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.

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.

Internet addiction, depressive symptoms, and anxiety symptoms are associated with the risk of eating disorders among university students in Bangladesh

The risk of developing an eating disorder among university students is higher than the general population in Bangladesh. Since psychiatric disorders (such as depression and anxiety) and addictive behaviors (e.g., internet addiction) predominantly exist among university students in the country, these may increase their vulnerability to developing an eating disorder. The association of internet addiction, depression, and anxiety with the risk of eating disorders among Bangladeshi university students is relatively unknown; therefore, this study investigates the association. This study was a cross-sectional design. Students (N = 700) from two public universities in Bangladesh completed the Patient Health Questionnaire (PHQ-9) scale, the Generalized Anxiety Disorder (GAD-7) tool, and Orman's Internet Addiction Survey (OIAS) to measure exposure variables. Eating Attitudes Test-26 (EAT-26) assessed the outcome variable. Multivariable logistic regression analysis showed that internet addiction [adjusted odds ratio (aOR) for moderate addiction = 2.15 and severe addiction = 3.95], depressive (aOR 3.04), and anxiety (aOR 2.06) symptoms were associated with an increased risk of eating disorder among study participants. Future longitudinal studies on university students are recommended to gain a better understanding about the causal factors of eating disorder to support intervention initiatives and strategies by public health practitioners and policy experts.

Prevalence and predictors of binge eating disorder symptoms among a sample of university students in Bangladesh: A cross-sectional survey

Background and Aims

There is a dearth of information about binge eating disorder (BED) among Bangladeshi university students, who may be more susceptible to BED due to the rise in unhealthy lifestyles and food habits. Therefore, the purpose of this study was to assess the prevalence and associated factors of BED symptoms among Bangladeshi university students.

Methods

Students (N = 525) from three public universities in Bangladesh participated in this cross-sectional study between November 2022 and March 2023. Face-to-face interviews were conducted using a structured paper-based questionnaire that included two validated survey tools; the binge eating disorder screener and the patient health questionnaire-9. To identify the factors associated with BED symptoms, multiple logistic regression analysis was conducted, with sociodemographic and behavioral information (e.g., age, sex, smoking status, etc.) considered as covariates.

Results

The prevalence of BED symptoms among participants (mean age 21.28 years, 50.3% male and 49.7% female) was 20.6%. Male students had a 2.28 times higher likelihood of having BED symptoms compared to female counterparts (adjusted odds ratio [AOR] = 2.28; 95% CI: 1.33-3.89). Older students (AOR = 3.56, 95% CI: 1.80-7.05), students who were overweight or obese (AOR = 3.32, 95% CI: 1.87-5.89), and students reporting higher depressive symptoms (AOR = 2.69, 95% CI: 1.66-4.35) were at greater risk for developing BED compared to their respective counterparts.

Conclusions

This study provides new insights into the prevalence of BED symptoms and its contributing factors among Bangladeshi students. Approximately 1-in-5 university students reported having BED symptoms. University students who are older, overweight, or obese, and who report depressive symptoms may be at greatest risk. Future longitudinal studies are needed to determine the causal factors underlying BED. Findings from this study can assist policymakers and public health professionals in developing effective and targeted strategies to mitigate the risks associated with BED among Bangladeshi university students.

Exposure to secondhand smoke is associated with poor sleep quality among non-smoking university students in Bangladesh: a cross-sectional survey

Although secondhand smoke (SHS) exposure is predominant in Bangladesh, the adverse effect of SHS exposure on health-related behaviors, such as sleep quality, have remained an under-investigated area of the country's public health landscape. Therefore, the purpose of this study was to examine the association between SHS exposure and poor sleep quality among non-smoking university students in Bangladesh. A cross-sectional survey was carried out between May and September 2022. SHS exposure (main predictor variable) and other covariates (e.g., age, sex, etc.) were measured using a self-reported questionnaire and sleep quality (outcome variable) was measured via the Pittsburgh Sleep Quality Index. Multiple logistic regression models investigated the association between SHS exposure and poor sleep quality. The study included 390 students (mean age: 22 years, 53.8% male). Approximately 41.8% of the participants reported SHS exposure, and 50.5% had poor sleep quality. Students exposed to SHS were more likely to have poor sleep quality compared to their counterparts (AOR = 1.61; 95% CI 1.01, 2.58). Subgroup analysis revealed poor sleep quality was 2-times higher among male students exposed to SHS than those male students without SHS exposure (AOR = 2.03; 95% CI 1.05, 3.93). No association was found in female students. Findings from this study warrant increased awareness and public health initiatives on the implications of SHS on health behaviors, such as sleep quality, in non-smoking Bangladeshi university students.

Determinants of health care seeking behavior for childhood infectious diseases and malnutrition: A slum-based survey from Bangladesh

This study aimed to explore the magnitude and determinants of health care seeking behaviors for common infectious disease and malnutrition among Bangladeshi under-five children living in slum areas. A cross-sectional study of 300 children-caregiver dyads was conducted in an urban slum of Bangladesh. Data were collected via a structured questionnaire with accompanying anthropometric assessments of children administered by research staff. Multiple logistic regression was employed to identify associated factors of health care seeking behaviors. Only 44.7% and 13.0% of respondents sought care for childhood infectious diseases and malnutrition, respectively. Being a male child, 2-5 years old, having ≤5 family members, monthly family income >125$, and living in close proximity to a health facility were found to be potential determinants of health care seeking behavior for childhood infectious diseases. Mother/caregivers with poor nutritional information knowledge and who had a child 2-5 years old reported engaging in less care seeking behaviors regarding their child's malnutrition compared to their counterparts. Caregivers of children under the age of 5 years old reported low participation in health care seeking behaviors in relation to childhood infectious disease and malnutrition. Families living in slums require additional support targeting health and nutritional educational programs.

Factors influencing and changes in childhood vaccination coverage over time in Bangladesh: a multilevel mixed-effects analysis

INTRODUCTION

This study aimed to investigate the associated factors and changes in childhood vaccination coverage over time in Bangladesh.

METHODS

Bangladesh's Demographic and Health Surveys from 2011, 2014, and 2017-18 provided data for this study on vaccination coverage among children aged 12 to 35 months. For three survey periods, multilevel binary logistic regression models were employed.

RESULTS

The overall prevalence (weighted) of full vaccination among children aged 12-35 months were 86.17% in 2011, 85.13% in 2014, and 89.23% in 2017-18. Children from families with high wealth index, mothers with higher education, and over the age of 24 and who sought at least four ANC visits, as well as children from urban areas were more likely to receive full vaccination. Rangpur division had the highest change rate of vaccination coverage from 2011 to 2014 (2.26%), whereas Sylhet division had the highest change rate from 2014 to 2017-18 (34.34%).

CONCLUSION

To improve immunization coverage for Bangladeshi children, policymakers must integrate vaccine programs, paying special attention to mothers without at least a high school education and families with low wealth index. Increased antenatal care visits may also aid in increasing the immunization coverage of their children.

Food neophobia and its association with sociodemographic factors and food preferences among Bangladeshi university students: Evidence from a cross-sectional study

Food neophobia, described as a reluctance to eat and or avoid new food, is a personality trait that affects food choice. Despite its potential influence on an individual's food intake, food neophobia has been poorly investigated in Bangladesh. This cross-sectional study was designed to evaluate food neophobia and its association with sociodemographic factors and food preferences in a sample of Bangladeshi university students. Five hundred students from five public universities completed the structured surveys. Food neophobia was assessed by a 10-item validated food neophobia scale with some minor modifications based on study settings. A multiple linear regression model was used to observe the factors associated with food neophobia. The mean food neophobia score among study participants was 37.45 (SD: 13.39, Range: 13-67). According to the adjusted statistical model, being female (regression coefficient, β = 2.73), having higher monthly family income (β = -6.64), being underweight (β = 4.68), being overweight (β = -4.63), having any food allergy (β = 9.09), and a history of sickness after eating a new food item (β = 5.16) were significantly associated with food neophobia amongst the participants. The participants' liking of various food items such as vegetables were significantly correlated with food neophobia scores. Nutrition education policies and programs are of importance to address the students' food neophobia during their tertiary education so that they maintain lifelong healthy dietary habits and consume a variety of foods to improve their physical health and well-being.

Crystal structure of 4-[(4-methyl-benz-yl)-oxy]-N'-(4-nitro-benzyl-idene)benzohydrazide: a new hydrazone derivative

The mol-ecular structure of the title compound, C₂₂H₁₉N₃O₄, shows a non-coplanar conformation, with dihedral angles between the phenyl rings of 73.3 (1) and 80.9 (1)°. These deformations are induced by the crystal packing that is mainly governed by N-H⋯O and C-H⋯O hydrogen bonds, forming a mono-periodic arrangement parallel to the b axis.

Crystal structures of 4-[(4-methyl-benz-yl)-oxy]benzohydrazide and its N'-[(thio-phen-2-yl)-methyl-idene]- derivative

The mol-ecular and crystal structures of a benzoyl-hydrazine bearing an ether group, 4-[(4-methyl-benz-yl)-oxy]benzohydrazide, C₁₅H₁₆N₂O₂, (I), and of the corresponding N'-[(thio-phen-2-yl)-methyl-idene]- derivative, 4-[(4-methyl-benz-yl)-oxy]-N'-[(thio-phen-2-yl)-methyl-idene]benzohydrazide, C₂₀H₁₈N₂O₂S, (II), are described. The supra-molecular structures of both compounds are governed by N-H⋯N and N-H⋯O hydrogen-bonding inter-actions. The hydrazine compound (I) shows a crystal packing with a more complex hydrogen-bonding scheme because of the NH-NH₂ entity, forming a di-periodic supra-molecular structure extending parallel to (100). Hydrazone mol-ecules in (II) are hydrogen-bonded through N-H⋯O inter-actions, giving rise to the formation of ribbons parallel to [010]. Mol-ecules of (I) and (II) show a different orientation of the carbohydrazide moiety likely to favor the crystal packing and thus hydrogen-bonding inter-actions.

Investigating problematic uses of Facebook and other Internet activities among university students in Bangladesh during the COVID-19 pandemic

Problematic use of Internet (PUI) and problematic use of Facebook (PUF) has been linked to escalating behavioral health issues among university students and has increased during the COVID-19 pandemic. This study estimated the prevalence of and explored associated factors for PUI and PUF among Bangladeshi university students during the COVID-19 pandemic. A cross-sectional online survey was undertaken among 1101 Bangladeshi university students between November and December 2020. The Internet Addiction Test and Facebook Addiction Scale were used to assess PIU and PUF, respectively. A multiple linear regression analysis was performed to adjust for confounders. Among the participants, PUI and PUF were found in 39.3% and 37.1%, respectively. The multiple linear regression model indicated PUI was significantly associated with participants residing in a village, arts majors, those unsatisfied with their major, having mediocre parental relationships, failure in romantic relationships, physical comorbidities, longer use of the Internet, using the Internet for purposes other than education, using social media, and downloading movies/TV series. PUF was significantly associated with village residence, lower income, arts majors, failure in romantic relationships, longer use of the Internet, using the Internet for purposes other than education, and downloading movies/TV series. Both PUI and PUF have been prevalent among Bangladeshi university students during the COVID-19 pandemic. Longitudinal & exploratory studies are warranted in the future to identify causal factors for PUI and PUF and appropriate interventions should be designed quickly for this population.

Prevalence and determinants of contraceptive method use among Bangladeshi women of reproductive age: a multilevel multinomial analysis

BACKGROUND

Much scholarly debate has centered on Bangladesh's family planning program (FPP) in lowering the country's fertility rate. This study aimed to investigate the prevalence of using modern and traditional contraceptive methods and to determine the factors that explain the contraceptive methods use.

METHODS

The study used data from the 2017-18 Bangladesh Demographic and Health Survey (BDHS), which included 11,452 (weighted) women aged 15-49 years in the analysis. Multilevel multinomial logistic regression was used to identify the factors associated with the contraceptive method use.

RESULTS

The prevalence of using modern contraceptive methods was 72.16%, while 14.58% of women used traditional methods in Bangladesh. In comparison to women in the 15-24 years age group, older women (35-49 years) were more unwilling to use modern contraceptive methods (RRR: 0.28, 95% CI: 0.21-0.37). Women who had at least a living child were more likely to use both traditional and modern contraceptive methods (RRR: 4.37, 95% CI: 3.12-6.11). Similarly, given birth in the previous 5 years influenced women 2.41 times more to use modern method compared to those who had not given birth (RRR: 2.41, 95% CI: 1.65-3.52). Husbands'/partners' decision for using/not using contraception were positively associated with the use of both traditional (RRR: 4.49, 95% CI: 3.04-6.63) and modern methods (RRR: 3.01, 95% CI: 2.15-4.17) rather than using no method. This study suggests rural participants were 21% less likely to utilize modern methods than urban participants (RRR: 0.79, 95% CI: 0.67-0.94).

CONCLUSION

Bangladesh remains a focus for contraceptive use, as it is one of the most populous countries in South Asia. To lower the fertility rate, policymakers may design interventions to improve awareness especially targeting uneducated, and rural reproductive women in Bangladesh. The study also highlights the importance of male partners' decision-making regarding women's contraceptive use.

Socio-economic inequalities in minimum dietary diversity among Bangladeshi children aged 6-23 months: a decomposition analysis

This study aimed to measure the socio-economic inequalities in having minimum dietary diversity (MDD) among Bangladeshi children aged 6-23 months as well as to determine the factors that potentially contribute to the inequity. The Bangladesh Demographic and Health Survey (BDHS) 2017-2018 data were used in this study. A sample of 2405 (weighted) children aged 6-23 months was included. The overall weighted prevalence of MDD was 37.47%. The concentration index (CIX) value for inequalities in MDD due to wealth status was positive and the concentration curve lay below the line of equality (CIX: 0.1211, p < 0.001), where 49.47% inequality was contributed by wealth status, 25.06% contributed by the education level of mother, and 20.41% contributed by the number of ante-natal care (ANC) visits. Similarly, the CIX value due to the education level of mothers was also positive and the concentration curve lay below the line of equality (CIX: 0.1341, p < 0.001), where 52.68% inequality was contributed by the education level of mother, 18.07% contributed by wealth status, and 14.69% contributed by the number of ANC visits. MDD was higher among higher socioeconomic status (SES) groups. Appropriate intervention design should prioritize minimizing socioeconomic inequities in MDD, especially targeting the contributing factors of these inequities.

Association between Nutrition Literacy and Bangladeshi Adults' Healthy Eating Behaviors: Evidence from the Nutrition Literacy Study 2021

This study investigated the association between healthy eating behaviors and nutrition literacy in a sample of Bangladeshi adults. A cross-sectional survey was conducted among 400 adults from two districts of Bangladesh (Dhaka and Chattogram). Data were generated by in-person interviews using a structured questionnaire. The Nutrition Literacy Scale and National Dietary Guidelines for Bangladesh were used to assess nutrition literacy and healthy eating behaviors, respectively. Multiple linear regression models were used to observe the association. The mean score for healthy eating behavior was 21.8 (SD = 4.8, Range: 5−33) on a scale of 34. A moderate positive correlation was found between nutrition literacy and healthy eating behavior of participants (r = 0.28, p < 0.001). The adjusted regression model showed that a 1 unit increase in nutrition literacy reflected an increase in the healthy eating behavior score of participants by 0.22 units (β = 0.223, p < 0.001). Findings showed an association between nutrition literacy and eating behaviors in Bangladeshi adults. Future research could be carried out to establish a causal relationship that may help inform the necessity of educational interventions for Bangladeshi adults to assist with meeting national nutrition-related targets.

Factors associated with overweight and obesity among Bangladeshi university students: a case-control study

Objectives: Overweight and obesity has an adverse effect on public health, and emerging adulthood (18-25 years) is recognized as a potential period for the onset of obesity, thus, this study aimed to explore risk factors associated with overweight and obesity in Bangladeshi university students. Participants: Bangladeshi university students (n = 280). Methods: A case-control study of 140 students with overweight and obesity and 140 students with normal weight. Results: Multiple logistic regression revealed having at least one overweight or obese parent (AOR = 4.2; 95% CI: 2.2-8.4) and participating in no physical activity (AOR = 3.2; 95% CI: 1.0-9.9) were potential risk factors. Reported consumption ≥4 meals in a day, junk food/fast food, and soft drinks for ≥3 days a week were potential determinants of overweight and obesity in this population. Conclusion: Increased awareness on the importance of regular physical activity and a healthy diet may reduce the risk of overweight and obesity among Bangladeshi university students.

Prevalence and factors associated with dietary supplement use among Bangladeshi public university students: A cross-sectional study

INTRODUCTION

The usage of dietary supplement (DS) such as vitamins, minerals, and fish oil has expanded, but there is limited data on their use by sub-populations such as university students. The study was aimed to investigate the prevalence of DS use among Bangladeshi university students and its associated factors.

METHODS

A cross-sectional survey of 390 students was conducted from two public universities from Barishal Division in Bangladesh using a structured questionnaire with 72 questions divided into five sections: sociodemographic, knowledge, opinions, and attitudes, types of DS, reasons and sources for using DS, and adverse reactions after taking DS. Descriptive statistics and logistic regression were utilized to estimate the results.

RESULTS

Among all the students, 15.6% students were using DS where only 7.7% of them used DS according to physicians' recommendation. Additionally, students used DS for general health and well-being, weight gaining and as a source of energy for physical and sporting activities, etc. The use of DS was significantly associated with female sex (AOR = 5.44, 95% CI: 2.18-13.52), ≥25 years age (AOR = 0.08, 95% CI: 0.01-0.67), underweight (AOR = 5.86, 95% CI: 1.95-17.62), having major illness (AOR = 6.99, 95% CI: 1.98-24.70) and good knowledge of DS (AOR = 2.64, 95% CI: 1.23-5.64).

CONCLUSION

This study provides new findings on DS use and its correlates in Bangladeshi students which may be used by the policymakers to improve DS usage among students. Adaptation of an appropriate program is recommended to educate students on proper and safer ways of using DS.

Crystal structure of bis{4-[(4-methylbenzyl)oxy]-N′-(4-methylbenzylidene)benzohydrazidato}nickel(II)

In the title compound, the mononuclear nickel(II) complex exhibits point group symmetry .

In the title complex, [Ni(C₂₃H₂₁N₂O₂)₂], the central Ni^II atom is located on an inversion centre and exhibits a slightly distorted square-planar N₂O₂ coordination environment. A trans-configuration of the N,O chelating ligands results from the imposed site symmetry of the central Ni^II atom. In the crystal, individual mol­ecules stack along the a axis through weak π–π stacking inter­actions between the phenyl rings.

Crystal structure of ethyl 4-[(4-methylbenzyl)oxy]benzoate

Three mol­ecules of the title compound are present in the asymmetric unit, exhibiting different conformations relative to the eth­oxy group.

The title compound, C₁₇H₁₈O₃, crystallizes with three mol­ecules in the asymmetric unit. The mol­ecules differ in the conformation related to the eth­oxy group and in the orientation of the two phenyl rings, one of which has the eth­oxy group disordered over two positions with refined occupancies of 0.735:0.265 (9). In the crystal packing, the mol­ecules are connected by weak C—H⋯π inter­actions.

Nutritional, microbial and various quality aspects of common dried fish from commercial fish drying centers in Bangladesh

The purpose of this study was to evaluate the nutritional, microbial and sensory quality of five dried fish species from five fish drying centers in Bangladesh, and consumers' perception on quality and perceived health problems of consuming dried fish. Proximate composition and bacterial load were determined following AOAC and total plate count method, respectively. Data on peoples' perception regarding the quality aspects of dried fish were collected using a structured questionnaire. Sensory analysis showed samples from Cox’s Bazar had higher acceptability than other regions. Moisture content ranged from 12.00 ± 1.12% to 22.99 ± 1.09%, the highest found in Bombay duck from Patuakhali. The highest values of protein were found in shrimp from Chittagong (64.33 ± 0.99%) and the lowest in Bombay duck from Bhola (51.80 ± 0.95%). The lipid content varied from 5.38 ± 0.37% (Bombay duck from Cox’s Bazar) to 8.67 ± 0.96% (Bombay duck from Khulna). The ash content was ranged from 13.89 ± 0.94% to 20.07 ± 1.64% in Bombay duck from Patuakhali and Cox’s Bazar. The mean total plate count of dried Bombay duck were 7.1 ± 0.2×10⁷, 9.8 ± 0.1×10⁷ and 7.8 ± 0.52 × 10⁷ cfu/g, whereas, total Vibrio spp. count were estimated 1.1 ± 0.1×10³, 3.7 ± 0.2×10⁵ and 1.8 ± 0.1 × 10⁵ cfu/g for Chittagong, Cox’s Bazar and Bhola, respectively. The pathogenic bacterial species E. coli and Salmonella sp. were absent in dried Bombay duck from all locations. Of 500 respondents, the majority (94.8%) reported no complications after consuming dried fish. Significant quality variation among the dried fish samples suggested further improvement in dried fish quality through maintaining hygiene and sanitation to produce quality and safe dried fish for the consumers in home and abroad.

Prevalence of and factors associated with early initiation of breastfeeding in Bangladesh: a multilevel modelling

BACKGROUND

Early initiation breastfeeding (EIBF) is a sign of good health for both the mother and the newborn baby. The objective of this study was to estimate the prevalence of EIBF among mothers in Bangladesh and to identify its associated factors.

METHODS

The study used the most recent Bangladesh Demographic and Health Survey 2017-2018 data. A total of 4776 (weighted) respondents were included in the final analysis. The association between the outcome and the independent variables was determined using multilevel (mixed effects) logistic regression analysis.

RESULTS

The overall weighted prevalence of EIBF among Bangladeshi mothers was 61.19% (confidence interval [CI] 59.80 to 62.56). The study shows that non-poor wealth status (adjusted odds ratio [AOR] 0.81 [95% CI 0.68 to 0.95]), institutional delivery (AOR 0.77 [95% CI 0.61 to 0.96]) and caesarean delivery (AOR 0.31 [95% CI 0.26 to 0.38]) were associated with the lower odds of EIBF. Mother's secondary education (AOR 1.34 [95% CI 1.01 to 1.83]), at least four antenatal care visits (AOR 1.36 [95% CI 1.04 to 1.53]), normal birthweight (AOR 1.42 [95% CI 1.09 to 1.85]) and placed on mother's chest and bare skin after birth (AOR 1.33 [95% CI 1.11 to 1.60]) were associated with higher odds of EIBF.

CONCLUSION

In order to enhance EIBF in Bangladesh, health professionals should emphasise skin-to-skin contact after delivery.

Exploring the Factors Associated with Dietary Diversity of Children Aged 6-59 Months in Some Rural and Slum Areas of Bangladesh amid the COVID-19 Pandemic: A Mixed-Effect Regression Analysis

Background

Dietary diversity (DD) is a key component of diet quality, and malnutrition due to poor diet quality leads to child morbidity and mortality. However, in Bangladesh, there is a lack of information on childhood DD (for children aged 6-59 mo) amid the coronavirus disease 2019 (COVID-19) pandemic.

Objectives

The purpose of this study was to assess the minimum DD and its associated factors among children aged 6-59 mo during the COVID-19 pandemic in Bangladesh.

Methods

A cross-sectional study was carried out in 6 districts of Bangladesh. A total of 1190 respondents were included using cluster random sampling. The Individual Dietary Diversity Score (IDDS) for children was used to assess the children's DD. Factors associated with DD of children were identified using a multilevel binary logistics regression model.

Results

About 70% of the children aged 6-59 mo had minimum DD during the COVID-19 pandemic in Bangladesh. Children who belonged to slum areas [adjusted odds ratio (AOR): 0.45; 95% CI: 0.24, 0.83], family income 12,000-15,000 Bangladeshi taka (BDT) (AOR: 1.79; 95% CI: 1.06, 3.05) and >15,000 BDT (AOR: 2.59; 95% CI: 1.47, 4.57), mothers aged 26-30 y (AOR: 0.35; 95% CI: 0.20, 0.62) and >30 y (AOR: 0.43; 95% CI: 0.22, 0.85), respondents who had 2 children <5 y old (AOR: 0.43; 95% CI: 0.28, 0.66), and children aged 12-23 mo (AOR: 1.89; 95% CI: 1.14, 3.20) were significantly associated with DD among children aged 6-59 mo.

Conclusions

The findings of this study highlight the need for food and nutrition-related intervention, particularly targeting mothers of younger age and with >2 children <5 y old, mothers from slum regions, and fathers who were unemployed, to improve children's DD practices.

Assessment of Food Safety Knowledge, Attitudes and Practices of Food Service Staff in Bangladeshi Hospitals: A Cross-Sectional Study

Food safety knowledge, attitudes and practices among hospital food service staff are crucial in the prevention of foodborne disease outbreaks, as hospitalized patients are more vulnerable to potential hazards. This study, therefore, sought to assess the food safety knowledge, attitudes and practices of food service staff in Bangladeshi hospitals. A cross-sectional study was conducted among 191 food service staff from seven different hospitals in Dhaka and Chattogram from October 2021 to March 2022 using pretested questionnaires. Multiple linear regression was used to identify the factors associated with the food safety knowledge, attitudes and practices. The findings showed moderate knowledge but high levels of attitudes and practices of food safety among hospital food handlers. Food safety knowledge was significantly higher among males, participants from private hospitals and participants working in a hospital that had a food service supervisor and dietitian in charge of food service operations. Moreover, participants from private hospitals and participants working in a hospital that had a food service supervisor and dietitian in charge of food service operations had more positive attitudes and better practices regarding food safety. Hospital management should consider these factors for enhancing food handlers’ knowledge and increase training and supervision on food safety practices to reduce foodborne diseases and outbreaks.

The Association Between Bangladeshi Adults' Demographics, Personal Beliefs, and Nutrition Literacy: Evidence From a Cross-Sectional Survey

Background

Poverty and health illiteracy, combined with inappropriate systems to track disease and infection rates, contribute to children-and-mothers' poor adherence to nutrient-rich foods intake in Bangladesh. Although risk factors for child and pregnant women malnutrition have been explored, the relationship between Bangladeshi adults' nutrition literacy and their demographics and personal beliefs remains unknown. The purpose of this study was to examine the association between adults' nutrition literacy, demographics and personal beliefs in a large sample of Bangladeshi adults.

Methods

Four hundred adults from two districts (Dhaka and Chattogram) of Bangladesh participated in a cross-sectional survey. Data were collected by interviews using a structured questionnaire containing the Nutrition Literacy Scale. Multiple linear regression models were employed to analyze associations between nutrition literacy and related factors.

Results

The mean nutrition literacy score was 21.6 (SD: 3.7; range: 11-32) on a scale of 32. Multiple linear regression revealed that being a businessman (β = 1.66, p = 0.013) or private employee (β = 1.08, p = 0.030), having a higher family income (β = 1.17, p = 0.009), and a higher educational level were positively associated with higher nutrition literacy scores compared to their counterparts. Participants who had ever completed a nutrition-related course (β = 4.95, p < 0.001), and who perceived themselves as having a need for accessing nutrition-related information were positively associated with the higher nutrition literacy compared to their counterparts.

Conclusion

Findings from this study suggest the need for an integrated response plan involving educational interventions and accessible dietary plans targeting adult populations to enhance their nutritional literacy.

Prevalence of and factors associated with childhood diarrhoeal disease and acute respiratory infection in Bangladesh: an analysis of a nationwide cross-sectional survey

OBJECTIVES

This study aimed to estimate the prevalence of childhood diarrhoeal diseases (CDDs) and acute respiratory infections (ARIs) and also to determine the factors associated with these conditions at the population level in Bangladesh.

SETTING

The study entailed an analysis of nationally representative cross-sectional secondary data from the most recent Bangladesh Demographic and Health Survey conducted in 2017-2018.

PARTICIPANTS

A total of 7222 children aged below 5 years for CDDs and 7215 children aged below 5 years for ARIs during the survey from mothers aged between 15 and 49 years were the participants of this study. In the bivariate and multivariable analyses, we used Pearson χ2 test and binary logistic regression, respectively, for both outcomes.

RESULTS

The overall prevalence of CDD and ARI among children aged below 5 years was found to be 4.91% and 3.03%, respectively. Younger children were more likely to develop both CDDs and ARIs compared with their older counterparts. Children belonging to households classified as poorest and with unimproved floor materials had a higher prevalence of diarrhoea than those from households identified as richest and with improved floor material, respectively. Stunted children had 40.8% higher odds of diarrhoea than normal children. Being male and having mothers aged below 20 years were 48.9% and two times more likely to develop ARI than female counterparts and children of mothers aged 20-34 years, respectively. Children whose mothers had no formal education or had primary and secondary education had higher odds of ARI compared with children of mothers having higher education.

CONCLUSION

This study found that children aged below 24 months were at higher risk of having CDDs and ARIs. Thus, programmes targeting these groups should be designed and emphasis should be given to those from poorest wealth quintile to reduce CDDs and ARIs.

The impact of the COVID-19 pandemic on the mental health of the adult population in Bangladesh: a nationwide cross-sectional study

The recent COVID-19 pandemic has imposed threats on both physical and mental health since its outbreak. This study aimed to explore the impact of the COVID-19 pandemic on mental health among a representative sample of home-quarantined Bangladeshi adults. A cross-sectional design was used with an online survey completed by a convenience sample recruited via social media. A total of 1,427 respondents were recruited, and their mental health was assessed by the DASS-21 measure. The prevalence of anxiety symptoms and depressive symptoms was 33.7% and 57.9%, respectively, and 59.7% reported mild to extremely severe levels of stress. Perceptions that the pandemic disrupted life events, affected mental health, jobs, the economy and education, predictions of a worsening situation, and uncertainty of the health care system capacities were significantly associated with poor mental health outcomes. Multivariate logistic regressions showed that sociodemographic factors and perceptions of COVID-19 significantly predict mental health outcomes. These findings warrant the consideration of easily accessible low-intensity mental health interventions during and beyond this pandemic.

Factors associated with household food insecurity and dietary diversity among day laborers amid the COVID-19 pandemic in Bangladesh

Backgrounds

Food insecurity and dietary diversity remain a public health concern in developing countries like Bangladesh which is exacerbated by the COVID-19 especially for day laborers’ families in Bangladesh. This study aimed to determine factors associated with household food insecurity and household dietary diversity among day laborers during the COVID-19 pandemic in Bangladesh.

Methods

This cross-sectional study was conducted among 343 households of day laborers in Bangladesh using a semi-structured questionnaire. Household food security (HFS) and Household dietary diversity (HDD) scores were assessed using the HFS scale and household’s 24-h recall of intake of 12 food groups, respectively.

Results

The overall mean scores of HFS and HDD were 26.80 (SD, 4.83) and 4.08 (SD, 1.15). Having household head aged > 40 years and monthly household income > 5000 Bangladeshi Taka (BDT) were positively associated with HDD scores. Having an education level above secondary, monthly household income > 5000 BDT, and having a refrigerator were associated with the higher HFS scores, whereas having family members > 5 was a potential determinant of lower HFS scores. Pandemic-induced work loss and food scarcity were also potential determinants of lower HFS and HDD scores. Approximately 94% of respondents reported their wages were reduced, and 76% were deprived of the same quantity of food as pre-pandemic periods.

Conclusions

Lower socio-economic status and pandemic-induced work loss affect the HFS and HDD. Interventions with financial aid and complemented food distributions, particularly among the wage looser, may improve the HFS and HDD of day laborers.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40795-022-00517-8.

Probabilistic public health risks associated with pesticides and heavy metal exposure through consumption of common dried fish in coastal regions of Bangladesh

The chemical contaminants in dried fish are of great food safety concern and an emerging public health issue in Bangladesh. The aim of this study was to assess the public health risk associated with exposure to pesticides (organochlorine and organophosphorus) and heavy metals (lead, mercury, cadmium, chromium, arsenic) through the consumption of dried fish (Bombay duck, ribbon fish, silver jewfish, shrimp, Chinese promfret) in coastal districts (Cox's Bazar, Chittagong, Bhola, Patuakhali, Khulna) of Bangladesh. Dried fish consumption data were collected from 500 adult respondents (100 from each district) using a food frequency questionnaire (FFQ). Pesticide residues were determined using QuEChERS extraction coupled to gas chromatography and gas chromatography mass spectrometry, and heavy metals were estimated using an atomic absorption spectrophotometric method. The results revealed that the frequency and amount of dried fish consumption was highest for Bombay duck in Cox's Bazar (11.57 g/capita/day) and ribbon fish (12.10 g/capita/day) in Chittagong. The estimated daily intake (EDI, 7.40 × 10^-5 to 1.10 × 10^-4 mg/kg/day) and health risk index (HRI, 0.013 to 0.16) values expressed no health risk from pesticide residues in all the positive samples. For heavy metals, target hazard quotients (THQ) for non-carcinogenic health risk were below 1 (0.001-0.154), indicating no health risk for all samples. However, carcinogenic risk R value indicated a potential health risk for chromium (2.64 × 10^-6 to 4.06 × 10^-6), and carcinogenic R_T value (2.82 × 10^-6 to 5.71 × 10^-6) indicated a potential health risk for all the metals. It is concluded that the risk of exposure to pesticides through the consumption of dried fish is low, while heavy metals pose moderate-to-high health risks to dried fish consumers in the study area. Thus, the study suggests an appropriate risk management policy that controls pesticides and heavy metals in dried fish to ensure safe food for local and global consumers, underpinned by a producers' capacity building and consumers' awareness raising strategy.

Prevalence and determinants of eating disorder risk among Bangladeshi public university students: A cross-sectional study

Eating disorders among university students have been increasing day by day in developing countries. However, there is a dearth of existing literature that assessed eating disorder risk among this population group in Bangladesh. Thus, this study aimed to assess the prevalence of eating disorder risk and its associated factors among university students. A cross-sectional study was conducted among 365 Bangladeshi public university students from October to December 2019. Data were collected by self-reported questionnaire on socio-demographic characteristics, risk of eating disorder, and nutritional status of study participants. The respondents' eating disorder risk and nutritional status were assessed using the validated eating attitudes test-26 (EAT-26) tool and anthropometric measurement, respectively. A cut-off score of ≥ 20 based on EAT-26 indicates the presence of an eating disorder risk. Finally, a binary logistic regression was employed to identify the determinants of an eating disorder. The prevalence of 'eating disorder risk' was 23.0% (95% confidence interval [CI]: 18.6 to 27.4). Being female (adjusted odds ratio [AOR] = 2.4, 95% CI: 1.4 to 4.2), aged between 17-21 years (AOR = 2.0, 95% CI: 1.2 to 3.6), overweight (AOR = 4.9; 95% CI: 1.6 to 14.9) and obese (AOR = 7.7, 95% CI: 1.9 to 31.4) showed a higher odds of having an eating disorder risk in the present study. The higher prevalence of eating disorders in the study indicates that psychological intervention and health awareness programs, particularly to younger age, female, and overweight and obese students at the university level, would effectively prevent the eating disorder risk.

Knowledge, attitudes, and preventive practices toward the COVID-19 pandemic: an online survey among Bangladeshi residents

AIM

The novel coronavirus (SARS-CoV-2) has rapidly infected people worldwide, leading to a massive public reaction. Peoples' knowledge, attitudes, and practices (KAP) toward COVID-19 are the most important for the control and prevention of the infectious disease pandemic. This study aimed to assess the knowledge, attitude, and preventive practices (KAP) toward the COVID-19 among Bangladeshi residents during the lockdown situation.

SUBJECTS AND METHODS

An online-based cross-sectional survey was conducted among 1765 Bangladeshi adults through the social media networks of the authors.

RESULTS

The respondents were older than 18 years, with an average age of 24.88 years (SD 6.30). Approximately 15% of our participants received online training. The mean knowledge score was 14.49 (SD 1.8, range 0-17), and the overall correct response rate on this knowledge test was 85%. Approximately 67.2% scored well (above the mean 4.5, range 1-5) regarding the practices. To avoid the infection, 96.6% wore masks outside the home, and 98.7% washed their hands with soap when they came back. COVID-19 knowledge score was significantly associated with a lower odds of (OR 0.87, 95% CI 0.79-0.92) negative attitudes. Again, the awareness score was associated with a lower likelihood of (OR 0.94, 95% CI 0.87-0.98) poor practices.

CONCLUSION

Online health education programs focusing on young people, housewives, and people with less education may potentially improve the attitudes and practices to control the COVID-19 pandemic in the long term in such a low-resource setting.

Determinants of household food security and dietary diversity during the COVID-19 pandemic in Bangladesh

OBJECTIVES

The study aimed to determine the associated factors of household food security (HFS) and household dietary diversity (HDD) during the COVID-19 pandemic in Bangladesh.

DESIGN

Both online survey and face-to-face interviews were employed in this cross-sectional study. The Household Food Security Scale and Household Dietary Diversity Score were used to access HFS and HDD, respectively. The HDD scores were derived from a 24-h recall of food intake from 12 groups.

SETTING

Bangladesh.

PARTICIPANTS

A total sample of 1876 households were recruited.

RESULTS

The overall mean scores of HFS and HDD were 31·86 (sd 2·52) and 6·22 (sd 5·49), respectively. Being a rural resident, having no formal education, occupation of household head other than government job and low monthly income were potential determinants of lower HFS and HDD. Approximately 45 % and 61 % of Bangladeshi households did not get the same quantity and same type of food, respectively, as they got before the pandemic. Over 10 % of respondents reported that they lost their job or had to close their businesses, and income reduction was reported by over 70 % of household income earners during the COVID-19 pandemic, which in turn was negatively associated with HFS and HDD.

CONCLUSION

Household socio-economic variables and COVID-19 effects on occupation and income are potential predictors of lower HFS and HDD scores. HFS and HDD deserve more attention during this pandemic particularly with reference to low-earning households and the households whose earning persons' occupation has been negatively impacted during the COVID-19 pandemic.

Mental health difficulties of adults with COVID-19-like symptoms in Bangladesh: A cross-sectional correlational study

BACKGROUND

The rapid spread of novel corona virus disease (COVID-19) coupled with inefficient testing capacities in Bangladesh has resulted in a number of deaths from COVID-19-like symptoms that have no official test results. This study was the first study that explored the mental health of adults with the most common COVID-19-like symptoms in Bangladesh.

METHODS

This cross-sectional correlational study gathered data via an online survey to explore the mental health of Bangladeshi adults with symptoms akin to COVID-19. Level of stress, anxiety symptoms, and depressive symptoms were measured with the DASS-21. Chi-square tests and multivariate logistic regression was performed to examine the association of variables.

RESULTS

The prevalence rates of anxiety symptoms and depressive symptoms of the overall population were 26.9% and 52.0% respectively and 55.6% reported mild to extremely severe levels of stress. Multivariate logistic regression determined that respondents with COVID-19-like symptoms reported higher odds for stress level (AOR = 2.043, CI = 1.51 to 2.76), anxiety symptoms (AOR = 2.770, CI = 2.04 to 3.77) and depressive symptoms (AOR = 1.482, CI = 1.12 to 1.96) than asymptomatic respondents.

LIMITATIONS

There was a chance of recall bias as it was not possible to validate the information due to the retrospective design of the study. Recruitment methods only captured internet users, which reduces the generalizability of findings.

CONCLUSIONS

Patients with symptoms like those of COVID-19 should be prioritized in the healthcare setting in order to reduce mental health difficulties throughout the pandemic .

Depressive symptoms associated with loneliness and physical activities among graduate university students in Bangladesh: findings from a cross-sectional pilot study

In low-resource settings like Bangladesh, there is a dearth of research on the mental health of university students. This pilot study aimed to identify the prevalence of depressive symptoms, loneliness, and physical activities as well as the associated factors of depressive symptoms among graduate students in a public university of Bangladesh.

This cross-sectional study was carried out among 323 graduate students between February 2019 and May 2019. By the convenience sampling technique, data were collected by a pretested, structured questionnaire. Depressive symptoms were assessed by the validated Patient Health Questionnaire-9 (PHQ-9) tool with a cut-off score of ≥10 vs. less; University of California, Los Angeles (UCLA) loneliness scale was applied to assess loneliness, International Physical Activity Questionnaire (IPAQ) scale was used to measure physical activity level.

The overall prevalence of depressive symptoms was 52% and about 43% of participants felt most lonely. About 32.8% of students were involved in low physical activity. Being female, from lower income families, having poor academic performance, experiencing shorter sleep time, lower physical activity, and being lonely were potential risk factors for depressive symptoms among graduate university students. A positive correlation was found between loneliness and depressive symptoms of students (r = 0.367, p < 0.001).

The higher prevalence of depressive symptoms among Bangladeshi graduate university students suggests the need for situation analysis, confirmatory clinical diagnosis, in-depth qualitative explorations, and large-scale surveys to explore the burden of such disorders and design appropriate low-intensity interventions like implementing student counselling service, offering mental assistance or other mental health support program in the country.

Mental Health Outcomes of Adults with Comorbidity and Chronic Diseases during the COVID-19 Pandemic: A Matched Case-Control Study

BACKGROUND

Individuals with certain pre-existing chronic health conditions have been identified as a high-risk group for fatalities of COVID-19. Therefore, it is likely that individuals with chronic diseases may worry during this pandemic to the detriment of their mental health. This study compares the mental health of Bangladeshi adults affected by chronic disease to a healthy, matched control group during the COVID-19 pandemic.

SUBJECTS AND METHODS

A matched case-control analysis was performed with data collected from 395 respondents with chronic diseases and 395 controls matched for age, gender, and residence. Inclusion criteria for cases were respondents who self-reported having asthma, cardiovascular disease symptoms and/or diabetes. Respondents were recruited using an online survey, which included the DASS-21 measure to assess symptoms of stress, anxiety, and depression. Chi-square test, t-test, Fisher's exact test and a conditional logistic regression were performed to examine associations among variables.

RESULTS

The prevalence of anxiety symptoms and depression symptoms and the level of stress were significantly higher among cases (59%; 71.6%; 73.7%, respectively) than among controls (25.6%; 31.1%; 43.3%, respectively). Chi-square and t-test showed significant associations and differences between having chronic diseases and mental health outcomes. A conditional logistic regression showed that respondents with asthma, diabetes, cardiovascular disease symptoms, or any combination of these diseases had higher odds of exhibiting symptoms of stress, anxiety, and depression than healthy individuals.

CONCLUSION

These results underscore a subpopulation vulnerable to mental health consequences during this pandemic and indicate the need for additional mental health resources to be available to those with chronic diseases.

Mental health outcomes during the COVID-19 and perceptions towards the pandemic: Findings from a cross sectional study among Bangladeshi students

Although the COVID-19 pandemic triggered commination on both physical and mental wellbeing since its outbreak, the impact of the pandemic on mental health difficulties among Bangladeshi students is still lack in substantial evidence. The study aimed to explore such an impact on mental health among Bangladeshi students and their perception towards the COVID-19 pandemic. A web-based cross-sectional study was conducted among 589 students from Bangladesh in between April 29th to 7th May 2020. Data was collected by using an online questionnaire on demographic status, perceptions towards COVID-19, and mental health symptoms by using the Depression, Anxiety and Stress Scale (DASS 21). About 26.66% and 61.97% of students reported mild to extremely severe anxiety symptoms, and depressive symptoms, respectively, and 57.05% reported mild to extremely severe levels of stress. Multivariate logistic regression reported that students' age, gender, family income, residence, and family size are associated with mental health difficulties. Negative perceptions on the effect of the pandemic on life events, mental health, disruptions in education, and health care system, existing physical health conditions, and COVID-19 like symptoms were significantly associated with poor mental outcomes. It is suggested that students' mental health difficulties should be monitored to provide adequate support and services during this ongoing pandemic.

Sources of nutrition information and nutritional knowledge among school-going adolescents in Bangladesh

Objectives

Study design

Methods

Results

Conclusion

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Family members were the most popular (52.4%) source among school adolescents.

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Nearly half of the participants (48.1%) scored low on basic nutritional knowledge assessment.

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Majority (48.9%) of participants believe family members as accurate source.

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Only 12.4% of participants treat online resources as accurate and it was the least used source.

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Students used family members and online resources were less likely to obtain low score.