Absorption of macronutrients from a rice-vegetable diet before and after treatment of ascariasis in children

The apparent absorption of nitrogen (N), fat, and total energy from a rice and vegetable diet was measured in 13 children of similar nutritional status but infected with varying loads of Ascaris lumbricoides. Apparent N absorption was modestly decreased initially in subjects with heavy infections as compared to those with light infections (57.2% of intake versus 64.1% of intake, 0.05 < P < 0.1). After antihelminthic therapy there ws a significant improvement in apparent N absorption (P < 0.02), apparent N retention (P < 0.05), and apparent fat absorption (P < 0.05) for the group as a whole, particularly for those with heavy infections. Total energy absorption improved slightly, but not significantly, after treatment, and there was no change in xylose excretion tests. Treatment of ascariasis may be nutritionally advantageous for children with heavy worm burdens and marginal protein availability.

Use-effectiveness of standard-dose and low-dose oral contraceptives in Dacca

Five hundred women accepting oral contraceptives at an urban clinic were alternately prescribed standard-dose (50 microgram of estrogen) or low-dose (30 microgram of estrogen) combined pills. Life-table continuation rates at 12 months were approximately 40% for both groups, with no significant differences between or within the two groups after controlling for sociodemographic variables and nutritional status. Approximately three fifths of those who discontinued using both formulations cited medical reasons, especially dizziness. The low-dose oral contraceptive appeared to be as acceptable to these urban Bangladeshi women as the higher-dose pill.

Dizziness associated with discontinuation of oral contraceptives in Bangladesh

Data from four studies in Bangladesh indicate that dizziness is a frequent complaint of women taking oral contraceptives and the most commonly cited reason for discontinuation. Results of a fifth study showed that multiple vitamin or glucose capsules were effective in treating dizziness in about half of the women studied. Although the cause of dizziness is not clear, it may be partly due to the small stature and poor nutritional status of many Bangladeshi women.

A comparative study of standard-dose and low-dose oral contraceptives in rural Bangladesh

Fieldworkers in a rural area of Bangladesh distributed two kinds of oral contraceptives to women accepting this method; 286 women received a standard-dose oral contraceptive and 366 women one mile away were given a low-dose pill of the same formulation. Continuation rates at 12 months were 86% for the standard-dose and 75% for the low-dose pill. Worker performance accounted for some of the difference, but the results suggest that the lower-dose pill is less acceptable in rural Bangladesh than the standard-dose pill of the same formulation.

Oral rehydration therapy for treatment of rotavirus diarrhoea in a rural treatment centre in Bangladesh

In November 1977, an enzyme-linked immunosorbent assay for detecting rotavirus antigen was introduced in the laboratory of a rural treatment centre in Bangladesh. During the next 40 days rotavirus without other pathogens was found in the stools of 216 (45%) of 480 children under age 5 years who visited the centre with a gastrointestinal illness. 188 (87%) of these children were treated with oral rehydration alone, using the solution currently recommended by the World Health Organisation, while 28 (13%) also required some intravenous rehydration; there were no deaths. Oral rehydration treatment was judged successful in 205 (95%) of the rotavirus patients and was not associated with any serious side effects. Oral rehydration treatment, with this solution, has been used extensively and successfully in the treatment of enterotoxin-mediated diarrhoea and can also safely be used for treating rotavirus diarrhoea in infants and young children.

A randomized, single blind comparative trial of norethindrone enanthate and depo-medroxyprogesterone acetate in Bangladesh

A randomized, single blind comparative trial of norethindrone enanthate (NET-ENT) and depo-medroxyprogesterone acetate (DMPA) was conducted in the Model Clinic, Decca, Bangladesh, to determine if there were differences in reported side effects, reasons for discontinuation and discontinuation rates of these two injectables. On all follow-up visits the proportion of women reporting no bleeding (amenorrhea) was higher for the DMPA clients compared to the NET-ENT clients. Concurrent with these findings, the proportion of women reporting irregular bleeding was consistently higher for the NET-ENT clients. Concurrent with these findings, the proportion of women reporting irregular bleeding was consistently higher for the NET-ENT clients compared to those receiving DMPA. By the fourth injection, less than 15% of the clients in both drug groups still reported having regular cyclic bleeding (4 of the 26 DMPA clients and 4 of the 28 NET-ENT clients). Five of the 133 women on DMPA and 6 of the 106 women on NET-ENT became pregnant while using the injectables. At the end of one year of follow-up, 14 of the 133 DMPA and 14 of the 106 NET-ENT clients were still continuing (came back for a fifth injection).

Epidemiology and causes of death among children in a rural area of Bangladesh

From a longitudinal surveillance programme among a rural Bangladesh population of 260,000, the epidemiology and causes of child death (under age 5) over 3 years (1975-1977) were analyzed. The most significant causes of death were diarrhoea (watery and dysentery), tetanus, measles, fever, respiratory disease, drowning, skin disease, and other causes. Of an infant mortality rate of 142.6/1000 live births, neonatal tetanus (37.4/1000), diarrhoea (19.6/1000), and respiratory disease (10.4/1000) were the most significant identifiable causes. Many infant deaths (62.2/1000) were unidentified, taking place during the neonatal (1-28 days) period. The 1-4 year mortality averaged 34.3/1 000. Diarrhoea (15.1/1 000), measles (4.5/1 000), fever (2.9/1 000) and respiratory disease (1.6/1 000) accounted for most 1-4 year deaths. Mortality trends over the past 10 years showed sharp temporary fluctuations in response to 2 disasters but no definitive long-term trend. Most causes of death displayed seasonal fluctuation, and sex differentials were marked with female deaths exceeding male deaths for all ages after the neonatal period. Malnourished children from low socioeconomic status families had higher mortality rates than their better nourished and wealthier counterparts. Overall, the data suggest that the delivery of a few basic health measures (oral hydration and immunization) could result in substantial reduction of under 5 mortality.

Breast-feeding patterns in rural Bangladesh

Nearly 1500 women with live births from February through September 1974 were included in this multiple phase study of breast-feeding patterns in a rural area of Banglandesh. The median duration of breast feeding was observed to be 30 months. Over 75% of the women whose most recently born children were living were breast feeding at 2 1/2 years postpartum. The major reason for discontinuing breast feeding in the 1st year was infant death, and in the 2nd year, pregnancy. Insufficient milk was given as a reason for discontinuing breast feeding by 18% of the women who stopped breast feeding for reasons other than child death; among these women almost 60% were pregnant at the time they stopped. Of the breast-feeding women who became pregnant, over 50% continued to breast feed through the 6th month of pregnancy. A sample of 200 breast-feeding women with children ages 17 to 25 months were followed longitudinally for 1 1/2 years or until the mothers conceived. A seasonal trend in suckling time was observed with women reducing suckling during the harvest season. Total suckling time was inversely associated with socioeconomic factors and with infant nutritional status. No association was found between mean suckling time and maternal nutritional status, maternal morbidity, infant morbidity, or child's sex.

Are voluntary agencies helping to improve health in Bangladesh?

Since independence in 1971, a large number of health programs run by local and foreign voluntary organizations have been started in Bangladesh. This paper is the result of a survey undertaken on behalf on the Oxford Famine Relief Committee of ten of the most interesting of these projects. On the basis of an analysis of the underlying causes of ill health in Bangladesh, a criterion for the assessment of these health programs is developed. Following an overview of the performance of these "innovative" projects, the pertinent issues which have been and have to be dealt with by appropriate projects are addressed by means of a case study of one of the best of these projects. A basic premise of this analysis is that ill health in particular communities is not simply a result of local conditions; rather, the structural determinants of ill health are frequently national and even international in scope. The effect of these structural determinants of the presence and funding policies of the many voluntary agencies in Bangladesh is assessed by analyzing the performance of the Oxford Famine Relief Committee, one of the more enlightened of these agencies.

Indian famines and peasant victims: the case of Bengal in 1943-44

What, in detail, do Indian peasants do when famine looms? How do they defend themselves, who succumbs and who survives? Recently several talented economic historians have given these questions a vigorous airing. Morris D. Morris in particular set off the discussion by suggesting that South Asian peasants are well prepared for periodic drought famines. He argues (I compress him almost to parody) that long experience with the monsoon's periodic failures has taught the Indian cultivator prudence: when crops begin to fail the cultivator draws upon previously stored substances—his wife's jewelry, grain, cattle, etc.—and sells them or barters them to keep up his usual level of food consumption. Thus, while his assets are cyclically depleted and replenished, he can usually stave off the most feared effect of drought, which is starvation. N. S. Jodha, however, has partially contradicted Morris by adducing evidence from Rajasthan and elsewhere which shows the peasant cultivator to be more likely to cut back his current food intake rather than risk a loss of future production by depleting his capital assets. Like Morris, Jodha sees that farmers are rational and plan for the future, the disagreement being whether they plan for crop failures in the midst of good harvests or plan for good harvests in the midst of crop failures In fact these two views, suitably softened, are not incompatible, and one can imagine both operating at different phases of a worsening episode of drought.

A survey of sterilization acceptors in a family planning program in rural Bangladesh

The results of a survey of 275 Bangladeshi women who were sterilized at a rural family planning clinic are presented. The survey comprised two interviews of each woman: one conducted immediately prior to the sterilization procedure and the second conducted one month after each woman was sterilized. Sociodemographic data were gathered for the survey from the patients' clinic records. Reasons for the choice of sterilization and sociodemographic impact of the procedure are discussed, as are implications of the results on other rural family planning programs.

Women's reality: critical issues for program design

The following article looks at social controls on the behavior of rural women in Bangladesh that need to be considered in project designs if women are to be able to respond to development programs. Rural women in many countries are constrained by analogous social pressures, which usually have an economic basis favoring the more powerful and therefore are resistant to change. Since these pressures on rural women often have a negative effect on the goals of rural development, they need to be understood and addressed.

Lactose malabsorption in Bangladeshi village children: relation with age, history of recent diarrhea, nutritional status, and breast feeding

The prevalence of lactose malabsorption (LM) among Bangladeshi village children has been determined using the recent developed breath hydrogen test. Initial hospital-based comparison studies showed general agreement between the breath hydrogen test and a modified lactose tolerance test. Two hundred thirty-four children, stratified by age, nutritional status, and history of recent diarrhea then participated in the field study. LM was diagnosed in more than 80% of children over 36 months of age but in none of the children under 6 months. Rates of LM were significantly increased in children with a history of recent diarrhea and a greater proportion of children in some age groups evidenced malabsorption in association with acute undernutrition. In the weanling age group children who were still breast feeding had a lower rate of LM than fully weaned subjects.

Abnormalities of early conceptus: a morphological study of 500 cases

Although MR and PT are post-conception family planning measures, a large number of women were found to be non-pregnant. In the absence of direct evidence, presence of necrosis in the placental tissue in 20.8% cases is regarded as suggestive of abnormal ova which might have ended in abortion.

Resumption of menstruation among urban post-partum women in Bangladesh

Half the women in this study had resumed menses by the 6th month post-partum. Concurrent with these findings, less than 50% were still breast-feeding at the 6th month post-partum. The majority of these breast-feeding women were partially breast-feeding. By the 6th post-partum month more than 90% of the women had resumed intercourse and slightly less than half were using contraceptives. Nevertheless, the cross-sectional data indicate that only 25% of the women were using contraceptives at 12 months post-partum. These results show a much shorter period of lactational amenorrhoea than has been reported for a rural area of Bangladesh.

A method of estimating adult mortality trends from widowhood and death distribution data

"This paper is an attempt to find a procedure for estimating past trends in the rate of decline of adult mortality [using] data collected during a census or a single sample survey. It indirectly focuses on trends in adult death rates by looking at proportions not-widowed by age-groups and changes in these proportions caused by diminishing death rates. An equation has been developed which expresses the proportion not-widowed of the ever-married population in an age-group as a function of the current level of mortality in the population, a first marriage frequency distribution, and the past rate of mortality decline." The technique is applied to data from the 1974 Bangladesh Retrospective Survey of Fertility and Mortality.