profit providers in urban areas affecting their provision of accurate information about LAPM choices. Practitioners should be offered the necessary tools to provide women full access to all modern methods, especially LAPMs, in order to contribute to decreasing unmet need and improving full method choice in Bangladesh. Copyright © 2016 Elsevier Inc. All rights reserved.

The impact of food supplementation on infant weight gain in rural Bangladesh; an assessment of the Bangladesh Integrated Nutritional Program (BINP).

PubMed

Begum, Housne Ara; Mascie-Taylor, Cgn; Nahar, Shamsun

2007-01-01

To examine the efficiency of the Bangladesh Integrated Nutritional Program (BINP) in identifying which infants should be supplemented, whether full supplementation was given for the stipulated period of time, and whether the correct exit criteria from the supplementation programme were used. To test whether targeted food supplementation of infants between 6-12 months of age resulted in enhanced weight gain. Mallickbari Union, Bhaluka, a rural area located about 100 km north of Dhaka, Bangladesh. Five hundred and twenty-six infants followed for 6 to 12 months. Of the 526 infants studied, 368 should have received supplementation based on BINP criteria but only 111 infants (30%) did so, while a further 13% were incorrectly given supplementation. So in total over half (52.8%) of the sample was incorrectly identified for supplementation. In addition, less than a quarter of the infants received the full 90 days of supplementation and close to half of the infants exited the programme without the requisite weight gain. Infants were assigned to one of four groups: correctly supplemented, correctly non-supplemented, incorrectly supplemented or incorrectly non-supplemented. This classification provided natural controls; the correctly supplemented infants versus the incorrectly non-supplemented infants, and the correctly non-supplemented infants versus the incorrectly supplemented infants. There were no significant differences in weight gain between the correctly supplemented group and the incorrectly non-supplemented group or between the correctly non-supplemented and the incorrectly supplemented groups, nor was there any evidence of growth faltering in the incorrectly non-supplemented group. This study found serious programmatic deficiencies - inability to identify growth faltering in infants, failure to supplement for the full time period and incorrect exit procedures. There was no evidence that food supplementation had any impact on improving infant weight gain.

Criminal poisoning of commuters in Bangladesh: prospective and retrospective study.

PubMed

Majumder, M Mahbub Alam; Basher, Ariful; Faiz, M Abul; Kuch, Ulrich; Pogoda, Werner; Kauert, Gerold F; Toennes, Stefan W

2008-08-25

Travel-related poisoning is an emerging social and public health emergency in Bangladesh but its cause and significance have not been determined. To investigate this syndrome we performed a prospective clinical study and retrospective analysis of hospital records in a general medicine unit of a public tertiary care teaching hospital in Dhaka, Bangladesh, using toxicological analysis by fluorescence polarization immunoassay (FPIA) and liquid chromatography coupled to time-of-flight mass spectrometry (LC-TOF MS). The participants of the prospective study were 130 consecutive patients aged 16-80 years who were admitted with central nervous system depression (Glasgow Coma Score 3-14) after using public transportation, in the absence of other abnormalities, from January through June 2004, and a convenience sample of 15 such patients admitted during 3 days in May 2006. In 2004-2006, travel-related poisoning increased from 6.1 to 9.5% of all admissions (210-309 of 3266-3843 per year), representing 46.6-55.7% of all admitted poisoning cases. Incidents were associated with bus (76%), taxi, train, and air travel, or local markets; 98% of patients remembered buying or accepting food or drinks before losing consciousness. Direct financial damage (missing property) was diverse and frequently existential. Among 94 urine samples analyzed by FPIA, 74% tested positive for benzodiazepines. Among 15 urine samples analyzed by LC-TOF MS, lorazepam was detected in all; five also contained diazepam or metabolites; nitrazepam was present in three. FPIA results obtained for these 15 samples were below the recommended cut-off in eight (53%; lorazepam only). Our findings show that the massive medicosocial emergency of travel-related poisoning in Bangladesh is the result of drug-facilitated organized crime and that benzodiazepine drugs are used to commit these crimes, suggesting modifications to the local emergency management of the victims of this type of poisoning. They also highlight the need for more research in the neglected field of acute poisoning in Bangladesh, and for criminal investigations of the use of benzodiazepine drugs in this country.

Spinal cord lesions in Bangladesh: an epidemiological study 1994 - 1995.

PubMed

Hoque, M F; Grangeon, C; Reed, K

1999-12-01

Spinal Cord Lesions are a major public health problem in Bangladesh. This epidemiological study was undertaken in order to identify the causes of spinal cord lesions and thus to allow prevention and control programs to be developed. The records of 247 patients with spinal cord lesions admitted to The Centre for the Rehabilitation of the Paralysed (CRP), Savar, Dhaka from January 1994 to June 1995 were reviewed retrospectively. Comparisons were made with the reports of studies from other countries, both developing and developed. The most common cause of traumatic lesions was a fall from a height followed by falling when carrying a heavy weight on the head and road traffic accidents. Most of the patients were between 20 - 40 years old and the overall age group ranged from 10 - 70 years. The male:female ratio was 7.5 : 1.0. Among the traumatic spinal cord lesions, 60% were paraplegics and 40% tetraplegics. Among the non-traumatic spinal cord lesions cases 84% were paraplegics and 16% tetraplegics. The leading cause of death resulted from respiratory complications and these deaths occurred in the very early period of admission. From the results it can be deduced that the high incidence of spinal cord lesion as a result from falls from a height, and from falling when carrying a heavy weight on the head, can be explained by the mainly agricultural based economy of Bangladesh. The most common age group (10 - 40 years) of patients reflects the socio-economic conditions of Bangladesh. The male:female ratio (7.5 : 1.0) of patients with a spinal cord lesion is due to the socio-economic status and to the traditional culture of the society.

Health research in the developing world: a gastroenterological view from Bangladesh.

PubMed

Hamilton, J R

1997-01-01

Ill health is a serious impediment to progress in most poor countries, yet health is not a high priority on foreign aid agendas. Health research, which provides the essential base for sustainable progressive health programs, is barely visible in developing countries. For example, in Bangladesh, one finds unacceptably high morbidity and mortality rates among infants and children, health programs that are struggling and a rudimentary health research establishment; for the huge foreign donor community in that country, health programs and research do not appear to warrant major investments. Diarrheal diseases are at the top of the list of killers in many poor nations including Bangladesh. Recent advances in our understanding of diarrhea suggest that when prevention may not be possible soon, improved active treatment can evolve from an aggressive research effort centered in a developing country and linked to appropriate international partners. Global agencies such as the World Health Organization have demonstrated a declining interest in health research, as reflected in the policies of their Diarrhoeal Disease Control Programme. Major donors to the developing world, the Canadian International Development Agency for example, have had a relatively minor involvement in health and little commitment to health research. University links with the west, private enterprises and specially targeted programs are involved in developing world health research but they have not been able to foster and leave behind sustainable, high quality research programs. The problem should be attacked directly by supporting focused, relevant health research centres in regions of the world where the burden of disease continues to impede progress and where the environment is conducive to high quality research that is well integrated with care delivery programs. An instructive model of this approach is the International Centre for Diarrhoeal Disease Research in Dhaka, Bangladesh.

Modelling H5N1 in Bangladesh across spatial scales: Model complexity and zoonotic transmission risk.

PubMed

Hill, Edward M; House, Thomas; Dhingra, Madhur S; Kalpravidh, Wantanee; Morzaria, Subhash; Osmani, Muzaffar G; Yamage, Mat; Xiao, Xiangming; Gilbert, Marius; Tildesley, Michael J

2017-09-01

Highly pathogenic avian influenza H5N1 remains a persistent public health threat, capable of causing infection in humans with a high mortality rate while simultaneously negatively impacting the livestock industry. A central question is to determine regions that are likely sources of newly emerging influenza strains with pandemic causing potential. A suitable candidate is Bangladesh, being one of the most densely populated countries in the world and having an intensifying farming system. It is therefore vital to establish the key factors, specific to Bangladesh, that enable both continued transmission within poultry and spillover across the human-animal interface. We apply a modelling framework to H5N1 epidemics in the Dhaka region of Bangladesh, occurring from 2007 onwards, that resulted in large outbreaks in the poultry sector and a limited number of confirmed human cases. This model consisted of separate poultry transmission and zoonotic transmission components. Utilising poultry farm spatial and population information a set of competing nested models of varying complexity were fitted to the observed case data, with parameter inference carried out using Bayesian methodology and goodness-of-fit verified by stochastic simulations. For the poultry transmission component, successfully identifying a model of minimal complexity, which enabled the accurate prediction of the size and spatial distribution of cases in H5N1 outbreaks, was found to be dependent on the administration level being analysed. A consistent outcome of non-optimal reporting of infected premises materialised in each poultry epidemic of interest, though across the outbreaks analysed there were substantial differences in the estimated transmission parameters. The zoonotic transmission component found the main contributor to spillover transmission of H5N1 in Bangladesh was found to differ from one poultry epidemic to another. We conclude by discussing possible explanations for these discrepancies in transmission behaviour between epidemics, such as changes in surveillance sensitivity and biosecurity practices. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Who serves the urban poor? A geospatial and descriptive analysis of health services in slum settlements in Dhaka, Bangladesh

PubMed Central

Adams, Alayne M; Islam, Rubana; Ahmed, Tanvir

2015-01-01

In Bangladesh, the health risks of unplanned urbanization are disproportionately shouldered by the urban poor. At the same time, affordable formal primary care services are scarce, and what exists is almost exclusively provided by non-government organizations (NGOs) working on a project basis. So where do the poor go for health care? A health facility mapping of six urban slum settlements in Dhaka was undertaken to explore the configuration of healthcare services proximate to where the poor reside. Three methods were employed: (1) Social mapping and listing of all Health Service Delivery Points (HSDPs); (2) Creation of a geospatial map including Global Positioning System (GPS) co-ordinates of all HSPDs in the six study areas and (3) Implementation of a facility survey of all HSDPs within six study areas. Descriptive statistics are used to examine the number, type and concentration of service provider types, as well as indicators of their accessibility in terms of location and hours of service. A total of 1041 HSDPs were mapped, of which 80% are privately operated and the rest by NGOs and the public sector. Phamacies and non-formal or traditional doctors make up 75% of the private sector while consultation chambers account for 20%. Most NGO and Urban Primary Health Care Project (UPHCP) static clinics are open 5–6 days/week, but close by 4–5 pm in the afternoon. Evening services are almost exclusively offered by private HSDPs; however, only 37% of private sector health staff possess some kind of formal medical qualification. This spatial analysis of health service supply in poor urban settlements emphasizes the importance of taking the informal private sector into account in efforts to increase effective coverage of quality services. Features of informal private sector service provision that have facilitated market penetration may be relevant in designing formal services that better meet the needs of the urban poor. PMID:25759453

Impact of adding hand-washing and water disinfection promotion to oral cholera vaccination on diarrhoea-associated hospitalization in Dhaka, Bangladesh: evidence from a cluster randomized control trial

PubMed Central

Najnin, Nusrat; Leder, Karin; Qadri, Firdausi; Forbes, Andrew; Unicomb, Leanne; Winch, Peter J; Ram, Pavani K; Leontsini, Elli; Nizame, Fosiul A; Arman, Shaila; Begum, Farzana; Biswas, Shwapon K; Clemens, John D; Ali, Mohammad; Cravioto, Alejandro; Luby, Stephen P

2017-01-01

Abstract Background Information on the impact of hygiene interventions on severe outcomes is limited. As a pre-specified secondary outcome of a cluster-randomized controlled trial among >400 000 low-income residents in Dhaka, Bangladesh, we examined the impact of cholera vaccination plus a behaviour change intervention on diarrhoea-associated hospitalization. Methods Ninety neighbourhood clusters were randomly allocated into three areas: cholera-vaccine-only; vaccine-plus-behaviour-change (promotion of hand-washing with soap plus drinking water chlorination); and control. Study follow-up continued for 2 years after intervention began. We calculated cluster-adjusted diarrhoea-associated hospitalization rates using data we collected from nearby hospitals, and 6-monthly census data of all trial households. Results A total of 429 995 people contributed 500 700 person-years of data (average follow-up 1.13 years). Vaccine coverage was 58% at the start of analysis but continued to drop due to population migration. In the vaccine-plus-behaviour-change area, water plus soap was present at 45% of hand-washing stations; 4% of households had detectable chlorine in stored drinking water. Hospitalization rates were similar across the study areas [events/1000 person-years, 95% confidence interval (CI), cholera-vaccine-only: 9.4 (95% CI: 8.3–10.6); vaccine-plus-behaviour-change: 9.6 (95% CI: 8.3–11.1); control: 9.7 (95% CI: 8.3–11.6)]. Cholera cases accounted for 7% of total number of diarrhoea-associated hospitalizations. Conclusions Neither cholera vaccination alone nor cholera vaccination combined with behaviour-change intervention efforts measurably reduced diarrhoea-associated hospitalization in this highly mobile population, during a time when cholera accounted for a small fraction of diarrhoea episodes. Affordable community-level interventions that prevent infection from multiple pathogens by reliably separating faeces from the environment, food and water, with minimal behavioural demands on impoverished communities, remain an important area for research. PMID:29025064

Effect of Active Case Finding on Prevalence and Transmission of Pulmonary Tuberculosis in Dhaka Central Jail, Bangladesh

PubMed Central

Banu, Sayera; Rahman, Md. Toufiq; Uddin, Mohammad Khaja Mafij; Khatun, Razia; Khan, Md. Siddiqur Rahman; Rahman, Md. Mojibur; Uddin, Syed Iftekhar; Ahmed, Tahmeed; Heffelfinger, James D.

2015-01-01

Background Understanding tuberculosis (TB) transmission dynamics is essential for establishing effective TB control strategies in settings where the burden and risk of transmission are high. The objectives of this study were to evaluate the effect of active screening on controlling TB transmission and also to characterize Mycobacterium tuberculosis strains for investigating transmission dynamics in a correctional setting. Methods The study was carried out in Dhaka Central Jail (DCJ), from October 2005 to February 2010. An active case finding strategy for pulmonary TB was established both at the entry point to the prison and inside the prison. Three sputum specimens were collected from all pulmonary TB suspects and subjected to smear microscopy, culture, and drug susceptibility testing as well as genotyping which included deletion analysis, spoligotyping and analysis of mycobacterial interspersed repetitive units (MIRU). Results A total of 60,585 inmates were screened during the study period. We found 466 inmates with pulmonary TB of whom 357 (77%) had positive smear microscopy results and 109 (23%) had negative smear microscopy results but had positive results on culture. The number of pulmonary TB cases declined significantly, from 49 cases during the first quarter to 8 cases in the final quarter of the study period (p=0.001). Deletion analysis identified all isolates as M. tuberculosis and further identified 229 (70%) strains as ‘modern’ and 100 (30%) strains as ‘ancestral’. Analysis of MIRU showed that 347 strains (85%) exhibited unique patterns, whereas 61 strains (15%) clustered into 22 groups. The largest cluster comprised eight strains of the Beijing M. tuberculosis type. The rate of recent transmission was estimated to be 9.6%. Conclusions Implementation of active screening for TB was associated with a decline in TB cases in DCJ. Implementation of active screening in prison settings might substantially reduce the national burden of TB in Bangladesh. PMID:25933377

Immediate Clinical and Echocardiographic Outcome of Percutaneous Transvenous Mitral Commissurotomy for Patients of Mitral Stenosis with Atrial Fibrillation.

PubMed

Rahman, M T; Rahman, M M; Islam, M M; Khan, M R; Haque, S A; Chowdhury, A W; Majumder, A S; Rahman, A; Islam, Q I

2015-07-01

Rheumatic fever and rheumatic heart disease continue to be the major health problem in all developing countries including Bangladesh. Rheumatic mitral stenosis is a very common problem in our population having an incidence of 54 percent among rheumatic heart disease with a female preponderance of 2:1. Percutaneous balloon mitral commissurotomy is appealing because the mechanism of valve dilation closely parallels the mechanism of surgical mitral commissurotomy. The technique of balloon mitral commissurotomy has evolved rapidly, with improvements in balloons, guide wires, and the application of double-balloon techniques. There is controversy that whether the presence of AF has a direct negative effect on the immediate or long-term outcome after PTMC in mitral stenosis patients. The purpose of this study was to see the effect of atrial fibrillation (AF) on the immediate clinical and echocardiographic outcome of patients undergoing Percutaneous Transvenous Mitral Commissurotomy (PTMC). The immediate procedural and in-hospital clinical outcome after PTMC of 264 patients with AF were prospectively collected and compared with those of 288 patients in normal sinus rhythm (NSR) with mitral stenosis admitted in National Institute of Cardiovascular Diseases, Dhaka and Al-Helal Heart Institute, Mirpur, Dhaka, Bangladesh. Patients with AF were older than patients with normal sinus rhythm (53 ± 11 vs. 33 ± 12 years; p<0.0001) and presented more frequently with New York Heart Association (NYHA) class III-IV (78.3% vs. 58.5%; p<0.0001), echocardiographic score >8 (38.9% vs. 22.7%; p<0.0001), calcified valves under fluoroscopy (22.2% vs.12.4%, p<0.0001) and with history of previous surgical commissurotomy (21.7% vs. 10.5%; p<0.0001). In patients with AF, PTMC resulted in worse outcomes, as reflected in a smaller post-PTMC mitral valve area (1.6±0.4 vs. 2.1 ± 0.8 cm²; p<0.0001). Patients with atrial fibrillation have a worse immediate clinical and echocardiographic outcome after PTMC.

Mild Respiratory Illness Among Young Children Caused by Highly Pathogenic Avian Influenza A (H5N1) Virus Infection in Dhaka, Bangladesh, 2011.

PubMed

Chakraborty, Apurba; Rahman, Mahmudur; Hossain, M Jahangir; Khan, Salah Uddin; Haider, M Sabbir; Sultana, Rebeca; Ali Rimi, Nadia; Islam, M Saiful; Haider, Najmul; Islam, Ausraful; Sultana Shanta, Ireen; Sultana, Tahmina; Al Mamun, Abdullah; Homaira, Nusrat; Goswami, Doli; Nahar, Kamrun; Alamgir, A S M; Rahman, Mustafizur; Mahbuba Jamil, Khondokar; Azziz-Baumgartner, Eduardo; Simpson, Natosha; Shu, Bo; Lindstrom, Stephen; Gerloff, Nancy; Davis, C Todd; Katz, Jaqueline M; Mikolon, Andrea; Uyeki, Timothy M; Luby, Stephen P; Sturm-Ramirez, Katharine

2017-09-15

In March 2011, a multidisciplinary team investigated 2 human cases of highly pathogenic avian influenza A(H5N1) virus infection, detected through population-based active surveillance for influenza in Bangladesh, to assess transmission and contain further spread. We collected clinical and exposure history of the case patients and monitored persons coming within 1 m of a case patient during their infectious period. Nasopharyngeal wash specimens from case patients and contacts were tested with real-time reverse-transcription polymerase chain reaction, and virus culture and isolates were characterized. Serum samples were tested with microneutralization and hemagglutination inhibition assays. We tested poultry, wild bird, and environmental samples from case patient households and surrounding areas for influenza viruses. Two previously healthy case patients, aged 13 and 31 months, had influenzalike illness and fully recovered. They had contact with poultry 7 and 10 days before illness onset, respectively. None of their 57 contacts were subsequently ill. Clade 2.2.2.1 highly pathogenic avian influenza H5N1 viruses were isolated from the case patients and from chicken fecal samples collected at the live bird markets near the patients' dwellings. Identification of H5N1 cases through population-based surveillance suggests possible additional undetected cases throughout Bangladesh and highlights the importance of surveillance for mild respiratory illness among populations frequently exposed to infected poultry. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Source apportionment and pollution evaluation of heavy metals in water and sediments of Buriganga River, Bangladesh, using multivariate analysis and pollution evaluation indices.

PubMed

Bhuiyan, Mohammad Amir Hossain; Dampare, Samuel B; Islam, M A; Suzuki, Shigeyuki

2015-01-01

Concentrations of heavy metals in water and sediment samples of Buriganga River in the capital city Dhaka, Bangladesh, were studied to understand the level of heavy metals and their source apportionment. The results showed that the mean concentrations of heavy metals both in water and sediment samples were very high and, in most cases, exceeded the permissible limits recommended by the Bangladesh government and other international organizations. Significantly higher concentrations of Pb, Cr, Mn, Co, Ni, Cu, Zn, As, and Cd were found in sediment samples. However, average concentrations of metals both in water and sediment samples were above the effect range median. The heavy metal pollution index (HPI) and degree of contamination (Cd) yielded different results in water samples despite significant correlations between them. The heavy metal evaluation index (HEI) showed strong correlations with HPI and Cd and provided better assessment of pollution levels. The enrichment factor (EF) and geoaccumulation index (Igeo) showed the elevated value of Cr, Pb, and Cd in access of background values. The measured elements were subjected to positive matrix factorization (PMF) and examining correlations in order to explain the content, behavior, and source apportionment of metals. PMF resulted in a successful partitioning of variances into sources related to background geochemistry and contaminant influences. However, the PMF approach successfully demarcated the major sources of metals from tannery, paint, municipal sewage, textiles, and agricultural activities.

Can a woman refuse sex if her husband has a sexually transmitted infection? Attitudes toward safer-sex negotiation among married women in Bangladesh.

PubMed

Jesmin, Syeda S; Cready, Cynthia M

2014-06-01

In developing countries, HIV, sexually transmitted infections (STIs) and unintended pregnancy take an enormous toll on women's reproductive health, yet preventive programmes are lacking as married women's risks are frequently underestimated. We examined predictors of married Bangladeshi women's attitudes towards safer-sex negotiation using data on 15,178 currently married women aged 15-49 from the 2011 Bangladesh Demographic Health Survey. Approximately 92% of women believed that a wife's refusal to have sex with her husband is justified if he has an STI. Multilevel logistic regression analysis revealed that the likelihood of a woman holding this belief increased with her autonomy, as measured by the ability to go to a health centre/hospital without another adult, participation in household decision making and rejection of wife beating (p < 0.001). Other significant predictors were knowledge/awareness of STIs (p < 0.05), living in Dhaka division (p < 0.001) and younger age (p < 0.01). Our findings suggest that sexual health education programmes may be more effective if they include strategies to address social norms and cultural practices that limit women's autonomy in society.

Clinical risk factors, bacterial aetiology, and outcome of urinary tract infection in children hospitalized with diarrhoea in Bangladesh.

PubMed

Das, R; Ahmed, T; Saha, H; Shahrin, L; Afroze, F; Shahid, A S M S B; Shahunja, K M; Bardhan, P K; Chisti, M J

2017-04-01

Urinary tract infection (UTI) is common in children aged <5 years with diarrhoea, but little is known about risk factors, aetiology and outcome of such children. We aimed to evaluate these knowledge gaps of UTI in children aged <5 years with diarrhoea. We enrolled all children aged <5 years with diarrhoea admitted to Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh, between May 2011 and April 2013, who had history of fever (⩾38 °C) and obtained a urine sample for culture. Diarrhoea with UTI (confirmed by culture) constituted cases (n = 26) and those without UTI constituted controls (n = 78). Threefold controls were randomly selected. The case-fatality rate was comparable in cases and controls (4% vs. 1%, P = 0·439). Escherichia coli (69%) and Klebsiella (15%) were the most commonly isolated pathogens. Persistent diarrhoea, pneumonia and prior antibiotics use were identified as risk factors for UTI in logistic regression analysis (P < 0·05 for all). Thus, children with diarrhoea presenting with persistent diarrhoea, pneumonia, and prior antibiotic use should be investigated for UTI for their prompt management that may reduce morbidity.

Blood lead levels and health problems of lead acid battery workers in Bangladesh.

PubMed

Ahmad, Sk Akhtar; Khan, Manzurul Haque; Khandker, Salamat; Sarwar, A F M; Yasmin, Nahid; Faruquee, M H; Yasmin, Rabeya

2014-01-01

Use of lead acid battery (LAB) in Bangladesh has risen with sharp rise of motor vehicles. As result, manufacture of LAB is increasing. Most of the lead used by these industries comes from recycling of LAB. Workers in LAB industry are at risk of exposure lead and thus development of lead toxicity. The objective of this study was to measure the blood lead concentration and to assess the magnitude of health problems attributable to lead toxicity among the LAB manufacturing workers. A cross-sectional study was conducted among the workers of LAB manufacturing industries located in Dhaka city. Mean blood lead level (BLL) among the workers was found to be high. They were found to be suffering from a number of illnesses attributable to lead toxicity. The common illnesses were frequent headache, numbness of the limbs, colic pain, nausea, tremor, and lead line on the gum. High BLL was also found to be related to hypertension and anemia of the workers. High BLL and illnesses attributable to lead toxicity were prevalent amongst workers of the LAB manufacturing industries, and this requires attention especially in terms of occupational hygiene and safety.

Dietary intake of heavy metals from eight highly consumed species of cultured fish and possible human health risk implications in Bangladesh.

PubMed

Ullah, A K M Atique; Maksud, M A; Khan, S R; Lutfa, L N; Quraishi, Shamshad B

2017-01-01

Concentrations of five heavy metals (Pb, Cd, Cr, As and Hg) in eight highly consumed cultured fish species ( Labeo rohita, Clarias gariepinus, Hypophthalmichthys molitrix, Cyprinus capio, Puntius sarana, Oreochromis mossambicus, Pangasius pangasius and Anabas testudineus ) collected from four wholesale markets of Dhaka city, Bangladesh (Karwan Bazar, Mohammadpur Town Hall, Newmarket and Mirpur-1) were measured using atomic absorption spectrometry (AAS) in order to evaluate the potential human health risks from the consumption of fish. The estimated daily intake (EDI) of all the studied heavy metals calculated on the basis of mean fish consumption of 49.5 g person -1 d -1 by Bangladeshi households indicated that no risk to people's health with respect to the EDI of investigated heavy metals through the consumption of the fish samples. From the human health point of view, the estimation of non-carcinogenic risk indicated that intake of individual heavy metal through the consumption of fish was safe for human health, whereas, consumption of combined heavy metals suggested potential health risk to highly exposed consumers. However, the estimation of carcinogenic risk of arsenic due to the consumption of fish indicated that consumers remain at risk of cancer.

The role of orthophosphate and dissolved oxygen in the performance of arsenic-iron removal plants in Bangladesh.

PubMed

Brennan, Ryan T; McBean, Edward A

2011-01-01

Arsenic iron removal plants (AIRPs) are used in some locations in Bangladesh to remove arsenic from groundwater to provide access to safer drinking water. In this study, the influence of orthophosphate in influent water on the performance of 21 (of 105) AIRPs installed in the Manikganj District was evaluated. The degree of aeration was also estimated, and the role of dissolved oxygen in AIRP performance is discussed. AIRP installations were done by a local non-governmental organization (The Society for People's Action in Change and Equity) with financial assistance from the Australian High Commission, Dhaka under the Direct Aid Program of the Australian Government. The presence of orthophosphate in the influent did not influence arsenic removal efficiency in the tested AIRPs, likely due to the high iron concentrations at all sites. The high iron provides adequate surface area for both orthophosphate and arsenic to be removed. Orthophosphate co-precipitated with iron oxides much more quickly than arsenic, in one cleaning cycle study, and is expected to play a more significant role in interfering with arsenic removal at sites with much lower iron concentrations. The aeration trays studied are estimated to introduce at least 2.4-3.7 mg/L of dissolved oxygen. In normal operation, sufficient oxygen is introduced through the aeration tray to fully oxidize all influent iron. The AIRPs studied show promise for use in areas of Bangladesh with high natural iron, where users are concerned with arsenic, iron, or both, in their drinking water.

Microbiological quality of drinking water from dispensers in roadside restaurants of Bangladesh.

PubMed

Moniruzzaman, M; Akter, S; Islam, M A; Mia, Z

2011-01-15

The microbiological status of water from dispensers in different roadside restaurants of Dhaka city and Savar area was analyzed in this study. Seven samples from Dhaka and 8 samples of Savar were checked. The heterotrophic plate count was in a range of 1.0 x 10(3) CFU mL(-1) to 2.0 x 10(4) CFU mL(-1) (from new bottles), 1.0 x 10(3) to 1.5 x 10(4) CFU mL(-1) (after dispensation), and 1.5 x 10(3) CFU mL(-1) to 1.0 x l0(5) CFU mL(-1) (from serving glass). In several of the samples, the heterotrophic plate count was higher than the count in water from new bottle or after dispensation, suggesting added contamination from the serving glass. 80% of the samples were contaminated with total and fecal coliform bacteria, which render these waters unacceptable for human consumption. The samples were found to contain gram negative bacteria like E coli, Shigella sp., Klebsiella sp., Enterobacter sp., Pseudomonas sp., and Salmonella sp., which are potential pathogens and thus pose a serious threat to public health. This study elucidates the importance of monitoring the bottling companies and the restaurants and put them under strict regulations to prevent future outbreak of any water borne diseases caused by consumption of dispensed water.

Identification of Essential Containers for Aedes Larval Breeding to Control Dengue in Dhaka, Bangladesh

PubMed Central

Ferdousi, Farhana; Yoshimatsu, Shoji; Ma, Enbo; Sohel, Nazmul; Wagatsuma, Yukiko

2015-01-01

Dengue fever (DF), one of the most important emerging arboviral diseases, is transmitted through the bite of container breeding mosquitoes Aedes aegypti and Aedes albopictus. A household entomological survey was conducted in Dhaka from August through October 2000 to inspect water-holding containers in indoor, outdoor, and rooftop locations for Aedes larvae. The objective of this study was to determine mosquito productivity of each container type and to identify some risk factors of households infested with Aedes larvae. Of 9,222 households inspected, 1,306 (14.2%) were positive for Aedes larvae. Of 38,777 wet containers examined, 2,272 (5.8%) were infested with Aedes larvae. Containers used to hold water, such as earthen jars, tanks, and drums were the most common containers for larval breeding. Tires in outdoor and rooftop locations of the households were also important for larval breeding. Although present in abundance, buckets were of less importance. Factors such as independent household, presence of a water storage system in the house, and fully/partly shaded outdoors were found to be significantly associated with household infestation of Aedes larvae. Identification and subsequent elimination of the most productive containers in a given area may potentially reduce mosquito density to below a level at which dengue transmission may be halted. PMID:26865829

Utilization of mobile phones for accessing menstrual regulation services among low-income women in Bangladesh: a qualitative analysis.

PubMed

Messinger, Chelsea Jordan; Mahmud, Ilias; Kanan, Sushama; Jahangir, Yamin Tauseef; Sarker, Malabika; Rashid, Sabina Faiz

2017-01-14

As many as one-third of all pregnancies in Bangladesh are unplanned, with nearly one-half of these pregnancies ending in either menstrual regulation (MR) or illegal clandestine abortion. Although MR is provided free of charge, or at a nominal cost, through the public sector and various non-profits organizations, many women face barriers in accessing safe, affordable MR and post-MR care. Mobile health (mHealth) services present a promising platform for increasing access to MR among low-income women at risk for clandestine abortion. We sought to investigate the knowledge, attitudes and practices regarding mHealth of both MR clients and formal and informal sexual and reproductive healthcare providers in urban and rural low-income settlements in Bangladesh. A total of 58 interviews were conducted with MR clients, formal MR providers, and informal MR providers in four low-income settlements in the Dhaka and Sylhet districts of Bangladesh. Interview data was coded and qualitatively analysed for themes using standard qualitative research practices. Our findings suggest that low-income MR clients in Bangladesh have an inadequate understanding of how to use their mobile phones to obtain health service information or counselling related to MR, and correspondingly low levels of formal or informal mHealth service utilization. Few were aware of any formal mHealth services in place in their communities, despite the fact that providers stated that hotlines were available. Overall, MR clients expressed positive opinions of mHealth services as a means of improving women's access to affordable and timely MR. Formal and informal MR providers believed that mobile phones had benefits with respect to information dissemination and making appointments, but emphasized the necessity of in-person consultations for effective sexual and reproductive healthcare. We report low utilization yet high acceptability of mHealth services among low-income MR clients in Bangladesh. Expanding formal and informal mHealth services targeted towards MR - and increasing publicity of these services in low-income communities - may help increase timely access to accurate MR information and formal providers among women at risk for clandestine abortion. While expanding formal and informal mHealth services for SRHR in Bangladesh may be useful in disseminating information about MR and connecting women with formal providers, in-person visits remain necessary for adequate treatment.

Ready-to-Use Therapeutic Food Made From Locally Available Food Ingredients Is Well Accepted by Children Having Severe Acute Malnutrition in Bangladesh.

PubMed

Choudhury, Nuzhat; Ahmed, Tahmeed; Hossain, Md Iqbal; Islam, M Munirul; Sarker, Shafiqul A; Zeilani, Mamane; Clemens, John David

2018-03-01

With a prevalence of 3.1%, approximately, 450 000 children in Bangladesh are having severe acute malnutrition (SAM). There is currently no national community-based program run by government to take care of these children, one of the reasons being lack of access to ready-to-use therapeutic food (RUTF). To develop RUTF using locally available food ingredients and test its acceptability. A checklist was prepared for all food ingredients available and commonly consumed in Bangladesh that have the potential of being used for developing a RUTF. Linear programming was used to identify the combinations of nutrients that would result in an ideal RUTF. To test the acceptability of 2 local RUTFs compared to the prototype RUTF, Plumpy'Nut, a clinical trial with a crossover design was conducted among 30 children in the Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh. The acceptability was determined by using the mean proportion of offered food consumed by the children themselves. Two RUTFs were developed, one based on chickpea and the other on rice-lentils. The total energy content of 100 g of chickpea and rice-lentil-based RUTF were 537.4 and 534.5 kcal, protein 12.9 and 13.5 g, and fat 31.8 and 31.1 g, respectively, without any significant difference among the group. On an average, 85.7% of the offered RUTF amount was consumed by the children in 3 different RUTF groups which implies that all types of RUTF were well accepted by the children. Ready-to-use therapeutic foods were developed using locally available food ingredients-rice, lentil, and chickpeas. Chickpea-based and rice-lentil-based RUTF were well accepted by children with SAM.

PREVALENCE OF CHILDHOOD OBESITY AND UNDERNUTRITION AMONG URBAN SCHOOL CHILDREN IN BANGLADESH.

PubMed

Sultana, Niru; Afroz, Sadya; Tomalika, Nehlin; Momtaz, Hasina; Kabir, Md Humayun

2018-04-10

SummaryDespite the ongoing problems of undernutrition and infectious disease, obesity and overweight have become a major problem in developing countries, including Bangladesh. This cross-sectional study was undertaken to determine the prevalence of obesity, overweight and underweight among school children aged 6-12 years in Bangladesh. The study was conducted from June 2012 to May 2013 and the study sample comprised 1768 children (980 boys; 788 girls) from eight purposively selected schools in different areas of Dhaka city. Students were interviewed about their diet and physical activity, and anthropometric measurements were made, including height, weight, mid-upper-arm circumference (MUAC), waist circumference, hip circumference and body mass index (BMI). Undernutrition, overweight and obesity were defined using internationally accepted BMI cut-off points. Mean height, weight, BMI, MUAC, waist circumference and hip circumference values were found to be higher in boys than in girls, except at age 12 when these were found to be significantly higher in girls than in boys (p<0.05). The mean prevalence of overweight was 10.0% (boys 10.2%; girls 9.8%), and that of obesity 5.0% (boys 4.3%; girls 5.8%). The prevalence of underweight was 16.3% in boys and 12.7% in girls. The prevalence of underweight was significantly higher in poor than in rich children (22.1% vs 11.2%) and that of obesity was higher in rich than in poor children (9.9% vs 1.3%; p<0.001). A family history of obesity and hypertension emerged as a significant predictor of developing overweight and obesity (p<0.001). The data suggest that underweight and obesity co-exist in urban areas of Bangladesh, posing a challenge for the nutritional health of Bangladeshi children.

Talking about sexuality at secondary schools of periurban area of Dhaka city.

PubMed

Tasnim, Saria; Rahman, Aminur; Ara, Iffat

2009-01-01

Adolescents constitute 23 percent of population in Bangladesh yet access to information and education on reproductive health is limited for them. To determine the effect of introducing an education booklet on reproductive health knowledge among the adolescents and its acceptability to them. Students of grade IX and X in eight secondary schools (both boys and girls schools) of periurban location of Dhaka city. A quasi-experimental pre-post test design study was conducted during October 2004 to May 2005. The intervention was distribution of an education booklet and conduction of a health education session at the respective classes. Total number of respondents were 1,490 (862 during pre test and 628 during post test). About 4% of parents never attended school, whereas 10.7% of fathers and 3.2% of mothers were graduates. A greater proportion of adolescents could correctly narrate the physiological changes of adolescence, duration of menstrual cycle, fertile period, leucorrhoea, masturbation, and night emission in the post test. Almost all adolescents stated that health education was necessary and should be given in secondary schools. About 95% stated that the education booklet was necessary. They appreciated that the language was easy and fluent, the illustration was meaningful, and some suggested a few modifications. Providing reproductive health information to adolescents can be sustained through inclusion in school curriculum and has the potential to produce health benefits in future.

Blood Lead Levels and Health Problems of Lead Acid Battery Workers in Bangladesh

PubMed Central

Ahmad, Sk. Akhtar; Khan, Manzurul Haque; Khandker, Salamat; Sarwar, A. F. M.; Yasmin, Nahid; Faruquee, M. H.; Yasmin, Rabeya

2014-01-01

Introduction. Use of lead acid battery (LAB) in Bangladesh has risen with sharp rise of motor vehicles. As result, manufacture of LAB is increasing. Most of the lead used by these industries comes from recycling of LAB. Workers in LAB industry are at risk of exposure lead and thus development of lead toxicity. Objective. The objective of this study was to measure the blood lead concentration and to assess the magnitude of health problems attributable to lead toxicity among the LAB manufacturing workers. Methods. A cross-sectional study was conducted among the workers of LAB manufacturing industries located in Dhaka city. Result. Mean blood lead level (BLL) among the workers was found to be high. They were found to be suffering from a number of illnesses attributable to lead toxicity. The common illnesses were frequent headache, numbness of the limbs, colic pain, nausea, tremor, and lead line on the gum. High BLL was also found to be related to hypertension and anemia of the workers. Conclusion. High BLL and illnesses attributable to lead toxicity were prevalent amongst workers of the LAB manufacturing industries, and this requires attention especially in terms of occupational hygiene and safety. PMID:24707223

Family planning choice behaviour in urban slums of Bangladesh: an econometric approach.

PubMed

Barkat, A; Rahman, M U; Bose, M L

1997-03-01

Bangladesh's urban population is projected to account for 26% of the country's total population by the year 2000 and 37% by 2015. A 1991 Bangladesh census report found that about 21 million of the total 111.5 million population were living in urban areas. 1551 currently-married women of reproductive age in 1551 households sampled from a representative sample of 91 slums in the metropolitan areas of Dhaka, Chittagong, and Khulna participated in a study of family planning behavior choice. 673 of the women were practicing family planning. The authors describe the construction of the econometric model used for analysis. Economic status as indicated by household income was found to considerably influence people's decisions concerning family planning practices. Higher women's educational status is also positively correlated with family planning practice. Husband's educational status has a less significant effect upon family planning practice. The change of a person from non-Muslim to Muslim has an insignificant, though positive, impact upon family planning practice. The more a woman feels empowered, being over age 19 years, the greater the number of living children, and the lower the level of preference for sons, the more likely a woman is to practice family planning.

Violations of the international code of marketing of breast milk substitutes: prevalence in four countries

PubMed Central

Taylor, Anna

1998-01-01

Objective: To estimate the prevalence of violations of the international code of marketing of substitutes for breast milk in one city in each of Bangladesh, Poland, South Africa, and Thailand. Design: Multistage random sampling was used to select pregnant women and mothers of infants ⩽6 months old to interview at health facilities. Women were asked whether they had received free samples of substitutes for breast milk (including infant formula designed to meet the nutritional needs of infants from birth to 4 to 6 months of age, follow on formula designed to replace infant formula at the age of 4 to 6 months, and complementary foods for infants aged ⩽6 months), bottles, or teats. The source of the free sample and when it had been given to the women was also determined. 3 health workers were interviewed at each facility to assess whether the facility had received free samples, to determine how they had been used, and to determine whether gifts had been given to health workers by companies that manufactured or distributed breast milk substitutes. Compliance with the marketing code for information given to health workers was evaluated using a checklist. Setting: Health facilities in Dhaka, Bangladesh; Warsaw, Poland; Durban, South Africa; and Bangkok, Thailand. Subjects: 1468 pregnant women, 1582 mothers of infants aged ⩽6 months, and 466 health workers at 165 health facilities. Main outcome measures: Number of free samples received by pregnant women, mothers, and health workers; number of gifts given to health workers; and availability of information that violated the code in health facilities. Results: 97 out of 370 (26%) mothers in Bangkok reported receiving free samples of breast milk substitutes, infant formula, bottles, or teats compared with only 1 out of 385 mothers in Dhaka. Across the four cities from 3 out of 40 (8%) to 20 out of 40 (50%) health facilities had received free samples which were not being used for research or professional evaluation; from 2 out of 123 (2%) to 21 out of 119 (18%) health workers had received gifts from companies involved in the manufacturing or distribution of breast milk substitutes. From 6 out of 40 (15%) to 22 out of 39 (56%) health facilities information that violated the code had been provided by companies and was available to staff. Conclusion: Violations of the code were detected with a simple survey instrument in all of the four countries studied. Governmental and non-governmental agencies should monitor the prevalence of code violations using the simple methodology developed for this study. Key messages A simple multistage random sampling procedure can be used to interview women and health professionals to assess whether violations of the international code of marketing of substitutes for breast milk are occurring 3050 women and 466 health professionals were interviewed at 165 health facilities in Bangladesh, Poland, South Africa, and Thailand 97 out of 370 mothers in Bangkok reported receiving free samples of breast milk substitutes, infant formula, bottles, or teats compared with only 1 out of 385 mothers in Dhaka. In Bangkok health workers reported that 20 out of 40 health facilities had also received free samples. Most free samples were distributed by health facilities In Warsaw 56% of facilities surveyed were found to have information available for health workers that had been provided by manufacturers or distributors of breast milk substitutes in contravention of the code; 18% of health workers in Warsaw had received free gifts from manufacturers PMID:9552947

Prevalence and risk factors of hepatitis B and C virus infections in an impoverished urban community in Dhaka, Bangladesh

PubMed Central

2010-01-01

Background Viral hepatitis is a serious global public health problem affecting billions of people globally, and both hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are rapidly spreading in the developing countries including Bangladesh due to the lack of health education, poverty, illiteracy and lack of hepatitis B vaccination. Also there is lack of information on their prevalence among the general population. So, a population-based serological survey was conducted in Dhaka to determine the prevalence and risk factors of HBV and HCV infections. Methods Healthy individuals were selected for demographic and behavioural characteristics by stratified cluster sampling and blood tested for hepatitis B surface antigen (HBsAg), antibody to HBV core antigen (anti-HBc), and anti-HCV antibodies (anti-HCV). Results From June 2005-November 2006, 1997 participants were screened for HBsAg, anti-HBc and anti-HCV, 738 (37%) were males with mean (SD) age of 24 (14) years. HBV-seropositivity was documented in 582 (29%) participants: 14 (0.7%) were positive for HBsAg, 452 (22.6%) for anti-HBc and 116 (5.8%) for both HBsAg and anti-HBc. Four (0.2%) participants were positive for anti-HCV, and another five (0.3%) for both anti-HBc and anti-HCV. Ninety-six/246 (39%) family members residing at same households with HBsAg positive participants were also HBV-seropositive [74 (30.1%) for anti-HBc and 22 (8.9%) for both HBsAg and anti-HBc], which was significantly higher among family members (39%) than that of study participants (29%) (OR 1.56; p < 0.001). In bivariate analysis, HBV-seropositivity was significantly associated with married status (OR 2.27; p < 0.001), history of jaundice (OR 1.35; p = 0.009), surgical operations (OR 1.26; p = 0.04), needle-stick injuries (OR 2.09; p = 0.002), visiting unregistered health-care providers (OR 1.40; p = 0.008), receiving treatment for sexually transmitted diseases (STD) (OR 1.79; p = 0.001), animal bites (OR 1.73; p < 0.001); ear-nose-body piercing in females (OR 4.97; p < 0.001); circumcision (OR 3.21; p < 0.001), and visiting community barber for shaving in males (OR 3.77; p < 0.001). In logistic regression analysis, married status (OR 1.32; p = 0.04), surgical operations (OR 1.39; p = 0.02), animal bites (OR 1.43; p = 0.02), visiting unregistered health-care providers (OR 1.40; p = 0.01); and ear-nose-body piercing in females (OR 4.97; p < 0.001) were significantly associated with HBV-seropositivity. Conclusions The results indicate intermediate level of endemicity of HBV infection in Dhaka community, with much higher prevalence among family members of HBsAg positive individuals but low prevalence of HCV infections, clearly indicating need for universal hepatitis B vaccination. The use of disposable needles for ear-nose-body piercing need to be promoted through public awareness programmes as a preventive strategy. PMID:20630111

Indoor air pollution and the health of children in biomass- and fossil-fuel users of Bangladesh: situation in two different seasons

PubMed Central

Khalequzzaman, Md.; Sakai, Kiyoshi; Hoque, Bilqis Amin; Nakajima, Tamie

2010-01-01

Objectives Indoor air pollution levels are reported to be higher with biomass fuel, and a number of respiratory diseases in children are associated with pollution from burning such fuel. However, little is known about the situation in developing countries. The aim of the study was to compare indoor air pollution levels and prevalence of symptoms in children between biomass- and fossil-fuel-using households in different seasons in Bangladesh. Methods We conducted a cross-sectional study among biomass- (n = 42) and fossil-fuel (n = 66) users having children <5 years in Moulvibazar and Dhaka, Bangladesh. Health-related information of one child from each family was retrieved once in winter (January 2008) and once in summer (June 2008). The measured pollutants were carbon monoxide (CO), carbon dioxide (CO2), dust particles, volatile organic compounds (VOCs), and nitrogen dioxide. Results Mean concentration of dust particles and geometric mean concentrations of VOCs such as benzene, toluene, and xylene, which were significantly higher in biomass- than fossil-fuel-users’ kitchens (p < 0.05), were significantly higher in winter than in summer (p < 0.05). Levels of CO and CO2, which were significantly higher in biomass than fossil-fuel users (p < 0.05), were significantly higher in summer than winter (p < 0.05). However, no significant difference was found in the occurrence of symptoms between biomass- and fossil-fuel users either in winter or in summer. Conclusions It was suggested that the measured indoor air pollution did not directly result in symptoms among children. Other factors may be involved. PMID:21432551

Determinants of Academics' Job Satisfaction: Empirical Evidence from Private Universities in Bangladesh

PubMed Central

Masum, Abdul Kadar Muhammad; Azad, Md. Abul Kalam; Beh, Loo-See

2015-01-01

The job satisfaction of academics is related to a number of variables of complex function such as demographic characters, the work itself, pay, work responsibilities, variety of tasks, promotional opportunities, relationship with co-workers and others. Academics may be simultaneously satisfied with some facets of the job and dissatisfied with others. This paper aims at determining the influential factors that contribute to the enhancement or reduction of academics’ job satisfaction among private universities in Bangladesh with special reference to Dhaka, the capital city of Bangladesh. A total of 346 respondents are considered from ten private universities using non-probability sampling. A pre-tested and closed-ended questionnaire using a seven-point Likert scale is used for data collection. In this study, descriptive statistics, Pearson product moment correlation, multiple regression, and factor analysis are exercised as statistical tools. A conceptual model of job satisfaction is developed and applied for academics’ job satisfaction. The results reveal that compensation package, supervisory support, job security, training and development opportunities, team cohesion, career growth, working conditions, and organizational culture and policies are positively associated with the academics’ job satisfaction. Amongst them, three factors stood out as significant contributors for job satisfaction of academics i.e. compensation package, job security, and working conditions. Therefore, the management of private universities should focus their effort on these areas of human resource management for maintaining academics’ job satisfaction and employee retention. The study will be useful for university management in improving overall job satisfaction as it suggests some strategies for employee satisfaction practices. PMID:25699518

Determinants of academics' job satisfaction: empirical evidence from private universities in Bangladesh.

PubMed

Masum, Abdul Kadar Muhammad; Azad, Md Abul Kalam; Beh, Loo-See

2015-01-01

The job satisfaction of academics is related to a number of variables of complex function such as demographic characters, the work itself, pay, work responsibilities, variety of tasks, promotional opportunities, relationship with co-workers and others. Academics may be simultaneously satisfied with some facets of the job and dissatisfied with others. This paper aims at determining the influential factors that contribute to the enhancement or reduction of academics' job satisfaction among private universities in Bangladesh with special reference to Dhaka, the capital city of Bangladesh. A total of 346 respondents are considered from ten private universities using non-probability sampling. A pre-tested and closed-ended questionnaire using a seven-point Likert scale is used for data collection. In this study, descriptive statistics, Pearson product moment correlation, multiple regression, and factor analysis are exercised as statistical tools. A conceptual model of job satisfaction is developed and applied for academics' job satisfaction. The results reveal that compensation package, supervisory support, job security, training and development opportunities, team cohesion, career growth, working conditions, and organizational culture and policies are positively associated with the academics' job satisfaction. Amongst them, three factors stood out as significant contributors for job satisfaction of academics i.e. compensation package, job security, and working conditions. Therefore, the management of private universities should focus their effort on these areas of human resource management for maintaining academics' job satisfaction and employee retention. The study will be useful for university management in improving overall job satisfaction as it suggests some strategies for employee satisfaction practices.

Clinical outcomes and mortality before and after implementation of a pediatric sepsis protocol in a limited resource setting: A retrospective cohort study in Bangladesh.

PubMed

Kortz, Teresa Bleakly; Axelrod, David M; Chisti, Mohammod J; Kache, Saraswati

2017-01-01

Pediatric sepsis has a high mortality rate in limited resource settings. Sepsis protocols have been shown to be a cost-effective strategy to improve morbidity and mortality in a variety of populations and settings. At Dhaka Hospital in Bangladesh, mortality from pediatric sepsis in high-risk children previously approached 60%, which prompted the implementation of an evidenced-based protocol in 2010. The clinical effectiveness of this protocol had not been measured. We hypothesized that implementation of a pediatric sepsis protocol improved clinical outcomes, including reducing mortality and length of hospital stay. This was a retrospective cohort study of children 1-59 months old with a diagnosis of sepsis, severe sepsis or septic shock admitted to Dhaka Hospital from 10/25/2009-10/25/2011. The primary outcome was inpatient mortality pre- and post-protocol implementation. Secondary outcomes included fluid overload, heart failure, respiratory insufficiency, length of hospital stay, and protocol compliance, as measured by antibiotic and fluid bolus administration within 60 minutes of hospital presentation. 404 patients were identified by a key-word search of the electronic medical record; 328 patients with a primary diagnosis of sepsis, severe sepsis, or septic shock were included (143 pre- and185 post-protocol) in the analysis. Pre- and post-protocol mortality were similar and not statistically significant (32.17% vs. 34.59%, p = 0.72). The adjusted odds ratio (AOR) for post-protocol mortality was 1.55 (95% CI, 0.88-2.71). The odds for developing fluid overload were significantly higher post-protocol (AOR 3.45, 95% CI, 2.04-5.85), as were the odds of developing heart failure (AOR 4.52, 95% CI, 1.43-14.29) and having a longer median length of stay (AOR 1.81, 95% CI 1.10-2.96). There was no statistically significant difference in respiratory insufficiency (pre- 65.7% vs. post- 70.3%, p = 0.4) or antibiotic administration between the cohorts (pre- 16.08% vs. post- 12.43%, p = 0.42). Implementation of a pediatric sepsis protocol did not improve all-cause mortality or length of stay and may have been associated with increased fluid overload and heart failure during the study period in a large, non-governmental hospital in Bangladesh. Similar rates of early antibiotic administration may indicate poor protocol compliance. Though evidenced-based protocols are a potential cost-effective strategy to improve outcomes, future studies should focus on optimal implementation of context-relevant sepsis protocols in limited resource settings.

Clinical outcomes and mortality before and after implementation of a pediatric sepsis protocol in a limited resource setting: A retrospective cohort study in Bangladesh

PubMed Central

Axelrod, David M.; Chisti, Mohammod J.; Kache, Saraswati

2017-01-01

Background Pediatric sepsis has a high mortality rate in limited resource settings. Sepsis protocols have been shown to be a cost-effective strategy to improve morbidity and mortality in a variety of populations and settings. At Dhaka Hospital in Bangladesh, mortality from pediatric sepsis in high-risk children previously approached 60%, which prompted the implementation of an evidenced-based protocol in 2010. The clinical effectiveness of this protocol had not been measured. We hypothesized that implementation of a pediatric sepsis protocol improved clinical outcomes, including reducing mortality and length of hospital stay. Materials and methods This was a retrospective cohort study of children 1–59 months old with a diagnosis of sepsis, severe sepsis or septic shock admitted to Dhaka Hospital from 10/25/2009-10/25/2011. The primary outcome was inpatient mortality pre- and post-protocol implementation. Secondary outcomes included fluid overload, heart failure, respiratory insufficiency, length of hospital stay, and protocol compliance, as measured by antibiotic and fluid bolus administration within 60 minutes of hospital presentation. Results 404 patients were identified by a key-word search of the electronic medical record; 328 patients with a primary diagnosis of sepsis, severe sepsis, or septic shock were included (143 pre- and185 post-protocol) in the analysis. Pre- and post-protocol mortality were similar and not statistically significant (32.17% vs. 34.59%, p = 0.72). The adjusted odds ratio (AOR) for post-protocol mortality was 1.55 (95% CI, 0.88–2.71). The odds for developing fluid overload were significantly higher post-protocol (AOR 3.45, 95% CI, 2.04–5.85), as were the odds of developing heart failure (AOR 4.52, 95% CI, 1.43–14.29) and having a longer median length of stay (AOR 1.81, 95% CI 1.10–2.96). There was no statistically significant difference in respiratory insufficiency (pre- 65.7% vs. post- 70.3%, p = 0.4) or antibiotic administration between the cohorts (pre- 16.08% vs. post- 12.43%, p = 0.42). Conclusions Implementation of a pediatric sepsis protocol did not improve all-cause mortality or length of stay and may have been associated with increased fluid overload and heart failure during the study period in a large, non-governmental hospital in Bangladesh. Similar rates of early antibiotic administration may indicate poor protocol compliance. Though evidenced-based protocols are a potential cost-effective strategy to improve outcomes, future studies should focus on optimal implementation of context-relevant sepsis protocols in limited resource settings. PMID:28753618

Modelling typhoid risk in Dhaka metropolitan area of Bangladesh: the role of socio-economic and environmental factors.

PubMed

Corner, Robert J; Dewan, Ashraf M; Hashizume, Masahiro

2013-03-16

Developing countries in South Asia, such as Bangladesh, bear a disproportionate burden of diarrhoeal diseases such as cholera, typhoid and paratyphoid. These seem to be aggravated by a number of social and environmental factors such as lack of access to safe drinking water, overcrowdedness and poor hygiene brought about by poverty. Some socioeconomic data can be obtained from census data whilst others are more difficult to elucidate. This study considers a range of both census data and spatial data from other sources, including remote sensing, as potential predictors of typhoid risk. Typhoid data are aggregated from hospital admission records for the period from 2005 to 2009. The spatial and statistical structures of the data are analysed and principal axis factoring is used to reduce the degree of co-linearity in the data. The resulting factors are combined into a quality of life index, which in turn is used in a regression model of typhoid occurrence and risk. The three principal factors used together explain 87% of the variance in the initial candidate predictors, which eminently qualifies them for use as a set of uncorrelated explanatory variables in a linear regression model. Initial regression result using ordinary least squares (OLS) were disappointing, this was explainable by analysis of the spatial autocorrelation inherent in the principal factors. The use of geographically weighted regression caused a considerable increase in the predictive power of regressions based on these factors. The best prediction, determined by analysis of the Akaike information criterion (AIC) was found when the three factors were combined into a quality of life index, using a method previously published by others, and had a coefficient of determination of 73%. The typhoid occurrence/risk prediction equation was used to develop the first risk map showing areas of Dhaka metropolitan area whose inhabitants are at greater or lesser risk of typhoid infection. This, coupled with seasonal information on typhoid incidence also reported in this paper, has the potential to advise public health professionals on developing prevention strategies such as targeted vaccination.

Who serves the urban poor? A geospatial and descriptive analysis of health services in slum settlements in Dhaka, Bangladesh.

PubMed

Adams, Alayne M; Islam, Rubana; Ahmed, Tanvir

2015-03-01

In Bangladesh, the health risks of unplanned urbanization are disproportionately shouldered by the urban poor. At the same time, affordable formal primary care services are scarce, and what exists is almost exclusively provided by non-government organizations (NGOs) working on a project basis. So where do the poor go for health care? A health facility mapping of six urban slum settlements in Dhaka was undertaken to explore the configuration of healthcare services proximate to where the poor reside. Three methods were employed: (1) Social mapping and listing of all Health Service Delivery Points (HSDPs); (2) Creation of a geospatial map including Global Positioning System (GPS) co-ordinates of all HSPDs in the six study areas and (3) Implementation of a facility survey of all HSDPs within six study areas. Descriptive statistics are used to examine the number, type and concentration of service provider types, as well as indicators of their accessibility in terms of location and hours of service. A total of 1041 HSDPs were mapped, of which 80% are privately operated and the rest by NGOs and the public sector. Phamacies and non-formal or traditional doctors make up 75% of the private sector while consultation chambers account for 20%. Most NGO and Urban Primary Health Care Project (UPHCP) static clinics are open 5-6 days/week, but close by 4-5 pm in the afternoon. Evening services are almost exclusively offered by private HSDPs; however, only 37% of private sector health staff possess some kind of formal medical qualification. This spatial analysis of health service supply in poor urban settlements emphasizes the importance of taking the informal private sector into account in efforts to increase effective coverage of quality services. Features of informal private sector service provision that have facilitated market penetration may be relevant in designing formal services that better meet the needs of the urban poor. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

Socio-demographic, environmental and caring risk factors for childhood drowning deaths in Bangladesh.

PubMed

Hossain, Mosharaf; Mani, Kulanthayan K C; Sidik, Sherina Mohd; Hayati, K S; Rahman, A K M Fazlur

2015-09-10

Drowning contributes to incapacity and early death in many countries. In low- and middle-income countries, children are the most susceptible to fatalities. Over 50 % of the global drowning deaths occur among children aged under 15 years old with children aged between 1 and 4 years of age being most at risk. In Bangladesh, drowning rates are 10 to 20 times more than those in other developing countries. The object of this study is to determine the socio-demographic, environmental and caring hazard issues for child drowning in Bangladesh. A case-control study was conducted, with data collected from the Bangladesh Health and Injury Survey (BHIS) to identify the social-demographic and environmental factors associated with childhood drowning. The participants represented 171,366 households from seven divisions of Bangladesh-Dhaka, Rajshahi, Chittagong, Barisal, Sylhet, Khulna and Rangpur. The survey was conducted between January and December of 2003. A total of 141 children drowning were identified in the year preceding the survey. Data were analysed using descriptive statistics and logistic regression analysis. The odds ratios with 95% CI intervals were estimated for various associated factors for child drowning deaths. In Bangladesh, in 2003, the incidence of drowning deaths was 104.8 per 100,000 among those aged less than 5 years; 168.7 per 100,000 in rural areas; male 32.4 per 100,000; 112.7 per 100,000 between 10:00 a.m. and 2:00 p.m.; and cannot swim 134.9 per 100,000. The socio-demographic danger factors for child drowning deaths were: being male (OR = 1.45, 95% CI = 1.34-1.78), aged less than 5 years (OR = 2.89, 95% CI = 1.89-3.11), urban areas (OR = 0.67, 95% CI = 0.67-1.87), and mother being illiterate (OR = 1.69, 95% CI = 1.01-2.81). Significant environmental and caring factors included mother/caregiver not being the accompanying person (OR = 25.4, 95% CI = 14.4-45.3) and children cannot swim (OR = 4.5, 95% CI = 1.25-19.4). Drowning is the single largest reason for the mortality of children aged less than five years. There is a need to educate Bangladeshi parents and encourage behavioural change concerning supervision. The Government should use mass media to raise awareness about drowning among the community with a focus on rural areas. Policies should focus on increasing supervision by mothers/care persons, swimming skills, and should target illiterate mothers. Therefore, there is an immediate need for the Bangladeshi Government to address the problem of drowning.

Development of community based curriculum on ophthalmology for under graduate medical course in Bangladesh.

PubMed

Khan, A K; Hussain, A Z M I

2012-08-01

The curriculum represents the expression of educational ideas in practice. Ophthalmic education is the corner stone to improve eye care globally. Curriculum needs continuous modification varying in different geographic locations. Though 90% of common conditions are either preventable or curable but emphasis on the common conditions is inadequate. This is a stepwise descriptive study aiming to develop a community based ophthalmology curriculum for undergraduate medical course in Bangladesh conducted during March 2007 to February 2008 at UniSA School of Public Health and Life Sciences, University of South Asia, Banani, Dhaka. Delphi technique, a modified qualitative method was used to accumulate data and reaching a consensus opinion for developing the curriculum. Study approach includes two iterative rounds and finally a workshop. Iteration of round-I was "What are the eye diseases with overall knowledge of their management one MBBS physician should acquire"; followed by a list of eye diseases and topics for expert opinion. The response was collated. Iteration round-II was "How much a MBBS student should have percentage of knowledge, attitude and skills on each topic while being taught". The response was collated and presented to panel of expert ophthalmologists for discussion and validation. In the round-I Delphi, 400 (62%) out to total 641 ophthalmologist were randomly selected dividing in categories (62% in each) of Professor-22, Associate Professor-12, Assistant Professor-26, Consultant-27, ophthalmologists working in NGO-56 and ophthalmologists in private sector-257. Sixty (15%) responded with opinion. In the round-II, 200 (31%) including 60 of round-I, selected randomly but proportionately as before. Forty five (22.5%) responded with opinion. Result collated. The results and opinion of respondents were presented at a workshop attended by 24 (80%), out of 30 invited expert ophthalmic specialists for discussion, criticism, opinion, addition, modification and finally for validation. On the basis of the opinion of the respondents, reviewing literature, analyzing the ocular disease pattern in Bangladesh and also analyzing the present ophthalmology curriculum, a community and need based ophthalmology curriculum for undergraduate medical course in Bangladesh was developed. This research would help developing community and need based ophthalmology curriculum for undergraduate medical course in Bangladesh.

Understanding the Unusual 2017 Monsoon and Floods in South Asia

NASA Astrophysics Data System (ADS)

Akanda, A. S.; Palash, W.; Hasan, M. A.; Nusrat, F.

2017-12-01

Driven primarily by the South Asian Monsoon, the Ganges-Brahmaputra-Meghna (GBM) river basin system collectively drains intense precipitation for an area of more than 1.5 million square kilometers during the wet summer season. Bangladesh, being the lowest riparian country in the system, experiences recurrent floods and immense suffering to its population. The 2017 monsoon season was quite unusual in terms of the characteristics of the precipitation received in the basin. The monsoon was spread out over a much larger time span (April-October) compared to the average monsoon season (June-September). Although the monsoon does not typically start until June in Bangladesh, the 2017 season started much earlier in April with unusually heavy precipitation in the Meghna basin region and caused major damage to agriculture in northeastern Bangladesh. The rainfall continued in several record-breaking pulses, compared to the typical one or two large waves. One of the largest pulses occurred in early August with very high in intensity and volume, causing ECMWF to issue a major warning about widespread flooding in Bangladesh, Northern India, and Eastern Nepal. This record flood event impacted over 40 million people in the above regions, causing major damage to life and infrastructure. Although the Brahmaputra rose above the danger level several times this season, the Ganges was unusually low, thus sparing downstream areas from disastrous floods. However, heavy precipitation continued until October, causing urban flooding in Dhaka and Chittagong - and worsening sanitation and public health conditions in southern Bangladesh - currently undergoing a terrible humanitarian crisis involving Rohingya refugees from the Myanmar. Despite marked improvement in flood forecasting systems in recent years, the 2017 floods identified critical gaps in our understanding of the flooding phenomena and limitations of dissemination in these regions. In this study, we investigate 1) the unusual characteristics of the 2017 season, 2) the nature of the floods in northern areas and the Teesta basin region, 3) the performance of rainfall and flood forecasts, 4) the stark difference in Ganges and Brahmaputra basin rainfall, and 5) corresponding relations to known teleconnections such as ENSO and other climate phenomena.

Neonatal Transport - Experience of a Tertiary Care Hospital of Bangladesh.

PubMed

Dey, S K; Sharker, S; Jahan, I; Moni, S C; Shabuj, K H; Chisti, M J; Mannan, M A; Shahidullah, M

2017-01-01

Safe transportation is mostly an unnoticed neonatal health issue in Bangladesh and no documentation is available regarding the existing practices. So this study was intended to document transport status of the referred newborn to a tertiary care hospital. This observational study included 150 out born neonates over 12 months period transported from various places to NICU, Bangabandhu Sheikh Mujib Medical University (BSMMU) from May 2015 to April 2016. A structured data collection form was used to record information categorized into pre-transport, during transport and at admission. At admission detailed clinical assessment of the baby was done and recorded. Outcome was determined as discharge or death. Of 150 transported neonates, two-third were preterm 115(77%) & LBW 113(75%). Common indications for referral were prematurity and sepsis. Most of the patients were referred from private hospital 107(71%). Majority of newborns (86%) were referred from hospitals of Dhaka city while only 14% were referred from outside Dhaka. Referral notes were supplied in most of the cases 134(89%) but comprehensive information was obtainable only in 3 cases. Although main transport vehicle was ambulance 130(87%), medical personnel accompanied the sick baby only in 6(4%) of cases. The distance traveled was less than 10 kilometers (kms) in 95(63%) and more than 100 km in 10(7%) of enrolled neonates. Transport time was less than 1 hour in 72(48%), 1-6 hours in 66(44%) and more than 6 hours in 12(8%) of cases. Nearly two third of newborn were transported after office period, 107(72%). At admission 21(14%) babies had hypothermia, 8(7.62%) hypoglycemia, 16(11%), poor perfusion 28(19%), low saturation 27(18%). Hyperthermia & hyperglycemia were observed in 8(5%) & 7(5%) cases respectively. Of the total 150 babies referred, 17(11%) died. While comparing with discharged newborn, died newborn were more frequent sufferer of hypothermia (p value 0.007) and low saturation (p value 0.049) at admission. Premature, low birth weight and sick newborns are being transported despite lack of safe transport system.

Overview of a multi-stakeholder dialogue around Shared Services for Health: the Digital Health Opportunity in Bangladesh.

PubMed

Ashraf, Sania; Moore, Carolyn; Gupta, Vaibhav; Chowdhury, Anir; Azad, Abul K; Singh, Neelu; Hagan, David; Labrique, Alain B

2015-12-09

National level policymaking and implementation includes multiple stakeholders with varied interests and priorities. Multi-stakeholder dialogues (MSDs) can facilitate consensus building through collective identification of challenges, recognition of shared goals and interests, and creation of solution pathways. This can shape joint planning and implementation for long-term efficiency in health and other sectors. Scaling up the effective use of information and communication technologies (ICTs) requires cohesive strategic planning towards a shared goal. In Bangladesh, the government and partners convened an MSD in March 2015 to increase stakeholder engagement in policymaking and implementation of a national ICT or electronic or mobile health (eHealth or mHealth) strategy, which seeks to incorporate ICTs into the national health system, aligning with the Digital Bangladesh Vision 2021. Relevant stakeholders were identified and key priorities and challenges were mapped through key informant interviews. An MSD was conducted with key stakeholders in Dhaka, Bangladesh. The MSD included presentations, group option generation, agreement and prioritization of barriers to scaling up ICTs. The MSD approach to building consensus on key priorities highlights the value of dialogue and collaboration with relevant stakeholders to encourage country ownership of nationwide efforts such as ICT scale-up. This MSD showed the dynamic context in which stakeholders operate, including those from academia, donors and foundations, healthcare professionals, associations, multilateral organizations, non-governmental organizations, partner countries and the private sector. Through this MSD, participants improved understanding of each other's contributions and interests, identified existing relationships, and agreed on policy and implementation gaps that needed to be filled. Collaboration among stakeholders in ICT efforts and research can promote a cohesive approach to scaling up, as well as improve policymaking by integrating interests and feedback of different key cross sectoral actors. MSDs can align stakeholders to identify challenges and solution pathways, and lead to coordinated action and accountability for resources and results. In addition, the MSD template and approach has been useful to guide ICT scale up in Bangladesh and could be replicated in other contexts to facilitate multi-constituency, multi-sector collaboration.

Increased childhood morbidity after measles is short-term in urban Bangladesh.

PubMed

Akramuzzaman, S M; Cutts, F T; Wheeler, J G; Hossain, M J

2000-04-01

In a 1995-1996 cohort study in the city of Dhaka, Bangladesh, morbidity in 117 hospitalized and 137 acute measles cases compared with age-matched children without measles (unexposed) was determined by weekly interview for 6 months. Compared with unexposed children, there were higher incidences of hospitalization (adjusted rate ratio (RR) = 3.1, 95% confidence interval (CI): 1.3, 7.6) and bloody diarrhea (adjusted RR = 2.7, 95% CI: 1.4, 5.1) in hospital measles cases during the 6 weeks after recruitment. Among community cohorts, there were higher incidences of bloody diarrhea (adjusted RR = 4.1, 95% CI: 1.1, 14.6), watery diarrhea (adjusted RR = 1.6, 95% CI: 0.9, 2.7), fast breathing (adjusted RR = 3.8, 95% CI: 2.1, 6.9), and the weekly point prevalence of pneumonia (adjusted prevalence ratio = 3.1, 95% CI: 1.0, 9.8) in measles cases during the same period. All measles cases regained lost weight within about 6 weeks. The prevalence of anergy to seven recall antigens 6 weeks after recruitment was higher in both hospital (adjusted odds ratio = 2.8, 95% CI: 1.2, 6.4) and community (adjusted odds ratio = 3.1, 95% CI: 1.1, 8.9) measles cases. Morbidity increased during the first 6-8 weeks after measles, but the authors found no consistent evidence of longer-term morbidity or wasting. The results support recent findings that measles is not associated with increased delayed mortality.

An assessment of risk behaviours to HIV/AIDS vulnerability among young female garment workers in Bangladesh.

PubMed

Sayem, A; Popsci, M

2010-02-01

This study attempted to assess the risk behaviours for HIV/AIDS among female garment workers aged 15-24 years.A total of 300 garment workers in Dhaka city were assessed with a semi-structured interview. Their knowledge of HIV/AIDS was moderate with high rates of misperception regarding modes of transmission. Further, symptoms of possible sexually transmitted infections (STIs) such as genital ulcer disease and vaginal discharge were prevalent, and risk behaviours such as low use of condoms, multiple sex partners and drug abuse were also found. Logistic regression identified that women who sourced information through radio/television, health service providers or friends had higher age at first intercourse and higher HIV/AIDS knowledge scores and were more likely to use condoms. Those who gained information through radio/television or health service providers and those who abused drugs were more likely to have sex with multiple sex partners, while information gained through health service providers, and higher HIV/AIDS knowledge were protective against drug abuse, whereas sex with multiple partners was a predictor of drug abuse. We conclude that in Bangladesh, female garment workers are at risk of HIV/AIDS due to low education, lack of knowledge, STIs and risky behaviour.

Quantifying the Impact of Natural Immunity on Rotavirus Vaccine Efficacy Estimates: A Clinical Trial in Dhaka, Bangladesh (PROVIDE) and a Simulation Study.

PubMed

Rogawski, Elizabeth T; Platts-Mills, James A; Colgate, E Ross; Haque, Rashidul; Zaman, K; Petri, William A; Kirkpatrick, Beth D

2018-03-05

The low efficacy of rotavirus vaccines in clinical trials performed in low-resource settings may be partially explained by acquired immunity from natural exposure, especially in settings with high disease incidence. In a clinical trial of monovalent rotavirus vaccine in Bangladesh, we compared the original per-protocol efficacy estimate to efficacy derived from a recurrent events survival model in which children were considered naturally exposed and potentially immune after their first rotavirus diarrhea (RVD) episode. We then simulated trial cohorts to estimate the expected impact of prior exposure on efficacy estimates for varying rotavirus incidence rates and vaccine efficacies. Accounting for natural immunity increased the per-protocol vaccine efficacy estimate against severe RVD from 63.1% (95% confidence interval [CI], 33.0%-79.7%) to 70.2% (95% CI, 44.5%-84.0%) in the postvaccination period, and original year 2 efficacy was underestimated by 14%. The simulations demonstrated that this expected impact increases linearly with RVD incidence, will be greatest for vaccine efficacies near 50%, and can reach 20% in settings with high incidence and low efficacy. High rotavirus incidence leads to predictably lower vaccine efficacy estimates due to the acquisition of natural immunity in unvaccinated children, and this phenomenon should be considered when comparing efficacy estimates across settings. NCT01375647.

Work, gender roles, and health: neglected mental health issues among female workers in the ready-made garment industry in Bangladesh

PubMed Central

Akhter, Sadika; Rutherford, Shannon; Akhter Kumkum, Feroza; Bromwich, David; Anwar, Iqbal; Rahman, Aminur; Chu, Cordia

2017-01-01

Background Traditionally, women in Bangladesh stayed at home in their role as daughter, wife, or mother. In the 1980s, economic reforms created a job market for poor, uneducated rural women in the ready-made garment industry, mostly located in urban areas. This increased participation in paid work has changed the gender roles of these women. Women’s earnings support their family, but they are also separated from their children, with impacts on their mental health and well-being. This study explores the lived experience of women in Bangladesh working in the ready-made garment industry as they strive to be mothers and family providers, often in high-stress conditions. Methods The study was conducted in two industrial areas of Dhaka over 8 months. Data collection included a literature review, 20 in-depth interviews with married female garment workers, and 14 key-informant interviews with officials from the Ministry of Labour and Employment, health-service providers within the garment factories, factory managers, and representatives of the Bangladesh Garment Manufacturers and Exporters Association. The data collected were analyzed thematically. Results Poverty was a key motivating factor for female migrant workers to move from rural areas. Their children stay in their village with their grandparents, because of their mothers’ work conditions and the lack of childcare. The women reported stress, anxiety, restlessness, and thoughts of suicide, due to the double burden of work and separation from their children and family support. Further, they cannot easily access government hospital services due to their long work hours, and the limited medical services provided in the workplace do not meet their needs. Conclusion In order to improve the health and well-being of female garment workers, steps should be taken to develop health interventions to meet the needs of this important group of workers who are contributing significantly to the economic development of the country. PMID:28860866

Present scenario of landing and distribution of fish in Bangladesh.

PubMed

Rahman, M; Khatun, S; Hossain, M B; Hassan, M N; Nowsad, A A K M

2013-11-15

The present study was designed to know the landing and distribution pathways of fish and types and nature of stakeholders involved in fish distribution chain in Bangladesh. A total of 237 fish landing centers and 5440 markets were detected. The number of landing center and market were highest in Chittagong and Dhaka division respectively. Stakeholders in fish distribution, viz., arotdars, paikers and retailers were found to be 6219, 39506 and 122922, respectively. A 84.71% of the landing centers were found to be operated year round while 15.29% were seasonal. The major fish production zones and major gateways of the country where inland capture and culture and marine capture fish landed were identified. In any locality 62.83% of the landed fish were transported within 100 km area and 5.73% of fish were transported beyond 500 km. The quantity of fish harvested from river, beel, Kaptai lake floodplain, pond, baor, coastal area/sea and shrimp/prawn farm were 5.25, 4.41, 0.13, 35.03, 38.22, 0.23, 10.93 and 5.80%, respectively. The common constraints identified were lack of adequate infrastructure facilities in the landing center and market, unhygienic environment, influence of middlemen, money lending at high rate etc. For the betterment of fish landing and distribution, appropriate authority should pay proper attention so that both quality and fair price are ensured.

Management of acid burns: experience from Bangladesh.

PubMed

Das, Kishore Kumar; Olga, Loren; Peck, Michael; Morselli, Paolo G; Salek, A J M

2015-05-01

Acid burn injuries in Bangladesh primarily occur as a result of intentional attacks although there are incidences of accidental acid burns in industry, on the street, and at home. A total of 126 patients with acid burns, 95 from attacks and 31 from accidents, were studied from July 2004 to December 2012. A diagnosis of acid burn was made from history, physical examination and in some cases from chemical analysis of the patients' clothing. Alkali burns were excluded from the study. In the burn unit of Dhaka Medical College Hospital, we applied a slightly different protocol for management of acid burns, beginning with plain water irrigation of the wound, which effectively reduced burn depth and the requirement of surgical treatment. Application of hydrocolloid dressing for 48-72 h helped with the assessment of depth and the course of treatment. Early excision and grafting gives good results but resultant acid trickling creates a marble cake-like appearance of the wound separated by the vital skin. Excision with a scalpel and direct stitching of the wounds are often a good option. Observation of patients on follow-up revealed that wounds showed a tendency for hypertrophy. Application of pressure garments and other scar treatments were given in all cases unless the burn was highly superficial. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Association between depression and diabetes amongst adults in Bangladesh: a hospital based case–control study

PubMed Central

Islam, Sheikh Mohammed Shariful; Ferrari, Uta; Seissler, Jochen; Niessen, Louis; Lechner, Andreas

2015-01-01

Methods A matched case–control study was conducted among 591 consecutive patients with diabetes attending a tertiary hospital in Dhaka and 591 controls matched for age, sex and area of residence without diabetes not related with the index–case. Depression was measured using the Patient Health Questionnaire–9. Multivariate logistic regression was performed to examine the association between depression and diabetes. Results The mean age (±standard deviation) of the participants was 50.4 ± 11.4 years, with a male to female ratio of 43:57. The prevalence of depression was 45.2% and 19.8% among cases and controls, respectively. In the multivariate analysis, mild as well as moderate to severe depression were significantly associated with diabetes and independent of sociodemographic factors and co–morbidity (adjusted odds ratio (OR) = 2.0, 95% confidence interval (CI) = 1.4–2.9 and adjusted OR = 6.4, 95% CI = 3.4–12.3; P < 0.001 for both). Conclusion The high prevalence and strong association of depression in individuals with diabetes in Bangladesh suggests that depression should be routinely screened for patients with diabetes at the clinics and that management strategies adequate for resource–poor settings need to be developed. Further research to determine the pathophysiological role of depression in the development of diabetes is merited. PMID:26649173

One Solution to the Arsenic Problem: A Return to Surface (Improved Dug) Wells

PubMed Central

Joya, Sakila Afroz; Mostofa, Golam; Yousuf, Jabed; Islam, Ariful; Elahi, Altab; Mahiuddin, Golam; Rahman, Mahmuder; Quamruzzaman, Quazi

2006-01-01

Arsenic contamination in drinking-water in Bangladesh is a major catastrophe, the consequences of which exceed most other man-made disasters. The national policy encourages the use of surface water as much as possible without encountering the problems of sanitation that led to the use of groundwater in the first place. This paper describes the success of the Dhaka Community Hospital (DCH) team and the procedure in implementing sanitary, arsenic-free, dugwells. The capital cost for running water is US$ 5–6 per person. Sixty-six sanitary dugwells were installed in phases between 2000 and 2004 in Pabna district of Bangladesh where there was a great need of safe water because, in some villages, 90% of tubewells were highly contaminated with arsenic. In total, 1,549 families now have access to safe arsenic-free dugwell water. Some of them have a water-pipe up to their kitchen. All of these were implemented with active participation of community members. They also pay for water-use and are themselves responsible for the maintenance and water quality. The DCH helped the community with installation and maintenance protocol and also with monitoring water quality. The bacteria levels are low but not always zero, and studies are in progress to reduce bacteria by chlorination. PMID:17366778

Feasibility and effectiveness of oral cholera vaccine in an urban endemic setting in Bangladesh: a cluster randomised open-label trial.

PubMed

Qadri, Firdausi; Ali, Mohammad; Chowdhury, Fahima; Khan, Ashraful Islam; Saha, Amit; Khan, Iqbal Ansary; Begum, Yasmin A; Bhuiyan, Taufiqur R; Chowdhury, Mohiul Islam; Uddin, Md Jasim; Khan, Jahangir A M; Chowdhury, Atique Iqbal; Rahman, Anisur; Siddique, Shah Alam; Asaduzzaman, Muhammad; Akter, Afroza; Khan, Arifuzzaman; Ae You, Young; Siddik, Ashraf Uddin; Saha, Nirod Chandra; Kabir, Alamgir; Riaz, Baizid Khoorshid; Biswas, Shwapon Kumar; Begum, Farzana; Unicomb, Leanne; Luby, Stephen P; Cravioto, Alejandro; Clemens, John D

2015-10-03

Cholera is endemic in Bangladesh with epidemics occurring each year. The decision to use a cheap oral killed whole-cell cholera vaccine to control the disease depends on the feasibility and effectiveness of vaccination when delivered in a public health setting. We therefore assessed the feasibility and protective effect of delivering such a vaccine through routine government services in urban Bangladesh and evaluated the benefit of adding behavioural interventions to encourage safe drinking water and hand washing to vaccination in this setting. We did this cluster-randomised open-label trial in Dhaka, Bangladesh. We randomly assigned 90 clusters (1:1:1) to vaccination only, vaccination and behavioural change, or no intervention. The primary outcome was overall protective effectiveness, assessed as the risk of severely dehydrating cholera during 2 years after vaccination for all individuals present at time of the second dose. This study is registered with ClinicalTrials.gov, number NCT01339845. Of 268,896 people present at baseline, we analysed 267,270: 94,675 assigned to vaccination only, 92,539 assigned to vaccination and behavioural change, and 80,056 assigned to non-intervention. Vaccine coverage was 65% in the vaccination only group and 66% in the vaccination and behavioural change group. Overall protective effectiveness was 37% (95% CI lower bound 18%; p=0·002) in the vaccination group and 45% (95% CI lower bound 24%; p=0·001) in the vaccination and behavioural change group. We recorded no vaccine-related serious adverse events. Our findings provide the first indication of the effect of delivering an oral killed whole-cell cholera vaccine to poor urban populations with endemic cholera using routine government services and will help policy makers to formulate vaccination strategies to reduce the burden of severely dehydrating cholera in such populations. Bill & Melinda Gates Foundation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Female labour force status and fertility behaviour in Bangladesh: search for policy interventions.

PubMed

Chaudhury, R H

1983-09-01

This paper examines the effect of female labor force participation on fertility behavior because of its immediate relevance to the formulation of small family norm policies. The hypothesis that female employment is inversely related to fertility and positively related to contraceptive use is based on the following assumptions: 1) the satisfactions of outside employment can substitute for those of child rearing; 2) employment delays marriage and increases the probability of women remaining single, thus reducing fertility; 3) every additional child increases the "opportunity cost" (income lost) of a working mother; 4) a working wife has more status with her husband, and the resultant improved spousal communication leads to more contraceptive use; and 5) working women do not have to rely on their children for support in their old age. Using data from various rural and urban surveys of women in Bangladesh (mostly in Dhaka) and data from the 1961 Bangladesh Population Census, the author finds that fertility is reduced and contraceptive use increases for poor and illiterate women if they work outside the home, but employment has no effect on fertility for higher educated women, who have comparatively fewer children to begin with. In Java, Indonesia, it was found that poor working women have the lowest fertility compared to any other higher socioeconomic group. In Thailand, too, it was found that women who worked outside the home and who had modern values had significantly fewer children than other women. Evaluations of income generating programs for women in Bangladesh attest to the fertility lowering success of integrating family planning and health services with employment programs. Employment through these cooperatives has also indirectly lowered fertility by leading to longer birth spacing and marriage delays. The author recommends such integrated programs and cooperatives because they enhance the social and economic status of women, and by doing so, modernize the entire village. Before the programs are expanded, a cost-benefit analysis of them should be undertaken.

Indoor air pollution and the health of children in biomass- and fossil-fuel users of Bangladesh: situation in two different seasons.

PubMed

Khalequzzaman, Md; Kamijima, Michihiro; Sakai, Kiyoshi; Hoque, Bilqis Amin; Nakajima, Tamie

2010-07-01

Indoor air pollution levels are reported to be higher with biomass fuel, and a number of respiratory diseases in children are associated with pollution from burning such fuel. However, little is known about the situation in developing countries. The aim of the study was to compare indoor air pollution levels and prevalence of symptoms in children between biomass- and fossil-fuel-using households in different seasons in Bangladesh. We conducted a cross-sectional study among biomass- (n = 42) and fossil-fuel (n = 66) users having children <5 years in Moulvibazar and Dhaka, Bangladesh. Health-related information of one child from each family was retrieved once in winter (January 2008) and once in summer (June 2008). The measured pollutants were carbon monoxide (CO), carbon dioxide (CO(2)), dust particles, volatile organic compounds (VOCs), and nitrogen dioxide. Mean concentration of dust particles and geometric mean concentrations of VOCs such as benzene, toluene, and xylene, which were significantly higher in biomass- than fossil-fuel-users' kitchens (p < 0.05), were significantly higher in winter than in summer (p < 0.05). Levels of CO and CO(2), which were significantly higher in biomass than fossil-fuel users (p < 0.05), were significantly higher in summer than winter (p < 0.05). However, no significant difference was found in the occurrence of symptoms between biomass- and fossil-fuel users either in winter or in summer. It was suggested that the measured indoor air pollution did not directly result in symptoms among children. Other factors may be involved.

Mobile-health tool to improve maternal and neonatal health care in Bangladesh: a cluster randomized controlled trial.

PubMed

Tobe, Ruoyan Gai; Haque, Syed Emdadul; Ikegami, Kiyoko; Mori, Rintaro

2018-04-16

In Bangladesh, the targets on reduction of maternal mortality and utilization of related obstetric services provided by skilled health personnel in Millennium Development Goals 5 remains unmet, and the progress in reduction of neonatal mortality lag behind that in the reduction of infant and under-five mortalities, remaining as an essential issue towards the achievement of maternal and neonatal health targets in health related Sustainable Development Goals (SDGs). As access to appropriate perinatal care is crucial to reduce maternal and neonatal deaths, recently several mobile platform-based health programs sponsored by donor countries and Non-Governmental Organizations have targeted to reduce maternal and child mortality. On the other hand, good health-care is necessary for the development. Thus, we designed this implementation research to improve maternal and child health care for targeting SDGs. This cluster randomized trial will be conducted in Lohagora of Narail District and Dhamrai of Dhaka District. Participants are pregnant women in the respective areas. The total sample size is 3000 where 500 pregnant women will get Mother and Child Handbook (MCH) and messages using mobile phone on health care during pregnancy and antenatal care about one year in each area. The other 500 in each area will get health education using only MCH book. The rest 1000 participants will be controlled; it means 500 in each area. We randomly assigned the intervention and controlled area based on smallest administrative area (Unions) in Bangladesh. The data collection and health education will be provided through trained research officers starting from February 2017 to August 2018. Each health education session is conducting in their house. The study proposal was reviewed and approved by NCCD, Japan and Bangladesh Medical Research Council (BMRC), Bangladesh. The data will be analyzed using STATA and SPSS software. For the improvement of maternal and neonatal care, this community-based intervention using mobile phone and handbook will do great contribution. Thus, a developing country where resources are limited received the highest benefit. Such intervention will guide to design for prevention of other diseases too. UMIN000025628 Registered June 13, 2016.

Urban Cholera and Water Sustainability Challenges under Climatic and Anthropogenic Change

NASA Astrophysics Data System (ADS)

Akanda, A. S.; Jutla, A.; Huq, A.; Faruque, A. G.; Colwell, R. R.

2013-12-01

The last three decades of surveillance data shows a drastic increase of cholera prevalence in the largest cholera-endemic city of the world - Dhaka, Bangladesh. Emerging megacities in the developing world, especially those located in coastal regions of the tropics remain vulnerable to similar. However, there has not been any systematic study on linking the long-term disease trends with changes in related climatic, environmental, or societal variables. Here, we analyze the 30-year dynamics of urban cholera prevalence in Dhaka with changes in climatic or societal factors: regional hydrology, flooding, water usage, changes in distribution systems, population growth and density in urban settlements, as well as shifting climate patterns. An interesting change is observed in the seasonal trends of cholera incidence; while an endemic upward trend is seen in the dry season, the post-monsoon trend seem to be more epidemic in nature. Evidence points to growing urbanization and rising population in unplanned settlements that have negligible to poor water and sanitation systems compounded by increasing frequency of record flood events. Growing water scarcity in the dry season and lack of sustainable water and sanitation infrastructure for urban settlements have increased endemicity of spring outbreaks, while record flood events and prolonged post-monsoon inundation have contributed to increased epidemic outbreaks in fall. We analyze our findings with the World Health Organization recommended guidelines and investigate water sustainability challenges in the context of climatic and anthropogenic changes in the region.

Acceptability and Feasibility of Sharing a Soapy Water System for Handwashing in a Low-Income Urban Community in Dhaka, Bangladesh: A Qualitative Study.

PubMed

Sultana, Farhana; Unicomb, Leanne E; Nizame, Fosiul A; Dutta, Notan Chandra; Ram, Pavani K; Luby, Stephen P; Winch, Peter J

2018-06-11

Handwashing with soap at key times is an effective means of reducing pathogen transmission. In a low-income community in urban Dhaka, we piloted and evaluated the acceptability and feasibility of a shared handwashing intervention. This included promotion by community health promoters of a homemade solution of detergent powder mixed with water and stored in a 1.5-L reclaimed mineral water bottle. Community health promoters encouraged sharing of the recurrent detergent cost among compound members. Of 152 participating compounds, fieldworkers randomly selected 60 for qualitative assessment. Fieldworkers conducted 30 in-depth interviews and five focus group discussions among purposively selected compound members. The reclaimed bottles served as an easily accessible dispenser for the soapy water, which could feasibly be retained next to the toilet and kitchen areas for communal use. Bottles functioned as a positive reminder for handwashing at recommended key times. Most compounds (45/60, 75%) shared a common soapy water system and its associated costs. There was reluctance to prepare soapy water for shared use in the remaining 25%. Soapy water was an acceptable hand cleaning agent, with the bottle as a feasible dispenser. It was simple in design, cost-effective, replicable, popular with intervention recipient, and neighboring nonrecipients, and commonly shared among nonrelated households. The need to share expenses and product preparation served as a barrier. Developing a sustainable maintenance system, therefore, is critical to ensuring the public health benefits of handwashing with soap.

Application of Satellite Remote Sensing to Identify Climatic and Anthropogenic Changes Related to Water and Health Conditions in Emerging Megacities

NASA Astrophysics Data System (ADS)

Akanda, A. S.; Serman, E. A.; Jutla, A.

2014-12-01

By 2050, more than 70% of the world's population is expected to be living in a city. In many of the urbanizing regions in Asia and Africa, most new development is taking place without adequate urban or regional planning, and a majority population is crowded into densely populated unplanned settlements, also known as slums. During the same period, precipitation and temperature patterns are likely to see significant changes in many of these regions while coastal megacities will have to accommodate sea-level rise in their ecosystems. The rapid increase in population is usually observed in fringes of the urban sprawl without adequate water or sanitation facilities or access to other municipal amenities (such as utilities, healthcare, and education). Collectively, these issues make the ever increasing slum dwellers in emerging megacities significantly vulnerable to a combination of climatic and anthropogenic threats. However, how the growth of unplanned urban and peri-urban sprawl and simultaneous change in climatic patterns have impacted public health in the emerging megacities remain largely unexplored due to lack of readily available and usable data. We employ a number of Remote Sensing products (GRACE, LANDSAT, MODIS) to bridge above knowledge gaps and to identify relevant hydrologic and anthropogenic changes in emerging megacities that are most vulnerable due to the climate-water-health nexus. We explore one of the largest and the fastest growing megacities in the world - Dhaka, Bangladesh - on identifying and investigating the changes in the water environment and growth of slum areas, and impact on water services and health outcomes. The hydroclimatology of South Asia is highly seasonal and the asymmetric availability of water affects vast areas of Bangladesh differently in space and time, exposing the population of Dhaka region to both droughts and floods and periodic spring-fall outbreaks of diarrheal diseases, such as cholera and rotavirus. This research focuses on stretching this understanding to water and health implications in this growing megacity and adjoining slum areas, and how satellite remote sensing data products and derived knowledge can inform urban planning, water management, and public health sectors to adapt to these climatic and anthropogenic changes for the benefit of societies.

Modelling typhoid risk in Dhaka Metropolitan Area of Bangladesh: the role of socio-economic and environmental factors

PubMed Central

2013-01-01

Background Developing countries in South Asia, such as Bangladesh, bear a disproportionate burden of diarrhoeal diseases such as Cholera, Typhoid and Paratyphoid. These seem to be aggravated by a number of social and environmental factors such as lack of access to safe drinking water, overcrowdedness and poor hygiene brought about by poverty. Some socioeconomic data can be obtained from census data whilst others are more difficult to elucidate. This study considers a range of both census data and spatial data from other sources, including remote sensing, as potential predictors of typhoid risk. Typhoid data are aggregated from hospital admission records for the period from 2005 to 2009. The spatial and statistical structures of the data are analysed and Principal Axis Factoring is used to reduce the degree of co-linearity in the data. The resulting factors are combined into a Quality of Life index, which in turn is used in a regression model of typhoid occurrence and risk. Results The three Principal Factors used together explain 87% of the variance in the initial candidate predictors, which eminently qualifies them for use as a set of uncorrelated explanatory variables in a linear regression model. Initial regression result using Ordinary Least Squares (OLS) were disappointing, this was explainable by analysis of the spatial autocorrelation inherent in the Principal factors. The use of Geographically Weighted Regression caused a considerable increase in the predictive power of regressions based on these factors. The best prediction, determined by analysis of the Akaike Information Criterion (AIC) was found when the three factors were combined into a quality of life index, using a method previously published by others, and had a coefficient of determination of 73%. Conclusions The typhoid occurrence/risk prediction equation was used to develop the first risk map showing areas of Dhaka Metropolitan Area whose inhabitants are at greater or lesser risk of typhoid infection. This, coupled with seasonal information on typhoid incidence also reported in this paper, has the potential to advise public health professionals on developing prevention strategies such as targeted vaccination. PMID:23497202

Factors associated with knowledge about breastfeeding among female garment workers in Dhaka city.

PubMed

Afrose, Lucen; Banu, Bilkis; Ahmed, Kazi R; Khanom, Khurshida

2012-01-01

Knowledge about breastfeeding among women is very important for healthy children. The present study aims to determine the level of knowledge and factors associated with knowledge on breastfeeding among female garment workers in a selected garment factory in Dhaka city. A cross-sectional study was conducted among 200 female garment workers in the reproductive age group (15-49 years). Data were collected through a pre-tested questionnaire using the face-to-face interview method. Bivariate and multivariate analysis was done to determine the association between sociodemographic variables and knowledge on breastfeeding. The study showed that, overall the level of knowledge regarding breastfeeding is very poor (88%) among the study subjects. Most of the respondents have very poor knowledge regarding advantages of exclusive breastfeeding (89%) and breastfeeding (100%). In contrast, a majority have good knowledge on duration of exclusive breastfeeding (74%) and breastfeeding (66%). No significant association was found between the knowledge score of breastfeeding with remaining socio-demographic variables like age, marital status, family income and expenditure. Education is significantly (p<0.001) associated with a higher total knowledge score of breastfeeding. Women with secondary level of education had a significantly higher (p<0.001) level of total knowledge score than other categories (illiterate, primary and higher secondary) of education. A large proportion of female garment workers had inadequate knowledge regarding breastfeeding. It is also important that health education on breastfeeding is urgently provided to the female garments workers of Bangladesh.

Work, gender roles, and health: neglected mental health issues among female workers in the ready-made garment industry in Bangladesh.

PubMed

Akhter, Sadika; Rutherford, Shannon; Akhter Kumkum, Feroza; Bromwich, David; Anwar, Iqbal; Rahman, Aminur; Chu, Cordia

2017-01-01

Traditionally, women in Bangladesh stayed at home in their role as daughter, wife, or mother. In the 1980s, economic reforms created a job market for poor, uneducated rural women in the ready-made garment industry, mostly located in urban areas. This increased participation in paid work has changed the gender roles of these women. Women's earnings support their family, but they are also separated from their children, with impacts on their mental health and well-being. This study explores the lived experience of women in Bangladesh working in the ready-made garment industry as they strive to be mothers and family providers, often in high-stress conditions. The study was conducted in two industrial areas of Dhaka over 8 months. Data collection included a literature review, 20 in-depth interviews with married female garment workers, and 14 key-informant interviews with officials from the Ministry of Labour and Employment, health-service providers within the garment factories, factory managers, and representatives of the Bangladesh Garment Manufacturers and Exporters Association. The data collected were analyzed thematically. Poverty was a key motivating factor for female migrant workers to move from rural areas. Their children stay in their village with their grandparents, because of their mothers' work conditions and the lack of childcare. The women reported stress, anxiety, restlessness, and thoughts of suicide, due to the double burden of work and separation from their children and family support. Further, they cannot easily access government hospital services due to their long work hours, and the limited medical services provided in the workplace do not meet their needs. In order to improve the health and well-being of female garment workers, steps should be taken to develop health interventions to meet the needs of this important group of workers who are contributing significantly to the economic development of the country.

Incidence and characteristics of early childhood wheezing, Dhaka, Bangladesh, 2004-2010.

PubMed

Dawood, Fatimah S; Fry, Alicia M; Goswami, Doli; Sharmeen, Amina; Nahar, Kamrun; Anjali, Bilkis Ara; Rahman, Mustafizur; Brooks, W Abdullah

2016-06-01

Early childhood wheezing substantially impacts quality of life in high-income countries, but data are sparse on early childhood wheezing in low-income countries. We estimate wheezing incidence, describe wheezing phenotypes, and explore the contribution of respiratory viral illnesses among children aged <5 years in urban Bangladesh. During 2004-2010, respiratory illness surveillance was conducted through weekly home visits. Children with fever or respiratory illness were referred for examination by study physicians including lung auscultation. During 2005-2007, every fifth referred child had nasal washes tested for human metapneumovirus, respiratory syncytial viruses, and influenza and parainfluenza viruses. During April 2004-July 2010, 23,609 children were enrolled in surveillance. Of these, 11,912 (50%) were male, median age at enrollment was 20 months (IQR 5-38), and 4,711 (20%) had ≥1 wheezing episode accounting for 8,901 episodes (733 [8%] associated with hospitalization); 25% wheezed at <1 year of age. Among children aged <5 years, incidences of wheezing and wheezing hospitalizations were 2,335/10,000 and 192/10,000 child-years. Twenty-eight percent had recurrent wheezing. Recurrent versus non-recurrent wheezing episodes were more likely to be associated with oxygen saturation <93% (OR 6.9, 95%CI 2.8-17.3), increased work of breathing (OR 1.6, 95%CI 1.4-1.8), and hospitalization (OR 2.0, 95%CI 1.6-2.4). Respiratory viruses were detected in 66% (578/873) of episodes with testing. In urban Bangladesh, early childhood wheezing is common and largely associated with respiratory virus infections. Recurrent wheezing is associated with more severe illness and may predict children who would benefit most from closer follow-up and targeted interventions. Pediatr Pulmonol. 2016;51:588-595. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Recharge of low-arsenic aquifers tapped by community wells in Araihazar, Bangladesh, inferred from environmental isotopes

PubMed Central

Mihajlov, I.; Stute, M.; Schlosser, P.; Mailloux, B. J.; Zheng, Y.; Choudhury, I.; Ahmed, K.M.; van Geen, A.

2017-01-01

More than 100,000 community wells have been installed in the 150–300 m depth range throughout Bangladesh over the past decade to provide low-arsenic drinking water (<10 μg/L As), but little is known about how aquifers tapped by these wells are recharged. Within a 25 km2 area of Bangladesh east of Dhaka, groundwater from 65 low-As wells in the 35–240 m depth range was sampled for tritium (3H), oxygen and hydrogen isotopes of water (18O/16O and 2H/1H), carbon isotope ratios in dissolved inorganic carbon (DIC, 14C/12C and 13C/12C), noble gases, and a suite of dissolved constituents, including major cations, anions, and trace elements. At shallow depths (<90 m), 24 out of 42 wells contain detectable 3H of up to 6 TU, indicating the presence of groundwater recharged within 60 years. Radiocarbon (14C) ages in DIC range from modern to 10 kyr. In the 90–240 m depth range, however, only 5 wells shallower than 150 m contain detectable 3H (<0.3 TU) and 14C ages of DIC cluster around 10 kyr. The radiogenic helium (4He) content in groundwater increases linearly across the entire range of 14C ages at a rate of 2.5×10−12 ccSTP 4He g−1 yr−1. Within the samples from depths >90 m, systematic relationships between 18O/16O, 2H/1H, 13C/12C and 14C/12C, and variations in noble gas temperatures, suggest that changes in monsoon intensity and vegetation cover occurred at the onset of the Holocene, when the sampled water was recharged. Thus, the deeper low-As aquifers remain relatively isolated from the shallow, high-As aquifer. PMID:28966406

Indoor air pollution and health of children in biomass fuel-using households of Bangladesh: comparison between urban and rural areas.

PubMed

Khalequzzaman, Md; Kamijima, Michihiro; Sakai, Kiyoshi; Ebara, Takeshi; Hoque, Bilqis Amin; Nakajima, Tamie

2011-11-01

Indoor air pollutants from biomass combustion pose a risk for respiratory diseases in children. It is plausible that distinct differences in the indoor air quality (IAQ) exist between urban and rural areas in developing countries since the living environment between these two areas are quite different. We have investigated possible differences in IAQ in urban and rural Dhaka, Bangladesh and the association of such differences with the incidence of respiratory and some non-respiratory symptoms in children of families using biomass fuel. Indoor air concentrations of carbon monoxide (CO), carbon dioxide (CO(2)), dust particles, volatile organic compounds (VOCs), and nitrogen dioxide were measured once in the winter and once in the summer of 2008. Health data on 51 urban and 51 rural children under 5 years of age from 51 families in each area were collected once a week starting in the winter and continuing to the summer of 2008. Mean concentrations of CO, CO(2,), dust particles, and major VOCs were significantly higher in urban kitchens than in rural ones (p < 0.05). The incidence rate ratio (IRR) suggests that compared to the urban children, the children in the rural area suffered significantly more from respiratory symptoms [IRR 1.63, 95% confidence interval (CI) 1.62-1.64], skin itchiness (IRR 3.3, 95% CI 1.9-5.7), and diarrhea (IRR 1.8, 95% CI 1.4-2.4), while fewer experienced fever (IRR 0.5, 95% CI 0.4-0.6). No difference was observed for other symptoms. We found lower IAQ in the homes of urban biomass fuel-users compared to rural ones in Bangladesh but could not attribute the occurrence of respiratory symptoms among children to the measured IAQ. Other factors may be involved.

Recharge of low-arsenic aquifers tapped by community wells in Araihazar, Bangladesh, inferred from environmental isotopes.

PubMed

Mihajlov, I; Stute, M; Schlosser, P; Mailloux, B J; Zheng, Y; Choudhury, I; Ahmed, K M; van Geen, A

2016-05-01

More than 100,000 community wells have been installed in the 150-300 m depth range throughout Bangladesh over the past decade to provide low-arsenic drinking water (<10 μg/L As), but little is known about how aquifers tapped by these wells are recharged. Within a 25 km 2 area of Bangladesh east of Dhaka, groundwater from 65 low-As wells in the 35-240 m depth range was sampled for tritium ( 3 H), oxygen and hydrogen isotopes of water ( 18 O/ 16 O and 2 H/ 1 H), carbon isotope ratios in dissolved inorganic carbon (DIC, 14 C/ 12 C and 13 C/ 12 C), noble gases, and a suite of dissolved constituents, including major cations, anions, and trace elements. At shallow depths (<90 m), 24 out of 42 wells contain detectable 3 H of up to 6 TU, indicating the presence of groundwater recharged within 60 years. Radiocarbon ( 14 C) ages in DIC range from modern to 10 kyr. In the 90-240 m depth range, however, only 5 wells shallower than 150 m contain detectable 3 H (<0.3 TU) and 14 C ages of DIC cluster around 10 kyr. The radiogenic helium ( 4 He) content in groundwater increases linearly across the entire range of 14 C ages at a rate of 2.5×10 -12 ccSTP 4 He g -1 yr -1 . Within the samples from depths >90 m, systematic relationships between 18 O/ 16 O, 2 H/ 1 H, 13 C/ 12 C and 14 C/ 12 C, and variations in noble gas temperatures, suggest that changes in monsoon intensity and vegetation cover occurred at the onset of the Holocene, when the sampled water was recharged. Thus, the deeper low-As aquifers remain relatively isolated from the shallow, high-As aquifer.

Characteristics and Predictors of Death among Hospitalized HIV-Infected Patients in a Low HIV Prevalence Country: Bangladesh

PubMed Central

Shahrin, Lubaba; Leung, Daniel T.; Matin, Nashaba; Pervez, Mohammed Moshtaq; Azim, Tasnim; Bardhan, Pradip Kumar

2014-01-01

Background Predictors of death in hospitalized HIV-infected patients have not been previously reported in Bangladesh. Objective The primary aim of this study was to determine predictors of death among hospitalized HIV-infected patients at a large urban hospital in Bangladesh. Methods A study was conducted in the HIV in-patient unit (Jagori Ward) of icddr,b's Dhaka Hospital. Characteristics of patients who died during hospitalization were compared to those of patients discharged from the ward. Bivariate analysis was performed to determine associations between potential risk factors and death. Multivariable logistic regression was used to identify factors independently associated with death. Results Of 293 patients admitted to the Jagori Ward, 57 died during hospitalization. Most hospitalized patients (67%) were male and the median age was 35 (interquartile range: 2–65) years. Overall, 153 (52%) patients were diagnosed with HIV within 6 months of hospitalization. The most common presumptive opportunistic infections (OIs) identified were tuberculosis (32%), oesophageal candidiasis (9%), Pneumocystis jirovecii pneumonia (PJP) (8%), and histoplasmosis (7%). On multivariable analysis, independent predictors of mortality were CD4 count ≤200 cells/mm3 (adjusted odds ratio [aOR]: 16.6, 95% confidence interval [CI]: 3.7–74.4), PJP (aOR: 18.5, 95% CI: 4.68–73.3), oesophageal candidiasis (aOR: 27.5, 95% CI: 5.5–136.9), malignancy (aOR:15.2, 95% CI: 2.3–99.4), and bacteriuria (aOR:7.9, 95% CI: 1.2–50.5). Being on antiretroviral therapy prior to hospitalization (aOR: 0.2, 95% CI: 0.06–0.5) was associated with decreased mortality. Conclusion This study showed that most patients who died during hospitalization on the Jagori Ward had HIV-related illnesses which could have been averted with earlier diagnosis of HIV and proper management of OIs. It is prudent to develop a national HIV screening programme to facilitate early identification of HIV. PMID:25485634

Antimicrobial Susceptibilities and Plasmid Contents of Neisseria gonorrhoeae Isolates from Commercial Sex Workers in Dhaka, Bangladesh: Emergence of High-Level Resistance to Ciprofloxacin

PubMed Central

Bhuiyan, Bahar Uddin; Rahman, Motiur; Miah, Mohammed Ruhul Amin; Nahar, Shamsun; Islam, Nazrul; Ahmed, Monira; Rahman, Kazi Masihur; Albert, M. John

1999-01-01

Commercial sex workers (CSWs) serve as the most important reservoir of sexually transmitted diseases (STD), including gonorrhea. Periodic monitoring of the antimicrobial susceptibility profile of Neisseria gonorrhoeae in a high-risk population provides essential clues regarding the rapidly changing pattern of antimicrobial susceptibilities. A study concerning the prevalence of gonococcal infection among CSWs was conducted in Bangladesh. The isolates were examined with regards to their antimicrobial susceptibility to, and the MICs of, penicillin, tetracycline, ciprofloxacin, cefuroxime, ceftriaxone, and spectinomycin by disk diffusion and agar dilution methods. The total plasmid profile of the isolates was also analyzed. Of the 224 CSWs, 94 (42%) were culture positive for N. gonorrhoeae. There was a good correlation between the results of the disk diffusion and agar dilution methods. Some 66% of the isolates were resistant to penicillin, and 34% were moderately susceptible to penicillin. Among the resistant isolates, 23.4% were penicillinase-producing N. gonorrhoeae (PPNG). 60.6% of the isolates were resistant and 38.3% were moderately susceptible to tetracycline, 17.5% were tetracycline-resistant N. gonorrhoeae, 11.7% were resistant and 26.6% had reduced susceptibility to ciprofloxacin, 2.1% were resistant and 11.7% had reduced susceptibility to cefuroxime, and 1% were resistant to ceftriaxone. All PPNG isolates contained a 3.2-MDa African type of plasmid, and a 24.2-MDa conjugative plasmid was present in 34.1% of the isolates. Since quinolones such as ciprofloxacin are recommended as the first line of therapy for gonorrhea, the emergence of significant resistance to ciprofloxacin will limit the usefulness of this drug for treatment of gonorrhea in Bangladesh. PMID:10074537

Role of the Gut Microbiota of Children in Diarrhea Due to the Protozoan Parasite Entamoeba histolytica

PubMed Central

Gilchrist, Carol A.; Petri, Sarah E.; Schneider, Brittany N.; Reichman, Daniel J.; Jiang, Nona; Begum, Sharmin; Watanabe, Koji; Jansen, Caroline S.; Elliott, K. Pamela; Burgess, Stacey L.; Ma, Jennie Z.; Alam, Masud; Kabir, Mamun; Haque, Rashidul; Petri, William A.

2016-01-01

Background. An estimated 1 million children die each year before their fifth birthday from diarrhea. Previous population-based surveys of pediatric diarrheal diseases have identified the protozoan parasite Entamoeba histolytica, the etiological agent of amebiasis, as one of the causes of moderate-to-severe diarrhea in sub-Saharan Africa and South Asia. Methods. We prospectively studied the natural history of E. histolytica colonization and diarrhea among infants in an urban slum of Dhaka, Bangladesh. Results. Approximately 80% of children were infected with E. histolytica by the age of 2 years. Fecal anti-galactose/N-acetylgalactosamine lectin immunoglobulin A was associated with protection from reinfection, while a high parasite burden and expansion of the Prevotella copri level was associated with diarrhea. Conclusions. E. histolytica infection was prevalent in this population, with most infections asymptomatic and diarrhea associated with both the amount of parasite and the composition of the microbiota. PMID:26712950

Disclosure and help seeking behavior of women exposed to physical spousal violence in Dhaka slums.

PubMed

Parvin, Kausar; Sultana, Naznin; Naved, Ruchira Tabassum

2016-05-10

Despite high prevalence of intimate partner violence (IPV) and its adverse social and health consequences, the rate of help seeking for IPV is generally low. Although the level of IPV is much higher in urban slums of Bangladesh, the level and nature of help seeking of the victims are unknown. This paper aims to address this gap in the literature. Using a cross-sectional survey conducted between August 2011-February 2012, we explored disclosure of violence, help seeking behavior, and their correlates among randomly selected currently married women aged 15-29 in Dhaka slums (n = 2604). About 60 % of the currently married women reported past year spousal physical violence, but only 21 % disclosed and 19 % sought any help. High acceptance of violence was the main reason for not seeking help. Help was most commonly sought from informal sources (89 %). Any education, frequent and severe physical abuse, and presence of children increased the likelihood of disclosure and help seeking. Most survivors from slum who disclosed also sought help. Despite widespread physical abuse, many survivors never sought help. Wide acceptance of violence hampering help seeking needs to be challenged. Increasing disclosure would also enhance help seeking. Awareness rising regarding rights of women to live a violence free life is essential. Although many services are available in the urban area, information about these services needs to be available to women. Promoting education is important in increasing both disclosure and service uptake.

Lead induced oxidative DNA damage in battery-recycling child workers from Bangladesh.

PubMed

Arif, Mohammad; Islam, Mm Towhidul; Shekhar, Hossain Uddin

2018-04-01

Lead exposure can damage cells directly by effecting DNA or indirectly by modifying proteins and enzymes. In Bangladesh, many working children are exposed to a very high level of lead during their early life due to their involvement with lead-oriented professions. This imposes a severe threat to the growth and development of the children. Therefore to study the effect of lead, we enrolled 60 age-matched male children, from an area of old Dhaka city, where battery-recycling shops are located, depending on their blood lead concentration. If the children had a plasma lead concentration above the WHO recommended threshold level of 10 µg/dl, we grouped them as test subjects and others as control subjects to determine the effect of lead on different biochemical parameters of the body. Compared to the controls, acculumlation of the lipid peroxidation product, malondialdehyde, increased significantly in test subjects ( p < 0.01). Lead exposure also increased the protein carbonyl content ( p < 0.05) and significantly decreased the plasma glutathione levels of test subjects compared to the controls ( p < 0.05). While comparing the lead-exposed group against controls, it was found that the percentage of damaged DNA, as measured using the Comet assay, significantly increased in tail ( p < 0.01) and decreased in head regions. All of these results suggest that high-plasma lead content may induce an oxidative stress to the study population, which may lead to DNA damage.

Hypertension prevalence and influence of basal metabolic rate on blood pressure among adult students in Bangladesh.

PubMed

Ali, Nurshad; Mahmood, Shakil; Manirujjaman, M; Perveen, Rasheda; Al Nahid, Abdullah; Ahmed, Shamim; Khanum, Farida Adib; Rahman, Mustafizur

2017-07-25

Hypertension is a global health issue and is currently increasing at rapid pace in South Asian countries including Bangladesh. Although, some studies on hypertension have been conducted in Bangladesh, there is a lack of scientific evidence in the adult student population that was missing from the previous and recent national cross-sectional studies. Moreover, the specific risk factors of hypertension in the Bangladeshi adults still need to be investigated. This study was conducted to estimate hypertension prevalence among adult students in Bangladesh and to test the hypothesis of Luke et al. (Hypertension 43:555-560, 2004) that basal metabolic rate (BMR) and blood pressure are positively associated independent of body size. The data was collected on 184 adult university students (118 female and 66 male) in Dhaka, Bangladesh. Anthropometric, BMR details and an average of at least two blood pressure measurements were obtained. Hypertension was defined by a systolic blood pressure (SBP) ≥ 140 mmHg and/or, diastolic blood pressure (DBP) ≥ 90 mmHg. Overall, 6.5% of participants had hypertension with significantly (p < 0.001) higher prevalence in male (12.1%) than in the female (3.4%) students. Age and BMI showed positive and significant correlation with hypertension among the students. When adjusted for body mass index (BMI), as well as other potentially confounding variables such as age, sex, smoking status and degree of urbanization, BMR was positively correlated with SBP and DBP (p < 0.001). Thus, higher BMR is associated with SBP and DBP; this is opposite the well documented inverse relationship between physical activity and blood pressure. If the influence of BMR on blood pressure is confirmed, the systematically elevated BMR might be an important predictor that can explain relatively high blood pressure and hypertension in humans. This study reports the prevalence and associated risk factors of hypertension in the Bangladeshi adult students. The study also showed a positive association between BMR and blood pressure among the participants. A large scale longitudinal study across the country is needed to find out the underlying causes of hypertension in the Bangladeshi adults. In addition, comprehensive and integrated intervention programs focusing on modifiable risk factors are recommended to make awareness and prevent hypertension.

Occurrence and characterization of Shiga toxin-producing Escherichia coli in raw meat, raw milk, and street vended juices in Bangladesh.

PubMed

Islam, Mohammad A; Mondol, Abdus S; Azmi, Ishrat J; de Boer, Enne; Beumer, Rijkelt R; Zwietering, Marcel H; Heuvelink, Annet E; Talukder, Kaisar A

2010-11-01

The major objective of this study was to investigate the prevalence of Shiga toxin (Stx)-producing Escherichia coli (STEC) in different types of food samples and to compare their genetic relatedness with STEC strains previously isolated from animal sources in Bangladesh. We investigated a total of 213 food samples, including 90 raw meat samples collected from retail butcher shops, 20 raw milk samples from domestic cattle, and 103 fresh juice samples from street vendors in Dhaka city. We found that more than 68% (n = 62) of the raw meat samples were positive for the stx gene(s); 34% (n = 21) of buffalo meats and 66% (n = 41) of beef. Approximately 10% (n = 2) of the raw milk and 8% (n = 8) of the fresh juice samples were positive for stx. We isolated STEC O157 from seven meat samples (7.8%), of which two were from buffalo meats and five from beef; and no other STEC serotypes could be isolated. We could not isolate STEC from any of the stx-positive raw milk and juice samples. The STEC O157 isolates from raw meats were positive for the stx(2), eae, katP, etpD, and enterohemorrhagic E. coli hly virulence genes, and they belonged to three different phage types: 8 (14.3%), 31 (42.8%), and 32 (42.8%). Pulsed-field gel electrophoresis (PFGE) typing revealed six distinct patterns among seven isolates of STEC O157, suggesting a heterogeneous clonal diversity. Of the six PFGE patterns, one was identical and the other two were ≥90% related to PFGE patterns of STEC O157 strains previously isolated from animal feces, indicating that raw meats are readily contaminated with fecal materials. This study represents the first survey of STEC in the food chain in Bangladesh.

How many hours do people sleep in Bangladesh? A country-representative survey.

PubMed

Yunus, Fakir M; Khan, Safayet; Akter, Tahera; Jhohura, Fatema T; Reja, Saifur; Islam, Akramul; Rahman, Mahfuzar

2016-06-01

This study investigated total sleep time in the Bangladeshi population and identified the proportion of the population at greater risk of developing chronic diseases due to inadequate sleep. Using a cross-sectional survey, total sleep time was captured and analysed in 3968 respondents aged between 6 and 106 years in 24 (of 64) districts in Bangladesh. Total sleep time was defined as the hours of total sleep in the previous 24 h. We used National Sleep Foundation (2015) guidelines to determine the recommended sleep hours in different age categories. Less or more than the recommended total sleep time (in hours) was considered 'shorter' and 'longer' sleep time, respectively. Linear and multinomial logistic regression models were used to determine the relationship between demographic variables and estimated risk of shorter and longer total sleep time. The mean (±standard deviation) total sleep time of children (6-13 years), teenagers (14-17 years), young adults and adults (18-64 years) and older adults (≥65 years) were 8.6 (±1.1), 8.1 (±1.0), 7.7 (±0.9) and 7.8 (±1.4) h, respectively, which were significantly different (P < 0.01). More than half of school-age children (55%) slept less than, and 28.2% of older adults slept longer than, recommended. Residents in all divisions (except Chittagong) in Bangladesh were less likely to sleep longer than in the Dhaka division. Rural populations had a 3.96× greater chance of sleeping for a shorter time than urban residents. The Bangladeshi population tends to sleep for longer and/or shorter times than their respective recommended sleep hours, which is detrimental to health. © 2016 European Sleep Research Society.

The Northern Rupture of the 1762 Arakan Meghathrust Earthquake and other Potential Earthquake Sources in Bangladesh.

NASA Astrophysics Data System (ADS)

Akhter, S. H.; Seeber, L.; Steckler, M. S.

2015-12-01

Bangladesh is one of the most densely populated countries in the world. It occupies a major part of the Bengal Basin, which contains the Ganges-Brahmaputra Delta (GBD), the largest and one of the most active of world deltas, and is located along the Alpine-Himalayan seismic belt. As such it is vulnerable to many natural hazards, especially earthquakes. The country sits at the junction of three tectonic plates - Indian, Eurasian, and the Burma 'sliver' of the Sunda plate. These form two boundaries where plates converge- the India-Eurasia plate boundary to the north forming the Himalaya Arc and the India-Burma plate boundary to the east forming the Indo-Burma Arc. The India-Burma plate boundary is exceptionally wide because collision with the GBD feeds an exception amount of sediment into the subduction zone. Thus the Himalayan continent collision orogeny along with its syntaxes to the N and NE of Bangladesh and the Burma Arc subduction boundary surround Bangladesh on two sides with active faults of regional scale, raising the potential for high-magnitude earthquakes. In recent years Bangladesh has experienced minor to moderate earthquakes. Historical records show that major and great earthquakes have ravaged the country and the neighboring region several times over the last 450 years. Field observations of Tertiary structures along the Chittagong-Teknaf coast reveal that the rupture of 1762 Arakan megathrust earthquake extended as far north as the Sitakund anticline to the north of the city of Chittagong. This earthquake brought changes to the landscape, uplifting the Teknaf peninsula and St. Martin's Island by about 2-2.5 m, and activated two mud volcanos along the axis of the Sitakund anticline, where large tabular blocks of exotic crystalline limestone, were tectonically transported from a deep-seated formation along with the eruptive mud. Vast area of the coast including inland areas east of the lower Meghna River were inundated. More than 500 peoples died near Dhaka as the tsunami or a seiche destroyed mud bamboo houses and capsized boats. The St. Martin's Island is believed to have been an unpopulated shoal before the 1762 earthquake. The presence of three uplifted terraces in the Teknaf coast suggest similar earthquakes of great magnitude have ruptured the Chittagong-Arakan coast in the historic past.

Attitudes towards justifying intimate partner violence among married women in Bangladesh.

PubMed

Sayem, Amir Mohammad; Begum, Housne Ara; Moneesha, Shanta Shyamolee

2012-11-01

This study examines women's attitude towards intimate partner violence among 331 Bangladeshi women in five selected disadvantaged areas of Dhaka city. This study used a shorter version of the Inventory of Beliefs about Wife Beating (IBWB) to measure women's attitude towards intimate partner violence. The results revealed that the mean score on the wife-beating scale of 15 items was 7.81 (SD = 4.893). Significant amounts of the variance (42.9%) in women's attitude towards intimate partner violence can be attributed to respondent's education (B = -0.60, p < 0.001), husband's education (B = -1.251, p < 0.01), exposure to mass media (B = -1.251, p < 0.01), respondent's current age (B = 0.081, p < 0.05), age at marriage (B = 0.215, p < 0.01), intimate partner violence victimization within the last 12 months (B = -1.533, p < 0.001) and women receiving micro-credit (small-scale loan or financial assistance) (B = -2.214, p < 0.001). The paper concludes with a discussion of the implications of the findings.

Maternal vitamin D supplementation during pregnancy and lactation to prevent acute respiratory infections in infancy in Dhaka, Bangladesh (MDARI trial): protocol for a prospective cohort study nested within a randomized controlled trial.

PubMed

Morris, Shaun K; Pell, Lisa G; Rahman, Mohammed Ziaur; Dimitris, Michelle C; Mahmud, Abdullah; Islam, M Munirul; Ahmed, Tahmeed; Pullenayegum, Eleanor; Kashem, Tahmid; Shanta, Shaila S; Gubbay, Jonathan; Papp, Eszter; Science, Michelle; Zlotkin, Stanley; Roth, Daniel E

2016-10-13

Early infancy is a high-risk period for severe acute respiratory infection (ARI), particularly in low-income countries with resource-limited health systems. Lower respiratory tract infection (LRTI) is commonly preceded by upper respiratory infection (URTI), and often caused by respiratory syncytial virus (RSV), influenza and other common community-acquired viral pathogens. Vitamin D status is a candidate modifiable early-life determinant of the host antiviral immune response and thus may influence the risk of ARI-associated morbidity in high-risk populations. In the Maternal Vitamin D for Infant Growth (MDIG) study in Dhaka, Bangladesh (NCT01924013), 1300 pregnant women are randomized to one of five groups: placebo, 4200 IU/week, 16,800 IU/week, or 28,000 IU/week from 2 nd trimester to delivery plus placebo from 0-6 months postpartum; or, 28,000 IU/week prenatal and until 6-months postpartum. In the Maternal Vitamin D for ARI in Infancy (MDARI) sub-study nested within the MDIG trial, trained personnel conduct weekly postnatal home visits to inquire about ARI symptoms and conduct a standardized clinical assessment. Supplementary home visits between surveillance visits are conducted when caregivers make phone notifications of new infant symptoms. Mid-turbinate nasal swab samples are obtained from infants who meet standardized clinical ARI criteria. Specimens are tested by polymerase chain reaction (PCR) for 8 viruses (influenza A/B, parainfluenza 1/2/3, RSV, adenovirus, and human metapneumovirus), and nasal carriage density of Streptococcus pneumoniae. The primary outcome is the incidence rate of microbiologically-positive viral ARI, using incidence rate ratios to estimate between-group differences. We hypothesize that among infants 0-6 months of age, the incidence of microbiologically-confirmed viral ARI will be significantly lower in infants whose mothers received high-dose prenatal/postpartum vitamin D supplements versus placebo. Secondary outcomes include incidence of ARI associated with specific pathogens (influenza A or B, RSV), clinical ARI, and density of pneumococcal carriage. If shown to reduce the risk of viral ARI in infancy, integration of maternal prenatal/postpartum vitamin D supplementation into antenatal care programs in South Asia may be a feasible primary preventive strategy to reduce the burden of ARI-associated morbidity and mortality in young infants. NCT02388516 , registered March 9, 2015.

Relationship between Serum Iron Profile and Blood Groups among the Voluntary Blood Donors of Bangladesh.

PubMed

Hoque, M M; Adnan, S D; Karim, S; Al-Mamun, M A; Faruki, M A; Islam, K; Nandy, S

2016-04-01

Blood donation results in a substantial iron loss and subsequent mobilization from body stores. Chronic iron deficiency is a well-recognized complication of regular blood donation. The present study conducted to compare the level of serum ferritin, serum iron, total iron binding capacity (TIBC) and percentage transferrin saturation in different ABO and Rhesus type blood groups among the voluntary blood donors of Bangladesh. The present prospective study included 100 healthy voluntary donors attending at Department of Blood Transfusion, Dhaka Medical College, Dhaka between the periods of July 2013 to Jun 2014. From each donor 10mL venous blood sample was taken and divided into heparinized and non-heparinized tubes for determination of hemoglobin (Hb), hematocrit (Hct), serum iron (SI), total iron binding capacity (TIBC) and serum ferritin by standard laboratory methods. Percentage of transferrin saturation (TS) calculated from serum iron and TIBC. Data were analyzed with SPSS (version 16) software and comparisons between groups were made using student's t-test and one way ANOVA. In the present study mean±SD of age of the respondents was 27.2±6.5 years with a range of 18 to 49 years and 81.0% were male and 19.0% were female. Among the donors 18.0% had blood group A, 35.0% had blood group B, 14.0% had blood group AB and 33.0% had blood group O. Among the donors 91.0% had rhesus positive and 9.0% had rhesus negative. Donors with blood group O had lowest haemoglobin, serum iron and transferring saturation levels. Donors with blood group A had highest TIBC level. Donors with blood group B had lowest serum ferritin level. An independent samples 't' test showed statistically significant difference in serum ferritin and percentage transferrin saturation between blood group AB and blood group O and in percentage transferrin saturation between blood group B and blood group O. One way ANOVA showed that there is no significant difference in haemoglobin, serum iron, serum ferritin and percentage transferring saturation in different ABO and Rh blood grouping categories. Blood donors with blood group O had lowest haemoglobin, serum iron and transferring saturation levels and donors with blood group A had highest TIBC level. Blood donors with blood group B had lowest serum ferritin level. The understanding of the different blood groups ability to retain iron in their system can give an insight into their ability to handle the disease iron deficiency anaemia.

Exploring the context in which different close-to-community sexual and reproductive health service providers operate in Bangladesh: a qualitative study.

PubMed

Mahmud, Ilias; Chowdhury, Sadia; Siddiqi, Bulbul Ashraf; Theobald, Sally; Ormel, Hermen; Biswas, Salauddin; Jahangir, Yamin Tauseef; Sarker, Malabika; Rashid, Sabina Faiz

2015-09-01

A range of formal and informal close-to-community (CTC) health service providers operate in an increasingly urbanized Bangladesh. Informal CTC health service providers play a key role in Bangladesh's pluralistic health system, yet the reasons for their popularity and their interactions with formal providers and the community are poorly understood. This paper aims to understand the factors shaping poor urban and rural women's choice of service provider for their sexual and reproductive health (SRH)-related problems and the interrelationships between these providers and communities. Building this evidence base is important, as the number and range of CTC providers continue to expand in both urban slums and rural communities in Bangladesh. This has implications for policy and future programme interventions addressing the poor women's SRH needs. Data was generated through 24 in-depth interviews with menstrual regulation clients, 12 focus group discussions with married men and women in communities and 24 semi-structured interviews with formal and informal CTC SRH service providers. Data was collected between July and September 2013 from three urban slums and one rural site in Dhaka and Sylhet, Bangladesh. Atlas.ti software was used to manage data analysis and coding, and a thematic analysis was undertaken. Poor women living in urban slums and rural areas visit a diverse range of CTC providers for SRH-related problems. Key factors influencing their choice of provider include the following: availability, accessibility, expenses and perceived quality of care, the latter being shaped by notions of trust, respect and familiarity. Informal providers are usually the first point of contact even for those clients who subsequently access SRH services from formal providers. Despite existing informal interactions between both types of providers and a shared understanding that this can be beneficial for clients, there is no effective link or partnership between these providers for referral, coordination and communication regarding SRH services. Training informal CTC providers and developing strategies to enable better links and coordination between this community-embedded cadre and the formal health sector has the potential to reduce service cost and improve availability of quality SRH (and other) care at the community level.

The wicked problem of earthquake hazard in developing countries: the example of Bangladesh

NASA Astrophysics Data System (ADS)

Steckler, M. S.; Akhter, S. H.; Stein, S.; Seeber, L.

2017-12-01

Many developing nations in earthquake-prone areas confront a tough problem: how much of their limited resources to use mitigating earthquake hazards? This decision is difficult because it is unclear when an infrequent major earthquake may happen, how big it could be, and how much harm it may cause. This issue faces nations with profound immediate needs and ongoing rapid urbanization. Earthquake hazard mitigation in Bangladesh is a wicked problem. It is the world's most densely populated nation, with 160 million people in an area the size of Iowa. Complex geology and sparse data make assessing a possibly-large earthquake hazard difficult. Hence it is hard to decide how much of the limited resources available should be used for earthquake hazard mitigation, given other more immediate needs. Per capita GDP is $1200, so Bangladesh is committed to economic growth and resources are needed to address many critical challenges and hazards. In their subtropical environment, rural Bangladeshis traditionally relied on modest mud or bamboo homes. Their rapidly growing, crowded capital, Dhaka, is filled with multistory concrete buildings likely to be vulnerable to earthquakes. The risk is compounded by the potential collapse of services and accessibility after a major temblor. However, extensive construction as the population shifts from rural to urban provides opportunity for earthquake-risk reduction. While this situation seems daunting, it is not hopeless. Robust risk management is practical, even for developing nations. It involves recognizing uncertainties and developing policies that should give a reasonable outcome for a range of the possible hazard and loss scenarios. Over decades, Bangladesh has achieved a thousandfold reduction in risk from tropical cyclones by building shelters and setting up a warning system. Similar efforts are underway for earthquakes. Smart investments can be very effective, even if modest. Hence, we suggest strategies consistent with high uncertainty and limited resources. The most crucial steps are enforcing building codes and public education on earthquake risk reduction. Requiring moderate investments that increases building costs by 5-10% can substantially improve safety and is a cost effective strategy. Over time, natural building turnover will make communities more resilient.

Availability and rational use of drugs in primary healthcare facilities following the national drug policy of 1982: is Bangladesh on right track?

PubMed

Ahmed, Syed Masud; Islam, Qazi Shafayetul

2012-03-01

In Bangladesh, the National Drug Policy (NDP) 1982 was instrumental in improving the supply of essential drugs of quality at an affordable price, especially in the early years. However, over time, evidence showed that the situation deteriorated in terms of both availability of essential drugs and their rational use. The study examined the current status of the outcome of the NDP objectives in terms of the availability and rational use of drugs in the primary healthcare (PHC) facilities in Bangladesh, including affordability by consumers. The study covered a random sample (n=30) of rural Upazila Health Complexes (UHCs) and a convenient sample (n=20) of urban clinics (UCs) in the Dhaka metropolitan area. Observations on prescribing and dispensing practices were made, and exit-interviews with patients and their attendants, and a mini-market survey were conducted to collect data on the core drug-use indicators of the World Health Organization from the health facilities. The findings revealed that the availability of essential drugs for common illnesses was poor, varying from 6% in the UHCs to 15% in the UCs. The number of drugs dispensed out of the total number of drugs prescribed was higher in the UHCs (76%) than in the UCs (44%). The dispensed drugs were not labelled properly, although >70% of patients/care-givers (n=1,496) reported to have understood the dosage schedule. The copy of the list of essential drugs was available in 55% and 47% of the UCs and UHCs respectively, with around two-thirds of the drugs being prescribed from the list. Polypharmacy was higher in the UCs (46%) than in the UHCs (33%). An antibiotic was prescribed in 44% of encounters (n=1,496), more frequently for fever (36-40%) and common cold (26-34%) than for lower respiratory tract infection, including pneumonia (10-20%). The prices of key essential drugs differed widely by brands (500% or more), seriously compromising the affordability of the poor people. Thus, the availability and rational use of drugs and the affordability of the poor people have remained to be achieved in Bangladesh even 27 years after approving the much-acclaimed NDP 1982.

The HERrespect intervention to address violence against female garment workers in Bangladesh: study protocol for a quasi-experimental trial.

PubMed

Al Mamun, Mahfuz; Parvin, Kausar; Yu, Marat; Wan, Jessica; Willan, Samantha; Gibbs, Andrew; Jewkes, Rachel; Naved, Ruchira Tabassum

2018-04-18

Women in Bangladesh experience high rates of Intimate Partner Violence (IPV). IPV is more prevalent against income earning women compared to their non-earning counterparts, and Workplace Violence (WPV) is also common. Such violence is a violation of women's rights, and also constrains them from contributing to their personal growth, household, community and the economy at large. There is limited evidence on what works to prevent IPV and WPV amongst garment workers. This paper describes an evaluation of HERrespect, an intervention which aims to reduce IPV and WPV against female garment workers in and around Dhaka, Bangladesh. The trial employs a quasi-experimental design, with four intervention and four control factories. In the intervention factories a randomly selected cohort of married female line workers, a cohort of male line workers, and all middle management staff received the intervention. The intervention strategies involved (1) gender transformative group-based training for workers and management staff; (2) joint session between workers (15 female and male) and middle-management staff; (3) factory-wide activities; (4) awareness raising among top management; (5) factory policy review and development and 6) a community based campaign. For the evaluation, a cohort of randomly selected female workers and a cohort of selected management staff have been established. All workers (n = 800) and management staff (n = 395) from these cohorts were interviewed at baseline using two different questionnaires, and will be interviewed in the endline, 24 months post-baseline. Intention to treat analysis will be used for assessing the impact of HERrespect, comparing the intervention and control factories. To our knowledge this is the first study that seeks to evaluate the impact on IPV and WPV, of group sessions with female workers, male workers, and management; factory-wide campaigns and a community intervention among female garment workers in Bangladesh. Apart from informing programmers and policy makers about intervention effectiveness in reducing IPV and WPV against female garment workers this study will also present evidence on an intervention tailored to the situation in the garment sector, which makes HERrespect scalable. ClinicalTrials.gov NCT03304015, retrospectively registered on October 06, 2017.

Intervention study shows suboptimal growth among children receiving a food supplement for five months in a slum in Bangladesh

PubMed Central

Choudhury, Nuzhat; Bromage, Sabri; Alam, M. Ashraful; Ahmed, A.M. Shamsir; Islam, M. Munirul; Hossain, M. Iqbal; Mahfuz, Mustafa; Mondal, Dinesh; Haque, M. Rashidul; Ahmed, Tahmeed

2017-01-01

Aim This study assessed weight and height changes among underweight children who received a locally produced, cereal-based, ready-to-use supplementary food. Methods We recruited 500 underweight Bangladeshi children aged 6–23 months from a Dhaka slum and individually matched them by sex and neighbourhood with 480 well-nourished controls. The intervention group received the daily food supplement for five months and both groups received daily micronutrient supplements. Their weight, height, mid-upper-arm circumference and head circumference were measured monthly. Results The children’s mean daily weight gain decreased from 1.27 to 0.66 grams per kilogram per day (g/kg/day) in the intervention group and 0.77 to 0.49 g/kg/day in the controls after adjusting for age differences between the two groups from baseline to five months of follow up. The mean monthly height gain decreased from 1.13 to 1.03 millimeters per metre per month in the intervention children and 1.26 to 1.01 in the controls. The weight gain was highest in the intervention children who were most wasted at baseline and the controls who were least stunted. Conclusion The children showed suboptimal growth despite food supplements, highlighting the need for ongoing research to develop inexpensive, locally-sourced food supplements to improve the nutrition of underweight children in Bangladesh. PMID:27415153

Shifting away from doorstep distribution of contraceptives in urban Bangladesh: effects on discontinuation and acceptance of family planning.

PubMed

Routh, S; Jahan, S A

2000-01-01

This paper examined the effects of alternative service-delivery strategies with regard to dropouts among the current pill and condom users who, before the intervention, were supplied with the methods by the fieldworkers at their homes in an operations research conducted by the Centre for Health and Population Research in urban Bangladesh. Moreover, the effects of the selective home visitation approach on acceptance of modern family planning methods among current nonusers were assessed. Two program areas of the Concerned Women for Family Planning in Dhaka City, one each at Wari and Siddiquebazar, served as the comparison areas. Data for the analyses came from the service records of the fieldworkers and community-based surveys. Results showed that the contraceptive prevalence rate (CPR) considerably increased in both the intervention areas: from the pre-intervention level of 63% to 68% at the Hazaribag primary health care clinic (PHCC) intervention area and from 55% to 57% at the Gandaria community service points (CSPs) intervention area. The corresponding increases at the two comparison areas were from 61% to 63% at Wari and from 60% to 63% at Siddiquebazar. The quantitative growth in the CPR in the PHCC-based strategy clearly indicated the comparative advantage of the clinic-based strategy in terms of sustainable program performance over conventional doorstep CBD- and CSP-based strategies.

Typhoid Fever and Its Association with Environmental Factors in the Dhaka Metropolitan Area of Bangladesh: A Spatial and Time-Series Approach

PubMed Central

Dewan, Ashraf M.; Corner, Robert; Hashizume, Masahiro; Ongee, Emmanuel T.

2013-01-01

Typhoid fever is a major cause of death worldwide with a major part of the disease burden in developing regions such as the Indian sub-continent. Bangladesh is part of this highly endemic region, yet little is known about the spatial and temporal distribution of the disease at a regional scale. This research used a Geographic Information System to explore, spatially and temporally, the prevalence of typhoid in Dhaka Metropolitan Area (DMA) of Bangladesh over the period 2005–9. This paper provides the first study of the spatio-temporal epidemiology of typhoid for this region. The aims of the study were: (i) to analyse the epidemiology of cases from 2005 to 2009; (ii) to identify spatial patterns of infection based on two spatial hypotheses; and (iii) to determine the hydro-climatological factors associated with typhoid prevalence. Case occurrences data were collected from 11 major hospitals in DMA, geocoded to census tract level, and used in a spatio-temporal analysis with a range of demographic, environmental and meteorological variables. Analyses revealed distinct seasonality as well as age and gender differences, with males and very young children being disproportionately infected. The male-female ratio of typhoid cases was found to be 1.36, and the median age of the cases was 14 years. Typhoid incidence was higher in male population than female (χ2 = 5.88, p<0.05). The age-specific incidence rate was highest for the 0–4 years age group (277 cases), followed by the 60+ years age group (51 cases), then there were 45 cases for 15–17 years, 37 cases for 18–34 years, 34 cases for 35–39 years and 11 cases for 10–14 years per 100,000 people. Monsoon months had the highest disease occurrences (44.62%) followed by the pre-monsoon (30.54%) and post-monsoon (24.85%) season. The Student's t test revealed that there is no significant difference on the occurrence of typhoid between urban and rural environments (p>0.05). A statistically significant inverse association was found between typhoid incidence and distance to major waterbodies. Spatial pattern analysis showed that there was a significant clustering of typhoid distribution in the study area. Moran's I was highest (0.879; p<0.01) in 2008 and lowest (0.075; p<0.05) in 2009. Incidence rates were found to form three large, multi-centred, spatial clusters with no significant difference between urban and rural rates. Temporally, typhoid incidence was seen to increase with temperature, rainfall and river level at time lags ranging from three to five weeks. For example, for a 0.1 metre rise in river levels, the number of typhoid cases increased by 4.6% (95% CI: 2.4–2.8) above the threshold of 4.0 metres (95% CI: 2.4–4.3). On the other hand, with a 1°C rise in temperature, the number of typhoid cases could increase by 14.2% (95% CI: 4.4–25.0). PMID:23359825

Changes in the selected reproductive health indicators among married women of reproductive age in low performing areas of Bangladesh: findings from an evaluation study

PubMed Central

2014-01-01

Background Three-year duration Demand-Based Reproductive Commodity Project (DBRHCP) was launched in three low performing areas: rural Nabiganj (population 323,357), Raipur (population 260,983) and urban slum in Dhaka (population 141,912). Objectives: Assessing changes in knowledge among married women of reproductive age on selected reproductive health issues and to explore their service utilization patterns over the project period in selected low performing areas of Bangladesh. Methods The study adopted a pre- posts design. In the project areas, the entire chain of service provision were modified through the interventions under the DBRHCP, including training of the providers, enhanced behavioral change communication activities, follow-up and counseling, record keeping, reporting and monitoring, as well as improvement in logistics and supplies. Peer promoters were established as linkages between clients and service providers. All households were enlisted. Baseline and end line surveys were done using representative simple random sampling method, capturing changes over one year intervention period. Descriptive analysis was done using SPSS package, version 10. Proportional tests using Stata, version 8 were done to assess changes from baseline to end line. Results The overall contraceptive prevalence was markedly different in the three study areas but significantly increased in both Dhaka urban slums and Nabiganj. In the rural areas, a higher proportion of the women in endline compared to baseline obtained contraceptive methods from the public sectors. Irrespective of study sites, significantly higher proportion of women received ANC (Antenatal Care) and PNC (Post natal care) in endline compared to baseline. In all study sites higher proportions of women were aware of maternal complications at endline. Services were obtained from qualified persons for reported symptoms of sexually transmitted infections by a higher proportion of women at endline compared to baseline. There were improvements in other RH indicators, such as use of skilled birth attendants and overall utilization of health care facilities by women. Conclusions The improvements in several important RH indicators in the intervention areas suggest that the interventions affected selected outcomes reported in the study. The study findings also suggest that investment in the reproductive health sector, particularly in existing government programs, improves RH outcomes. PMID:24886357

Cross-cultural adaptation of the short-form condom attitude scale: validity assessment in a sub-sample of rural-to-urban migrant workers in Bangladesh.

PubMed

Roy, Tapash; Anderson, Claire; Evans, Catrin; Rahman, Mohammad Shafiqur; Rahman, Mosiur

2013-03-19

The reliable and valid measurement of attitudes towards condom use are essential to assist efforts to design population specific interventions aimed at promoting positive attitude towards, and increased use of condoms. Although several studies, mostly in English speaking western world, have demonstrated the utility of condom attitude scales, very limited culturally relevant condom attitude measures have been developed till to date. We have developed a scale and evaluated its psychometric properties in a sub-sample of rural-to-urban migrant workers in Bangladesh. This paper reports mostly on cross-sectional survey components of a mixed methods sexual health research in Bangladesh. The survey sample (n = 878) comprised rural-to-urban migrant taxi drivers (n = 437) and restaurant workers (n = 441) in Dhaka (aged 18-35 years). The study also involved focus group sessions with same populations to establish the content validity and cultural equivalency of the scale. The current scale was administered with a large sexual health survey questionnaire and consisted of 10 items. Quantitative and qualitative data were assessed with statistical and thematic analysis, respectively, and then presented. The participants found the scale simple and easy to understand and use. The internal consistency (α) of the scale was 0.89 with high construct validity (the first component accounted for about 52% of variance and second component about 20% of the total variance with an Eigen-value for both factors greater than one). The test-retest reliability (repeatability) was also found satisfactory with high inter-item correlations (the majority of the intra-class correlation coefficient values was above 2 and was significant for all items on the scale, p < 0.001). The 2-week repeatability assessed by the Pearson product-moment correlation coefficient was 0.75. The results indicated that Bengali version of the scale have good metric properties for assessing attitudes toward condom use. Validated scale is a short, simple and reliable instrument for measuring attitudes towards condom use in vulnerable populations like current study sample. This culturally-customized scale can be used to monitor the progress of condom uptake and promotion activities in Bangladesh or similar settings.

Determinants of Shallow Groundwater As Variability in Bangladesh

NASA Astrophysics Data System (ADS)

Radloff, K. A.; Zheng, Y.; Stute, M.; Rahman, M.; Mihajlov, I.; Siu, H.; Huq, M.; Choudhury, I.; Ahmed, K.; van Geen, A.

2010-12-01

Manually operated tube wells that tap into shallow aquifers remain a critical source of untreated drinking water in south Asia and an estimated 37 million people are still exposed to elevated levels of As in Bangladesh(1). This field effort sought to address two questions. What mechanisms control the partitioning of As between groundwater and sediment? How does groundwater transport affect the spatial variability of dissolved As? Understanding the source of groundwater variability is essential for understanding how [As] will change with time, especially as Bangladesh and its water demands develop. Arsenic mobility and transport within the shallow aquifer was investigated at a 0.5 km2 site where [As] increases from <5 to 600 μg/L over 300 m as the aquifer becomes increasingly reducing. Aquifer recharge occurs in the raised, sandy village, where low [As] and elevated [SO4] are found. Until a few years ago, the net groundwater flow extended from the village, beneath a thickening silty layer covered by agricultural fields, towards a small stream. The sediments, however, were a homogenous, highly reduced sand throughout the site. Arsenic adsorption along this transect was investigated by two different approaches. Despite the geochemical gradients along the transect, adsorption of As under anaerobic conditions measured by spiking freshly collected sediment was remarkably uniform: Kd = 1.5 ± 0.5 L/kg, at 14 of 15 locations. Push- pull tests were used to alter groundwater [As] surrounding a well, without disturbing the sediment. The aquifer responded to the imposed dis-equilibrium by either adsorbing or desorbing As within a few days. These results provide further evidence that groundwater [As] is controlled by As sorption reactions with the sediment that reach equilibrium rapidly compared to the time scale of groundwater flow. A simple reactive-transport model for the site based on the measured partitioning coefficient, Kd, however, supports the notion that the [As] gradient observed reflects the gradual removal of As by groundwater flow over hundreds to thousands of years. The onset of irrigation and industrial pumping at this site has induced a reversal in flow, consequently groundwater now moves from high [As] into low [As] areas. This change could result in rising [As] to levels >50 μg/L in the village within the next few decades. The rapid economic development of Bangladesh could induce similar changes in groundwater flow, and thus As concentrations, elsewhere. This suggests that periodic monitoring of shallow wells low in As within regions of where the As content of groundwater is variable is particularly important. The size of the pool of As adsorbed on the sediment also indicates that current attempts to flush Bangladeshi aquifers “clean” through increased pumping will likely be ineffective. 1. BBS/UNICEF. Bangladesh: Multiple Indicator Cluster Survey, 2009. (Dhaka, Bangladesh, 2009).

Fertility differentials according to females' education, employment and family planning adoption in rural Bangladesh.

PubMed

Bhuyan, K C

1996-01-01

This study examines differential fertility in 16 contiguous villages of both Savar and Dhamrai upazila in Dhaka district, Bangladesh. The sample includes 890 couples. Levels of female education were positively correlated with family planning use. 50.6% of housewives with a secondary or higher education used contraception. 59.8% of employed women with a secondary or higher education used contraception. 21.6% of illiterate women used contraception. Fertility declined with an increase in educational level. Child mortality increased fertility regardless of educational level or contraceptive usage. The average number of children ever born differed significantly between contraceptive and noncontraceptive users who did not work. Fertility between working and nonworking women did not differ significantly. Fertility was higher throughout the life cycle among adopters and nonadopters who had husbands that were laborers. Multivariate analysis reveals that fertility was highly significantly affected by duration of marriage and desired number of children. Differences in fertility between working and nonworking individuals was insignificantly related to differences in socioeconomic factors. The impact of socioeconomic factors on the fertility of adopter and nonadopter women was significantly different. Regression findings show that duration of marriage, desired number of children, and spouse's occupation had the strongest impact on fertility. Significant changes in impacts were due to changes in female education and contraceptive usage. Duration of marriage and desired number of children did not have the same level of impact among educated women and illiterate women. Income had a negative effect on the fertility of contraceptive users.

Solid waste recycling in Rajshahi city of Bangladesh.

PubMed

Bari, Q Hamidul; Hassan, K Mahbub; Haque, M Ehsanul

2012-11-01

Efficient recycling of solid wastes is now a global concern for a sustainable and environmentally sound management. In this study, traditional recycling pattern of solid waste was investigated in Rajshahi municipality which is the fourth largest city of Bangladesh. A questionnaire survey had been carried out in various recycle shops during April 2010 to January 2011. There were 140 recycle shops and most of them were located in the vicinity of Stadium market in Rajshahi. About 1906 people were found to be involved in recycling activities of the city. The major fraction of recycled wastes were sent to capital city Dhaka for further manufacture of different new products. Only a small amount of wastes, specially plastics, were processed in local recycle factories to produce small washing pots and bottle caps. Everyday, an estimated 28.13 tons of recycled solid wastes were handled in Rajshahi city area. This recycled portion accounted for 8.25% of the daily total generated wastes (341 ton d(-1)), 54.6% of total recyclable wastes (51.49 ton d(-1)) and 68.29% of readily recyclable wastes (41.19 ton d(-1)). Major recycled materials were found to be iron, glass, plastic, and papers. Only five factories were involved in preliminary processing of recyclable wastes. Collecting and processing secondary materials, manufacturing recycled-content products, and then buying recycled products created a circle or loop that ensured the overall success of recycling and generated a host of financial, environmental, and social returns. Copyright © 2012 Elsevier Ltd. All rights reserved.

Randomized Controlled Trial of Hospital-Based Hygiene and Water Treatment Intervention (CHoBI7) to Reduce Cholera.

PubMed

George, Christine Marie; Monira, Shirajum; Sack, David A; Rashid, Mahamud-ur; Saif-Ur-Rahman, K M; Mahmud, Toslim; Rahman, Zillur; Mustafiz, Munshi; Bhuyian, Sazzadul Islam; Winch, Peter J; Leontsini, Elli; Perin, Jamie; Begum, Farzana; Zohura, Fatema; Biswas, Shwapon; Parvin, Tahmina; Zhang, Xiaotong; Jung, Danielle; Sack, R Bradley; Alam, Munirul

2016-02-01

The risk for cholera infection is >100 times higher for household contacts of cholera patients during the week after the index patient seeks hospital care than it is for the general population. To initiate a standard of care for this high-risk population, we developed Cholera-Hospital-Based-Intervention-for-7-Days (CHoBI7), which promotes hand washing with soap and treatment of water. To test CHoBI7, we conducted a randomized controlled trial among 219 intervention household contacts of 82 cholera patients and 220 control contacts of 83 cholera patients in Dhaka, Bangladesh, during 2013-2014. Intervention contacts had significantly fewer symptomatic Vibrio cholerae infections than did control contacts and 47% fewer overall V. cholerae infections. Intervention households had no stored drinking water with V. cholerae and 14 times higher odds of hand washing with soap at key events during structured observation on surveillance days 5, 6, or 7. CHoBI7 presents a promising approach for controlling cholera among highly susceptible household contacts of cholera patients.

Prevalence of Salmonella serovars and antimicrobial resistance profiles in poultry of Savar area, Bangladesh.

PubMed

Mahmud, Md Showkat; Bari, Md Latiful; Hossain, M Anwar

2011-10-01

Salmonellosis is one of the major concerns in the poultry industry and some serovars of Salmonella involve in zoonosis. This study determines the seroprevalence of Salmonella in poultry and their drug-resistant patterns, variability in infectivity and mortality rate of birds, and predilection of some serovars to cause zoonoses. The average seroprevalance of Salmonella in three different age groups was found to be 37.9%. A total of 503 samples were examined over a period of 1 year from five different poultry farms of a semiurban area of Savar, Dhaka, Bangladesh. The prevalence of Salmonella was recorded to be 21.1%. Salmonella was found high in dead birds (31.2%) than live birds (18.1%). Salmonella infection was higher (23.6%) in summer than in winter (12.9%) season. Among the 106 isolates, 46 belong to serogroup B (43%) and 60 isolates to serogroup D (57%). The highest Salmonella infection was recorded as 47.9% on the 30-35-week-old birds. A total of 106 Salmonella isolates were used for antimicrobial susceptibility test against 10 common antibiotics and 17 multiple drug resistance patterns were found. Among the isolates, 69 (65%) harbored plasmids 1-4 with size variation between >1.63 and >40 kb and rest 37 (35%) isolates were plasmid free but showed resistance against 5-10 antibiotics. The results of the present investigation suggested that multiple drug resistance is common among the Salmonella isolates of poultry and some of these isolates may have zoonotic implications.

Antismoking public policies as envisioned by bangladeshi smokers and non-smokers.

PubMed

Budden, M C; Hossain, N

1986-01-01

Tobacco use is growing quickly in the developing countries. International tobacco companies often escape the strict labeling laws of their national origins by operating in developing societies where such laws are lacking. Bangladesh is a prime example of a developing society where tobacco use and its subsequent social costs are increasing. A survey of Bangladeshis in the capital city of Dhaka shows that both smokers and non-smokers believe public programs aimed at educating the public on the dangers of tobacco use should be implemented. Schools were seen as a viable medium for educating the young. Government warnings concerning any dangers were mandated by both smokers and non-smokers. Limitations on where persons would be allowed to smoke was seen as a viable government policy by the respondents. A promising finding was that the more aware a person was of the dangers of tobacco consumption, the less likely the person was to use tobacco. Implications for government policy makers are discerned.

Basic occupational health services (BOHS) in community primary care: the MSF (Dhaka) model.

PubMed

Muralidhar, Venkiteswaran; Ahasan, Md Faizul; Khan, Ahad Mahmud; Alam, Mohammad Shariful

2017-03-20

The Médecins Sans Frontiérs (MSF) established basic occupational health services to diagnose and treat work-related diseases among tannery, metal, plastics and garment workers and families in one of the more polluted areas of the world populated by 600 000 people. In spite of project limitations, an analysis of the 6-month data showed that of the original cohort of 5000, 3200 (64%) came for at least 1 consultation. Among them, 468 (14.6%) were diagnosed with suspected work-related diseases as per defined protocols. Follow-up consultation was performed for 1447 cases of occupational diseases and work-related injuries. The MSF experience begs the need for replication of such services in densely populated urban areas in developing nations like Bangladesh and India, where no specialty occupational health clinics exist in primary care but are desperately needed and where occupational health clinics on factory premises are exclusive to industry workers and are not accessible to communities. 2017 BMJ Publishing Group Ltd.

Mortality in perforated peptic ulcer patients after selective management of stratified poor risk cases.

PubMed

Rahman, M Mizanur; Islam, M Saiful; Flora, Sabrina; Akhter, S Fariduddin; Hossain, Shahid; Karim, Fazlul

2007-12-01

Perforated peptic ulcer disease continues to inflict high morbidity and mortality. Although patients can be stratified according to their surgical risk, optimal management has yet to be described. In this study we demonstrate a treatment option that improves the mortality among critically ill, poor risk patients with perforated peptic ulcer disease. In our study, two series were retrospectively reviewed: group A patients (n = 522) were treated in a single surgical unit at the Dhaka Medical College Hospital, Dhaka, Bangladesh during the 1980s. Among them, 124 patients were stratified as poor risk based on age, delayed presentation, peritoneal contamination, and coexisting medical problems. These criteria were the basis for selecting a group of poor risk patients (n = 84) for minimal surgical intervention (percutaneous peritoneal drainage) out of a larger group of patients, group B (n = 785) treated at Khulna Medical College Hospital during the 1990s. In group A, 479 patients underwent conventional operative management with an operative mortality of 8.97%. Among the 43 deaths, 24 patients were >60 years of age (55.8%), 12 patients had delayed presentation (27.9%), and 7 patients were in shock or had multiple coexisting medical problems (16.2%). In group B, 626 underwent conventional operative management, with 26 deaths at a mortality rate of 4.15%. Altogether, 84 patients were stratified as poor risk and were managed with minimal surgical intervention (percutaneous peritoneal drainage) followed by conservative treatment. Three of these patients died with an operative mortality of 3.5%. Minimal surgical intervention (percutaneous peritoneal drainage) can significantly lower the mortality rate among a selected group of critically ill, poor risk patients with perforated peptic ulcer disease.

Role of PCR method using IS6110 primer in detecting Mycobacterium tuberculosis among the clinically diagnosed childhood tuberculosis patients at an urban hospital in Dhaka, Bangladesh.

PubMed

Kabir, Senjuti; Uddin, Mohammad Khaja Mafij; Chisti, Mohammod Jobayer; Fannana, Tilka; Haque, Mohammad Enamul; Uddin, Muhammad Reaj; Banu, Sayera; Ahmed, Tahmeed

2018-03-01

Better methods are needed for the accurate detection of child tuberculosis (TB). This study compared different laboratory tests and evaluated IS6110 PCR for the detection of Mycobacterium tuberculosis (MTB) among clinically diagnosed child TB patients. A total of 102 paediatric patients (<15 years old) with clinically diagnosed TB were enrolled in this study. The patients were admitted to the icddr,b hospital in Dhaka between 2003 and 2005. Sputum/gastric lavage samples were collected for smear microscopy, culture (solid/Lowenstein-Jensen medium and liquid/MGIT), and IS6110 PCR testing. The sensitivity, specificity, and positive and negative predictive values (PPV, NPV) of smear microscopy and PCR were compared to the two culture methods. Three patients were positive on smear microscopy (2.9%). MTB was detected by conventional culture in 15.7% (16/102), liquid culture in 14% (14/100), and IS6110 PCR in 61.8% (63/102). PCR detected an additional 45 patients who were undetected with the three other tests. Compared to conventional and liquid culture, respectively, smear microscopy showed sensitivity of 18.8% and 21.4%, specificity of 100% individually, PPV of 100% individually, and NPV of 86.9% and 88.7%, whereas PCR had sensitivity of 87.5% and 92.9%, specificity of 43% individually, PPV of 22.2% and 21%, and NPV of 94.9% and 97.4%. PCR can be useful compared to smear microscopy and culture methods and is applicable as a rapid screening test for child TB. A larger scale study is required to determine its diagnostic efficacy in improving the detection of child TB in the presence and absence of severe malnutrition. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

A survey of Japanese quail (Coturnix coturnix japonica) farming in selected areas of Bangladesh

PubMed Central

Nasar, Abu; Rahman, Aminoor; Hoque, Nazmul; Kumar Talukder, Anup; Das, Ziban Chandra

2016-01-01

Aim: To investigate the status, problems and prospects of Japanese quail (Coturnix coturnix japonica) farming in selected areas of Bangladesh. Materials and Methods: The study was conducted in 14 districts of Bangladesh, viz., Dhaka, Narayanganj, Munshiganj, Mymensingh, Netrakona, Faridpur, Jessore, Khulna, Satkhira, Kushtia, Bogra, Naogaon, Comilla, and Sylhet during the period from July 2011 to June 2012. A total of 52 quail farmers were interviewed for data collection using a structured questionnaire. Focus group discussions were also carried out with unsuccessful farmers and those want to start quail farming. Workers of quail farms, quail feeds and medicine suppliers, quail eggs and meat sellers were also interviewed regarding the issue. Results: Out of 52 farms, 86.5% were operated by male, 67.3% farmers did not receive any training and 92.3% farmers had no earlier experience of quail farming although 58.0% farmers primary occupation was quail farming. Most of the farms (63.4%) were mixed in type having ≤5000 birds of two or three varieties. About 80.7% farms were operated separately round the year with no other poultry and 83.0% farmers wanted to expand their farming. The average pullet weight 145.0±0.12, 110.0±0.07, 120.0±0.22, and 128.0±0.17 g; age at the first lay 46.0±0.04, 42.0±0.31, 42.0±0.09, and 45.2±0.05 days; rearing period 15.0±0.01, 12.0±0.14, 15.0±0.32, and 15.2±0.18 months; culling period 15.5±0.14, 13.0±0.06, 15.0±0.03, and 15.4±0.26 months were for layer, parent stock, hatchery, and mixed farms, respectively. Most of the layer farms had an average egg production of ≤5000/day and net profit BDT 0.75/egg. However, an average number of birds, hatchability and net profit per day-old-chick were ≤5000, 76.8% and BDT 2.75, respectively, in the hatchery. Broiler quails were sold at 30 days with mean weight of 110.8 g and net profit BDT 9.02/bird. The major constraints of quail farming were higher feed price, outbreak of endemic diseases, lack of proper knowledge, farmers training, proper market access, difficulties of parent stock collection, inadequate biosecurity practices, and limited access to veterinary care. Thus, a proper training on quail farming, bio-security management, and government subsidy on feeds could make quail farming sustainable in Bangladesh. Conclusions: The study concludes that Japanese quail farming has enormous potentiality and could be an alternative to chicken farming particularly in providing gainful employment, supplementary income and as a valuable source of meat and egg, quail farming should be encouraged and promoted in Bangladesh. PMID:27733793

Reactive Transport Modeling of Subsurface Arsenic Removal Systems in Rural Bangladesh

NASA Astrophysics Data System (ADS)

Bakker, M.; Rahman, M. M.; van Breukelen, B. M.; Ahmed, K. M.

2014-12-01

Elevated concentrations of arsenic (As) in the groundwater of the shallow aquifers of Bangladesh are a major public health concern. Subsurface Arsenic Removal (SAR) is a relatively new treatment option that can potentially be a cost effective method for arsenic removal for community-based drinking water supplies. The basic idea of SAR is to extract water, aerate it, and re-inject it, after which groundwater with reduced arsenic concentrations may be extracted. The main process for As reduction is sorption to Hydrous Ferric Oxides (HFO) that forms after injection of the aerated water. The purpose of this poster is to investigate the major geochemical processes responsible for the (im)mobilization of As during SAR operation. SAR was applied at a test site in Muradnagar upazila in Comilla district about 100 km southeast of Dhaka in Bangladesh. Multiple extraction/aeration/re-injection cycles were performed and water samples were analyzed. A PHREEQC reactive transport model (RTM) was used in a radial flow setting to try to reproduce the measurements. Kinetic oxidation/dissolution reactions, cation exchange, and surface complexation were simulated. The simulation of different reactions enables the possibility to discern the reaction parameters involved in the im(mobilization) of As. The model fit has reasonable agreement with the observed data for major ions and trace elements. The model suggests an increasing sorption capacity due to the gradual development of HFO precipitates resulting from the injection phases. Modeled breakthrough curves of As, Fe(II), and Mn, match the measured increase of As, Fe(II), and Mn removal with successive cycles. The model illustrates that the pH of groundwater during SAR operation has a great impact on As sorption in the subsurface. The surface complexation modeling suggests that competitive displacement of As by H4SiO4 is an important factor limiting As removal during SAR operation.

What Point-of-Use Water Treatment Products Do Consumers Use? Evidence from a Randomized Controlled Trial among the Urban Poor in Bangladesh

PubMed Central

Luoto, Jill; Najnin, Nusrat; Mahmud, Minhaj; Albert, Jeff; Islam, M. Sirajul; Luby, Stephen; Unicomb, Leanne; Levine, David I.

2011-01-01

Background There is evidence that household point-of-use (POU) water treatment products can reduce the enormous burden of water-borne illness. Nevertheless, adoption among the global poor is very low, and little evidence exists on why. Methods We gave 600 households in poor communities in Dhaka, Bangladesh randomly-ordered two-month free trials of four water treatment products: dilute liquid chlorine (sodium hypochlorite solution, marketed locally as Water Guard), sodium dichloroisocyanurate tablets (branded as Aquatabs), a combined flocculant-disinfectant powdered mixture (the PUR Purifier of Water), and a silver-coated ceramic siphon filter. Consumers also received education on the dangers of untreated drinking water. We measured which products consumers used with self-reports, observation (for the filter), and chlorine tests (for the other products). We also measured drinking water's contamination with E. coli (compared to 200 control households). Findings Households reported highest usage of the filter, although no product had even 30% usage. E. coli concentrations in stored drinking water were generally lowest when households had Water Guard. Households that self-reported product usage had large reductions in E. coli concentrations with any product as compared to controls. Conclusion Traditional arguments for the low adoption of POU products focus on affordability, consumers' lack of information about germs and the dangers of unsafe water, and specific products not meshing with a household's preferences. In this study we provided free trials, repeated informational messages explaining the dangers of untreated water, and a variety of product designs. The low usage of all products despite such efforts makes clear that important barriers exist beyond cost, information, and variation among these four product designs. Without a better understanding of the choices and aspirations of the target end-users, household-based water treatment is unlikely to reduce morbidity and mortality substantially in urban Bangladesh and similar populations. PMID:22028817

Feeding difficulties in children with cerebral palsy: low-cost caregiver training in Dhaka, Bangladesh.

PubMed

Adams, M S; Khan, N Z; Begum, S A; Wirz, S L; Hesketh, T; Pring, T R

2012-11-01

The majority of children with cerebral palsy have feeding difficulties, which, if not managed, result in stressful mealtimes, chronic malnutrition, respiratory disease, reduced quality of life for caregiver and child, and early death. In well-resourced countries, high- and low-cost medical interventions, ranging from gastrostomy tube feeding to caregiver training, are available. In resource-poor countries such as Bangladesh, the former is not viable and the latter is both scarce and its effectiveness not properly evaluated. The aim of this study was to evaluate the effectiveness of a low-cost, low-technology intervention to improve the feeding practices of carers of children with moderate-severe cerebral palsy and feeding difficulties in Bangladesh. An opportunistic sample of 37 caregivers and their children aged 1-11 years were invited to a six-session training programme following an initial feeding assessment with brief advice. During home visits, pre- and post-measures of nutritional status, chest health and feeding-related stress were taken and feeding practices were observed. A control phase was evaluated for 20 of the participant pairs following initial assessment with advice, while awaiting full training. A minimum of four training sessions showed significant improvements in the children's respiratory health (P = 0.005), cooperation during mealtimes (P = 0.003) and overall mood (P < 0.001). Improvements in growth were inconsistent. Dramatic reductions were observed in caregiver stress (P < 0.001). A significant difference in the outcomes following advice only compared with advice plus training was also observed. In situations of poverty, compliance is restricted by lack of education, finances and time. Nonetheless, carers with minimal formal education, living in conditions of extreme poverty were able to change feeding practices after a short, low-cost training intervention, with highly positive consequences. The availability of affordable food supplementation for this population, however, requires urgent attention. © 2011 Blackwell Publishing Ltd.

Building social networks for maternal and newborn health in poor urban settlements: a cross-sectional study in Bangladesh.

PubMed

Adams, Alayne M; Nababan, Herfina Y; Hanifi, S M Manzoor Ahmed

2015-01-01

The beneficial influence of social networks on health and wellbeing is well-established. In poor urban settlements in Bangladesh, BRAC's Manoshi programme trains community health workers (CHWs) to support women through pregnancy, delivery and postpartum periods. This paper test the hypothesis that the introduction of CHWs as weak ties into the social networks of Manoshi members mediates improvements in maternal and neonatal health (MNH) best practices by providing support, facilitating ideational change, connecting mother to resources, and strengthening or countering the influence of strong ties. 1000 women who had given birth in the last three months were identified and interviewed as part of ongoing monitoring of 5 poor urban settlements in Dhaka, Bangladesh. A social networks questionnaire was administered which elicited women's perceived networks around pregnancy, delivery and post-partum periods. Mediation analysis was performed to test the hypothesis that penetration of Manoshi CHWs into women's perceived networks has a beneficial effect on MNH best practises. The presence and influence of Manoshi CHWs in women's networks significantly mediated the effect of Manoshi membership on MNH best practices. Respondents who were Manoshi members and who listed Manoshi CHWs as part of their support networks were significantly more likely to deliver with a trained birth attendant (OR 3.61; 95%CI 2.36-5.51), to use postnatal care (OR 3.09; 95%CI 1.83-5.22), and to give colostrum to their newborn (OR 7.51; 95%CI 3.51-16.05). Manoshi has succeeded in penetrating the perceived pregnancy, delivery and post-partum networks of poor urban women through the introduction of trained CHWs. Study findings demonstrate the benefits of moving beyond urban health care delivery models that concentrate on the provision of clinical services by medical providers, to an approach that nurtures the power of social networks as a means to support the poorest and most marginalized in changing behaviour and effectively accessing appropriate maternal services.

Arsenic in Bangladesh Groundwater: from Science to Mitigation

NASA Astrophysics Data System (ADS)

van Geen, A.; Ahmed, K. M.; Graziano, J. H.

2004-12-01

A large proportion of the populations of Bangladesh and other South Asian countries is at risk of contracting cancers and other debilitating diseases due to exposure to high concentrations of naturally occurring arsenic in groundwater supplied by millions of tube wells. Starting in January 2000, and in partnership with several Bangladeshi institutions, an interdisciplinary team of health, earth, and social scientists from Columbia University has focused its efforts to address this crisis on a 25 km2 region in Araihazar upazila, about 20 km northeast of Dhaka. The project started with the recording of the position and depth of ~6600 wells in the area, the collection of groundwater samples from these wells, and laboratory analyses for arsenic and a suite of other constituents. This was followed by the recruitment of 12,000 adult inhabitants of the area for a long-term cohort study of the effects of arsenic exposure, as well as cross-sectional studies of their children. This presentation will focus on (1) the extreme degree of spatial variability of arsenic concentrations in Bangladesh groundwater, (2) the notion that spatial variability hampers mitigation in the sense that it complicates predictions but also offers an opportunity for mitigation because many households live within walking or drilling distance of safe water, and (3) the implication of recent advances in our understanding of the mechanisms of arsenic mobilization for potential temporal changes in groundwater arsenic. In addition, (4) a unique data set documenting the response of 6500 households to 4 years of mitigation in Araihazar, supported by documented reductions in exposure to arsenic based on urine analyses, will be presented. The presentation will conclude with (5) a proposal for scaling up mitigation efforts to the rest of the country by targeting safe aquifers with information transmitted to the village level from a central data base using cellular phones.

Patients' perspective of disease and medication adherence for type 2 diabetes in an urban area in Bangladesh: a qualitative study.

PubMed

Islam, Sheikh Mohammed Shariful; Biswas, Tuhin; Bhuiyan, Faiz A; Mustafa, Kamrun; Islam, Anwar

2017-03-21

Patients' perspective of diabetes and adherence to its prescribed medications is a significant predictor of glycemic control and overall management of the disease. However, there is a paucity of such information in Bangladesh. This study aimed to explore patients' perspective of diabetes, their experience of taking oral hypoglycemic medications and explore factors that contribute to medication adherence in patients with type 2 diabetes in Bangladesh. We conducted in-depth face-to-face interviews with 12 type 2 diabetes patients attending a tertiary hospital in Dhaka city between February and March, 2014. Participants were purposively sampled representing different age groups, education levels, years since diagnosis with diabetes, and glycemic status, to achieve maximum variation sampling. All interviews were conducted using a topic guide and were audio-recorded, transcribed verbatim, checked for errors, coded and analyzed by means of a qualitative content analysis framework. The data analysis generated rich information on the participants' knowledge and perception on diabetes, its causes, self-management, medication use, adverse effects of medication use, medication adherence, and impact of diabetes, Although most of the participants demonstrated substantive knowledge on diabetes and its consequences, they also reported numerous misconceptions about the disease. Knowledge on diabetes medication, their appropriate use and side effects was rather poor. Respondents also reported non-compliance to dietary and physical activity advice by their physicians and concerns on diabetes diabetes-induced psychological stress. High cost of medications, concerns over medication side effects and forgetfulness was noted as factors for non-adherence to medication. Participants' knowledge and perception on diabetes are key factors determining their adherence to medications and, thereby, diabetes management. Healthcare providers should explore to better understand patients' perspective on diabetes, medication beliefs, identify psychological stress and provide more effective health education interventions to enhance medication adherence.

Pretreatment and co-administration of oral anti-diabetic agent with clomiphene citrate or rFSH for ovulation induction in clomiphene-citrate-resistant polycystic ovary syndrome.

PubMed

Begum, Mosammat Rashida; Akhter, Sayeba; Ehsan, Mariya; Begum, Mosammat Shahina; Khan, Farzana

2013-05-01

The objective of this study was to explore the result of pretreatment and concomitant use of metformin with clomiphene citrate (CC) and rFSH for ovulation induction in clomiphene-citrate-resistant polycystic ovary syndrome (PCOS). This randomized controlled trial was done in the Dhaka Medical College and Hospital and the Infertility Care and Research Centre, Dhaka, Bangladesh. A total of 165 infertile patients with CC-resistant PCOS who attended for treatment were the target population for this study. Patients were divided into three groups: groups A and B were given metformin and group C was the control. Along with metformin, group A received CC and group B received rFSH. Group C was treated with only rFSH. Metformin was given 1500 mg daily for 4 weeks. Afterwards CC or rFSH were added for induction of ovulation along with metformin. Six ovulatory cycles were assessed. Treatment was terminated when there was no response with maximum dose of CC and rFSH or after six ovulatory cycles without pregnancy or after achieving pregnancy. A P-value of <0.5 was considered as significant. Ovulation (89.09%) and pregnancy (54.55%) rates were higher in group B. Ovulation (74.55%) and pregnancy (29.09%) rates were also satisfactory in group C but a dose of rFSH requirement was significantly higher (P = 0.000). In group A, both ovulation and pregnancy rate were much lower than the other two groups (27.27% and 12.73%, respectively). Use of metformin increases the response of ovulation-inducing agents and can be used safely in PCOS. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.

The quality of life, mental health, and perceived stigma of leprosy patients in Bangladesh.

PubMed

Tsutsumi, Atsuro; Izutsu, Takashi; Islam, Akramul Md; Maksuda, A N; Kato, Hiroshi; Wakai, Susumu

2007-06-01

The present study aims to determine the quality of life (QOL) and general mental health of leprosy patients compared with the general population, and evaluate contributing factors such as socio-economic characteristics and perceived stigma. A total of 189 patients (160 outpatients, 29 inpatients) and 200 controls without leprosy or other chronic diseases were selected from Dhaka district, Bangladesh, using stratified random sampling. A Bangladeshi version of a structured questionnaire including socio-demographic characteristics-the Bangla version of the World Health Organization Quality of Life Assessment BREF (WHOQOL-BREF)-was used to assess QOL; a Self-Reporting Questionnaire (SRQ) was used to evaluate general mental health; the Barthel Index to control activities of daily living (ADL); and the authors' Perceived Stigma Questionnaire was used to assess perceived stigma of patients with leprosy. Medical records were examined to evaluate disability grades and impairment. QOL and general mental health scores of leprosy patients were worse than those of the general population. Multiple regression analysis revealed that factors potentially contributing to the deteriorated QOL of leprosy patients were the presence of perceived stigma, fewer years of education, the presence of deformities, and a lower annual income. Perceived stigma showed the greatest association with adverse QOL. We conclude that there is an urgent need for interventions sensitive to the effects of perceived stigma, gender, and medical conditions to improve the QOL and mental health of Bangladeshi leprosy patients.

Is serum zinc level associated with prediabetes and diabetes?: a cross-sectional study from Bangladesh.

PubMed

Islam, Md Rafiqul; Arslan, Iqbal; Attia, John; McEvoy, Mark; McElduff, Patrick; Basher, Ariful; Rahman, Waliur; Peel, Roseanne; Akhter, Ayesha; Akter, Shahnaz; Vashum, Khanrin P; Milton, Abul Hasnat

2013-01-01

To determine serum zinc level and other relevant biological markers in normal, prediabetic and diabetic individuals and their association with Homeostasis Model Assessment (HOMA) parameters. This cross-sectional study was conducted between March and December 2009. Any patient aged ≥ 30 years attending the medicine outpatient department of a medical university hospital in Dhaka, Bangladesh and who had a blood glucose level ordered by a physician was eligible to participate. A total of 280 participants were analysed. On fasting blood sugar results, 51% were normal, 13% had prediabetes and 36% had diabetes. Mean serum zinc level was lowest in prediabetic compared to normal and diabetic participants (mean differences were approximately 65 ppb/L and 33 ppb/L, respectively). In multiple linear regression, serum zinc level was found to be significantly lower in prediabetes than in those with normoglycemia. Beta cell function was significantly lower in prediabetes than normal participants. Adjusted linear regression for HOMA parameters did not show a statistically significant association between serum zinc level, beta cell function (P = 0.07) and insulin resistance (P = 0.08). Low serum zinc accentuated the increase in insulin resistance seen with increasing BMI. Participants with prediabetes have lower zinc levels than controls and zinc is significantly associated with beta cell function and insulin resistance. Further longitudinal population based studies are warranted and controlled trials would be valuable for establishing whether zinc supplementation in prediabetes could be a useful strategy in preventing progression to Type 2 diabetes.

Consumption of unsafe food in the adjacent area of Hazaribag tannery campus and Buriganga River embankments of Bangladesh: heavy metal contamination.

PubMed

Islam, G M Rabiul; Khan, Faysal Elahi; Hoque, Md Mozammel; Jolly, Yeasmin Nahar

2014-11-01

The concentrations of Cr, Cd, Pb, Hg, and As in water, poultry meat, fish, vegetables, and rice plants obtained from the area adjacent to the Hazaribag tannery campus, Dhaka, Bangladesh, were estimated and compared with permissible levels established by the WHO and FAO and levels reported previously by other authors. The metal contents were in the following order according to the concentration in contaminated irrigation water: Cr > Pb > As > Hg > Cd. Mean concentrations of Cr, Pb, Hg, and As in irrigated water were above the permissible levels, whereas the results were below the permissible levels for Cd. The metal concentrations in poultry meat, fish, rice, and vegetables were in the following orders: Pb > Cr > Cd > Hg > As, Pb > Cr > Cd > As > Hg, Pb > As, and Cr > Pb > Cd > As > Hg, respectively. The mean concentrations of metals in poultry meat, fish, rice, and vegetables were much higher than the permissible levels. The trends of weekly intake of heavy metals (WIMs) from poultry meat, fish, rice, and vegetables were as follows: Pb > Cr > Cd > Hg > As, Pb > Cr > Cd > As > Hg, Pb > As, and Cr > Pb > Cd > As > Hg, respectively. WIMs for all the metals were lower than the provisional maximum weekly intake recommended by WHO/FAO and USNAS.

Influence of multi-industrial activities on trace metal contamination: an approach towards surface water body in the vicinity of Dhaka Export Processing Zone (DEPZ).

PubMed

Ahmed, Golam; Miah, M Arzu; Anawar, Hossain M; Chowdhury, Didarul A; Ahmad, Jasim U

2012-07-01

Industrial wastewater discharged into aquatic ecosystems either directly or because of inadequate treatment of process water can increase the concentrations of pollutants such as toxic metals and others, and subsequently deteriorate water quality, environmental ecology and human health in the Dhaka Export Processing Zone (DEPZ), the largest industrial belt of 6-EPZ in Bangladesh. Therefore, in order to monitor the contamination levels, this study collected water samples from composite effluent points inside DEPZ and the surrounding surface water body connected to effluent disposal sites and determined the environmental hazards by chemical analysis and statistical approach. The water samples were analysed by inductively coupled plasma mass spectrometry to determine 12 trace metals such as As, Ag, Cr, Co, Cu, Li, Ni, Pb, Se, Sr, V and Zn in order to assess the influence of multi-industrial activities on metal concentrations. The composite effluents and surface waters from lagoons were characterized by a strong colour and high concentrations of biochemical oxygen demand, chemical oxygen demand, electrical conductivity, pH, total alkalinity, total hardness, total organic carbon, Turb., Cl(-), total suspended solids and total dissolved solids, which were above the limit of Bangladesh industrial effluent standards, but dissolved oxygen concentration was lower than the standard value. The measurement of skewness and kurtosis values showed asymmetric and abnormal distribution of the elements in the respective phases. The mean trend of variation was found in a decreasing order: Zn > Cu > Sr > Pb > Ni > Cr > Li > Co > V > Se > As > Ag in composite industrial effluents and Zn > Cu > Sr > Pb > Ni > Cr > Li > V > As > Ag > Co > Se in surface waters near the DEPZ. The strong correlations between effluent and surface water metal contents indicate that industrial wastewaters discharged from DEPZ have a strong influence on the contamination of the surrounding water bodies by toxic metals. The average contamination factors were reported to be 0.70-96.57 and 2.85-1,462 for industrial effluents and surface waters, respectively. The results reveal that the surface water in the area is highly contaminated with very high concentrations of some heavy/toxic metals like Zn, Pb, Cu, Ni and Cr; their average contamination factors are 1,460, 860, 136, 74.71 and 4.9, respectively. The concentrations of the metals in effluent and surface water were much higher than the permissible limits for drinking water and the world average concentrations in surface water. Therefore, the discharged effluent and surface water may create health hazards especially for people working and living inside and in the surrounding area of DEPZ.

An update on the prevalence of HIV/AIDS in Bangladesh.

PubMed

Islam, M M; Karim, E; Mian, M A; Kristensen, S; Chowdhury, M R; Vermund, S H

1999-06-01

The National AIDS Committee was formed in 1985 to develop and support policies that prevent transmission of human immunodeficiency virus (HIV). In 1990, the Institute of Epidemiology, Disease Control and Research in the Ministry of Health began sero-surveillance for AIDS/HIV infection. Convenience sampling was conducted among prisoners, sailors, truckers, antenatal attendees, repatriated Bangladeshi workers, and brothel-based prostitutes in Dhaka. In 1994, commercial sex workers in other high-risk areas were included in surveillance activities. Among over 75,700 HIV tests through 1998, 119 have been confirmed positive for HIV. While the cumulative HIV prevalence rate was only 1.5/1,000 tests, it was significantly higher among men (p < 0.0001) than among women. The rates among men were as high as 28/1,000 tests in 1996 and 21/1,000 tests in 1997. Almost 50% of the reported HIV cases are from cities on the border of India and Myanmar. It is anticipated that HIV transmission will increase further given the high prevalence of risk behaviors, core high-risk groups, and extreme poverty.

Public policy, risk and fertility in Bangladesh: a comment.

PubMed

Robinson, W C

1983-09-01

In their report for the Planning Commission and the US Agency for International Development (USAID), Dhaka, Cain and Lieberman argue that Bangladesh's present family planning program efforts will be fruitless until some minimum level of economic security is provided for the nation's households. They specifically propose an employment guarantee scheme, but other approaches are also possible. The author estimates exactly how such an "economic risk" reducing scheme might be implemented by the government, how much it would cost, and its logical and empirical foundations. He offers 4 reasons for rejecting the idea. 1) The level of economic well being which would reduce fertility is unclear in their model, and it would not be a moderate income; at 250 Taka a month would a man feel secure, even if this were guaranteed to him and he believed the guarantee? 2) The cost to the government of even raising all presently unemployed, disabled, or aged indigent persons to slightly above the poverty level would be several times the yearly development budget. 3) The logical and theoretical underpinnings of the model appear confused and questionable. Cain's model of children as insurance against risk by guaranteeing future family income labor supply is not borne out by the historical evidence. The latter shows fertility has fallen slightly in response to growing economic pressure, not risen; that land owners have higher fertility than non-owners; that there is a substantial volume of unwanted fertility--not all births are viewed as functional or valuable; and that contraceptive rates are as high as 40% in parts of rural Bangladesh. 4) The following 2 data sets show that the empirical evidence for such a link between risk and fertility is negative: a) district level fertility data from the 1981 Census in conjunction with an index of "famine proneness" prepared by the Ministry of Food, and b) the Bangladesh Fertility Survey fertility and community characteristics data. The author concedes the idea deserves serious consideration, but disproves its thesis.

Vaccine specific immune response to an inactivated oral cholera vaccine and EPI vaccines in a high and low arsenic area in Bangladeshi children.

PubMed

Saha, Amit; Chowdhury, Mohiul I; Nazim, Mohammad; Alam, Mohammad Murshid; Ahmed, Tanvir; Hossain, Mohammad Bakhtiar; Hore, Samar Kumar; Sultana, Gazi Nurun Nahar; Svennerholm, Ann-Mari; Qadri, Firdausi

2013-01-11

Immune responses to the inactivated oral whole cell cholera toxin B (CTB) subunit cholera vaccine, Dukoral(®), as well as three childhood vaccines in the national immunization system were compared in children living in high and low arsenic contaminated areas in Bangladesh. In addition, serum complement factors C3 and C4 levels were evaluated among children in the two areas. VACCINATIONS: Toddlers (2-5 years) were orally immunized with two doses of Dukoral 14 days apart. Study participants had also received diphtheria, tetanus and measles vaccines according to the Expanded Program on Immunization (EPI) in Bangladesh. The mean level of arsenic in the urine specimens in the children of the high arsenic area (HAA, Shahrasti, Chandpur) was 291.8μg/L while the level was 6.60μg/L in the low arsenic area (LAA, Mirpur, Dhaka). Cholera specific vibriocidal antibody responses were significantly increased in the HAA (87%, P<0.001) and the LAA (75%, P<0.001) children after vaccination with Dukoral, but no differences were found between the two groups. Levels of CTB specific IgA and IgG antibodies were comparable between the two groups, whereas LPS specific IgA and IgG were higher in the LAA group, although response rates were comparable. Diphtheria and tetanus vaccine specific IgG responses were significantly higher in the HAA compared to the LAA group (P<0.001, P=0.048 respectively), whereas there were no differences in the measles specific IgG responses between the groups. Complement C3 and C4 levels in sera were higher in participants from the HAA than the LAA groups (P<0.001, P=0.049 respectively). The study demonstrates that the oral cholera vaccine as well as the EPI vaccines studied are immunogenic in children in high and low arsenic areas in Bangladesh. The results are encouraging for the potential use of cholera vaccines as well as the EPI vaccines in arsenic endemic areas. Copyright © 2012 Elsevier Ltd. All rights reserved.

Building Social Networks for Maternal and Newborn Health in Poor Urban Settlements: A Cross-Sectional Study in Bangladesh

PubMed Central

Adams, Alayne M.; Nababan, Herfina Y.; Hanifi, S. M. Manzoor Ahmed

2015-01-01

Background The beneficial influence of social networks on health and wellbeing is well-established. In poor urban settlements in Bangladesh, BRAC’s Manoshi programme trains community health workers (CHWs) to support women through pregnancy, delivery and postpartum periods. This paper test the hypothesis that the introduction of CHWs as weak ties into the social networks of Manoshi members mediates improvements in maternal and neonatal health (MNH) best practices by providing support, facilitating ideational change, connecting mother to resources, and strengthening or countering the influence of strong ties. Methods 1000 women who had given birth in the last three months were identified and interviewed as part of ongoing monitoring of 5 poor urban settlements in Dhaka, Bangladesh. A social networks questionnaire was administered which elicited women’s perceived networks around pregnancy, delivery and post-partum periods. Mediation analysis was performed to test the hypothesis that penetration of Manoshi CHWs into women’s perceived networks has a beneficial effect on MNH best practises. Results The presence and influence of Manoshi CHWs in women’s networks significantly mediated the effect of Manoshi membership on MNH best practices. Respondents who were Manoshi members and who listed Manoshi CHWs as part of their support networks were significantly more likely to deliver with a trained birth attendant (OR 3.61; 95%CI 2.36–5.51), to use postnatal care (OR 3.09; 95%CI 1.83–5.22), and to give colostrum to their newborn (OR 7.51; 95%CI 3.51–16.05). Conclusion Manoshi has succeeded in penetrating the perceived pregnancy, delivery and post-partum networks of poor urban women through the introduction of trained CHWs. Study findings demonstrate the benefits of moving beyond urban health care delivery models that concentrate on the provision of clinical services by medical providers, to an approach that nurtures the power of social networks as a means to support the poorest and most marginalized in changing behaviour and effectively accessing appropriate maternal services. PMID:25910191

A Comparative Analysis of Vibrio cholerae Contamination in Point-of-Drinking and Source Water in a Low-Income Urban Community, Bangladesh.

PubMed

Ferdous, Jannatul; Sultana, Rebeca; Rashid, Ridwan B; Tasnimuzzaman, Md; Nordland, Andreas; Begum, Anowara; Jensen, Peter K M

2018-01-01

Bangladesh is a cholera endemic country with a population at high risk of cholera. Toxigenic and non-toxigenic Vibrio cholerae ( V. cholerae ) can cause cholera and cholera-like diarrheal illness and outbreaks. Drinking water is one of the primary routes of cholera transmission in Bangladesh. The aim of this study was to conduct a comparative assessment of the presence of V. cholerae between point-of-drinking water and source water, and to investigate the variability of virulence profile using molecular methods of a densely populated low-income settlement of Dhaka, Bangladesh. Water samples were collected and tested for V. cholerae from "point-of-drinking" and "source" in 477 study households in routine visits at 6 week intervals over a period of 14 months. We studied the virulence profiles of V. cholerae positive water samples using 22 different virulence gene markers present in toxigenic O1/O139 and non-O1/O139 V. cholerae using polymerase chain reaction (PCR). A total of 1,463 water samples were collected, with 1,082 samples from point-of-drinking water in 388 households and 381 samples from 66 water sources. V. cholerae was detected in 10% of point-of-drinking water samples and in 9% of source water samples. Twenty-three percent of households and 38% of the sources were positive for V. cholerae in at least one visit. Samples collected from point-of-drinking and linked sources in a 7 day interval showed significantly higher odds ( P < 0.05) of V. cholerae presence in point-of-drinking compared to source [OR = 17.24 (95% CI = 7.14-42.89)] water. Based on the 7 day interval data, 53% (17/32) of source water samples were negative for V. cholerae while linked point-of-drinking water samples were positive. There were significantly higher odds ( p < 0.05) of the presence of V. cholerae O1 [OR = 9.13 (95% CI = 2.85-29.26)] and V. cholerae O139 [OR = 4.73 (95% CI = 1.19-18.79)] in source water samples than in point-of-drinking water samples. Contamination of water at the point-of-drinking is less likely to depend on the contamination at the water source. Hygiene education interventions and programs should focus and emphasize on water at the point-of-drinking, including repeated cleaning of drinking vessels, which is of paramount importance in preventing cholera.

Cross-cultural adaptation of the short-form condom attitude scale: validity assessment in a sub-sample of rural-to-urban migrant workers in Bangladesh

PubMed Central

2013-01-01

Background The reliable and valid measurement of attitudes towards condom use are essential to assist efforts to design population specific interventions aimed at promoting positive attitude towards, and increased use of condoms. Although several studies, mostly in English speaking western world, have demonstrated the utility of condom attitude scales, very limited culturally relevant condom attitude measures have been developed till to date. We have developed a scale and evaluated its psychometric properties in a sub-sample of rural-to-urban migrant workers in Bangladesh. Methods This paper reports mostly on cross-sectional survey components of a mixed methods sexual health research in Bangladesh. The survey sample (n = 878) comprised rural-to-urban migrant taxi drivers (n = 437) and restaurant workers (n = 441) in Dhaka (aged 18–35 years). The study also involved focus group sessions with same populations to establish the content validity and cultural equivalency of the scale. The current scale was administered with a large sexual health survey questionnaire and consisted of 10 items. Quantitative and qualitative data were assessed with statistical and thematic analysis, respectively, and then presented. Results The participants found the scale simple and easy to understand and use. The internal consistency (α) of the scale was 0.89 with high construct validity (the first component accounted for about 52% of variance and second component about 20% of the total variance with an Eigen-value for both factors greater than one). The test-retest reliability (repeatability) was also found satisfactory with high inter-item correlations (the majority of the intra-class correlation coefficient values was above 2 and was significant for all items on the scale, p < 0.001). The 2-week repeatability assessed by the Pearson product–moment correlation coefficient was 0.75. Conclusion The results indicated that Bengali version of the scale have good metric properties for assessing attitudes toward condom use. Validated scale is a short, simple and reliable instrument for measuring attitudes towards condom use in vulnerable populations like current study sample. This culturally-customized scale can be used to monitor the progress of condom uptake and promotion activities in Bangladesh or similar settings. PMID:23510383

Changing patient population in Dhaka Hospital and Matlab Hospital of icddr,b.

PubMed

Das, S K; Rahman, A; Chisti, M J; Ahmed, S; Malek, M A; Salam, M A; Bardhan, P K; Faruque, A S G

2014-02-01

The Diarrhoeal Disease Surveillance System of icddr,b noted increasing number of patients ≥60 years at urban Dhaka and rural Matlab from 2001 to 2012. Shigella and Vibrio cholerae were more frequently isolated from elderly people than children under 5 years and adults aged 5-59 in both areas. The resistance observed to various drugs of Shigella in Dhaka and Matlab was trimethoprim-sulphamethoxazole (72-63%), ampicillin (43-55%), nalidixic acid (58-61%), mecillinam (12-9%), azithromycin (13-0%), ciprofloxacin (11-13%) and ceftriaxone (11-0%). Vibrio cholerae isolated in Dhaka and Matlab was resistant to trimethoprim-sulphamethoxazole (98-94%), furazolidone (100%), erythromycin (71-53%), tetracycline (46-44%), ciprofloxacin (3-10%) and azithromycin (3-0%). © 2013 John Wiley & Sons Ltd.

Zinc supplementation for improving glucose handling in pre-diabetes: A double blind randomized placebo controlled pilot study.

PubMed

Islam, Md Rafiqul; Attia, John; Ali, Liaquat; McEvoy, Mark; Selim, Shahjada; Sibbritt, David; Akhter, Ayesha; Akter, Shahnaz; Peel, Roseanne; Faruque, Omar; Mona, Tazreen; Lona, Hafiza; Milton, Abul Hasnat

2016-05-01

There are a number of studies showing that zinc supplementation may improve glucose handling in people with established diabetes. We sought to investigate whether this zinc-dependent improvement in glucose handling could potentially be harnessed to prevent the progression of pre-diabetes to diabetes. In this double-blind randomized placebo-controlled trial, we determined participants' fasting blood glucose levels, (FBG) and Homeostasis Model Assessment (HOMA) parameters (beta cell function, insulin sensitivity and insulin resistance) at baseline and after 6 months of zinc supplementation. The Bangladesh Institute of Health Sciences Hospital (BIHS) (Mirpur, Dhaka, Bangladesh) database was used to identify 224 patients with prediabetes, of whom 55 met the inclusion criteria and agreed to participate. The participants were randomized either to the intervention or control group using block randomization. The groups received either 30mg zinc sulphate dispersible tablet or placebo, once daily for six months. After six months, the intervention group significantly improved their FBG concentration compared to the placebo group (5.37±0.20mmol/L vs 5.69±0.26, p<0.001) as well as compared to their own baseline (5.37±0.20mmol/L vs 5.8±0.09, p<0.001). Beta cell function, insulin sensitivity and insulin resistance all showed a statistically significant improvement as well. To our knowledge this is the first trial to show an improvement in glucose handling using HOMA parameters in participants with prediabetes. Larger randomized controlled trials are warranted to confirm these findings and to explore clinical endpoints. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Is Serum Zinc Level Associated with Prediabetes and Diabetes?: A Cross-Sectional Study from Bangladesh

PubMed Central

Islam, Md. Rafiqul; Arslan, Iqbal; Attia, John; McEvoy, Mark; McElduff, Patrick; Basher, Ariful; Rahman, Waliur; Peel, Roseanne; Akhter, Ayesha; Akter, Shahnaz; Vashum, Khanrin P.; Milton, Abul Hasnat

2013-01-01

Aims To determine serum zinc level and other relevant biological markers in normal, prediabetic and diabetic individuals and their association with Homeostasis Model Assessment (HOMA) parameters. Methods This cross-sectional study was conducted between March and December 2009. Any patient aged ≥30 years attending the medicine outpatient department of a medical university hospital in Dhaka, Bangladesh and who had a blood glucose level ordered by a physician was eligible to participate. Results A total of 280 participants were analysed. On fasting blood sugar results, 51% were normal, 13% had prediabetes and 36% had diabetes. Mean serum zinc level was lowest in prediabetic compared to normal and diabetic participants (mean differences were approximately 65 ppb/L and 33 ppb/L, respectively). In multiple linear regression, serum zinc level was found to be significantly lower in prediabetes than in those with normoglycemia. Beta cell function was significantly lower in prediabetes than normal participants. Adjusted linear regression for HOMA parameters did not show a statistically significant association between serum zinc level, beta cell function (P = 0.07) and insulin resistance (P = 0.08). Low serum zinc accentuated the increase in insulin resistance seen with increasing BMI. Conclusion Participants with prediabetes have lower zinc levels than controls and zinc is significantly associated with beta cell function and insulin resistance. Further longitudinal population based studies are warranted and controlled trials would be valuable for establishing whether zinc supplementation in prediabetes could be a useful strategy in preventing progression to Type 2 diabetes. PMID:23613929

H. pylori infection and gastric cancer in Bangladesh: a case-control study.

PubMed

Sarker, Khandker Kawser; Kabir, Md Jahangir; Bhuyian, A K M Minhaj Uddin; Alam, Md Shahjadul; Chowdhury, Fazle Rabbi; Ahad, M Abdul; Rahman, Md Anisur; Rahman, M Mizanur

2017-11-01

Like that of other Asian countries gastric cancer (GC) is also a leading cancer in Bangladesh and also a cause for cancer-related mortality. Infection with Helicobacter pylori ( H. pylori ) is the strongest recognized risk factor for gastric adenocarcinoma. The infection is also prevalent in common people. This case-control study was carried out to find an association between GC and H. pylori infection in the community. To evaluate association of H. pylori and carcinoma of stomach this study was conducted at National Institute of Cancer Research & Hospital, Dhaka from January 2013 to December 2014. H. pylori status was determined serologically by using H. pylori kit in the department of Biochemistry laboratory of Bangabandhu Sheikh Mujib Medical University. In total, 114 patients with GC and 520 patients not having GC were studied as controls. Logistic regression method was used to calculate the odds ratio. Significantly more patients in the case group (86.8%) were found to be seropositive for H. pylori antigen in contrast to the control group (67.5%). All of the cases in the present study were in advanced stage. No significant association between H. pylori seropositivity and tumor location was found. It was noted that undifferentiated gastric carcinoma had slightly more association with H. pylori infection. Younger H. pylori -infected patients had been found to be at higher relative risk for GC than older patients. As there is a strong association found between GC and H. pylori infection special emphasis to eradicate H. pylori infection might reduce the incidence of this dreadly disease.

Vitamin A deficiency among adolescent female garment factory workers in Bangladesh.

PubMed

Ahmed, F; Hasan, N; Kabir, Y

1997-10-01

To investigate the prevalence of vitamin A deficiency among adolescent female factory workers in Bangladesh, and examine the association between various factors and vitamin A status. A cross-sectional study. Garment factories in Dhaka city, Bangladesh. Three hundred and eighty eight adolescent girls aged 12-19 y from ten garment factories were selected randomly for the present study. Information on socio-economic conditions and usual pattern of dietary intake were obtained by interview. Anthropometric data and blood samples were collected following the interview. By NCHS reference standard, 15.5% of the participants were thin (< 90% Wt/Ht) and about 7% overweight (> 120% Wt/Ht). In about 56%, serum vitamin A level was below the adequate level of 1.05 mumol/l, with 14% having vitamin A deficiency (< 0.70 mumol/l). Forty four per cent of the participants were found to be anaemic (haemoglobin < 120 g/l). Food frequency data on vitamin A rich foods revealed that a large percentage of the participants do not take eggs (41%), milk (64%), liver (85%) and sweet pumpkin (85%); while about 40% of the girls take dark green leafy vegetables (DGLV) and 17% take small fish at least four servings a week. The girls who consumed four or more servings per week of DGLV had significantly higher serum vitamin A level than the girls who took three servings or less. There was a significant positive association between the level of serum vitamin A and frequency of intake of DGLV (r = 0.12; P = 0.023). When age, level of education, percapita income, haemoglobin concentration, serum protein concentration, menstruation at the time of blood collection, prevalence of current morbidity, frequency of intake of egg, milk, small fish, DGLV, liver and sweet pumpkin were accounted for by multiple regression analysis, a strong relationship was found for serum vitamin A concentration with age, menstruation, haemoglobin level and frequency of intake of DGLV. For every unit change in the frequency of consumption of DGLV, there was 0.013 mumol/l change in serum vitamin A level whilst taking other factors into account. The data show that there is a high prevalence of subclinical vitamin A deficiency among the adolescent female garment factory workers in Bangladesh, although the anthropometric indices suggest that they do not suffer from acute under nutrition. Consumption of DGLV appears to have an important relation with the vitamin A status of these girls.

A Comparative Analysis of Vibrio cholerae Contamination in Point-of-Drinking and Source Water in a Low-Income Urban Community, Bangladesh

PubMed Central

Ferdous, Jannatul; Sultana, Rebeca; Rashid, Ridwan B.; Tasnimuzzaman, Md.; Nordland, Andreas; Begum, Anowara; Jensen, Peter K. M.

2018-01-01

Bangladesh is a cholera endemic country with a population at high risk of cholera. Toxigenic and non-toxigenic Vibrio cholerae (V. cholerae) can cause cholera and cholera-like diarrheal illness and outbreaks. Drinking water is one of the primary routes of cholera transmission in Bangladesh. The aim of this study was to conduct a comparative assessment of the presence of V. cholerae between point-of-drinking water and source water, and to investigate the variability of virulence profile using molecular methods of a densely populated low-income settlement of Dhaka, Bangladesh. Water samples were collected and tested for V. cholerae from “point-of-drinking” and “source” in 477 study households in routine visits at 6 week intervals over a period of 14 months. We studied the virulence profiles of V. cholerae positive water samples using 22 different virulence gene markers present in toxigenic O1/O139 and non-O1/O139 V. cholerae using polymerase chain reaction (PCR). A total of 1,463 water samples were collected, with 1,082 samples from point-of-drinking water in 388 households and 381 samples from 66 water sources. V. cholerae was detected in 10% of point-of-drinking water samples and in 9% of source water samples. Twenty-three percent of households and 38% of the sources were positive for V. cholerae in at least one visit. Samples collected from point-of-drinking and linked sources in a 7 day interval showed significantly higher odds (P < 0.05) of V. cholerae presence in point-of-drinking compared to source [OR = 17.24 (95% CI = 7.14–42.89)] water. Based on the 7 day interval data, 53% (17/32) of source water samples were negative for V. cholerae while linked point-of-drinking water samples were positive. There were significantly higher odds (p < 0.05) of the presence of V. cholerae O1 [OR = 9.13 (95% CI = 2.85–29.26)] and V. cholerae O139 [OR = 4.73 (95% CI = 1.19–18.79)] in source water samples than in point-of-drinking water samples. Contamination of water at the point-of-drinking is less likely to depend on the contamination at the water source. Hygiene education interventions and programs should focus and emphasize on water at the point-of-drinking, including repeated cleaning of drinking vessels, which is of paramount importance in preventing cholera. PMID:29616005

Underground coal gasification with extended CO2 utilization as economic and carbon neutral approach to address energy and fertilizer supply shortages in Bangladesh

NASA Astrophysics Data System (ADS)

Nakaten, Natalie; Islam, Rafiqul; Kempka, Thomas

2014-05-01

The application of underground coal gasification (UCG) with proven carbon mitigation techniques may provide a carbon neutral approach to tackle electricity and fertilizer supply shortages in Bangladesh. UCG facilitates the utilization of deep-seated coal seams, not economically exploitable by conventional coal mining. The high-calorific synthesis gas produced by UCG can be used for e.g. electricity generation or as chemical raw material for hydrogen, methanol and fertilizer production. Kempka et al. (2010) carried out an integrated assessment of UCG operation, demonstrating that about 19 % of the CO2 produced during UCG may be mitigated by CO2 utilization in fertilizer production. In the present study, we investigated an extension of the UCG system by introducing excess CO2 storage in the gas deposit of the Bahkrabad gas field (40 km east of Dhaka, Bangladesh). This gas field still holds natural gas resources of 12.8 million tons of LNG equivalent, but is close to abandonment due to a low reservoir pressure. Consequently, applying enhanced gas recovery (EGR) by injection of excess carbon dioxide from the coupled UCG-urea process may mitigate carbon emissions and support natural gas production from the Bahkrabad gas field. To carry out an integrated techno-economic assessment of the coupled system, we adapted the techno-economic UCG-CCS model developed by Nakaten et al. (2014) to consider the urea and EGR processes. Reservoir simulations addressing EGR in the Bakhrabad gas field by utilization of excess carbon dioxide from the UCG process were carried out to account for the induced pressure increase in the reservoir, and thus additional gas recovery potentials. The Jamalganj coal field in Northwest Bangladesh provides favorable geological and infrastructural conditions for a UCG operation at coal seam depths of 640 m to 1,158 m. Excess CO2 can be transported via existing pipeline networks to the Bahkrabad gas field (about 300 km distance from the coal deposit) to be injected in the scope of the scheduled EGR operation. Our techno-economic modeling results considering EGR reservoir simulations demonstrate that an economic and carbon neutral operation of UCG combined with fertilizer production and CCS is feasible. The suggested approach may provide a bridging technology to tackle fertilizer and power supply shortages in Bangladesh, and in addition support further production from depleting natural gas deposits. References Kempka, T., Plötz, M.L., Hamann, J., Deowan, S.A., Azzam, R. (2010) Carbon dioxide utilisation for carbamide production by application of the coupled UCG-urea process. Energy Procedia 4: 2200-2205. Nakaten, N., Schlüter, R., Azzam, R., Kempka, T. (2014) Development of a techno-economic model for dynamic calculation of COE, energy demand and CO2 emissions of an integrated UCG-CCS process. Energy (in print). Doi 10.1016/j.energy.2014.01.014

Risk Factors for Death in Bangladeshi Children Under 5 Years of Age Hospitalized for Diarrhea and Severe Respiratory Distress in an Urban Critical Care Ward

PubMed Central

Alam, Tahmina; Ahmed, Tahmeed; Sarmin, Monira; Shahrin, Lubaba; Afroze, Farzana; Sharifuzzaman; Akhter, Shamima; Shahunja, K. M.; Shahid, Abu Sadat Mohammad Sayeem Bin; Bardhan, Pradip Kumar; Chisti, Mohammod Jobayer

2017-01-01

Children with diarrhea hospitalized for respiratory distress often have fatal outcome in resource-limited settings, although data are lacking on risk factors for death in such children. We sought to evaluate clinical predictors for death in such children. In this prospective cohort study, we enrolled under-5 children with diarrhea admitted with severe respiratory distress to the intensive care unit of Dhaka Hospital of International Centre for Diarhoeal Disease Research, Bangladesh, from September 2014 through September 2015. We compared clinical and laboratory characteristics between study children those who died (n = 29) and those who survived (n = 62). In logistic regression analysis, after adjusting for potential confounders, the independent predictors for death in children hospitalized for diarrhea and severe respiratory distress were severe sepsis and hypoglycemia (P < .05 for all). Thus, recognition of these simple parameters may help clinicians identify children with diarrhea at risk of deaths in order to initiate prompt management for the better outcome, especially in resource-poor settings. PMID:28491923

Risk Factors for Death in Bangladeshi Children Under 5 Years of Age Hospitalized for Diarrhea and Severe Respiratory Distress in an Urban Critical Care Ward.

PubMed

Alam, Tahmina; Ahmed, Tahmeed; Sarmin, Monira; Shahrin, Lubaba; Afroze, Farzana; Sharifuzzaman; Akhter, Shamima; Shahunja, K M; Shahid, Abu Sadat Mohammad Sayeem Bin; Bardhan, Pradip Kumar; Chisti, Mohammod Jobayer

2017-01-01

Children with diarrhea hospitalized for respiratory distress often have fatal outcome in resource-limited settings, although data are lacking on risk factors for death in such children. We sought to evaluate clinical predictors for death in such children. In this prospective cohort study, we enrolled under-5 children with diarrhea admitted with severe respiratory distress to the intensive care unit of Dhaka Hospital of International Centre for Diarhoeal Disease Research, Bangladesh, from September 2014 through September 2015. We compared clinical and laboratory characteristics between study children those who died (n = 29) and those who survived (n = 62). In logistic regression analysis, after adjusting for potential confounders, the independent predictors for death in children hospitalized for diarrhea and severe respiratory distress were severe sepsis and hypoglycemia ( P < .05 for all). Thus, recognition of these simple parameters may help clinicians identify children with diarrhea at risk of deaths in order to initiate prompt management for the better outcome, especially in resource-poor settings.

Microbiological Evaluation of the Efficacy of Soapy Water to Clean Hands: A Randomized, Non-Inferiority Field Trial

PubMed Central

Amin, Nuhu; Pickering, Amy J.; Ram, Pavani K.; Unicomb, Leanne; Najnin, Nusrat; Homaira, Nusrat; Ashraf, Sania; Abedin, Jaynal; Islam, M. Sirajul; Luby, Stephen P.

2014-01-01

We conducted a randomized, non-inferiority field trial in urban Dhaka, Bangladesh among mothers to compare microbial efficacy of soapy water (30 g powdered detergent in 1.5 L water) with bar soap and water alone. Fieldworkers collected hand rinse samples before and after the following washing regimens: scrubbing with soapy water for 15 and 30 seconds; scrubbing with bar soap for 15 and 30 seconds; and scrubbing with water alone for 15 seconds. Soapy water and bar soap removed thermotolerant coliforms similarly after washing for 15 seconds (mean log10 reduction = 0.7 colony-forming units [CFU], P < 0.001 for soapy water; mean log10 reduction = 0.6 CFU, P = 0.001 for bar soap). Increasing scrubbing time to 30 seconds did not improve removal (P > 0.05). Scrubbing hands with water alone also reduced thermotolerant coliforms (mean log10 reduction = 0.3 CFU, P = 0.046) but was less efficacious than scrubbing hands with soapy water. Soapy water is an inexpensive and microbiologically effective cleansing agent to improve handwashing among households with vulnerable children. PMID:24914003

Emigration and development: the case of a Bangladeshi village.

PubMed

Rahman, M M

2000-01-01

This article examines the developmental consequences of international labor migration in a Bangladeshi village. The data are from the Hoglakandi, a village 30 km southeast of Dhaka, capital of Bangladesh. A structured questionnaire with both open-ended and closed category questions was used among 50 Singapore returnees, supplemented with additional in-depth interviews. International labor migration has often been seen by many sending countries as a short cut development because of its role in unemployment relief, balance of payments relief, and capital formation of national level. The study argues that the causes and effects of emigration can better be understood only when the process is placed within its local context, since what may prove to be advantageous at the national level may prove to be detrimental to a household or community or vice-versa. It demonstrates how the contribution of labor migration is merely the transformation of labor into a structural component of the international political economy. The Hoglakandi experience reveals that labor migration does not fuel the local economy from an external pipeline of remittances and skill acquisition, rather it drains local resources that retard the development.

Illness perception of tuberculosis (TB) and health seeking practice among urban slum residents of Bangladesh: a qualitative study.

PubMed

Bam, Kiran; Bhatt, Lokesh Prasad; Thapa, Rajshree; Dossajee, Hussein Karimjee; Angdembe, Mirak Raj

2014-08-27

Combating tuberculosis (TB) in urban slums is more complex than in rural areas due to reasons such as over-crowding, unhygienic living conditions and poverty. This study aimed to assess illness perception of TB and identify barriers and facilitators for health seeking practice among the residents of Badda slum, Dhaka, Bangladesh. The Badda slum was purposively selected. Convenience sampling was carried out to select participants aged 18 years and above. Twenty two in-depth interviews, two key informants' interviews and participatory rapid appraisal (PRA) were conducted. Data were analyzed manually by using defined a priori codes and color coding of the quotes in data matrix table. TB was commonly recognized as Jokkha (pulmonary TB), Sas rog (disease associated to breathing) followed by TB. More females than males had knowledge about TB related illness. Very few perceived of being at risk of TB despite the high risk behavior and environment. Prime barriers for health seeking practice of TB were cost along with other barriers like prevailing stigma on TB, lack of information on service sites and unavailability of accompanying person. Training and orientation to community organizations and people, awareness on TB and free treatment through advertisements/media, community level diagnostic and home based care were identified as the facilitators for the health seeking practice of TB. Perceptions of TB and knowledge associated with the disease shape the health seeking practice, therefore promotion of media awareness campaign, targeting the people of urban slums for reducing misconceptions and promotion of home based service is needed to encourage health seeking practice in the future.

Personal series with clinical review of fracture penis.

PubMed

Bhuiyan, Z H; Khan, S A; Tawhid, M H; Islam, M F

2007-07-01

Penile fracture is an uncommon Urological emergency. In flaccid state it allows significant degree of deformation without any injury to the vital structures but in erected state it is vulnerable to blunt injury. The tumescent corpora cavernosa may have got injured due to nonphysiological bending of penile shaft. The true incidence of penile fracture is not known even in western countries. It is either under reported or hidden for potential social embracement. We have reviewed all of our cases of penile fracture and has been conducted a retrospective study in the Department of Urology, Bangladesh Medical College, Dhaka. The study period was from October 2001 to January 2006. The sample size was 23. All patients have got classical history of penile fracture. The time between the onset of symptom and seeking of medical care ranges from 02 hours to 07 days. The diagnosis was made on the basis of history and clinical examination only. All the patients were underwent surgery. The potency was well preserved in all of our patients. The local tissue healing process is better among the patients, reported earlier. The overall result is excellent.

Nutrient composition of strawberry genotypes cultivated in a horticulture farm.

PubMed

Hossain, Ashrafi; Begum, Parveen; Salma Zannat, M; Hafizur Rahman, Md; Ahsan, Monira; Islam, Sheikh Nazrul

2016-05-15

This article decribes the nutrient composition of four strawberry genotypes cultivated at the Sher-e-Bangla Agriculture University horticulture farm in Dhaka (Bangladesh). AOAC and standard validated methods were employed to analyse the nutrient composition. Protein, fat and ash contents were found to be vary significantly (LSD<0.05), while the variation in moisture (LSD<1.33), dietary fibre (LSD<0.15) and total sugar (LSD<0.09) were found to be insignificant among the genotypes. Vitamin C content ranged from 26.46 mg to 37.77 mg per 100g edible strawberries (LSD<0.060). Amount of carotenoids were found to be very low being in a range of 0.99-3.30 μg per 100g edible fruit. Analysis of mineral revealed that strawberry genotypes contained a wide array of minerals including Ca, Mg, Na, K, P, Mn, Zn, Cu and Fe; most of which varied significantly (LSD<0.05) among the genotypes. Strawberries could be a potential dietary supplement for vitamin C along with minerals, particularly for the children who do not like local fruits, but love to eat the colourful strawberries. Copyright © 2015 Elsevier Ltd. All rights reserved.

Socioeconomic drivers of vaccine uptake: An analysis of the data of a geographically defined cluster randomized cholera vaccine trial in Bangladesh.

PubMed

Saha, Amit; Hayen, Andrew; Ali, Mohammad; Rosewell, Alexander; MacIntyre, C Raina; Clemens, John D; Qadri, Firdausi

2018-05-08

Evaluations of oral cholera vaccines (OCVs) have demonstrated their effectiveness in diverse settings. However, low vaccine uptake in some settings reduces the opportunity for prevention. This paper identifies the socioeconomic factors associated with vaccine uptake in a mass vaccination program. This was a three-arm (vaccine, vaccine plus behavioral change, and non-intervention) cluster randomized trial conducted in Dhaka, Bangladesh. Socio-demographic and vaccination data were collected from 268,896 participants. A geographical information system (GIS) was used to design and implement the vaccination program. A logistic regression model was used to assess the association between vaccine uptake and socioeconomic characteristics. The GIS supported the implementation of the vaccination program by identifying ideal locations of vaccination centres for equitable population access, defining catchment areas of daily activities, and providing daily coverage maps during the campaign. Among 188,206 individuals in the intervention arms, 123,686 (66%) received two complete doses, and 64,520 (34%) received one or no doses of the OCV. The vaccine uptake rate was higher in females than males (aOR: 1.80; 95% CI = 1.75-1.84) and in younger (<15 years) than older participants (aOR: 2.19; 95% CI = 2.13-3.26). Individuals living in their own house or having a higher monthly family expenditure were more likely to receive the OCV (aOR: 1.60; 95% CI = 1.50-1.70 and aOR: 1.14; 95% CI = 1.10-1.18 respectively). Individuals using treated water for drinking or using own tap as the source of water were more likely to receive the OCV (aOR: 1.23; 95% CI = 1.17-1.29 and aOR: 1.14; 95% CI = 1.02-1.25 respectively) than their counterpart. Vaccine uptake was also significantly higher in participants residing farther away from health facilities (aOR: 95% 1.80; CI = 1.36-2.37). The GIS was useful in designing field activities, facilitating vaccine delivery and identifying socioeconomic drivers of vaccine uptake in the urban area of Bangladesh. Addressing these socioeconomic drivers may help improve OCV uptake, thereby effectiveness of the OCV in a community. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Creating a public space and dialogue on sexuality and rights: a case study from Bangladesh.

PubMed

Rashid, Sabina Faiz; Standing, Hilary; Mohiuddin, Mahrukh; Ahmed, Farah Mahjabeen

2011-06-16

This article describes and analyses a research based engagement by a university school of public health in Bangladesh aimed at raising public debate on sexuality and rights and making issues such as discrimination more visible to policy makers and other key stakeholders in a challenging context. The impetus for this work came from participation in an international research programme with a particular interest in bridging international and local understandings of sexual and reproductive rights. The research team worked to create a platform to broaden discussions on sexuality and rights by building on a number of research activities on rural and urban men's and women's sexual health concerns, and on changing concepts of sexuality and understandings of sexual rights among specific population groups in Dhaka city, including sexual minorities. Linked to this on-going process of improving the evidence base, there has been a series of learning and capacity building activities over the last four years consisting of training workshops, meetings, conferences and dialogues. These brought together different configurations of stakeholders - members of sexual minorities, academics, service providers, advocacy organisations, media and policy makers. This process contributed to developing more effective advocacy strategies through challenging representations of sexuality and rights in the public domain. Gradually, these efforts brought visibility to hidden or stigmatised sexuality and rights issues through interim outcomes that have created important steps towards changing attitudes and policies. These included creating safe spaces for sexual minorities to meet and strategise, development of learning materials for university students and engagement with legal rights groups on sexual rights. Through this process, it was found to be possible to create a public space and dialogue on sexuality and rights in a conservative and challenging environment like Bangladesh by bringing together a diverse group of stakeholders to successfully challenge representations of sexuality in the public arena. A further challenge for BRAC University has been to assess its role as a teaching and research organisation, and find a balance between the two roles of research and activism in doing work on sexuality issues in a very sensitive political context.

Safety of Russian-backbone seasonal trivalent, live-attenuated influenza vaccine in a phase II randomized placebo-controlled clinical trial among children in urban Bangladesh.

PubMed

Ortiz, Justin R; Goswami, Doli; Lewis, Kristen D C; Sharmeen, Amina Tahia; Ahmed, Moshtaq; Rahman, Mustafizur; Rahman, Mohammed Z; Feser, Jodi; Neuzil, Kathleen M; Brooks, W Abdullah

2015-06-26

Live-attenuated influenza vaccines (LAIVs) have the potential to be affordable, effective, and logistically feasible for immunization of children in low-resource settings. We conducted a phase II, randomized, double-blind, parallel group, placebo-controlled trial on the safety of the Russian-backbone, seasonal trivalent LAIV among children aged 24 through 59 months in Dhaka, Bangladesh in 2012. After vaccination, we monitored participants for six months with weekly home visits and study clinic surveillance for solicited and unsolicited adverse events, protocol-defined wheezing illness (PDWI), and serious adverse events (SAEs), including all cause hospitalizations. Three hundred children were randomized and administered LAIV (n=150) or placebo (n=150). No immediate post-vaccination reactions occurred in either group. Solicited reactions were similar between vaccine and placebo groups during the first 7 days post-vaccination and throughout the entire trial. There were no statistically significant differences in participants experiencing PDWI between LAIV and placebo groups throughout the trial (n=13 vs. n=16, p=0.697). Of 131 children with a history of medical treatment or hospitalization for asthma or wheezing at study entry, 65 received LAIV and 66 received placebo. Among this subset, there was no statistical difference in PDWI occurring throughout the trial between the LAIV or placebo groups (7.7% vs. 19.7%, p=0.074). While there were no related SAEs, LAIV recipients had six unrelated SAEs and placebo recipients had none. These SAEs included three due to traumatic injury and bone fracture, and one each due to accidental overdose of paracetamol, abdominal pain, and acute gastroenteritis. None of the participants with SAEs had laboratory-confirmed influenza, wheezing illness, or other signs of acute respiratory illness at the time of their events. In this randomized, controlled trial among 300 children aged 24 through 59 months in urban Bangladesh, Russian-backbone LAIV was safe and well tolerated. Further evaluation of LAIV safety and efficacy in a larger cohort is warranted. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Haemophilus influenzae type-b and non-b-type invasive diseases in urban children (<5years) of Bangladesh: implications for therapy and vaccination.

PubMed

Rahman, Mahbubur; Hossain, Shahadat; Baqui, Abdullah Hel; Shoma, Shereen; Rashid, Harunur; Nahar, Nazmun; Zaman, Mohammed Khalequ; Khatun, Farida

2008-03-01

To prospectively study the epidemiology and antibiotic resistance of Haemophilus infuenzae isolates from invasive infections in children. Children (<5years) with pneumonia, meningitis and septicemia from three hospitals in Dhaka, Bangladesh were enrolled (1999-2003); clinical and laboratory data, and blood for cultures were collected. Cerebrospinal fluid (CSF) of meningitis cases was analyzed (Gram stain, culture and biochemical tests). Hib antigen was detected by latex agglutination (LA) in culture-negative pyogenic CSF and PCR was done for bexA gene in culture- and LA-negative pyogenic CSF. Antibiotic susceptibility was determined by E-Tests and beta-lactamase by nitrocefin stick. Seventy-three cases of H. influenzae infections (46 of 293 meningitis cases, 25 of 1493 pneumonia cases, 2 of 48 septicemia cases) were detected; 63%, 34% and 3% of them had meningitis, pneumonia and septicemia respectively. H. influenzae type b (Hib) caused infections in 80.8% of cases (60.3% meningitis, 20.5% pneumonia). Most (86%) infections clustered in 4-12month infants. The case-fatality in pneumonia was 8% compared to 19% in meningitis. H. influenzae isolates from pneumonia and meningitis children were equally resistant to antibiotics (46% vs 43%). Of 10 drugs tested, isolates were resistant to ampicillin (31%), chloramphenicol (42%), trimethoprim-sulfamethoxazole (44%) and azithromycin (1.4%). Multidrug-resistant (MDR) strains were equally prevalent in Hib (31%) and non-b-type (29%) isolates, and in pneumonia (31%) and meningitis (34%) cases. None was resistant to amoxicillin-clavulanate, ceftriaxone, ciprofloxacin, levofloxacin, moxifloxacin, and gatifloxacin. Of all H. influenzae infections, 40%, 4.4% and 100% of pneumonia, meningitis and septicemia cases were caused by other serotypes or non-typeable strains. All ampicillin-resistant-strains produced beta-lactamase without detection of beta-lactamase-negative-ampicillin-resistant (BLNAR) strains. Hib is a leading cause of invasive bacterial infections in infants. Multidrug-resistant H. influenzae is common and requires amoxicillin-clavulanate, ceftriaxone or azithromycin as empirical therapy with specific recommendation for use of ceftriaxone for treatment of meningitis particularly MDR cases. New fluoroquinolines has potential utility. An effective national Hib vaccination programme is essential in Bangladesh although non-Hib infections will remain an issue.

Association between enteropathogens and malnutrition in children aged 6-23 mo in Bangladesh: a case-control study.

PubMed

Platts-Mills, James A; Taniuchi, Mami; Uddin, Md Jashim; Sobuz, Shihab Uddin; Mahfuz, Mustafa; Gaffar, Sm Abdul; Mondal, Dinesh; Hossain, Md Iqbal; Islam, M Munirul; Ahmed, Am Shamsir; Petri, William A; Haque, Rashidul; Houpt, Eric R; Ahmed, Tahmeed

2017-05-01

Background: Early exposure to enteropathogens has been associated with malnutrition in children in low-resource settings. However, the contribution of individual enteropathogens remains poorly defined. Molecular diagnostics offer an increase in sensitivity for detecting enteropathogens but have not been comprehensively applied to studies of malnutrition. Objective: We sought to identify enteropathogens associated with malnutrition in Bangladesh. Design: Malnourished children [weight-for-age z score (WAZ) <-2] aged 6-23 mo in Dhaka, Bangladesh, and identified by active community surveillance were enrolled as cases, and normal-weight children (WAZ >-1) of the same age and from the same community were enrolled as controls. Stools were collected at enrollment and, for cases, after a 5-mo nutritional intervention. Enrollment and follow-up stools were tested by quantitative polymerase chain reaction for 32 enteropathogens with the use of a custom-developed TaqMan Array Card. Results: Enteropathogen testing was performed on 486 cases and 442 controls upon enrollment and 365 cases at follow-up. At enrollment, the detection of enteroaggregative Escherichia coli (OR: 1.39; 95% CI: 1.05, 1.83), Campylobacter spp. (OR: 1.46; 95% CI: 1.11, 1.91), heat-labile enterotoxin-producing E. coli (OR: 1.55; 95% CI: 1.04, 2.33), Shigella /enteroinvasive E. coli (OR: 1.65; 95% CI: 1.10, 2.46), norovirus genogroup I (OR: 1.66; 95% CI: 1.23, 2.25), and Giardia (OR: 1.73; 95% CI: 1.20, 2.49) were associated with malnourished cases, and the total burden of these pathogens remained associated with malnutrition after adjusting for sociodemographic factors. The number of these pathogens at follow-up was negatively associated with the change in WAZ during the intervention (-0.10 change in WAZ per pathogen detected; 95% CI: -0.14, -0.06), whereas the number at enrollment was positively associated with the change in WAZ (0.05 change in WAZ per pathogen detected; 95% CI: 0.00, 0.10). Conclusions: A subset of enteropathogens was associated with malnutrition in this setting. Broad interventions designed to reduce the burden of infection with these pathogens are needed. This trial was registered at clinicaltrials.gov as NCT02441426.

Controlling scabies in madrasahs (Islamic religious schools) in Bangladesh.

PubMed

Talukder, K; Talukder, M Q K; Farooque, M G; Khairul, M; Sharmin, F; Jerin, I; Rahman, M A

2013-01-01

To assess the effectiveness of a scabies control programme in reducing the prevalence of scabies in urban Bangladesh madrasahs, where the condition is extremely common. A controlled trial involving four intervention madrasahs (total students 2359) and four control madrasahs (total students 2465) in Dhaka Metropolitan Area. A baseline scabies sample survey was carried out on 40 and 44 students of four intervention and four control madrasahs, respectively. Another 40 students of the intervention madrasahs were administered a pre-intervention test on scabies knowledge. This was followed by mass treatment of all students, teachers and staff of the eight madrasahs with topical 5% permethrin cream. The subsequent intervention involved daily monitoring of students for five key personal hygiene practices, weekly 10-min scabies health education classes, supply of simple and inexpensive products to students to prevent cross-infestation to/from peers (e.g. plastic bags, clothes hangers), and chemotherapy of new students detected with scabies. After 4 months of the intervention, the prevalence of scabies, personal hygiene practices and scabies knowledge were assessed in students of the intervention madrasahs. Before the intervention, the prevalence of scabies was 61% and 62% in intervention and control madrasahs, respectively (P = 1.00). After mass scabies treatment in all eight madrasahs and 4 months of intervention, the prevalence of scabies was reduced to 5% and 50% in intervention and control madrasahs, respectively (P < 0.001). There were significant improvements in all five personal hygiene practices at the intervention madrasahs. Mean test scores for scabies knowledge were 40% before the intervention and 99% after the intervention in the four intervention madrasahs. The cost of this programme was US$1.60 per student, and primarily included products such as plastic bags and clothes hangers, and health education material. This programme demonstrates a pragmatic and cost-effective way to control scabies in a residential institutional setting. It is recommended that this programme should be scaled up to all residential madrasahs in Bangladesh. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Women's decision-making autonomy and utilisation of maternal healthcare services: results from the Bangladesh Demographic and Health Survey.

PubMed

Ghose, Bishwajit; Feng, Da; Tang, Shangfeng; Yaya, Sanni; He, Zhifei; Udenigwe, Ogochukwu; Ghosh, Sharmistha; Feng, Zhanchun

2017-09-07

The aim of this study was to determine the association between women's decision-making power and utilisation of maternal healthcare services (MHS) among Bangladeshi women. This is a nationally representative survey that encompassed Dhaka, Rajshahi, Rangpur, Chittagong, Khulna, Barisal and Sylhet in Bangladesh. Sample households were selected by a two-stage stratification technique. First, 207 clusters in urban areas and 393 in rural areas were selected for 600 enumeration areas with proportional probability. In the second stage, on average 30 households were selected systematically from the enumeration areas. Finally, 17 989 households were selected for the survey of which 96% were interviewed successfully. Cross-sectional data on 4309 non-pregnant women were collected from Bangladesh demographic and health survey 2014. Decision-making status on respondent's own healthcare, large household purchases, having a say on child's healthcare and visiting to family or relatives were included in the analysis. Prevalence of at least four antenatal attendance, facility delivery and postnatal check-up were respectively 32.6% (95% CI 31.2 to 34), 40.6% (95% CI 39.13 to 42.07) and 66.3% (95% CI 64.89 to 67.71). Compared with women who could make decisions alone, women in the urban areas who had to decide on their healthcare with husband/partner had 20% (95% CI 0.794 to 1.799) higher odds of attending at least four antenatal visits and those in rural areas had 35% (95% CI 0.464 to 0.897) lower odds of attending at least four antenatal visits. Women in urban and rural areas had respectively 43% (95% CI 0.941 to 2.169) and 28% (95% CI 0.928 to 1.751) higher odds of receiving postnatal check-up when their health decisions were made jointly with their husband/partner. Neither making decisions alone, nor deciding jointly with husband/partner was always positively associated with the utilisation of all three types of MHS. This study concludes that better spousal cooperation on household and health issues could lead to higher utilisation of MHS services. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Women-focused development intervention reduces delays in accessing emergency obstetric care in urban slums in Bangladesh: a cross-sectional study.

PubMed

Nahar, Shamsun; Banu, Morsheda; Nasreen, Hashima E

2011-01-30

Recognizing the burden of maternal mortality in urban slums, in 2007 BRAC (formally known as Bangladesh Rural Advancement Committee) has established a woman-focused development intervention, Manoshi (the Bangla abbreviation of mother, neonate and child), in urban slums of Bangladesh. The intervention emphasizes strengthening the continuum of maternal, newborn and child care through community, delivery centre (DC) and timely referral of the obstetric complications to the emergency obstetric care (EmOC) facilities. This study aimed to assess whether Manoshi DCs reduces delays in accessing EmOC. This cross-sectional study was conducted during October 2008 to January 2009 in the slums of Dhaka city among 450 obstetric complicated cases referred either from DCs of Manoshi or from their home to the EmOC facilities. Trained female interviewers interviewed at their homestead with structured questionnaire. Pearson's chi-square test, t-test and Mann-Whitney test were performed. The median time for making the decision to seek care was significantly longer among women who were referred from home than referred from DCs (9.7 hours vs. 5.0 hours, p < 0.001). The median time to reach a facility and to receive treatment was found to be similar in both groups. Time taken to decide to seek care was significantly shorter in the case of life-threatening complications among those who were referred from DC than home (0.9 hours vs.2.3 hours, p = 0.002). Financial assistance from Manoshi significantly reduced the first delay in accessing EmOC services for life-threatening complications referred from DC (p = 0.006). Reasons for first delay include fear of medical intervention, inability to judge maternal condition, traditional beliefs and financial constraints. Role of gender was found to be an important issue in decision making. First delay was significantly higher among elderly women, multiparity, non life-threatening complications and who were not involved in income-generating activities. Manoshi program reduces the first delay for life-threatening conditions but not non-life-threatening complications even though providing financial assistance. Programme should give more emphasis on raising awareness through couple/family-based education about maternal complications and dispel fear of clinical care to accelerate seeking EmOC.

Retention of female volunteer community health workers in Dhaka urban slums: a case-control study.

PubMed

Alam, Khurshid; Tasneem, Sakiba; Oliveras, Elizabeth

2012-09-01

Volunteer community health workers (CHWs) are one approach to addressing the health workforce shortage in developing countries. BRAC, a large NGO in Bangladesh, is a pioneer in using female volunteer CHWs as core workers in its successful health programmes. After 25 years of implementing the CHW model in rural areas, BRAC is now using CHWs in urban slums of Dhaka through Manoshi, a community-based maternal and child health project. However, high dropout rates among CHWs in the slums suggested a need to better understand factors associated with their retention, and consequently recommend strategies for increasing their retention. This mixed-method study included a case-control design to assess factors relating to the retention of volunteer CHWs, and focus group discussions (FGDs) to explore solutions to problems. In total, 542 current and 146 dropout CHWs participated in the survey. Six FGDs were held with groups of current and groups of dropout CHWs. Financial incentives were the main factor linked to CHW retention. CHWs who joined with the expectation of income were almost twice as likely to remain as CHWs. This finding was reinforced by the inverse association between wealth quintile of the CHWs and retention; the poorest CHWs were significantly more likely to stay in the programme than the richest. However, social prestige, community approval and household responsibilities were important non-financial factors associated with CHW retention. Restructuring and expansion of existing financial incentives to better compensate CHWs were recommended by CHWs to improve their retention. Factors found to be important in this study are similar to those from earlier studies in rural areas. While the data indicate that financial incentives are the most commonly discussed factor regarding CHW retention in urban slums, the results also suggest other avenues that could be strengthened to improve their retention.

Comparison of Success of Clomiphene citrate and Letrozole in Ovulation Induction.

PubMed

Saha, J; Akhter, S; Prasad, I; Siddiq, S

2016-01-01

The study was carried out to evaluate which drug is better in ovulation induction between clomiphene citrate and letrozole. The study was carried out in the infertility unit of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka and Centre for Assisted Reproduction (CARE) at Bangladesh Institute of Research and Rehabilitation in Diabetes Endocrine and Metabolic Disorders (BIRDEM), Dhaka from January 2007 to December 2007. One hundred and sixty five cases were taken for the study. It was a prospective interventional comparative study of clomiphene citrate and letrozole in infertile cases. The patients were divided into three groups. Group I--newly detected cases of sub fertility studied with clomiphene citrate. Group II--clomiphene citrate resistant cases studied with letrozole, Group III--newly detected cases of sub fertility studied with letrozole. The cases were followed up for outcome; (ovulation). The TVS was done on 12th or 13th day of menstruation and level of serum progesterone on 21st day of menstrual cycle to see the evidence of ovulation. Endometrial thickness was also measured. The data was collected on a predesigned questionnaire. The variables that influenced the study were-age, occupation, socioeconomic status, menstrual cycle, marital age, parity, history of MR, history of abortion, past medical and surgical history. In the current study it was observed that the signs of ovulation were significantly (p<0.05) higher in Group I treated with clomiphene citrate in comparison to Group II clomiphene citrate resistant cases treated with letrozole. The rate of ovulation was higher in Group I than that of Group III treated with letrozole, but the difference was not statistically significant (p>0.05). The signs of ovulation were present in 45(81.8%) cases in Group I, 33(60.0%) cases in Group II and 37(67.3%) cases in Group III. This findings of the study suggested that clomiphene citrate is higher successful than letrozole though not statistically significant. Letrozole can be preferred in clomiphene citrate resistant cases before starting other expensive therapies.

Thyroid Status in Children with Transfusion Dependent Hb-E β-Thalassaemia.

PubMed

Sharmin, T; Mollah, A H; Morshed, A A; Chowdhury, M K

2018-04-01

Despite improved haematological care, multi-endocrine dysfunction is a common complication in thalassemia. Iron overload is thought to be the most likely mechanism in thyroid dysfunction in these patients. Moreover, chronic tissue hypoxia might havedirect toxic effect on thyroid gland resulting in hypothyroidism. This study was designed to evaluate the thyroid status of children with Hb-E β-thalassemia. This cross sectional analytic study was conducted among thepatients with Hb-E β-thalassemia attending both in-patient & out-patient department of Paediatrics, Dhaka Medical College & Hospital, Dhaka, Bangladesh from April 2012 to March 2013. The children who attended inpatient and outpatient department of Paediatrics for some other illness were screened out for thalassaemia and were recruited as comparison group. Thyroid function tests (TSH & FT₄ level) were performed in both thalassaemic patients and comparison group. Serum ferritin level was also measured for assessing iron status of thalassaemic patients and their pre-transfusion Hb levels were recorded in the pre-formed data collection form. Of the 50 thalassaemia patients, 13(26%) had subclinical hypothyroidism. This proportion of subclinical hypothyroidism was significantly high, compared to that (2.5%) of non thalassaemia comparison group. Among the subclinically hypothyroid thalassaemia subjects, 8 were males and 5 were females and their mean age was 102.38±33.29 months. The mean serum ferritin levels in hypothyroid and euthyroid thalassaemia cases were 2387.87±1642.85ng/ml and 1822.95±1345.33ng/ml respectively (normal level upto 300ng/ml). This difference was not statistically significant (p=0.279); but the pre-transfusion Hb level wasfound significantly different (p=0.02) among the two groups. It was 5.57±0.98g/dl in hypothyroid & 6.37±0.09g/dl in euthyroid thalassaemic cases. Subclinical hypothyroidism was quite high among the children with transfusion dependent Hb-E β-thalassaemia. Their hypothyroid status had no significant correlation with their serum ferritin level but had significant correlation with low haemoglobin status.

A hygiene experiment in rural Bangladesh.

PubMed

Khanom, K; Leonard, R C

1989-01-01

In February 1987, 10 students from the health education department at the National Institute of Preventive and Social Medicine of Bangladesh conducted a before after only health education experiment concerning intestinal worm infestation and sanitation by interviewing at least 160 individuals in a village outside of Dhaka. 74.5% initially believed that the only action to take for intestinal worm infestation was to visit a physician and take medicines. After 30 days of intense health education efforts, a 38% increase in those who gave preventive answers occurred among the lower class and a 52% increase among the middle class. Nevertheless 50% of the poor and 37% of the middle class still believed in curative care. In the pretest, 85% did not know how the worms entered the intestine and, in the posttest, this percent fell to 25%. The pretest showed that the typical village member only had 1 correct answer concerning adverse effects of the worms. After intense health education, the number of correct answers of the typical respondent climbed to 2. Moreover, before the intervention, only 20% reported washing their hands correctly after defecation using either rash or soap. After intervention, 96% did so. On the other hand, no change occurred in water sources (2 public tube wells or dirt storage ponds) or the latrine situation. Financial restraints and/or social class may have been responsible for the lack of changes. For example, a tube well is a status symbol of the rich and it would offend the rich if lesser families used them. Further, even the middle class could not afford a sanitary latrine. Therefore the health education intervention had little effect on 2 major sources of the worm infestation problem.

Prevalence of colorectal diseases in immunological fecal occult blood test (I-FOBT) positive patients in a tertiary care hospital in Bangladesh.

PubMed

Mollick, S H; Roy, P K; Bhuiyan, M R; Mia, A R; Alam, M S; Mollick, K A; Pervin, S; Hassan, M Q

2014-10-01

Bleeding lesion anywhere in the GI tract can cause positive reaction to Immunological Fecal Occult Blood Test (FOBT). Although any colonic lesion can cause occult lower GI bleeding, relative frequency of this lesion not known. Guaic based tests require prior preparation and dietary restriction and less sensitive and specific than IFOBT for detection of occult bleeding .IFOBT is specific for human hemoglobin and is more sensitive and specific for detection of occult bleeding from any colonic lesion. Aim of this study was to diagnose occult gastrointestinal bleeding with positive IFOBT and the prevalence of colorectal disease in IFOBT positive patients in a tertiary care hospital in Bangladesh. This was a prospective cross sectional study conducted in Department of gastroenterology in collaboration with clinical pathology, BSMMU, Dhaka during the period of January 2009 to December 2009. In this study 200 patients meeting the inclusion criteria were included. Detailed clinical history and physical findings were recorded; FOBT was done on single stool specimen. Positive occult bleeding was confirmed in 90 patients of whom 80 patients underwent colonoscopy. The mean age of study population was 36.73±13.64 (range 16 to 72) years. At colonoscopy lesion were identified in 46(57.50%) patients, of which colonic polyp in12 (15%), colorectal cancer in 11(13.7%), inflammatory bowel disease in 3(3.75%), hemorrhoids and anal fissure in 7(8.75%), tuberculosis in 5(6.25%), and proctitis in 1(1.25%) cases. A positive IFOBT is more sensitive and specific test than other FOBT for detection of occult lower GI bleeding of colonic origin. In this study colorectal diseases were detected in 57.50% of the IFOBT positive patients, so IOBT can be used as an important diagnostic tool for detection of occult lower GI bleeding.

Quality of Life in Children with Asthma in Bangladesh.

PubMed

Hassan, M R; Kabir, S; Basher, A E; Rahman, M A; Islam, M A; Khan, M K; Basher, M S

2017-07-01

Asthma is a public health problem that adversely affects different aspects of quality of life. Childhood asthma is common in Bangladesh affecting their lifestyle. The objective of the study was to assess health-related quality of life in children with bronchial asthma. A descriptive, cross-sectional study was carried out from January 2014 to December 2014 at the Outpatient Department of National Asthma Centre, Mohakhali, Dhaka among hundred sixty-two purposively selected children of both sexes with bronchial asthma aged from 7 to 17 years. Data were collected through interview with children or their parents using an interviewer-administered questionnaire based on Pediatric Asthma Quality of Life Questionnaire (PAQLQ). Data were analyzed by computer software SPSS version 16.0. The mean age was 12.5 years with a standard deviation (SD) of 2.9 years. Overwhelming majority 157(96.9%) of children were literate, while only 5(3.1%) children were illiterate. Eighty (49.4%) children were male, while 82(50.6%) female. As many as 148(91.4%) children were students, while 10(6.2%) children were engaged in some type of job and 4(2.5%) children had no occupation. Parents of 145(89.5%) children were currently married, while 10(6.2%) children had single parent and 7(4.3%) children's parents were divorced or separated. Quality of life in children with asthma decreases with age as the disease intensity increases with age. Female asthmatic children had lower overall score of Quality of life (p=0.017), as well as lower activity domain score (p<0.001). Emotional domain score was found lower in children with single parent (p=0.021) and low monthly family income (p<0.001). Furthermore, children with lower monthly family income and working children had lower Quality of life score in all domains.

The impact of type 2 diabetes on health related quality of life in Bangladesh: results from a matched study comparing treated cases with non-diabetic controls.

PubMed

Safita, Novie; Islam, Sheikh Mohammed Shariful; Chow, Clara K; Niessen, Louis; Lechner, Andreas; Holle, Rolf; Laxy, Michael

2016-09-13

Little is known about the association between diabetes and health related quality of life (HRQL) in lower-middle income countries. This study aimed to investigate HRQL among individuals with and without diabetes in Bangladesh. The analysis is based on data of a case-control study, including 591 patients with type 2 diabetes (cases) who attended an outpatient unit of a hospital in Dhaka and 591 age -and sex-matched individuals without diabetes (controls). Information about socio-demographic characteristics, health conditions, and HRQL were assessed in a structured interview. HRQL was measured with the EuroQol (EQ) visual analogue scale (VAS) and the EQ five-dimensional (5D) descriptive system. The association between diabetes status and quality of life was examined using multiple linear and logistic regression models. Mean EQ-VAS score of patients with diabetes was 11.5 points lower (95 %-CI: -13.5, -9.6) compared to controls without diabetes. Patients with diabetes were more likely to report problems in all EQ-5D dimensions than controls, with the largest effect observed in the dimensions 'self-care' (OR = 5.9; 95 %-CI: 2.9, 11.8) and 'mobility' (OR = 4.5; 95 %-CI: 3.0, -6.6). In patients with diabetes, male gender, high education, and high-income were associated with higher VAS score and diabetes duration and foot ulcer associated with lower VAS scores. Other diabetes-related complications were not significantly associated with HRQL. Our findings suggest that the impact of diabetes on HRQL in the Bangladeshi population is much higher than what is known from western populations and that unlike in western populations comorbidities/complications are not the driving factor for this effect.

Heavy metal contamination of freshwater prawn (Macrobrachium rosenbergii) and prawn feed in Bangladesh: A market-based study to highlight probable health risks.

PubMed

Rabiul Islam, G M; Habib, Mohammad Ruzlan; Waid, Jillian L; Rahman, M Safiur; Kabir, J; Akter, S; Jolly, Y N

2017-03-01

An assessment of the dietary risk of heavy metal exposure to humans is important since it is the main source of exposure. This study aimed to estimate the degree of contamination and assess the probable health risk in the prawn food chain. In prawn feed, the concentrations of metals were detected in the following order: Hg > Co > Pb > Cd. The concentrations of heavy metals in prawn were the highest for Co and lowest for Cd. Trace amounts of As and Cr were detected in the analyzed sample. Target hazard quotients for heavy metals for adults were >1 for Pb, Cd, Hg, and Co, and for children, the same were high for Co and Hg, indicating significant health risks upon dietary exposure. All the prawn samples contained nine-fold and fourteen-fold higher concentrations than the maximum acceptable levels for Pb and Hg, respectively (0.5 mg kg -1 ; WHO/FAO). Human health risk due to the Co exposure is quite alarming as the level of exposure was found to be very high. In the prawn samples intended for human consumption, the hazard index (HI) was highest in the samples obtained from Bagerhat (3.25 in flesh and 3.26 in skin), followed by the samples obtained from Satkhira (2.84 in flesh and 3.10 in skin) and Dhaka City Corporation (2.81 in flesh and 3.42 in Skin); this indicates a potential risk of prawn consumption obtained from Southeast Bangladesh. This is particularly problematic as this area accounts for the majority of prawn production and export of the country. Copyright © 2016 Elsevier Ltd. All rights reserved.

Recent Trends in the Presentation of Neuroanatomy in Contemporary Neuroanatomy Books as Revealed in Their 'Preface's: A Review.

PubMed

Yasmin, Q S; Banu, L A; Rahman, M F; Paul, S

2015-04-01

Many changes have been made in the field of Neuroanatomy teaching and assessment. One important way to know the changes in other country is by analyzing the Neuroanatomy text books and we can compare their reflections in our curriculum by analyzing the assessment system. To analyze the 'Preface's of contemporary Neuroanatomy text books, qualitatively, for noting the approaches taken and means applied in dealing with Neuroanatomy in the text books. This review was done in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from July 2008 and June 2009. The 'Preface's of ten contemporary text books dealing with Neuroanatomy, published since 1993, was analyzed. Among them, the two that are most commonly recommended to the medical postgraduates in Bangladesh were selected for analyzing their presentation of text and illustrations. The 'Preface's of ten books were analyzed qualitatively to identify the information and explanations provided and comments made by their author(s)/editor(s) on the approaches taken and the means applied in the books in selecting and presenting topics, text and illustrations. The observations were organized into specific 'theme's. Twelve 'theme's were identified from the analyses of the 'Preface's of ten contemporary Neuroanatomy text books. These include special emphasis in the books on incorporation of new information, on practical application of Neuroanatomical facts. Addition and improvement regarding illustrations are also highlighted. By incorporating the findings of the present study with the present-day ideas and trends in Neuroanatomy in the developed world as evident from the available literature, suggestions could be formulated on improving the methods of teaching and assessment of Neuroanatomy in Bangladesh.

The role of negative affect and message credibility in perceived effectiveness of smokeless tobacco health warning labels in Navi Mumbai, India and Dhaka, Bangladesh: A moderated-mediation analysis.

PubMed

Mutti-Packer, Seema; Reid, Jessica L; Thrasher, James F; Romer, Daniel; Fong, Geoffrey T; Gupta, Prakash C; Pednekar, Mangesh S; Nargis, Nigar; Hammond, David

2017-10-01

There is strong evidence showing that pictorial health warnings are more effective than text-only warnings. However, much of this evidence comes from high-income countries and is limited to cigarette packaging. Moreover, few studies have identified mechanisms that might explain the impact of warnings. The current study examined the potential mediating role of negative affect and the moderating influence of message credibility in perceived effectiveness of smokeless tobacco warnings in two low- and middle-income countries (LMICs). Field interviews were conducted in India and Bangladesh, with adult (19+ years) smokeless tobacco users (n=1053), and youth (16-18years) users (n=304) and non-users (n=687). Respondents were randomly assigned to view warnings in one of four conditions: (1) Text-only, (2) pictorial with symbolic imagery, (3) pictorial with graphic images of health effects, or (4) pictorial with personalized graphic images plus a personal testimonial. The findings provide support for the mediating influence of negative affect in perceived effectiveness, for adult and youth smokeless tobacco users who viewed pictorial warnings (vs. text-only), and graphic health warnings (vs. personal testimonials). Among adults, message credibility moderated the indirect effect; the association was stronger when credibility was high and weaker when it was low. Among youth users and non-users, message credibility did not moderate the indirect effect. Consistent with research from high-income countries, these findings highlight the importance of selecting imagery that will elicit negative emotional reactions and be perceived as credible. Differential effects among adults and youth highlight the importance of pre-testing images. Copyright © 2017 Elsevier Ltd. All rights reserved.

Bacterial and viral pathogen spectra of acute respiratory infections in under-5 children in hospital settings in Dhaka city

PubMed Central

Bhuyan, Golam Sarower; Hossain, Mohammad Amir; Sarker, Suprovath Kumar; Rahat, Asifuzzaman; Islam, Md Tarikul; Haque, Tanjina Noor; Begum, Noorjahan; Qadri, Syeda Kashfi; Muraduzzaman, A. K. M.; Islam, Nafisa Nawal; Islam, Mohammad Sazzadul; Sultana, Nusrat; Jony, Manjur Hossain Khan; Khanam, Farhana; Mowla, Golam; Matin, Abdul; Begum, Firoza; Shirin, Tahmina; Ahmed, Dilruba; Saha, Narayan; Qadri, Firdausi

2017-01-01

The study aimed to examine for the first time the spectra of viral and bacterial pathogens along with the antibiotic susceptibility of the isolated bacteria in under-5 children with acute respiratory infections (ARIs) in hospital settings of Dhaka, Bangladesh. Nasal swabs were collected from 200 under-five children hospitalized with clinical signs of ARIs. Nasal swabs from 30 asymptomatic children were also collected. Screening of viral pathogens targeted ten respiratory viruses using RT-qPCR. Bacterial pathogens were identified by bacteriological culture methods and antimicrobial susceptibility of the isolates was determined following CLSI guidelines. About 82.5% (n = 165) of specimens were positive for pathogens. Of 165 infected cases, 3% (n = 6) had only single bacterial pathogens, whereas 43.5% (n = 87) cases had only single viral pathogens. The remaining 36% (n = 72) cases had coinfections. In symptomatic cases, human rhinovirus was detected as the predominant virus (31.5%), followed by RSV (31%), HMPV (13%), HBoV (11%), HPIV-3 (10.5%), and adenovirus (7%). Streptococcus pneumoniae was the most frequently isolated bacterial pathogen (9%), whereas Klebsiella pneumaniae, Streptococcus spp., Enterobacter agglomerans, and Haemophilus influenzae were 5.5%, 5%, 2%, and 1.5%, respectively. Of 15 multidrug-resistant bacteria, a Klebsiella pneumoniae isolate and an Enterobacter agglomerans isolate exhibited resistance against more than 10 different antibiotics. Both ARI incidence and predominant pathogen detection rates were higher during post-monsoon and winter, peaking in September. Pathogen detection rates and coinfection incidence in less than 1-year group were significantly higher (P = 0.0034 and 0.049, respectively) than in 1–5 years age group. Pathogen detection rate (43%) in asymptomatic cases was significantly lower compared to symptomatic group (P<0.0001). Human rhinovirus, HPIV-3, adenovirus, Streptococcus pneumonia, and Klebsiella pneumaniae had significant involvement in coinfections with P values of 0.0001, 0.009 and 0.0001, 0.0001 and 0.001 respectively. Further investigations are required to better understand the clinical roles of the isolated pathogens and their seasonality. PMID:28346512

Health Related Quality of Life in Children with Nephrotic Syndrome in Bangladesh.

PubMed

Rahman, M; Afroz, S; Ali, R; Hanif, M

2016-10-01

Outcome of children with nephrotic syndrome has continued to improve over time. However minimal data exist to describe health-related quality of life in children with nephrotic syndrome. This cross sectional study was conducted over a period of six months to assess the health related quality of life in children with nephrotic syndrome in the Department of Pediatric Nephrology, Dhaka Medical College Hospital, Bangladesh. Fifty children (age ranged 2-12 years) with nephrotic syndrome who had three or more relapses diagnosed at least one year back receiving treatment and on follow up were included in this study. Quality of Life scores were collected using Bengali translated instruments- the Pediatric Quality of Life Inventory™ (PedsQL™) version 4.0 Generic Scale and the Pediatric Quality of Life Questionnaire for Nephrotic Syndrome proxy-report from parents. Medical data and Demographic data were collected from medical records, and from parents in outpatient department or hospital ward. Interviews of eligible guardians were performed individually to collect quality of life (QoL) scores. Among 50 children, mean±SD age of the children was 7±2.92 years. Most children were male (58%). Female parents respondent during interview were 62%, most parents (48%) were very poor in socioeconomic condition. Most children had frequent relapses (60%). Median time since diagnosis was 2 years. Regarding PedsQL scores, child age with physical summary score (p value <0.001), child age with social summary score (p value 0.003), frequent relapse with kidney disease summary score (p value 0.04) and time since diagnosis (p value <0.001) were statistically significant. In conclusion physical and social summary score were worst. Frequent relapse found to be an important factor in impaired QoL. Prolonged duration of the disease activity was associated with significant impairment of QoL.

Hand hygiene knowledge and practice among university students: evidence from Private Universities of Bangladesh.

PubMed

Sultana, Marufa; Mahumud, Rashidul Alam; Sarker, Abdur Razzaque; Hossain, Sarder Mahmud

2016-01-01

Hand hygiene has achieved the reputation of being a convenient means of preventing communicable diseases. Although causal links between hand hygiene and rates of infectious disease have also been established earlier, studies focusing on hand hygiene among university-going students are not adequate in number. This study evaluated handwashing knowledge, practice, and other related factors among the selected university students in the city of Dhaka, Bangladesh. A cross-sectional study was conducted among 200 undergraduate students from four selected universities. A pretested, semistructured questionnaire, that included a checklist associated with handwashing practice, was applied to capture all relevant data. The mean (± SD) age of the participants was 20.4 (±1.8) years. The majority of the students washed their hands with water, but only 22.5% washed their hands effectively by maintaining the correct steps and frequency of handwashing with water, and soap or hand sanitizer. The mean (± SD) score of the participants' hand hygiene practice was 50.81 (±4.79), while the total score with all perfect answers was considered as 66. Regression coefficient demonstrated that age has a negative influence on hand hygiene practice, as older students have lower scores compared to the younger ones (P<0.01). However, the unmarried students were a significant predictor for influencing the incensement of handwashing practice compared to the married ones (P<0.01). Findings of this study designate widespread insufficient hand hygiene practice in the university-going students and indicate a need for an extensive public health education program on this topic. Furthermore, availability of soap and sufficient water supply is needed within the university setting to facilitate handwashing. Therefore, supporting quantity and quality of available campus-based public health education programs along with providing health-washing equipment is suggested.

Qualitative insights into promotion of pharmaceutical products in Bangladesh: how ethical are the practices?

PubMed

Mohiuddin, Mahrukh; Rashid, Sabina Faiz; Shuvro, Mofijul Islam; Nahar, Nahitun; Ahmed, Syed Masud

2015-12-01

The pharmaceutical market in Bangladesh is highly concentrated (top ten control around 70 % of the market). Due to high competition aggressive marketing strategies are adopted for greater market share, which sometimes cross limit. There is lack of data on this aspect in Bangladesh. This exploratory study aimed to fill this gap by investigating current promotional practices of the pharmaceutical companies including the role of their medical representatives (MR). This qualitative study was conducted as part of a larger study to explore the status of governance in health sector in 2009. Data were collected from Dhaka, Chittagong and Bogra districts through in-depth interview (healthcare providers and MRs), observation (physician-MR interaction), and round table discussion (chief executives and top management of the pharmaceutical companies). Findings reveal a highly structured system geared to generate prescriptions and ensure market share instituted by the pharmaceuticals. A comprehensive training curriculum for the MRs prepares the newly recruited science graduates for generating enough prescriptions by catering to the identified needs and demands of the physicians expressed or otherwise, and thus grab higher market-share for the companies they represent. Approaches such as inducements, persuasion, emotional blackmail, serving family members, etc. are used. The type, quantity and quality of inducements offered to the physicians depend upon his/her capacity to produce prescriptions. The popular physicians are cultivated meticulously by the MRs to establish brand loyalty and fulfill individual and company targets. The physicians, willingly or unwillingly, become part of the system with few exceptions. Neither the regulatory authority nor the professional or consumer rights bodies has any role to control or ractify the process. The aggressive marketing of the pharmaceutical companies compel their MRs, programmed to maximize market share, to adopt unethical means if and when necessary. When medicines are prescribed and dispensed more for financial interests than for needs of the patients, it reflects system's failed ability to hold individuals and entities accountable for adhering to basic professional ethics, code of conduct, and statutory laws.

A new methodology for dynamic modelling of health risks arising from wastewater influenced urban flooding

NASA Astrophysics Data System (ADS)

Jørgensen, Claus; Mark, Ole; Djordjevic, Slobodan; Hammond, Michael; Khan, David M.; Erichsen, Anders; Dorrit Enevoldsen, Ann; Heinicke, Gerald; Helwigh, Birgitte

2015-04-01

Indroduction Urban flooding due to rainfall exceeding the design capacity of drainage systems is a global problem and it has significant economic and social consequences. While the cost of the direct flood damages of urban flooding is well understood, the indirect damages, like the water borne diseases is in general still poorly understood. Climate changes are expected to increase the frequency of urban flooding in many countries which is likely to increase water borne diseases. Diarrheal diseases are most prevalent in developing countries, where poor sanitation, poor drinking water and poor surface water quality causes a high disease burden and mortality, especially during floods. The level of water borne diarrhea in countries with well-developed water and waste water infrastructure has been reduced to an acceptable level, and the population in general do not consider waste water as being a health risk. Hence, exposure to wastewater influenced urban flood water still has the potential to cause transmission of diarrheal diseases. When managing urban flooding and planning urban climate change adaptations, health risks are rarely taken into consideration. This paper outlines a novel methodology for linking dynamic urban flood modelling with Quantitative Microbial Risk Assessment (QMRA). This provides a unique possibility for understanding the interaction between urban flooding and the health risks caused by direct human contact with flood water and provides an option for reducing the burden of disease in the population through the use of intelligent urban flood risk management. Methodology We have linked hydrodynamic urban flood modelling with quantitative microbial risk assessment (QMRA) to determine the risk of infection caused by exposure to wastewater influenced urban flood water. The deterministic model MIKE Flood, which integrates the sewer network model in MIKE Urban and the 2D surface model MIKE21, was used to calculate the concentration of pathogens in the flood water, based on either measured waste water pathogen concentrations or on assumptions regarding the prevalence of infections in the population. The exposure (dosage) to pathogens was estimated by multiplying the concentration with literature values for the ingestion of water for different exposure groups (e.g. children, adults). The probability of infection was determined by applying dose response relations and MonteCarlo simulation. The methodology is demonstrated on two cases, i.e one case from a developing country with poor sanitation and one case from a developed country, where climate adaptation is the main issue: The risk of cholera in the City of Dhaka, Bangladesh during a flood event 2004, and the risk of bacterial and viral infections of during a flood event in Copenhagen, Denmark in 2011. Results PIC The historical flood events in Dhaka (2004) and Copenhagen (2011) were successfully modelled. The urban flood model was successfully coupled to QMRA. An example of the results of the quantitative microbial risk assessment given as the average estimated risk of cholera infection for children below 5 years living in slum areas in Dhaka is shown in the figure. Similarly, the risk of infection during the flood event in Copenhagen will be presented in the article. Conclusions We have developed a methodology for the dynamic modeling of the risk of infection during waste water influenced urban flooding. The outcome of the modelling exercise indicates that direct contact with polluted flood water is a likely route of transmission of cholera in Dhaka, and bacterial and viral infectious diseases in Copenhagen. It demonstrates the applicability and the potential for linking urban flood models with QMRA in order to identify interventions to reduce the burden of disease on the population in Dhaka City and Copenhagen.

Calculation of the Carbon Footprint to Determine Sustainability Status: A Comparative Analysis of Some Selected Planned and Unplanned Areas of Dhaka Megacity

NASA Astrophysics Data System (ADS)

Iqbal, S. M. S.

2015-12-01

Resource scarcity is considered to be one of the most serious issues plaguing Dhaka city. Because of the massive pressure of increasing population (15.931 million), a very unsustainable situation is waiting for this city in the upcoming future. It is inevitable to know how far this city is from being sustainable. This paper embodies the comparative analysis of the carbon footprint of four different areas in Dhaka city. It is considered as one of the most important key indicators of sustainability. It calculates the amount of biologically productive land in order to produce all the resources consumed by an individual or a particular community. This research has been conducted in both the planned and unplanned areas of this city. Among compound, component and direct method, component method was used to calculate the carbon footprint. Primary data were collected from door to door questionnaire survey. Total 371 samples were drawn from all the study areas at 95 % confidence level and 5% confidence interval. After finishing data analysis it was clear that the per capita carbon footprint of the selected study areas exceeds the per capita biocapacity of Dhaka city. And there exists a huge variation between the planned and unplanned areas of Old Dhaka and New Dhaka. Per capita carbon footprint of Gulshan & Jhigatola (part of New Dhaka) is higher than the per capita carbon footprint of Gandaria & Wari (part of Old Dhaka) that means resource stress is higher in Gulshan & Jhigatola in comparison with Gandaria & Wari because of the difference of daily consumption pattern. One of the most important findings of this study is that the per capita carbon footprint is the highest in Gulshan (1.2407 gha) among all the study areas and it is 85.56 times greater than the per capita biocapacity of Dhaka city (0.0145 gha) that means a single resident of this area needs 1.2407 gha land in order to support his/her demand on nature but only 0.0145 gha land (in an average) is available for him/her which indicates a very unsustainable future for the residents of this area. So now it is the most suitable time that urban planners and policy makers of our country immediately undertake some indispensable measures to ensure the sustainable future of this city. Key Words: Resource Scarcity, Sustainability, Per Capita Carbon Footprint and Per Capita Biocapacity.

Waste Management in Greater Dhaka City.

ERIC Educational Resources Information Center

Rahman, M. H.

1993-01-01

This study focuses on the environmental degradation of Greater Dhaka City (GDC) resulting from pollution created by the indiscriminate disposal of industrial wastes, open dumping of solid wastes, inadequate treatment and disposal of domestic sewage, and unplanned disposal of leachate from agricultural land. Measures to protect the GDC environment…

Hand hygiene knowledge and practice among university students: evidence from Private Universities of Bangladesh

PubMed Central

Sultana, Marufa; Mahumud, Rashidul Alam; Sarker, Abdur Razzaque; Hossain, Sarder Mahmud

2016-01-01

Hand hygiene has achieved the reputation of being a convenient means of preventing communicable diseases. Although causal links between hand hygiene and rates of infectious disease have also been established earlier, studies focusing on hand hygiene among university-going students are not adequate in number. This study evaluated handwashing knowledge, practice, and other related factors among the selected university students in the city of Dhaka, Bangladesh. A cross-sectional study was conducted among 200 undergraduate students from four selected universities. A pretested, semistructured questionnaire, that included a checklist associated with handwashing practice, was applied to capture all relevant data. The mean (± SD) age of the participants was 20.4 (±1.8) years. The majority of the students washed their hands with water, but only 22.5% washed their hands effectively by maintaining the correct steps and frequency of handwashing with water, and soap or hand sanitizer. The mean (± SD) score of the participants’ hand hygiene practice was 50.81 (±4.79), while the total score with all perfect answers was considered as 66. Regression coefficient demonstrated that age has a negative influence on hand hygiene practice, as older students have lower scores compared to the younger ones (P<0.01). However, the unmarried students were a significant predictor for influencing the incensement of handwashing practice compared to the married ones (P<0.01). Findings of this study designate widespread insufficient hand hygiene practice in the university-going students and indicate a need for an extensive public health education program on this topic. Furthermore, availability of soap and sufficient water supply is needed within the university setting to facilitate handwashing. Therefore, supporting quantity and quality of available campus-based public health education programs along with providing health-washing equipment is suggested. PMID:26929673

Can Escherichia coli fly? The role of flies as transmitters of E. coli to food in an urban slum in Bangladesh.

PubMed

Lindeberg, Yrja Lisa; Egedal, Karen; Hossain, Zenat Zebin; Phelps, Matthew; Tulsiani, Suhella; Farhana, Israt; Begum, Anowara; Jensen, Peter Kjaer Mackie

2018-01-01

To investigate the transmission of faecal bacteria by flies to food under natural settings. Over a period of 2 months, paired (exposed and non-exposed) containers with cooked rice were placed on the ground in kitchen areas in an urban slum area in Dhaka, Bangladesh, and the numbers of flies landing on the exposed rice were counted. Following exposure, the surface of the rice was microbiologically and molecularly analysed for the presence of Escherichia coli and genes of diarrhoeagenic E. coli and Shigella strains. Rice was at greater risk (P < 0·001) of being contaminated with E. coli if flies landed on the rice than if no flies landed on the rice (odds ratio 5·4 (P < 0·001, 95% CI: 2·5-11·7). Mean contamination in exposed rice samples (n = 60) was 3·1 × 103 CFU/g (95% CI: 2·2 × 103-4·0 × 103). Furthermore, for approximately half of the observed fly landings, the average CFU per fly landing was >0·6 × 103 CFU. Genes of diarrhoeagenic E. coli and Shigella species were detected in 39 of 60 (65%) of exposed rice samples. Two fly species were identified: the common housefly (Musca domestica) and the oriental latrine fly (Chrysomya megacephala). Flies may transmit large quantities of E. coli to food under field settings. The findings highlight the importance of implementing control measures to minimise exposure of food to flies to ensure food safety. Fly control measures should be considered for the prevention of diarrhoeal diseases caused by E. coli. © 2017 John Wiley & Sons Ltd.

A comprehensive situation assessment of injection practices in primary health care hospitals in Bangladesh

PubMed Central

2011-01-01

Background Understanding injection practices is crucial for evidence-based development of intervention initiatives. This study explored the extent of injection use and injection safety practices in primary care hospitals in Bangladesh. Methods The study employed both quantitative and qualitative research methods. The methods used were - a retrospective audit of prescriptions (n = 4320), focus group discussions (six with 43 participants), in-depth interviews (n = 38) with a range service providers, and systematic observation of the activities of injection providers (n = 120), waste handlers (n = 48) and hospital facilities (n = 24). Quantitative and qualitative data were assessed with statistical and thematic analysis, respectively, and then combined. Results As many as 78% of our study sample (n = 4230) received an injection. The most commonly prescribed injections (n = 3354) including antibiotics (78.3%), IV fluids (38.6%), analgesics/pain killers (29.4%), vitamins (26.7%), and anti-histamines (18.5%). Further, 43.7% (n = 1145) of the prescribed antibiotics (n = 2626) were given to treat diarrhea and 42.3% (n = 600) of IV fluids (n = 1295) were used to manage general weakness conditions. Nearly one-third (29.8%; n = 36/120) of injection providers reported needle-stick injuries in the last 6 months with highest incidences in Rajshahi division followed by Dhaka division. Disposal of injection needles, syringes and other materials was not done properly in 83.5% (n = 20/24) of the facilities. Health providers' safety concerns were not addressed properly; only 23% (n = 28/120) of the health providers and 4.2% (n = 2/48) of the waste handlers were fully immunized against Hepatitis B virus. Moreover, 73% (n = 87/120) of the injection providers and 90% (n = 43/48) of the waste handlers were not trained in injection safety practices and infection prevention. Qualitative data further confirmed that both providers and patients preferred injections, believing that they provide quick relief. The doctors' perceived injection use as their prescribing norm that enabled them to prove their professional credibility and to remain popular in a competitive health care market. Additionally, persistent pressure from hospital administration to use up injections before their expiry dates also influenced doctors to prescribe injections regardless of actual indications. Conclusions As far as the patients and providers' safety is concerned, this study demonstrated a need for further research exploring the dynamics of injection use and safety in Bangladesh. In a context where a high level of injection use and unsafe practices were reported, immediate prevention initiatives need to be operated through continued intervention efforts and health providers' training in primary care hospitals in Bangladesh. PMID:21985397

Risk factors of hemorrhagic and ischemic stroke among hospitalized patients in Bangladesh--A case control study.

PubMed

Riaz, B K; Chowdhury, S H; Karim, M N; Feroz, S; Selim, S; Rahman, M R

2015-04-01

The risk factor profiles, management and outcome have significant difference between stroke subsets. Aim of this study was to investigate the risk for the two most common subtypes of stroke in Bangladeshi population. Seventy cases of hemorrhagic stroke (HS) and 105 cases of confirmed ischemic stroke (IS) were recruited from the Shaheed Suhrawardy Medical College Hospital (ShSMCH) and Dhaka Medical College Hospital between January-June 2011. Total 171 age, sex matched controls were selected from the hospitalized patients with history of no stroke ever. Average hemorrhagic stroke patients (60.4 ± 12.3 years) were younger than both ischemic strokes (63.5 ± 13 years). Family history of premature cardiovascular death was found more in HS patients (p = 0.001). Multivariate logistic regression showed, in IS model 'less fruit consumption (OR 4.6), table salt intake (OR 8.15), psychosocial stress (OR 3.5), abnormal ECG (OR 3.6) and Increased WHR (OR 6.9) appeared as significant predictors adjusted for all potential candidate confounders. In HS model less fruit consumption (OR 5.0), table salt intake (OR 9.9), Stress (OR 4.1), family history of cardiovascular disease (CVD) death (OR 11.3), hypertension (OR 43), aspirin intake (OR 4.5) and increased WHR (OR 3.7) remained as significant predictors.

Climate-driven endemic cholera is modulated by human mobility in a megacity

NASA Astrophysics Data System (ADS)

Perez-Saez, Javier; King, Aaron A.; Rinaldo, Andrea; Yunus, Mohammad; Faruque, Abu S. G.; Pascual, Mercedes

2017-10-01

Although a differential sensitivity of cholera dynamics to climate variability has been reported in the spatially heterogeneous megacity of Dhaka, Bangladesh, the specific patterns of spread of the resulting risk within the city remain unclear. We build on an established probabilistic spatial model to investigate the importance and role of human mobility in modulating spatial cholera transmission. Mobility fluxes were inferred using a straightforward and generalizable methodology that relies on mapping population density based on a high resolution urban footprint product, and a parameter-free human mobility model. In accordance with previous findings, we highlight the higher sensitivity to the El Niño Southern Oscillation (ENSO) in the highly populated urban center than in the more rural periphery. More significantly, our results show that cholera risk is largely transmitted from the climate-sensitive core to the periphery of the city, with implications for the planning of control efforts. In addition, including human mobility improves the outbreak prediction performance of the model with an 11 month lead. The interplay between climatic and human mobility factors in cholera transmission is discussed from the perspective of the rapid growth of megacities across the developing world.

Enhancing University Courses and Field Schools through Cross-cultural Exchange: Joint US-Bangladeshi Trips to the Ganges-Brahmaputra and Mississippi Deltas

NASA Astrophysics Data System (ADS)

Steckler, M. S.; Goodbred, S. L., Jr.; Lowes, S.; Gilligan, J. M.; Ackerly, B.; Ahmed, K. M.; Akhter, S. H.; Sousa, D.; Wilson, C.; Datta, D. K.; Roy, K.; Mondal, D. R.

2014-12-01

As part of an NSF PIRE grant, we have led four field trips for undergraduate, MS and PhD students to large deltaic systems. Three trips took US students to the Ganges-Brahmaputra (GB) delta in Bangladesh and one brought Bangladeshi faculty and students to the Mississippi (Miss.) delta in the US. An essential component in the learning process and overall experience of each trip was that ~2/5 of the participants were students and professors from Bangladesh. In all cases, the involvement of a substantial international cohort greatly broadened perspectives on the topics being covered. For example, in GBD the local geologic and cultural knowledge of the Bangladeshis deepened the learning and engagement of the US students, an outcome that was almost universally noted in student reviews. The trips received similar feedback from Bangladeshi participants, as they had an enthusiastic and engaged audience of peers from the US. Even for the Miss. delta trip, the Bangladeshis added a unique perspective from a nation that faces similar environmental issues. These overwhelmingly positive contributions have been experienced in several different contexts. Three trips were associated with US courses and run over Spring Break. One matched sustainable development undergrads at Columbia U. with geology undergrads from Dhaka U., and two others matched a mixed group of graduate and undergrad students from Vanderbilt U. with cohorts from Bangladesh. The fourth trip was a stand-alone Field School for PhD students from 14 US universities and mostly MS students from 4 Bangladeshi universities. The focus of each trip ranged from broader surveys of tectonic, fluvial and coastal processes to investigations of geology and people affected by tropical storms. Of particular interest was the success of mixing undergrad and graduate students in the Vanderbilt course, which centered on the intersection of social sciences, physical sciences, and engineering. In this case, undergrads engaged in a liberal arts education brought a generally broader perspective than the more specialized graduate students. Overcoming this condition for the grad students is one of the principal reasons that the course was designed, and incorporating undergrads involved in the humanities and social disciplines invigorated these transdisciplinary aspects of the course.

Commercial cinema: a medium for development communication.

PubMed

Riber, J; Smith, S

1985-01-01

Worldview International Foundation, an international voluntary organization whose activities focus on practical participation in the information process, established a media center in Dhaka, Bangladesh in 1982 in an effort to use the film media to disseminate development messages. Initially, WIF worked with the Ministry of Education (MOE) to promote literacy. Using the social marketing approach to promote a development theme, the producers were able to plug into a commercially successful network that assured them of reaching a large, attentive audience for a very low cost. An estimated 8 million Bangladeshis have seen this literacy film in cinema halls, mobile film projection vans, and on television. Project evaluation showed that 95% of the surveyed audience enjoyed the film and understood the intended message. The film was so popular that it was submitted as the Bangladesh entry at an international film festival in Moscow. WIF's next project was the production of another film, this time for the Social Marketing Project -- an Agency for International Development (AID) funded family planning cimmunication project. This time a family planning theme was the social development message. The script was developed from research conducted by Manoff International, Inc., an American social marketing agency who worked closely with MRCB, a Bangladeshi market research agency. They identified the target audiences and the constraints against using contraceptive methods in Bangladesh. Then messages were designed to address these issues. A love story entitled "Together" was developed. The social message revolves around a newlywed couple; both are hesitant to immediately start a family, but neither feels comfortable discussing his/her feelings on the subject with the other because of strong cultural taboos against such a delay. As the story develops, the barriers are surmounted, and this "model couple" begins to discuss the issue -- using singing and dancing to express their concerns about family planning. Understanding audience expectations in a commercial cinema context is the key to successfully adapting this medium for social development messages. Although some foreign technical assistance was provided, the success of the 2 films described depended on how their themes were adapted to the traditional feature film format. To date, commercial cinema has been an underutilized medium for development messages. WIF's experiences demonstrate how effective, well-conceived social messages can be presented in a commercial cinema context. It is hoped this will encourage other to use this widely available channel of mass communication.

Mobile phone intervention for increasing adherence to treatment for type 2 diabetes in an urban area of Bangladesh: protocol for a randomized controlled trial.

PubMed

Islam, Sheikh Mohammed Shariful; Lechner, Andreas; Ferrari, Uta; Froeschl, Guenter; Alam, Dewan Shamsul; Holle, Rolf; Seissler, Jochen; Niessen, Louis W

2014-11-26

Mobile phone technologies including SMS (short message service) have been used to improve the delivery of health services in many countries. However, data on the effects of mobile health technology on patient outcomes in resource-limited settings are limited. The aim of this study therefore is to measure the impact of a mobile phone SMS service on treatment success of newly diagnosed type 2 diabetes in an urban area of Bangladesh. This is a single-centred randomized controlled intervention trial (prospective) comparing standard-of-care with standard-of-care plus a mobile phone-based SMS intervention for 6 months. A total of 216 participants with newly diagnosed type 2 diabetes will be recruited. Data will be collected at the outpatient department of Bangladesh Institute of Health Science (BIHS) hospital at baseline and after 6 months. The primary outcome measure will be change in HbA1c between baseline and 6 months. The secondary outcome measures are self-reported medication adherence, clinic attendance, self-reported adoption of healthy behaviours, diabetes knowledge, quality of life and cost effectiveness of the SMS intervention. The inclusion criteria will be as follows: diagnosed as patients with type 2 diabetes by the BIHS physician, using oral medication therapy, living in Dhaka city, registered with the BIHS hospital, using a mobile phone, willing to return for follow up after 6 months and providing written informed consent. Participants will be allocated to control and intervention arms after recruitment using a randomization software. Data will be collected on socio-demographic and economic information, mobile phone use and habits, knowledge of prevention, management and complications of diabetes, self-perceived quality of life assessment, self-reported diseases, medical history, family history of diseases, medication history, medication adherence, health seeking behaviour, tobacco use, physical activity, diet, mental health status, life events and disability, anthropometric measurements of weight, height, blood pressure and blood tests for HbA1c. Mobile phone SMS services have the potential to communicate with diabetes patients and to build awareness about the disease, improve self-management and avoid complications also in resource-limited setting. If this intervention proves to be efficient and cost-effective in the current trial, large-scale implementation could be undertaken. DRKS00005188 .

Kerosene lamp "Kupi": lights the house, but may bring darkness to life.

PubMed

Ahmed, S; Hussain, M; Rahman, A; Halim, A; Rahman, F

2009-07-01

In terms of mortality and morbidity, childhood burn comprises a significant public health problem in Bangladesh, especially in rural poor families who use kerosene-lamp "Kupi" for lighting and traditional mud-made open oven for cooking. They lack optimum safety measures. A total of 100 patients in the age group of 01 to 15 years who got admitted into the burn unit of Dhaka Medical College Hospital during the first half of 2005 were enrolled in the study. Data on socio-demographic variables and information on events and consequences of burn were extracted and analyzed. The results identified flame burn from kerosene lamp "Kupi" as the major cause and source of burn in affected children. Both electrical burn and burn by ash were seen to happen in older male and toddler boys respectively. There were 02 deaths in the series; both were females and were the victims of massive flame burn-one from Kupi and other form oven fire during cooking. Pediatric burn imposes stress on the physique, psyche and socio-economic status of the affected personnel and families. Effective measures are needed to prevent this unfortunate injury in children which is preventable to a large extent.

Influences of dehydration on clinical features of radiological pneumonia in children attending an urban diarrhoea treatment centre in Bangladesh.

PubMed

Chisti, M J; Salam, M A; Bardhan, P K; Ahad, R; La Vincente, S; Duke, T

2010-01-01

As the signs of dehydration often overlap with those of pneumonia, it may be difficult for health workers in resource-poor settings to make a clinical diagnosis of pneumonia in children with dehydration. This issue has received very little attention. To compare the clinical features of pneumonia in children with and without dehydration caused by diarrhoea. All children aged 2-59 months with diarrhoea and radiologically confirmed pneumonia admitted to the Special Care Ward (SCW) of Dhaka Hospital, ICDDR,B between September and December 2007 were enrolled for the study. Children with dehydration (67 cases) and those without (101 controls) were compared. Cases presented less frequently with fast breathing (60% vs 88%, p<0.001) and lower chest-wall indrawing (67% vs 82%, p=0.035) than did controls. In logistic regression analysis, cases more often had severe malnutrition (OR 2.31, CI 1.06-5.02, p=0.035) and cyanosis (OR 19.05, CI 1.94-186.68, p=0.011) and were abnormally sleepy (OR 372, CI 1.71-8.08, p=0.001). Fast breathing and lower chest-wall indrawing may be less reliable for the diagnosis of pneumonia in children with dehydration, especially when there is severe malnutrition.

Reservation wage of female volunteer community health workers in Dhaka urban slums: a bidding game approach.

PubMed

Alam, Khurshid; Tasneem, Sakiba; Huq, Molla

2014-12-01

BRAC, a large Bangladeshi NGO, recently has been using female volunteer community health workers (CHWs) in Dhaka urban slums to provide maternal and child health services. Due to erratic performance-based income and higher opportunity cost the urban CHWs lose motivation which contributes to high dropout and poor performance. This results challenges for the cost effectiveness and sustainability of the urban health program. CHWs also consider their performance-based income very low compare to their work load. So, CHWs raise their voice for a fixed income. In order to understand this problem we explored fixed income for CHWs and the correlates that influence it. We surveyed a sample of 542 current CHWs. We used bidding game approach to derive the equilibrium reservation wage for CHWs for providing full-time services. Then, we performed ordered logit models with bootstrap simulation to identify the determinants of reservation wage. The average reservation wage of CHWs to continue their work as full-time CHWs rather than volunteer CHWs was US$24.11 which was three times higher than their current performance-based average income of US$ 8.03. Those CHWs received additional health training outside BRAC were 72% and those who joined with an expectation of income were 62% more likely to ask for higher reservation wage. On the contrary, CHWs who were burdened with household loan were 65% and CHWs who had alternative income generating scope were 47% less likely to ask for higher reservation wage. Other important factors we identified were BRAC village organization membership, competition with other health services providers, performance as a CHW, and current and past monthly CHW income. The findings of this study are relevant to certain developing countries such as Bangladesh and Tanzania which commonly use volunteer CHWs, and where poor retention and performance is a common issue due to erratic and performance-based income. So, the study has implications in improving retention of health workers as well as their level of performance. The study also suggests that the financial incentives provided to CHWs should be clearly based on their qualifications and opportunity cost to ensure a high performing and motivated health workforce.

Hygiene on maternity units: lessons from a needs assessment in Bangladesh and India

PubMed Central

Cross, Suzanne; Afsana, Kaosar; Banu, Morsheda; Mavalankar, Dileep; Morrison, Emma; Rahman, Atiya; Roy, Tapash; Saxena, Deepak; Vora, Kranti; Graham, Wendy J

2016-01-01

Background As the proportion of deliveries in health institutions increases in low- and middle-income countries, so do the challenges of maintaining standards of hygiene and preventing healthcare-associated infections (HCAIs) in mothers and babies. Adequate water, sanitation, and hygiene (WASH) and infection prevention and control (IPC) in these settings should be seen as integral parts of the broader domain of quality care. Assessment approaches are needed which capture standards for both WASH and IPC, and so inform quality improvement processes. Design A needs assessment was conducted in seven maternity units in Gujarat, India, and eight in Dhaka Division, Bangladesh in 2014. The WASH & CLEAN study developed and applied a suite of tools – a ‘walkthrough checklist’ which included the collection of swab samples, a facility needs assessment tool and document review, and qualitative interviews with staff and recently delivered women – to establish the state of hygiene as measured by visual cleanliness and the presence of potential pathogens, and individual and contextual determinants or drivers. Results No clear relationship was found between visually assessed cleanliness and the presence of pathogens; findings from qualitative interviews and the facility questionnaire found inadequacies in IPC training for healthcare providers and no formal training at all for ward cleaners. Lack of written policies and protocols, and poor monitoring and supervision also contributed to suboptimal IPC standards. Conclusions Visual assessment of cleanliness and hygiene is an inadequate marker for ‘safety’ in terms of the presence of potential pathogens and associated risk of infection. Routine environmental screening of high-risk touch sites using simple microbiology could improve detection and control of pathogens. IPC training for both healthcare providers and ward cleaners represents an important opportunity for quality improvement. This should occur in conjunction with broader systems changes, including the establishment of functioning IPC committees, implementing standard policies and protocols, and improving health management information systems to capture information on maternal and newborn HCAIs. PMID:27964775

Assessment of roadside surface water quality of Savar, Dhaka, Bangladesh using GIS and multivariate statistical techniques

NASA Astrophysics Data System (ADS)

Ahmed, Fahad; Fakhruddin, A. N. M.; Imam, MD. Toufick; Khan, Nasima; Abdullah, Abu Tareq Mohammad; Khan, Tanzir Ahmed; Rahman, Md. Mahfuzur; Uddin, Mohammad Nashir

2017-11-01

In this study, multivariate statistical techniques in collaboration with GIS are used to assess the roadside surface water quality of Savar region. Nineteen water samples were collected in dry season and 15 water quality parameters including TSS, TDS, pH, DO, BOD, Cl-, F-, NO3 2-, NO2 -, SO4 2-, Ca, Mg, K, Zn and Pb were measured. The univariate overview of water quality parameters are TSS 25.154 ± 8.674 mg/l, TDS 840.400 ± 311.081 mg/l, pH 7.574 ± 0.256 pH unit, DO 4.544 ± 0.933 mg/l, BOD 0.758 ± 0.179 mg/l, Cl- 51.494 ± 28.095 mg/l, F- 0.771 ± 0.153 mg/l, NO3 2- 2.211 ± 0.878 mg/l, NO2 - 4.692 ± 5.971 mg/l, SO4 2- 69.545 ± 53.873 mg/l, Ca 48.458 ± 22.690 mg/l, Mg 19.676 ± 7.361 mg/l, K 12.874 ± 11.382 mg/l, Zn 0.027 ± 0.029 mg/l, Pb 0.096 ± 0.154 mg/l. The water quality data were subjected to R-mode PCA which resulted in five major components. PC1 explains 28% of total variance and indicates the roadside and brick field dust settle down (TDS, TSS) in the nearby water body. PC2 explains 22.123% of total variance and indicates the agricultural influence (K, Ca, and NO2 -). PC3 describes the contribution of nonpoint pollution from agricultural and soil erosion processes (SO4 2-, Cl-, and K). PC4 depicts heavy positively loaded by vehicle emission and diffusion from battery stores (Zn, Pb). PC5 depicts strong positive loading of BOD and strong negative loading of pH. Cluster analysis represents three major clusters for both water parameters and sampling sites. The site based on cluster showed similar grouping pattern of R-mode factor score map. The present work reveals a new scope to monitor the roadside water quality for future research in Bangladesh.

Antiepileptic drug utilization in Bangladesh: experience from Dhaka Medical College Hospital.

PubMed

Habib, Mansur; Khan, Sharif Uddin; Hoque, Azhahul; Mondal, Badrul Alam; Hasan, A T M Hasibul; Chowdhury, Rajib Nayan; Haque, Badrul; Rahman, Kazi Mohibur; Chowdhury, Ahmed Hossain; Ghose, Swapon Kumar; Mohammad, Quazi Deen

2013-11-18

Epilepsy is a common health problem which carries a huge medical social psychological and economic impact for a developing country. The aim of this hospital-based study was to get an insight into the effectiveness and tolerability of low cost antiepileptic drugs (AEDs) in Bangladeshi people with epilepsy. This retrospective chart review was done from hospital records in weekly Epilepsy outdoor clinic of Department of Neurology, Dhaka Medical College Hospital (DMCH) from October 1998 to February 2013. A total of 854 epilepsy patients met the eligibility criteria (had a complete record of two years of follow up data) from hospital database. A checklist was used to take demographics (age and gender), epilepsy treatment and adverse event related data. At least two years of follow up data were considered for analysis. Out of 854 patients selected, majority of the patients attending outdoor clinic were >11-30 years age group (55.2%) with a mean age of 20.3 ± 9 years and with a male (53%) predominance. Focal epilepsy were more common (53%), among whom secondary generalized epilepsy was the most frequent diagnosis (67%) followed by complex partial seizure (21%). Among those with Idiopathic Generalized Epilepsy (46%), generalized tonic clonic seizure was encountered in 74% and absence seizure was observed in 13%. The number of patients on monotherapy and dual AED therapy were 67% and 24% respectively and polytherapy (i.e. >3 AEDs) was used only in 9%. CBZ (67%) was the most frequently prescribed AED, followed by VPA (43%), PHB (17%), and PHT (8%). CBZ was prescribed in 37% patients as monotherapy followed by VPA in 21% and PHB in 8% patients. Newer generation drugs eg lemotrigine and topiramate were used only as add on therapy in combination with CBZ and VPA in only 2% patients. The treatment retention rates over the follow up period for the AEDs in monotherapy varied between 86 and 91% and were highest for CBZ, followed by VPA. Most of the combination regimens had a treatment retention rate of 100%. The effectiveness of AED in terms of reduction of seizure frequency was highest for PHT (100%) and PHB (98%) followed by CBZ (96%) and VPA (95%). PHB and PHT were the cheapest of all AEDs (42 I$ and 56 I$/ year respectively). The costs of VPA and CBZ were two times and LTG and TOP were six to eight times higher. Adverse drug reaction (ADR) were observed among 140 (24.5%) of those with monotherapy. PHT (64%) was the most common drug to cause ADR, CBZ was at the bottom of the list to cause adverse effect (11.6%). VPA and PHB caused weight gain commonly. Adjustment of drug dose or withdrawal due to ADRs was necessary in 39% with PHT and 26% with PHB. Though PHT and PHB are cheapest and efficacious among all, CBZ and VPA are less costly, effective and well tolerated drug for seizure control in context of Bangladesh.

Marriage patterns and some issues related to adolescent marriage in Bangladesh.

PubMed

Islam, M M; Mahmud, M

1996-09-01

Data from the 1989 Bangladesh Fertility Survey are used to examine marriage patterns among adolescents, factors associated with adolescent marriage, and socioeconomic characteristics of married adolescents. Findings indicate that 100% of females married before the age of 30 years. The proportion of those never married increased after 1974 and among females aged 10-14 years and 15-19 years. The proportion of those never married increased from 73.4% to 95.8% among women aged 10-14 years and from 11.3% to 48.6% among women aged 15-19 years. In 1989 only 4% were married after age 20. 55% of total marriages occurred among women aged 13-15 years. 80% of total marriages occurred under 16 years of age. The highest mean age of marriage was found among women aged 20-29 years at the time of the survey. 63.9% of women who married before the age of 20 years married after menarche, 18.1% married before menarche, and 18.0% married during menarche. The average age at menarche was 13.4 years. 13.9% of marriages were dissolved among women who married before the age of 20 years, and 46% remarried. 8.5% of marriages were dissolved among ever married women who married after the age of 20 years, and only 24.4% remarried. Teenage marriage was more prevalent in rural areas and in Dhaka division, followed by Rajshahi division. About 70% of married adolescents were illiterate or had no formal education, and almost 86% did not work outside the home. Only 26% of married adolescents had husbands with more than a primary education. Marriages took place earlier among families with some land. 92.6% of married adolescents lived in poorly constructed housing. Logistic findings indicate that female education was closely associated with an increased chance of adolescent marriage. Low age at marriage was also influenced strongly by husband's occupation. Regional differences were significant covariates.

A high performance neutron powder diffractometer at 3 MW Triga Mark-II research reactor in Bangladesh

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kamal, I., E-mail: imtiaz-kamal26@yahoo.com; Yunus, S. M., E-mail: yunussm11@yahoo.com; Datta, T. K., E-mail: tk-datta4@yahoo.com

2016-07-12

A high performance neutron diffractometer called Savar Neutron Diffractometer (SAND) was built and installed at radial beam port-2 of TRIGA Mark II research reactor at AERE, Savar, Dhaka, Bangladesh. Structural studies of materials are being done by this technique to characterize materials crystallograpohically and magnetically. The micro-structural information obtainable by neutron scattering method is very essential for determining its technological applications. This technique is unique for understanding the magnetic behavior in magnetic materials. Ceramic, steel, electronic and electric industries can be benefited from this facility for improving their products and fabrication process. This instrument consists of a Popovicimonochromator with amore » large linear position sensitive detector array. The monochromator consists of nine blades of perfect single crystal of silicon with 6 mm thickness each. The monochromator design was optimized to provide maximum flux on 3 mm diameter cylindrical sample with a relatively flat angular dependence of resolution. Five different wave lengths can be selected by orienting the crystal at various angles. A sapphire filter was used before the primary collimator to minimize the first neutron. The detector assembly is composed of 15 linear position sensitive proportional counters placed at either 1.1 m or 1.6 m from the sample position and enclosed in a air pad supported high density polythene shield. Position sensing is obtained by charge division using 1-wide NIM position encoding modules (PEM). The PEMs communicate with the host computer via USB. The detector when placed at 1.1 m, subtends 30° (2θ) at each step and covers 120° in 4 steps. When the detector is placed at 1.6 m it subtends 20° at each step and covers 120° in 6 steps. The instrument supports both low and high temperature sample environment. The instrument supports both low and high temperature sample environment. The diffractometer is a state-of-the art technology for diffraction study in our country.« less

A high performance neutron powder diffractometer at 3 MW Triga Mark-II research reactor in Bangladesh

NASA Astrophysics Data System (ADS)

Kamal, I.; Yunus, S. M.; Datta, T. K.; Zakaria, A. K. M.; Das, A. K.; Aktar, S.; Hossain, S.; Berliner, R.; Yelon, W. B.

2016-07-01

A high performance neutron diffractometer called Savar Neutron Diffractometer (SAND) was built and installed at radial beam port-2 of TRIGA Mark II research reactor at AERE, Savar, Dhaka, Bangladesh. Structural studies of materials are being done by this technique to characterize materials crystallograpohically and magnetically. The micro-structural information obtainable by neutron scattering method is very essential for determining its technological applications. This technique is unique for understanding the magnetic behavior in magnetic materials. Ceramic, steel, electronic and electric industries can be benefited from this facility for improving their products and fabrication process. This instrument consists of a Popovicimonochromator with a large linear position sensitive detector array. The monochromator consists of nine blades of perfect single crystal of silicon with 6mm thickness each. The monochromator design was optimized to provide maximum flux on 3mm diameter cylindrical sample with a relatively flat angular dependence of resolution. Five different wave lengths can be selected by orienting the crystal at various angles. A sapphire filter was used before the primary collimator to minimize the first neutron. The detector assembly is composed of 15 linear position sensitive proportional counters placed at either 1.1 m or 1.6 m from the sample position and enclosed in a air pad supported high density polythene shield. Position sensing is obtained by charge division using 1-wide NIM position encoding modules (PEM). The PEMs communicate with the host computer via USB. The detector when placed at 1.1 m, subtends 30˚ (2θ) at each step and covers 120˚ in 4 steps. When the detector is placed at 1.6 m it subtends 20˚ at each step and covers 120˚ in 6 steps. The instrument supports both low and high temperature sample environment. The instrument supports both low and high temperature sample environment. The diffractometer is a state-of-the art technology for diffraction study in our country.

Islamic Fundamentalism in South Asia

DTIC Science & Technology

2007-08-20

Dhaka in March 1948, that Urdu would be the country’s official language . Nearly 99% of the population of East Bengal spoke Bengali, a language that...In 1955 East Bengal’s name was changed to East Pakistan. On April 19, 1954, Bengali was finally made an official state language , and 1956 it...word of God. Dhaka newspapers, reflecting the conflicts in Bengali culture, list three dates: in the Bengali ( Bangla ), Muslim, and Gregorian

Stochastic frontier model approach for measuring stock market efficiency with different distributions.

PubMed

Hasan, Md Zobaer; Kamil, Anton Abdulbasah; Mustafa, Adli; Baten, Md Azizul

2012-01-01

The stock market is considered essential for economic growth and expected to contribute to improved productivity. An efficient pricing mechanism of the stock market can be a driving force for channeling savings into profitable investments and thus facilitating optimal allocation of capital. This study investigated the technical efficiency of selected groups of companies of Bangladesh Stock Market that is the Dhaka Stock Exchange (DSE) market, using the stochastic frontier production function approach. For this, the authors considered the Cobb-Douglas Stochastic frontier in which the technical inefficiency effects are defined by a model with two distributional assumptions. Truncated normal and half-normal distributions were used in the model and both time-variant and time-invariant inefficiency effects were estimated. The results reveal that technical efficiency decreased gradually over the reference period and that truncated normal distribution is preferable to half-normal distribution for technical inefficiency effects. The value of technical efficiency was high for the investment group and low for the bank group, as compared with other groups in the DSE market for both distributions in time-varying environment whereas it was high for the investment group but low for the ceramic group as compared with other groups in the DSE market for both distributions in time-invariant situation.

An evaluation of automated chest radiography reading software for tuberculosis screening among public- and private-sector patients

PubMed Central

Rahman, Md Toufiq; Codlin, Andrew J.; Rahman, Md Mahfuzur; Nahar, Ayenun; Reja, Mehdi; Islam, Tariqul; Qin, Zhi Zhen; Khan, Md Abdus Shakur; Banu, Sayera

2017-01-01

Computer-aided reading (CAR) of medical images is becoming increasingly common, but few studies exist for CAR in tuberculosis (TB). We designed a prospective study evaluating CAR for chest radiography (CXR) as a triage tool before Xpert MTB/RIF (Xpert). Consecutively enrolled adults in Dhaka, Bangladesh, with TB symptoms received CXR and Xpert. Each image was scored by CAR and graded by a radiologist. We compared CAR with the radiologist for sensitivity and specificity, area under the receiver operating characteristic curve (AUC), and calculated the potential Xpert tests saved. A total of 18 036 individuals were enrolled. TB prevalence by Xpert was 15%. The radiologist graded 49% of CXRs as abnormal, resulting in 91% sensitivity and 58% specificity. At a similar sensitivity, CAR had a lower specificity (41%), saving fewer (36%) Xpert tests. The AUC for CAR was 0.74 (95% CI 0.73–0.75). CAR performance declined with increasing age. The radiologist grading was superior across all sub-analyses. Using CAR can save Xpert tests, but the radiologist's specificity was superior. Differentiated CAR thresholds may be required for different populations. Access to, and costs of, human readers must be considered when deciding to use CAR software. More studies are needed to evaluate CAR using different screening approaches. PMID:28529202

Stochastic Frontier Model Approach for Measuring Stock Market Efficiency with Different Distributions

PubMed Central

Hasan, Md. Zobaer; Kamil, Anton Abdulbasah; Mustafa, Adli; Baten, Md. Azizul

2012-01-01

The stock market is considered essential for economic growth and expected to contribute to improved productivity. An efficient pricing mechanism of the stock market can be a driving force for channeling savings into profitable investments and thus facilitating optimal allocation of capital. This study investigated the technical efficiency of selected groups of companies of Bangladesh Stock Market that is the Dhaka Stock Exchange (DSE) market, using the stochastic frontier production function approach. For this, the authors considered the Cobb-Douglas Stochastic frontier in which the technical inefficiency effects are defined by a model with two distributional assumptions. Truncated normal and half-normal distributions were used in the model and both time-variant and time-invariant inefficiency effects were estimated. The results reveal that technical efficiency decreased gradually over the reference period and that truncated normal distribution is preferable to half-normal distribution for technical inefficiency effects. The value of technical efficiency was high for the investment group and low for the bank group, as compared with other groups in the DSE market for both distributions in time- varying environment whereas it was high for the investment group but low for the ceramic group as compared with other groups in the DSE market for both distributions in time-invariant situation. PMID:22629352

An evaluation of automated chest radiography reading software for tuberculosis screening among public- and private-sector patients.

PubMed

Rahman, Md Toufiq; Codlin, Andrew J; Rahman, Md Mahfuzur; Nahar, Ayenun; Reja, Mehdi; Islam, Tariqul; Qin, Zhi Zhen; Khan, Md Abdus Shakur; Banu, Sayera; Creswell, Jacob

2017-05-01

Computer-aided reading (CAR) of medical images is becoming increasingly common, but few studies exist for CAR in tuberculosis (TB). We designed a prospective study evaluating CAR for chest radiography (CXR) as a triage tool before Xpert MTB/RIF (Xpert).Consecutively enrolled adults in Dhaka, Bangladesh, with TB symptoms received CXR and Xpert. Each image was scored by CAR and graded by a radiologist. We compared CAR with the radiologist for sensitivity and specificity, area under the receiver operating characteristic curve (AUC), and calculated the potential Xpert tests saved.A total of 18 036 individuals were enrolled. TB prevalence by Xpert was 15%. The radiologist graded 49% of CXRs as abnormal, resulting in 91% sensitivity and 58% specificity. At a similar sensitivity, CAR had a lower specificity (41%), saving fewer (36%) Xpert tests. The AUC for CAR was 0.74 (95% CI 0.73-0.75). CAR performance declined with increasing age. The radiologist grading was superior across all sub-analyses.Using CAR can save Xpert tests, but the radiologist's specificity was superior. Differentiated CAR thresholds may be required for different populations. Access to, and costs of, human readers must be considered when deciding to use CAR software. More studies are needed to evaluate CAR using different screening approaches. Copyright ©ERS 2017.

Evaluation of the accuracy in detecting cervical lesions by nurses versus doctors using a stationary colposcope and Gynocular in a low-resource setting.

PubMed

Nessa, Ashrafun; Roy, Joya Shree; Chowdhury, Most Afroza; Khanam, Quayuma; Afroz, Romena; Wistrand, Charlotte; Thuresson, Marcus; Thorsell, Malin; Shemer, Isaac; Wikström Shemer, Elisabeth Andrea

2014-11-03

Evaluation of the performance of VIA (visual inspection with acetic acid) trained nurses to learn colposcopy and the Swede score method to detect cervical lesions by using stationary colposcope or a portable, hand-held colposcope; the Gynocular, as compared to doctors. A crossover randomised clinical trial. The Colposcopy Clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. 932 women attending the clinic as either screening naïve for VIA screening (404) or women referred as VIA positive (528) from other VIA screening centres in the Dhaka region. VIA trained nurses were trained on-site in colposcopy and in the Swede score systematic colposcopy method. The Swede score grade cervical acetowhiteness, margins plus surface. vessel pattern, lesion size and iodine staining. The women were randomised to start the examination by either a stationary colposcope or the Gynocular. Swede scores were first obtained by a nurse and the same patient was equally evaluated by a doctor. Agreement between nurses and doctors in Swede scores was evaluated using the weighted κ statistic for the Gynocular and standard colposcope. The ability to predict CIN 2+ (CIN 2, CIN 3 and invasive cervical cancer) using Swede scores was evaluated using receiver-operating characteristic curves. The Swede scores obtained by nurses and doctors using the Gynocular and stationary colposcope showed high agreement with a κ statistic of 0.858 and 0.859, respectively, and no difference in detecting cervical lesions in biopsy. Biopsy detected CIN 2+ in 39 (4.2%) women. Our study showed that VIA nurses can perform colposcopy. There was no significant differences compared to doctors in detecting cervical lesions by stationary colposcope or the Gynocular using the Swede score system. Swede scores obtained by nurses using the Gynocular could offer an accurate cervical diagnostic approach in low resource settings. ISRCTN53264564. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A spatial epidemiological analysis of self-rated mental health in the slums of Dhaka

PubMed Central

2011-01-01

Background The deprived physical environments present in slums are well-known to have adverse health effects on their residents. However, little is known about the health effects of the social environments in slums. Moreover, neighbourhood quantitative spatial analyses of the mental health status of slum residents are still rare. The aim of this paper is to study self-rated mental health data in several slums of Dhaka, Bangladesh, by accounting for neighbourhood social and physical associations using spatial statistics. We hypothesised that mental health would show a significant spatial pattern in different population groups, and that the spatial patterns would relate to spatially-correlated health-determining factors (HDF). Methods We applied a spatial epidemiological approach, including non-spatial ANOVA/ANCOVA, as well as global and local univariate and bivariate Moran's I statistics. The WHO-5 Well-being Index was used as a measure of self-rated mental health. Results We found that poor mental health (WHO-5 scores < 13) among the adult population (age ≥15) was prevalent in all slum settlements. We detected spatially autocorrelated WHO-5 scores (i.e., spatial clusters of poor and good mental health among different population groups). Further, we detected spatial associations between mental health and housing quality, sanitation, income generation, environmental health knowledge, education, age, gender, flood non-affectedness, and selected properties of the natural environment. Conclusions Spatial patterns of mental health were detected and could be partly explained by spatially correlated HDF. We thereby showed that the socio-physical neighbourhood was significantly associated with health status, i.e., mental health at one location was spatially dependent on the mental health and HDF prevalent at neighbouring locations. Furthermore, the spatial patterns point to severe health disparities both within and between the slums. In addition to examining health outcomes, the methodology used here is also applicable to residuals of regression models, such as helping to avoid violating the assumption of data independence that underlies many statistical approaches. We assume that similar spatial structures can be found in other studies focussing on neighbourhood effects on health, and therefore argue for a more widespread incorporation of spatial statistics in epidemiological studies. PMID:21599932

Quaternary stratigraphy, sediment characteristics and geochemistry of arsenic-contaminated alluvial aquifers in the Ganges-Brahmaputra floodplain in central Bangladesh.

PubMed

Shamsudduha, M; Uddin, A; Saunders, J A; Lee, M-K

2008-07-29

This study focuses on the Quaternary stratigraphy, sediment composition, mineralogy, and geochemistry of arsenic (As)-contaminated alluvial aquifers in the Ganges-Brahmaputra floodplain in the central Bangladesh. Arsenic concentrations in 85 tubewells in Manikganj area, 70 km northwest of Dhaka City, range from 0.25 microg/L to 191 microg/L with a mean concentration of 33 microg/L. Groundwater is mainly Ca-HCO(3) type with high concentrations of dissolved As, Fe, and Mn, but low level of SO(4). The uppermost aquifer occurs between 10 m and 80 m below the surface that has a mean arsenic concentration of 35 microg/L. Deeper aquifer (>100 m depth) has a mean arsenic concentration of 18 microg/L. Sediments in the upper aquifer are mostly gray to dark-gray, whereas sediments in the deep aquifer are mostly yellowing-gray to brown. Quartz, feldspar, mica, hornblende, garnet, kyanite, tourmaline, magnetite, ilmenite are the major minerals in sediments from both aquifers. Biotite and potassium feldspar are dominant in shallow aquifer, although plagioclase feldspar and garnet are abundant in deep aquifer sediments. Sediment composition suggests a mixed provenance with sediment supplies from both orogenic belts and cratons. High arsenic concentrations in sediments are found within the upper 50 m in drilled core samples. Statistical analysis shows that As, Fe, Mn, Ca, and P are strongly correlated in sediments. Concentrations of Cd, Cu, Ni, Zn, and Bi also show strong correlations with arsenic in the Manikganj sediment cores. Authigenic goethite concretions, possibly formed by bacteria, are found in the shallow sediments, which contain arsenic of a concentration as high as 8.8 mg/kg. High arsenic concentrations in aquifers are associated with fine-grained sediments that were derived mostly from the recycled orogens and relatively rapidly deposited mainly by meandering channels during the Early to Middle Holocene rising sea-level conditions.

Hybrid Machine Learning Technique for Forecasting Dhaka Stock Market Timing Decisions

PubMed Central

Banik, Shipra; Khodadad Khan, A. F. M.; Anwer, Mohammad

2014-01-01

Forecasting stock market has been a difficult job for applied researchers owing to nature of facts which is very noisy and time varying. However, this hypothesis has been featured by several empirical experiential studies and a number of researchers have efficiently applied machine learning techniques to forecast stock market. This paper studied stock prediction for the use of investors. It is always true that investors typically obtain loss because of uncertain investment purposes and unsighted assets. This paper proposes a rough set model, a neural network model, and a hybrid neural network and rough set model to find optimal buy and sell of a share on Dhaka stock exchange. Investigational findings demonstrate that our proposed hybrid model has higher precision than the single rough set model and the neural network model. We believe this paper findings will help stock investors to decide about optimal buy and/or sell time on Dhaka stock exchange. PMID:24701205

Implementing a Mental Health Care Program and Home-Based Training for Mothers of Children With Autism Spectrum Disorder in an Urban Population in Bangladesh: Protocol for a Feasibility Assessment Study

PubMed Central

Uddin Ahmed, Helal; Akhter, Shaheen; Uddin, MM Jalal; Smith Fawzi, Mary C; Chandir, Subhash; Mannan, Muzharul; Hossain, Saima; Nelson, Charles; Munir, Kerim

2017-01-01

Background Mothers of children with autism spectrum disorder (ASD) have reported a higher level of depression than mothers of children with other neurodevelopmental disorders in both developed and developing countries. Mothers are the lifetime caregivers of children with ASD, and a high burden of depression can negatively impact their ability to provide care. However, access to mental health services in primary care is limited, given the scarcity of qualified providers in Bangladesh. Objective We aim to pilot the feasibility of integrating mental health services for the mothers of children with ASD attending schools offering ASD care and improve skills of mothers for child care through a home-based training program. Methods The study will be conducted in two selected schools in Dhaka in Bangladesh that have been offering services for ASD for more than 10 years. A female psychologist will be deployed at the schools to offer nonpharmacological services for all mothers having a depressive episode. Referral for pharmacological treatment will be made at the discretion of supervising psychiatrists. An ASD special educator will provide training to the mothers for enhancing their child care skills at home on a monthly basis. The proposed intervention package will be implemented over a period of 4-6 months, and the feasibility of the intervention will be assessed through a pre- and postintervention evaluation by obtaining the perspectives of various stakeholders involved in the implementation of mental health services and maternal training. The primary outcome will include assessment of acceptability, adaptability, demand, practicality, implementation, and integration of the package intervention in the school settings. The secondary outcomes will include assessment of: 1) the prevalence of maternal depression; 2) children’s behavioral, social, and communication skills; and 3) the intervention participation costs incurred by institutions and families. Results Between February and March 2017, 188 mothers of children with ASD were screened for depression following a written informed consent. Based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), the Structured Clinical Interview for the DSM-IV (SCID-1) was administered to 66 mothers. In-depth interviews were conducted with 10 mothers and 8 various stakeholders. Between January-June 2017, the team finalized a draft psychosocial counseling module and a maternal training module. Between April-May 2017, mental health services were provided by psychologists to 41 mothers who attended the counseling centers at each school. Three special educators have been trained in June 2017 to initiate training of the participating mothers. Conclusions This is the first study of a mental health intervention for mothers of children with ASD to reduce their burden of depression and improve the outcomes of their children. The findings will inform the provision of services for children with ASD and their mothers in Bangladesh and similar settings. PMID:29242177

Sex differences in obesity, dietary habits, and physical activity among urban middle-class Bangladeshis.

PubMed

Saquib, Juliann; Saquib, Nazmus; Stefanick, Marcia L; Khanam, Masuma Akter; Anand, Shuchi; Rahman, Mahbubur; Chertow, Glenn M; Barry, Michele; Ahmed, Tahmeed; Cullen, Mark R

2016-07-01

The sustained economic growth in Bangladesh during the previous decade has created a substantial middle-class population, who have adequate income to spend on food, clothing, and lifestyle management. Along with the improvements in living standards, has also come negative impact on health for the middle class. The study objective was to assess sex differences in obesity prevalence, diet, and physical activity among urban middle-class Bangladeshi. In this cross-sectional study, conducted in 2012, we randomly selected 402 adults from Mohammedpur, Dhaka. The sampling technique was multi-stage random sampling. We used standardized questionnaires for data collection and measured height, weight, and waist circumference. Mean age (standard deviation) was 49.4 (12.7) years. The prevalence of both generalized (79% vs. 53%) and central obesity (85% vs. 42%) were significantly higher in women than men. Women reported spending more time watching TV and spending less time walking than men (p<.05); however, men reported a higher intake of unhealthy foods such as fast food and soft drinks. We conclude that the prevalence of obesity is significantly higher in urban middle-class Bangladeshis than previous urban estimates, and the burden of obesity disproportionately affects women. Future research and public health efforts are needed to address this severe obesity problem and to promote active lifestyles.

An illicit economy: scavenging and recycling of medical waste.

PubMed

Patwary, Masum A; O'Hare, William Thomas; Sarker, M H

2011-11-01

This paper discusses a significant illicit economy, including black and grey aspects, associated with medical waste scavenging and recycling in a megacity, considering hazards to the specific group involved in scavenging as well as hazards to the general population of city dwellers. Data were collected in Dhaka, Bangladesh, using a variety of techniques based on formal representative sampling for fixed populations (such as recycling operatives) and adaptive sampling for roaming populations (such as scavengers). Extremely hazardous items (including date expired medicines, used syringes, knives, blades and saline bags) were scavenged, repackaged and resold to the community. Some HCE employees were also observed to sell hazardous items directly to scavengers, and both employees and scavengers were observed to supply contaminated items to an informal plastics recycling industry. This trade was made possible by the absence of segregation, secure storage and proper disposal of medical waste. Corruption, a lack of accountability and individual responsibility were also found to be contributors. In most cases the individuals involved with these activities did not understand the risks. Although motivation was often for personal gain or in support of substance abuse, participants sometimes felt that they were providing a useful service to the community. Copyright © 2011 Elsevier Ltd. All rights reserved.

Predictors of smoking cessation behavior among Bangladeshi adults: findings from ITC Bangladesh survey.

PubMed

Abdullah, Abu S; Driezen, Pete; Quah, Anne C K; Nargis, Nigar; Fong, Geoffrey T

2015-01-01

Research findings on the predictors of smoking cessation behavior identified in Western countries may not be generalizable to smokers in the Southeast Asian countries (i.e., Bangladesh). This study examined the factors associated with smoking cessation behavior (quit attempts and smoking cessation) among a representative sample of Bangladeshi adults. Data from Wave 1 (2009) and Wave 2 (2010) of the International Tobacco Control (ITC) Survey in Bangladesh, a face-to-face survey of adult smokers, were analysed. Households were sampled using a stratified multistage design and interviewed using a structured questionnaire. Respondents included in the study are 1,861 adult daily smokers (cigarette only or dual use of cigarette and bidi) in the Wave 1 survey who completed the Wave 2 follow up. Of the smokers (N = 1,861), 98 % were male, 18 % illiterate, 78 % married and 42 % were aged 40 or above; 89 % were cigarette smokers and 11 % were dual users (cigarette & bidi). Overall, 21.8 % of the baseline smokers made quit attempts (that is, making at least one quit attempt that lasted for at least 24 hours) during the 11- to 12-month interval between Waves 1 and 2 with only 4.1 % quitting successfully (that is, smokers who had stopped smoking for at least 6 months at the time of the Wave 2 survey). Significant predictors of attempts to quit included: residing areas outside Dhaka (OR = 3.41), being aged 40 or older (OR = 1.53), having a monthly income of above BDT10,000 (US$126) versus below BDT 5,000 (US$63) (OR = 1.57), intending to quit sometime in the future (OR = 1.73). Respondents not working indoors/outside the home were less likely to have made a quit attempt than those with no workplace restrictions on smoking (OR = 0.62). Predictors of successful smoking cessation included: being aged 40 or older (OR = 3.11), perceiving self-rated health as good or excellent (OR = 2.40), and an increased level of self-efficacy (OR = 1.75). Smokers who made a quit attempt not so recently (6 months ago or earlier) were less likely to quit than those who made a more recent (in last 6 months) quit attempt (OR = 0.23). Among Bangladeshi smokers, different factors were associated with quit attempt or successful cessation. Population based smoking cessation programs should take these factors into consideration in the design of smoking cessation interventions. At the same time, measures are necessary to encourage more smokers to make quit attempts.

Hybrid machine learning technique for forecasting Dhaka stock market timing decisions.

PubMed

Banik, Shipra; Khodadad Khan, A F M; Anwer, Mohammad

2014-01-01

Forecasting stock market has been a difficult job for applied researchers owing to nature of facts which is very noisy and time varying. However, this hypothesis has been featured by several empirical experiential studies and a number of researchers have efficiently applied machine learning techniques to forecast stock market. This paper studied stock prediction for the use of investors. It is always true that investors typically obtain loss because of uncertain investment purposes and unsighted assets. This paper proposes a rough set model, a neural network model, and a hybrid neural network and rough set model to find optimal buy and sell of a share on Dhaka stock exchange. Investigational findings demonstrate that our proposed hybrid model has higher precision than the single rough set model and the neural network model. We believe this paper findings will help stock investors to decide about optimal buy and/or sell time on Dhaka stock exchange.

Learning to dislike safe water products: results from a randomized controlled trial of the effects of direct and peer experience on willingness to pay.

PubMed

Luoto, Jill; Mahmud, Minhaj; Albert, Jeff; Luby, Stephen; Najnin, Nusrat; Unicomb, Leanne; Levine, David I

2012-06-05

Low-cost point-of-use (POU) safe water products have the potential to reduce waterborne illness, but adoption by the global poor remains low. We performed an eight-month randomized trial of four low-cost household water treatment products in Dhaka, Bangladesh. Intervention households (n = 600) received repeated educational messages about the importance of drinking safe water along with consecutive two-month free trials with each of four POU products in random order. Households randomly assigned to the control group (n = 200) did not receive free products or repeated educational messages. Households' willingness to pay for these products was quite low on average (as measured by bids in an incentive-compatible real-money auction), although a modest share was willing to pay the actual or expected retail price for low-cost chlorine-based products. Furthermore, contrary to our hypotheses that both one's own personal experience and the influence of one's peers would increase consumers' willingness to pay, direct experience significantly decreased mean bids by 18-55% for three of the four products and had no discernible effect on the fourth. Neighbor experience also did not increase bids. Widespread dissemination of safe water products is unlikely until we better understand the preferences and aspirations of these at-risk populations.

The "Performance of Rotavirus and Oral Polio Vaccines in Developing Countries" (PROVIDE) study: description of methods of an interventional study designed to explore complex biologic problems.

PubMed

Kirkpatrick, Beth D; Colgate, E Ross; Mychaleckyj, Josyf C; Haque, Rashidul; Dickson, Dorothy M; Carmolli, Marya P; Nayak, Uma; Taniuchi, Mami; Naylor, Caitlin; Qadri, Firdausi; Ma, Jennie Z; Alam, Masud; Walsh, Mary Claire; Diehl, Sean A; Petri, William A

2015-04-01

Oral vaccines appear less effective in children in the developing world. Proposed biologic reasons include concurrent enteric infections, malnutrition, breast milk interference, and environmental enteropathy (EE). Rigorous study design and careful data management are essential to begin to understand this complex problem while assuring research subject safety. Herein, we describe the methodology and lessons learned in the PROVIDE study (Dhaka, Bangladesh). A randomized clinical trial platform evaluated the efficacy of delayed-dose oral rotavirus vaccine as well as the benefit of an injectable polio vaccine replacing one dose of oral polio vaccine. This rigorous infrastructure supported the additional examination of hypotheses of vaccine underperformance. Primary and secondary efficacy and immunogenicity measures for rotavirus and polio vaccines were measured, as well as the impact of EE and additional exploratory variables. Methods for the enrollment and 2-year follow-up of a 700 child birth cohort are described, including core laboratory, safety, regulatory, and data management practices. Intense efforts to standardize clinical, laboratory, and data management procedures in a developing world setting provide clinical trials rigor to all outcomes. Although this study infrastructure requires extensive time and effort, it allows optimized safety and confidence in the validity of data gathered in complex, developing country settings. © The American Society of Tropical Medicine and Hygiene.

Impact of dropout of female volunteer community health workers: An exploration in Dhaka urban slums

PubMed Central

2012-01-01

Background The model of volunteer community health workers (CHWs) is a common approach to serving the poor communities in developing countries. BRAC, a large NGO in Bangladesh, is a pioneer in this area, has been using female CHWs as core workers in its community-based health programs since 1977. After 25 years of implementing of the CHW model in rural areas, BRAC has begun using female CHWs in urban slums through a community-based maternal health intervention. However, BRAC experiences high dropout rates among CHWs suggesting a need to better understand the impact of their dropout which would help to reduce dropout and increase program sustainability. The main objective of the study was to estimate impact of dropout of volunteer CHWs from both BRAC and community perspectives. Also, we estimated cost of possible strategies to reduce dropout and compared whether these costs were more or less than the costs borne by BRAC and the community. Methods We used the ‘ingredient approach’ to estimate the cost of recruiting and training of CHWs and the so-called ‘friction cost approach’ to estimate the cost of replacement of CHWs after adapting. Finally, we estimated forgone services in the community due to CHW dropout applying the concept of the friction period. Results In 2009, average cost per regular CHW was US$ 59.28 which was US$ 60.04 for an ad-hoc CHW if a CHW participated a three-week basic training, a one-day refresher training, one incentive day and worked for a month in the community after recruitment. One month absence of a CHW with standard performance in the community meant substantial forgone health services like health education, antenatal visits, deliveries, referrals of complicated cases, and distribution of drugs and health commodities. However, with an additional investment of US$ 121 yearly per CHW BRAC could save another US$ 60 invested an ad-hoc CHW plus forgone services in the community. Conclusion Although CHWs work as volunteers in Dhaka urban slums impact of their dropout is immense both in financial term and forgone services. High cost of dropout makes the program less sustainable. However, simple and financially competitive strategies can improve the sustainability of the program. PMID:22897922

Instrumented posterior lumbar interbody fusion (PLIF) with interbody fusion device (Cage) in degenerative disc disease (DDD): 3 years outcome.

PubMed

Ahsan, M K; Hossain, M A; Sakeb, N; Khan, S I; Zaman, N

2013-10-01

This prospective interventional study carried out at Bangabandhu Sheikh Mujib Medical University and a private hospital in Dhaka, Bangladesh during the period from October 2003 to September 2011. Surgical treatment of degenerative disc disease (DDD) should aim to re-expand the interbody space and stabilize until fusion is complete. The present study conducted to find out the efficacy of using interbody fusion device (Cage) to achieve interbody space re-expansion and fusion in surgical management of DDD. We have performed the interventional study on 53 patients, 42 female and 11 male, with age between 40 to 67 years. All the patients were followed up for 36 to 60 months (average 48 months). Forty seven patients were with spondylolisthesis and 06 with desiccated disc. All subjects were evaluated with regard to immediate and long term complications, radiological fusion and interbody space re-expansion and maintenance. The clinical outcome (pain and disability) was scored by standard pre and postoperative questionnaires. Intrusion, extrusion and migration of the interbody fusion cage were also assessed. Forty seven patients were considered to have satisfactory outcome in at least 36 months follow up. Pseudoarthrosis developed in 04 cases and 06 patients developed complications. In this series posterior lumbar interbody fusion (PLIF) with interbody cage and instrumentation in DDD showed significant fusion rate and maintenance of interbody space. Satisfactory outcome observed in 88.68% cases.

Chlamydia trachomatis IgM seropositivity during pregnancy and assessment of its risk factors.

PubMed

Rahman, M; Chowdhury, S B; Akhtar, N; Jahan, M; Jahan, M K; Jebunnahar, S

2014-01-01

The study was undertaken to determine socio-demographic and reproductive risk factors associated with Chlamydia trachomaties IgM seropositivity during pregnancy. This cross sectional comparative study was carried out in the obstetrics outdoor of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh in collaboration with the department of Virology between the periods from July 2007 to December 2008. Pregnant women at their first visit to the hospital were approached consecutively and asked to complete a questionnaire and 2cc blood was collected from each subject for Chlamydia trachomatis IgM antibody testing using ELISA method. The study population was divided into two groups according to the presence and absence of serum Chlamydia trachomatis IgM antibody. Finally socio-demographic and reproductive risk factors were compared between the groups. Among 172 women the sero-prevalence of Chlamydia IgM was 41%. The multiple logistic regression model (step wise) finally extracted for characteristics correlated with seropositivity. Ten years or less (≤SSC) education (OR 2.6 95% CI 1.1to 5.9), history of adverse pregnancy outcome (OR 2.8 95% CI 1.2 to 6.5) and multiple sex partner of husband (OR 4.1 95% CI 1.2 to 14.8) were associated with chlamydia infection. The use of condom (OR 0.28 95% CI 0.12 to 0.63) was associated with decreased risk of infection. Chlamydia trachomatis infection during pregnancy is associated with risk factors on the basis of which selective screening can be done.

Sex differences in obesity, dietary habits, and physical activity among urban middle-class Bangladeshis

PubMed Central

Saquib, Juliann; Saquib, Nazmus; Stefanick, Marcia L.; Khanam, Masuma Akter; Anand, Shuchi; Rahman, Mahbubur; Chertow, Glenn M.; Barry, Michele; Ahmed, Tahmeed; Cullen, Mark R.

2016-01-01

Background The sustained economic growth in Bangladesh during the previous decade has created a substantial middle-class population, who have adequate income to spend on food, clothing, and lifestyle management. Along with the improvements in living standards, has also come negative impact on health for the middle class. The study objective was to assess sex differences in obesity prevalence, diet, and physical activity among urban middle-class Bangladeshi. Methods In this cross-sectional study, conducted in 2012, we randomly selected 402 adults from Mohammedpur, Dhaka. The sampling technique was multi-stage random sampling. We used standardized questionnaires for data collection and measured height, weight, and waist circumference. Results Mean age (standard deviation) was 49.4 (12.7) years. The prevalence of both generalized (79% vs. 53%) and central obesity (85% vs. 42%) were significantly higher in women than men. Women reported spending more time watching TV and spending less time walking than men (p<.05); however, men reported a higher intake of unhealthy foods such as fast food and soft drinks. Conclusions We conclude that the prevalence of obesity is significantly higher in urban middle-class Bangladeshis than previous urban estimates, and the burden of obesity disproportionately affects women. Future research and public health efforts are needed to address this severe obesity problem and to promote active lifestyles. PMID:27610059

Effect of weekly high-dose vitamin D3 supplementation on serum cholecalciferol concentrations in pregnant women.

PubMed

Dimitris, Michelle C; Perumal, Nandita; Craig-Barnes, Hayley A; Leadley, Michael; Mahmud, Abdullah A; Baqui, Abdullah H; Roth, Daniel E

2016-04-01

Vitamin D status is conventionally defined by the serum concentration of 25-hydroxyvitamin D. However, it has been proposed that the serum cholecalciferol concentration (D3) also determines functional vitamin D sufficiency. The objective of this study was to describe the effect of weekly high-dose vitamin D3 supplementation on inter-dose serum D3 in pregnant women. We conducted a sub-study of a completed randomized double-blind placebo-controlled trial of vitamin D3 (35,000 IU/week) supplementation in late pregnancy (AViDD trial) in Dhaka, Bangladesh. This study included pregnant women enrolled at 26-29 weeks gestation who fully adhered to the prenatal supplement intervention for ≥8 consecutive weeks and for whom serum samples were available for D3 analysis (n=65). Serum D3 was uniformly low at enrolment. Mean D3 increased and was maximal at 1 day after vitamin D dose administration (152.09nmol/L, SD 25.11nmol/L) and remained significantly higher in VitD vs. Pl at 7 days (29.59nmol/L vs. 1.92nmol/L, p=0.007). Daily average of the group mean D3 during the week following dosing was 66.97nmol/L in VitD versus 2.13nmol/L in Pl. In conclusion, serum D3 remained significantly elevated throughout the week following ≥8 consecutive weekly doses of 35,000 IU D3 in pregnant women. However, the clinically significant minimum threshold of serum D3 remains to be established. Copyright © 2016 Elsevier Ltd. All rights reserved.

Arsenic attenuation by oxidized aquifer sediments in Bangladesh

USGS Publications Warehouse

Stollenwerk, K.G.; Breit, G.N.; Welch, A.H.; Yount, J.C.; Whitney, J.W.; Foster, A.L.; Uddin, M.N.; Majumder, R.K.; Ahmed, N.

2007-01-01

Recognition of arsenic (As) contamination of shallow fluvio-deltaic aquifers in the Bengal Basin has resulted in increasing exploitation of groundwater from deeper aquifers that generally contain low concentrations of dissolved As. Pumping-induced infiltration of high-As groundwater could eventually cause As concentrations in these aquifers to increase. This study investigates the adsorption capacity for As of sediment from a low-As aquifer near Dhaka, Bangladesh. A shallow, chemically-reducing aquifer at this site extends to a depth of 50??m and has maximum As concentrations in groundwater of 900????g/L. At depths greater than 50??m, geochemical conditions are more oxidizing and groundwater has < 5????g/L As. There is no thick layer of clay at this site to inhibit vertical transport of groundwater. Arsenite [As(III)] is the dominant oxidation state in contaminated groundwater; however, data from laboratory batch experiments show that As(III) is oxidized to arsenate [As(V)] by manganese (Mn) minerals that are present in the oxidized sediment. Thus, the long-term viability of the deeper aquifers as a source of water supply is likely to depend on As(V) adsorption. The adsorption capacity of these sediments is a function of the oxidation state of As and the concentration of other solutes that compete for adsorption sites. Arsenite that was not oxidized did adsorb, but to a much lesser extent than As(V). Phosphate (P) caused a substantial decrease in As(V) adsorption. Increasing pH and concentrations of silica (Si) had lesser effects on As(V) adsorption. The effect of bicarbonate (HCO3) on As(V) adsorption was negligible. Equilibrium constants for adsorption of As(V), As(III), P, Si, HCO3, and H were determined from the experimental data and a quantitative model developed. Oxidation of As(III) was modeled with a first-order rate constant. This model was used to successfully simulate As(V) adsorption in the presence of multiple competing solutes. Results from these experiments show that oxidized sediments have a substantial but limited capacity for removal of As from groundwater.

Arsenic Attenuation By Oxidized Aquifer Sediments in Bangladesh

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stollenwerk, K.G.; Breit, G.N.; Welch, A.H.

2007-07-13

Recognition of arsenic (As) contamination of shallow fluvio-deltaic aquifers in the Bengal Basin has resulted in increasing exploitation of groundwater from deeper aquifers that generally contain low concentrations of dissolved As. Pumping-induced infiltration of high-As groundwater could eventually cause As concentrations in these aquifers to increase. This study investigates the adsorption capacity for As of sediment from a low-As aquifer near Dhaka, Bangladesh. A shallow, chemically-reducing aquifer at this site extends to a depth of 50 m and has maximum As concentrations in groundwater of 900 {micro}g/L. At depths greater than 50 m, geochemical conditions are more oxidizing and groundwatermore » has < 5 {micro}g/L As. There is no thick layer of clay at this site to inhibit vertical transport of groundwater. Arsenite [As(III)] is the dominant oxidation state in contaminated groundwater; however, data from laboratory batch experiments show that As(III) is oxidized to arsenate [As(V)] by manganese (Mn) minerals that are present in the oxidized sediment. Thus, the long-term viability of the deeper aquifers as a source of water supply is likely to depend on As(V) adsorption. The adsorption capacity of these sediments is a function of the oxidation state of As and the concentration of other solutes that compete for adsorption sites. Arsenite that was not oxidized did adsorb, but to a much lesser extent than As(V). Phosphate (P) caused a substantial decrease in As(V) adsorption. Increasing pH and concentrations of silica (Si) had lesser effects on As(V) adsorption. The effect of bicarbonate (HCO{sub 3}) on As(V) adsorption was negligible. Equilibrium constants for adsorption of As(V), As(III), P, Si, HCO3, and H were determined from the experimental data and a quantitative model developed. Oxidation of As(III) was modeled with a first-order rate constant. This model was used to successfully simulate As(V) adsorption in the presence of multiple competing solutes. Results from these experiments show that oxidized sediments have a substantial but limited capacity for removal of As from groundwater.« less

Socioeconomic risk factors for cholera in different transmission settings: An analysis of the data of a cluster randomized trial in Bangladesh.

PubMed

Saha, Amit; Hayen, Andrew; Ali, Mohammad; Rosewell, Alexander; Clemens, John D; Raina MacIntyre, C; Qadri, Firdausi

2017-09-05

Cholera remains a threat globally, and socioeconomic factors play an important role in transmission of the disease. We assessed socioeconomic risk factors for cholera in vaccinated and non-vaccinated communities to understand whether the socioeconomic risk factors differ by transmission patterns for cholera. We used data from a cluster randomized control trial conducted in Dhaka, Bangladesh. There were 90 geographic clusters; 30 in each of the three arms of the study: vaccine (VAC), vaccine plus behavioural change (VBC), and non-intervention. The data were analysed for the three populations: (1) vaccinees in the vaccinated communities (VAC and VBC arms), (2) non-vaccinated individuals in the vaccinated communities and (3) all individuals in the non-vaccinated communities (non-intervention arm). A generalized estimating equation with logit link function was used to evaluate the risk factors for cholera among these different populations adjusting for household level correlation in the data. A total of 528 cholera and 226 cholera with severe dehydration (CSD) in 268,896 persons were observed during the two-year follow-up. For population 1, the cholera risk was not associated with any socioeconomic factors; however CSD was less likely to occur among individuals living in a household having ≤4 members (aOR=0.55, 95% CI=0.32-0.96). Among population 2, younger participants and individuals reporting diarrhoea during registration were more likely to have cholera. Females and individuals reporting diarrhoea during registration were at increased risk of CSD. Among population 3, individuals living in a household without a concrete floor, in an area with high population density, closer to the study hospital, or not treating drinking water were at significantly higher risk for both cholera and CSD. The profile of socioeconomic factors associated with cholera varies by individuals' vaccination status as well as the transmission setting. In a vaccinated community where transmission would be expected to be lower, socioeconomic factors may not increase the risk of the disease. Copyright © 2017. Published by Elsevier Ltd.

Impact of lack of breast feeding during neonatal age on the development of clinical signs of pneumonia and hypoxemia in young infants with diarrhea.

PubMed

Chisti, Mohammod J; Salam, Mohammed A; Smith, Jonathan Harvey; Ahmed, Tahmeed; Ashraf, Hasan; Bardhan, Pradip K; Pietroni, Mark A C

2011-01-01

Hypoxemia is a grave sequel of pneumonia, and an important predictor of a fatal outcome. Pneumonia in the neonatal period is often associated with lack of breast feeding. However, there is no published report on the impact of the cessation of breast feeding in the neonatal period on the development of pneumonia and hypoxemia. The purpose of our study was to assess the impact of non-breast feeding or stopping breast feeding during the neonatal period (henceforth to be referred to as non-breast fed) on clinical features of pneumonia and hypoxemia in 0-6-month-old infants with diarrhea admitted to an urban hospital in Bangladesh. We prospectively enrolled all infants (n = 107) aged 0 to 6 months who were admitted to the Special Care Ward (SCW) of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research Bangladesh (ICDDR,B) with diarrhea and pneumonia from September 2007 through December 2007.We compared the clinical features of pneumonia and hypoxemia of breast fed infants (n = 34) with those who were non-breast fed (n = 73). The median (inter-quartile range) duration of hypoxemia (hours) in non-breast-feds was longer than breast-fed infants [0.0 (0.0, 12.0) vs. 12.0 (0.0, 21.75); p = 0.021]. After adjusting for potential confounders such as inability to drink, fever, head nodding, cyanosis, grunting respiration, and lower chest wall in drawing, the non-breast-fed infants with pneumonia along with diarrhea had a higher probability of cough (OR 9.09; CI 1.34-61.71; p = 0.024), hypoxemia (OR 3.32; CI 1.23-8.93; p = 0.017), and severe undernutrition (OR 3.42; CI 1.29-9.12; p = 0.014). Non-breast feeding or cessation of breast feeding during the neonatal period may substantially increase the incidence of severe malnutrition, incidence of cough, and both the incidence and duration of hypoxemia in young infants presenting with pneumonia and diarrhea. The findings emphasize the paramount importance of the continuation of breast feeding in the neonatal period and early infancy.

Development and acceptability testing of ready-to-use supplementary food made from locally available food ingredients in Bangladesh.

PubMed

Ahmed, Tahmeed; Choudhury, Nuzhat; Hossain, M Iqbal; Tangsuphoom, Nattapol; Islam, M Munirul; de Pee, Saskia; Steiger, Georg; Fuli, Rachel; Sarker, Shafiqul A M; Parveen, Monira; West, Keith P; Christian, Parul

2014-06-27

Inadequate energy and micronutrient intake during childhood is a major public health problem in developing countries. Ready-to-use supplementary food (RUSF) made of locally available food ingredients can improve micronutrient status and growth of children. The objective of this study was to develop RUSF using locally available food ingredients and test their acceptability. A checklist was prepared of food ingredients available and commonly consumed in Bangladesh that have the potential of being used for preparing RUSF. Linear programming was used to determine possible combinations of ingredients and micronutrient premix. To test the acceptability of the RUSF compared to Pushti packet (a cereal based food-supplement) in terms of amount taken by children, a clinical trial was conducted among 90 children aged 6-18 months in a slum of Dhaka city. The mothers were also asked to rate the color, flavor, mouth-feel, and overall liking of the RUSF by using a 7-point Hedonic Scale (1 = dislike extremely, 7 = like extremely). Two RUSFs were developed, one based on rice-lentil and the other on chickpea. The total energy obtained from 50 g of rice-lentil, chickpea-based RUSF and Pushti packet were 264, 267 and 188 kcal respectively. Children were offered 50 g of RUSF and they consumed (mean ± SD) 23.8 ± 14 g rice-lentil RUSF, 28.4 ± 15 g chickpea based RUSF. Pushti packet was also offered 50 g but mothers were allowed to add water, and children consumed 17.1 ± 14 g. Mean feeding time for two RUSFs and Pushti packet was 20.9 minutes. Although the two RUSFs did not differ in the amount consumed, there was a significant difference in consumption between chickpea-based RUSF and Pushti packet (p = 0.012). Using the Hedonic Scale the two RUSFs were more liked by mothers compared to Pushti packet. Recipes of RUSF were developed using locally available food ingredients. The study results suggest that rice-lentil and chickpea-based RUSF are well accepted by children. ClinicalTrials.gov NCT01553877. Registered 24 January 2012.

Clinical Risk Factors of Death From Pneumonia in Children with Severe Acute Malnutrition in an Urban Critical Care Ward of Bangladesh

PubMed Central

Chisti, Mohammod Jobayer; Salam, Mohammed Abdus; Ashraf, Hasan; Faruque, Abu S. G.; Bardhan, Pradip Kumar; Hossain, Md Iqbal; Shahid, Abu S. M. S. B.; Shahunja, K. M.; Das, Sumon Kumar; Imran, Gazi; Ahmed, Tahmeed

2013-01-01

Background Risks of death are high when children with pneumonia also have severe acute malnutrition (SAM) as a co-morbidity. However, there is limited published information on risk factors of death from pneumonia in SAM children. We evaluated clinically identifiable factors associated with death in under-five children who were hospitalized for the management of pneumonia and SAM. Methods For this unmatched case-control design, SAM children of either sex, aged 0–59 months, admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) during April 2011 to July 2012 with radiological pneumonia were studied. The SAM children with pneumonia who had fatal outcome constituted the cases (n = 35), and randomly selected SAM children with pneumonia who survived constituted controls (n = 105). Results The median (inter-quartile range) age (months) was comparable among the cases and the controls [8.0 (4.9, 11.0) vs. 9.7 (5.0, 18.0); p = 0.210)]. In logistic regression analysis, after adjusting for potential confounders, such as vomiting, abnormal mental status, and systolic hypotension (<70 mm of Hg) in absence of dehydration, fatal cases of severely malnourished under-five children with pneumonia were more often hypoxemic (OR = 23.15, 95% CI = 4.38–122.42), had clinical dehydration (some/severe) (OR = 9.48, 95% CI = 2.42–37.19), abdominal distension at admission (OR = 4.41, 95% CI = 1.12–16.52), and received blood transfusion (OR = 5.50, 95% CI = 1.21–24.99) for the management of crystalloid resistant systolic hypotension. Conclusion and Significance We identified hypoxemia, clinical dehydration, and abdominal distension as the independent predictors of death in SAM children with pneumonia. SAM children with pneumonia who required blood transfusion for the management of crystalloid resistant systolic hypotension were also at risk for death. Thus, early identification and prompt management of these simple clinically recognizable predictors of death and discourage the use of blood transfusion for the management of crystalloid resistant systolic hypotension may help reduce deaths in such population. PMID:24040043

Cooking fuel type, household ventilation, and the risk of acute lower respiratory illness in urban Bangladeshi children: a longitudinal study.

PubMed

Murray, E L; Brondi, L; Kleinbaum, D; McGowan, J E; Van Mels, C; Brooks, W A; Goswami, D; Ryan, P B; Klein, M; Bridges, C B

2012-04-01

Acute lower respiratory illnesses (ALRI) are the leading cause of death among children <5 years. Studies have found that biomass cooking fuels are an important risk factor for ALRI. However, few studies have evaluated the influence of natural household ventilation indicators on ALRI. The purpose of this study was to assess the association between cooking fuel, natural household ventilation, and ALRI. During October 17, 2004-September 30, 2005, children <5 years living in a low-income neighborhood of Dhaka, Bangladesh, were assessed weekly for ALRI and surveyed quarterly about biomass fuel use, electric fan ownership, and natural household ventilation (windows, ventilation grates, and presence of a gap between the wall and ceiling). Bivariate and multivariate analyses were performed using generalized estimating equations. Six thousand and seventy-nine children <5 years enrolled during the study period (99% participation) experienced 1291 ALRI. In the multivariate model, ≥2 windows [OR = 0.75, 95% CI = (0.58, 0.96)], ventilation grates [OR = 0.80, 95% CI = (0.65, 0.98)], and not owning an electric fan [OR = 1.50, 95% CI = (1.21, 1.88)] were associated with ALRI; gap presence and using biomass fuels were not associated with ALRI. Structural factors that might improve household air circulation and exchange were associated with decreased ALRI risk. Improved natural ventilation might reduce ALRI among children in low-income families. The World Health Organization has stated that controlling pneumonia is a priority for achieving the fourth Millennium Development Goal, which calls for a two-third reduction in mortality of children <5 years old compared to the 1990 baseline. Our study represents an important finding of a modifiable risk factor that might decrease the burden of respiratory illness among children living in Bangladesh and other low-income settings similar to our study site. We found that the existence of at least two windows in the child's sleeping room was associated with a 25% decreased ALRI risk. Increasing available natural ventilation within the household in similar settings has the potential to reduce childhood mortality because of acute lower respiratory illnesses. © 2011 John Wiley & Sons A/S.

Paradox of Migration in Kolkata: A Megacity in GBM Delta

NASA Astrophysics Data System (ADS)

Das, S.; Hazra, S.; Ghosh, T.

2015-12-01

Contrary to other coastal cities (Mumbai, Chennai, Bhubaneswar etc.) in India, Kolkata, the largest city of India until 1990, has been showing a persistent trend of out-migration over the last decade. The situation is more paradoxical when compared to Dhaka in Bangladesh, the other coastal city in Ganga-Brahmaputra-Meghna (GBM) delta. Exacerbating impacts of Climate Change like accelerated sea level rise, impact of cyclones, rising temperature and high rainfall events and waterlogging, vis-à-vis the density of poor population in slums, Kolkata has been assessed as one of the most vulnerable cities of the world. However, Kolkata has long been a preferred destination for migrants for its port based economy, existence of industrial belt with labour intensive industries. The city and its surrounding districts attracted a massive influx of trans-border migrants when India and Bangladesh gained Independence in 1947 and 1971 respectively. The paper attempts to explore reasons behind the present trend of depopulation in the erstwhile preferred migration destination. This paper distinguishes between 'Kolkata City' (census district) with 4.5 million residents and 'Kolkata Megacity' which encompasses also the peri-urban areas and home to almost 14.1 million people according to Census 2011. Analysing migration as an ongoing research activity under DECCMA project, an overall 'in-migration' pattern can be deciphered in Kolkata 'megacity'. On the contrary, the Kolkata 'city' located right in the heart of the megacity exhibits negative net migration (-5.11%) i.e. high 'out-migration'. Plausible causes can be movement of people from Kolkata 'city' to peri-urban areas and satellite towns (urban to urban migration) probably due to closure of labour intensive industries, comparatively lower land prices, availability of space and accommodation, lower costs of living, development of different modes of commutation and communication. Further growth of population in the Kolkata Megacity area is accomplished by rural to urban migration from vulnerable areas of Sundarban. Thus in spite of the declining population in Kolkata city, Kolkata megacity is emerging as a 'major setting of human habitation' in a 21st century world stressed by climate change.

Distribution, Management Difficulty and Outcome of Branchial Anomalies.

PubMed

Sattar, M A; Sultana, M T; Ahmed, S

2018-01-01

Branchial arch anomalies are one of the most common congenital anomalies of the neck. Developmental anomalies of the branchial apparatus account for 17% of all pediatric cervical masses. This study aimed to focus on proper diagnosis of branchial anomaly and describe occurrence, presentation, management and outcome of usual and unusual types. This ten-year prospective observational study was conducted from November 2005 to November 2015 including 2-year postoperative follow-up of the patients in Department of ENT, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Total 89 patients were enrolled for this study. Information was recorded on Clinical examination, relevant investigation, Per-operative findings and Histo-pathological findings. After receiving Histo-pathological findings 61 cases were proved as branchial arch anomalies. Ultrasonography and Histopathology was done for every patient. Fistulogram and sinogram was done for patient of fistula and sinus respectively. CT scan was needed for 9 patients, MRI for 3 patients and 12 patient undergone FNAC. Outcomes of those patients were described in terms of Hospital stay, Complications and Follow up studies. Data analysis was done by Standard Statistical Method.Presentation of a number of participant's mimics Branchial arch anomalies; 4.91% was syndromal. Second branchial arch anomalies were the highest. Management was exclusively surgical. Recurrence rate was about 6.56%. Surgery is the tool for diagnosis, treatment, preventing complications, avoiding carcinoma for branchial arch anomalies.

Assessment of Subvalvular Apparatus in Patients with Rheumatic Mitral Stenosis: Comparison between 2D and 3D Echocardiography.

PubMed

Shakil, S S; Ahmed, C M; Khaled, F I; Nahar, S; Perveen, R; Pandit, H; Osmani, D M

2017-10-01

Mitral valve is the most involved valve in rheumatic heart disease especially in the form of mitral stenosis. Treatment options of mitral stenosis depend upon pattern, extent & the severity of disease and echocardiography has the key role in this area. Severity of involvement of subvalvular apparatus (SVA) is an important factor for determining the treatment option. 2D echocardiography (2DE) is conventionally used. With the advancement of echocardiographic technology 3D echocardiography (3DE) would offer better assessment of subvalvular apparatus. This study compared transthoracic 2D versus 3D echocardiography for assessment of SVA in chronic rheumatic mitral valve disease. This cross sectional observational study was done in University cardiac centre, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from May 2012 to October 2012. In this study, considering all ethical issues, data were collected from 50 subjects who underwent transthoracic 2D and 3D echocardiography for the assessment of extent and severity of mitral stenosis. Accurate measurement of Mitral valvular area is very important in assessment of severity, which is found similar by both 2DE (0.98±0.24cm²) and 3DE (0.92 ±0.23cm²). But assessment of subvalvular involvement especially chordal adhesion can be done better by 3DE (p<0.001). This observation suggests superiority of 3DE for assessment of SVA in chronic rheumatic mitral stenosis. The result of the study demonstrates that 3DE is superior to 2DE for the assessment of SVA in chronic rheumatic mitral stenosis.

Risk Factors of Rheumatic Heart Disease in Bangladesh: A Case-Control Study

PubMed Central

Riaz, Baizid Khoorshid; Karim, Md. Nazmul; Chowdhury, Kamrun Nahar; Chowdhury, Shahabul Huda; Rahman, Md. Ridwanur

2013-01-01

Not all cases of rheumatic fever (RF) end up as rheumatic heart disease (RHD). The fact raises the possibility of existence of a subgroup with characteristics that prevent RF patients from developing the RHD. The present study aimed at exploring the risk factors among patients with RHD. The study assessed the risk of RHD among people both with and without RF. In total, 103 consecutive RHD patients were recruited as cases who reported to the National Centre for Control of Rheumatic Fever and Heart Disease, Dhaka, Bangladesh. Of 309 controls, 103 were RF patients selected from the same centre, and the remaining 206 controls were selected from Shaheed Suhrawardy Medical College Hospital, who got admitted for other non-cardiac ailments. RHD was confirmed by auscultation and colour Doppler echocardiography. RF was diagnosed based on the modified Jones criteria. An unadjusted odds ratio was generated for each variable, with 95% confidence interval (CI), and only significant factors were considered candidate for multivariate analysis. Three separate binary logistic regression models were generated to assess the risk factors of RF, risk factors of RHD compared to non-rheumatic control patients, and risk factors of RHD compared to control with RF. RF and RHD shared almost a similar set of risk factors in the population. In general, age over 19 years was found to be protective of RF; however, age of the majority (62.1%) of the RHD cases was over 19 years. Women [odds ratio (OR)=2.2, 95% CI 1.1-4.3], urban resident (OR=3.1, 95% CI 1.2–8.4), dwellers in brick-built house (OR=3.6, 95% CI 1.6-8.1), having >2 siblings (OR=3.1, 95% CI 1.5- 6.3), offspring of working mothers (OR=7.6, 95% CI 2.0-24.2), illiterate mother (OR=2.6, 95% CI 1.2-5.8), and those who did not brush after taking meals (OR=2.5, 95% CI 1.0-6.3) were more likely to develop RF. However, more than 5 members in a family showed a reduced risk of RF. RHD shared almost a similar set of factors in general. More than three people sharing a room also showed an increased risk of RHD (OR=1.9, 95% CI 1.0-3.4), in addition to the risk factors of RF. Multivariate model also assessed the factors that may perpetuate RHD among RF patients. Overcrowding (OR=2.4, 95% CI 1.2-4.7) and illiteracy (OR=2.4, 95% CI 1.1-5.2) posed the risk of RHD in the RF patients. The study did not find new factors that might pose an increased risk, rather looked for the documented risk factors and how these operate in the population of Bangladesh. PMID:23617207

Validity of the global physical activity questionnaire (GPAQ) in Bangladesh.

PubMed

Mumu, Shirin Jahan; Ali, Liaquat; Barnett, Anthony; Merom, Dafna

2017-08-10

Feasible and cost-effective as well as population specific instruments for monitoring physical activity (PA) levels are needed for the management and prevention of non-communicable diseases. The WHO-endorsed Global Physical Activity Questionnaire (GPAQ) has been widely used in developing countries, but the evidence base for its validity, particularly for rural populations, is still limited. The aim of the study was to validate GPAQ among rural and urban residents in Bangladesh. A total of 162 healthy participants of both genders aged 18-60 years were recruited from Satia village (n = 97) and Dhaka City (n = 65). Participants were invited to take part in the study and were asked to wear an accelerometer (GT3X) for 7 days, after which they were invited to answer the GPAQ in a face to face interview. Valid accelerometer data (i.e., ≥10 h of wear times over ≥3 days) were received from 155 participants (rural = 94, urban = 61). The mean age was 35 (SD = ±9) years, 55% were females and 19% of the participants had no schooling, which was higher in the rural area (21% vs 17%). The mean ± SD steps/day was 9998 ± 3936 (8658 ± 2788 and 12,063 ± 4534 for rural and urban respectively, p = 0.0001) and the mean ± SD daily moderate-to-vigorous physical activity (MVPA) was 58 ± 30 min (51 ± 26 for rural and 69 ± 34 for the urban, p = 0.001) for accelerometer. In case of GPAQ, rural residents reported significantly higher moderate work related PA (MET-minutes/week: 600 vs. 360 p = 0.02). Spearman correlation coefficients between GPAQ total MVPA MET-min/day and accelerometer MVPA min/day, counts per minute (CPM) or steps counts/day were acceptable for urban residents (rho: 0.46, 0.55 and 0.63, respectively; p < 0.01) but poor for rural residents. The overall correlation between the GPAQ and accelerometer for sitting was low (rho: 0.23; p < 0.001). GPAQ-Accelerometer correlation for MVPA was higher for females (rho: 0.42), ≤35 age group (rho: 0.31) and those with higher education attainment (rho: 0.48). The Bland-Altman plots illustrated bias towards over estimation of GPAQ MVPA with increased activity levels for urban and rural residents. GPAQ is an acceptable measure for physical activity surveillance in Bangladesh particularly for urban residents, women and people with high education. Given waist worn accelerometers do not capture the typical PA in rural context, further study using a physical activity diary and a combination of multiple sensors (e.g., wrist, ankle and waist worn accelerometers) to capture all movement is warranted among rural population with purposive sampling of all education levels.

Efficacy of a Single-Dose, Inactivated Oral Cholera Vaccine in Bangladesh.

PubMed

Qadri, Firdausi; Wierzba, Thomas F; Ali, Mohammad; Chowdhury, Fahima; Khan, Ashraful I; Saha, Amit; Khan, Iqbal A; Asaduzzaman, Muhammad; Akter, Afroza; Khan, Arifuzzaman; Begum, Yasmin A; Bhuiyan, Taufiqur R; Khanam, Farhana; Chowdhury, Mohiul I; Islam, Taufiqul; Chowdhury, Atique I; Rahman, Anisur; Siddique, Shah A; You, Young A; Kim, Deok R; Siddik, Ashraf U; Saha, Nirod C; Kabir, Alamgir; Cravioto, Alejandro; Desai, Sachin N; Singh, Ajit P; Clemens, John D

2016-05-05

A single-dose regimen of the current killed oral cholera vaccines that have been prequalified by the World Health Organization would make them more attractive for use against endemic and epidemic cholera. We conducted an efficacy trial of a single dose of the killed oral cholera vaccine Shanchol, which is currently given in a two-dose schedule, in an urban area in which cholera is highly endemic. Nonpregnant residents of Dhaka, Bangladesh, who were 1 year of age or older were randomly assigned to receive a single dose of oral cholera vaccine or oral placebo. The primary outcome was vaccine protective efficacy against culture-confirmed cholera occurring 7 to 180 days after dosing. Prespecified secondary outcomes included protective efficacy against severely dehydrating culture-confirmed cholera during the same interval, against cholera and severe cholera occurring 7 to 90 versus 91 to 180 days after dosing, and against cholera and severe cholera according to age at baseline. A total of 101 episodes of cholera, 37 associated with severe dehydration, were detected among the 204,700 persons who received one dose of vaccine or placebo. The vaccine protective efficacy was 40% (95% confidence interval [CI], 11 to 60%; 0.37 cases per 1000 vaccine recipients vs. 0.62 cases per 1000 placebo recipients) against all cholera episodes, 63% (95% CI, 24 to 82%; 0.10 vs. 0.26 cases per 1000 recipients) against severely dehydrating cholera episodes, and 63% (95% CI, -39 to 90%), 56% (95% CI, 16 to 77%), and 16% (95% CI, -49% to 53%) against all cholera episodes among persons vaccinated at the age of 5 to 14 years, 15 or more years, and 1 to 4 years, respectively, although the differences according to age were not significant (P=0.25). Adverse events occurred at similar frequencies in the two groups. A single dose of the oral cholera vaccine was efficacious in older children (≥5 years of age) and in adults in a setting with a high level of cholera endemicity. (Funded by the Bill and Melinda Gates Foundation and others; ClinicalTrials.gov number, NCT02027207.).

Impact of Lack of Breast Feeding during Neonatal Age on the Development of Clinical Signs of Pneumonia and Hypoxemia in Young Infants with Diarrhea

PubMed Central

Chisti, Mohammod J.; Salam, Mohammed A.; Smith, Jonathan Harvey; Ahmed, Tahmeed; Ashraf, Hasan; Bardhan, Pradip K.; Pietroni, Mark A. C.

2011-01-01

Background Hypoxemia is a grave sequel of pneumonia, and an important predictor of a fatal outcome. Pneumonia in the neonatal period is often associated with lack of breast feeding. However, there is no published report on the impact of the cessation of breast feeding in the neonatal period on the development of pneumonia and hypoxemia. The purpose of our study was to assess the impact of non-breast feeding or stopping breast feeding during the neonatal period (henceforth to be referred to as non-breast fed) on clinical features of pneumonia and hypoxemia in 0–6-month-old infants with diarrhea admitted to an urban hospital in Bangladesh. Methods We prospectively enrolled all infants (n = 107) aged 0 to 6 months who were admitted to the Special Care Ward (SCW) of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research Bangladesh (ICDDR,B) with diarrhea and pneumonia from September 2007 through December 2007.We compared the clinical features of pneumonia and hypoxemia of breast fed infants (n = 34) with those who were non-breast fed (n = 73). Results The median (inter-quartile range) duration of hypoxemia (hours) in non-breast-feds was longer than breast-fed infants [0.0 (0.0, 12.0) vs. 12.0 (0.0, 21.75); p = 0.021]. After adjusting for potential confounders such as inability to drink, fever, head nodding, cyanosis, grunting respiration, and lower chest wall in drawing, the non-breast-fed infants with pneumonia along with diarrhea had a higher probability of cough (OR 9.09; CI 1.34–61.71; p = 0.024), hypoxemia (OR 3.32; CI 1.23–8.93; p = 0.017), and severe undernutrition (OR 3.42; CI 1.29–9.12; p = 0.014). Conclusions and Significance Non-breast feeding or cessation of breast feeding during the neonatal period may substantially increase the incidence of severe malnutrition, incidence of cough, and both the incidence and duration of hypoxemia in young infants presenting with pneumonia and diarrhea. The findings emphasize the paramount importance of the continuation of breast feeding in the neonatal period and early infancy. PMID:21991362

Optima Nutrition: an allocative efficiency tool to reduce childhood stunting by better targeting of nutrition-related interventions.

PubMed

Pearson, Ruth; Killedar, Madhura; Petravic, Janka; Kakietek, Jakub J; Scott, Nick; Grantham, Kelsey L; Stuart, Robyn M; Kedziora, David J; Kerr, Cliff C; Skordis-Worrall, Jolene; Shekar, Meera; Wilson, David P

2018-03-20

Child stunting due to chronic malnutrition is a major problem in low- and middle-income countries due, in part, to inadequate nutrition-related practices and insufficient access to services. Limited budgets for nutritional interventions mean that available resources must be targeted in the most cost-effective manner to have the greatest impact. Quantitative tools can help guide budget allocation decisions. The Optima approach is an established framework to conduct resource allocation optimization analyses. We applied this approach to develop a new tool, 'Optima Nutrition', for conducting allocative efficiency analyses that address childhood stunting. At the core of the Optima approach is an epidemiological model for assessing the burden of disease; we use an adapted version of the Lives Saved Tool (LiST). Six nutritional interventions have been included in the first release of the tool: antenatal micronutrient supplementation, balanced energy-protein supplementation, exclusive breastfeeding promotion, promotion of improved infant and young child feeding (IYCF) practices, public provision of complementary foods, and vitamin A supplementation. To demonstrate the use of this tool, we applied it to evaluate the optimal allocation of resources in 7 districts in Bangladesh, using both publicly available data (such as through DHS) and data from a complementary costing study. Optima Nutrition can be used to estimate how to target resources to improve nutrition outcomes. Specifically, for the Bangladesh example, despite only limited nutrition-related funding available (an estimated $0.75 per person in need per year), even without any extra resources, better targeting of investments in nutrition programming could increase the cumulative number of children living without stunting by 1.3 million (an extra 5%) by 2030 compared to the current resource allocation. To minimize stunting, priority interventions should include promotion of improved IYCF practices as well as vitamin A supplementation. Once these programs are adequately funded, the public provision of complementary foods should be funded as the next priority. Programmatic efforts should give greatest emphasis to the regions of Dhaka and Chittagong, which have the greatest number of stunted children. A resource optimization tool can provide important guidance for targeting nutrition investments to achieve greater impact.

The effect of urban and rural habitats and resource type on activity budgets of commensal rhesus macaques (Macaca mulatta) in Bangladesh.

PubMed

Jaman, M Firoj; Huffman, Michael A

2013-01-01

Macaques are characterized by their wide distribution and ability to adapt to a variety of habitats. Activity budgets are affected by habitat type, season, and food availability in relation to differing age-sex class and individual requirements. We conducted a comparative study on two commensal rhesus groups, one living in a rural village and the other in the center of urban Dhaka, Bangladesh. The study was conducted in three different seasons between 2007 and 2009 in order to evaluate how habitat type and season affects their behavioral activities. Differences in food type and its availability between these two habitats were mainly responsible for the variations in activity budgets between groups. Feeding time in the rural group was significantly longer than that in the urban group. In contrast, grooming and object manipulation/play were significantly greater in the urban than the rural group. Seasonal variations in all major behaviors were significantly affected by group, with more time spent feeding in summer than in winter/dry season, and more time spent grooming and moving in winter/dry season than summer in the rural group. In contrast, time spent resting was greater in the monsoon and summer seasons than the winter/dry season in the urban group. Grooming time was greater in the winter/dry season than the monsoon and summer seasons. In both groups, immature of both sexes spent significantly more time on feeding and object manipulation/playing and less time resting than adults. Adult females spent more time grooming than males and immatures, of both sexes, in both groups. Moreover, the rural group spent most of their time feeding on garden/crop produce and wild plant food resources, while the urban group spent more time feeding on provisioned foods. These results showed that differences in the activity budgets of rural and urban dwelling macaques were due largely to the differences in available food resources. Commensal rhesus macaques show a high degree of behavioral flexibility in response to habitat and resource variability, and knowledge of these differences is important for the conservation and management of highly commensal primates.

Vaccination coverage survey in Dhaka District.

PubMed

Khan, M N A; Rahman, M L; Awal Miah, A; Islam, M S; Musa, S A J M; Tofail, F

2005-08-01

A survey was conducted in Dhaka District to measure the level of routine immunization coverage of children (12-23 months), to assess the tetanus toxoid (TT) immunization coverage among mothers of children (12-23 month), to evaluate EPI program continuity (dropout rates) and quality (percent of Invalid doses, vaccination card availability etc.) For this purpose, a thirty cluster cross-sectional survey was conducted in October 2002 to assess the immunization coverage in Dhaka. In this survey 30 clusters were randomly selected from a list of villages in 63 Unions of Dhaka following probability proportion to size (PPS) sampling procedure. A total of 210 children was studied using pre-tested structured questionnaire. Descriptive statistics was employed using software SPSS package for data analysis. The study showed that the routine immunization coverage in Dhaka among children by 12 months of age by card + history was 97% for BCG, 97% for Diphtheria, Pertussis Tetanus (DPT 1) and Oral Polio Vaccine (OPV 1), 75% for DPT3 and OPV3 and 67% for measles. Sixty six percent of all children surveyed had received valid doses of all vaccines by 12 months (fully immunized child). Programme access as measured by crude DPT1 coverage was better in Keranigonj (97%). Vaccination cards retention rate for children was 84%. Invalid DPT (1,2 or 3) doses were given to 25% of vaccinated children; 18% of measles doses were invalid. Surprisingly, major cause for invalid doses were not due to early immunizations or due to card lost but for giving tick in the card, instead of writing a valid date. DPT1 and DPT3 and DPT1- Measles drop out rates were 5% and 13% respectively. Major reason parents gave for never vaccinating their children (zero dose children) was (43%), major reasons for incomplete vaccination was lack of knowledge regarding subsequent doses (46%). TT surveys were also conducted for mothers of the children surveyed for vaccination coverage (mothers between 15-49 year old). Valid TT 1-5 coverage by card+ history was 97%, 55%, 44%, 24% and 11%, respectively. Card retention rate for TT was 67%. The findings of this study revealed that access to child and TT immunizations were good. But high dropouts and invalid doses reduced these percentages of fully immunized child to 66%. Programmatic strategy must be undertaken to reduce the existing high dropout rate in both child and TT immunizations.

Hypophosphataemia among severely-malnourished children: case series.

PubMed

Yoshimatsu, Shoji; Chisti, Mohammod Jobayer; Hossain, Md Iqbal; Islam, Md Munirul; Fukushima, Takashi; Wagatsuma, Yukiko; Smith, Jonathan Harvey; Sumazaki, Ryo; Ahmed, Tahmeed

2012-12-01

Phosphorus is an essential substance in our body, and hypophosphataemia (HP) is well-described in rickets, refeeding syndrome, diabetic ketoacidosis (DKA), and in chronic alcohol-abuse. However, to our knowledge, HP among severely-malnourished children has not been studied in detail, and information on prevalence, severity, and treatment is scarce. Currently, there are only a few published case reports of HP. This case series describes three cases of HP that presented to Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). Our first case required mechanical ventilation for respiratory distress associated with severe hypokalaemia (K 1.1 mmol/L) and moderate hypophosphataemia (P 2.1 mg/dL). The second case presented with severe sepsis which was associated with symptomatic hypocalcaemia (Ca 1.68 mmol/L), hypokalaemia (K 1.82 mmol/L), and severe hypophosphataemia (P 0.9 mg/dL). The third case presented with pneumonia and sepsis which were complicated by hypokalaemia (K 2.05 mmol/L) and severe hypophosphataemia (P 1.1 mg/dL). Marked lethargy and severe hypotonia were associated with HP in all of these cases. Manifestations of HP are diverse and can occur in association with other electrolyte imbalances, especially among malnourished children. Malnutrition, combined with sepsis, is one of the major killers of children younger than 5 years of age, and both malnutrition and sepsis can cause HP. It is concluded that the underlying causes of morbidity, including HP, should be actively sought and treated to reduce the mortality of children aged below five years.

Mechanism for prevention of infection in preterm neonates by topical emollients: a randomized, controlled clinical trial.

PubMed

Darmstadt, Gary L; Ahmed, Saifuddin; Ahmed, A S M Nawshad Uddin; Saha, Samir K

2014-11-01

Topical applications of emollients such as sunflower seed oil and Aquaphor have been shown to reduce the incidence of bloodstream infections and mortality of preterm infants in resource-poor settings. The causal mechanism for prevention of infection through cutaneous portals of entry is not well understood. We examined the relationship between skin condition score as a measure of skin barrier integrity and risk for bloodstream infection, and the effect of emollients on that relationship. Data for this study come from a randomized controlled trial of the impact of topical emollient therapy on nosocomial infections in 491 preterm infants <33 weeks gestational age at Dhaka Shishu Hospital, Bangladesh. Latent growth trajectory model with random-coefficient and multivariable logistic regression were utilized. Rate of deterioration of skin condition was significantly lower (P < 0.05) in both emollient arms compared with the untreated control group. Adjusted odds ratio of skin score for infection was 1.32 (95% confidence interval: 1.06-1.65). Emollients reduced the incidence of infection only when the skin had no signs of deterioration [Aquaphor incidence rate ratio: 0.43 (95% confidence interval: 0.19-0.97) and sunflower seed oil incidence rate ratio: 0.46 (95% confidence interval: 0.21-0.99)]. Skin condition deteriorated progressively after birth and compromised skin condition increased the risk of infection. Emollients preserved skin integrity and thus prevented infection in preterm neonates. To optimize benefits of emollients for the prevention of bloodstream infection, use of emollients should begin immediately after birth when the skin is still intact.

Female unmarried adolescents' knowledge on selected reproductive health issues in two low performing areas of Bangladesh: an evaluation study.

PubMed

Kabir, Humayun; Saha, Nirod Chandra; Gazi, Rukhsana

2015-12-21

In Bangladesh, 24 % of the total populations are adolescents. Twelve months intervention was implemented under Demand-Based Reproductive Health Commodity Project (DBRHCP) in two low performing areas: rural Sub-district Nabiganj (population 323,357) and an urban slum in Dhaka city (population 141,912). We evaluated the changes in knowledge of female unmarried adolescents on selected reproductive health issues over the project period in two low performing areas of Bangladesh. A pre-post study design was adopted. Under DBRHCP, interventions were focused on training of government service providers, disseminating behaviour change materials within the targeted communities, and employing community-based health promoters (Community Support Group and Peer Promoters) to foster linkages between the community and providers. All households were enumerated. A baseline survey was conducted during November 2006 to March 2007 and an end-line survey was conducted during November 2008 to March 2009. Eight hundred female unmarried adolescents (12-19 years) were selected independently for each survey from each study area through systematic random sampling, capturing changes over the 12 months intervention period. Data was analyzed using SPSS. A chi-square test was used to assess the changes in knowledge between baseline and end-line among the female unmarried adolescents. Female unmarried adolescents had significantly increased knowledge at the end-line about measures to be taken during menstruation like: using clean and dry cloths. Overall, two-third of female unmarried adolescents knew about Family Planning (FP) methods in both study areas but had significantly increased knowledge on injectables and condoms at the end-line. Overall knowledge on Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDs) was markedly different in the urban and rural areas, but a significantly higher proportion of female unmarried adolescents knew about HIV/AIDs from relatives and school curricula, and had increased knowledge about mode of transmission of HIV/AIDs, like: receiving blood from an HIV infected person and using a HIV infected needle or syringe, at the end-line. A significantly higher proportion of female unmarried adolescents reported sexually transmitted infection (STI) related symptoms at the end-line compared to baseline. Overall variation in knowledge about Government healthcare facilities, Non-Government Organization (NGO) healthcare facilities and private healthcare facilities was found in both study areas, but awareness was increased about the type of healthcare facilities at the end-line. The improvement of the female unmarried adolescents' knowledge on selected Reproductive Health (RH) issues suggest that the interventions affected RH related knowledge reported in the study. These interventions can be adapted in the health service delivery system to enhance people's knowledge on RH issues to achieve RH for adolescents.

Knowledge attitude and practice regarding diabetes mellitus among Nondiabetic and diabetic study participants in Bangladesh.

PubMed

Fatema, Kaniz; Hossain, Sharmin; Natasha, Khurshid; Chowdhury, Hasina Akhter; Akter, Jesmin; Khan, Tahmina; Ali, Liaquat

2017-04-26

Increased awareness amongst large population groups is a major determinant for the prevention of diabetes and its complications as well as related metabolic disorders. Knowledge and attitude are the principal markers of awareness that need to be studied in various population groups in specific racial and cultural contexts. The present study was undertaken to explore knowledge, attitude and practice (KAP) regarding -diabetes mellitus (DM) among nondiabetic (nonDM) and type 2 diabetes mellitus (T2DM) patients in Bangladesh. A cross-sectional study was conducted among 18,697 adults (aged 18 years and above; 7796 male and 10,901 female; 6780 nonDM and 11,917 T2DM) selected purposively from the OPD of 19 healthcare centres in and around Dhaka and in northern parts of Bangladesh. KAP were assessed by a pre-structured, interviewer-administered questionnaire and categorised using predefined scores of poor (mean + 1 SD). Univariate and bivariate statistical analysis were done as appropriate. Multivariate linear regression was done to examine the association between diabetes related KAP and other covariates. The mean (±SD) age (years) of all the study participants was 46 ± 14, mean BMI 24.4 ± 4.1 and mean waist-hip ratio (WHR) was 0.93 ± 0.07. The proportion of poor, average and good knowledge scores among T2DM subjects were 17%, 68% and 15% respectively. The corresponding values for attitude score were 23%, 67% and 10% respectively. The KAP regarding diabetes was found to be better among people who were living with diabetes compared to their counterparts. DM males showed better knowledge and practice regarding diabetes, compared to nonDM counterparts (M ± SD; 44.18 ± 16.13 vs 40.88 ± 15.62, p = <0.001; 66.00 ± 29.68 vs 64.21 ± 31.79, p < 0.001, respectively). Females showed better attitude score compared to males. Overall KAP were found to be significantly higher (p < 0.001) in middle aged (31-50 years) participants in each group. Participants from urban residents, higher educational background and upper socio-economic class demonstrated significantly greater score in terms of KAP in both nonDM and T2DM groups (p < 0.001). On linear regression analysis, knowledge scores correlated strongly with education, income, residence, diabetic state, BMI and attitude. The overall level of knowledge and practice concerning diabetes among Bangladeshi population is average, but the overall level of attitude is good both in nonDM and T2DM subjects. To prevent diabetes and its complications there is an urgent need for coordinated educational campaigns with a prioritized focus on poorer, rural and less educated groups.

Hypophosphataemia among Severely-malnourished Children: Case Series

PubMed Central

Chisti, Mohammod Jobayer; Hossain, Md. Iqbal; Islam, Md. Munirul; Fukushima, Takashi; Wagatsuma, Yukiko; Smith, Jonathan Harvey; Sumazaki, Ryo; Ahmed, Tahmeed

2012-01-01

Phosphorus is an essential substance in our body, and hypophosphataemia (HP) is well-described in rickets, refeeding syndrome, diabetic ketoacidosis (DKA), and in chronic alcohol-abuse. However, to our knowledge, HP among severely-malnourished children has not been studied in detail, and information on prevalence, severity, and treatment is scarce. Currently, there are only a few published case reports of HP. This case series describes three cases of HP that presented to Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). Our first case required mechanical ventilation for respiratory distress associated with severe hypokalaemia (K 1.1 mmol/L) and moderate hypophosphataemia (P 2.1 mg/dL). The second case presented with severe sepsis which was associated with symptomatic hypocalcaemia (Ca 1.68 mmol/L), hypokalaemia (K 1.82 mmol/L), and severe hypophosphataemia (P 0.9 mg/dL). The third case presented with pneumonia and sepsis which were complicated by hypokalaemia (K 2.05 mmol/L) and severe hypophosphataemia (P 1.1 mg/dL). Marked lethargy and severe hypotonia were associated with HP in all of these cases. Manifestations of HP are diverse and can occur in association with other electrolyte imbalances, especially among malnourished children. Malnutrition, combined with sepsis, is one of the major killers of children younger than 5 years of age, and both malnutrition and sepsis can cause HP. It is concluded that the underlying causes of morbidity, including HP, should be actively sought and treated to reduce the mortality of children aged below five years. PMID:23304916

Bacterial and Fungal Counts of Dried and Semi-Dried Foods Collected from Dhaka, Bangladesh, and Their Reduction Methods.

PubMed

Feroz, Farahnaaz; Shimizu, Hiromi; Nishioka, Terumi; Mori, Miho; Sakagami, Yoshikazu

2016-01-01

　Food is a basic necessity for human survival, but it is still the vehicle for the transmission of food borne disease. Various studies have examined the roles of spices, herbs, nuts, and semi-dried fruits, making the need for safe and convenient methods of decontamination a necessity. The current study determined the bacterial and fungal loads of 26 spices and herbs, 5 nuts, 10 semi-dried fruits and 5 other foods. Spices, herbs and semi-dried foods demonstrated the highest bacterial and fungal loads with the majority showing over 10 4 CFU/mL. Nuts and other foods showed growths ranging from 10 2 to 10 6 CFU/mL. The current study also attempted to determine the effects of heat and plasma treatment. The log reduction of bacterial growth after heat treatment (maximum: 120 min for 60℃) was between 0.08 to 4.47, and the log reduction after plasma treatment (maximum: 40 min) ranged from 2.37 to 5.75. Spices showed the lowest rates of reduction, whereas the semi-dried and other foods showed moderate to high levels of decrease after heat treatment. The log reduction of fungal growth after heat treatment ranged from 0.27 to 4.40, and log reduction after plasma treatment ranged from 2.15 to 5.91．Furthermore, we validated the sterilization effect of plasma treatment against Bacillus spp. and Staphylococcus spp. by using scanning electron microscopy. Both treatment methods could prove to be advantageous in the agriculture related fields, enhancing the quality of the foods.

Efficacy of Vitamin C in Lowering Serum Uric Acid.

PubMed

Choudhury, M R; Haq, S M; Saleh, A A; Hakim, F; Azad, A K

2016-10-01

The objective of the study was to determine the efficacy of vitamin C in reducing serum uric acid (UA). This study was a double-blind placebo-controlled randomized trial conducted in the Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka, Bangladesh from July 2007 and August 2008. Study participants were included from out patient department (OPD) of Rheumatology of BSMMU suffering from various Rheumatological problems other than gouty arthritis. All of the participants were non-smokers, non-alcoholics, and randomized to take either placebo or vitamin C (500 mg/day) for 12 weeks. A total of 98 subjects were enrolled in the study; 71 completed the trial, with 34 in the placebo group and 37 receiving vitamin C. Serum uric acid levels were not significantly reduced in the experimental group and they increased in the placebo group. In the vitamin C group, the mean change was -0.32mg/dl [95% confidence interval -0.73, 0.77], whereas in the placebo group, the mean change was +0.12mg/dl [95% confidence interval was -0.22, 0.47]. Subgroups were defined by sex, body mass index, and quartiles of baseline serum uric acid levels. In a subgroup analysis, vitamin C lowered serum uric acid significantly in those who had comparatively higher baseline uric acid levels. Although vitamin C did not lower serum uric acid significantly, participants with higher baseline serum uric acid levels experienced a significant uric acid lowering effect, but as the sample size was very small, it is difficult to draw any definitive conclusion.

Road traffic accident among motor vehicle drivers in selected high ways.

PubMed

Ahmed, M; Khanom, K; Shampa, R M; Bari, M H

2004-07-01

To assess the knowledge of the motor vehicle driver about the causes of road traffic accidents. This cross sectional study was conducted among the 107 motor vehicle drivers of selected Bus & Truck terminal & taxi stands of Dhaka city. The study was carried out during April to June 2002 at the Department of Health Promotion & Health Education of NIPSOM. The study showed about 55.1% learned driving from a friend. Out of 107 respondent 20.6% showed very high speed is one of the reason for road traffic accident.39.3% claimed for poor maintenance of roads. Regarding engine/vehicle defect 46.7% said head light defect. Increased earning is one of the reasons of very fast driving 35.5% respondent opined. These may be the reason of accident proneness of the society along with factor like family pressure, job dissatisfaction etc. Majority of the driver who took part in this study used light vehicle 54.2% and the rest 30.8% were heavy and 15% like medium light vehicle. Most of the respondent 67.3% was working as professional over for 3-6 years. 41.1% for 3 and 26.2% for 6 years. There were significant relationship (p < 0.002) between very fast driving and defective road and also engine defect were highly significant association (p < 0.005) with road traffic accident It is revealed that formal education, driving license through Bangladesh road traffic authority without unnecessary botheration, proper implementation of traffic law, training of drivers and increase level of public awareness through mass communication could reduce the road traffic accident

When South meets South.

PubMed

Wulf, D

1997-01-01

This article describes the establishment of a new organization, Partners in Population and Development, which promotes collaboration between developing countries. The organization was an outcome of the 1994 Cairo Conference on Population and Development. The basic aim is to share technical knowledge and experience between developing countries. In rural Ha Tay province in northern Vietnam, for example, a community mapping technique for tracking contraceptive use was implemented. The mapping technique was first developed in Indonesia and transferred to Vietnam via the Indonesian national family planning coordinating board. A Bangkok-based nongovernmental group was working in Ninh Binh province with income generation among rice workers as part of a reproductive health program. Partners in Population and Development includes high ranking government officials responsible for national family planning programs from Colombia, Egypt, Kenya, Indonesia, Mexico, Morocco, Thailand, Tunisia, and Zimbabwe. In 1996, a permanent secretariat was established in Dhaka, Bangladesh. The secretariat includes a small staff consisting of an executive director and three deputies from developing countries. The secretariat will act as a clearinghouse and coordinating unit between countries and projects. The office will answer field requests for assistance and help identify potential sources of donor support. The office will operate on funding from the UN Population Fund, the World Bank, and the Rockefeller Foundation. The Partnership will diffuse the appearance that developed countries are "demographic imperialists" and offer sound financial political advice. Projects will emphasize appropriateness and sustainability. The aim is to build bridges between countries where there are barriers and to extend services beyond regional borders.

Carotid Flow Time Test Performance for the Detection of Dehydration in Children With Diarrhea.

PubMed

Mackenzie, David C; Nasrin, Sabiha; Atika, Bita; Modi, Payal; Alam, Nur H; Levine, Adam C

2018-06-01

Unstructured clinical assessments of dehydration in children are inaccurate. Point-of-care ultrasound is a noninvasive diagnostic tool that can help evaluate the volume status; the corrected carotid artery flow time has been shown to predict volume depletion in adults. We sought to determine the ability of the corrected carotid artery flow time to identify dehydration in a population of children presenting with acute diarrhea in Dhaka, Bangladesh. Children presenting with acute diarrhea were recruited and rehydrated according to hospital protocols. The corrected carotid artery flow time was measured at the time of presentation. The percentage of weight change with rehydration was used to categorize each child's dehydration as severe (>9%), some (3%-9%), or none (<3%). A receiver operating characteristic curve was constructed to test the performance of the corrected carotid artery flow time for detecting severe dehydration. Linear regression was used to model the relationship between the corrected carotid artery flow time and percentage of dehydration. A total of 350 children (0-60 months) were enrolled. The mean corrected carotid artery flow time was 326 milliseconds (interquartile range, 295-351 milliseconds). The area under the receiver operating characteristic curve for the detection of severe dehydration was 0.51 (95% confidence interval, 0.42, 0.61). Linear regression modeling showed a weak association between the flow time and dehydration. The corrected carotid artery flow time was a poor predictor of severe dehydration in this population of children with diarrhea. © 2017 by the American Institute of Ultrasound in Medicine.

Temporary Seismic Installation in Eastern Bangladesh: Microseismicity and Structure of an On-Land Accretionary Prism

NASA Astrophysics Data System (ADS)

Foster, A. E.; Almeida, R. V.; Akhter, S. H.; Hubbard, J.; Bhattacharya, R.; Shing, U. M.; Hosain, A.; Bulbul, M. A.

2016-12-01

Eastern Bangladesh is underlain by a fold and thrust belt accumulating 13-17 mm/yr of plate convergence on a locked, shallowly dipping décollement (Steckler et al., 2016). We have installed a network of short-period and broadband instruments in this region to better assess microseismicity and investigate the structure of the fold belt. Stations will remain in place for 1-2 years and will complement the temporary stations installed by the University of Dhaka and the Lamont-Doherty Earth Observatory. Thirteen Lennartz 1-Hz instruments and three Trillium Compact 120-s instruments were installed in the Sylhet area in June 2016. Station spacing is between 15-30 km. Installations ranged from shallow vaults to above-ground locations on solid foundations, as required by local conditions. One focus of this deployment is to locate microseismicity. Neither large numbers nor magnitudes of earthquakes are expected in this area, but improved locations may help define active areas of the convergence as well as illuminate the interactions between the Dauki fault (responsible for uplift of the Shillong Plateau), the Sylhet anticline, and the rest of the Indo-Burman Ranges. Nine additional short-period instruments and three additional broadband instruments will be installed in the Chittagong area in September 2016. The southern-most stations are located over the Andaman subduction zone, thought to be associated with a large subduction earthquake in 1762 (Steckler et al., 1998). Thus, the full deployment will span the transition from an on-land accretionary prism to an area considered a classic subduction zone. Combined, the northern and southern parts of the network should provide good locations for events within the Tripura area (India) as well. We present initial estimates of station quality and the potential for an earthquake catalogue. We plan to obtain earthquake locations and focal mechanisms, when possible, as the data is collected. We will apply ambient noise tomography methods to investigate the structure of the fold belt. These applications and others may contribute to unanswered questions in the area, such as the location of the frontal-most deformation associated with the fold and thrust belt and the geometry of the basal décollement at depth, and allow better characterization of the risk to nearby populations.

Sensory Acceptability of Iron-Fortified Red Lentil (Lens culinaris Medik.) Dal.

PubMed

Podder, Rajib; Khan, Shaan M; Tar'an, Bunyamin; Tyler, Robert T; Henry, Carol J; Jalal, Chowdhury; Shand, Phyllis J; Vandenberg, Albert

2018-03-01

Panelists in Saskatoon, Canada (n = 45) and Dhaka, Bangladesh (n = 98) participated in sensory evaluations of the sensory properties of both cooked and uncooked dehulled red lentil dal fortified with FeSO 4 ·7H 2 O, NaFeEDTA or FeSO 4 ·H 2 O at fortificant Fe concentrations of 800, 1,600 (both cooked and uncooked), or 2,800 ppm. Appearance, odor, and overall acceptability of cooked and uncooked samples were rated using a 9-point hedonic scale (1 = dislike extremely to 9 = like extremely). Taste and texture were rated for the cooked samples prepared as typical south Asian lentil meals. Significant differences in sensory quality were observed among all uncooked and cooked samples at both locations. Overall, scores for all sensory attributes and acceptability of uncooked lentil decreased with increasing concentration of Fe in the fortificant; however, Fe fortification (particularly with NaFeEDTA) had small effects on acceptability. Panelists from Saskatoon provided a wider range of scores than those from Bangladesh for all attributes of cooked lentil. Overall, sensory evaluation of Fe fortification using NaFeEDTA minimally affected consumer perception of color, taste, texture, odor, and overall acceptability of cooked lentil. Reliability estimates (Cronbach's alpha [CA]) indicated that consumer scores were generally consistent for all attributes of all lentil samples (mean CA > 0.80). NaFeEDTA was found to be the most suitable Fe fortificant for lentil based on consumer acceptability. Consumption of 45 to 50 g of NaFeEDTA-fortified lentil (fortificant Fe concentration of 1,600 ppm) per day meets the estimated average requirements (EARs) of Fe for humans (10.8 to 29.4 mg). Iron fortification of dehulled lentil dal may change organoleptic attributes that can influence consumer acceptability. Sensory evaluation by consumers helps to determine the effect on appearance, odor, taste, texture, and overall acceptability of fortified lentils. In this study, consumer acceptability was evaluated with panelists who consume lentil regularly. Panelists provided significantly different scores for 5 sensory attributes for 10 uncooked and 3 cooked lentil samples. Panelists reliably preferred NaFeEDTA as the most suitable Fe fortificant for dehulled lentils for 5 attributes. Overall, lentil dal fortified with NaFeEDTA can offer a simple and low-cost solution to human health problems associated with iron-related malnutrition. © 2018 Institute of Food Technologists®.

Mental health in the slums of Dhaka - a geoepidemiological study

PubMed Central

2012-01-01

Background Urban health is of global concern because the majority of the world's population lives in urban areas. Although mental health problems (e.g. depression) in developing countries are highly prevalent, such issues are not yet adequately addressed in the rapidly urbanising megacities of these countries, where a growing number of residents live in slums. Little is known about the spectrum of mental well-being in urban slums and only poor knowledge exists on health promotive socio-physical environments in these areas. Using a geo-epidemiological approach, the present study identified factors that contribute to the mental well-being in the slums of Dhaka, which currently accommodates an estimated population of more than 14 million, including 3.4 million slum dwellers. Methods The baseline data of a cohort study conducted in early 2009 in nine slums of Dhaka were used. Data were collected from 1,938 adults (≥ 15 years). All respondents were geographically marked based on their households using global positioning systems (GPS). Very high-resolution land cover information was processed in a Geographic Information System (GIS) to obtain additional exposure information. We used a factor analysis to reduce the socio-physical explanatory variables to a fewer set of uncorrelated linear combinations of variables. We then regressed these factors on the WHO-5 Well-being Index that was used as a proxy for self-rated mental well-being. Results Mental well-being was significantly associated with various factors such as selected features of the natural environment, flood risk, sanitation, housing quality, sufficiency and durability. We further identified associations with population density, job satisfaction, and income generation while controlling for individual factors such as age, gender, and diseases. Conclusions Factors determining mental well-being were related to the socio-physical environment and individual level characteristics. Given that mental well-being is associated with physiological well-being, our study may provide crucial information for developing better health care and disease prevention programmes in slums of Dhaka and other comparable settings. PMID:22404959

Geographic information system (GIS) representation of coal-bearing areas in India and Bangladesh

USGS Publications Warehouse

Trippi, Michael H.; Tewalt, Susan J.

2011-01-01

Geographic information system (GIS) information may facilitate energy studies, which in turn provide input for energy policy decisions. Prior to this study, no GIS file representing the occurrence of coal-bearing units in India or Bangladesh was known to exist. This Open-File Report contains downloadable shapefiles representing the coalfields of India and Bangladesh and a limited number of chemical and petrographic analyses of India and Bangladesh coal samples. Also included are maps of India and Bangladesh showing the locations of the coalfields and coal samples in the shapefiles, figures summarizing the stratigraphic units in the coalfields of India and Bangladesh, and a brief report summarizing the stratigraphy and geographic locations of coal-bearing deposits in India and Bangladesh.

Validity of Antibodies in Lymphocyte Supernatant in Diagnosing Tuberculosis in Severely Malnourished Children Presenting with Pneumonia

PubMed Central

Chisti, Mohammod Jobayer; Salam, Mohammed Abdus; Raqib, Rubhana; Banu, Sayera; Shahid, Abu ASMSB; Shahunja, KM; Sharmin, Lazina; Ashraf, Hasan; Faruque, Abu Syed Golam; Bardhan, Pradip Kumar; Ahmed, Tahmeed

2015-01-01

Background The diagnosis of tuberculosis (TB) in young children can be challenging, especially in severely malnourished children. There is a critical need for improved diagnostics for children. Thus, we sought to evaluate the performance of a technique that measures antibodies in lymphocyte supernatant (ALS) for the diagnosis of TB in severely malnourished children presenting with suspected pneumonia. Methods Children less than 5 years with severe acute malnutrition and radiological features of pneumonia admitted to the Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh, were enrolled consecutively following informed written consent. In addition to clinical and radiological assessment, samples taken for TB diagnosis included gastric lavage fluid and induced sputum for microbiological confirmation. ALS was measured from venous blood, and results were evaluated in children classified as “confirmed”, “non-confirmed TB” or “not TB”. Results Among 224 children who had ALS analysis, 12 (5.4%) children had microbiologically “confirmed TB”, a further 41 (18%) had clinically diagnosed “non-confirmed TB” and the remaining 168 (75%) were considered not to have TB. ALS was positive in 89 (40%) and negative in 85 (39%) of children, with a large number (47 or 21%) reported as “borderline”. These proportions were similar between the three diagnostic groups. The sensitivity and specificity of ALS when comparing “Confirmed TB” to “Not TB” was only 67% (95% CI: 31–91%) and 51% (95% CI: 42–60%), respectively. Conclusions and Significance Our data suggest that ALS is not sufficiently accurate to improve the diagnosis of TB in children with severe malnutrition. PMID:26020966

Kinetics of Poliovirus Shedding following Oral Vaccination as Measured by Quantitative Reverse Transcription-PCR versus Culture

PubMed Central

Begum, Sharmin; Uddin, Md Jashim; Platts-Mills, James A.; Liu, Jie; Kirkpatrick, Beth D.; Chowdhury, Anwarul H.; Jamil, Khondoker M.; Haque, Rashidul; Petri, William A.; Houpt, Eric R.

2014-01-01

Amid polio eradication efforts, detection of oral polio vaccine (OPV) virus in stool samples can provide information about rates of mucosal immunity and allow estimation of the poliovirus reservoir. We developed a multiplex one-step quantitative reverse transcription-PCR (qRT-PCR) assay for detection of OPV Sabin strains 1, 2, and 3 directly in stool samples with an external control to normalize samples for viral quantity and compared its performance with that of viral culture. We applied the assay to samples from infants in Dhaka, Bangladesh, after the administration of trivalent OPV (tOPV) at weeks 14 and 52 of life (on days 0 [pre-OPV], +4, +11, +18, and +25 relative to vaccination). When 1,350 stool samples were tested, the sensitivity and specificity of the quantitative PCR (qPCR) assay were 89 and 91% compared with culture. A quantitative relationship between culture+/qPCR+ and culture−/qPCR+ stool samples was observed. The kinetics of shedding revealed by qPCR and culture were similar. qPCR quantitative cutoffs based on the day +11 or +18 stool samples could be used to identify the culture-positive shedders, as well as the long-duration or high-frequency shedders. Interestingly, qPCR revealed that a small minority (7%) of infants contributed the vast majority (93 to 100%) of the total estimated viral excretion across all subtypes at each time point. This qPCR assay for OPV can simply and quantitatively detect all three Sabin strains directly in stool samples to approximate shedding both qualitatively and quantitatively. PMID:25378579

Autism Spectrum disorders (ASD) in South Asia: a systematic review.

PubMed

Hossain, Mohammad Didar; Ahmed, Helal Uddin; Jalal Uddin, M M; Chowdhury, Waziul Alam; Iqbal, Mohd S; Kabir, Razin Iqbal; Chowdhury, Imran Ahmed; Aftab, Afzal; Datta, Pran Gopal; Rabbani, Golam; Hossain, Saima Wazed; Sarker, Malabika

2017-08-01

Autism spectrum disorders (ASD) are a group of complex neurodevelopmental disorders. The prevalence of ASD in many South Asian countries is still unknown. The aim of this study was to systematically review available epidemiological studies of ASD in this region to identify gaps in our current knowledge. We searched, collected and evaluated articles published between January 1962 and July 2016 which reported the prevalence of ASD in eight South Asian countries. The search was conducted in line with the PRISMA guidelines. We identified six articles from Bangladesh, India, and Sri Lanka which met our predefined inclusion criteria. The reported prevalence of ASD in South Asia ranged from 0.09% in India to 1.07% in Sri Lanka that indicates up to one in 93 children have ASD in this region. Alarmingly high prevalence (3%) was reported in Dhaka city. Study sample sizes ranged from 374 in Sri Lanka to 18,480 in India. The age range varied between 1 and 30 years. No studies were found which reported the prevalence of ASD in Pakistan, Nepal, Bhutan, Maldives and Afghanistan. This review identifies methodological differences in case definition, screening instruments and diagnostic criteria among reported three countries which make it very difficult to compare the studies. Our study is an attempt at understanding the scale of the problem and scarcity of information regarding ASD in the South Asia. This study will contribute to the evidence base needed to design further research and make policy decisions on addressing this issue in this region. Knowing the prevalence of ASD in South Asia is vital to ensure the effective allocation of resources and services.

Effects of psychosocial stimulation on growth and development of severely malnourished children in a nutrition unit in Bangladesh.

PubMed

Nahar, B; Hamadani, J D; Ahmed, T; Tofail, F; Rahman, A; Huda, S N; Grantham-McGregor, S M

2009-06-01

Young children with severe malnutrition usually have poor mental development. Psychosocial stimulation may reduce their cognitive deficit, but it is not usually provided. The aim of the study was to incorporate stimulation into the routine treatment of severely malnourished children in a nutrition unit and evaluate the impact on their growth and development. Time-lagged controlled study. Nutritional Rehabilitation Unit (NRU) in ICDDR,B Dhaka Hospital. Severely malnourished children, aged 6-24 months, admitted to the NRU were enrolled. All received standard nutritional care. A control group of 43 children was studied initially, followed by an intervention group of 54 children. The intervened mothers and children participated in daily group meetings and individual play sessions for 2 weeks in hospital and were visited at home for 6 months. Children's growth was measured and development assessed using the Bayley Scales of Infant Development. Twenty-seven children were lost to the study. In the remaining children, both groups had similar developmental scores and anthropometry initially. After 6 months, the intervention group had improved more than the controls did by a mean of 6.9 (P<0.001; 95% CI: 3.9, 10.0) mental and 3.1 (P=0.024; 95% CI: 0.4, 5.7) motor raw scores and a mean of 0.4 (P=0.029; 95% CI: 0.1, 0.8) weight-for-age z scores, controlling for background variables. Psychosocial stimulation integrated into treatment of severely malnourished children in hospital, followed by home visits for 6 months, was effective in improving children's growth and development and should be an integral part of their treatment.

Improved national growth rate method: a comment.

PubMed

Begum, N

1991-09-01

Rahman's 1987 paper on an improvement in the National Growth Rate Method (NGRM) is discussed. Rahman's assumption is that migration in/out of a city of region is constant, and because the method requires minimal data, it is suitable for application in developing countries. This assumption means that the model is inappropriate for developing countries which are known to have nonuniform rates of population change. Size of city also affects the migration pattern, where larger cities with greater numbers of industrial and business concerns and social services receive a rapid influx of new migrants. This view is also reflected in Rahman's paper. The example is given that Dhaka SMA, Bangladesh received 60% more migrants in 2 periods: 130,000 in migrants/year from 1974 to 1981 vs. 82,000/year from 1961 to 1974. Chittagong, Khulna, and Rajshahi SMA's had similar growth from 1961 to 1981, but there was a slower rate in the 2nd period. Positive contributions of the Rahman paper are the identification of the problems of the nuisance parameter. Rahman points out that the definition of the migration rate is flawed by the traditional NGRM parameter describing the natural increase of migrants. It is stated that recognition of this flaw and the development of a simple case of uniform migration is a good beginning for developing a more realistic model of migration. It is suggested that an extra parameter to represent departure from uniformity in the estimation be introduced. More data would be required. If the task is to use only 2 censuses for estimation of a single parameter, then there is a seemingly insurmountable problem.

The Effectiveness of Farm Programmes on Bangladesh Betar in Educating Farmers

ERIC Educational Resources Information Center

Hasan, Md. Mahedi; Mondal, Md. Nazrul Islam; Islam, Md. Nurul; Hoque, Md. Aminul

2017-01-01

Farm programmes (FPs) of varied categories have been developed and aired over several decades by Bangladesh Betar, the national radio of Bangladesh for the diffusion of farm technologies. The study aimed to produce an in-depth academic evaluation of their effectiveness in educating farmers in Bangladesh. A sample of 465 respondents from the Khulna…

Education Achievements and School Efficiency in Rural Bangladesh. World Bank Discussion Papers, 319.

ERIC Educational Resources Information Center

Khandker, Shahidur R.

Two of the largest World Bank investment projects in Bangladesh are the general education project and the female secondary scholarship and assistance project. This paper evaluates the expected results of these educational projects using the household and school survey data recently collected in rural Bangladesh. Bangladesh spends only 2 percent of…

Infant mortality in Bangladesh: trends and differentials.

PubMed

Begum, S

1983-12-01

Overall mortality decline in contemporary developing countries including Bangladesh has remained a remarkable success story. In Bangladesh, the mortality rate has dropped from about 45/1000 in the early 1920s to about 20/1000 by the mid 1970s. This study investigates recent behavior of infant mortality in Bangladesh. Using 1974 Bangladesh Retrospective Survey of Fertility and Mortality data, infant mortality rates for Bangladesh are obtained by Feeney's method. In understanding trends and differentials of Bangladesh infant mortality it is desirable that one remains confined to the 1960s only instead of the total period covered in the study (1957-1978). During the 1960s urban areas achieved a very steady and distinct improvement in their mortality rates while rural areas at that time could barely maintain a status quo. In the 1960s, parents' education was inversely related to infant mortality; mother's education is far more important than father's education in augmenting the prospect of survival of their children. Findings reveal: 1) despite the fact that Bangladesh has accomplished some decline in overall mortality in recent decades, no corresponding decline has taken place in infant mortality; 2) the absence of mortality improvement is not true for all sub-groups of population while such stagnation holds true for a large marjority; 3) Bangladesh has strong differentials in infant mortality; and 4) these differentials have widened further in recent years. The Bangladesh government has to make a definite attack on death in infancy; about 33% of the total Bangladesh deaths took place at this age, and overall mortality is reducible to that extent by proper policy devices.

World EpidemiologyReview No. 83

DTIC Science & Technology

1977-06-09

form of dysentery. In Bangladesh , a team of researchers participating in the Teknaf Dysentery Project have succeeded in establish- ing a link...report. CONTENTS PAGE I. HUMAN DISEASES ANGOLA 1 AUSTRALIA 2 BANGLADESH . 4 BRAZIL 6 BURMA 17 EAST GERMANY 21 ECUADOR 24 GABON , 26...typhoid, caused by contaminated milk. BANGLADESH SHIGELLOSIS DYSENTERY IN BANGLADESH Kampala VOICE OF UGANDA in English 17 May 77 p 6 [Text

If I do not have enough water, then how could I bring additional water for toilet cleaning?! Addressing water scarcity to promote hygienic use of shared toilets in Dhaka, Bangladesh.

PubMed

Saxton, Ronald E; Yeasmin, Farzana; Alam, Mahbub-Ul; Al-Masud, Abdullah; Dutta, Notan Chandra; Yeasmin, Dalia; Luby, Stephen P; Unicomb, Leanne; Winch, Peter J

2017-09-01

Provision of toilets is necessary but not sufficient to impact health as poor maintenance may impair toilet function and discourage their consistent use. Water in urban slums is both scarce and a prerequisite for toilet maintenance behaviours. We describe the development of behaviour change communications and selection of low-cost water storage hardware to facilitate adequate flushing among users of shared toilets. We conducted nine focus group discussions and six ranking exercises with adult users of shared toilets (50 females, 35 males), then designed and implemented three pilot interventions to facilitate regular flushing and improve hygienic conditions of shared toilets. We conducted follow-up assessments 1 and 2 months post-pilot including nine in-depth interviews and three focus group discussions with adult residents (23 females, 15 males) and three landlords in the pilot communities. Periodic water scarcity was common in the study communities. Residents felt embarrassed to carry water for flushing. Reserving water adjacent to the shared toilet enabled slum residents to flush regularly. Signs depicting rules for toilet use empowered residents and landlords to communicate these expectations for flushing to transient tenants. Residents in the pilot reported improvements in cleanliness and reduced odour inside toilet cubicles. Our pilot demonstrates the potential efficacy of low-cost water storage and behaviour change communications to improve maintenance of and user satisfaction with shared toilets in urban slum settings. © 2017 John Wiley & Sons Ltd.