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Aivey SA, Fukushima Y, Rahman MM, Nahar NS, Ahmed A, Prihanto JB, Hawlader MDH, Moriyama M. Effects of school nurse-led health education to reduce malnutrition among primary school children in Bangladesh: Cluster nonrandomized controlled trial. J Family Med Prim Care 2024; 13:1024-1036. [PMID: 38736776 PMCID: PMC11086752 DOI: 10.4103/jfmpc.jfmpc_1560_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 05/14/2024] Open
Abstract
Background Malnutrition is a major health concern among children especially in low and middle-income countries. However, there are limited studies on school health in Bangladesh. This study aimed to reduce malnutrition among primary school children in Bangladesh by increasing awareness and knowledge through school nurse-led health education. Methods and Materials A prospective, open-label, parallel-group (1:1), cluster nonrandomized controlled trial on primary school children conducted in rural Bangladesh. The study lasted 13 months between September 2021 and September 2022. Four schools were selected and assigned to the intervention and control groups (CGs). Next, school nurses provided evidence-based health education to the children in the intervention group (IG) for 9 months to improve awareness and knowledge of malnutrition. Data were collected at baseline, midline, and endline. Results Overall, 604 children were enrolled at the baseline; among them, 455 (CG, n = 220; IG, n = 235) completed the study. Changes in the malnutrition rate-the primary outcome-were not significant (P = 0.225). However, after adjusting the endline data with baseline and sociodemographic data, the children's body mass index improved significantly in the IG than in the CG (P < 0.05). Changes in eating behavior, and awareness and knowledge of malnutrition-the secondary outcomes-significantly differed between the groups (P < 0.001). Conclusion The school nurse-led health education program significantly improved primary school children's awareness and knowledge of malnutrition. This study revealed the effectiveness of school nurses in reducing malnutrition among children, which may decrease future morbidity and mortality rates in children.
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Affiliation(s)
- Sadia A. Aivey
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasuko Fukushima
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Md Moshiur Rahman
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Niru S. Nahar
- Department of Nursing Science, Grameen Caledonian College of Nursing, Dhaka, Bangladesh
| | - Ashir Ahmed
- Faculty of Information Science and Electrical Engineering, Kyushu University, Fukuoka, Japan
| | - Junaidi B. Prihanto
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Department of Physical Education, Universitas Negeri Surabaya (State University of Surabaya), Surabaya, East Java, Indonesia
| | | | - Michiko Moriyama
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Khan MJ, Ganesan B, Fong KNK, Yip J, Forhadul Hoque M, Mahmudul Hasan SM, Zaman S, Hawlader MDH, Tong RKY. Factors predictive of Ponseti casting for treating clubfoot: analysis of Bayesian Poisson regression model. Eur Rev Med Pharmacol Sci 2022; 26:1868-1875. [PMID: 35363335 DOI: 10.26355/eurrev_202203_28332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Clubfoot is a growing public health concern in Bangladesh, with the incidence of approximately 0.64 to 6.8 in every 1000 live births. For over a decade, Ponseti method has been considered a gold standard for treating the clubfoot. Despite few studies have been estimating the number of casts required to correct the clubfoot deformities by Ponseti method, the subject of interest has always remained. Therefore, this current study aimed to investigate the significant predictive factors for the number of casts required to correct congenital clubfoot. PATIENTS AND METHODS In this retrospective cohort study, we used Bayesian Poisson Regression Model to investigate the influencing factors that could predict how many casts are needed to correct the clubfoot. We included 69 patients with 99 affected feet, who completed their corrective phase of treatment in the Ponseti method. For this cohort study, we integrated only pre-tenotomy casting data with no age restrictions. We used Bayesian Poisson regression analysis technique to estimate the predictive factors. RESULTS In Bayesian Poisson model, age was the most influencing predictive factor (24.3%) for increasing the number of castings to correct the clubfoot deformity. The clubfoot offspring of the ≤1-year-old was positive, and the incidence rate increased significantly with the casting number. The number of Ponseti casts in male clubfoot children was 28% higher than in female, and this was marginally statistically significant. There was no marked change estimated in the pattern of clubfoot, foot involvement and Pirani score of the severity. CONCLUSIONS We concluded that the age factor may influence the number of casts required for the correction of clubfoot and specifically ≤ 1-year-old children are highly impacted. Treating clubfoot at an early age is suggested in this study to increase the success of clubfoot treatment and decrease the risk of relapse.
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Affiliation(s)
- M J Khan
- Department of Public Health, North South University, Dhaka, Bangladesh.
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Shahjalal M, Gow J, Alam MM, Ahmed T, Chakma SK, Mohsin FM, Hawlader MDH, Mahumud RA. Workplace Violence Among Health Care Professionals in Public and Private Health Facilities in Bangladesh. Int J Public Health 2022; 66:1604396. [PMID: 35035349 PMCID: PMC8759559 DOI: 10.3389/ijph.2021.1604396] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/10/2021] [Indexed: 01/08/2023] Open
Abstract
Objectives: The main objectives of this study were to examine the prevalence of workplace violence (WPV), its associated factors and explore the experiences of healthcare workers. Methods: A hospital-based cross-sectional study design used a nationally representative sample of 1,081 healthcare workers covering eight administrative divisions of Bangladesh. Logistic regression analysis was employed to estimate the adjusted effect of independent factors on WPV among healthcare workers. Results: Of the participants, 43% (468) experienced some form of WPV. Of those, 84% reported experiencing nonphysical violence, and 16% experienced physical violence in the past year. About 65% of victims claimed no action was taken to investigate the incident, and 44% reported no consequence for perpetrators. Four factors: being married (AOR = 1.63; CI: 1.12-2.39); public sector healthcare worker (AOR = 2.74; CI:1.99-3.76); working in an emergency department (AOR = 2.30; CI:1.03-5.12); and undertaking shift work (AOR = 1.52; CI: 1.10-2.11) were found to be significantly associated with WPV. One-third of the participants were worried about violence in their workplace. Conclusion: WPV is highly prevalent among healthcare workers in Bangladesh. Formal guidelines for reporting and managing WPV are urgently needed at the individual, hospital, and national levels.
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Affiliation(s)
- Md Shahjalal
- Department of Public Health, School of Health and Life Sciences, North South University, Dhaka, Bangladesh.,Research Rats, Dhaka, Bangladesh
| | - Jeff Gow
- School of Business and Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, Australia.,School of Accounting, Economics and Finance, College of Law and Management Studies, University of KwaZulu-Natal, Durban, South Africa
| | - Mohammad M Alam
- Research Rats, Dhaka, Bangladesh.,Health, Nutrition and Population (HNP) Global Practice, The World Bank (Bangladesh), Dhaka, Bangladesh
| | - Tanvir Ahmed
- Department of Public Health, School of Health and Life Sciences, North South University, Dhaka, Bangladesh.,Research Rats, Dhaka, Bangladesh
| | - Samar K Chakma
- Department of Public Health, School of Health and Life Sciences, North South University, Dhaka, Bangladesh.,Research Rats, Dhaka, Bangladesh
| | - Faroque M Mohsin
- Department of Public Health, School of Health and Life Sciences, North South University, Dhaka, Bangladesh.,Research Rats, Dhaka, Bangladesh
| | - Mohammad D H Hawlader
- Department of Public Health, School of Health and Life Sciences, North South University, Dhaka, Bangladesh
| | - Rashidul A Mahumud
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, QLD, Australia.,Centre for Health Research, University of Southern Queensland, Queensland, QLD, Australia
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Takeuchi H, Khan AF, Hasan MI, Hawlader MDH, Yunus M, Zaman K, Chowdhury HR, Takanashi S, Wagatsuma Y, Iwata T. Comment on IgE responses to Ascaris and mite tropomyosins are risk factors for asthma. Clin Exp Allergy 2016; 46:178-80. [PMID: 26587793 PMCID: PMC4738426 DOI: 10.1111/cea.12678] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- H Takeuchi
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.,Department of Pediatrics, Funabashi General Hospital, Funabashi, Chiba, Japan
| | - A F Khan
- Centre for Nutrition and Food Security, International Centre for Diarrheal Disease Research, Bangladesh, Mohakhali, Dhaka, Bangladesh
| | - M I Hasan
- Centre for Child and Adolescent Health, International Centre for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka, Bangladesh
| | - M D H Hawlader
- Department of Epidemiology, Bangladesh University of Health Sciences, Mirpur, Dhaka, Bangladesh
| | - M Yunus
- Centre for Child and Adolescent Health, International Centre for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka, Bangladesh
| | - K Zaman
- Centre for Child and Adolescent Health, International Centre for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka, Bangladesh
| | - H R Chowdhury
- Global Burden of Disease Group, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia
| | - S Takanashi
- Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Y Wagatsuma
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - T Iwata
- Department of Education for Childcare, Faculty of Child Studies, Tokyo Kasei University, Sayama, Saitama, Japan
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Ahmed S, Moore SE, Kippler M, Gardner R, Hawlader MDH, Wagatsuma Y, Raqib R, Vahter M. Arsenic exposure and cell-mediated immunity in pre-school children in rural Bangladesh. Toxicol Sci 2014; 141:166-75. [PMID: 24924402 DOI: 10.1093/toxsci/kfu113] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Prenatal arsenic exposure has been associated with reduced thymic index and increased morbidity in infants, indicating arsenic-related impaired immune function. We aimed at elucidating potential effects of pre- and postnatal arsenic exposure on cell-mediated immune function in pre-school aged children. Children born in a prospective mother-child cohort in rural Bangladesh were followed up at 4.5 years of age (n = 577). Arsenic exposure was assessed by concentrations of arsenic metabolites (U-As) in child urine and maternal urine during pregnancy, using high-performance liquid chromatography online with inductively coupled plasma mass spectrometry. For assessment of delayed type hypersensitivity response, an intradermal injection of purified protein derivative (PPD) was given to Bacillus Calmette-Guerin vaccinated children. The diameter (mm) of induration was measured after 48-72 h. Plasma concentrations of 27 cytokines were analyzed by a multiplex cytokine assay. Children's concurrent, but not prenatal, arsenic exposure was associated with a weaker response to the injected PPD. The risk ratio (RR) of not responding to PPD (induration <5 mm) was 1.37 (95% confidence interval (CI): 1.07, 1.74) in children in the highest quartile of U-As (range 126-1228 μg/l), compared with the lowest (range 12-34 μg/l). The p for trend across the quartiles was 0.003. The association was stronger in undernourished children. Children's U-As in tertiles was inversely associated with two out of 27 cytokines only, i.e., IL-2 and TNF-α, both Th1 cytokines (in the highest tertile, regression coefficients (95% CI): -1.57 (-2.56, -0.57) and -4.53 (-8.62, -0.42), respectively), but not with Th2 cytokines. These associations were particularly strong in children with recent infections. In conclusion, elevated childhood arsenic exposure appeared to reduce cell-mediated immunity, possibly linked to reduced concentrations of Th1 cytokines.
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Affiliation(s)
- Sultan Ahmed
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Centre for Vaccine Sciences, International Centre for Diarrheal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - Sophie E Moore
- MRC International Nutrition Group, London School of Hygiene and Tropical Medicine, London, UK, and MRC Keneba, The Gambia
| | - Maria Kippler
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Renee Gardner
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - M D H Hawlader
- Centre for Vaccine Sciences, International Centre for Diarrheal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yukiko Wagatsuma
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Rubhana Raqib
- Centre for Vaccine Sciences, International Centre for Diarrheal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - Marie Vahter
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Hawlader MDH, Ma E, Noguchi E, Itoh M, Arifeen SE, Persson LÅ, Moore SE, Raqib R, Wagatsuma Y. Ascaris lumbricoids Infection as a Risk Factor for Asthma and Atopy in Rural Bangladeshi Children. Trop Med Health 2014; 42:77-85. [PMID: 25237284 PMCID: PMC4139537 DOI: 10.2149/tmh.2013-19] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 12/09/2013] [Indexed: 02/01/2023] Open
Abstract
Controversy persists as to whether helminth infections cause or protect against asthma and atopy. The aim of this study was to investigate the effects of helminth infection on asthma and atopy among Bangladeshi children. A total of 912 children aged 4.5 years (mean = 54.4, range = 53.5–60.8 months) participated in a cross-sectional study nested into a randomized controlled trial in Bangladesh. Ever-asthma, ever-wheezing and current wheezing were identified using the International Study of Asthma and Allergies in Childhood questionnaire. Current helminth infection was defined by the presence of helminth eggs in stools, measured by routine microscopic examination. Repeated Ascaris infection was defined by the presence of anti-Ascaris IgE ≥ 0.70 UA/ml in serum measured by the CAP-FEIA method. Atopy was defined by specific IgE to house dust mite (anti-DP IgE) ≥ 0.70 UA/ml measured by the CAP-FEIA method and/or positive skin prick test (≥ 5 mm). Anti-Ascaris IgE was significantly associated with ever asthma (odds ratio (OR) = 1.86, 95% CI: 1.14–3.04, highest vs. lowest quartile; P for trend 0.016). Anti-Ascaris IgE was also significantly associated with positive anti-DP IgE (OR = 9.89, 95% CI: 6.52–15.00, highest vs. lowest; P for trend < 0.001) and positive skin prick test (OR = 1.69, 95% CI: 1.01–2.81, highest vs. lowest, P for trend 0.076). These findings suggest that repeated Ascaris infection is a risk factor for asthma and atopy in rural Bangladeshi children. Further analysis is required to examine the mechanism of developing asthma and atopy in relation to helminth infection.
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Affiliation(s)
- Mohammad D H Hawlader
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba , 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan ; International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b) , Mohakhali, Dhaka 1212, Bangladesh
| | - Enbo Ma
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba , 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Emiko Noguchi
- Department of Medical Genetics, Faculty of Medicine, University of Tsukuba , 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan ; Japan Science and Technology Agency, Core Research for Evolutional Science and Technology (CREST) , 7 Gobancho, Chiyoda-ku, Tokyo 102-0076, Japan
| | - Makoto Itoh
- Department of Infection and Immunology, Aichi Medical University School of Medicine , Nagakute, Aichi 480-1195, Japan
| | - Shams E Arifeen
- International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b) , Mohakhali, Dhaka 1212, Bangladesh
| | - Lars Å Persson
- International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University , SE-75185 Uppsala, Sweden
| | - Sophie E Moore
- MRC International Nutrition Group, Nutrition and Public Health Intervention Research Unit, Department of Epidemiology & Population Health, London School of Hygiene and Tropical Medicine , Keppel Street, London, WC1E 7HT, United Kingdom
| | - Rubhana Raqib
- International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b) , Mohakhali, Dhaka 1212, Bangladesh
| | - Yukiko Wagatsuma
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba , 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
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Hawkesworth S, Wagatsuma Y, Kahn AI, Hawlader MDH, Fulford AJC, Arifeen SE, Persson LÅ, Moore SE. Combined food and micronutrient supplements during pregnancy have limited impact on child blood pressure and kidney function in rural Bangladesh. J Nutr 2013; 143:728-34. [PMID: 23514767 PMCID: PMC3970319 DOI: 10.3945/jn.112.168518] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Observational evidence suggests nutritional exposures during in utero development may have long-lasting consequences for health; data from interventions are scarce. Here, we present a trial follow-up study to assess the association between prenatal food and micronutrient supplementation and childhood blood pressure and kidney function. During the MINIMat Trial in rural Bangladesh, women were randomly assigned early in pregnancy to receive an early or later invitation to attend a food supplementation program and additionally to receive either iron and folate or multiple micronutrient tablets daily. The 3267 singleton birth individuals with measured anthropometry born during the trial were eligible for a follow-up study at 4.5 y old. A total of 77% of eligible individuals were recruited and blood pressure, kidney size by ultrasound, and glomerular filtration rate (GFR; calculated from plasma cystatin c) were assessed. In adjusted analysis, early invitation to food supplementation was associated with a 0.72-mm Hg [(95% CI: 0.16, 1.28); P = 0.01] lower childhood diastolic blood pressure and maternal MMS supplementation was associated with a marginally higher [0.87 mm Hg (95% CI: 0.18, 1.56); P = 0.01] childhood diastolic blood pressure. There was also some evidence that a supplement higher in iron was associated with a higher offspring GFR. No other effects of the food or micronutrient interventions were observed and there was no interaction between the interventions on the outcomes studied. These marginal associations and small effect sizes suggest limited public health importance in early childhood.
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Affiliation(s)
- Sophie Hawkesworth
- Medical Research Council International Nutrition Group, London School of Hygiene and Tropical Medicine, London, UK.
| | | | - Ashraf I. Kahn
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; and
| | - Mohammad D. H. Hawlader
- Faculty of Medicine, University of Tsukuba, Tsukuba, Japan,International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; and
| | - Anthony J. C. Fulford
- Medical Research Council International Nutrition Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Shams-El Arifeen
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; and
| | - Lars-Åke Persson
- International Maternal and Child Health, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Sophie E. Moore
- Medical Research Council International Nutrition Group, London School of Hygiene and Tropical Medicine, London, UK
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