COVID-19 pandemic, dengue epidemic, and climate change vulnerability in Bangladesh: Scenario assessment for strategic management and policy implications

"The COVID-19 pandemic in BRICS: Milestones, interventions, and molecular epidemiology"

Brazil, Russia, India, China, and South Africa (BRICS) are a group of developing countries with shared economic, healthcare, and scientific interests. These countries navigate multiple syndemics, and the COVID-19 pandemic placed severe strain on already burdened BRICS' healthcare systems, hampering effective pandemic interventions. Genomic surveillance and molecular epidemiology remain indispensable tools for facilitating informed pandemic intervention. To evaluate the combined manner in which the pandemic unfolded in BRICS countries, we reviewed the BRICS pandemic epidemiological and genomic milestones, which included the first reported cases and deaths, and pharmaceutical and non-pharmaceutical interventions implemented in these countries. To assess the development of genomic surveillance capacity and efficiency over the pandemic, we analyzed the turnaround time from sample collection to data availability and the technologies used for genomic analysis. This data provided information on the laboratory capacities that enable the detection of emerging SARS-CoV-2 variants and highlight their potential for monitoring other pathogens in ongoing public health efforts. Our analyses indicated that BRICS suffered >105.6M COVID-19 infections, resulting in >1.7M deaths. BRICS countries detected intricate genetic combinations of SARS-CoV-2 variants that fueled country-specific pandemic waves. BRICS' genomic surveillance programs enabled the identification and characterization of the majority of globally circulating Variants of Concern (VOCs) and their descending lineages. Pandemic intervention strategies first implemented by BRICS countries included non-pharmaceutical interventions during the onset of the pandemic, such as nationwide lockdowns, quarantine procedures, the establishment of fever clinics, and mask mandates- which were emulated internationally. Vaccination rollout strategies complemented this, some representing the first of their kind. Improvements in BRICS sequencing and data generation turnaround time facilitated quicker detection of circulating and emerging variants, supported by investments in sequencing and bioinformatic infrastructure. Intra-BRICS cooperation contributed to the ongoing intervention in COVID-19 and other pandemics, enhancing collective capabilities in addressing these health challenges. The data generated continues to inform BRICS-centric pandemic intervention strategies and influences global health matters. The increased laboratory and bioinformatic capacity post-COVID-19 will support the detection of emerging pathogens.

Projections of future bioclimatic indicators using bias-corrected CMIP6 models: a case study in a tropical monsoon region

This study evaluates the potential impacts of climate change on Bangladesh by analyzing 19 bioclimatic indicators based on temperature and precipitation. Data from 18 bias-corrected CMIP6 global climate models (GCMs) were used, covering four Shared Socioeconomic Pathways (SSPs)-SSP126, SSP245, SSP370, and SSP585-across three future timeframes: near-term (2015-2044), mid-term (2045-2074), and long-term (2075-2100). Under the high-emission SSP585 scenario, average temperatures are projected to rise by up to 3.76 °C, and annual precipitation could increase by 52.6%, reaching up to 3446.38 mm by the end of the century. The maximum temperature (Bio5) could reach 32.91 °C, while the minimum temperature (Bio6) might rise by 4.43 °C, particularly during winter. Precipitation seasonality (Bio15) is projected to increase by as much as 7.9% in the northwest, indicating heightened variability between wet and dry seasons. The diurnal temperature range (Bio2) is expected to decrease by up to - 1.3 °C, signifying reduced nighttime cooling, which could exacerbate heat stress. Significant reductions in temperature seasonality (Bio4) are forecast for the northeast, with notable declines in isothermality (Bio3) under SSP585, pointing to increased climatic extremes. These climatic shifts pose severe risks to agricultural productivity, water resource availability, and biodiversity, particularly in flood-prone regions. The findings highlight the need for urgent adaptation measures, including improved flood management systems, efficient water resource use, and climate-resilient agricultural practices. By providing robust region-specific projections, this study offers critical insights for policymakers and stakeholders to mitigate the adverse effects of climate change and safeguard environmental and economic sustainability in Bangladesh.

Upsurge of dengue outbreaks in several WHO regions: Public awareness, vector control activities, and international collaborations are key to prevent spread

Background

Dengue, the world's fastest-growing vector-borne disease, has skyrocketed in the 21st century. Dengue has harmed human health since its first known cases among Spanish soldiers in the Philippines to its 21st-century outbreaks in Southeast Asia, the Pacific, and the Americas. In light of the current circumstances, it is imperative to investigate its origin and prevalence, enabling the implementation of effective interventions to curb the upsurge.

Methods

Our study examines the history of dengue outbreaks, and evolving impact on public health, aiming to offer valuable insights for a more resilient public health response worldwide. In this comprehensive review, we incorporated data from renowned databases such as PubMed, Google Scholar, and Scopus to provide a thorough analysis of dengue outbreaks.

Results

Recent dengue outbreaks are associated with rapid urbanization, international travel, climatic change, and socioeconomic factors. Rapid urbanization and poor urban design and sanitation have created mosquito breeding places for dengue vectors. Also, international travel and trade have spread the pathogen. Climate change in the past two decades has favored mosquito habitats and outbreaks. Socioeconomic differences have also amplified the impact of dengue outbreaks on vulnerable communities. Dengue mitigation requires vector control, community engagement, healthcare strengthening, and international cooperation.

Conclusion

Climate change adaptation and urban planning are crucial. Although problems remain, a comprehensive vector control and community involvement plan may reduce dengue epidemics and improve public health in our interconnected world.

Unveiling the global nexus: Pandemic fear, government responses, and climate change-an empirical study

This study examined the relationships between pandemic fear, government responses, and climate change using a time-series dataset from January 1, 2020, to December 31, 2020. By employing an auto-regressive distributed lag (ARDL) approach, the results revealed that pandemic fear significantly impacts climate change, while government responses to COVID-19 negatively influence climate change in the long run. Climate change and government responses significantly positively affect pandemic fear in the long run. Moreover, we found a bidirectional causality between government responses and climate change, unidirectional causality from government responses to pandemic fear, and no Granger causality between pandemic fear and climate change. Our findings have some important policy implications. Governments must encourage coordination, enhance crisis responses, and consider revising economic metrics to maintain environmental sustainability. The COVID-19 experience can inform strategies for reducing CO2 emissions and investing in green economies and healthcare to prepare for future challenges.

COVID-19 in Bangladesh: Wave-centric assessments and mitigation measures for future pandemics

The ongoing pandemic COVID-19 caused by Severe Acute Respiratory Coronavirus-2 (SARS-CoV-2) has wreaked havoc globally by affecting millions of lives. Although different countries found the implementation of emergency measures useful to combat the viral pandemic, many countries are still experiencing the resurgence of COVID-19 cases with new variants even after following strict containment guidelines. Country-specific lessons learned from the ongoing COVID-19 pandemic can be utilized in commencing a successful battle against the potential future outbreaks. In this article, we analyzed the overall scenario of the COVID-19 pandemic in Bangladesh from Alpha to Omicron variant and discussed the demographic, political, economic, social, and environmental influences on the mitigation strategies employed by the country to combat the pandemic. We also tried to explore the preparedness and precautionary measures taken by the responsible authorities, the choice of strategies implemented, and the effectiveness of the response initiated by the government and relevant agencies. Finally, we discussed the possible strategies that might help Bangladesh to combat future COVID-19 waves and other possible pandemics based on the experiences gathered from the ongoing COVID-19 pandemic.

Dengue in Timor-Leste during the COVID-19 phenomenon

Dengue is a significant public health problem in mostly tropical countries, including Timor-Leste. Dengue continues to draw attention from the health sector during the COVID-19 phenomenon. Therefore, the goal of this study is to evaluate the dengue incidence rate in comparison with the COVID-19 cumulative number and associated dengue risk factors, including the fatality rate of dengue infection in each municipality during the COVID-19 phenomenon in Timor-Leste, by applying the data processing program in Geographic Information Systems (GIS). A descriptive study using GIS was performed to provide a spatial-temporal mapping of dengue cases. Secondary data, which were sourced from the Department of Health Statistics Information under the Ministry of Health Timor-Leste, were collected for the period during the COVID-19 outbreak in 2020-2021. These data were grounded at the municipal (province) level. Quantum GIS and Microsoft Excel were used to analyze the data. During the COVID-19 outbreak (2020-2021), dengue spread nationwide. It was found that there was an increase in municipalities with high dengue cases and cumulative COVID-19 numbers. The high number of dengue cases associated with the COVID-19 cumulative number found in municipalities with an urban characteristic and in terms of severity, dengue fever (DF) is most commonly reported with a total of 1,556 cases and is followed by dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Most cases were reported in the months of the monsoon season, such as December, January, and March. Dengue GIS mapping helps understand the disease's presence and dynamic nature over time.

Assessing climate change and urban poverty in the context of the COVID 19 lockdowns: Rethinking personality and societal challenges in Zimbabwe

The study explored the challenges urbanites faced due to climate change and the COVID-19 pandemic. Urban vulnerability ills such as food insecurity, poverty and malnutrition have increased as climate change and COVID-19 jointly affect societies. Urban residents have resorted to urban farming and street vending as coping strategies. COVID-19 protocols and strategies for social distancing have compromised the urban poor livelihoods. Due to lockdown protocols such as curfew, closure of businesses, and the limited number of people doing certain activities, the urban poor often compromised lockdown rules to earn a living. The study used document analysis to gather data on climate change and poverty amidst the COVID-19 pandemic. Academic journals, newspaper articles, books and information from various reliable websites were used for data collection. Content and thematic analysis were used to analyse data, while data triangulation from various sources enhanced data reliability and trustworthiness. The study found that climate change increased food insecurity in urban areas. Low agricultural output and climate change impacts compromised food availability and affordability for urbanites. The COVID-19 protocols increased financial constraints on urbanites as lockdown restrictions negatively impacted income from formal and informal jobs. The study recommends looking beyond the virus for prevention strategies to improve poor peoples' livelihoods. Countries must develop response strategies to cushion the urban poor from climate change and the COVID-19 impact. Developing countries are urged to sustainably adapt to climate change through scientific innovation to promote people's livelihoods.

Indigenous peoples and the COVID-19 pandemic: a systematic scoping review

Past influenza pandemics including the Spanish flu and H1N1 have disproportionately affected Indigenous Peoples. We conducted a systematic scoping review to provide an overview of the state of understanding of the experience of Indigenous peoples during the first 18 months of the COVID-19 pandemic, in doing so we capture the state of knowledge available to governments and decision makers for addressing the needs of Indigenous peoples in these early months of the pandemic. We addressed three questions: (a) How is COVID-19 impacting the health and livelihoods of Indigenous peoples, (b) What system level challenges are Indigenous peoples experiencing, (c) How are Indigenous peoples responding? We searched Web of Science, Scopus, and PubMed databases and UN organization websites for publications about Indigenous peoples and COVID-19. Results were analyzed using descriptive statistics and content analysis. A total of 153 publications were included: 140 peer-reviewed articles and 13 from UN organizations. Editorial/commentaries were the most (43%) frequent type of publication. Analysis identified Indigenous peoples from 19 different countries, although 56% of publications were centered upon those in Brazil, United States, and Canada. The majority (90%) of articles focused upon the general adult population, few (<2%) used a gender lens. A small number of articles documented COVID-19 testing (0.04%), incidence (18%), or mortality (16%). Five themes of system level challenges affecting exposure and livelihoods evolved: ecological, poverty, communication, education and health care services. Responses were formal and informal strategies from governments, Indigenous organizations and communities. A lack of ethnically disaggregated health data and a gender lens are constraining our knowledge, which is clustered around a limited number of Indigenous peoples in mostly high-income countries. Many Indigenous peoples have autonomously implemented their own coping strategies while government responses have been largely reactive and inadequate. To 'build back better' we must address these knowledge gaps.

Climate change and COVID-19: Interdisciplinary perspectives from two global crises

The repercussions of the COVID-19 pandemic and climate change - two major current global crises - are far-reaching, the parallels between the two are striking, and their influence on one another are significant. Based on the wealth of evidence that has emerged from the scientific literature during the first two years of the pandemic, this study argues that these two global crises require holistic multisectoral mitigation strategies. Despite being different in nature, neither crisis can be effectively mitigated without considering their interdependencies. Herein, significant interactions between these two crises are highlighted and discussed. Major implications related to the economy, energy, technology, environment, food systems and agriculture sector, health systems, policy, management, and communities are detailed via a review of existing joint literature. Based on these outcomes, practical recommendations for future research and management are provided. While the joint timing of these crises has created a global conundrum, the COVID-19 pandemic has demonstrated opportunities and lessons for devising sustainable recovery plans in relation to the climate crisis. The findings indicated that governments should work collaboratively to develop durable and adjustable strategies in line with long-term, global decarbonisation targets, promote renewable energy resources, integrate climate change into environmental policies, prioritise climate-smart agriculture and local food systems, and ensure public and ecosystem health. Further, differences in geographic distributions of climate change and COVID-19 related death cases revealed that these crises pose different threats to different parts of the world. These learnings provide insights to address the climate emergency - and potential future global problems with similar characteristics - if international countries act urgently and collectively.

Interactions between climate and COVID-19

In this Personal View, we explain the ways that climatic risks affect the transmission, perception, response, and lived experience of COVID-19. First, temperature, wind, and humidity influence the transmission of COVID-19 in ways not fully understood, although non-climatic factors appear more important than climatic factors in explaining disease transmission. Second, climatic extremes coinciding with COVID-19 have affected disease exposure, increased susceptibility of people to COVID-19, compromised emergency responses, and reduced health system resilience to multiple stresses. Third, long-term climate change and prepandemic vulnerabilities have increased COVID-19 risk for some populations (eg, marginalised communities). The ways climate and COVID-19 interact vary considerably between and within populations and regions, and are affected by dynamic and complex interactions with underlying socioeconomic, political, demographic, and cultural conditions. These conditions can lead to vulnerability, resilience, transformation, or collapse of health systems, communities, and livelihoods throughout varying timescales. It is important that COVID-19 response and recovery measures consider climatic risks, particularly in locations that are susceptible to climate extremes, through integrated planning that includes public health, disaster preparedness, emergency management, sustainable development, and humanitarian response.

Understanding rural local government response during COVID-19-induced lockdown: perspective from Bangladesh

This study intends to explore the responses of local government during the COVID-19-induced lockdown in the rural areas, with particular emphasis on Bangladesh. By adopting a qualitative phenomenological research approach and employing multi-method data collection techniques (for instance, Key Informant Interview (KII), Focus Group Discussion (FGD), participant observation, and content analysis), this study found that the local governments managed the crisis of the pandemic relatively well with its limited manpower and funding through adequate preparedness and prevention strategies; effective emergency responses; and consolidated post-lockdown measures. The study revealed that the Bangladesh local government promptly took some essential actions, such as preparedness and prevention, arrangement of home quarantine and isolation, the training program for readiness, and disseminated crucial information to the local people during the pandemic, such as using masks, hand washing and sanitizing, and social distancing. Besides, the local government delivered relief, such as food and non-food items and financial support. Furthermore, the rural local government took post-lockdown responses to tackle pandemic in rural Bangladesh. Nevertheless, the service delivery individuals from local governance encountered numerous challenges, like scarcity of manpower, less support, and superstition, while providing services during the pandemic.

Recovery of value-added products by mining microalgae

Microalgae blooms are always blamed for the interruption of the aquatic environment and pose a risk to the source of drinking water. Meanwhile, microalgae as primary producers are a kind of resource pool and could benefit the environment and contribute to building a circular economy. The lipid and polyhydroxybutyrate (PHB) in the cells of microalgae could be alternatives to fossil fuels and plastics, respectively, which are the culprits of global warming and plastic pollution. Besides, some microalgae are rich in nutrients, such as proteins and astaxanthin, which make themselves suitable for feed additives. As wastewater is rich in nutrients necessary for microalgae, thus, value-added product recovery via microalgae could be an approach to valorizing wastewater. However, a one-size-fits-all approach deploying various wastewater for the above products cannot be summarized. On the contrary, specific technical protocols should be tailored regarding each product in microalgae biomass with various wastewater. Thus, this review is to summarize the research effort by far on wastewater-cultivated microalgae for value-added products. Wastewater type, regulation methods, and targeted product yields are compiled and discussed and are expected to guide future extrapolation into a commercial scale.

Systematic Assessment of COVID-19 Pandemic in Bangladesh: Effectiveness of Preparedness in the First Wave

Background: To develop an effective countermeasure and determine our susceptibilities to the outbreak of COVID-19 is challenging for a densely populated developing country like Bangladesh and a systematic review of the disease on a continuous basis is necessary. Methods: Publicly available and globally acclaimed datasets (4 March 2020-30 September 2020) from IEDCR, Bangladesh, JHU, and ECDC database are used for this study. Visual exploratory data analysis is used and we fitted a polynomial model for the number of deaths. A comparison of Bangladesh scenario over different time points as well as with global perspectives is made. Results: In Bangladesh, the number of active cases had decreased, after reaching a peak, with a constant pattern of death rate at from July to the end of September, 2020. Seventy-one percent of the cases and 77% of the deceased were males. People aged between 21 and 40 years were most vulnerable to the coronavirus and most of the fatalities (51.49%) were in the 60+ population. A strong positive correlation (0.93) between the number of tests and confirmed cases and a constant incidence rate (around 21%) from June 1 to August 31, 2020 was observed. The case fatality ratio was between 1 and 2. The number of cases and the number of deaths in Bangladesh were much lower compared to other countries. Conclusions: This study will help to understand the patterns of spread and transition in Bangladesh, possible measures, effectiveness of the preparedness, implementation gaps, and their consequences to gather vital information and prevent future pandemics.

Livelihood challenges of 'double strike' disasters: Evidence from rural communities of southwest coastal Bangladesh during the Covid-19 pandemic and cyclone Amphan

The Covid-19 pandemic has adversely affected livelihoods in the Global South and exacerbated the effects of natural disaster. This study examines the 'double strike' of the Covid-19 lockdown and 'super-cyclone' Amphan on the 12 villages of Dakshin Bedkashi Union, southwest Bangladesh. It employs questionnaire surveys to assess the impact of the compound disaster on rural livelihoods over a period of five months, comparing pre-lockdown, post-lockdown, and post-Amphan phases. The results demonstrate the severe impact of the pandemic on income, occupation, and workdays, and consequently on livelihood resilience leading up to Amphan. Although effects vary moderately by livelihood category, village, and socio-spatial characteristics, overall rates of income reduction (58%) and occupation loss (77%) between the advent of the lockdown and the aftermath of Amphan are high. Thus, livelihood resilience to the double strike is generally poor. The study analyses the predictors of lost working days to illuminate the influences on livelihood resilience throughout the double strike. We conclude that the pandemic has presented novel challenges to this region, complicating vulnerability to more common cyclonic natural hazards. Finding that the degree of livelihood diversification is low in the sample, we recommend implementing diversification policies and strengthening local networks and community trust to better anticipate and combat the complex, varied impacts of double strike scenarios in future.

COVID-19 and environmental concerns: A rapid review

COVID-19 has slowed global economic growth and consequently impacted the environment as well. Parallelly, the environment also influences the transmission of this novel coronavirus through various factors. Every nation deals with varied population density and size; air quality and pollutants; the nature of land and water, which significantly impact the transmission of coronavirus. The WHO (Ziaeepour et al., 2008) [1] has recommended rapid reviews to provide timely evidence to the policymakers to respond to the emergency. The present study follows a rapid review along with a brief bibliometric analysis of 328 research papers, which synthesizes the evidence regarding the environmental concerns of COVID-19. The novel contribution of this rapid review is threefold. One, we take stock of the diverse findings as regards the transmission of the novel coronavirus in different types of environments for providing conclusive directions to the ongoing debate regarding the transmission of the virus. Two, our findings provide topical insights as well as methodological guidance for future researchers in the field. Three, we inform the policymakers on the efficacy of environmental measures for controlling the spread of COVID-19.

Decreasing transmission and initiation of countrywide vaccination: Key challenges for future management of COVID-19 pandemic in Bangladesh

With a fragile healthcare system, Bangladesh, much like other countries in South East Asia, struggled during the early days of COVID-19 pandemic. In following months several encouraging initiatives were undertaken including nationwide lockdown, maintaining social distancing and setting up COVID-19 dedicated laboratories and hospitals. Despite fear of an escalation in COVID-19 transmission during the winter months like their European counterparts, fortunately infection rates subsided and Bangladesh came out largely unharmed. But the next phase of COVID-19 pandemic management that includes viral transmission suppression and conduction of nationwide immunization program require several urgent steps from government of Bangladesh (GoB) and relevant stakeholders. This qualitative research piece discussed about issues including an urgent need to enhance critical care facilities around the country, especially in peripheral districts; ramping up COVID-19 testing at existing laboratories in view of diagnosing each case, and ensuring vaccines for the vulnerable populations in the country. Furthermore, the researchers shed light on other issues including a need to reinforce a struggling healthcare workforce, encouraging people to take vaccine, proper maintenance of social distancing regulations, routine epidemiological surveillance, management of environment and biomedical waste and undertaking a holistic approach to combat the pandemic and its environmental and financial consequences.

Detection of Anti-Nucleocapsid Antibody in COVID-19 Patients in Bangladesh Is not Correlated with Previous Dengue Infection

BACKGROUND

The assessment of antibody responses to severe acute respiratory syndrome coronavirus-2 is potentially confounded by exposures to flaviviruses. The aims of the present research were to determine whether anti-dengue antibodies affect the viral load and the detection of anti-coronavirus nucleocapsid (N)-protein antibodies in coronavirus infectious disease 2019 (COVID-19) in Bangladesh.

METHODS

Viral RNA was evaluated in swab specimens from 115 COVID-19 patients by real-time reverse transcription polymerase chain reaction (rT-PCR). The anti-N-protein antibodies, anti-dengue virus E-protein antibodies and the dengue non-structural protein-1 were determined in serum from 115 COVID-19 patients, 30 acute dengue fever pre-COVID-19 pandemic and nine normal controls by ELISA.

RESULTS

The concentrations of viral RNA in the nasopharyngeal; Ct median (95% CI); 22 (21.9-23.3) was significantly higher than viral RNA concentrations in oropharyngeal swabs; and 29 (27-30.5) p < 0.0001. Viral RNA concentrations were not correlated with-dengue IgG levels. The anti-nucleocapsid antibodies were IgA 27% positive and IgG 35% positive at days 1 to 8 post-onset of COVID-19 symptoms versus IgA 0% and IgG 0% in dengue patients, p < 0.0001. The levels of anti- nucleocapsid IgA or IgG versus the levels of anti-dengue IgM or IgG revealed no significant correlations.

CONCLUSIONS

Viral RNA and anti-nucleocapsid antibodies were detected in COVID-19 patients from dengue-endemic regions of Bangladesh, independently of the dengue IgG levels.

Analyzing the Risk to COVID-19 Infection using Remote Sensing and GIS

Globally, the COVID-19 pandemic has become a threat to humans and to the socioeconomic systems they have developed since the industrial revolution. Hence, governments and stakeholders call for strategies to help restore normalcy while dealing with this pandemic effectively. Since till now, the disease is yet to have a cure; therefore, only risk-based decision making can help governments achieve a sustainable solution in the long term. To help the decisionmakers explore viable actions, we propose a risk-based assessment framework for analyzing COVID-19 risk to areas, using integrated hazard and vulnerability components associated with this pandemic for effective risk mitigation. The study is carried on a region administrated by Jaipur municipal corporation (JMC), India. Based on the current understanding of this disease, we hypothesized different COVID-19 risk indices (C19Ri) of the wards of JMC such as proximity to hotspots, total population, population density, availability of clean water, and associated land use/land cover, are related with COVID-19 contagion and calculated them in a GIS-based multicriteria risk reduction method. The results showed disparateness in COVID-19 risk areas with a higher risk in north-eastern and south-eastern zone wards within the boundary of JMC. We proposed prioritizing wards under higher risk zones for intelligent decision making regarding COVID-19 risk reduction through appropriate management of resources-related policy consequences. This study aims to serve as a baseline study to be replicated in other parts of the country or world to eradicate the threat of COVID-19 effectively.

Pandemic and Typhoon: Positive Impacts of a Double Disaster on Mental Health of Female Students in the Philippines

Humanitarian emergencies pose a great challenge to how all sectors perform their functions in society. In several countries, these emergencies combined the pandemic and other man-made and natural disasters: "double disaster", which affected the health, safety, and well-being of both individuals and communities. Students are a particularly vulnerable population for mental health problems considering the challenges with their transitions to adulthood. Using narrative analysis, this study explored the impacts of a double disaster on the mental health of students and how they cope up with these emergencies. The results showed that the occurrence of natural disasters during the lockdowns from pandemic brought stress to students in adjusting to distance education, completing academic requirements, and accessing technology for online learning. Participants expressed their anxieties about the spread of the virus in the community, particularly in the disaster evacuation centers with less strictly observed social distancing, insufficient hygiene and sanitation facilities, and lack of basic needs. Participants described their learnings and coping strategies that included helping one another, following the government protocols, finding additional sources of income, using energy for important purposes only, and leaning on faith. The findings of this study would be instrumental in formulating policies and strategic measures that best complement the needs of community members during a double disaster, particularly in addressing the mental health impacts of humanitarian emergencies.

Disparities in Risks of Malaria Associated with Climatic Variability among Women, Children and Elderly in the Chittagong Hill Tracts of Bangladesh

Malaria occurrence in the Chittagong Hill Tracts in Bangladesh varies by season and year, but this pattern is not well characterized. The role of environmental conditions on the occurrence of this vector-borne parasitic disease in the region is not fully understood. We extracted information on malaria patients recorded in the Upazila (sub-district) Health Complex patient registers of Rajasthali in Rangamati district of Bangladesh from February 2000 to November 2009. Weather data for the study area and period were obtained from the Bangladesh Meteorological Department. Non-linear and delayed effects of meteorological drivers, including temperature, relative humidity, and rainfall on the incidence of malaria, were investigated. We observed significant positive association between temperature and rainfall and malaria occurrence, revealing two peaks at 19 °C (logarithms of relative risks (logRR) = 4.3, 95% CI: 1.1-7.5) and 24.5 °C (logRR = 4.7, 95% CI: 1.8-7.6) for temperature and at 86 mm (logRR = 19.5, 95% CI: 11.7-27.3) and 284 mm (logRR = 17.6, 95% CI: 9.9-25.2) for rainfall. In sub-group analysis, women were at a much higher risk of developing malaria at increased temperatures. People over 50 years and children under 15 years were more susceptible to malaria at increased rainfall. The observed associations have policy implications. Further research is needed to expand these findings and direct resources to the vulnerable populations for malaria prevention and control in the Chittagong Hill Tracts of Bangladesh and the region with similar settings.