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BACKGROUND: The prevalence of MSS among office workers is high worldwide, having a significant effect on medical costs, absenteeism, and quality of life. In Bangladesh, there are many office workers but there is no data on the prevalence and impact of MSS. OBJECTIVE: The aim of this pilot study was to determine the prevalence and distribution of MSS among paper based office workers from one local office in order to determine whether or not an ergonomic intervention is required and the focus of the intervention needed.METHODS: A cross sectional study was conducted among 200 paper based office workers using a proportional stratified random sample. The Standardized Nordic Questionnaire was used to determine the prevalence and distribution of MSS. Data were analyzed using SPSS version 16.0. RESULTS: The mean age of the respondents was 43.0 years with a mean of 12.0 years work experience. 76.0% (n=152) of the respondents reported having MSS during the last 12 months. MSS complaints were reported primarily in the lower back region. 40.5% (n=81) of the respondents reported interruption of their normal daily activities within the last 12 months reportedly due to MSS.CONCLUSION: The current study showed the high prevalence rate of MSS among office workers in one workplace in Bangladesh. This was a pilot study, but it suggests that there is likely a need for further study into office workers' work sites and work practices to prevent work related injuries. [ABSTRACT FROM AUTHOR]

Introduction: Innovative interventions are needed to address the growing burden of breast cancer globally, especially among vulnerable patient populations. Given the success of Community Health Workers (CHWs) in addressing communicable diseases and non-communicable diseases, this scoping review will investigate the roles and impacts of CHWs in breast cancer screening programs. This paper also seeks to determine the effectiveness and feasibility of these programs, with particular attention paid to differences between CHW-led interventions in low- and middle-income countries (LMICs) and high-income countries (HICs).Methods: A scoping review was performed using six databases with dates ranging from 1978 to 2019. Comprehensive definitions and search terms were established for 'Community Health Workers' and 'breast cancer screening', and studies were extracted using the World Bank definition of LMIC. Screening and data extraction were protocolized using multiple independent reviewers. Chi-square test of independence was used for statistical analysis of the incidence of themes in HICs and LMICs.Results: Of the 1,551 papers screened, 33 were included based on inclusion and exclusion criteria. Study locations included the United States (n=27), Bangladesh (n=1), Peru (n=1), Malawi (n=2), Rwanda (n=1), and South Africa (n=1). Three primary roles for CHWs in breast cancer screening were identified: education (n=30), direct assistance or performance of breast cancer screening (n=7), and navigational services (n=6). In these roles, CHWs improved rates of breast cancer screening (n=23) and overall community member knowledge (n=21). Two studies performed cost-analyses of CHW-led interventions.Conclusion: This review extends our understanding of CHW effectiveness to breast cancer screening. It illustrates how CHW involvement in screening programs can have a significant impact in LMICs and HICs, and highlights the three CHW roles of education, direct performance of screening, and navigational services that emerge as useful pillars around which governments and NGOs can design effective programs in this area. [ABSTRACT FROM AUTHOR]

The university cafeteria is a crucial element in shaping students' dining experiences and their physical well-being. This study was conducted at a public university in Bangladesh. This research has a dual purpose: firstly, to assess student satisfaction with the university cafeteria using key indicators and secondly, to identify critical factors influencing this satisfaction through advanced data analysis employing recursive feature elimination (RFE). The ultimate goal is to enhance cafeteria services, align them with student preferences, and boost overall satisfaction. Data collection involved 150 paper-based questionnaires with mixed data types, including questions based on prior research assessments. The model-building process included the chi-squared test and the recursive feature elimination process. The study identifies 12 factors significantly affecting cafeteria food satisfaction, with four factors having a notable impact: meal type and freshness, staff attitude, and wait length. This research highlights the interconnectedness of seemingly distinct cafeteria factors and their potential to influence health outcomes. Practical recommendations are made for improving cafeteria efficiency and adapting to changing student needs. Health education interventions aimed at enhancing the cafeteria experience for university students should include a quantitative analysis of factors impacting students' overall cafeteria satisfaction. [ABSTRACT FROM AUTHOR]

Background: Persons with disabilities comprise more than one billion people in the world, yet they are one of the most discriminated groups and face significant health disparities. Particularly in developing countries, which contain 80% of the entire population with disabilities, these individuals experience major barriers in accessing sexual and reproductive health (SRH) services. Education is an important factor that greatly affects individuals' SRH service utilization. Hence, we sought to investigate the relationship between education and SRH service utilization for persons with disabilities in Bangladesh. Methods: Using an explanatory sequential mixed-methods design, a total of 5000 persons with disabilities were surveyed for the quantitative component and 15 mini-ethnographic case studies were conducted with persons with disabilities for the qualitative component. Chi-squared tests and logistic regression analyses were performed on the survey data, while the qualitative interviews were coded and their SRH themes synthesized accordingly. Results: Our quantitative findings show that education statistically significantly increases persons with disabilities' SRH service utilization of antenatal care, delivery care, postnatal care, and family planning (P < 0.05). Interestingly, for persons with disabilities, primary education shows increased adjusted odds of family planning use but is likely not enough to increase antenatal care, delivery care, or postnatal care use; secondary or post-secondary education may be required to improve utilization of these latter services. Qualitative findings support the association between higher education levels and greater SRH service use. Persons with disabilities of lower educational attainment held misinformation and distrust in SRH services and experienced mistreatment by SRH healthcare providers, discouraging them from seeking future SRH services. Conclusions: We report that higher formal education level is associated with greater SRH service use for persons with disabilities in Bangladesh. Formally educating persons with disabilities expands their SRH knowledge and familiarity with SRH services, as well as leads to more economic opportunities so they can afford SRH services. Increasing formal education levels for persons with disabilities, paired with integrating comprehensive sexuality education (CSE) in their schools, will likely help close the gap in SRH health disparities for this vulnerable population. Plain Language Summary: Out of more than one billion persons with disabilities in the world, 80% of them live in developing countries. Persons with disabilities commonly face discrimination and health disparities, particularly experiencing major barriers in accessing sexual and reproductive health (SRH) services. Education is a key factor that often leads to social and economic empowerment, which positively contributes towards individuals' SRH service utilization. In this paper, we examined the relationship between education and SRH service utilization for persons with disabilities in Bangladesh. We surveyed persons with disabilities across all of Bangladesh on their utilization of SRH services and conducted mini-ethnographic case studies with selected participants to more deeply understand their SRH issues and SRH service utilization. Our survey findings show that education significantly increases persons with disabilities' SRH service utilization of antenatal care, delivery care, postnatal care, and family planning in Bangladesh. Interestingly, for persons with disabilities, primary education may only be able to increase family planning use while secondary or post-secondary education may be required to increase antenatal care, delivery care, and postnatal care use. Our qualitative findings support the association between higher education levels and greater SRH service use. Persons with disabilities of higher education prioritized obtaining formal SRH services from qualified health care providers, even when financially constrained, while lower educated participants tended to be misinformed and distrustful of formal SRH services. We recommend helping persons with disabilities attain higher formal education levels and including comprehensive sexuality education (CSE) in their schools, as it likely will reduce SRH health disparities for this vulnerable group. [ABSTRACT FROM AUTHOR]

This research paper attempts to examine the prevalence and determinants of sleep disorder of rural elderly in the northeastern part of Bangladesh. A total of four hundred elderly both males and females were selected randomly from the rural area of the Sunamgonj district in Bangladesh. Descriptive statistics, Chi-square test, and Logistic regression model were applied to analyze the data. The results show that about fifty-seven per cent of the elderly were suffering from a sleep disorder. Male elderly were suffering more than female elderly. Unmarried elderly were suffering more than married elderly. Chi-square analysis shows that sleep disorders of the elderly are significantly associated with their income, age, blood pressure, physical exercise, smoking behavior, and family type. The logistic regression analysis shows that economic condition, family type, blood pressure, and physical exercise are significant factors of sleep disorder of the elderly. The present findings may be helpful for the policymakers and researchers of rural geriatric of the country. [ABSTRACT FROM AUTHOR]

In this paper, an attempt is made to show the impact of education and media on contraceptive use and also to identify the factors that associated with the current use of contraception and continuing of contraception. To reach our goal, Bangladesh Demographic and Health Survey ( BDHS 2007) data were used. Findings of this study reveal that education, age of the respondents, religion, media exposure, area of residence and if they belong to any of the non-governmental organizations ( Grameen Bank, Bangladesh Rural Advancement Committee, ASA, Mother's club, etc.) have significant contribution to current use of contraception and continuing of contraception. Media, particularly TV, and education play the leading role regarding this issue, whereas the others have an indirect relationship. Multivariate analyses showed that contraceptive use were higher among educated women and those women who watch TV at least once a week as compared with their respective counterpart. The results indicate urgent need to give emphasis on education, ensuring electronic media exposure, head-to-head communication programme, institutional-based family planning education and necessary information to learn about the impact of overpopulation for the people all over the country. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to examine the effects of social networks on contraceptive adoption in Bangladesh. Design/methodology/approach: Data were collected from 430 couples; the age of men was between 15 and 49 years. χ2 test was applied to test the association between independent variables and current contraceptive use. Binary logistic regression was applied to examine the effects of social network on contraceptive use, and multinomial logistic regression was applied to examine the effect of social network on the choice of method. Findings: Results from binary logistic regression reveal that social networks of both men (OR=2.71, 95% CI=1.371−5.354) and women (OR= 3.597, 95% CI=1.754−7.380) had a strong positive effect on current contraceptive use. The result from multinomial logistic regression also shows that men's social network (OR= 2.74, 95% CI= 1.356−5.548) and women's social network (OR=4.165,95% CI=1.958−8.860) were also associated with choosing a modern contraceptive method. Originality/value: Social networks have a significant effect on current contraceptive use and modern method choice in Bangladesh. A social network approach should be included in family planning program in Bangladesh. [ABSTRACT FROM AUTHOR]

Domestic violence against women is a major social problem in Bangladesh. This paper examines the determinants of domestic violence in Bangladesh during the COVID-19 pandemic. The project was carried out in selected areas of Khulna district of the country and followed survey research design. A total of 312 ever married female respondents who experienced domestic violence at any stage of their life were surveyed. The respondents were selected through simple random sampling as a semi-structured questionnaire/interview schedules was used as the primary tool for data collection. The data were collected in two stages between the months of May-October, 2021 through face-to-face interviews. Results from the chi-square analysis show that, respondents' residence, educational status, age at first marriage, duration of marriage life, husband's income, husband's occupation, and a demand for dowry were all associated with domestic violence against women (p < .01). The study concludes that creation of awareness and empowerment of women through income generating activities particularly in the rural areas of Bangladesh is necessary to reduce the prevalence of domestic violence. [ABSTRACT FROM AUTHOR]

Background: In Bangladesh, the most prevalent musculoskeletal condition among office employees is considered as BlackBerry thumb (BBT). Alike official perspectives, our educational system was significantly regulating with the digital interfaces at COVID-19 lockdown, where a greater reliance on Android phones were experienced among the adults. Numerous studies have been conducted in studying the incidences of BBT in young individuals as a result of hazards of Android phone usage (HAPU) in Bangladesh. Objective: This research sought to determine the relationship between BBT symptoms and the risks associated with the using Android phones among Bangladeshi university students. Methods: A nationwide cross-sectional study was undertaken on a group of university students between the ages of 18 and 25 to determine if BBT symptoms were present based on the Finkelstein test and HAPU, which were also assessed using a well-designed questionnaire. We calculated the crude and adjusted prevalence ratios (aPR) and used a generalized linear model from the Poisson family, using their respective 95% confidence intervals (CI). Results: There were 2455 individuals in this research, with a median age of 20 and an interquartile range (IQR) of 19 to 23. Of them, 1185 males (48.27%) and 1270 women (51.75%) made up the study's participant population. Physical exams showed that 1300 individuals had positive Finkelstein test results (52.95%), whereas 1040 people had occasional risks from using an Android phone and 115 participants had occasional risks from using an iPhone. In our generalized linear model, we observed that participants with occasional and frequent HAPU had higher rates of BBT symptoms than responders without HAPU (aPR = 1.73, 95% CI: 1.47–2.05, and aPR = 1.61, 95% CI: 1.29–2.00), respectively. Conclusion: The current study found that Bangladeshi university students experiencing BlackBerry thumb symptoms were more likely to have risks associated with using Android phones. [ABSTRACT FROM AUTHOR]

Background: In low-income settings, community health workers (CHWs) are frequently the first point of contact for newborns. Mobile technology may aid health workers in classifying illness and providing referral and management guidance for newborn care. This study evaluates the potential for mobile health technology to improve diagnosis and case management of newborns in Bangladesh.Methods: A mobile application based on Bangladesh's Comprehensive Newborn Care Package national guidelines (mCNCP) was developed to aid CHWs in identifying and managing small and sick infants. After a 2-day training, CHWs assessed newborns at Sylhet Osmani Medical College Hospital and in the Projahnmo research site (Sylhet, Bangladesh) using either mCNCP or a comparable paper form (pCNCP), similar to standard IMCI-formatted paper forms. CHWs were randomized to conduct a block of ~ 6 newborn assessments starting with either mCNCP or pCNCP, then switched to the alternate method. Physicians using mCNCP served as gold standard assessors. CHW performance with mCNCP and pCNCP were compared using chi-squared tests of independence for equality of proportions, and logistic regressions clustered by CHW.Results: Two hundred seven total CHW assessments were completed on 101 enrolled infants. mCNCP assessments were more often fully completed and completed faster than pCNCP assessments (100% vs 23.8%, p < 0.001; 17.5 vs 23.6 min; p < 0.001). mCNCP facilitated calculations of respiratory rate, temperature, and gestational age. CHWs using mCNCP were more likely to identify small newborns (Odds Ratio (OR): 20.8, Confidence Interval (CI): (7.1, 60.8), p < 0.001), and to correctly classify 7 out of 16 newborn conditions evaluated, including severe weight loss (OR: 13.1, CI: (4.6, 37.5), p < 0.001), poor movement (OR: 6.6, CI: (2.3, 19.3), p = 0.001), hypothermia (OR: 14.9, CI: (2.7, 82.2), p = 0.002), and feeding intolerance (OR: 2.1, CI: (1.3, 3.3), p = 0.003). CHWs with mCNCP were more likely to provide counseling as needed on 4 out of 7 case management recommendations evaluated, including kangaroo mother care.Conclusions: CHWs in rural Bangladesh with limited experience using tablets successfully used a mobile application for neonatal assessment after a two-day training. mCNCP may aid frontline health workers in Bangladesh to improve completion of neonatal assessment, classification of illnesses, and adherence to neonatal management guidelines. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to explore the initial understanding of what perceptions have the faculty members of Dhaka University and how they use cloud for academic activities. Design/methodology/approach: A semi-structured questionnaire was used to collect responses from the faculty members of Dhaka University. An online questionnaire was sent out to the faculty members of Dhaka University via e-mail. The questionnaire was both open and close-ended. Overall, 125 respondents participated in this survey and convenience sampling method was used. Mann–Whitney and chi-square test were carried out to see the influence of demographic characteristics on cloud use for teaching and learning activities. Findings: The results showed that faculty members are generally aware of cloud computing, and they are using some of the cloud applications for teaching and learning purposes. They use cloud for research, collaboration, faculty-students engagement, student supporting activities and sharing course materials. They identified limited wireless access or internet facilities, lack of ICT infrastructure and lack of cloud training and knowledge as major constraints. However, these constraints are mainly related to the poor IT infrastructure and limited access to internet, which may also lead to other constraints. Originality/value: This is the first time an attempt has been made to explore the perception and use of cloud among the faculty members in a public university, Bangladesh. The findings of this study may shed light to other align research areas of cloud computing in Bangladesh. [ABSTRACT FROM AUTHOR]

Abstract: Improving infant and young child feeding practices is critical for improving growth and reducing child mortality and morbidity. This paper aims to compare predictors of minimum dietary diversity, an important indicator of adequate complementary feeding practices, in Bangladesh in 2011 and 2014. The 2011 and 2014 Bangladesh Demographic and Health Survey were used to examine predictors of minimum dietary diversity among 6–23 months. An additional analysis was conducted for the 18–23‐month group, because a significant increase in meeting minimum dietary diversity recommendations was seen in this age group only. Factors found to be associated with practices were compared across time points. In 2011, minimum dietary diversity was 23.8% and increased to 28.8% in 2014. Among children 18–23 months, in 2011, minimum dietary diversity was 32.5% and increased to 42.8% in 2014. Among all children, wealth, education, exposure to media, and antenatal care were significant predictors of dietary diversity. In the 18–23‐month age group, significant predictors in 2011 were wealth and decision making. In 2014, significant predictors were education and exposure to media. Demographic trends indicated a significant increase in education and exposure to media between 2011 and 2014. As these were significant for minimum dietary diversity in 2014 overall and for 18–23 months, they might be important targets of future interventions, specifically utilizing media channels and tailoring special strategies for women with low education and limited exposure to media. [ABSTRACT FROM AUTHOR]

Behaviour change communication (BCC) can improve infant and young child nutrition (IYCN) knowledge, practices, and health outcomes. However, few studies have examined whether the improved knowledge persists after BCC activities end. This paper assesses the effect of nutrition sensitive social protection interventions on IYCN knowledge in rural Bangladesh, both during and after intervention activities. We use data from two, 2-year, cluster randomised control trials that included nutrition BCC in some treatment arms. These data were collected at intervention baseline, midline, and endline, and 6-10 months after the intervention ended. We analyse data on IYCN knowledge from the same 2,341 women over these 4 survey rounds. We construct a number correct score on 18 IYCN knowledge questions and assess whether the impact of the BCC changes over time for the different treatment groups. Effects are estimated using ordinary least squares accounting for the clustered design of the study. There are 3 main findings: First, the BCC improves IYCN knowledge substantially in the 1st year of the intervention; participants correctly answer 3.0-3.2 more questions (36% more) compared to the non-BCC groups. Second, the increase in knowledge between the 1st and 2nd year was smaller, an additional 0.7-0.9 correct answers. Third, knowledge persists; there are no significant decreases in IYCN knowledge 6-10 months after nutrition BCC activities ended. [ABSTRACT FROM AUTHOR]

Introduction: The utilization of facility delivery is crucial to achieve sustainable development goals by reducing maternal and neonatal deaths. This study aimed to compare the distributions and determinants of childbirth in health facilities in urban and rural regions of Bangladesh. Methods: Cross-sectional data from the 2017-2018 Bangladesh Demographic and Health Survey were analyzed. Multilevel logistic regression was applied. Results: A total of 4 751 women were included in the analyses. Only 50% of childbirths took place in health facilities, 63.4% and 44.6% in urban and rural regions, respectively. Overall, the odds of the association between facility delivery and the studied factors were similar. Multiparous women had significantly lower odds of facility delivery in both rural (adjusted odds ratio [AOR] = 0.3, 95% confidence interval [CI]: 0.2 to 0.5) and urban (AOR = 0.2, 95% CI: 0.1 to 0.5) regions. In both regions, women with higher education levels, highly educated husbands, antenatal care (ANC), and higher wealth indexes had significantly higher odds of facility delivery. Conclusion: Several common associated factors were identified. However, differences were observed regarding distributions of these factors. The differences in facility delivery utilization could result from lower ANC utilization, socioeconomic status, and transportation facilities in rural regions than urban regions; therefore, improving these conditions could increase facility delivery in these regions. [ABSTRACT FROM AUTHOR]

Background: C-section prevalence has increased drastically over the past few decades across the globe. This growth has been caused by an array of factors, including maternal, socio-demographic, and institutional factors, and it is a global concern in both developed and developing countries. Therefore, the objective of this study is to identify relevant risk factors for the delivery type, and find a more accurate ML-based model for identifying cesarean women. Methods: The study is based on 5139 delivery cases from the Bangladesh Demographic Health Survey (BDHS) 2017-18. The number of C-sections performed in the nation has increased to at least 45 percent in the two years prior to 2022. Because of this, we have used multiple logistic regression and machine learning algorithms to determine cesarean delivery and identify the socio-demographic risk factor among mothers in Bangladesh. Results: An independent X² test was performed before we considered six popular machine learning (ML) algorithms to predict C-section among women in Bangladesh, including logistic regression (LR), random forest (RF), support vector machine (SVM), k-nearest neighbor (KNN), naive Bayes (NB), and decision tree (DT). Model evaluation criteria included accuracy, mean absolute error (MAE), Cohen's kappa, precision, specificity, area under the curve (AUC), and F1 score value. Bivariate analysis results revealed that higher educated mothers and fathers, the richest family, overweight mothers, and hospital delivery had a higher percentage of cesarean babies. With an accuracy of 83.74%, NB (naive Bayes) outperforms the other five classifiers. We can get more precise information than accuracy from the ROC curve and the AUC. Depending on the AUC value, we can see that among all classifiers, Logistic Regression (LR) and Random Forest (RF) provide the most accurate classification for determining c-section among Bangladeshi women. Conclusion: Our findings contribute to a better understanding of how to categorize C-section intentions among Bangladeshi women. The technique will be useful in identifying the women who are most likely to undergo a C-section in the healthcare system. As a result, the government can launch an effective public awareness campaign. [ABSTRACT FROM AUTHOR]

Background Children from developing countries are more vulnerable to traumatic experiences and more likely to suffer a range of psychological problems than children from developed countries. Method The current paper describes a survey of 1360 children and adolescents from Bangladesh who were selected either from the general community or through a range of social service organizations. Children completed a checklist of traumatic events and questionnaires to assess symptoms of PTSD, anxiety and depression. Results Children from both samples reported high levels of exposure to traumatic events, both via direct experience and indirectly. Direct experiences with intentional, man-made events were more frequently reported by children from support services while trauma from natural disasters was more common among community children. Psychological symptoms were significantly higher within children from social support services. The strongest predictors of psychological symptoms were age, gender, sample source and exposure to man-made direct traumas. Conclusion The results point to the common occurrence of traumatic events and their emotional consequences among children and adolescents from Bangladesh and indicate the need to develop effective and accessible mental health services for Bangladeshi children and adolescents. [ABSTRACT FROM AUTHOR]

Background Maternal depression is associated with poor child development and growth in low-income countries. This paper evaluates the effect of a community-based trial providing psychosocial stimulation and food supplements to severely malnourished children on maternal depressive symptoms in Bangladesh. Methods Severely underweight (weight-for-age Z-score < −3) hospitalized children aged 6-24 months ( n = 507), were randomly assigned to: psychosocial stimulation ( PS), food supplementation ( FS), PS+ FS, clinic control ( CC) and hospital control ( CH) at discharge. PS included play sessions with children and parental counselling to mothers during fortnightly follow-up visit at community clinics, conducted by trained play leaders for 6 months. FS involved cereal-based supplements (150-300 kcal/day) for 3 months. All groups received medical care, micronutrient supplements and growth monitoring. We used Bayley scales, Home Observation for Measurement of Environment ( HOME) inventory and a parenting questionnaire to assess child development, home stimulation and mothers' child-rearing practices, respectively. We assessed mothers' depressive symptoms using a modified version of Centre for Epidemiologic Studies Depression Scale at baseline and at 6 months post intervention. Results Maternal depressive symptoms were significantly lower in the CH group at baseline ( P = 0.014). After 6 months of intervention there was no significant effect of intervention after adjusting for baseline scores and all possible confounders. Maternal depressive symptoms were higher among poorer ( P = 0.06), older ( P = 0.057) and less educated ( P = 0.019) mothers, who were housewives ( P = 0.053), and whose husbands had more unstable jobs ( P = 0.058). At 6 months post intervention, children's cognitive ( P = 0.045) and motor ( P = 0.075) development, HOME ( P = 0.012) and mother's parenting score ( P = 0.057) were higher among mothers with lower depressive symptoms. Conclusion The study did not show a significant effect of the intervention on the level of maternal depressive symptoms. Interventions with higher intensity and/or of longer duration focusing directly on maternal psychosocial functioning are probably needed to reduce maternal depressive symptoms. [ABSTRACT FROM AUTHOR]

Ageing is going to be a major problem in Bangladesh given its population size, scarce resources, existing poverty, insufficient health facilities and lack of a social security system. This paper examines how many years older people expect to be in good health, and what are the correlates of self-rated health (SRH). The data used in this study come from 896 older people aged 60 years and above from Rajshahi district in Bangladesh and from United Nations’ projected population figures. Results show that individuals at age 60 expected about 41 per cent of their remaining life to be in good health, while individuals at age 80 expected only 21 per cent of their remaining life to be in good health. Having exercised during the six months prior to the survey was the single most important correlate of SRH (odds ratio=5.49; confidence interval 4.03–7.47; without any adjustment). While rural–urban differentials and some health decline in old age are inevitable, four factors (exercise behaviour, sufficiency of income, physical limitations and facing abusive behaviour) are to a certain extent modifiable and therefore provide the potential for improving SRH and healthy life expectancy in Rajshahi district, Bangladesh. [ABSTRACT FROM PUBLISHER]

Like other non-bank financial institutions and NGOs, Commercial banks are also extending financial services in terms of loan or credit to entrepreneurship development in Bangladesh. This paper aims at evaluating the impact of the intensity and sources of bank finance on the determinants of entrepreneurship development. To the end, both interview schedule and semi-structured questionnaire were used as instruments of primary data collection from the randomly selected 200 entrepreneurs and 20 officers of the sample two banks respectively. Tables with simple percentage and rank order and the chi-square statistic to test the formulated hypotheses were used in the data processing and analysis. Results of the study claim that commercial bank's finance strongly impact on the entrepreneurship development and the public commercial bank remains the better position in this regard. The study ends with some recommendations which can remove the barriers to entrepreneurship development through bank finance. [ABSTRACT FROM AUTHOR]

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Introduction: COVID-19 has changed all the routine works of human beings around the globe. The food habits of the elderly are changing due to various reasons. The purpose of this study was to find out the factors influencing food habit changes due to the pandemic. Methods: A non-experimental research design, a survey, was executed at Sachibunia, Nijkhamr, Krishnonagar, and Raingamari villages under Batiaghata Upazila in the Khulna District of Bangladesh. Following a simple random sampling technique, data were collected through a field survey using an interview schedule. To show the relations between/among the variables, the chi-square/Fisher exact test was performed. For measuring the degree of relations of those variables, Binary Logistic Regression was used to find out the factors of food habit changes with a 95% confidence interval. For the model, p < 0.05 was considered statistically significant. Results: The study reveals that 39% of the elderly changed their food habits during COVID-19. Except for the sex and employment status of the elderly, all the sociodemographic factors of this study were associated with food habit changes. Among these sociodemographic factors, age (OR = 2.51, 95% CI, 1.22-5.18), religion (OR = 2.07, 95% CI, 1.13-3.78), spouses' occupation (OR = 3.73, 95% CI, 1.90-7.32), and family head (OR = 3.74, 95% CI, 1.43-9.75) of the elderly influenced their food habits changes. Conclusion: The socio-demographic and economic situations were responsible for the elderly's food habits changes. [ABSTRACT FROM AUTHOR]

Bangladesh is one of the most vulnerable countries in the world under the context of climate change. Each year thousands of migrants arrive in Dhaka City, the capital of the country, mainly forced by events such as floods, cyclone and riverbank erosion. Such group of migrants has been termed as “climate-induced” migrants in this research. The city also received other types of migrants who are not driven by climatic factors; rather their reasons for migration are purely opportunistic. This group has been termed as non-climate-induced migrants. The paper deals with the climate-induced and non-climate-induced migrants in Korail slum of Bangladesh who had arrived in Dhaka after 2006. This research attempted to analyse whether there are any differences in the characteristics, experiences and future aspiration between these two groups in spite of living in the same slum located in the capital of Bangladesh. Questionnaire survey, focus groups and key informant interview were the methods of data collection. Independent sample t-test and Chi-square test have been conducted to analyse data. Results revealed significant differences between the two groups in terms of income and savings, educational level, access to credit, contacts in the city, family structure, pattern of migration and relationship with the place of origin. The study revealed that if not properly planned, migration cannot be a suitable adaptation option. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore whether socio-economic factors determine the level of menstrual knowledge and perceptions of schoolgirls in Bangladesh. The aim of this study is to understand how knowledge and perceptions vary with variations in the different socio-economic factors in a schoolgirl's life such as place of residence, religion, age, grade, parents' education, parents' occupation, family income and even family size. Design/methodology/approach: Data were collected from four schools (two in urban areas and two in rural areas). A total of 450 schoolgirls from grades V–X were interviewed to examine how knowledge and perceptions varied with different socio-economic aspects. Multiple logistic regression models were used to measure the associations between various socio-economic variables and perceptions of and knowledge about menstruation. Findings: Respondents from urban areas were 4.75 times more likely and those 14–16 years old were two times more likely to report higher levels of knowledge about menstruation compared to their counterparts. Based on the father's occupation, respondents whose father was engaged in a professional occupation were 1.983 times more likely to have a higher level of knowledge on menstruation compared to those whose fathers were in an unskilled profession. Similarly, the odds of positive perceptions on menstruation were 1.456 and 1.987 times higher, respectively, among respondents living in urban areas and those 14–16 years old, compared to their counterparts. Originality/value: This study provides evidence that different socio-economic and even demographic factors are important in the development of menstrual knowledge and perceptions. Policy formulation and development actions related to adolescent girls' physical and reproductive health development need to consider these factors in Bangladesh and in other developing countries, where poor knowledge and perception related to menstruation are hindering girls' mental and physical development. This is expected that better knowledge and perception will facilitate girls' right to have better health and social lives. [ABSTRACT FROM AUTHOR]

Aim: This study aimed at exploring the perception and experiences with regard to the COVID-19 pandemic among Bangladeshi urban young adults. Subject and methods: Using a mixed-method approach, an online cross-sectional survey among 315 participants and in-depth interviews (IDI) among 20 young adults were conducted from May 1 to May 25, 2020. Descriptive statistics and chi-square tests were performed for quantitative data, along with the thematic analysis for qualitative data. Results: The mean (± SD) age of the participants was 26.54 (± 3.05), and the majority were male (54.9%). About 81.6% of the participants reported COVID-19 as a viral disease, transmitted through droplets of sneezing and coughing, and close contact with another person (90.8%). Nearly 40% of participants reported news channels as a reliable source of information for COVID-19. Participants who were male were less likely to be aware than females in terms of mode of transmission of COVID-19 such as going outside of the home (82.7% male vs 90.8% female; p < 0.05). Male participants thought they were perfectly healthy and more reluctant to agree with maintaining social distance compared to female participants (72.8% male vs 90.1% female; p < 0.001). Participant's satisfaction level with services provided by the government was also significantly different and higher among females than male participants (39.9% male vs 53.5% female; p < 0.05). The majority of the participants reported suffering due to financial uncertainty, psychological distress, and inadequate health facilities. Dissatisfaction was reported with the existing health services as creating several misconceptions, lacking testing facilities, and debasement by the health professionals. Conclusion: This study found a better perception regarding COVID-19 among the young adults, but they had poor preventive practices. Health education intervention with the rapid response should be implemented targeting this vulnerable group to improve their preventive practices. [ABSTRACT FROM AUTHOR]

Aim: To investigate the prevalence of cognitive impairment and its predictors among the elderly in Bangladesh. Subject and Methods: We use a cross-sectional survey of 1015 older people (≥60 years) in Bangladesh collected jointly by the Sir William Beveridge Foundation (SWBF) and Aging Support Forum (ASF), Bangladesh. The Mini-Mental State Examination (MMSE) scale, adapted to the Bengali language, was used for assessing cognitive impairment, which was available for 111 participants. Logistic regression analysis was used to identify predictors of cognitive impairment. Multiple imputation under the missing-at-random (MAR) mechanism was used to deal with missing data. Results: Overall, 31 out of 111 (27.9%) participants had mild, moderate or severe cognitive impairment, with a higher proportion among women (33.3%, 17 out of 51) than men (23.3%, 14 out of 60). More precisely, 24 out of 111 (21.6%) and 7 out of 111 (6.3%) had mild/moderate and severe cognitive impairment, respectively, with a higher percentage among women (mild/moderate: 25.5%, severe: 7.8%) than men (mild/moderate: 18.3%, severe: 5.0%). Age (odds ratio, OR = 1.06, p = 0.046, 95% CI: 1.001 to 1.119) and social engagement (OR = 0.25, p = 0.033, 95% CI: 0.072 to 0.898) were found to be statistically significant predictors of cognitive impairment in this group of people. The effect of physical disability fell short of statistical significance at the 5% level but was significant at the 10% level (OR = 2.89, p = 0.099, 90% CI: 0.999 to 8.370). Conclusion: The prevalence of cognitive impairment in Bangladesh is alarming and is comparatively higher among elderly women, which seems to increase with age and the presence of any physical disability. Also, prevalence appears to be lower in people who are more socially engaged or active. [ABSTRACT FROM AUTHOR]

Purpose: Early literacy and numeracy development among children may be the best measure of a child's well-being. The purpose of this research was to examine the impact of child factors, quality of care and household factors, and community factors in early childhood on the development of literacy and numeracy skills of children in Bangladesh. Design/methodology/approach: For this study, the authors used data from Bangladesh's 2019 Multiple Indicator Cluster Survey. The association between response variables and selected covariates was examined using the chi-square test. To determine the risk factors for early child literacy and numeracy development, the authors applied two-level logistic regression models. Findings: Among the total of under five children (n = 9,449), in general, 29.1% of the children were growing in the development early childhood literacy and numeracy in Bangladesh. Children (36–47 months), male children, children with moderate stunting, children with severe and moderate underweight status, mothers without education and primary education, and mothers from the poorest, poorer, middle and richer households were less likely than their counterparts to develop children's early literacy and numeracy skills. In contrast, women from the eastern and central regions, children who read at least 3 books, and early childhood education had higher odds of children's literacy and numeracy skills development than their counterparts. Originality/value: The results from this study suggest that children's, community, quality of care and household level significant factors should be considered when trying to improve children's literacy and numeracy skills development in Bangladesh. [ABSTRACT FROM AUTHOR]

We examined intra-regional variations and contextual influences on institutional delivery of women using the nationally representative 2014 Bangladesh Demographic and Health Survey data. Due to the hierarchical structure of the data, we employed multi-level logistic regression analysis. Of the women who had had a live birth in the last three years preceding the survey, only 38% availed the opportunity of institutional delivery. From the findings of this study, we observed that women of the Eastern region were less likely and those of the Western region were more likely to use FBD compared to the women of the Central region. Both individual- and community-level factors influence women to use facility-based delivery. Community-level programs aimed at improving availability and easy accessibility to economically deprived and geographically disadvantaged areas may increase safe motherhood practices among women. [ABSTRACT FROM AUTHOR]

We studied South Asian immigrant patients who did not return to Elmhurst Hospital Center (EHC) after emergent cardiac catheterization in order to propose interventions to improve follow up care. We identified 74 eligible patients, interviewed 30 about follow up practices, and analyzed findings. Most patients are Bangladeshi and 77% preferred a foreign language. Some were visiting the US during the admission without intent to follow up. Half were dissatisfied with EHC providers, complications, and inadequate care at follow up appointments. Some patients were unaware of scheduled appointments or the necessity of follow up. Most follow with private providers due to language accessibility, availability, and proximity. We found that language barriers contribute to loss to follow up and the true loss to follow up rate is lower than reported at EHC. This can inform practices at hospitals with immigrant populations, minimize resource waste, and improve quality of care. [ABSTRACT FROM AUTHOR]

Aim: The association between urbanization and childhood overweight/obesity (OWOB) in lower- and middle-income countries (LMICs) is poorly understood. Therefore, this study aimed to explore the association between residential district-level urbanization and OWOB among children under 5 years of age in Bangladesh. Subjects and methods: This study used data from a nationally representative sample of children under 5 years of age (N = 19,640) from the Bangladesh Multiple Indicator Cluster Survey 2012–13, including OWOB status of eligible children and other sociodemographic variables. District-level social and physical environmental features were used to create an urbanization index (low, medium, and high) using modified factor analysis. Individuals' data were linked to the district-level urbanization index, and design-based binary logistic regression was used to explore the association between urbanization and OWOB. Results: Prevalence of childhood OWOB was 1.6%, and the average urbanization score was 37.4% (standard deviation: 8.7%). Childhood OWOB was higher in highly urbanized districts (2.0%) than in low urbanization districts (1.2%). The odds of OWOB was 53% higher in highly urbanized districts compared to low urbanization districts (adjusted odds ratio: 1.53; 95% CI: 1.01–2.31). Conclusions: Residential area urbanization was associated with childhood OWOB. These results suggest the importance of formulating context-specific prevention programs and policies to mitigate the adverse impacts of urbanization on childhood overnutrition in LMICs like Bangladesh. Future studies are required to understand its causal relationship with OWOB. [ABSTRACT FROM AUTHOR]

The main aim of this study is to identify the role of information dissemination on urban and rural citizens of Bangladesh during the COVID-19 pandemic and the role of misinformation in this process. The study also aimed at finding appropriate counter misinformation strategies regarding COVID-19. An online questionnaire was prepared to collect the viewpoints of the urban and rural citizens of Bangladesh regarding dissemination of information during COVID-19, misinformation regarding COVID-19, and counter misinformation strategies. Along with demographic and general information, a five-point Likert scale was used to measure COVID-19 related misinformation beliefs and how to counter them. Chi square tests were used to determine the association between current residency, information sources, the importance of information dissemination, reactions after getting COVID related information, and evaluative steps after getting information and before disseminating it. Additionally, nonparametric Mann–Whitney U and Kruskal–Wallis tests were conducted to know the significance of difference in respondents’ assessment on COVID-19 related misinformation in terms of their demographic characteristics. Cronbach’s alpha score was obtained to see the reliability of the questionnaire items. The current study reveals that both urban and rural citizens of Bangladesh are influenced by information dissemination regarding COVID-19 and they have lower level of misinformation belief. The respondents have differences in misinformation belief by different demographic groups. Respondents’ educational status, information literacy, sources of getting information, and evaluative steps after getting information have significant differences in misinformation belief. The study also noticed the support of respondents for countering misinformation strategies regarding COVID-19. [ABSTRACT FROM AUTHOR]

Although Bangladesh has made significant progress in reducing child mortality, proper utilization of health services for under-five children among mothers remains one of the major challenges. Hence, this study was designed to investigate the factors influencing health service utilization among mothers for under-five children in the Khulna district of Bangladesh. Administering a semi-structured interview schedule, data were collected from 364 randomly selected mothers from the study area between June and August 2021. At first, Pearson's Chi-square test was conducted to measure the association between outcome and predictor variables. Multivariable logistic regression model was used to identify the factors associated with utilization of health services. Overall, about 59 percent of the mother received health services from unqualified doctors during their children's illness and the rest of them (41.5%) seek care from the qualified doctors. Results of regression analysis revealed that long duration of illness (AOR = 2.338; CI: 1.175–4.649; p = 0.015), the severity of illness (AOR = 6.402; CI: 3.275–12.513; p<0.001), and higher cost of treatment (AOR = 7.371; CI: 3.297–16.480; p<0.001) were the significant predictors of utilization of health services from the qualified doctors for under-five children. Thus, the study suggests that to reduce under-five child mortality by ensuring proper utilization of health services, it is necessary to raise awareness among mothers, improve transport facilities, establish need-based health care centers, and lower treatment costs. [ABSTRACT FROM AUTHOR]

Aim: The prevalence of cesarean section (CS) delivery has been increasing dramatically in both developed and developing countries. South Asian countries, including Bangladesh, have recorded substantial increases in CS over the past decade. The objective of this study was to assess the prevalence and associated factors of cesarean delivery in Bangladesh. Subject and methods: Nationally representative cross-sectional secondary data was extracted from the Multiple Indicator Cluster Survey (MICS) 2019, Bangladesh. CS was measured in two categories with cesarean and non-cesarean responses obtained by interviewing the women aged 15–49 years with a live birth in the past 2 years. Chi-square test was used to examine the significant association of mode of delivery (cesarean or non-cesarean delivery). Binary logistic regression was used to assess the factors of CS. Analysis was carried out using STATA version 16. Results: The study showed that among 9208 respondents, 36.1% of women underwent CS. The multivariate analysis indicated that mothers who were over 30 years old [OR 1.02; (95% CI 0.85, 1.21)], had higher education [OR 3.80; (95% CI 2.92, 4.94)], had rich wealth indexes [OR 2.41; (95% CI 2.12, 2.75)], gave birth in private health facility [OR = 8.77; (95% CI 7.6, 10.2)], took antenatal care (ANC) more than three times [OR 4.84, (95% CI 4.02,5.83)], and also gave birth to a larger than average sized baby [OR 1.45; (95% CI 1.22, 1.73)] were significantly associated with CS delivery. Conclusion: Bangladesh's health system urgently needs policy guidelines to monitor clinical indications of CS delivery and prevent an exessive number of CS in private health facilities, which is an essential step to reduce the high prevalence of CS. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of the study is to assess the differences between socio-demographic status of low-prevalence Bangladeshi (BD) and high-prevalence forcibly displaced Myanmar nationals (FDMN) HIV patients. Material and methods: In this cross-sectional study, demographic details and behavioural patterns were analysed and compared. Results: The highest number of patients was observed in adult females (54.4%) in FDMN and adult males (54%) in BD (p = 0.006). 97.74% FDMN and 59.70% BD had no income (p = 0.000). Most (94.5%) of the Bangladeshi males were migrants (p = 0.000). There was a significant difference in the mode of transmission between the 2 countries (p = 0.000). The highest mode of transmission among BD was heterogenous sexual exposure (70.8%) and among FDMN it was unsafe injections (49%). Mother-to-child transmission was significantly (p = 0.00) higher among FDMN (16.6%) than BD (8.3%). High-risk behaviours were higher among BD (65%) than FDMN (26%) (p = 0.000). Male clients of BD (35%) and female clients of FDMN (13%) had a higher likelihood of bad habits like smoking and alcohol abuse (p = 0.01). A statistically significant difference (p = 0.002 with 95% CI) was observed in the spousal status of the affected individual between the 2 countries. HIV status was found to be negative in spouses 35% and 64.5% of BD and FDMN, respectively. About 3% of FDMN people had broken/separated from their families due to HIV. About 61% of BD and 37% of FDMN adults had multiple sexual partners (p = 0.001). Conclusions: This study compares the sociodemographic variability among HIV patients of BD and FDMN groups and measures these results against other similar studies. [ABSTRACT FROM AUTHOR]

Introduction: Handwashing practice is an effective way to minimize severe infectious diseases such as COVID-19, diarrhea, and pneumonia. The study aimed to explore the prevalence of handwashing behavior and associated determinants in rural and urban areas of Bangladesh. Methods: The research was performed using cross-sectional survey data from the 2019 Bangladesh Multiple Indicator Cluster Survey, and 61,242 household members were the sample for this study. The Chi-square test was applied for the bivariate analysis. A generalized linear mixed-effects model was used to identify the risk factors of practicing handwashing in both urban and rural areas of Bangladesh. Results: Only 65% of the country's households had access to handwashing facilities (place, water, and materials). While urban dwellers were more likely to wash their hands, rural dwellers were only 63% likely to do so. The level of education of household heads, wealth status, division, number of family members, sanitation facilities, and water source were the key factors associated with handwashing behavior. This study revealed that the odds were significantly lower among illiterate respondents compared to those with secondary and above-secondary education in both areas of Bangladesh, and a positive association was found between wealth status and handwashing behavior practiced in both urban and rural areas. In this study, the size of the family was statistically significant for both rural and urban areas of Bangladesh. Conclusion: Handwashing is the most prominent consideration for controlling COVID-19. Policymakers are striving to improve handwashing facilities by increasing awareness-raising programs, especially among rural residents of Bangladesh. [ABSTRACT FROM AUTHOR]

Aim: The COVID-19 pandemic drove the Government of Bangladesh to shut down educational institutions, which had an enormous effect on the psychological health of students. This study aimed to assess the mental health status of Bangladeshi university students during the lockdown period. Subject and methods: Through an online-based questionnaire, information was collected from 509 university students of Bangladesh from June 19, 2020, to June 28, 2020, using convenient sampling. K-means clustering was applied to organize students according to their psychological health score, and confirmatory factor analysis (CFA) was also conducted to determine the association among the student's activities and their mental health during the pandemic. In addition, these associations were examined through chi-square test and ordinal logistic regression. Results: Students were categorized into four categories where 4.32% had mild, 72.7% had moderate, 12.57% had moderately severe, and 10.41% suffered from severe mental health imbalance. The results showed that having family members affected by the coronavirus, facing insecurity, using social media, and smoking habits increased the mental health imbalances of students; in contrast, being worried about studying, future career, spending more time with family members, and participation in household chores reduced the mental health disturbances of students. On the other hand, the results of the ordinal logistic regression indicated that sleeping time and participation in household chores were preventive factors for students. Conclusion: This study reveals that a large proportion of University students of Bangladesh suffered from mental health disturbances during the lockdown period. Implementing mental health plans and providing job security, improved communication approaches toward family members, not flattening illusive news, and preoccupation in household activities may assist to enhance the mental health status of the university students. The authors believe that this study's findings will be helpful to expedite the rate of attaining the sustainable development goal associated with health status in Bangladesh. [ABSTRACT FROM AUTHOR]

The International Code of Marketing of Breast‐milk Substitutes (BMS) instituted to protect breastfeeding against unethical marketing, has been adopted by many countries, including Bangladesh. Despite national adoption, evidence suggests violations occur and inadequate BMS Code implementation is an issue. The study aimed to assess violations of the International BMS Code and the national 'Breast‐milk Substitutes, Infant Foods, Commercially Manufactured Complementary Foods and the Accessories Thereof (Regulation of Marketing) Act, 2013' of Bangladesh in commercial settings (retail outlets and media) in Bangladesh, for different types of milk, bottles, and teats using a standardized Network for Global Monitoring and Support for Implementation of the Code and Subsequent relevant World Health Assembly Resolutions (NetCode) protocol. This cross‐sectional quantitative study was conducted in Bangladesh from January to September 2018 in Dhaka, Chattogram, and Sylhet cities. Descriptive statistics were reported and χ2 tests were conducted to assess differences between categorical variables of interest. Data were analysed using SPSS version 20. In retail outlets, there were higher proportion of violations observed in Dhaka than in Sylhet and Chattogram (p < 0.001). Significantly greater proportion of violations in product labels occurred among products sold without local distributors compared to others (p < 0.05); violations were higher among "other milk" for children aged 0 to <36 months compared to formulas and growing‐up milk (p < 0.05). Among media channels, internet clips had significantly higher proportions of violations compared to television, radio and newspaper (p < 0.001). BMS Code violations were prevalent in product labels and promotion of products through retail outlets. The study findings highlight the need for specific multisectoral strategies for better enforcement of BMS Code and points to the need for periodic assessment of Code violations. Key messages: This is the first known study documenting violations in retail outlets, online stores, and media using the standard NetCode protocol in Bangladesh.BMS Code violations were high in retail stores and were more prevalent in the capital city compared to others.Violations were significantly higher in the internet compared to radio, television, and newspapers, highlighting the need for strengthening the monitoring of internet‐based promotions.It is essential to allocate resources to sensitize retail stores to the BMS Code to enhance the implementation of the law. [ABSTRACT FROM AUTHOR]

COVID-19 posed the healthcare professionals at enormous risk during this pandemic era while vaccination was recommended as one of the effective preventive approaches. It was visualized that almost all health workforces would be under vaccination on a priority basis as they are the frontline fighters during this pandemic. This study was designed to explore the reality regarding infection and vaccination status of COVID-19 among healthcare professionals of Bangladesh. It was a web-based cross-sectional survey and conducted among 300 healthcare professionals available in the academic platform of Bangladesh. A multivariate logistic regression model was used for the analytical exploration. Adjusted and Unadjusted Odds Ratio (OR) with 95% confidence intervals (95% CI) were calculated for the specified setting indicators. A Chi-square test was used to observe the association. Ethical issues were maintained according to the guidance of the declaration of Helsinki. Study revealed that 41% of all respondents identified as COVID-19 positive whereas a significant number (18.3%) found as non-vaccinated due to registration issues as 52.70%, misconception regarding vaccination as 29.10%, and health-related issues as 18.20%. Respondents of more than 50 years of age found more significant on having positive infection rather than the younger age groups. Predictors for the non-vaccination guided that male respondents (COR/p = 3.49/0.01), allied health professionals, and respondents from the public organizations (p = 0.01) who were ≤29 (AOR/p = 4.45/0.01) years of age significantly identified as non-vaccinated. As the older female groups were found more infected and a significant number of health care professionals found as non-vaccinated, implementation of specific strategies and policies are needed to ensure the safety precautions and vaccination among such COVID-19 frontiers. [ABSTRACT FROM AUTHOR]

Purpose: The present study is the first investigating unexplored psychological issues of university entrance test‐taking students in Bangladesh. Design and Methods: This cross‐sectional study investigates suicidal behaviors and their socio‐demographic, admission test‐related, and psychopathological risk factors among a total of 911‐Bangladeshi university entrance test‐takers. Findings: About 17.7% of the participants report suicidal thoughts, whereas it is 8.0% and 2.5% for suicide plans and suicide attempts, respectively. Significantly higher suicidal thought is observed in the repeat test‐taking students compared to the first‐time test‐takers (20.7% vs. 14.6%, χ2 = 5.669, p = 0.017), though the suicide plan and suicide attempt are not associated with student status. The suicidal thought risk factors include female gender, urban residence, satisfaction with the mock test, mental disorders etc. Practical Implications: The present findings warrant implementing initiatives for this suicide‐prone cohort, especially for the test‐failing students. [ABSTRACT FROM AUTHOR]

Background: Tobacco smoking (TS) and illicit drug use (IDU) are of public health concerns especially in developing countries, including Bangladesh. This paper aims to (i) identify the determinants of TS and IDU, and (ii) examine the association of TS with IDU among young slum dwellers in Bangladesh. Methodology/Principal Findings: Data on a total of 1,576 young slum dwellers aged 15–24 years were extracted for analysis from the 2006 Urban Health Survey (UHS), which covered a nationally representative sample of 13,819 adult men aged 15–59 years from slums, non-slums and district municipalities of six administrative regions in Bangladesh. Methods used include frequency run, Chi-square test of association and multivariable logistic regression. The overall prevalence of TS in the target group was 42.3%, of which 41.4% smoked cigarettes and 3.1% smoked bidis. The regression model for TS showed that age, marital status, education, duration of living in slums, and those with sexually transmitted infections were significantly (p<0.001 to p<0.05) associated with TS. The overall prevalence of IDU was 9.1%, dominated by those who had drug injections (3.2%), and smoked ganja (2.8%) and tari (1.6%). In the regression model for IDU, the significant (p<0.01 to p<0.10) predictors were education, duration of living in slums, and whether infected by sexually transmitted diseases. The multivariable logistic regression (controlling for other variables) revealed significantly (p<0.001) higher likelihood of IDU (OR = 9.59, 95% CI = 5.81–15.82) among users of any form of TS. The likelihood of IDU increased significantly (p<0.001) with increased use of cigarettes. Conclusions/Significance: Certain groups of youth are more vulnerable to TS and IDU. Therefore, tobacco and drug control efforts should target these groups to reduce the consequences of risky lifestyles through information, education and communication (IEC) programs. [ABSTRACT FROM AUTHOR]

Background. Early marriage is a common practice in developing countries, with tremendous health implications for women and their newborn children. Few studies have explored teenage marriage in Bangladesh, where the current study was designed to fill this gap. Objectives. This study aimed to find the socio-economic and demographic factors that influence the timing of early marriage among women in Bangladesh. Material and methods. A cross-sectional study design was used in our study. Using Bangladesh Demographic and Health Survey 2014 data, we have applied the non-parametric survival analysis technique of the Cox proportional hazards model. Results. Early marriage was more common in all regions, and this risk was highest in the Rangpur Division (HR = 1.297; CI: 1.215–1.385; p < 0.001). Women who reside in rural areas married earlier than their counterparts in urban areas (HR = 0.918; CI: 0.883–0.955; p < 0.001). The age at first marriage was directly related to access to media (HR = 0.767; CI: 0.739–0.794; p < 0.001) and education levels, where women should have at least secondary education before marriage. Poor women also married early than upper-class (HR = 0.925; CI: 0.871–0.983) and middle-class (HR = 0.954; CI: 0.915–0.994) women. Conclusions. The study’s findings may provide some clues to increase the age of Bangladeshi women at first marriage. Region, maternal education, place of residence, wealth index, working status and media access were significantly associated factors with the timing of first marriage among women in Bangladesh. [ABSTRACT FROM AUTHOR]

Background: Malnutrition contributes to children's morbidity and mortality, and the situation undermines the economic growth and development of Bangladesh. Malnutrition is associated with lower levels of education that decrease economic productivity and leads to poverty. The global burden of malnutrition continues to be unacceptably high amid social and economic growth, including in Bangladesh. Therefore, identifying the factors associated with childhood malnutrition and poverty is necessary to stop the vicious cycle of malnutrition leaded poverty. Methods: The study utilized the 2017–18 Bangladesh Demographic and Health Survey (BDHS), accumulating 7,738 mother-child pairs. Associations between potential risk factors and nutritional status were determined using chi-square tests, and multivariate logistic regression models were utilized on significant risk factors to measure their odds ratio (OR) with their 95% confidence intervals (CI). Results: The prevalence of moderate and severe wasting was 7.0% and 1.8%, respectively, whereas the prevalence of moderate and severe stunting was 19.2% and 8.0%, while 16.4% and 3.6% of children were moderately and severely underweight. Children from the poorest and poor households were suffering from at least one form of malnutrition. Adjusted ORs were estimated by controlling socio-economic and demographic risk factors, such as poor maternal body mass index, parents' lower education level, use of unhygienic toilet, child age in months, and recent experience of diarrhea and fever. The pattern was almost similar for each malnutrition status (i.e., stunting, underweight, and wasting) in the poorest and poor households. Conclusion: Bangladesh achieved the Millennium Development Goals, focusing primarily on health-related indicators and working to achieve the Sustainable Development Goals. Even considering this success, the prevalence of malnutrition and poverty in same household remains relatively high compared to other developing countries. Therefore, the study recommends the implementation of nationwide systematic measures to prevent poverty and malnutrition. [ABSTRACT FROM AUTHOR]

Background: Vaccination has important consequences for childhood development, mortality, and inequalities in health and well-being. This research explores the trend of vaccinations coverage from 1993 to 2014 and determines the significant factors for vaccinations coverage in Bangladesh, considering geospatial, socioeconomic, and demographic characteristics.Methods: This study uses a secondary dataset extracted from the Bangladesh Demographic and Health Survey (BDHS) from 1992 to 93 to 2014. The association between selected independent variables and vaccination coverage of children was examined through the Chi-square test. In addition, unadjusted and adjusted logistic regression approaches were applied to determine the effects of covariates on vaccination status by using the BDHS-2014 dataset.Results: The results reveal that the trend of the vaccination coverage rate has gradually been increased over the study period. The coverage rate of BCG is observed maximum while the lowest for Measles vaccination among all types of vaccinations. The findings revealed that the significantly lower coverage of all vaccination had been observed in the Sylhet region. Children of higher educated mothers (OR 10.21; CI: 4.10-25.37) and father (OR 8.71; CI: 4.03-18.80), born at health facilities (OR 4.53; CI: 2.4-8.55) and whose mother has media exposure (OR 3.20; CI: 2.22-4.60) have more chance of receiving BCG vaccine. For DPT vaccination coverage, there is a significant difference from children whose mothers have primary (OR 1.7; CI: 1.35-2.15), secondary (OR 3.5; CI: 2.75-4.45), and higher (OR 9.6; CI: 5.28-17.42) educational qualification compared to children of illiterate mothers. Findings demonstrated that children born in wealthier households have a higher likelihood of being immunized against DPT, Polio, and Measles vaccination than children born in the poorest households.Conclusions: The findings reveal that to enhance and make sustainable the overall country's vaccination coverage, we should pay more attention to the mother's education, socioeconomic condition, children's age, birth order number, having media exposure, place of residence, and religion. The authors think that this finding would be helpful to accelerate the achievement target of Sustainable Development Goals (SDGs) for children's health in Bangladesh. [ABSTRACT FROM AUTHOR]

Background. Nutritional status is the best indicator of global well-being. Childhood malnutrition is a major public health problem among Bangladeshi children. Objectives. The main objectives of this study are to: (i) determine the prevalence of malnutrition among under-five (U5) children; (ii) assess the association between malnutrition and selected factors; (iii) determine the high-risk factors for malnutrition and its impact on U5 mortality. Material and methods. The data was taken from the Bangladesh Demographic and Health Survey (BDHS), 2014. Chi-square analysis was performed to explore the association between malnutrition and selected potential factors. Moreover, logistic regression (LR) was also performed to determine the factors associated with malnutrition and its impact on U5 mortality based on the p-value and odds ratio (OR) along with a 95% confidence interval (CI). Results. The prevalence of stunting, wasting and underweight were 37.1%, 14.7% and 33%, respectively. Most of the selected factors were found to be highly significant (p < 0.05), which were performed via chi-square analysis. In the LR model, it was found that place of residence, region, mother’s working status, mother’s education, mother’s age at first birth, wealth index and toilet facilities were the factors mostly responsible for child malnutrition. Our study also showed that wasting and underweight have a significant impact on U5 mortality. Conclusions. It is recommended that educating mothers, delaying a mother’s age for first birth, improving sanitation facilities, reducing poverty and creating health-related services are essential to improve a child’s health and nutritional status. As a result, U5 mortality will be reduced in Bangladesh. [ABSTRACT FROM AUTHOR]

Background: Gene alterations are required for the development of gastric cancer, which are influenced by environmental and host factors. We conducted the present study to find the status of Helicobacter pylori (H. pylori) infection and its association with altered genes P53, hMLH1, and HER2 in gastric cancer patients and to analyze their correlation with clinical, pathological, and environmental factors. Method: This was a cross-sectional study. For genetic (P53 and hMLH1) study of the gastrectomized tissue DNA extraction and optimization, we performed PCR amplification and DNA sequencing. HER2 was studied by immunochemical technique. The results were matched with tumor status, age and sex, smoking, and H. pylori antibody status of the patients to find their association. Results: The mean age of the patients was 52.91 (±13.94) years. Among the 45 patients selected for genetic tests, 12 aged 40 or more and 33 aged over 40. Among the genes, 33(73.3%) in P53 and 17(37.7%) in hMLH1 were mutated and 11(24.2%) in HER2 were found to be overexpressed. Chi square and regression analysis showed that they all had associations with H. pylori positivity (P < 0.05, odds ratio >1). hMLH1 was associated with the location of the tumor, smoking, sex, blood group, and age, and P53 was found to be affected by extra salt intake, sex, blood group, and age of the patients (P ≤ 0.05 ). Conclusion: Genetic mutation was found in nearly all the patients with gastric cancer, which was significantly associated with H. pylori infection. Mass eradication of this organism might play a role in reducing cancer incidence in Bangladesh. [ABSTRACT FROM AUTHOR]

We conducted a longitudinal study of cryptosporidiosis from birth to three years of age in an urban slum of Dhaka Bangladesh. Fecal DNA was extracted from monthly surveillance samples and diarrheal stool samples collected from 392 infants from birth to three years. A pan-Cryptosporidium qPCR assay was used to identify sub-clinical and symptomatic cryptosporidiosis. Anthropometric measurements were collected quarterly to assess child nutritional status. 31% (121/392) of children experienced a single and 57% (222/392) multiple infections with Cryptosporidium. Repeat infections had a lower burden of parasites in the stool (Cq slope = -1.85; p<0.0001) and were more likely to be sub-clinical (Chi square test for trend; p = 0.01). Repeat infections were associated with the development of growth faltering (Pearson correlation = -0.18; p = 0.0004). High levels of fecal IgA antibodies against the Cryptosporidium Cp23 sporozoite protein at one year of life were associated with a delay in reinfection and amelioration of growth faltering through three years of life (HAZ IgA high responders -1.323 ± 0.932 versus HAZ -1.731 ± 0.984 p = 0.0001). We concluded that nonsterile immunity to cryptosporidiosis in young children was associated with high levels of mucosal IgA anti-Cp23 and protection from diarrhea and growth faltering. Trial Registration:NCT02764918. Author summary: Cryptosporidium is one of the top causes of diarrhea and growth faltering in Bangladesh infants. We discovered that a prior infection resulted in incomplete immunity that protected from diarrhea and growth faltering but not infection and was associated with mucosal IgA against a sporozoite surface protein Cp23. The most important implication of these findings is that a cryptosporidiosis vaccine may not need to achieve complete protection from infection to have a beneficial impact on child health. [ABSTRACT FROM AUTHOR]

Aim: The main aim of this study was to uncover the risk factors associated with wasting status of under-5 children residing in urban areas of Bangladesh. Subjects and methods: For analysis purposes, the necessary information was extracted from the Bangladesh Urban Health Survey (BUHS) 2013. The outcome measure was wasting. Chi-square analysis was performed to assess the association between outcome variables and selected factors. Multilevel logistic regression models with a random intercept at each of the individual and regional levels were considered to identify the risk factors of wasting. Results: A total of 10,511 urban children aged 0 to less than 60 months were included in this study. The overall prevalence of wasting was 17.2%. In the bivariate setup, all the selected covariates except child age were found to be significant for wasting status of children (p < 0.05). According to the two-level logistic regression model, the odds of wasting status of children increase with the age of the child and decrease with the increasing level of mother's education. Compared to children from poor income families, the odds of being wasted were 18% and 47% lower for children coming from middle and rich income families. Among the domains, the odds of having wasted children was higher in the city-corporation slum compared to the city-corporation non-slum. Mothers receiving ANC services had lower odds of having a wasted child. Moreover, a mother who regularly breastfed her baby had 57% lower odds of having a wasted child, compared to a mother who never breastfed her baby. Conclusion: The prevalence of wasting among under-5 children in Bangladesh is still high, and the risk was examined at various multilevel factors. Therefore, top priority should be given to reducing the rate of wasting as a major public health intervention. [ABSTRACT FROM AUTHOR]

Background: An estimated 40% of pregnancies globally are unintended. Measurement of pregnancy intention in low- and middle-income countries relies heavily on surveys, notably Demographic and Health Surveys (DHS), yet few studies have evaluated survey questions. We examined questions for measuring pregnancy intention, which are already in the DHS, and additional questions and investigated associations with maternity care utilisation and adverse pregnancy outcomes. Methods: The EN-INDEPTH study surveyed 69,176 women of reproductive age in five Health and Demographic Surveillance System sites in Ghana, Guinea-Bissau, Ethiopia, Uganda and Bangladesh (2017–2018). We investigated responses to survey questions regarding pregnancy intention in two ways: (i) pregnancy-specific intention and (ii) desired-versus-actual family size. We assessed data completeness for each and level of agreement between the two questions, and with future fertility desire. We analysed associations between pregnancy intention and number and timing of antenatal care visits, place of delivery, and stillbirth, neonatal death and low birthweight. Results: Missing data were <2% in all questions. Responses to pregnancy-specific questions were more consistent with future fertility desire than desired-versus-actual family size responses. Using the pregnancy-specific questions, 7.4% of women who reported their last pregnancy as unwanted reported wanting more children in the future, compared with 45.1% of women in the corresponding desired family size category. Women reporting unintended pregnancies were less likely to attend 4+ antenatal care visits (aOR 0.73, 95% CI 0.64–0.83), have their first visit during the first trimester (aOR 0.71, 95% CI 0.63–0.79), and report stillbirths (aOR 0.57, 95% CI 0.44–0.73) or neonatal deaths (aOR 0.79, 95% CI 0.64–0.96), compared with women reporting intended pregnancies. We found no associations for desired-versus-actual family size intention. Conclusions: We found the pregnancy-specific intention questions to be a much more reliable assessment of pregnancy intention than the desired-versus-actual family size questions, despite a reluctance to report pregnancies as unwanted rather than mistimed. The additional questions were useful and may complement current DHS questions, although these are not the only possibilities. As women with unintended pregnancies were more likely to miss timely and frequent antenatal care, implementation research is required to improve coverage and quality of care for those women. [ABSTRACT FROM AUTHOR]

• Examined the impact of COVID-19 on the mental health of Bangladeshi children. • Children were suffering from depression, anxiety, and sleeping disorder. • Estimates of moderate and severe mental disturbance were 19.3% and 7.2% respectively. • Children's mental disturbance linked to parent's stress, and abnormal behavior. • Psychological intervention and supportive care for children is urgently needed. COVID-19 pandemic poses a significant mental health threat among children in Bangladesh. This study aims to explore the impact of COVID-19 on the mental health of children during the lockdown in Bangladesh. An online cross-sectional study was conducted from 25th April to 9th May 2020 among 384 parents having at least one child aged between 5–15 years using non-probability sampling. K-means clustering used to group children according to mental health score and confirmatory factor analysis (CFA) performed to identify the relationship among the parental behavior and child mental health, and also these associations were assessed through chi-square test. Children were classified into four groups where 43% of child had subthreshold mental disturbances (mean Major Depressive Disorder (MDD)-10; 2.8), 30.5% had mild (mean MDD-10; 8.9), 19.3% suffered moderately (mean MDD-10; 15.9), and 7.2% of child suffered from severe disturbances (mean MDD-10; 25.2). The higher percentage of mental health disturbances of children with the higher education level of parents, relative infected by COVID-19 (yes), parents still need to go the workplace (yes), and parent's abnormal behavior but lower to their counterparts. This paper demonstrates large proportions of children are suffering from mental health disturbances in Bangladesh during the period of lockdown. Implementation of psychological intervention strategies and improvement in house-hold financial conditions, literacy of parents, taking care of children, and job security may help in improving the psychological/mental status of children and the authors believe that the findings will be beneficial to accelerate the rate of achieving the Sustainable Development Goal (SDG) linked to health status in Bangladesh. [ABSTRACT FROM AUTHOR]

Introduction: Childhood obesity is a threat worldwide; notably, some Asian nations are experiencing a shift toward obesity at a younger age. The context of overweight/obesity remains unexplored, more among younger age groups in Bangladesh. This study assessed prevalence and factors associated with overweight/obesity among 9--14-year-old school-going children studying in public and private primary schools in a selected area of Dhaka, Bangladesh. Materials and Methods: This descriptive cross-sectional study involved 150 children recruited from four purposively selected primary schools, following simple random sampling technique. Body mass index was assessed to classify children following the Centers for Disease Control and Prevention age and sex-specific cutoff points. Data were analyzed using SPSS, version 20, and Chi-square/Fisher's exact test was done to determine association. Results: A higher prevalence of overweight/obesity was observed among boys (67.1%) compared to girls, and the mean age was 11.6 years. Overweight and obesity were prevalent among girls (35.7% and 17.9%, respectively) in public schools and boys (38.8% and 32.7%, respectively) in private schools. The magnitude was higher (>80.0%) among those not participating in sports at school (P = 0.002) or outside school (P < 0.001). They exposed (97.5%) to sedentary behaviors (P < 0.001) and preferred fast food (60.8%) as regular meals (P = 0.001). Their dietary chart lacked an adequate serving of vegetables and fruits in a week. Conclusions: Overweight/obesity is prevalent among 9--14-year-old school-going children, and behavior factors are major determinants of childhood obesity. Effective public health interventions are required to address this emerging health problem. [ABSTRACT FROM AUTHOR]

Background: The use of complementary and alternative medicine (CAM) among type 2 diabetes mellitus (T2DM) patients is increasing worldwide. It can affect optimum glycemic management. This study was to determine the rate and influencing factors of CAM use among diabetes patients as well as their effect on glycemic control. Methods: This cross-sectional study was conducted among T2DM patients attending the outpatient department of Rajshahi Medical College Hospital. It is a tertiary hospital in the northern part of Bangladesh. A face-to-face interview with a pretested structured questionnaire was used for data collection. Chi-square (χ2) test and multivariate logistic regression model were used in this study for data analysis. Results: Out of 244 T2DM patients, 86 (35.2%) used CAM. Multivariate logistic regression model showed that lower family income group (AOR = 8.7, 95% CI: 2.15–35.22, p-value 0.002), having no institutional education (AOR = 3.4, 95% CI: 1.17–9.87, p-value 0.025) and having diabetes for more than five years (AOR = 2.821, 95% CI: 1.34–5.94, p-value 0.006) were the most influential predictors of CAM use. The most commonly used CAMs were herbal products (67.4%) and homeopathic medicine (37.2%). Most of the CAM users (72%) were influenced by friends, neighbors, and family members. The most common reasons behind CAM use were reported to be the belief that CAM helped control diabetes better (44.2%) and easy availability and lower cost (27.9%). More than half of the users reported the efficacy of CAM as 'nothing significant', while others reported as somewhat good. 14% of CAM users experienced side-effects, especially gastrointestinal upset. It was observed that using CAM was associated with poor glycemic control (AOR = 2.25, 95% CI: 1.14–4.44, p-value 0.018). Conclusion: Our study demonstrated that some modifiable factors are associated with the use of CAM, and it cannot maintain good glycemic control. So, patients should be made aware of the ineffectiveness and bad effects of CAM by enhancing educational and poverty-alleviating programs. [ABSTRACT FROM AUTHOR]