COVID-19 pandemic in Bangladesh: A scoping review of governance issues affecting response in public sector

Background

On January 30, 2020, WHO declared COVID-19 as a Global Public Health Emergency. The first three COVID-19 cases in Bangladesh were confirmed on March 8, 2020. Thus, Bangladesh got substantial time to prepare the people and the health systems to respond to the outbreak However, neither the health ministry nor the government was found to rise to the occasion and provide the necessary stewardship for a coordinated and comprehensive response.

Objective

The importance of governance to mount an evidence-based pandemic response cannot be overemphasised. This study presents critical reflections on the Bangladesh government's COVID-19 response through a review of selected papers, with expert deliberations on the review findings to consolidate emerging lessons for future pandemic preparedness.

Study design

A scoping review approach was taken for this study.

Methods

Documents focusing on COVID-19 governance were selected from a repository of peer-reviewed articles published by researchers using data from Bangladesh (n = 11).

Results

Findings reveal Bangladesh's COVID-19 response to be delayed, slow, and ambiguous, reflecting poorly on its governance. Lack of governance capability in screening for COVID-19, instituting quarantine and lockdown measures in the early weeks, safety and security of frontline healthcare providers, timely and equitable COVID-19 testing, and logistics and procurement were phenomenal. The pandemic unmasked the weaknesses of the health system in this regard and "created new opportunities for corruption." The failure to harmonise coordination among the government's different agencies for the COVID-19 response, along with poor risk communication, which was not culture-sensitive and context-specific. Over time, the government initiated necessary actions to mitigate the pandemic's impact on the lives and livelihoods of the people. Diagnostic and case management services gained strength after some initial faltering; however, the stewardship functions were not seamless.

Conclusions

Shortage of healthcare workers, incapability of health facilities to cater to COVID-19 suspects and cases, absence of health system resilience, and corruption in procurement and purchases were limited the government's COVID-19 response. These need urgent attention from policymakers to better prepare for the next epidemic/pandemic.

The reactive cholera vaccination campaign in urban Dhaka in 2022: experience, lessons learned and future directions

Introduction

An upsurge of diarrheal cases occurred in Dhaka, Bangladesh, with approximately 30% of the cases being identified as cholera in 2022. To combat this situation, a reactive Oral Cholera Vaccination campaign was organized in five highly cholera-affected areas of Dhaka city. The paper is a descriptive tale of experience gathering, organization and implementation of reactive oral cholera vaccination campaign.

Study design

This is a descriptive report of a reactive oral cholera vaccination campaign.

Methods

Population density maps were generated using GIS technology before launching the campaign. The target population comprised individuals aged over one year, excluding pregnant women, totaling 2,374,976 people residing in above mentioned areas. The campaign utilized Euvichol-Plus, an OCV with adherence to the necessary cold chain requirements. Total 700 teams, each consisting of six members, were deployed across the five zones. The campaign was conducted in two rounds, where first round took place in June-July 2022, followed by second round in August 2022. During the campaign, data on adverse events following immunization (AEFI) was collected. Expert teams from various government and non-government organizations monitored regularly and ensured the campaign's success.

Results

The first round achieved a coverage rate of 99%, whereas in the second round, 86.3% of individuals among the first dose recipients. During the campaigns, a total of 57 AEFIs were reported.

Conclusions

This campaign serves as a model for a multispectral approach in combating cholera epidemics, highlighting the collaborative efforts of policymakers, health authorities, local communities, and health partners.

The impact of comorbidity on the quality of life of people who recovered from COVID-19 in Bangladesh

Objectives

COVID-19 affects the quality of life (QoL) in a reverse way after recovery, which might be multiplied by the comorbid non-communicable diseases. This study explored the relationship between comorbidities and the QoL of people who recovered from COVID-19 in Bangladesh.

Methods

The cross-sectional study was conducted among 3244 participants between June 2020 and November 2020 using a pre-tested questionnaire through over-the-phone interviews. The WHOQOL-BREF was used to explore the QoL among the study participants. A multivariable linear regression model was conducted to identify the effects of the number of comorbidities on QoL scores of all four domains.

Results

Of 3244 patients who recovered from COVID-19, over one-third (39.4%) had one or more chronic diseases, such as hypertension, diabetes mellitus, ischemic heart disease, bronchial asthma/chronic obstructive pulmonary disease, chronic kidney disease, and cancer. Around 46.85% of the participants aged above 40 years presented with one to two chronic diseases, and 16.33% had three or more chronic diseases. Among all comorbidities, the participants with cancer and chronic kidney disease were found to have relatively lower scores in all four domains than other comorbidities. The lowest QoL scores were observed in the psychological domain. Those with three or more simultaneous chronic comorbidities had the lowest QoL score in all four domains: physical, psychological, social relationship, and environmental.

Conclusions

Persons who recovered from COVID-19 with comorbidities undergo a lower QoL. Therefore, special attention is required to these vulnerable groups to ensure their smooth recuperation.

Molecular survey of canine tick-borne pathogens in ticks and stray dogs in Dhaka city, Bangladesh

Molecular surveillance of canine tick-borne pathogens (TBPs) in Bangladesh has constantly been undervalued. Therefore, the emergence of new pathogens often remains undetected. This study aimed to screen tick-borne pathogens in stray dogs and ticks in the Dhaka metropolitan area (DMA). Eighty-five dog blood and 53 ticks were collected in six city districts of DMA from September 2022 to January 2023. The ticks were identified by morphology. Screening of TBPs was performed by polymerase chain reaction (PCR), followed by sequencing. The PCR assays were conducted to analyze the 18S rRNA (Babesia gibsoni, B. vogeli, and Hepatozoon canis), 16S rRNA (Anaplasma phagocytophilum, A. platys, and A. bovis), gltA (Ehrlichia canis and Rickettsia spp.), flagellin B (Borrelia spp.) and 16-23S rRNA (Bartonella spp.). Three tick species, Rhipicephalus sanguineus (50/53), R. microplus (1/53), and Haemaphysalis bispinosa (2/53), were identified. Babesia gibsoni (38 out of 85) and A. platys (7 out of 85) were detected in dog blood. In contrast, four pathogens, B. gibsoni (1 out of 53), B. vogeli (1 out of 53), H. canis (22 out of 53), and A. platys (1 out of 53), were detected in the ticks. However, the detection rates of TBPs in dog blood and ticks were not correlated in this study. The phylogenetic analyses suggested that a single genotype for each of the four pathogens is circulating in DMA. This study reports the existence of B. vogeli, H. canis, and A. platys in Bangladesh for the first time.

A qualitative exploration of purchasing, stockpiling, and use of drugs during the COVID-19 pandemic in an urban city of Bangladesh

Objectives

This research was conducted to explore the patterns and behavior of panic purchasing, stockpiling, and use of drugs during COVID-19 in the Sylhet city, Bangladesh.

Study design

The study adopted qualitative exploratory research design.

Methods

25 in-depth interviews with drug sellers and clients and 7 key informant interviews were conducted with pharmacists and medical representatives of pharmaceutical companies in Sylhet city in Bangladesh from October 2020 to March 2021. Thematic analysis was used to evaluate the primary data.

Results

The findings revealed that individuals sought out, purchased, and stockpiled prescription-only drugs for self-medication purposes during the COVID-19 pandemic. News and rumor spread by social media, television, and everyday interactions concerning the severity of infections and the number of deaths caused an increase in self-medication as a preventive measure. The reason for this panic buying of drugs was identified as a fear of drug shortages, price hikes, the rise of infection, and the availability of medicines and home delivery services during the pandemic.

Conclusion

The purchasing, stockpiling and use of drugs by pharmacies varied based on the person dispensing the drugs, the customer, and the COVID-19 pandemic situation. Furthermore, the role of social media in spreading rumor and (dis) misinformation about drug use, a greater tendency to self-medicate, and poor regulation, influenced the individual's use of drugs. Therefore, the drug regulatory authorities and policymakers need to consider the real level of local drug use in order to encourage more rational use of drugs which will help to ensure that there is reliable access to safe, effective, and high-quality medicines and vaccines for all.

Knowledge, attitudes and practices regarding zoonotic diseases among cat and dog owners in Bangladesh

The close relationship between human and companion animals like cats and dogs raises public health concerns regarding the potential transmission of zoonotic diseases in Bangladesh. The study aimed to evaluate the cat and dog owners' knowledge, attitudes, practices, and risk perception concerning zoonotic diseases for designing effective interventions and reducing disease transmission. A cross-sectional survey was conducted among 480 pet owners in various region of Bangladesh. For data collection, a structured, closed-ended questions were implemented. The data collection was anonymous and individuals were chosen through a random selection method. Responses were classified to evaluate comprehensive knowledge, using a threshold value of ≥65%. Quantitative score was created to measure Knowledge, Attitudes, and Practices, and these scores were divided into categories of good and poor knowledge, positive and negative attitudes, as well as correct and incorrect practices. The analysis included the application of both descriptive statistics and logistic regression analysis. The findings showed that females made up more than half of the survey participants (55.2%), with the predominant pet owned being cats (73.1%). Overall, only a small portion (21.25%) of the survey respondents demonstrated good knowledge about the topic as measured by a dichotomous outcome. A larger proportion of participants (84.58%) exhibited a positive attitude towards zoonotic diseases. However, when it came to correct practices, about one-third (29.79%) of performed satisfactorily. It is noteworthy that 90.4% of the participants exhibited a high level of understanding regarding the transmission of rabies through dog bites. The knowledge and practices of owners were markedly impacted by their education, occupation, and geographic location. Furthermore, 48.1% identified 'social media' as their primary source of information, and 80.0% regarded vaccination as a preventive measure. The study reveals gaps in knowledge and practices of risks regarding zoonotic diseases among pet owners in Bangladesh. It is crucial to implement focused educational initiatives and preventative measures to effectively tackle gaps in knowledge concerning zoonotic diseases and to avert potential infections.

Emergence of SARS-CoV-2 Omicron sub-lineage JN.1 in Bangladesh

We report complete genome sequences of 14 severe acute respiratory syndrome coronavirus 2 Omicron sub-lineage JN.1 obtained from Bangladeshi individuals between 19 December 2023 and 21 January 2024. All sequence data were generated by Oxford Nanopore Sequencing Technology using the amplicon sequencing approach developed by the ARTIC network.

Age and sex-specific disability-free life expectancy in urban and rural settings of Bangladesh

BACKGROUND

Disability-free life expectancy (DFLE) has been used to gain a better understanding of the population's quality of life.

OBJECTIVES

The authors aimed to estimate age and sex-specific disability-free life expectancy (DFLE) for urban and rural areas of Bangladesh, as well as to investigate the differences in DFLE between males and females of urban and rural areas.

METHODS

Data from the Bangladesh Sample Vital Statistics-2016 and the Bangladesh Household Income and Expenditure Survey (HIES)-2016 were used to calculate the disability-free life expectancy (DFLE) of urban and rural males and females in Bangladesh in 2016. The DFLE was calculated using the Sullivan method.

RESULTS

With only a few exceptions, rural areas have higher mortality and disability rates than urban areas. For both males and females, statistically significant differences in DFLE were reported between urban and rural areas between the ages of birth and 39 years. In comparison to rural males and females, urban males and females had a longer life expectancy (LE), a longer disability-free life expectancy, and a higher share of life without disability.

CONCLUSION

This study illuminates stark urban-rural disparities in LE and DFLE, especially among individuals aged < 1-39 years. Gender dynamics reveal longer life expectancy but shorter disability-free life expectancy for Bangladeshi women compared to men, emphasizing the need for targeted interventions to address these pronounced health inequalities.

Nutritional status of children with neurodevelopmental disorders: a cross-sectional study at a tertiary-level hospital in northern Bangladesh

BACKGROUND

Malnutrition in children with neurodevelopmental disorders (NDDs) is a significant global public health issue. Nutritional assessment combined with management or advice are essential to produce optimal outcomes.

OBJECTIVES

The objective of this study was to assess nutritional status and the sociodemographic profile of children with neurodevelopmental disorders in Bangladesh.

METHODS

A cross-sectional study was conducted from December to April 2020 among the population of children with NDDs who presented to the pediatric department of the TMSS Medical College and Rafatullah Community Hospital in Bogura during this period. Socio-demographic data along with anthropometric measurements of the children were taken. Assessment of nutritional status were made using metrics such as z-scores for weight-for-age (WAZ), height-for-age (HAZ), and body mass index-for-age (BAZ). Descriptive statistics (number and percentage) and analytical statistics (chi-square and logistic regression) were included.

RESULTS

58.6% of children displayed malnutrition, with 47.8% showing undernutrition (WHZ / BAZ - 1 SD-≤-3 SD), and 10.8% overnutrition (BAZ > 2SD). Significant negative associations were found between malnutrition and parental education level, urban residency, and monthly family income. Children diagnosed with cerebral palsy exhibited twice the likelihood to be malnourished (AOR 2.39, 95% CI 0.83-6.87). Furthermore, residing in rural regions was associated with an increased risk of experiencing malnutrition, as indicated by an adjusted odds ratio of 1.60 (95% CI 0.12-3.09).

CONCLUSIONS

While the results are cross-sectional, over half of children with NDDs were found to be malnourished, suggesting that children with NDD in Bangladesh are vulnerable to developing any form of malnutrition. Therefore, regular assessments and timely nutritional support may improve their situation.

Cost-effectiveness and public health impact of typhoid conjugate vaccine introduction strategies in Bangladesh

PURPOSE

Typhoid fever causes substantial morbidity and mortality in Bangladesh. The government of Bangladesh plans to introduce typhoid conjugate vaccines (TCV) in its expanded program on immunization (EPI) schedule. However, the optimal introduction strategy in addition to the costs and benefits of such a program are unclear.

METHODS

We extended an existing mathematical model of typhoid transmission to integrate cost data, clinical incidence data, and recently conducted serosurveys in urban, semi-urban, and rural areas. In our primary analysis, we evaluated the status quo (i.e., no vaccination) and eight vaccine introduction strategies including routine and 1-time campaign strategies, which differed by age groups targeted and geographic focus. Model outcomes included clinical incidence, seroincidence, deaths, costs, disability-adjusted life years (DALYs), and incremental cost-effectiveness ratios (ICERs) for each strategy. We adopted a societal perspective, 10-year model time horizon, and 3 % annual discount rate. We performed probabilistic, one-way, and scenario sensitivity analyses including adopting a healthcare perspective and alternate model time horizons.

RESULTS

We projected that all TCV strategies would be cost saving compared to the status quo. The preferred strategy was a nationwide introduction of TCV at 9-12 months of age with a single catch-up campaign for children ages 1-15, which was cost saving compared to all other strategies and the status quo. In the 10 years following implementation, we projected this strategy would avert 3.77 million cases (95 % CrI: 2.60 - 5.18), 11.31 thousand deaths (95 % CrI: 3.77 - 23.60), and save $172.35 million (95 % CrI: -14.29 - 460.59) compared to the status quo. Our findings were broadly robust to changes in parameter values and willingness-to-pay thresholds.

CONCLUSIONS

We projected that nationwide TCV introduction with a catch-up campaign would substantially reduce typhoid incidence and very likely be cost saving in Bangladesh.

Machine learning approach for predicting cardiovascular disease in Bangladesh: evidence from a cross-sectional study in 2023

BACKGROUND

Cardiovascular disorders (CVDs) are the leading cause of death worldwide. Lower- and middle-income countries (LMICs), such as Bangladesh, are also affected by several types of CVDs, such as heart failure and stroke. The leading cause of death in Bangladesh has recently switched from severe infections and parasitic illnesses to CVDs.

MATERIALS AND METHODS

The study dataset comprised a random sample of 391 CVD patients' medical records collected between August 2022 and April 2023 using simple random sampling. Moreover, 260 data points were collected from individuals with no CVD problems for comparison purposes. Crosstabs and chi-square tests were used to determine the association between CVD and the explanatory variables. Logistic regression, Naïve Bayes classifier, Decision Tree, AdaBoost classifier, Random Forest, Bagging Tree, and Ensemble learning classifiers were used to predict CVD. The performance evaluations encompassed accuracy, sensitivity, specificity, and area under the receiver operator characteristic (AU-ROC) curve.

RESULTS

Random Forest had the highest precision among the five techniques considered. The precision rates for the mentioned classifiers are as follows: Logistic Regression (93.67%), Naïve Bayes (94.87%), Decision Tree (96.1%), AdaBoost (94.94%), Random Forest (96.15%), and Bagging Tree (94.87%). The Random Forest classifier maintains the highest balance between correct and incorrect predictions. With 98.04% accuracy, the Random Forest classifier achieved the best precision (96.15%), robust recall (100%), and high F1 score (97.7%). In contrast, the Logistic Regression model achieved the lowest accuracy of 95.42%. Remarkably, the Random Forest classifier achieved the highest AUC value (0.989).

CONCLUSION

This research mainly focused on identifying factors that are critical in impacting patients with CVD and predicting CVD risk. It is strongly advised that the Random Forest technique be implemented in a system for predicting cardiac diseases. This research may change clinical practice by providing doctors with a new instrument to determine a patient's CVD prognosis.

Impact of legal recognition on the lives of the third gender: A study in Khulna district of Bangladesh

The third gender, popularly known as 'hijra', is a gender non-conforming person residing in Bangladesh. The government of Bangladesh granted legal recognition (LR) in 2013 to acknowledge them as a third gender. Thus, using an exploratory qualitative inquiry, the study sought to understand how LR affected the lives of the third gender community in the Khulna district of Bangladesh. Thirteen participants were selected following snowball sampling, and data were collected using in-depth interviews and key informant interviews. In the domain of socio-cultural dynamics, we found that the LR had enhanced the social participation of the third gender community and given them a sense of identity. On the contrary, within the domain of economic lives, the LR has not been able to change their economic situation. Moreover, in the third domain, we observed an improved situation for the third gender population in their right to vote and political participation, but in accessing healthcare facilities, inheritance, and legal services, LR remained unsatisfactory. The study recommends promoting acceptance and reducing social stigma towards the third gender community through awareness campaigns, providing professional training programs to enable their financial independence, and enacting laws to protect their rights in Bangladesh.

GIS-based spatial analysis for lightning scenario in Bangladesh

Bangladesh has witnessed alarmingly rising lightning frequency, particularly during pre-monsoon and monsoon seasons. This has resulted in significant annual death tolls from lightning strikes over the past decade. Recognizing this crisis, the country officially declared lightning casualties a natural disaster in 2016. This study delves deeper into the landscape of lightning fatalities and causalities in Bangladesh. Utilizing secondary data sources, this research introduces a unique approach by integrating Bangladesh Meteorological Department (BMD) data and NASA's Lightning Imaging Sensor (LIS) data from the International Space Station's (ISS) Near-real Time (NRT) mission. This combined dataset allows for a more comprehensive analysis. Furthermore, Geographic Information Systems (GIS) was employed to analyze spatial distributions and generate maps. The Inverse Distance Weighted (IDW) interpolation tool was used to create detailed spatial distribution maps of lightning fatalities, thunderstorm days (TSDs), and lightning flash frequency (LFF) across Bangladesh. The analysis revealed that farmers and fishermen were the most vulnerable populations, with the northeastern regions experiencing the highest impact. Sylhet division emerged as the area with the most fatalities, highlighting the northeastern zone's susceptibility. The study also identified monsoons as the period with the highest occurrences of lightning deaths and injuries. By combining innovative data integration and spatial analysis, this study offers valuable insights into the alarming trend of lightning fatalities in Bangladesh. These findings can inform targeted prevention strategies and interventions to safeguard vulnerable populations and communities.

Own price elasticities of the demand for sugar-sweetened beverages in Bangladesh

BACKGROUND

Consumption of sugar-sweetened beverages (SSB) is a major global public health problem. Increasing the price of SSBs through taxation is an effective tool to reduce SSB consumption. Price-elasticity estimates are useful in measuring the effect of taxation on consumption. We estimated the own price elasticities of demand for SSBs in Bangladesh, which will inform how SSB taxes could affect behaviour.

METHODS

We used Household Income and Expenditure Survey (HIES) 2016 data, which is a nationally representative dataset at the household level across the country and is conducted using stratified random sampling method. Deaton's method was used to estimate the price elasticities for SSBs in Bangladesh.

RESULTS

We found that the own price elasticity for SSBs varied between - 0.53% to -1.17% by types of SSBs in Bangladesh. The price elasticity for soft drinks was - 1.17, indicating that if the price of soft drinks increases by 10% via taxes, the quantity consumed of these beverages would reduce by 11.7%.

CONCLUSION

This is the first study that estimates the own price elasticities of demand for SSBs in Bangladesh. Our results suggest to raise SSB prices through increased taxation in order to reduce SSB consumption and ensure public health gains in Bangladesh.

Draft genome sequence of antibiotic-resistant Shigella flexneri MTR_GR_V146 strain isolated from a tomato (Solanum lycopersicum) sample collected from a peri-urban area of Bangladesh

This study announces the genome sequence of the Shigella flexneri MTR_GR_V146 strain isolated from a tomato (Solanum lycopersicum) sample in Bangladesh. This strain has a 4,624,521 bp genome length (coverage: 73.07×), 2 CRISPR arrays, 1 plasmid, 52 predicted antibiotic resistance genes, and 53 virulence factor genes.

Genome sequence of white spot syndrome virus (WSSV) infecting cultured black tiger shrimp (Penaeus monodon) in Bangladesh

The white spot syndrome virus (WSSV) is a causative agent of white spot disease (WSD) in crustaceans, especially in cultivated black tiger shrimp (Penaeus monodon), leading to significant economic losses in the aquaculture sector. The present study describes four whole genome sequences of WSSV obtained from coastal regions of Bangladesh.

Is smokeless tobacco use associated with lower health-related quality of life? A cross-sectional survey among women in Bangladesh

INTRODUCTION

Bangladesh has 22 million adult users of smokeless tobacco (ST). The prevalence among women is higher (24.8%). Health-related quality of life outcome (HRQoL) for ST use is little known. We investigated the association between HRQoL and daily ST use among adult women in Bangladesh.

METHODS

Using multi-stage design, a cross-sectional survey was conducted. Adult women (randomly selected) were surveyed from 4 purposively selected divisions (Dhaka, Chittagong, Khulna and Rangpur). Female ST users and non-users were compared using HRQoL scores. Self-perceived Visual Analogue Scale (EQ-VAS) values and HRQoL scores were modelled to examine their association with ST use.

RESULTS

A total of 2610 women (1149 users and 1461 non-users) were surveyed. The proportion reported any type of problem in all health dimensions was significantly higher among female ST users than non-users (mobility: 43.3% vs 19.5%, self-care: 29.6% vs 11.9%, usual activities: 48.7% vs 21.8%, pain or discomfort: 69.8% vs 40.6%, and anxiety or depression: 61.3% vs 37.5%). The average HRQoL scores were 0.79 (95% CI: 0.78-0.81) and 0.90 (95% CI: 0.89-0.90) for users and non-users, respectively. Moreover, EQ-VAS average values were significantly higher for non-users [80.7 (95% CI: 79.9-81.6) vs 70.27 (95% CI: 69.2-71.2)]. Controlling the sociodemographics, ST use significantly reduced the HRQoL score by an average of 0.15 points. The EQ-VAS values on average decreased by 0.04 points for ST use.

CONCLUSIONS

ST use is significantly associated with the HRQoL of females in Bangladesh. Considering the higher prevalence of ST, especially among women, HRQoL hazards need to be communicated for awareness building.

Availability and readiness of healthcare facilities and their effects on antenatal care services uptake in Bangladesh

BACKGROUND

Sustainable Development Goal (SDG) 3.7 aims to ensure universal access to sexual and reproductive healthcare services, where antenatal care (ANC) is a core component. This study aimed to examine the influence of health facility availability and readiness on the uptake of four or more ANC visits in Bangladesh.

METHODS

The 2017/18 Bangladesh Demographic and Health Survey data were linked with the 2017 Health Facility Survey and analyzed in this study. The associations of health facility-level factors with the recommended number of ANC uptakes were determined. A multilevel mixed-effect logistic regression model was used to determine the association, adjusting for potential confounders.

RESULTS

Nearly 44% of mothers reported four or more ANC uptakes, with significant variations across several areas in Bangladesh. The average distance of mothers' homes from the nearest health facilities was 6.36 km, higher in Sylhet division (8.25 km) and lower in Dhaka division (4.45 km). The overall uptake of the recommended number of ANC visits was positively associated with higher scores for the management (adjusted odds ratio (aOR) 1.85; 95% CI, 1.16-2.82) and infrastructure (aOR, 1.59; 95% CI, 1.09-2.19) of health facilities closest to mothers' homes. The odds of using the recommended number of ANC in mothers increased by 3.02 (95% CI, 2.01-4.19) and 2.36 (95% CI, 2.09-3.16) folds for each unit increase in the availability and readiness scores to provide ANC services at the closest health facilities, respectively. Every kilometer increase in the average regional-level distance between mothers' homes and the nearest health facilities reduced the likelihood of receiving the recommended number of ANC visits by nearly 42% (aOR, 0.58, 95% CI, 0.42-0.74).

CONCLUSION

The availability of healthcare facilities close to residence, as well as their improved management, infrastructure, and readiness to provide ANC, plays a crucial role in increasing ANC services uptake. Policies and programs should prioritize increasing the availability, accessibility, and readiness of health facilities to provide ANC services.

Clinical presentation of post-COVID pain and its impact on quality of life in long COVID patients: a cross-sectional household survey of SARS-CoV-2 cases in Bangladesh

BACKGROUND

Pain is one of the prevalent Long COVID Symptoms (LCS). Pain interferes with the quality of life (QoL) and induces disease burden.

PURPOSE

The study aimed to elicit the clinical presentation of pain and determine the relationships between QoL and pain in LCS.

METHODS

This household cross-sectional study of 12,925 SARS-CoV-2 cases between July and December 2021 was carried out in eight administrative divisions of Bangladesh. Stratified random sampling from the cases retrieved from the Ministry of Health was employed. Symptom screening was performed through COVID-19 Yorkshire Rehabilitation Scale, and long COVID was diagnosed according to World Health Organization (WHO) criteria. The analyses were conducted using IBM SPSS (Version 20.00).

RESULTS

The prevalence of pain in long COVID was between 01 and 3.1% in the studied population. The study also found five categories of pain symptoms as LCS in Bangladesh: muscle pain 3.1% (95% CI; 2.4-3.8), chest pain 2.4% (95% CI; 1.8-3.1), joint pain 2.8% (95% CI; 2.2-2.3), headache 3.1% (95% CI; 2.4-3.8), and abdominal pain 0.3% (95% CI; 0.01-0.5). People with LCS as pain, multiple LCS, and longer duration of LCS had significantly lower quality of life across all domains of the WHOQOL-BREF (P < 0.001) compared to asymptomatic cases.

CONCLUSION

Three out of ten people with long COVID experience painful symptoms, which can significantly reduce their quality of life. Comprehensive rehabilitation can improve the symptoms and reduce the burden of the disease.

Patterns and determinants of healthcare utilization and medication use before and during the COVID-19 crisis in Afghanistan, Bangladesh, and India

BACKGROUND

COVID-19 rapidly spread through South Asian countries and overwhelmed the health systems that were unprepared for such an outbreak. Evidence from high-income countries showed that COVID-19 impacted healthcare utilization, including medication use, but empirical evidence is lacking in South Asia. This study aimed to investigate the effect of COVID-19 on healthcare utilization and medication use in South Asia.

METHOD

The current study used longitudinal data from the 'Premise Health Service Disruption Survey' 2020 and 2021. The countries of interest were limited to Afghanistan, Bangladesh, and India. In these surveys, data related to healthcare utilization and medication use were collected for three-time points; 'Pre-COVID phase', 'Initial phase of COVID-19 outbreak', and 'One year of COVID-19 outbreak'. Generalized estimating equation (GEE) along with McNemar's test, Kruskal-Wallis test and χ2 test were applied in this study following the conceptualization of Andersen's healthcare utilization model.

RESULT

The use of healthcare and medication was unevenly impacted by the COVID-19 epidemic in Afghanistan, Bangladesh, and India. Immediately after the COVID-19 outbreak, respondents in Bangladesh reported around four times higher incomplete healthcare utilization compared to pre-COVID phase. In contrast, respondents in Afghanistan reported lower incomplete utilization of healthcare in a similar context. In the post COVID-19 outbreak, non-adherence to medication use was significantly higher in Afghanistan (OR:1.7; 95%CI:1.6,1.9) and India (OR:1.3; 95%CI:1.1,1.7) compared to pre-COVID phase. Respondents of all three countries who sought assistance to manage non-communicable diseases (NCDs) had higher odds (Afghanistan: OR:1.5; 95%CI:1.3,1.8; Bangladesh: OR: 3.7; 95%CI:1.9,7.3; India: OR: 2.3; 95% CI: 1.4,3.6) of non-adherence to medication use after the COVID-19 outbreak compared to pre-COVID phase.

CONCLUSION

The present study documented important evidence of the influence of COVID-19 epidemic on healthcare utilization and medication use in three countries of South Asia. Lessons learned from this study can feed into policy responses to the crisis and preparedness for future pandemics.

Self-Medication Practices among Adult Population in Bangladesh: A Cross-Sectional Study

BACKGROUND

The practice of self-medication (SM) is common worldwide and is an important component of medical self-care. However, improper practice can be dangerous. This study aimed to estimate the prevalence of SM and the factors associated with it among Bangladeshi adults.

METHODS

A cross-sectional survey was conducted between April and June 2021 among Bangladeshi adults (aged > 19 years) using convenient sampling. A total of 1320 subjects were collected through face-to-face interviews using a standardized questionnaire. Multivariable logistic regression analysis was used to identify factors associated with the practice of SM.

RESULTS

Overall, 41% of adults in our survey reported SMP. The most common illnesses that prompted SM were common cold/flu (66.4%), gastric problems (65%), and headache (64.4%). The most frequent reasons for SM were to get better-perceived quality of care (30.6%), perceiving SM without side effects (23.3%), and saving time with effectiveness (14.56%). Potential risk factors included 10 years (AOR = 1.91; 95% CI: 1.04-3.50) and >12 years of schooling (AOR = 5.03; 95% CI: 2.27-11.15), being a businessman (AOR = 4.64; 95% CI: 1.74-12.37), having ≤6 family members (AOR = 2.13; 95% CI: 1.40-3.24), being a member of a social group (AOR = 1.53; 95% CI: 1.10-2.12), a health status check after every six months (AOR = 1.52; 95% CI: 1.08-2.13), and current ill-health (AOR = 1.41; 95% CI: 1.06-1.87). Protective factors identified included ≤30 years of age (AOR = 0.40; 95% CI: 0.17-0.93), and practice of modern (AOR = 0.39; 95% CI: 0.22-0.69) and herbal (AOR = 0.45; 95% CI: 0.21-0.97) treatment modality.

CONCLUSION

More than one-third of the study participants reported practicing SM. Increasing the community's awareness of the adverse outcomes of SM and not just the average experience might sway individuals away from SM, and implementing strict jurisdiction could be a way to minimize inappropriate SM.

Women's Social Mobility and Attitudinal Acceptance of Wife Abuse: A Cross-Sectional Study Among Bengali, Santal, and Garo Ethnic Communities in Rural Bangladesh

Previous studies exploring the influential factors associated with attitudinal acceptance of wife abuse (AAWA) did not widely focus on the relation between women's social mobility (WSM) and different dimensions of AAWA in rural Bangladesh. This current study examined the association between WSM and different dimensions of AAWA in the context of socio-cultural differences among the Bengali, the Santal, and the Garo ethnic communities in rural Bangladesh. Adopting a cross-sectional design, 1,929 married men and women were randomly included in the study from 8 Bengali, 8 Santal, and 8 Garo villages where 50.2% were women and 49.8% were men. Of the sample, 33.2% Garo, 33.2% Santal, and 33.6% Bengali participants were included in this study. Data revealed that 45.5% of women had low social mobility and the prevalence of different dimensions of AAWA was high and varied among the study communities. We used descriptive statistics, chi-square, and binary logistic regression analysis to estimate the association. The multivariate binary logistic regression analysis results revealed that the likelihood of attitudinal acceptance of overall abuse, psychological abuse, physical abuse, abuse on disobeying family obligation, and abuse on challenging male authority were significantly lower for the respondents who belonged to families where women enjoyed high mobility compared to those who belonged to families where WSM was low. This study also showed that the Bengali and the Santal participants were more likely to accept different dimensions of AAWA compared to the Garos. This study suggests that WSM should be considered in policy-making and implementing interventions to reduce the different dimensions of AAWA in rural Bangladesh.

Biosecurity, health and disease management practices among the dairy farms in five districts of Bangladesh

Herd health management is a planned program to optimize health, welfare, and production of dairy cows. A cross-sectional study focused on herd health management of dairy farms, was carried out to assess the biosecurity, health, and disease management practices with associated socio-demographic factors. A structured questionnaire with closed- and open-ended questions was employed for farmers' interviews to acquire information on dairy farms. Data were collected from randomly selected 205 dairy farms in five districts (Dhaka-Savar, Mymensingh, Gazipur, Rangpur, and Sirajganj) of Bangladesh. Overall, 1.5% farms had "good", 17% had "moderate" and 81.5% had "poor" levels of biosecurity, health and disease management practices (BHDMP). Analysis of variance revealed that mean BHDMP scores were significantly (p < 0.05) higher in farms of Rangpur (27.6 ± 0.8) and Gazipur (26.7 ± 0.6) than those of the other three districts. Educational status had a significant effect on BHDMP scores. The farms owned by graduated farmers had the highest mean BHDMP score (30.4 ± 1.1) while the farms operated by illiterate farmers had the lowest BHDMP score (20.4 ± 0.4). Multiple linear regression analysis also revealed that educational status (secondary to post-graduation), training experience, area of study (Rangpur district), and herd size were significantly associated with BHDMP score of the farms. The findings lay a basis for improving dairy farms' biosecurity, health and disease management practices, which further envisage the adoption and implementation of herd health management programs.

Prevalence, antibiotic resistance pattern for bacteriuria from patients with urinary tract infections

Background and Aims

Antibiotic resistance presents a significant global public health challenge, particularly for urinary tract infections (UTIs), and is notably severe in developing countries. Surveillance of the antimicrobial susceptibility patterns of UTI-causing bacteria is crucial for effective treatment selection. This study aimed to analyze these patterns in bacteria isolated from the urine samples of patients at Mughda Medical College Hospital, Dhaka, Bangladesh.

Methods

A retrospective study (January 2019 to December 2020) at Mugdha Medical College and Hospital, Dhaka, examined clinical and laboratory data from patients with positive urine cultures (≥105 CFU/mL). The study classified patients into four age groups: children (1-<18 years), young adults (18-<33 years), middle-aged adults (33-50 years), and old adults (>50 years). The standard Kirby-Bauer method was used to assess antibiotic sensitivity to 28 common antibiotics.

Results

Among 243 positive urine cultures in both community- and hospital-acquired UTIs, Escherichia coli was the most common uropathogen (65.84%), followed by Klebsiella spp. (12.34%), Enterococcus spp. (8.23%), and other types of bacteria.

Conclusion

Old adults are particularly vulnerable to UTIs, with E. coli being the predominant causative agent in the study region. The observed antimicrobial resistance patterns underscore the necessity of judicious antibiotic selection to effectively treat UTIs across different age groups.

A comprehensive dataset for sentiment and emotion classification from Bangladesh e-commerce reviews

In the rapidly evolving domain of e-commerce, analyzing customer feedback through reviews is crucial, particularly for understanding and enhancing consumer experience in the Bangladeshi market. Our comprehensive dataset, derived from two Bangladeshi e-commerce platforms, Daraz and Pickaboo, features a diverse collection of reviews in both Bengali and English, covering a broad range of products. These reviews are not only rich in linguistic variety but also encapsulate a spectrum of emotions, some even conveyed through emojis, offering a deep dive into consumer sentiment. Expert annotators have meticulously examined and categorized each review, classifying emotions into five distinct types - Happiness, Sadness, Fear, Anger, and Love - and sentiments into Positive (Happiness, Love) and Negative (Sadness, Anger, Fear) categories. This level of detailed annotation enables precise assessments of customer emotions and preferences, which are essential for evaluating and improving existing product offerings. Moreover, the insights gleaned from this dataset are invaluable for guiding future product development and uncovering new opportunities in the dynamic Bangladeshi market. Ultimately, this dataset not only serves as a significant resource for sentiment analysis using natural language processing (NLP) techniques but also contributes valuable insights into the unique consumer behavior patterns in Bangladesh, enriching the NLP community's understanding of diverse market dynamics.

Blood lead, cadmium and hair mercury concentrations and association with soil, dust and occupational factors in e-waste recycling workers in Bangladesh

BACKGROUND

Electronic waste (e-waste) recycling activities release toxic metals, which pose substantial hazard to the environment and human health. We evaluated metal concentrations in biological and environmental samples, and examined the associations between biological lead (Pb), cadmium (Cd), and mercury (Hg) with soil and dust metals, and other possible determinants, among populations exposed and non-exposed to e-waste in Bangladesh.

METHODS

A total of 199 e-waste workers and 104 non-exposed individuals were recruited. We measured blood Pb (BPb) and Cd (BCd) concentrations and total Hg (THg) from hair samples. Data were collected on occupational, and behavioral factors. We fitted an elastic net regression (ENET) to model the relationship between a set of influencing factors and metals as outcome variables while controlling for potential covariates.

RESULTS

The median concentrations of BPb (11.89 μg/dL) and BCd (1.04 μg/L) among exposed workers were higher than those of non-exposed workers (BPb: 3.63 μg/dL and BCd: 0.83 μg/L respectively). A 100 ppm increment in soil Pb level was associated with an increase in ln-Pb (transformed) in blood (β = 0.002; 95% CI = 0.00, 0.02). Similarly, ln-BCd level increased (β = 0.02; 95% CI = 0.001, 0.07) with every ppm increase in dust Cd level. The number of years worked in e-waste activities was associated with elevated ln-BPb (β = 0.01; 95% CI = 0.01, 0.02) and ln-BCd levels (β = 0.003; 95% CI = 0.00, 0.05). Smoking significantly contributed to elevated levels of ln-BCd (β = 0.46; 95% CI = 0.43, 0.73). An increment of 100 kg of e-waste handling per week led to an increase in ln-BPb levels (β = 0.002; 95% CI = 0.00, 0.01), while respondents knowledge about adverse impact on e-waste reduced the ln-BPb level (β = -0.14; 95% CI = -0.31, -0.03). Fish consumption frequency had a positive association with THg in hair.

CONCLUSIONS

Our data show the need for workplace controls to reduce exposure to Pb and Cd with a broader view of exposure source taken.

Assessment of microplastic contamination in shrimps from the Bay of Bengal and associated human health risk

Microplastics (MPs) were analyzed in seven shrimp species Tiger shrimp (Penaeus monodon), Red tiger shrimp (Caridina cantonensis), Indian shrimp (Penaeus indicus), Red shrimp (Metapenaeus dobsoni), White shrimp (Penaeus merguiensis), Brown shrimp (Metapenaeus monoceros), and Roshna shrimp (Palaemon styliferus) collected from the Bay of Bengal. The abundance and characteristics of MPs were assessed in the gastrointestinal tract (GIT), which certainly translocated to the muscle of shrimp species. The highest MP abundance was found in C. cantonensis with 7.2 items/individual (25.3 items/g in the GIT and 6.3 items/g in muscle). The prominent types of MPs in shrimp samples were fibers (30 %) and fragments (29 %). The ingestion rate of MPs of black and transparent color was comparatively higher, with 64 % of the ingested MPs were < 100 μm. The primary polymer types detected based on Fourier Transform Infrared (FTIR) analysis were Low-Density Polyethylene (LDPE), High-Density Polyethylene (HDPE), Polymethyl Methacrylate (PMMA), Polyvinyl Chloride (PVC), Polypropylene (PP), and Ethylene Vinyl Acetate (EVA). Results from Scanning Electron Microscopy (SEM) showed rough surface textures and adhered particles on the MPs isolated from shrimps. The margin of exposure for females was 71.42, and for males, it was 80.64, indicating that women in Bangladesh are more likely to be exposed to MPs and face a higher risk than men. Sensitivity analysis revealed that MPs particle size was the most sensitive parameter. These findings provide a comprehensive understanding of MP ingestion, human exposure, and contamination in shrimps of Bangladesh, which can help future monitoring efforts.

Understanding the impacts of COVID-19 pandemic on mental health and well-being among university students in Dhaka, Bangladesh: A nested mixed-methods study

Background

University students are more at risk of mental illness compared with the general population. Declaration of a global COVID-19 pandemic led the Bangladesh government in March 2020 to implement a national lockdown, home quarantining, social distancing measures, and closure of educational institutions. We aimed to explore the impact of lockdown on the mental health and well-being of university students in Bangladesh.

Methods

A nested mixed-methods survey design was undertaken using a semi structured questionnaire and in-depth interviews conducted by telephone of 73 university students (mean age of 22 years, range 18 to 26-years-old) attending public and private academic institutions in Dhaka. A questionnaire was developed de-novo and pre-tested. Qualitative, open-ended questions were used to understand experiences regarding students' mental health and well-being, their perceptions of COVID-19, and coping strategies.

Results

Fifty nine percent of students reported that lockdown had a significant impact on their mental health and well-being. They described difficulties with social isolation and loneliness, motivation, and interpersonal conflict within families. Students' knowledge of COVID-19 were high with television, newspapers, online, and social media were main sources of information; few relied on government reports. Most pressing concerns were timely graduation and employment (83%), not being able to socialize (46%), being stuck at home (37%), and financial difficulties regarding university fees (29%). Additional underlying stressors included financial insecurity of respondents' households and parental health. Coping strategies included watching television or films, online meetings with friends, social media, as well interactions with family.

Conclusion

As a result of Bangladesh's first national lockdown, university students experienced negative effects on their mental health and well-being. There is an urgent need for greater proactive measures within educational settings, such as mental health literacy programmes and diagnosis management that could mitigate and prevent adverse impacts of future lockdowns.

Socio-economic status and pregnancy complications and their impact on antenatal care services provided at home and Upazila health complex

The stage of pregnancy is crucial for women of reproductive age and their families. However, in low- and middle-income countries like Bangladesh, antenatal and postnatal care are not widely practiced due to various socio-economic factors, such as low education levels, income, age, pregnancy knowledge, and limited healthcare facilities. The objective of this study was to examine the factors associated with antenatal care in two locations in Bangladesh based on the data collected from the Bangladesh Demographic and Health Survey (BDHS) 2017-2018. We explored different variables as explanatory variables related to ANC service. The results showed that most of the respondents were from rural areas, with 77.02% receiving antenatal care at home. Women with secondary education were more likely to receive care at home than those without education. The Chi-square test indicated a positive correlation between antenatal care at home with several variables, whereas, in the case of Upazila health complexes, only three variables showed a positive association. Logistic regression analysis further showed some specific variables such as geographical division, religion, iron intake during pregnancy, and reporting pregnancy complications had a significant impact on ANC at home. In contrast, covariates such as residence, division, and wealth index were significant for antenatal care at Upazila health complexes. The division was a significant covariate in both cases. Interestingly, we observed that mothers who had been informed about the signs of pregnancy complications were 92% more likely to receive antenatal care at home than those who had not experienced pregnancy complications. Conversely, the results revealed that mothers who were unaware of pregnancy complications were 32% more likely to receive antenatal care at home than those who had been informed about complications. This suggests that when women are educated about pregnancy complications, they are more likely to receive more antenatal care. However, Bangladesh's situation is quite different due to a lack of proper education and knowledge of antenatal care services.

Klebsiella pneumoniae

We unveil the genomic sequence of the Klebsiella pneumoniae Hakim-RU strain isolated from a patient with urinary tract infections. Our assembled genome spans 4.3 Mb with 73.0× coverage, an average GC content of 57.41%, 4 plasmids, 2 CRISPR arrays, 10 prophages, 41 antibiotic resistance genes, and 6 virulence factor genes.

Assessment of preventive practices towards hepatitis B infection among nursing students in Bangladesh: role of knowledge, attitudes and sociodemographic factors

BACKGROUND

Globally, hepatitis B infection (HBI) poses a substantial public health concern and healthcare workers, including nursing students, are at a higher risk of contracting this disease. Thus, the study aimed to assess how knowledge, attitudes, and sociodemographic factors are associated with HBI prevention among a sample of Bangladeshi nursing students.

METHODS

A cross-sectional survey was performed among 737 nursing students from the nursing institutes of Khulna and Barishal divisions in Bangladesh from January to April 2023. The data were collected by providing questionnaires (structured questionnaire) in the classroom, following a stratified random sampling process. A model of multinomial logistic regression was used to evaluate the factors linked to HBI prevention practices.

RESULT

The mean (SD) scores were 11.42 (± 2.88) for knowledge, 4.33 (± 1.91) for attitude and 4.27 (± 2.056) for practice respectively. Participants' low knowledge (adjusted odds ratio, aOR = 2.562, 95% CI: 1.29-5.07) and poor attitude (aOR = 5.730, 95% CI: 3.19-10.28) regarding HBI were significantly associated with higher likelihood of poor practice towards HBI prevention. Moreover, being 2nd year of nursing students (aOR = 2.147, 95% CI: 1.19-3.86), being aged 19-20 years (aOR = 3.038, 95% CI: 1.30-7.09), being married (aOR = 0.320, 95%CI: 0.13-0.82) and having a family history of HBI (aOR = 0.134, 95%CI: 0.05-0.36) were significantly associated with poor practices of HBI prevention among study participants.

CONCLUSION

The knowledge, attitude and practice scores of the nursing students on HBI prevention were suboptimal. We advocate for implementing regular HBI prevention education and policies, free or subsidized services, skill development, proper HBI prevention enforcement and strict professional ethics within nursing colleges. Such efforts should predominantly focus on second-year, aged 19-20 and unmarried nursing students.

Greening the grid: A comprehensive review of renewable energy in Bangladesh

The escalating global demand for energy has coincided with economic development, while Bangladesh's reliance on renewable energy remains modest at 4.59%. Investigating economically viable solutions such as solar, biomass, and other renewable sources, the research underscores the pivotal role of sound policies and a strategic plan in transforming the current energy landscape. Despite facing various challenges, particularly in technology, the implementation of sound policies and a strategic plan can substantially alter the current landscape. By reviewing the Renewable Energy Policy of 2008 and incorporating recommendations from United States Agency for International Development (USAID) in 2023, this paper not only delves into challenges and future prospects but also aligns with the Sustainable Development Goal (SDG) aimed at achieving affordable and clean energy. This study contributes valuable insights by proposing methodologies to generate renewable energy by offering a comprehensive overview of the present energy scenario in Bangladesh, with a focus on strategic policy recommendations, thus surpassing previous efforts in the literature. The paper, in its entirety, strives to foster the adoption of renewable energy while concurrently mitigating reliance on conventional fossil fuels.

Unraveling birth weight determinants: Integrating machine learning, spatial analysis, and district-level mapping

Despite a decrease in the prevalence of low birth weight (LBW) over time, its ongoing significance as a public health concern in Bangladesh remains evident. Low birth weight is believed to be a contributing factor to infant mortality, prolonged health complications, and vulnerability to non-communicable diseases. This study utilizes nationally representative data from the Multiple Indicator Cluster Surveys (MICS) conducted in 2012-2013 and 2019 to explore factors associated with birth weight. Modeling birth weight data considers interactions among factors, clustering in data, and spatial correlation. District-level maps are generated to identify high-risk areas for LBW. The average birth weight has shown a modest increase, rising from 2.93 kg in 2012-2013 to 2.96 kg in 2019. The study employs a regression tree, a popular machine learning algorithm, to discern essential interactions among potential determinants of birth weight. Findings from various models, including fixed effect, mixed effect, and spatial dependence models, highlight the significance of factors such as maternal age, household head's education, antenatal care, and few data-driven interactions influencing birth weight. District-specific maps reveal lower average birth weights in the southwestern region and selected northern districts, persisting across the two survey periods. Accounting for hierarchical structure and spatial autocorrelation improves model performance, particularly when fitting the most recent round of survey data. The study aims to inform policy formulation and targeted interventions at the district level by utilizing a machine learning technique and regression models to identify vulnerable groups of children requiring heightened attention.

Soil erodibility mapping of hilly watershed using analytical hierarchy process and geographical information system: A case of Chittagong hill tract, Bangladesh

Soil erosion across watersheds and river basins is an alarming environmental deterioration process that poses severe risks to hydrological systems, hydrogeochemical processes, agricultural productivity, and the global natural ecosystem. The use of the Analytical Hierarchy Process (AHP) and Geographical Information System (GIS) to assess soil erosivity for the watershed is widely known. This study applied the AHP and GIS to understand the degree of erosivity of the hilly Karnaphuli watershed in Chattogram, Bangladesh. The study used topographical maps, soil maps, and satellite imagery datasets. It implemented the GIS-based AHP and weighted overlay technique to derive eight factors (slope, elevation, Stream Power Index (SPI), Land Use and Land Cover (LULC), curvature, soil, Topographic Wetness Index (TWI), and rainfall. The geological stage of erosion potential was also identified using Digital Elevation Model (DEM) data through GIS-based hypsometric analysis. The findings demonstrated that the eastern and north-western parts are particularly vulnerable to erosion compared to other parts of the study area. The most dominant variables identified to influence the process of soil erosion are slope, LULC, elevation, and SPI. According to the AHP analysis, slope was the most influential factor (26%), followed by LULC (23.8%), elevation (20.3%), and SPI (13.9%) in the soil erosion process, and the geological stage of erosion potential was determined from the hypsometric curve (S-shaped) and hypsometric integral (0.49), which revealed that moderately eroded areas characterized the whole research region. The findings are significant as they provide valuable information for researchers and planners to address soil erosion and develop measures to control it effectively.

Assessing stocks of Mystus tengara (Hamilton, 1822) from three different management systems in Baors (Oxbow lake) of southwest Bangladesh: Implications for sustainable management

This study was conducted to observe the stock assessments of Tengara (Mystus tengara) in three different management systems of Baors (Oxbow lake) such as System-1, System-2, and System-3. In this study, 1806 specimens were sampled using traditional fishing nets to observe growth pattern, population structure, growth parameters, natural mortality (M), fishing mortality (F), total mortality (Z), recruitment pattern, exploitation rate (E), relative yield per-recruit (Y'/R), optimum catchable length, length at first capture, steady state biomass (SSB), and maximum sustainable yield (MSY) from January to December 2021. Digital slide calipers and a digital balance were used to measure each individual's total length (TL) and body weight (BW), respectively. An empirical maximum length-based model was used to calculate size at first sexual maturity (Lm), and optimum catchable length (Lopt) was calculated based on asymptotic length (L∞). The least square linear regression equation was used to determine the regression parameters. The value of regression parameter, 'b' was 3.01 for system-1, 2.78 for system-2, and 2.70 for system-3, indicating that growth pattern of Tengara is isometric in system-1, but negative allometric growth in system-2 and system-3. The highest asymptotic length (L∞) and weight (W∞) of Tengara were found in system-1 (11.19 cm and 13.67 g) in comparison with system-2, (10.98 cm and 12.49 g) and system-3 (9.09 cm and 6.96 g) respectively. The growth coefficient (K) of the von Bertalanffy growth function (VBGF) was 0.72 year-1, 0.72 year-1, and 0.73 year-1 for system-1, system-2 and system-3, respectively. The calculated M, F, Z were 1.72, 1.28, and 3.00 year-1 for system-1, 1.11, 0.67 and 1.78 year-1 for system-2 and 1.12, 0.84 and 1.96 year-1 for system-3 respectively. The calculated life span (tmax) was found 4.19 years for system-1, 4.15 years for system-2 and 4.12 years for system-3. The recruitment patterns showed that the highest relative percentage of recruits were found in July, June and September for system-1, system-2 and system-3 respectively, with the major recruitment peak occurring from April to June for system-1, May to June for system-2 and June to July for system-3. One minor recruitment peak also occurred from August to September in system-1. The exploitation rate was more or less same in all three systems indicating that Tengara is under exploited from all the Baors. The significantly highest SSB and MSY were found in system-1 (22.65 and 12.11 metric tons), compared to system-2 (16.16 and 10.28 metric tons) and system-3 (5.55 and 5.49 metric tons), respectively. Considering the values of regression parameters, recruitment pattern, SSB and MSY, system-1 was found more suitable for Tengara compared to system-2 and system-3 management practices of Baors. Finally, these findings will turn out to be paradigm for the impregnable management of Tengara in Baors of southwest Bangladesh.

Prediction of suicidal ideation with associated risk factors among university students in the southern part of Bangladesh: Machine learning approach

BACKGROUND

The prevalence of suicidal ideation has become an urgent issue, particularly among adolescents. The primary objective of this research is to determine the prevalence of suicidal ideation among students in the southern region of Bangladesh and to predict this phenomenon using machine learning (ML) models.

METHODS

The data collection process involved using a simple random sampling technique to gather information from university students located in the southern region of Bangladesh during the period spreading from April 2022 to June 2022. Upon accounting for missing values and non-response rates, the ultimate sample size was determined to be 584, with 51.5 % of participants identifying as male and 48.5 % female.

RESULTS

A significant proportion of students, precisely 19.9 %, reported experiencing suicidal ideation. Most participants were female (77 %) and unmarried (78 %). Within the machine learning (ML) framework, KNN exhibited the highest accuracy score of 91.45 %. In addition, the Random Forest (RF), and Categorical Boosting (CatBoost) algorithms exhibited comparable levels of accuracy, achieving scores of 90.60 and 90.59 respectively.

LIMITATIONS

Using a cross-sectional design in research limits the ability to establish causal relationships.

CONCLUSION

Mental health practitioners can employ the KNN model alongside patients' medical histories to detect those who may be at a higher risk of attempting suicide. This approach enables healthcare professionals to take appropriate measures, such as counselling, encouraging regular sleep patterns, and addressing depression and anxiety, to prevent suicide attempts.

Effectiveness of a hand hygiene training intervention in improving knowledge and compliance rate among healthcare workers in a respiratory disease hospital

Background

Practicing hand hygiene (HH) is a crucial element of infection control, with healthcare workers (HCWs) playing a vital role in preventing the spread of infection. However, inadequate knowledge and non-compliance to HH protocols pose significant challenges in healthcare settings. This study aimed to evaluate the effectiveness of an HH training intervention in enhancing knowledge and staff compliance within a respiratory disease hospital.

Method

A pre-and post-training study was conducted among the healthcare workers in a respiratory disease treatment facility. The intervention comprised a series of 3-hour training sessions conducted over five days, focusing on the World Health Organization's (WHO) recommended guideline "Your Five Moments For Hand Hygiene." These sessions covered proper HH techniques and underscored the repercussions of inadequate compliance. Educational materials related to HH were displayed in prominent locations throughout the facility. The knowledge levels and compliance rate were assessed before and after the intervention.

Result

The intervention significantly improved HH knowledge levels and compliance rates among the participants. Marking a significant improvement, the compliance rate of HH protocols increased from 66.0% to 88.3% during the pre-to post-training period, with a concurrent increase in the mean knowledge score from 68.6% to 78.9%.

Conclusion

This study underscores the potential of training and education in elevating HH compliance and knowledge among healthcare workers. The findings advocate that healthcare facilities routinely incorporate such interventions into their infection control programs, ultimately improving patient and healthcare worker safety.

Two decades of endemic dengue in Bangladesh (2000-2022): trends, seasonality, and impact of temperature and rainfall patterns on transmission dynamics

The objectives of this study were to compare dengue virus (DENV) cases, deaths, case-fatality ratio [CFR], and meteorological parameters between the first and the recent decades of this century (2000-2010 vs. 2011-2022) and to describe the trends, seasonality, and impact of change of temperature and rainfall patterns on transmission dynamics of dengue in Bangladesh. For the period 2000-2022, dengue cases and death data from Bangladesh's Ministry of Health and Family Welfare's website, and meteorological data from the Bangladesh Meteorological Department were analyzed. A Poisson regression model was performed to identify the impact of meteorological parameters on the monthly dengue cases. A forecast of dengue cases was performed using an autoregressive integrated moving average model. Over the past 23 yr, a total of 244,246 dengue cases were reported including 849 deaths (CFR = 0.35%). The mean annual number of dengue cases increased 8 times during the second decade, with 2,216 cases during 2000-2010 vs. 18,321 cases during 2011-2022. The mean annual number of deaths doubled (21 vs. 46), but the overall CFR has decreased by one-third (0.69% vs. 0.23%). Concurrently, the annual mean temperature increased by 0.49 °C, and rainfall decreased by 314 mm with altered precipitation seasonality. Monthly mean temperature (Incidence risk ratio [IRR]: 1.26), first-lagged rainfall (IRR: 1.08), and second-lagged rainfall (IRR: 1.17) were significantly associated with monthly dengue cases. The increased local temperature and changes in rainfall seasonality might have contributed to the increased dengue cases in Bangladesh.

The effectiveness of a government-sponsored health protection scheme in reducing financial risks for the below-poverty-line population in Bangladesh

The Government of Bangladesh is piloting a non-contributory health protection scheme called Shasthyo Surokhsha Karmasuchi (SSK) to increase access to quality essential healthcare services for the below-poverty-line (BPL) population. This paper assesses the effect of the SSK scheme on out-of-pocket expenditure (OOPE) for healthcare, catastrophic health expenditure (CHE) and economic impoverishment of the enrolled population. A comparative cross-sectional study was conducted in Tangail District, where the SSK was implemented. From August 2019 to March 2020, a total of 2315 BPL households (HHs) (1170 intervention and 1145 comparison) that had at least one individual with inpatient care experience in the last 12 months were surveyed. A household is said to have incurred CHE if their OOPE for healthcare exceeds the total (or non-food) HH's expenditure threshold. Multiple regression analysis was performed using OOPE, incidence of CHE and impoverishment as dependent variables and SSK membership status, actual BPL status and benefits use status as the main explanatory variables. Overall, the OOPE was significantly lower (P < 0.01) in the intervention areas (Bangladeshi Taka (BDT) 23 366) compared with the comparison areas (BDT 24 757). Regression analysis revealed that the OOPE, CHE incidence at threshold of 10% of total expenditure and 40% of non-food expenditure and impoverishment were 33% (P < 0.01), 46% (P < 0.01), 42% (P < 0.01) and 30% (P < 0.01) lower, respectively, in the intervention areas than in the comparison areas. Additionally, HHs that utilized SSK benefits experienced even lower OOPE by 92% (P < 0.01), CHE incidence at 10% and 40% threshold levels by 72% (P < 0.01) and 59% (P < 0.01), respectively, and impoverishment by 27% at 10% level of significance. These findings demonstrated the significant positive effect of the SSK in reducing financial burdens associated with healthcare utilization among the enrolled HHs. This illustrates the importance of the nationwide scaling up of the scheme in Bangladesh to reduce the undue financial risk of healthcare utilization for those in poverty.

Stakeholder perspectives of mental healthcare services in Bangladesh, its challenges and opportunities: a qualitative study

This study explores Bangladesh's mental health services from an individual- and system-level perspective and provides insights and recommendations for strengthening it's mental health system. We conducted 13 in-depth interviews and 2 focus group discussions. Thirty-one participants were recruited using a combination of purposive and snowball sampling methods. All interviews and group discussions were audio-recorded and transcribed, and key findings were translated from Bengali to English. Data were coded manually and analysed using a thematic and narrative analysis approach. Stakeholders perceived scarcity of service availability at the peripheral level, shortage of professionals, weak referral systems, lack of policy implementation and regulatory mechanisms were significant challenges to the mental health system in Bangladesh. At the population level, low levels of mental health literacy, high societal stigma, and treatment costs were barriers to accessing mental healthcare. Key recommendations included increasing the number of mental health workers and capacity building, strengthening regulatory mechanisms to enhance the quality of care within the health systems, and raising awareness about mental health. Introducing measures that relate to tackling stigma, mental health literacy as well as building the capacity of the health workforce and governance systems will help ensure universal mental health coverage.

Heavy Metals in Common Fishes Consumed in Dhaka, a Megacity of Asia: A Probabilistic Carcinogenic and Non-Carcinogenic Health Hazard

Heavy metal contamination of fish is a serious public health concern worldwide, including in Bangladesh. In this study, six commonly consumed fish species namely Hilsha (Tenualosa ilisha), Kachki (Corica soborna), Punti (Puntitus ticto), Taki (Channa punctatus), Meni (Nandus nandus), and Tengra (Mystus tengara) were analyzed for arsenic (As), cadmium (Cd), lead (Pb), zinc (Zn), copper (Cu), chromium (Cr), manganese (Mn), and nickel (Ni), by inductively coupled plasma mass spectrometry. The fish samples were collected from wholesale markets in Dhaka city, the main business hub of Bangladesh where the fishes converged from countrywide and are redistributed to the whole city. The metal concentration varied among the studied fish species. Hilsha, the national fish of Bangladesh, contained the highest As among the other fishes of this study, whereas Zn, Cd, Cu, Mn, and Ni were the highest in Kachki, and Pb and Cr were the highest in Tengra. The probable source of metal accumulation in the fish species may be the river or marine water that can be contaminated by industrial waste, pesticide, and/or fertilizer use in agriculture and/or commercial fish feeds. All analyzed fish species showed serious heavy metal pollution, having high average pollution load index (APLI) values (> 1). The estimated daily intake (EDI) values for the metals were lower than the maximum tolerable daily intake (MTDI). The hazard index (HI) for all the fish species was above 1 for adults, showing non-carcinogenic health risks. The target carcinogenic risk (TCR) values were below the acceptable limit (10-4) for most of the metals, indicating safe for consumption with respect to the risk of cancer.

from tilapia and shrimp sold at wet markets in Dhaka, Bangladesh

Wet markets in low-and middle-income countries are often reported to have inadequate sanitation resulting in fecal contamination of sold produce. Consumption of contaminated wet market-sourced foods has been linked to individual illness and disease outbreaks. This pilot study, conducted in two major wet markets in Dhaka city, Bangladesh during a 4-month period in 2021 aimed to assess the occurrence and characteristics of Escherichia coli and non-typhoidal Salmonella spp. (NTS) from tilapia (Oreochromis niloticus) and shrimp (Penaeus monodon). Fifty-four individuals of each species were collected. The identity of the bacterial isolates was confirmed by PCR and their susceptibility toward 15 antimicrobials was tested by disk diffusion. The whole genome of 15 E. coli and nine Salmonella spp. were sequenced using Oxford Nanopore Technology. E. coli was present in 60-74% of tilapia muscle tissue and 41-44% of shrimp muscle tissue. Salmonella spp. was found in skin (29%) and gills (26%) of tilapia, and occasionally in muscle and intestinal samples of shrimp. The E. coli had several Multilocus sequence typing and serotypes and limited antimicrobial resistance (AMR) determinants, such as point mutations on glpT and pmrB. One E. coli (BD17) from tilapia carried resistance genes for beta-lactams, quinolones, and tetracycline. All the E. coli belonged to commensal phylogroups B1 and A and showed no Shiga-toxin and other virulence genes, confirming their commensal non-pathogenic status. Among the Salmonella isolates, five belonged to Kentucky serovar and had similar AMR genes and phenotypic resistance patterns. Three strains of this serovar were ST198, often associated with human disease, carried the same resistance genes, and were genetically related to strains from the region. The two undetermined sequence types of S. Kentucky were distantly related and positioned in a separate phylogenetic clade. Two Brunei serovar isolates, one Augustenborg isolate, and one Hartford isolate showed different resistance profiles. This study revealed high fecal contamination levels in tilapia and shrimp sold at two main wet markets in Dhaka. Together with the occurrence of Salmonella spp., including S. Kentucky ST198, a well-known human pathogen, these results stress the need to improve hygienic practices and sanitation standards at markets to improve food safety and protect consumer health.

Impacts of climate change-induced natural hazards on women and their human rights implications: A study in the southwest coast of Bangladesh

Women in coastal areas are particularly vulnerable to climate change impacts due to existing gender inequality and socio-cultural norms in Bangladesh. This research aims to explore the vulnerability of women to climate change-induced natural hazards, the challenges they face due to the chain impacts of climate change, and the resulting violation of women's rights. Quantitative and qualitative data were used in this study, where 260 structured questionnaire surveys and 15 Focus Group Discussions were performed at Mongla and Shyamnagar Upazilas in Bagerhat and Satkhira districts, respectively. The quantitative data were analyzed using SPSS 26.0 software, and qualitative data was analyzed thematically. The results disclose that most respondents in Mongla and Shyamnagar reported an increase in the occurrence rate of climate change-induced natural hazards, with cyclones, salinity, and riverbank erosion being the most devastating in Mongla and cyclones, salinity, and storm surges in Shyamnagar. It affects the lives and livelihoods of people, with women being particularly vulnerable due to limited access to education, healthcare, and economic opportunities, and women's rights are violated in these areas. Half of the study area's population has been suffering from infections or inflammation in reproductive organs, especially among fisherwomen. The findings of this study recommend that provisions for alternative livelihoods should be made for women, and all women must be brought under the umbrella of fair social safety net programs.

Origin, spatial distribution, sediment contamination, ecological and health risk evaluation of trace metals in sediments of ship breaking area of Bangladesh

Eleven trace metals (Cd, Cr, Fe, Mn, Cu, Ni, Co, Zn, As, Pb, and Ag) in sediments of Bangladesh's ship breaking area were measured by an atomic absorption spectrometer to determine origin, contamination extent, spatial distributions, and associated ecological and human health hazards. This study found considerable quantities of Pb, Cd, Mn, Zn, and Cu when compared with standards and high levels of Pb, Cd, Zn, Cu, As, and Ag contamination according to pollution evaluation indices. Different indices indicate most of the sampling sites were highly polluted. However, spatial distribution maps indicate that trace metals were predominantly deposited in the northern and southern region. The ecological risk index revealed that Cd has the highest while Pb and As had moderate risk. Based on the health index values, Zn for both adults and children were higher than the safe limit while Mn, Pb, Cr, As, Fe, Cu, Ni, and Co for children were close to the threshold. The mean total carcinogenic risk values of Cr, As, and Ni for children and Ni for adults exceeded the permissible threshold. The cancer risk possibilities were further assessed using Monte Carlo simulation. Most trace metals have anthropogenic origins, which were attributed to ship breaking activities.

Assessment of the feasibility of a community-based mental health training programme for persons with disabilities by non-specialists from different stakeholders' perspectives in Bangladesh

INTRODUCTION

Bangladesh is a developing country where 11% of the population has at least one disability, but no community-level mental health service is available. There is limited evidence of the burden of mental health issues and health-seeking behaviour among this population. This study assessed the feasibility of a training intervention for persons with disabilities, where peer support providers provided community-based disability-inclusive mental health services.

METHODS

Four stakeholder groups participated in this qualitative study: peer responders (trained persons with disabilities), trainers, representatives of organisations of persons with disabilities and disability-specific organisations, and officials of international and national non-governmental organisations. Two types of qualitative interviews were used to collect data, and thematic analysis techniques were utilised.

RESULT

Stakeholders perceived the peer responder training programme as acceptable for persons with disabilities to develop themselves as peer support providers, with potential benefits including increased mental health literacy, ensuring accessible mental health services, and improving the well-being of persons with disabilities. Potential challenges included receiving training and delivering services. Increased training duration, more fieldwork, supervision opportunities, and refresher training were recommended to mitigate training challenges. Financial support and formal community recognition were deemed necessary for training delivery.

CONCLUSION

The peer responder training programme was feasible to ensure accessible mental health services for persons with disabilities, build a workforce to screen for mental health conditions, and provide appropriate referrals. A multi-sectoral collaboration of government and non-governmental institutions is recommended to policy advocates to expand the peer responder training programme in the mainstream mental healthcare system.

Perceptions and attitudes of Rohingya community stakeholders to pregnancy termination services: a qualitative study in camps of Cox's Bazar, Bangladesh

BACKGROUND

Rohingya women suffer from inaccessibility to sexual and reproductive health services in Myanmar. After the forcible displacement of the Rohingya from Myanmar to Bangladesh in 2017, pregnancy termination services have been increasingly important and desired, while knowledge gaps and obstacles to access services still exist. The role of community stakeholders is critical as gatekeepers and decision-makers to improve and strengthen pregnancy termination services for women in camps. However, there is paucity of evidence on their perspectives about pregnancy termination. This qualitative study aims to understand the perception and attitudes of Rohingya community stakeholders to pregnancy termination in the camps of Cox's Bazar.

METHODS

We used purposive sampling to select 48 participants from the community stakeholders, 12 from each group: majhis (Rohingya leaders), imams (religious leaders), school teachers, and married men. We conducted in-depth interviews of all the participants between May-June 2022 and October-November 2022. Data were coded on Atlas.ti and analysed using a thematic content analysis approach.

RESULTS

Multiple socio-cultural and religious factors, gendered norms and stigma associated with pregnancy termination acted as barriers to women seeking services for it. From a religious stance, there was greater acceptance of pregnancy termination in the earlier period than in the later period of pregnancy. We observed that pregnancy termination among community stakeholders in earlier stages of pregnancy than later. However, circumstances, such as a woman's marital status, whether she sought her husband's permission or her ability of childcare capacity, were often framed by community stakeholders as 'acceptable' for pregnancy termination. Health concerns and social and contextual factors can influence community stakeholders supporting pregnancy termination.

CONCLUSIONS

The community stakeholders perspectives on barriers and enablers of pregnancy termination were variable with the context. These perspectives may support or impede women's ability to choice to seek pregnancy termination services. To improve women's choice to pregnancy termination, it is critical to consider roles of community stakeholders in creating their supporting attitudes to women's choice and access, and to designing targeted culturally appropriate interventions with communities support and engagement.

Skipping breakfast and its association with sociodemographic characteristics, night eating syndrome, and sleep quality among university students in Bangladesh

INTRODUCTION

Skipping breakfast has become more common, and it can significantly affect a person's health, performance, mood, and other physiological and psychological factors. In Bangladesh, university students often encounter unhealthy dietary habits, which raises questions about why many university students choose to skip breakfast. The purpose of this study was to investigate the prevalence of skipping breakfast among university students in Bangladesh and explore the contributing factors.

METHODS

Patuakhali Science and Technology University, Bangladesh was the location of this cross-sectional study. Breakfast consumption was measured with the single-question item, "How often do you eat breakfast?" (Almost every day, sometimes, rarely, or never). Skipping breakfast was classified as respondents selecting sometimes, rarely, or never having breakfast. Sociodemographic, behavioral, and sleep-related data were collected as key predictor variables. Multiple logistic regression models identified factors associated with skipping breakfast.

RESULTS

The prevalence of skipping breakfast among study participants (N = 502, 51.6% female and mean age 21.31 years) was 63.5%. Female students were more likely to skip breakfast compared to male students (adjusted odds ratio, AOR = 1.65, 95% CI: 1.06-2.55). Smoker participants had a higher likelihood of skipping breakfast compared to non-smokers (AOR = 3.92, 95% CI: 1.57-9.78). Students with night eating syndrome had a higher likelihood of skipping breakfast compared to their counterparts (AOR = 1.84, 95% CI: 1.06-3.22). Students with poor sleep quality were three times more likely to skip breakfast than their counterparts (AOR = 2.95, 95% CI: 1.93-4.51). Overweight/obese students were less likely to skip breakfast compared to their counterparts (AOR = 0.40, 95% CI: 0.20-0.82).

CONCLUSION

This study highlights a high prevalence of skipping breakfast among university students in Bangladesh. Specifically, students who are females, smokers, poor sleepers and who have night eating syndrome are more likely to skip breakfast compared to their counterparts. These findings underscore a need for targeted interventions and educational programs to promote healthy breakfast habits. Addressing these modifiable risk factors can have a positive impact on students' nutritional practices and their health and wellbeing.

Genetic characterization of methicillin-resistant / susceptible Staphylococcus aureus (MRSA/MSSA) and Staphylococcus argenteus clinical isolates in Bangladesh: Dominance of ST6-MRSA-IV/t304 and detection of cfr/fexA in ST8-MSSA/t008

Objectives

Coagulase-positive staphylococcus (CoPS), represented by Staphylococcus aureus, is a major cause of infections in humans. This study aimed to investigate molecular epidemiological characteristics, antimicrobial resistance, and their trends of CoPS in Bangladesh.

Methods

Clinical isolates of CoPS were collected from two medical institutions in Bangladesh for a 2-year period and analyzed for their species, genotypes, virulence factors, antimicrobial susceptibility, and resistance determinants.

Results

172 CoPS isolates collected were identified as S. aureus or S. argenteus (170 and two, respectively). Methicillin-resistant S. aureus (MRSA) accounted for 36% (n = 61), having Staphylococcal cassette chromosome mec (SCCmec)-IV (82%) or V (18%). Panton-Valentine leukocidin (PVL) genes were detected at higher rate in methicillin-susceptible S. aureus (MSSA) (62%) than MRSA (26%). MRSA comprised 11 STs, including a dominant type ST6 (46%) associated with mostly SCCmec-IVa/spa-t304, and one isolate had genetic features of the USA300 clone (ST8/SCCmec-IVa/coa-IIIa/spa-t008/ACME-I/ΦSa2USA). STs of CC1, CC88, and CC398 were common in MSSA, with CC88 showing the highest PVL-positive rate. One MSSA isolate (ST8/spa-t008) harbored fexA and cfr showing susceptibility to linezolid. S. argenteus was methicillin-susceptible and belonged to ST2250/coa-XId.

Conclusions

Genetic characteristics of current MRSA/MSSA in Bangladesh were revealed, with first identification of S. argenteus at low prevalence.