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Salam SS, Rahman AE, Mhajabin S, Mazumder T, Majid T, Samad Talha MTU, Haider R, Chowdhury AT, Islam S, Ameen S, Jabeen S, Balen J, Arifeen SE, Nahar Q, Anumba DO. Perception and experiences of adolescent mothers and communities in caring for their preterm babies: findings from an in-depth study in rural Bangladesh. BMC Pregnancy Childbirth 2024; 24:145. [PMID: 38368364 PMCID: PMC10874081 DOI: 10.1186/s12884-024-06345-x] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 02/12/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND A significant concern for Bangladesh is the high prevalence of adolescent pregnancy and the associated negative consequences for mother and baby, including a teen-related increased risk of preterm birth (PTB). Bangladesh also has one of the highest incidences of PTB (19%). Despite these high numbers of adolescent pregnancies and PTB, little is reported about the experiences of adolescent mothers in caring for their preterm babies, and the interventions needed to support them. The aim of this study was to explore gaps and opportunities for improved care for preterm babies among adolescent mothers and communities in rural Bangladesh. METHODS We conducted a qualitative study in rural villages of Baliakandi sub-district of Bangladesh. Data collection involved in-depth interviews with adolescent mothers of premature and term babies, adult mothers with premature babies, and family members (n = 36); focus groups with community members (n = 5); and key informant interviews with healthcare providers (n = 13). Adolescent mothers with term and adult mothers with PTBs were included to elicit similarities and differences in understanding and care practices of PTB. A thematic approach was used for data analysis. RESULTS We explored two major themes- perceptions and understanding of PTB; care practices and care-seeking for illnesses. We observed gaps and variations in understanding of preterm birth (length of gestation, appearance, causes, problems faced) and care practices (thermal management, feeding, weight monitoring) among all, but particularly among adolescents. Immediate natal and marital-kins were prominent in the narratives of adolescents as sources of informational and instrumental support. The use of multiple providers and delays in care-seeking from trained providers for sick preterm babies was noted, often modulated by the perception of severity of illness, cost, convenience, and quality of services. Health systems challenges included lack of equipment and trained staff in facilities to provide special care to preterm babies. CONCLUSION A combination of factors including local knowledge, socio-cultural practices and health systems challenges influenced knowledge of, and care for, preterm babies among adolescent and adult mothers. Strategies to improve birth outcomes will require increased awareness among adolescents, women, and families about PTB and improvement in quality of PTB services at health facilities.
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Affiliation(s)
| | - Ahmed Ehsanur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Shema Mhajabin
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Tapas Mazumder
- Health Research Institute, University of Canberra, Canberra, Australia
| | - Tamanna Majid
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Rajib Haider
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Anika Tasneem Chowdhury
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sharmin Islam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Shafiqul Ameen
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sabrina Jabeen
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Julie Balen
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
- School of Allied and Public Health Professions, Canterbury Christ Church University, Kent, UK
| | - Shams El Arifeen
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Quamrun Nahar
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Dilly Oc Anumba
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
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Salam SS, Ramadurg U, Charantimath U, Katageri G, Gillespie B, Mhetri J, Patil S, Mallapur A, Karadiguddi C, Vastrad P, Dandappanavar A, Roy S, Peerapur B, Goudar S, Anumba DOC. Impact of a school-based nutrition educational intervention on knowledge related to iron deficiency anaemia in rural Karnataka, India: A mixed methods pre-post interventional study. BJOG 2023; 130 Suppl 3:113-123. [PMID: 37530624 DOI: 10.1111/1471-0528.17619] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/29/2023] [Accepted: 07/10/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVE To understand the extent to which adolescent awareness about anaemia and anaemia prevention can be changed by nutrition messages received at school. DESIGN Mixed-methods pre-post intervention study. SETTING Three government schools in Bagalkot, Belagavi and Raichur districts of Karnataka, India. POPULATION Students of grade six and seven and teachers involved in implementing the intervention. METHODS An educational intervention was co-developed by school teachers and nutrition experts using locally adapted resource materials that consisted of lectures, role play and practical demonstrations. Seven half-hour educational sessions were delivered by school teachers over 7 weeks to 455 students. Pre- and post-intervention tests measured changes in adolescents' knowledge about anaemia. Semi-structured in-depth interviews with teachers and focus groups with students explored their reactions to the intervention. MAIN OUTCOME MEASURES Knowledge score related to anaemia. RESULTS The percentage of children with correct scores increased by 7.3-49.0 percentage points for the tested questions after implementation of the intervention. The mean knowledge score increased by 3.67 ± 0.17 (p < 0.01). During interviews, teachers and students highlighted high acceptance of the intervention and materials, an increase in awareness, a positive attitude towards changing behaviour around diet, an increase in the demand for iron and folic acid supplements and improved sharing of messages learned with peers and families. Challenges expressed included need for further training, time limitations and hesitancy in teaching about menstruation and pregnancy. CONCLUSIONS Educational interventions carried out for adolescents by teachers in schools are effective in improving awareness and attitude related to anaemia and its prevention.
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Affiliation(s)
| | - Umesh Ramadurg
- S Nijalingappa Medical College and HSK Hospital and Research Centre, Bagalkot, Karnataka, India
| | - Umesh Charantimath
- KLE Academy of Higher Education and Research, J N Medical College, Belagavi, Karnataka, India
| | - Geetanjali Katageri
- S Nijalingappa Medical College and HSK Hospital and Research Centre, Bagalkot, Karnataka, India
| | - Bronwen Gillespie
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Jayaraj Mhetri
- S Nijalingappa Medical College and HSK Hospital and Research Centre, Bagalkot, Karnataka, India
| | - Shrinivas Patil
- S Nijalingappa Medical College and HSK Hospital and Research Centre, Bagalkot, Karnataka, India
| | - Ashalata Mallapur
- S Nijalingappa Medical College and HSK Hospital and Research Centre, Bagalkot, Karnataka, India
| | | | | | - Ashwini Dandappanavar
- KLE Academy of Higher Education and Research, J N Medical College, Belagavi, Karnataka, India
| | - Subarna Roy
- ICMR-National Institute of Traditional Medicine, Belagavi, Karnataka, India
| | | | - Shivaprasad Goudar
- KLE Academy of Higher Education and Research, J N Medical College, Belagavi, Karnataka, India
| | - Dilly O C Anumba
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
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Islam MI, Salam SS, Kabir E, Khanam R. Identifying Social Determinants and Measuring Socioeconomic Inequalities in the Use of Four Different Mental Health Services by Australian Adolescents Aged 13-17 Years: Results from a Nationwide Study. Healthcare (Basel) 2023; 11:2537. [PMID: 37761734 PMCID: PMC10531418 DOI: 10.3390/healthcare11182537] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/04/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
AIM In this study, we aimed to identify the determinants of four different forms of mental health service usage (general health services, school counselling, telephone, and online services), and the number of mental health services accessed (single and multiple) by Australian adolescents aged 13-17 years. We also measured socioeconomic inequality in mental health services' usage following the concentration index approach within the same sample. SUBJECT AND METHODS The data came from the nationwide cross-sectional survey, Young Minds Matter (YMM): the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Random effect models were used to identify the factors associated with four different mental health services and the number of services accessed. Further, the Erreygers' corrected concentration indices for binary variables were used to quantify the socioeconomic inequality in each mental health service. The four services were the general health service (GP, specialist, psychiatrist, psychologist, hospital including emergency), school services, telephone counselling and online services. RESULTS Overall, 31.9% of the total analytical sample (n = 2268) aged 13-17 years old visited at least one service, with 21.9% accessing a single service and 10% accessing multiple services. The highest percentage of adolescents used online services (20.1%), followed by general mental health services (18.3%), while school services (2.4%) were the least used service. Age, gender, family type and family cohesion statistically significantly increased the use of general health and multiple mental health service usage (p < 0.05). Area of residence was also found to be a significant factor for online service use. The concentration indices (CIs) were -0.073 (p < 0.001) and -0.032 (p < 0.001) for health and telephone services, respectively, which implies pro-rich socio-economic inequality. CONCLUSION Adolescents from low-income families frequently used general mental health services and telephone services compared to those who belonged to high-income families. The study concluded that if we want to increase adolescents' usage of mental health services, we need to tailor our approaches to their socioeconomic backgrounds. In addition, from a policy standpoint, a multi-sectoral strategy is needed to address the factors related to mental health services to reduce inequity in service utilisation.
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Affiliation(s)
- Md Irteja Islam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia
- Centre for Health Research and School of Business, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, QLD 4350, Australia;
- School of Mathematics, Physics and Computing, Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, QLD 4350, Australia;
| | | | - Enamul Kabir
- School of Mathematics, Physics and Computing, Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, QLD 4350, Australia;
| | - Rasheda Khanam
- Centre for Health Research and School of Business, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, QLD 4350, Australia;
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Salam SS, Ameen S, Balen J, Nahar Q, Jabeen S, Ahmed A, Gillespie B, Chauke L, Mannan A, Hoque M, Dey SK, Islam J, Ashrafee S, Alam HMS, Saberin A, Saha PK, Sarkar S, Alim A, Islam MS, Gray C, El Arifeen S, Rahman AE, Anumba DOC. Research prioritisation on prevention and management of preterm birth in low and middle-income countries (LMICs) with a special focus on Bangladesh using the Child Health and Nutrition Research Initiative (CHNRI) method. J Glob Health 2023; 13:07004. [PMID: 37651640 PMCID: PMC10472017 DOI: 10.7189/jogh.13.07004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Background Fifteen million babies are born preterm globally each year, with 81% occurring in low- and middle-income countries (LMICs). Preterm birth complications are the leading cause of newborn deaths and significantly impact health, quality of life, and costs of health services. Improving outcomes for newborns and their families requires prioritising research for developing practical, scalable solutions, especially in low-resource settings such as Bangladesh. We aimed to identify research priorities related to preventing and managing preterm birth in LMICs for 2021-2030, with a special focus on Bangladesh. Methods We adopted the Child Health and Nutrition Research Initiative (CHNRI) method to set research priorities for preventing and managing preterm birth. Seventy-six experts submitted 490 research questions online, which we collated into 95 unique questions and sent for scoring to all experts. A hundred and nine experts scored the questions using five pre-selected criteria: answerability, effectiveness, deliverability, maximum potential for burden reduction, and effect on equity. We calculated weighted and unweighted research priority scores and average expert agreement to generate a list of top-ranked research questions for LMICs and Bangladesh. Results Health systems and policy research dominated the top 20 identified priorities for LMICs, such as understanding and improving uptake of the facility and community-based Kangaroo Mother Care (KMC), promoting breastfeeding, improving referral and transport networks, evaluating the impact of the use of skilled attendants, quality improvement activities, and exploring barriers to antenatal steroid use. Several of the top 20 questions also focused on screening high-risk women or the general population of women, understanding the causes of preterm birth, or managing preterm babies with illnesses (jaundice, sepsis and retinopathy of prematurity). There was a high overlap between research priorities in LMICs and Bangladesh. Conclusions This exercise, aimed at identifying priorities for preterm birth prevention and management research in LMICs, especially in Bangladesh, found research on improving the care of preterm babies to be more important in reducing the burden of preterm birth and accelerating the attainment of Sustainable Development Goal 3 target of newborn deaths, by 2030.
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Affiliation(s)
| | - Shafiqul Ameen
- The University of Sheffield, Sheffield, UK
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Julie Balen
- The University of Sheffield, Sheffield, UK
- Canterbury Christ Church University, Canterbury, UK
| | - Quamrun Nahar
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sabrina Jabeen
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Anisuddin Ahmed
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | | | - Abdul Mannan
- Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | | | - Sanjoy Kumer Dey
- Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Jahurul Islam
- Directorate General of Health Services (DGHS), Government of Bangladesh, Ministry of Health and Family Welfare, Bangladesh
| | - Sabina Ashrafee
- Directorate General of Health Services (DGHS), Government of Bangladesh, Ministry of Health and Family Welfare, Bangladesh
| | - Husam Md Shah Alam
- Directorate General of Health Services (DGHS), Government of Bangladesh, Ministry of Health and Family Welfare, Bangladesh
| | - Ashfia Saberin
- Directorate General of Health Services (DGHS), Government of Bangladesh, Ministry of Health and Family Welfare, Bangladesh
| | - Palash Kumar Saha
- Directorate General of Health Services (DGHS), Government of Bangladesh, Ministry of Health and Family Welfare, Bangladesh
| | - Supriya Sarkar
- Directorate General of Health Services (DGHS), Government of Bangladesh, Ministry of Health and Family Welfare, Bangladesh
| | - Azizul Alim
- Directorate General of Health Services (DGHS), Government of Bangladesh, Ministry of Health and Family Welfare, Bangladesh
| | - Muhammad Shariful Islam
- Directorate General of Health Services (DGHS), Government of Bangladesh, Ministry of Health and Family Welfare, Bangladesh
| | - Clive Gray
- Stellenbosch University, Stellenbosch, South Africa
| | - Shams El Arifeen
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Ahmed Ehsanur Rahman
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
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Ashraf L, Agrawal P, Rahman A, Bhuiyan MAA, Salam SS, Li Q, Bachani AM. Caregivers’ Compliance and Perception of Daycare Centers—A Community-Based Childhood Drowning Prevention Intervention Implemented in Rural Bangladesh. IJERPH 2022; 19:ijerph19159537. [PMID: 35954900 PMCID: PMC9368301 DOI: 10.3390/ijerph19159537] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/29/2022] [Accepted: 07/31/2022] [Indexed: 11/28/2022]
Abstract
Drowning was one of the most prevalent causes of death worldwide for children under five in 2020. Drowning was the second leading cause of death for children under five in Bangladesh, while 58% of all deaths in the 1–5 years old age group resulted from drowning. Adult supervision helps prevent child drowning in rural areas where water bodies are easily accessible and located very close to homes. This paper aims to assess caregivers’ compliance and perception of community daycare centers in rural Bangladesh, piloted as a child drowning prevention intervention. In this longitudinal study, each child enrolled in the daycare intervention was visited and data on compliance and satisfaction with the daycare were collected. Descriptive statistics on daycare attendance, patterns of supervision, and caregivers’ perceptions about daycare were reported. When inquired about daycare attendance (n = 226,552), a total of 77.4% of children (n = 175,321) were found to attend daycare. The distance from homes and an adult’s unavailability to take the child to daycare were the most common reasons for not attending or discontinuing enrollment. The majority of children (76.4%) were supervised by their mothers during daycare closures. A total of 67.7% of respondents perceived daycare to be a safe place, where children also developed cognitive (51.7%) and social skills (50.6%). There were no incidences of drowning among children while attending daycare. Rural families were found to be compliant with the daycare and professed it to be a safe place protecting children from drowning and other injuries, while allowing them to focus on household chores or income-generating activities. These findings indicate a potential for the expansion of this intervention in rural Bangladesh and similar settings.
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Affiliation(s)
- Lamisa Ashraf
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA; (L.A.); (P.A.); (Q.L.)
| | - Priyanka Agrawal
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA; (L.A.); (P.A.); (Q.L.)
| | - Aminur Rahman
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), House # B-120, Road # 07, New DOHS, Mohakhali, Dhaka 1206, Bangladesh; (A.R.); (M.A.A.B.)
| | - Md. Al Amin Bhuiyan
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), House # B-120, Road # 07, New DOHS, Mohakhali, Dhaka 1206, Bangladesh; (A.R.); (M.A.A.B.)
| | - Shumona Sharmin Salam
- International Center for Diarrheal Disease Research, Bangladesh, 68, Shaheed Tajuddin Ahmed Sarani Mohakhali, Dhaka 1212, Bangladesh;
| | - Qingfeng Li
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA; (L.A.); (P.A.); (Q.L.)
| | - Abdulgafoor M. Bachani
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA; (L.A.); (P.A.); (Q.L.)
- Correspondence:
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Alfonso YN, Hyder AA, Alonge O, Salam SS, Baset K, Rahman A, Hoque DME, Islam MI, Rahman F, El-Arifeen S, Bishai D. Cost-effectiveness analysis of a large-scale crèche intervention to prevent child drowning in rural Bangladesh. Inj Epidemiol 2021; 8:61. [PMID: 34715946 PMCID: PMC8555188 DOI: 10.1186/s40621-021-00351-9] [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: 04/01/2021] [Accepted: 08/31/2021] [Indexed: 11/25/2022] Open
Abstract
Background Drowning is the leading cause of death among children 12–59 months old in rural Bangladesh. This study evaluated the cost-effectiveness of a large-scale crèche (daycare) intervention in preventing child drowning. Methods The cost of the crèches intervention was evaluated using an ingredients-based approach and monthly expenditure data collected prospectively throughout the study period from two agencies implementing the intervention in different study areas. The estimate of the effectiveness of the crèches intervention was based on a previous study. The study evaluated the cost-effectiveness from both a program and societal perspective. Results From the program perspective the annual operating cost of a crèche was $416.35 (95% CI: $221 to $576), the annual cost per child was $16 (95% CI: $8 to $23), and the incremental-cost-effectiveness ratio (ICER) per life saved with the crèches was $17,008 (95% CI: $8817 to $24,619). From the societal perspective (including parents time valued) the ICER per life saved was − $166,833 (95% CI: − $197,421 to − $141,341)—meaning crèches generated net economic benefits per child enrolled. Based on the ICER per disability-adjusted-life years averted from the societal perspective (excluding parents time), $1978, the crèche intervention was cost-effective even when the societal economic benefits were ignored. Conclusions Based on the evidence, the crèche intervention has great potential for generating net societal economic gains by reducing child drowning at a program cost that is reasonable. Supplementary Information The online version contains supplementary material available at 10.1186/s40621-021-00351-9.
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Affiliation(s)
- Y Natalia Alfonso
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Adnan A Hyder
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Olakunle Alonge
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Kamran Baset
- Center for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Aminur Rahman
- Center for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Dewan Md Emdadul Hoque
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Md Irteja Islam
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Fazlur Rahman
- Center for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Shams El-Arifeen
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - David Bishai
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Alonge O, Bishai D, Wadhwaniya S, Agrawal P, Rahman A, Dewan Hoque EM, Baset KU, Salam SS, Bhuiyan AA, Islam MI, Talab A, Rahman QSU, Rahman F, El-Arifeen S, Hyder AA. Large-scale evaluation of interventions designed to reduce childhood Drownings in rural Bangladesh: a before and after cohort study. Inj Epidemiol 2020; 7:17. [PMID: 32389128 PMCID: PMC7212604 DOI: 10.1186/s40621-020-00245-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/14/2020] [Indexed: 11/29/2022] Open
Abstract
Background This paper estimates the impact on childhood drowning rates of community-based introduction of crèches or playpens or both in rural Bangladesh for children aged 0–47 months. Methods A baseline census of the whole population of 270,387 households in 51 unions, 451 villages from 7 rural sub-districts in Bangladesh was conducted in 2013. The baseline census determined retrospective, age-specific, and cumulative drowning incidence rates (IR) experienced in the target households in the 12 months prior to the intervention. Beginning in late 2013, creches for drowning prevention were established across the study area. Acceptance into creches was provided and written assent to attend a creche was obtained for all children aged 9–47 months in all participating unions. Playpens were provided to 45,460 of these children, of which 5981 children received only the playpens. All children were followed-up until their 48-month birthday or administrative censoring (fixed timepoint to stop observing the drowning deaths), after a two-year implementation period (2014–2016). Drowning IR were estimated for children and compared to corresponding baseline rates from 2012. Age-specific drowning IR under different “as treated” categories (playpen-only, creche-only, and playpen-plus-creche) were compared to the baseline rates experienced by the categorized households prior to intervention. Results A total of 3205 creches (average of 7 creches per village) were established, and 116,054 children aged 9–47 months were exposed to the intervention packages. Aggregated drowning IRs between age 0 and 47 were estimated per 100,000 population per year at 86.73 (95% CI: 69.67–107.97) and 43.03 (95% CI: 35.55–52.10) in the baseline and post implementation period, respectively. Risk ratios were 0.40 (95% CI: 0.28–0.57) overall, and 0.34 (95% CI: 0.13–0.90), 0.09 (95% CI: 0.02–0.36), and 0.04 (95% CI: 0.002–0.60) in children under the creche-only, aged, 1, 2, and 3 years old respectively. Inexplicably, drowning rates were statistically significantly higher post-intervention in children 0-11 months. There was no mortality reduction with playpen use (alone or in combination), and this group may actually have had a higher risk of drowning. Conclusions Creches are effective for preventing childhood drowning in rural Bangladesh for children above age 1-year, and should be considered for further scale-up.
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Affiliation(s)
- Olakunle Alonge
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
| | - David Bishai
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.,Department of Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Shirin Wadhwaniya
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Priyanka Agrawal
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Aminur Rahman
- Center for Injury Prevention Research, Dhaka, Bangladesh
| | - Emdad Md Dewan Hoque
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | | | - Shumona Sharmin Salam
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | | | - Md Irteja Islam
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | - Abu Talab
- Center for Injury Prevention Research, Dhaka, Bangladesh
| | - Qazi Sadeq-Ur Rahman
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | - Fazlur Rahman
- Center for Injury Prevention Research, Dhaka, Bangladesh
| | - Shams El-Arifeen
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | - Adnan A Hyder
- Milken Institute School of Public Health, George Washington University, Washington DC, USA
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Ashraf L, Agrawal P, Rahman A, Salam SS, Li Q. Burden of Lesser-Known Unintentional Non-Fatal Injuries in Rural Bangladesh: Findings from a Large-Scale Population-Based Study. Int J Environ Res Public Health 2019; 16:E3366. [PMID: 31547240 PMCID: PMC6766074 DOI: 10.3390/ijerph16183366] [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] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/09/2019] [Accepted: 09/11/2019] [Indexed: 11/17/2022]
Abstract
Around 90% of all fatal and non-fatal unintentional injuries occur in low- and middle-income countries (LMICs). The magnitude of unintentional injuries is unclear due to limited research and data. This paper describes the burden of lesser-known injuries (LKIs-cut injuries, unintentional poisoning, machine injuries, electrocution, injury by blunt objects, and suffocation) in rural Bangladesh, using data from the Saving of Lives from Drowning (SoLiD) project in Bangladesh. Descriptive statistics were used to report counts and rates of injuries by socio-demographic factors, injury characteristics, and circumstantial details. The annual morbidity rate of LKIs was 6878 injuries per 100,000 persons, involving 3.4% (40,520) of the population. Cut injury (44,131.2/100,000 per year) and injury by blunt objects (19768.6/100,000 per year) attributed in large numbers to the overall burden of LKIs. Males (66.1%) suffered more injuries than females. More than half (52.9%) occurred among people aged 25 to 64 years. Those involved in agriculture suffered the most injuries, mainly cut injuries (9234.1/100,000 per year) and machine-related injuries (582.9/100,000 per year). Most injuries occurred in the home setting. Increased awareness about packaging, storage, and the proper handling of appliances can help lower the frequency of LKIs. Safe architecture and awareness about home injuries is required to reduce injuries occurring in the home environment.
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Affiliation(s)
- Lamisa Ashraf
- MPH 2019 Graduate, Johns Hopkins Bloomberg School of Public Health; 615 N Wolfe Street, Baltimore, MD 21205, USA.
| | - Priyanka Agrawal
- International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA.
| | - Aminur Rahman
- Center for Injury Prevention and Research, Bangladesh, House B 162, Rd No. 23, Dhaka 1206, Bangladesh.
| | - Shumona Sharmin Salam
- International Center for Diarrheal Disease Research, Bangladesh, 68, Shaheed Tajuddin Ahmed Sarani Mohakhali, Dhaka 1212, Bangladesh.
| | - Qingfeng Li
- International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA.
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Salam SS, Ali NB, Rahman AE, Tahsina T, Islam MI, Iqbal A, Hoque DME, Saha SK, El Arifeen S. Study protocol of a 4- parallel arm, superiority, community based cluster randomized controlled trial comparing paper and e-platform based interventions to improve accuracy of recall of last menstrual period (LMP) dates in rural Bangladesh. BMC Public Health 2018; 18:1359. [PMID: 30526560 PMCID: PMC6288958 DOI: 10.1186/s12889-018-6258-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 09/06/2018] [Accepted: 11/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gestational age (GA) is a key determinant of newborn survival and long-term impairment. Accurate estimation of GA facilitates timely provision of essential interventions to improve maternal and newborn outcomes. Menstrual based dating, ultrasound based dating, and neonatal estimates are the primarily used methods for assessing GA; all of which have some strength and weaknesses that require critical consideration. Last menstrual period (LMP) is simple, low-cost self-reported information, recommended by the World Health Organization for estimating GA but has issues of recall mainly among poorer, less educated women and women with irregular menstruation, undiagnosed abortion, and spotting during early pregnancy. Several studies have noted that about 20-50% of women cannot accurately recall the date of LMP. The goal of this study is therefore to improve recall and reporting of LMP and by doing so increase the accuracy of LMP based GA assessment in a rural population of Bangladesh where antenatal care-seeking, availability and utilization of USG is low. METHOD We propose to conduct a 4- parallel arm, superiority, community based cluster randomized controlled trial comparing three interventions to improve recall of GA with a no intervention arm. The interventions include (i) counselling and a paper based calendar (ii) counselling and a cell phone based SMS alert system (iii) counselling and smart-phone application. The trial is being conducted among 3360 adolescent girls and recently married women in Mirzapur sub-district of Bangladesh. DISCUSSION Enrolment of study participants continued from January 24, 2017 to March 29, 2017. Data collection and intervention implementation is ongoing and will end by February, 2019. Data analysis will measure efficacy of interventions in improving the recall of LMP date among enrolled participants. Results will be reported following CONSORT guideline. The innovative conventional & e-platform based interventions, if successful, can provide substantial evidence to scale-up in a low resource setting where m-Health initiatives are proliferating with active support from all sectors in policy and implementation. TRIAL REGISTRATION ClinicalTrials.gov NCT02944747 . The trial has been registered before starting enrolment on 24 October 2016.
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Affiliation(s)
| | - Nazia Binte Ali
- Maternal and Child Health Division, icddr,b, Dhaka, 1212, Bangladesh
| | | | - Tazeen Tahsina
- Maternal and Child Health Division, icddr,b, Dhaka, 1212, Bangladesh
| | - Md Irteja Islam
- Maternal and Child Health Division, icddr,b, Dhaka, 1212, Bangladesh
| | - Afrin Iqbal
- Maternal and Child Health Division, icddr,b, Dhaka, 1212, Bangladesh
| | | | - Samir Kumar Saha
- Department of Microbiology, Dhaka Shishu (Children's) Hospital, Dhaka, 1207, Bangladesh
| | - Shams El Arifeen
- Maternal and Child Health Division, icddr,b, Dhaka, 1212, Bangladesh
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Moinuddin M, Christou A, Hoque DME, Tahsina T, Salam SS, Billah SM, Kuppens L, Matin MZ, Arifeen SE. Birth preparedness and complication readiness (BPCR) among pregnant women in hard-to-reach areas in Bangladesh. PLoS One 2017; 12:e0189365. [PMID: 29228050 PMCID: PMC5724858 DOI: 10.1371/journal.pone.0189365] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 11/25/2017] [Indexed: 11/25/2022] Open
Abstract
Background Birth preparedness and complication readiness aims to reduce delays in care seeking, promote skilled birth attendance, and facility deliveries. Little is known about birth preparedness practices among populations living in hard-to-reach areas in Bangladesh. Objectives To describe levels of birth preparedness and complication readiness among recently delivered women, identify determinants of being better prepared for birth, and assess the impact of greater birth preparedness on maternal and neonatal health practices. Methods A cross-sectional survey with 2,897 recently delivered women was undertaken in 2012 as part of an evaluation trial done in five hard-to-reach districts in rural Bangladesh. Mothers were considered well prepared for birth if they adopted two or more of the four birth preparedness components. Descriptive statistics and multivariable logistic regression were used for analysis. Results Less than a quarter (24.5%) of women were considered well prepared for birth. Predictors of being well-prepared included: husband’s education (OR = 1.3; CI: 1.1–1.7), district of residence, exposure to media in the form of reading a newspaper (OR = 2.2; CI: 1.2–3.9), receiving home visit by a health worker during pregnancy (OR = 1.5; CI: 1.2–1.8), and receiving at least 3 antenatal care visits from a qualified provider (OR = 1.4; CI: 1.0–1.9). Well-prepared women were more likely to deliver at a health facility (OR = 2.4; CI: 1.9–3.1), use a skilled birth attendant (OR = 2.4, CI: 1.9–3.1), practice clean cord care (OR = 1.3, CI: 1.0–1.5), receive post-natal care from a trained provider within two days of birth for themselves (OR = 2.6, CI: 2.0–3.2) or their newborn (OR = 2.6, CI: 2.1–3.3), and seek care for delivery complications (OR = 1.8, CI: 1.3–2.6). Conclusion Greater emphasis on BPCR interventions tailored for hard to reach areas is needed to improve skilled birth attendance, care seeking for complications and essential newborn care and facilitate reductions in maternal and neonatal mortality in low performing districts in Bangladesh.
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Affiliation(s)
- Md Moinuddin
- Maternal and Child Health Division, icddr,b, Dhaka, Bangladesh
- * E-mail:
| | - Aliki Christou
- Maternal and Child Health Division, icddr,b, Dhaka, Bangladesh
| | | | - Tazeen Tahsina
- Maternal and Child Health Division, icddr,b, Dhaka, Bangladesh
| | | | - Sk Masum Billah
- Maternal and Child Health Division, icddr,b, Dhaka, Bangladesh
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Tahsina T, Ali NB, Hoque DE, Huda TM, Salam SS, Hasan MM, Hossain MA, Matin Z, Kuppen L, Garnett SP, Arifeen SE. Out-of-pocket expenditure for seeking health care for sick children younger than 5 years of age in Bangladesh: findings from cross-sectional surveys, 2009 and 2012. J Health Popul Nutr 2017; 36:33. [PMID: 28893323 PMCID: PMC5594455 DOI: 10.1186/s41043-017-0110-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 09/05/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Bangladesh has committed to universal health coverage, and options to decrease household out-of-pocket expenditure (OPE) are being explored. Understanding the determinants of OPE is an essential step. This study aimed to estimate and identify determinants of OPE in seeking health care for sick under-five children. METHODS Cross-sectional data was collected by structured questionnaire in 2009 (n = 7362) and 2012 (n = 6896) from mothers of the under-five children. OPE included consultation fees and costs of medicine, diagnostic tests, hospital admission, transport, accommodation, and food. Expenditure is expressed in US dollars and adjusted for inflation. Linear regression was used for ascertaining the determinants of OPE. RESULTS Between 2009 and 2012, the median OPE for seeking care for a sick under-five child increased by ~ 50%, from USD 0.82 (interquartile range 0.39-1.49) to USD 1.22 (0.63-2.36) per child/visit. Increases were observed in every component OPE measured, except for consultation fees which decreased by 12%. Medicine contributed the major portion of overall OPE. Higher overall OPE for care seeking was associated with a priority illness (20% increase), care from trained providers (90% public/~ 2-fold private), residing in hilly/wet lands areas (20%), and for mothers with a secondary education (19%). CONCLUSION OPE is a major barrier to quality health care services and access to appropriate medicine is increasing in rural Bangladesh. To support the goal of universal health care coverage, geographic imbalances as well as expanded health financing options need to be explored.
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Affiliation(s)
- Tazeen Tahsina
- Maternal and Child Health Division (MCHD), icddr,b, Dhaka, Bangladesh
| | - Nazia Binte Ali
- Maternal and Child Health Division (MCHD), icddr,b, Dhaka, Bangladesh
| | | | - Tanvir M. Huda
- Maternal and Child Health Division (MCHD), icddr,b, Dhaka, Bangladesh
| | | | | | - Md Altaf Hossain
- IMCI, Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare (MOHFW), Dhaka, Bangladesh
| | - Ziaul Matin
- Health Section, UNICEF Bangladesh, Dhaka, Bangladesh
| | - Lianne Kuppen
- Health Section, UNICEF Bangladesh, Dhaka, Bangladesh
| | - Sarah P. Garnett
- The Children’s Hospital at Westmead Clinical School, University of Sydney, Westmead, NSW Australia
| | - Shams El Arifeen
- Maternal and Child Health Division (MCHD), icddr,b, Dhaka, Bangladesh
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Sharmin Salam S, Alonge O, Islam MI, Hoque DME, Wadhwaniya S, Ul Baset MK, Mashreky SR, El Arifeen S. The Burden of Suicide in Rural Bangladesh: Magnitude and Risk Factors. Int J Environ Res Public Health 2017; 14:ijerph14091032. [PMID: 28891939 PMCID: PMC5615569 DOI: 10.3390/ijerph14091032] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/06/2017] [Accepted: 09/06/2017] [Indexed: 02/08/2023]
Abstract
The aim of the paper is to quantify the burden and risk factors of fatal and non-fatal suicidal behaviors in rural Bangladesh. A census was carried out in seven sub-districts encompassing 1.16 million people. Face-to-face interviews were conducted at the household level. Descriptive analyses were done to quantify the burden and Poisson regression was run to determine on risk factors. The estimated rates of fatal and non-fatal suicide were 3.29 and 9.86 per 100,000 person years (PY) observed, respectively. The risk of suicide was significantly higher by 6.31 times among 15-17 and 4.04 times among 18-24 olds compared to 25-64 years old. Married adolescents were 22 times more likely to commit suicide compared to never-married people. Compared to Chandpur/Comilla district, the risk of suicide was significantly higher in Narshingdi. Students had significantly lower risk of non-fatal suicidal behavior compared to skilled laborers. The risk of non-fatal suicidal behavior was lower in Sherpur compared to Chandpur/Comilla. Among adolescents, unskilled laborers were 16 times more likely to attempt suicide than students. The common methods for fatal and non-fatal suicidal behaviors were hanging and poisoning. Suicide is a major public health problem in Bangladesh that needs to be addressed with targeted interventions.
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Affiliation(s)
- Shumona Sharmin Salam
- International Centre for Diarrhoeal Disease Research, GPO Box 128, Dhaka 1000, Bangladesh.
| | - Olakunle Alonge
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MA 21205, USA.
| | - Md Irteja Islam
- International Centre for Diarrhoeal Disease Research, GPO Box 128, Dhaka 1000, Bangladesh.
| | - Dewan Md Emdadul Hoque
- International Centre for Diarrhoeal Disease Research, GPO Box 128, Dhaka 1000, Bangladesh.
| | - Shirin Wadhwaniya
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MA 21205, USA.
| | - Md Kamran Ul Baset
- Center for Injury Prevention and Research, House # B-162, Road # 23, New DOHS, Mohakhali, Dhaka 1206, Bangladesh.
| | - Saidur Rahman Mashreky
- Center for Injury Prevention and Research, House # B-162, Road # 23, New DOHS, Mohakhali, Dhaka 1206, Bangladesh.
| | - Shams El Arifeen
- International Centre for Diarrhoeal Disease Research, GPO Box 128, Dhaka 1000, Bangladesh.
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Alonge O, He S, Hoque DE, Salam SS, Islam I, El-Arifeen S, Hyder AA. Shifting disease burden in low and middle-income countries: a 14-year survival analysis of childhood mortality in Bangladesh. J Epidemiol Community Health 2017; 71:jech-2017-208981. [PMID: 28743731 DOI: 10.1136/jech-2017-208981] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 05/16/2017] [Accepted: 06/05/2017] [Indexed: 11/03/2022]
Abstract
BACKGROUND The objective of this study is to compare all-cause mortality and drowning-specific mortality rates and survival times among birth cohorts of children from rural Bangladesh over a 14-year period. METHOD Seven birth cohorts of children aged 12-59 months were created using data from the Matlab Health and Demographic Surveillance System in Bangladesh. Each cohort represents children born within a 2-year interval between 1 July 1995 and 30 June 2009, who were then evaluated over a 2-year snapshot. All-cause and drowning-specific mortality rates were compared for each cohort using the oldest cohort (cohort 1) as reference. A Cox proportional model was used to estimate hazard rate ratios (HRR) comparing the cohorts, and adjusted for key independent variables. Kaplan-Meier survivor function was estimated for each birth cohort and compared with cohort 1 using log-rank test. RESULTS The adjusted HRR for all-cause mortality showed that children in cohorts 4, 5, 6 and 7 had significantly lower hazard rate compared with cohort 1 with a dose-response relationship, the adjusted HRRs were 0.51 (95% CI 0.31, 0.84), 0.53 (95% CI 0.32, 0.87), 0.44 (95% CI 0.26, 0.76) and 0.42 (95% CI 0.24, 0.74), respectively. For drowning, none of the adjusted HRR was statistically significant. Mother's primary education and being married were protective of risk of death from all causes. CONCLUSION Whereas child mortality rates from all causes declined remarkably between 1998 and 2012 in rural Bangladesh, drowning-specific mortality rates remained unchanged. This shifting burden of disease underscores the epidemiological transition in the childhood causes of death in Bangladesh and the need for urgent action to review child health interventions.
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Affiliation(s)
- Olakunle Alonge
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Siran He
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Dewan Emdadul Hoque
- Center for Child and Adolescent Health, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | - Shumona Sharmin Salam
- Center for Child and Adolescent Health, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | - Irteja Islam
- Center for Child and Adolescent Health, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | - Shams El-Arifeen
- Center for Child and Adolescent Health, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | - Adnan A Hyder
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Hoque DME, Islam MI, Sharmin Salam S, Rahman QSU, Agrawal P, Rahman A, Rahman F, El-Arifeen S, Hyder AA, Alonge O. Impact of First Aid on Treatment Outcomes for Non-Fatal Injuries in Rural Bangladesh: Findings from an Injury and Demographic Census. Int J Environ Res Public Health 2017; 14:ijerph14070762. [PMID: 28704972 PMCID: PMC5551200 DOI: 10.3390/ijerph14070762] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/03/2017] [Accepted: 07/09/2017] [Indexed: 11/16/2022]
Abstract
Non-fatal injuries have a significant impact on disability, productivity, and economic cost, and first-aid can play an important role in improving non-fatal injury outcomes. Data collected from a census conducted as part of a drowning prevention project in Bangladesh was used to quantify the impact of first-aid provided by trained and untrained providers on non-fatal injuries. The census covered approximately 1.2 million people from 7 sub-districts of Bangladesh. Around 10% individuals reported an injury event in the six-month recall period. The most common injuries were falls (39%) and cuts injuries (23.4%). Overall, 81.7% of those with non-fatal injuries received first aid from a provider of whom 79.9% were non-medically trained. Individuals who received first-aid from a medically trained provider had more severe injuries and were 1.28 times more likely to show improvement or recover compared to those who received first-aid from an untrained provider. In Bangladesh, first-aid for non-fatal injuries are primarily provided by untrained providers. Given the large number of untrained providers and the known benefits of first aid to overcome morbidities associated with non-fatal injuries, public health interventions should be designed and implemented to train and improve skills of untrained providers.
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Affiliation(s)
- Dewan Md Emdadul Hoque
- Maternal and Child Health Division, International Centre for Diarrheal Diseases Research, GPO Box 128, Dhaka 1000, Bangladesh.
| | - Md Irteja Islam
- Maternal and Child Health Division, International Centre for Diarrheal Diseases Research, GPO Box 128, Dhaka 1000, Bangladesh.
| | - Shumona Sharmin Salam
- Maternal and Child Health Division, International Centre for Diarrheal Diseases Research, GPO Box 128, Dhaka 1000, Bangladesh.
| | - Qazi Sadeq-Ur Rahman
- Maternal and Child Health Division, International Centre for Diarrheal Diseases Research, GPO Box 128, Dhaka 1000, Bangladesh.
| | - Priyanka Agrawal
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Aminur Rahman
- Centre for Injury Prevention and Research, House #B-162, Road #23, New DOHS, Mohakhali, Dhaka 1206, Bangladesh.
| | - Fazlur Rahman
- Centre for Injury Prevention and Research, House #B-162, Road #23, New DOHS, Mohakhali, Dhaka 1206, Bangladesh.
| | - Shams El-Arifeen
- Maternal and Child Health Division, International Centre for Diarrheal Diseases Research, GPO Box 128, Dhaka 1000, Bangladesh.
| | - Adnan A Hyder
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Olakunle Alonge
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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Wadhwaniya S, Baset KU, Salam SS, Chowdhury NMRA, Khan J, Alonge O, Hyder AA. 672 Acceptability of child drowning prevention interventions in rural bangaladesh. Inj Prev 2016. [DOI: 10.1136/injuryprev-2016-042156.672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
Rates of childhood mortality due to diarrhoea remain unacceptably high and call for renewed global focus and commitment. Affordable, simple and effective diarrhoeal treatments have already been available for many years, yet a shift in international health priorities has seen coverage of recommended treatments slow to a near-standstill since 1995. This article reviews coverage of recommended childhood diarrhoeal treatments (low-osmolarity oral rehydration solution (ORS) and zinc), globally and regionally, and provides an overview of the major barriers to wide-scale coverage. It is argued that to ensure smooth supply and equitable distribution of ORS and zinc, adequate financing, relevant policy changes, strong public, private and non-government organisation (NGO) collaboration, local manufacturing of pharmaceuticals, mass media awareness and campaigning, in conjunction with strong government support, are necessary for successful treatment scale-up.
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Affiliation(s)
- Carla Chan Unger
- Centre for Child and Adolescent Health, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), , Dhaka, Bangladesh
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