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Data scarcity and discontinuity are common occurrences in the healthcare and epidemiological dataset and often is needed to form an educative decision and forecast the upcoming scenario. Often to avoid these problems, these data are processed as monthly/yearly aggregate where the prevalent forecasting tools like Autoregressive Integrated Moving Average (ARIMA), Seasonal Autoregressive Integrated Moving Average (SARIMA), and TBATS often fail to provide satisfactory results. Artificial data synthesis methods have been proven to be a powerful tool for tackling these challenges. The paper aims to propose a novel algorithm named Stochastic Bayesian Downscaling (SBD) algorithm based on the Bayesian approach that can regenerate downscaled time series of varying time lengths from aggregated data, preserving most of the statistical characteristics and the aggregated sum of the original data. The paper presents two epidemiological time series case studies of Bangladesh (Dengue, Covid-19) to showcase the workflow of the algorithm. The case studies illustrate that the synthesized data agrees with the original data regarding its statistical properties, trend, seasonality, and residuals. In the case of forecasting performance, using the last 12 years data of Dengue infection data in Bangladesh, we were able to decrease error terms up to 72.76% using synthetic data over actual aggregated data. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus (HBV) is a major source of disease burden worldwide, with an estimated 296 million individuals living with infections worldwide. Although vaccine programs exist to control infections, certain sub-populations around the world continue to have very high prevalence of HBV infection. Methods: A systematic search of studies of HBV published after 2010 was conducted for India, Pakistan, Bangladesh, Nepal, Sri Lanka and Bhutan. Each paper was independently screened for risk of bias and inclusion. Data were extracted from included studies before being analysed to estimate pooled prevalence, and to conduct sub-group analyses. Random-effects models were used for estimating summary prevalence due to a high level of heterogeneity between studies, and funnel plots were combined with Egger's test to assess publication bias. Meta-regression was conducted to investigate sources of between-study heterogeneity. Results: The pooled prevalence of HBV across all studies was 3% (95% CI 0.02, 0.05). For countries with multiple studies, the pooled prevalence in India was 3% (95% CI 0.02, 0.04), in Pakistan 6% (95% CI 0.03, 0.09), in Bangladesh 5% (95% CI of 0.02, 0.12), and in Nepal 1% (95% CI 0.00, 0.08). There was some evidence of publication bias, and a high level of heterogeneity across studies. Risk of bias analysis found most studies to be of fair or moderate quality. Conclusions: The prevalence of HBV among countries in the sub-continent was higher than the global average, but was not as high as some other regions. Countries with greater numbers of displaced persons had higher prevalence of HBV, with a wide range of prevalence between subpopulations likely reflecting differential uptake, and implementation, of vaccination programs. [ABSTRACT FROM AUTHOR]

Background: Malnutrition imposes enormous costs resulting from lost investments in human capital and increased healthcare expenditures. There is a dearth of research focusing on the prediction of women's body mass index (BMI) and malnutrition outcomes (underweight, overweight, and obesity) in developing countries. This paper attempts to fill out this knowledge gap by predicting the BMI and the risks of malnutrition outcomes for Bangladeshi women of childbearing age from their economic, health, and demographic features. Methods: Data from the 2017–18 Bangladesh Demographic and Health Survey and a series of supervised machine learning (SML) techniques are used. Additionally, this study circumvents the imbalanced distribution problem in obesity classification by utilizing an oversampling approach. Results: Study findings demonstrate that the support vector machine and k-nearest neighbor are the two best-performing methods in BMI prediction based on the coefficient of determination (R2), root mean square error (RMSE), and mean absolute error (MAE). The combined predictor algorithms consistently yield top specificity, Cohen's kappa, F1-score, and AUC in classifying the malnutrition status, and their performance is robust to alternative standards. The feature importance ranking based on several nonparametric and combined predictors indicates that socioeconomic status, women's age, and breastfeeding status are the most important features in predicting women's nutritional outcomes. Furthermore, the conditional inference trees corroborate that those three features, along with the partner's educational attainment and employment status, significantly predict malnutrition risks. Conclusion: To the best of our knowledge, this is the first study that predicts BMI and one of the pioneer studies to classify all three malnutrition outcomes for women of childbearing age in Bangladesh, let alone in any lower-middle income country, using SML techniques. Moreover, in the context of Bangladesh, this paper is the first to identify and rank features that are critical in predicting nutritional outcomes using several feature selection algorithms. The estimators from this study predict the outcomes of interest most accurately and efficiently compared to other existing studies in the relevant literature. Therefore, study findings can aid policymakers in designing policy and programmatic approaches to address the double burden of malnutrition among Bangladeshi women, thereby reducing the country's economic burden. [ABSTRACT FROM AUTHOR]

Since August 2020; the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) in collaboration with UNICEF has been operating a COVID-19 field hospital at the Teknaf sub-district of Cox's Bazar in Bangladesh. This paper is focused on estimating the effects of a history of tobacco smoking and pre-existing co-morbidities on the severity of COVID-19 infection among adult patients admitted into the aforesaid hospital. We conducted a retrospective data analysis of COVID-19 adult patients hospitalized from August 27, 2020 to April 20, 2022. Based on inclusion criteria; a total of 788 admitted patients were included in the analysis. We conducted a Chi-squared test and Fisher's exact test for the categorical variables to see their associations. Multinomial logistic regression models were performed to explore the risk factors for the severity of COVID-19 infection. Among 788 patients, 18.4%, 18.8%, 13%, 7.1%, 3.4%, and 1.9% have had a history of smoking, hypertension, diabetes, chronic obstructive pulmonary disease (COPD), cardiovascular diseases (CVD), and asthma respectively. Overall, the mean age of the patients was 40.3 ± 16.4 years and 51% were female. In multivariate analysis, history of smoking and co-morbidities were identified as the risk factors for the severity of COVID-19 infection; the history of smoking was found linked with an increase in the risk of developing critical, severe, and moderate level of COVID-19 infection- notably 3.17 times (RRR = 3.17; 95% CI: 1.3–7.68), 2.98 times (RRR = 2.98; 95% CI: 1.87–4.76) and 1.96 times (RRR = 1.96; 95% CI: 1.25–3.08) respectively more than the patients who never smoked. It was evident that patients with at least one of the selected co-morbidities such as hypertension, diabetes, COPD, CVD, and asthma exhibited a significantly higher likelihood of experiencing severe illness of COVID-19 compared to patients without any co-morbidity. History of tobacco smoking and pre-existing co-morbidities were significantly associated with an increased severity of COVID-19 infection. [ABSTRACT FROM AUTHOR]

Bangladesh has been ranked as one of the world's top countries affected by climate change, particularly in terms of agricultural crop sector. The purpose of this study is to identify spatial and temporal changes and trends in long-term climate at local and national scales, as well as their implications for rice yield. In this study, Modified Mann-Kendall and Sen's slope tests were used to detect significant trends and the magnitude of changes in temperature and rainfall. The temperature and rainfall data observed and recorded at 35 meteorological stations in Bangladesh over 65-years in the time span between the years 1949 and 2013 have been used to detect these changes and trends of variation. The results show that mean annual Tmean, Tmin, and Tmax have increased significantly by 0.13°C, 0.13°C, and 0.13°C/decade, respectively. The most significant increasing trend in seasonal temperatures for the respective Tmean, Tmin, and Tmax was 0.18°C per decade (post-monsoon), 0.18°C/decade (winter), and 0.23°C/decade (post-monsoon), respectively. Furthermore, the mean annual and pre-monsoon rainfall showed a significant increasing trend at a rate of 4.20 mm and 1.35 mm/year, respectively. This paper also evaluates climate variability impacts on three major rice crops, Aus, Aman, and Boro during 1970–2013. The results suggest that crop yield variability can be explained by climate variability during Aus, Aman, and Boro seasons by 33, 25, and 16%, respectively. Maximum temperature significantly affected the Aus and Aman crop yield, whereas rainfall significantly affected all rice crops' yield. This study sheds light on sustainable agriculture in the context of climate change, which all relevant authorities should investigate in order to examine climate-resilient, high-yield crop cultivation. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial resistance (AMR) is a major global public health crisis and around the last decade, newspapers were one of the main sources of public dissemination of information for so. This study highlights how Bangladeshi mainstream newspapers represented AMR-related news and how they created the narrative of AMR in Bangladesh. Methods: We conducted both quantitative and qualitative content analysis on 275 AMR-related news articles published in the twelve highest circulated dailies (January 2010 to September 2021). We divided the articles into report, opinion, and editorials and analyzed how their contents built the narrative of AMR in Bangladesh. Results: Bangladeshi newspapers reported misuse of antibiotics by the consumers the most (32.2%), followed by selling without prescriptions (29%), and over-prescription by the health providers (26.1%). There were hardly any news reports describing the impact of pharmaceutical companies in prescribing and selling antibiotics. Around 45% of the news articles were event-oriented. Moreover, they suggested inadequate recommendations to battle AMR. Conclusion: Valid, consistent, and reliable AMR news coverage can play a crucial role in creating mass awareness, making providers accountable, and supporting national action plan in mitigating AMR threat. The Bangladeshi journalists interested in reporting AMR-issues should focus on disseminating more Bangla articles with scientific information, and reporting causes and recommendations responsibly. [ABSTRACT FROM AUTHOR]

This paper investigates the associations between agricultural diversification and dietary diversity among men, women and children of farm households in Bangladesh. Using three waves of nationally representative Bangladesh Integrated Household Survey (BIHS- 2011–12, 2015 and 2018) data and a panel data model, the study found that agricultural production diversification can emphasize the dietary diversification across the life cycle of farm household members. The balanced panel data reveals that agricultural production diversification has a statistically significant and positive impact on dietary diversity of individual members (men, women and children) of farm households. Moreover, other important factors that impact on agricultural diversification and improve dietary diversity like women's education and employment, commercialization of farm households, access to non-farm income sources, and access to information facilities also have a strong association in improving dietary status, food and nutritional security as well. Although there is currently limited diversity in the diets of adult men, women and children of rural farm households, the situation can be improved over time with proper and consistent support. The findings suggest policy interventions should target not only agricultural diversification but also improve women's education and on and off farm employment opportunities and facilitate better access to information for rural households. These recommendations can support improved dietary diversity for all household members under different settings. [ABSTRACT FROM AUTHOR]

Background: Underweight is one of the important anthropometric components of malnutrition among under-five children and is a major public health concern in Bangladesh because it contributes to mortality as well as morbidity. In designing suitable health programs and policies with the goal of attaining UN SDG Goals, it is necessary to identify the critical risk factors of under-five malnutrition. It is evident that the quantile regression produces robust estimates in the presence of outliers. However, in the context of Bangladesh, no study has been conducted considering the sequential quantile regression on this topic. Therefore, the authors aimed to find the determinants of underweight among under-5 children in Bangladesh considering the latest country representative dataset. Methods and materials: The paper considers a weighted sample of size 7762 children are used and data were extracted from the latest Bangladesh Demographic and Health Survey (BDHS) 2017–18 data. Multivariable simultaneous quantile regression models were used to fulfill the objectives of this study. Results: Findings depict that undernutrition affects the majority of children in the population as compared to the reference population. The WAZ-score of the child increases by 0.202 points at the 10th quantile of the conditional distribution, and by 0.565 points at the 90th quantile as we move from children of underweight to overweight women. Moreover, the WAZ scores of children from the richest families in the 10th, 50th, and 75th quantiles, respectively, are increased by 0.171, 0.016, and 0.084 points. Conclusion: Quantile regression revealed the results of several socioeconomic and demographic factors acting differently across the WAZ distribution. Therefore, policymakers may consider the identified risk factors to lessen malnutrition among under-5 children in Bangladesh. [ABSTRACT FROM AUTHOR]

This paper aimed to develop a harm reduction model to reduce exposure to environmental tobacco smoke among children of rural households in Bangladesh. A mixed-methods exploratory sequential design has been applied, and data has been collated from six randomly selected villages of Munshigonj district, Bangladesh. The research was divided into three phases. In the first phase, the problem was identified through key informant interviews and a cross-sectional study. In the second phase, the model was developed by focus group discussion, and in the third phase, the model was evaluated through the modified Delphi technique. The data was analyzed by thematic analysis and multivariate logistic regression in phase one, qualitative content analysis for phase two, and descriptive statistics in phase three. The key informant interviews showed attitude toward environmental tobacco smoke, lack of awareness, inadequate knowledge as a reason and smoke-free rules, religious beliefs, social norms, and social awareness as preclusion of environmental tobacco smoke. The cross-sectional study detected that households with no smoker (OR 0.006, 95% CI 0.002–0.021), high implantation of smoke-free household rules (OR 0.005, 95% CI 0.001–0.058), moderate (OR 0.045, 95% CI 0.004–0.461) to strong (OR 0.023, 95% CI 0.002–0.224) influence of social norm and culture along with neutral (OR 0.024, 95% CI 0.001–0.510) and positive (OR 0.029, 95% CI 0.001–0.561) peer pressure had been significantly associated with environmental tobacco smoke exposure. The final components of the harm reduction model consist of a smoke-free household, social norms and culture, peer support, social awareness and religious practice identified by the FGDs and modified Delphi technique. [ABSTRACT FROM AUTHOR]

Technological advancements have long played crucial roles in rice productivity and food security in Bangladesh. Seasonal variation over time and regional differences in rice production, however, pose a threat to agricultural sustainability but remain unexplored. We performed a spatial-temporal mapping of rice cultivation area, production, and yield from 2006–2007 to 2019–2020 using secondary data for disaggregating 64 districts in Bangladesh. Growth and multivariate approaches were employed to analyze time-series data. Results showed that Mymensingh had the highest rice cultivated area and production, while Bandarban had the lowest. The 14 years highest average rice yield was found in Gopalganj and Dhaka (3.63 tons/ha), while Patuakhali (1.73 tons/ha) had the lowest. For the Aus, Aman, and Boro, the rice cultivation area in 19 districts, 11 districts, and 13 districts declined significantly. The overall rice production increased significantly in most districts. For the Aus, Aman, and Boro seasons, the rice yield in 54, 50, and 37 districts demonstrated a significant upward trend, respectively. The adoption rate of modern varieties has risen dramatically. However, there are notable variances between regions and seasons. A significant increasing trend in Aus (0.007% to 0.521%), Aman (0.004% to 0.039%), and Boro (0.013% to 0.584%) were observed in 28, 34, and 36 districts, respectively, with an increase of 1% adaptation of HYV. Predictions revealed that rice cultivation area and production of Aus, Aman, and Boro seasons will be increased in most of the regions of Bangladesh by 2030. Based on spatiotemporal cluster analysis, the five identified cluster groupings illustrated that clusters lack spatial cohesion and vary greatly seasonally. This suggests increasing rice production by expanding cultivable land, adopting high-yielding varieties, and integrating faster technological advancement in research and extension. The findings will assist scientists in developing region-specific production technologies and policymakers in designing decentral region-specific policies to ensure the future sustainability of rice production. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has been a major health concern in Bangladesh until very recently. Although the Bangladesh government has employed various infection control strategies, more targeted Non-Pharmaceutical interventions (NPIs), including school closure, mask-wearing, hand washing, and social distancing have gained special attention. Despite significant long-term adverse effects of school closures, authorities have opted to keep schools closed to curb the spread of COVID-19 infection. However, there is limited knowledge about the impact of reopening schools alongside other NPI measures on the course of the epidemic. In this study, we implemented a mathematical modeling framework developed by the CoMo Consortium to explore the impact of NPIs on the dynamics of the COVID-19 outbreak and deaths for Bangladesh. For robustness, the results of prediction models are then validated through model calibration with incidence and mortality data and using external sources. Hypothetical projections are made under alternative NPIs where we compare the impact of current NPIs with school closures versus enhanced NPIs with school openings. Results suggest that enhanced NPIs with schools opened may have lower COVID-19 related prevalence and deaths. This finding indicates that enhanced NPIs and school openings may mitigate the long-term negative impacts of COVID-19 in low- and middle-income countries. Potential shortcomings and ways to improve the research are also discussed. [ABSTRACT FROM AUTHOR]

Background: COBRA-BPS (Control of Blood Pressure and Risk Attenuation-Bangladesh, Pakistan, Sri Lanka), a multicomponent, community health-worker (CHW)-led hypertension management program, has been shown to be effective in rural communities in South Asia. This paper presents the acceptability of COBRA-BPS multicomponent intervention among the key stakeholders. Methods: We conducted post-implementation interviews of 87 stakeholder including 23 community health workers (CHWs), 19 physicians and 45 patients in 15 rural communities randomized to COBRA-BPS multicomponent intervention in in Bangladesh, Pakistan, and Sri Lanka. We used Theoretical Framework for Acceptability framework (TFA) with a focus on affective attitude, burden, ethicality, intervention coherence, opportunity cost, perceived effectiveness and self-efficacy. Results: COBRA-BPS multicomponent intervention was acceptable to most stakeholders. Despite some concerns about workload, most CHWs were enthusiastic and felt empowered. Physicians appreciated the training sessions and felt trusted by their patients. Patients were grateful to receive the intervention and valued it. However, patients in Pakistan and Bangladesh expressed the need for supplies of free medicines from the primary health facilities, while those in Sri Lanka were concerned about supplies' irregularities. All stakeholders favoured scaling-up COBRA-BPS at a national level. Conclusions: COBRA-BPS multicomponent intervention is acceptable to the key stakeholders in Bangladesh, Pakistan and Sri Lanka. Community engagement for national scale-up of COBRA-BPS is likely to be successful in all three countries. [ABSTRACT FROM AUTHOR]

Background: Due to the ease of access to the internet in modern society users have become more prone to experiencing addictive behaviors online. The present study aimed to develop and investigate the psychometric properties of the Bangla Internet Gaming Disorder Scale–Short-Form (IGDS9-SF), Gaming Disorder Test (GDT), and Bergen Social Media Addiction Scale (BSMAS) due to a lack of existing sound psychometric tools in Bangladesh. Methods: A cross-sectional paper-and-pencil survey was carried out among 428 school-aged adolescents who were active gamers (90.89% males; Meanage: 16.13±1.85 years; age range: 10–19 years). Participants were recruited using convenience sampling across four selected schools in Dhaka City, Bangladesh. Data collected included sociodemographic information, frequency of internet use and gaming behaviors, psychological states (i.e., Patient Health Questionnaire [PHQ-9], Generalized Anxiety Disorder [GAD-7]), disordered gaming and social media use (i.e., IGDS9-SF, GDT, and BSMAS). Psychometric testing was conducted to examine the validity and reliability levels of the Bangla IGDS9-SF, GDT, and BSMAS. Results: The newly adapted Bangla IGDS9-SF, GDT, and BSMAS exhibited adequate levels of internal consistency. All total scores were significantly correlated with depression, anxiety, frequencies of internet use/online activities and gaming, supporting criterion and convergent validity. CFA indicated excellent construct validity as all instruments had a good fit to the data. Conclusions: The findings suggest that the Bangla IGDS9-SF, GDT, and BSMAS are sound psychometric instruments due to their satisfactory psychometric properties including internal consistency, criterion validity, convergent validity, and construct validity. [ABSTRACT FROM AUTHOR]

Background: Bangladesh has experienced tremendous change in child nutrition over the past few decades, but there are large differences between different regions in progress made. The question is whether continuation of current policies will bring the progress needed to reach national and international targets on child nutrition security. Data and methods: Using national data BDHS 1996/97, 2014, and 2017, this study attempts to map such reductions across Bangladesh and to explore the distribution of covariate effects (joint effects) that are associated with childhood stunting over these two periods, overall and by region. The main contribution of this paper is to link observed stunting scores to a household profile. This implies that different variables are evaluated jointly with stunting to assess the likelihood of being associated with stunting. Results: Overall, the covariates: 'Parental levels of education', 'children older than one year old', 'children live in rural area', 'children born at home' formed the country winning profile in 1996/97, whereas parental levels of education disappear in the winning profile for children stunted in 2014. This implies that over the years, Bangladesh has been successful in addressing parental education for long-term reductions in child undernutrition. In addition, the diversity of profiles of households with stunted children increases over time, pointing at successful targeting of policies to increase food security among children over the period. However, in areas where improvements have been insignificant, also the profiles remain stable, indicating a failure of policies to reach the target populations. The analysis for 2017 confirms this picture: the diversity of profiles remains high, with little change in the dominant profiles. Conclusion: Further decline in stunting is possible through region specific multipronged interventions, targeting children older than one year among vulnerable groups, in addition with strengthening family planning programs as larger families also have a higher risk to have stunted children. In general, the profiles in 2014 and 2017/18 are much more diverse than in 1996, which can be explained by the relative success of specific targeted policies in some divisions, while being much less successful in other regions. In sum, our results suggest that the challenge lies in the implementation of policies, rather than in the generic approach and assumed theory of change. [ABSTRACT FROM AUTHOR]

Mortality forecasts are essential part for policymaking in any aging society. In recent years, methods to model and forecast mortality have improved considerably. Among them, Lee-Carter method is one of the most influential method. In this paper, Lee-Carter method is applied to forecast mortality and life expectancy of Bangladesh. A functional data analysis approach is used to decompose the smoothed log-mortality rates in Lee-Carter framework for higher goodness-of-fit of the models and for longer forecast horizons. Bangladesh has been experiencing a mortality transition and has gained life expectancy in last few decades. The fitted model here showed higher pace of mortality decline for women in Bangladesh than that of men. The forecasts showed continuation of mortality improvement in long run and by 2060 life expectancy at birth is expected to reach over 80 years for both sexes in Bangladesh. The study also predicts the effect of reduction in infant mortality on the life expectancy in Bangladesh. [ABSTRACT FROM AUTHOR]

Background: As COVID-19 was declared a global pandemic, the major focus of healthcare organizations shifted towards preparing healthcare systems to handle the inevitable COVID-19 burden at different phases and levels. A series of in-person training programs were operated in collaboration with government and partner organizations for the healthcare workers (HCW) of Bangladesh. This study aimed to assess the knowledge of HCWs regarding SARS-CoV-2 infection, their case management, infection prevention and control to fight against the ongoing pandemic. Methods: As a part of the National Preparedness and Response Plan for COVID-19 in Bangladesh, the training program was conducted at four district-level hospitals and one specialized hospital in Bangladesh from July 1, 2020 to June 30, 2021. A total of 755 HCWs participated in the training sessions. Among them, 357 (47%) were enrolled for the evaluation upon completion of the data, collected from one district hospital (Feni) and one specialized hospital (National Institute of Mental Health). Results: The mean percentage of pre-test and post-test scores of all the participants were found to be 57% (95% CI 8.34–8.91; p 0.01) and 65% (95% CI 9.56–10.15; p <0.001) respectively. The difference of score (mean) between the groups was significant (p<0.001). After categorizing participants' knowledge levels as poor, average and fair, doctors' group has shown to have significant enhancement from level of average to fair compared to that of the nurses. Factors associated with knowledge augmentation of doctors were working in primary health care centers (aOR: 4.22; 95% CI: 1.80, 9.88), job experience less than 5 years (aOR: 4.10; 95% CI: 1.01, 16.63) and experience in caring of family member with COVID-19 morbidity (aOR: 2.06; 95% CI: 1.03, 4.10), after adjusting for relevant covariates such as age, sex and prior COVID-19 illness. Conclusion: Considering the series of waves of COVID-19 pandemic with newer variants, the present paper underscores the importance of implementing the structured in-person training program on case management, infection prevention and control for the HCWs that may help for successful readiness prior to future pandemics that may further help to minimize the pandemic related fatal consequences. [ABSTRACT FROM AUTHOR]

Background and objectives: High out-of-pocket expenditures (OOPE) increases the probability that households will become impoverished or will forgo needed care. The aim of this paper is to study household medicines expenditure and its associated determining factors to develop policies to protect households from financial hardship. Methods: The present cross-sectional and population-level study used the Bangladesh 2016–17 National Household Income and Expenditure Survey (HIES). The final sample size was 46,080 households. We analyzed the probability of OOPE for medicines, the share of total OOPE due to medicines out of total OOPE in health (reported as a ratio between zero and one), the OOPE amount for medicines reported (in United States Dollars), and the share of OOPE amount on medicines out of total household expenditure (reported as a ratio between zero and one). Predictors of analyzed outcomes were identified using three regression models. Results: Out of those households who spent on healthcare, the probability of having any OOPE on medicines was 87.9%. Of those who spent on medicines, the median monthly expenditure was US$3.03. The poorest households spent 9.97% of their total household expenditure as OOPE on medicines, nearly double that of the wealthiest households (5.86%). The characteristic which showed the most significant correlation to a high OOPE on medicines was the presence of chronic diseases, especially cancer. Twenty six percent of all surveyed households spend more than 10% of their OOPE on medicines. Conclusions: Our study shows that financial protection should be targeted at the poorest quintiles and such protection should include enrollment of rural households. Further, outpatient medicines benefits should include those for non-communicable diseases (NCDs). [ABSTRACT FROM AUTHOR]

Globally, 21 percent of young women are married before their 18th birthday. Despite some progress in addressing child marriage, it remains a widespread practice, in particular in South Asia. While household predictors of child marriage have been studied extensively in the literature, the evidence base on macro-economic factors contributing to child marriage and models that predict where child marriage cases are most likely to occur remains limited. In this paper we aim to fill this gap and explore region-level indicators to predict the persistence of child marriage in four countries in South Asia, namely Bangladesh, India, Nepal and Pakistan. We apply machine learning techniques to child marriage data and develop a prediction model that relies largely on regional and local inputs such as droughts, floods, population growth and nightlight data to model the incidence of child marriages. We find that our gradient boosting model is able to identify a large proportion of the true child marriage cases and correctly classifies 77% of the true marriage cases, with a higher accuracy in Bangladesh (92% of the cases) and a lower accuracy in Nepal (70% of cases). In addition, all countries contain in their top 10 variables for classification nighttime light growth, a shock index of drought over the previous and the last two years and the regional level of education, suggesting that income shocks, regional economic activity and regional education levels play a significant role in predicting child marriage. Given the accuracy of the model to predict child marriage, our model is a valuable tool to support policy design in countries where household-level data remains limited. [ABSTRACT FROM AUTHOR]

Background: Over 165,000,000 people live in Bangladesh; approximately 97% of Bangladeshis drink well water. Approximately 49% of Bangladesh's area has drinking well water with arsenic (As) concentrations that exceed the 10 micrograms per liter (μg/L) World Health Organization (WHO) guideline. This exposure to a potent carcinogen is a significant threat to public health. About 21% of Bangladesh is flooded each year during a typical monsoon season. As climate change progresses, sea levels will continue to rise, and the area and duration of these annual floods will increase. We hypothesize that these consequences of climate change can increase the release of arsenic from sediments into Bangladesh's drinking well water. Methods: Drinking well water samples were collected during a national-scale survey in Bangladesh. The dissolved oxygen concentration, oxidation-reduction potential, specific conductance, pH, and temperature were measured at sampling with calibrated portable electronic sensors. The arsenic concentration was measured by the silver diethyldithiocarbamate method. Results: As the concentration of dissolved oxygen decreases, the concentration of arsenic increases (p-value = 0.0028). Relatedly, as the oxidation-reduction potential decreases, the concentration of arsenic increases (p-value = 1.3×10−5). This suggests that arsenic is released from sediments into Bangladesh's drinking well drinking water by reduction. As the specific conductance increases, the concentration of arsenic increases (p-value = 0.023). This suggests that arsenic is also released from sediments into water by the salt effect. Conclusions: Rising sea levels can cause a decrease in the dissolved oxygen concentration and oxidation-reduction potential of the underlying aquifer; this should increase the dissolution of insoluble arsenate (H3−xAs(V)O4x−) in sediments by reduction. This, in turn, should release soluble arsenite (H3−xAs(III)O3x−) into the drinking well water. Rising sea levels can cause an increase in the salt concentration of the underlying aquifer; this should increase the release of arsenic from sediments into the drinking well water by the salt effect. [ABSTRACT FROM AUTHOR]

This paper investigates the extent to which in-utero exposure to droughts influences the health outcomes of Bangladeshi children in early childhood. Exploiting the plausibly exogenous deviations of rainfall from the location-specific norms, we find that deficient rainfall during the prenatal period is harmful to child health. Specifically, in-utero exposure to droughts decreases the height-for-age, weight-for-height, and weight-for-age z-scores by 0.10, 0.11, and 0.11 standard deviations among children under five years old, respectively. Our heterogeneity analyses reveal that the adverse health setbacks fall disproportionately on children of disadvantaged backgrounds. Exploring the differential effects by trimesters of exposure, we further show that experiencing droughts during the second and the third trimesters leaves injurious effects on early childhood health. [ABSTRACT FROM AUTHOR]

The increasing use of Information Technology (IT) has led to many security and other related failures in the banks and other financial institutions in Bangladesh. In this paper, we investigated the factors contributing to the failurein the IT system of the banking industry in Bangladesh. Based on the experts' opinions and weight on the specified evaluating criteria, an empirical test was conducted using a rough set theory to produce a framework for the IT system failure factors. In this study, an extended approach involving the integration of rough set theory based flexible Failure Mode and Effect Analysis (FMEA) and the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) has beenapplied to help the managers of the corresponding field to identify the factors responsible for the failure of the IT system in the banking industries and then prioritize them accordingly, for the ease of decision-making.In this research, eleven such failure factors were identified, which were then quantitatively analyzed to facilitate managers in crucial decision-making. It was observed that cyber-attack, database hack risks, server failure, network interruption, broadcast data error, and virus effect were the most significant factors for the failure of the IT system. The framework developed in this research can be utilized to assist in efficient decision-makingin other serviceindustries where IT systems play a key role. To the best of the knowledge, this is the first study thatempirically tested key failure factors of the IT system for the banking sector using an integrated method. [ABSTRACT FROM AUTHOR]

Introduction: Internal migration is essential to understand the population dynamics and the multifaceted relationship between population and development of a nation. In Bangladesh, the study of international migration is more frequent due to its socioeconomic importance and data availability. However, the study of internal migration is less frequent as there lie complexities in measuring internal migration, and data are less available. Thus, this paper aimed to explore the dynamics of internal in Bangladesh. Data and methods: We utilized data from the Bangladesh Population and Housing Census 1991–2011. The number of internal migrants was estimated using the United Nations Manual on Methods of Measuring Internal Migration- Manual VI. District-wise lifetime and net internal migration rate were the dependent variables where several socioeconomic variables were used as independent variables. The correlation and the stepwise multiple linear regression analysis were employed. Results: Dhaka, Gazipur, Narayanganj, and all the Divisional cities have the highest in-migration rate, whereas the northern and southern districts of Bangladesh have the highest out-migration rate. The regression model showed that activity rate appeared to be the strongest predictor (β = 0.419, P<0.001) of net migration for 2011, followed by city corporation (β = 0.275, P<0.01) and poverty rate (β = -0.246, P<0.01). However, the lifetime internal migration rate was 9.8% in 2011. The pooled model (1991–2011) for lifetime internal migration showed that activity rate (β = 0.408, P<0.001), population density (β = 0.386, P<0.001), literacy rate (β = 0.341, P<0.001), and city corporation (β = 0.139, P<0.01) were the significant factors of internal migration. Marriage, looking for a job, employment/business, education, and natural calamities were the reasons for internal migration. Discussion and conclusion: The destinations of migrants are few developed and urbanized cities which needs particular attention in policy planning. If the current migration trends continue, few cities will have an excessive population, which will increase density and pollution, thereby decreasing living standards. Thus, along with comprehensive urban planning, decentralization of government and private institutions must be ensured. Since the rural to urban migration rate is high, the findings recommend more development and concentration in the rural area. Finally, education, training, and work opportunities for migrants should be safeguarded in the area of origin. [ABSTRACT FROM AUTHOR]

Background: "Contracting Out" is a popular strategy to expand coverage and utilization of health services. Bangladesh began contracting out primary healthcare services to NGOs in urban areas through the Urban Primary Health Care Project (UPHCP) in 1998. Over the three phases of this project, retention of trained and skilled human resources, especially doctors, proved to be an intractable challenge. This paper highlights the issues influencing doctor's retention both in managerial as well as service provision level in the contracted-out setting. Methodology: In this qualitative study, 42 Key Informant Interviews were undertaken with individuals involved with UPHCP in various levels including relevant ministries, project personnel representing the City Corporations and municipalities, NGO managers and doctors. Verbatim transcripts were coded in ATLAS.ti and analyzed using the thematic analysis. Document review was done for data triangulation. Results: The most cited problem was a low salary structure in contrast to public sector pay scale followed by a dearth of other financial incentives such as performance-based incentives, provident funds and gratuities. Lack of career ladder, for those in both managerial and service delivery roles, was also identified as a factor hindering staff retention. Other disincentives included inadequate opportunities for training to improve clinical skills, ineffective staffing arrangements, security issues during night shifts, abuse from community members in the context of critical patient management, and lack of job security after project completion. Conclusions: An adequate, efficient and dedicated health workforce is a pre-requisite for quality service provision and patient utilization of these services. Improved career development opportunities, the provision of salaries and incentives, and a safer working environment are necessary actions to retain and motivate those serving in managerial and service delivery positions in contracting out arrangements. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) is a global public health crisis that is now impacted by the COVID-19 pandemic. Little is known how COVID-19 risks influence people to consume antibiotics, particularly in contexts like Bangladesh where these pharmaceuticals can be purchased without a prescription. This paper identifies the social drivers of antibiotics use among home-based patients who have tested positive with SARS-CoV-2 or have COVID-19-like symptoms. Using qualitative telephone interviews, the research was conducted in two Bangladesh cities with 40 participants who reported that they had tested positive for coronavirus (n = 20) or had COVID-19-like symptoms (n = 20). Our analysis identified five themes in antibiotic use narratives: antibiotics as 'big' medicine; managing anxiety; dealing with social repercussions of COVID-19 infection; lack of access to COVID-19 testing and healthcare services; and informal sources of treatment advice. Antibiotics were seen to solve physical and social aspects of COVID-19 infection, with urgent ramifications for AMR in Bangladesh and more general implications for global efforts to mitigate AMR. [ABSTRACT FROM AUTHOR]

Despite substantial progress, Bangladesh still has a high rate of maternal deaths owing to difficulties during pregnancy, delivery, and the postpartum period. Increasing facility delivery is mandatory to reach the goal of bringing down the MMR to <70 deaths/100,000 live births by 2030. In the era of digitalization, the introduction of e-registration and mHealth may aid the government in reaching this target. The southern part of Bangladesh is a hazard-prone area, where service uptake from institutions is low. This study aims to determine the effect of an e-registration tracking system and mHealth counseling on institutional deliveries to pregnant mothers in hazard-prone areas of southern Bangladesh. We will conduct an open-label, two-arm, non-randomized controlled cluster trial for six months and use three hazard-prone areas for intervention and another three hazard-prone areas for control. We will collect data at baseline and end-line of the study period using a structured questionnaire. We will enroll at least 268 pregnant mothers from the intervention and 268 pregnant mothers from the control areas after screening based on the inclusion and exclusion criteria. Pregnancy information will be obtained from the Family Welfare Assistant register. The respondents of the intervention arm will be registered in the e-Registration system, and receive voice call and text messages from the midwives to have their deliveries done in healthcare facilities. We will follow the participants until their delivery and exclude those respondents from the study who will have post-dated delivery, migrate out, lost to follow-up, or die during the study period. Random-intercept mixed-effect logistic regression will be performed to explain the relationship of e-registration and mHealth package with institutional delivery. Institutional delivery is still uncommon in Southern Bangladesh despite several interventions. Innovative approaches like e-registration and mHealth counseling may be helpful to bring women to health facilities. The findings from the study might enable the policy makers of Bangladesh to integrate the intervention package into the existing healthcare system. This experiment is registered in the open science framework. Clinical trial registration: Registration number: DOI 10.17605/OSF.IO/YZE5C) and https://www.clinicaltrials.gov/ (registration number: NCT05398978. [ABSTRACT FROM AUTHOR]

Renewable energy has become the most prominent source of energy to reduce carbon emissions around the globe. Undoubtedly, hydro energy is very much clean energy among other sources. In Bangladesh, hydro energy is available only in a specific southern area contributing several hundred megawatts to the national grid. This paper devotes to assessing the capacity and practicability of a hydropower plant to boost the power output by implementing the combined cycle hydropower system. The proposed method has been developed by 1) studying the existing plant based on surveyed data, 2) selecting the site for installing the hydrokinetic turbine, 3) designing with consideration of numerous constraints of inter dependability, and 4) creating a prototype model to ensure the practicability. Preliminary results show that a significant amount of additional electric energy can be generated from the plant with higher efficiency. [ABSTRACT FROM AUTHOR]

Introduction: Transgender women (hijra) in Bangladesh are declared as a separate gender category by the Government. However, research revealed that they experience transphobia, which could potentially affect their physical and mental health outcomes, and their access to SRHR-related care. This warrants an exploration of their SRHR-related rights issues, particularly using a community-engaged approach. Moreover, it is crucial to operationalize these findings into actionable policies and practice. This study aims to explore and address the SRHR and other rights-related challenges experienced by hijra under the framework of policy analysis. Methods: The study population will include hijra in four selected service centers in Dhaka, Bangladesh. In the first phase, evidence will be generated through desk review and mixed methods research. The desk review will consist of reading and analyzing literature to understand the difference between policy and reality. For the quantitative component, a first-come-first-serve sampling approach will be used on a total sample size of 296. This will be complemented by the qualitative component, which will entail in-depth interviews, focus groups and key informant interviews. Moreover, life case histories will be conducted for particularly compelling cases. These findings will be collectively analyzed through the policy analysis framework, to analyze the differences between the policy and reality, which will ultimately generate a lay summary for stakeholders. Univariate and multivariate analysis will be used for the quantitative component whereas thematic analysis will be used for the qualitative component. In the second phase, the findings from the lay summary will be shared with stakeholders and hijra community members through a series of discussions. Discussion: There are a few limitations of the study. In particular, this study consists of various activities which may require substantial time and effort to complete. Additionally, this study merely goes up to the policy recommendation formulation stage, as opposed to formulating an intervention design. Moreover, the findings will be disseminated through various platforms, including dissemination seminars, scientific articles and the study report. [ABSTRACT FROM AUTHOR]

Maternal hypertension may be an underrecognized but important risk factor for perinatal death in low resource settings. We investigated the association of maternal hypertension and perinatal mortality in rural Bangladesh. This nested, matched case-control study used data from a 2019 cross-sectional survey and demographic surveillance database in Baliakandi, Bangladesh. We randomly matched each pregnancy ending in perinatal death with five pregnancies in which the neonate survived beyond seven days based on maternal age, education, and wealth quintile. We estimated associations of antenatal care-seeking and self-reported hypertension with perinatal mortality using conditional logistic regression and used median and interquartile ranges to assess the mediation of antenatal care by timing or frequency. Among 191 cases and 934 matched controls, hypertension prevalence was 14.1% among cases and 7.7% among controls. Compared with no diagnosis, the probability of perinatal death was significantly higher among women with a pre-gestational hypertension diagnosis (OR 2.90, 95% CI 1.29, 6.57), but not among women with diagnosis during pregnancy (OR 1.68, 95% CI 0.98, 2.98). We found no association between the number of antenatal care contacts and perinatal death (p = 0.66). Among women with pre-gestational hypertension who experienced a perinatal death, 78% had their first antenatal contact in the sixth or seventh month of gestation. Hypertension was more common among rural women who experience a perinatal death. Greater effort to prevent hypertension prior to conception and provide early maternity care to women with hypertension could improve perinatal outcomes in rural Bangladesh. [ABSTRACT FROM AUTHOR]

Anaemia is a major public health concern in developing countries, particularly among children, adolescents, and women of reproductive age. The study aimed to assess the anaemia status among adolescent girls, pregnant, and lactating women with their contributing factors in the southern rural regions of Bangladesh. This cross-sectional study was conducted among 400 adolescent girls, 375 pregnant, and 375 lactating women using a multistage cluster-random sampling technique. Anaemia was measured through haemoglobin concentration in blood capillaries collected with a Hemocue 301 machine. Multinomial logistic regression was used to determine the factors associated with anaemia. The average age of pregnant and lactating women was 24 years and 15.2 years for girls. Overall, the prevalence of anaemia was 50% among pregnant women, 46% among lactating women, and 38% among adolescent girls. The risk of anaemia among adolescent girls was higher among non-Muslim (aOR = 2.13, 95%CI:1.05–4.31), belonged to families having >5 members (aOR = 2.24, 95%CI:1.16–4.31) while exposure to media reduced their risk (aOR = 0.33, 95%CI:0.15–0.74). Pregnant women who consumed a diversified diet, washed their hands after toilet, and received ≥4 ANC visits had a lower likelihood of developing anaemia. Lactating women who were employed, consumed a diversified diet, washed their hands before preparing food, and after toilet, had been exposed to media, received ≥4 ANC visits, and consumed ≥90 IFA, had a lower risk of developing anaemia. However, anaemia was more likely to be associated with lactating women who were non-Muslim (aOR = 3.75; 95%CI:1.26–11.22). The high prevalence of anaemia emphasizes the need to reconsider the existing strategy for the prevention and control of micronutrient deficiencies in Bangladesh. [ABSTRACT FROM AUTHOR]

The use of quality seeds is crucial to improve rice yield, food security, and farmers' livelihoods. The large informal seed system, limited access to quality seeds, and low seed replacement rate challenge increasing rice yield. Despite robust government initiatives to support the seed system, progress has been slow. Besides, the need for farmers' behavioural change, enhanced coordination, and communication at the local level has not received adequate attention. We investigate rice farmers' preferences for quality seed, packet sizes, types, and sources, and assess the impact of utilizing good quality seed. We collected quantitative data from 1196 rice farmers in northern Bangladesh in 2019. To identify major factors influencing farmers' preferences regarding quality seed, packet sizes, packet types, and seed sources, we employed ordered logit and multinomial logit models. Additionally, we used the propensity score matching procedure to assess the impact of good quality and formal seed sources on the rice yield. The findings revealed that farmers strongly prefer using seeds from formal sources despite limited accessibility. Of the total farmers, 34% use public source seeds, 33% use private source seeds, and the rest rely on their own saved seeds. The use of good quality seeds increased rice yields from the base yield by 0.07–0.28 t/ha. We found about a 48% gap in accessing good-quality seeds, indicating significant potential for scaling up the seed systems. Farmers using formal seed sources yielded 0.03–0.15 t/ha more than informal seed users. Farmers strongly prefer 5 kg packets due to their cost-effectiveness, easy storage, and handling convenience. Additionally, farmers prefer polycoated jute sacks for their versatility, multi-purpose applications, and resistance to pests. The econometric model results showed that farmers' preferences were significantly influenced by gender, farm type, crop yield, seed price, market distance, various stakeholders' advice, and seed supply systems' constraints. The government should implement policies and programs to strengthen a well-connected seed network in rural areas, promoting inclusivity, and enhancing rice productivity. Besides, farmers' needs and preferences should be considered in designing and implementing seed-related initiatives to foster sustainable agricultural development. [ABSTRACT FROM AUTHOR]

Rice (Oryza sativa) stands as a crucial staple food worldwide, especially in Bangladesh, where it ranks as the third-largest producer. However, intensified cultivation has made high-yielding rice varieties susceptible to various biotic stresses, notably sheath blight caused by Rhizoctonia solani, which inflicts significant yield losses annually. Traditional fungicides, though effective, pose environmental and health risks. To address this, nanotechnology emerges as a promising avenue, leveraging the antimicrobial properties of nanoparticles like silver nanoparticles (AgNPs). This study explored the green synthesis of AgNPs using Ipomoea carnea leaf extract and silver nitrate (AgNO3), and also examined their efficacy against sheath blight disease in rice. The biosynthesized AgNPs were characterized through various analytical techniques such as UV-vis spectrophotometer, X-ray Diffraction (XRD), Fourier Transform Infrared Spectroscopy (FTIR), Particle size analyzer, Zeta potential, Scanning Electron Microscope (SEM), Field Emission Scanning Electron Microscope (FESEM), Transmission Electron Microscope (TEM) for confirming their successful production and crystalline nature of nanoparticles. The results of UV-visible spectrophotometers revealed an absorption peak ranging from 421 to 434 nm, validated the synthesis of AgNPs in the solution. XRD, DLS, and TEM estimated AgNPs sizes were ~45 nm, 66.2nm, and 46.38 to 73.81 nm, respectively. SEM and FESEM demonstrated that the synthesized AgNPs were spherical in shape. In vitro assays demonstrated the significant inhibitory effects of AgNPs on mycelial growth of Rhizoctonia solani, particularly at higher concentrations and pH levels. Further greenhouse and field experiments validated the antifungal efficacy of AgNPs against sheath blight disease in rice, exhibiting comparable effectiveness to commercial fungicides. The findings highlight the potential of AgNPs as a sustainable and effective alternative for managing rice sheath blight disease, offering a safer solution amidst environmental concerns associated with conventional fungicides. [ABSTRACT FROM AUTHOR]

This study describes how, as part of the administrative reform of Bangladesh, most of the urban local governments have set up some public service center like Pourasava Digital Center (PDC), where ICT (Information and Communication Technology) has been commonly applied to make e-services more convenient, efficient and transparent. The current study measures the Service Quality Satisfaction and Continuous Use Intention to use Pourasava Digital Center (PDC) in Bangladesh by adopting citizen participation as a moderator. Theoretically, this study has used the DeLone & McLean Information Systems (D&M IS) Success Model and Zhang's two-dimensional satisfaction model. However, most of the existing studies in Bangladesh are qualitative, and the relationship between service quality and citizen satisfaction has not been tested. A survey was conducted based on a structured questionnaire method and data collected from 332 respondents from 05 PDC and applying structural equation modelling in AMOS software while analyzing the data. The empirical results showed that the data fit the model. The finding of this study is that information quality affects specific satisfaction but not accumulative satisfaction, and specific satisfaction might not lead to accumulative satisfaction. One of the worthy findings of this study is that citizen satisfaction is highly dependent on system quality and service quality rather than information quality. The continuous use intention of the citizen is not based on specific satisfaction but significantly depends on accumulative satisfaction. To ensure the improvement of PDC's service quality, all dimensions related to the quality of service should be modified, and the administrative system and citizens should be encouraged to participate in all aspects of services. [ABSTRACT FROM AUTHOR]

BRRI31R is one of the Bangladesh's most promising restorer lines due to its abundant pollen producing capacity, strong restoring ability, good combining ability, high outcrossing rate and genetically diverse from cytoplasmic male sterile (CMS) line. But the drawback of this line is that it is highly susceptible to bacterial blight (BB) disease of rice caused by Xanthomonas oryzae pv. oryzae. The present study highlighted the pyramiding of effective BB resistance genes (xa5, xa13 and Xa21) into the background of BRRI31R, through marker–assisted backcrossing (MABC). Backcross progenies were confirmed and advanced based on the foreground selection of target genes. Pyramided lines were used for pathogenicity test against five Bangladeshi Xanthomonas oryzae (BXo) races (BXo93, BXo220, BXo822, BXo826, BXo887) and confirmed the dominant fertility restore genes, Rf3 and Rf4 and further validated against SNP markers for more confirmation of target resistance genes. All pyramided restorer lines consisted of Xa4 (in built), xa5, xa13, Xa21, and Chalk5 with two fertility restorer genes, Rf3, Rf4. and these restorer lines showed intermediate amylose content (<25%). Restorer lines BRRI31R-MASP3 and BRRI31R-MASP4 showed high levels of resistance against five virulent BXo races and SNP genotyping revealed that these lines also contained a blast resistance gene Pita races. Gene pyramided restorer lines, BRRI31R-MASP3 and BRRI31R-MASP4 can directly be used as a male parent for the development of new BB resistant hybrid rice variety or could be used as a replacement of restorer line of BRRI hybrid dhan5 and 7 to enhance the quality of hybrid seeds as well as rice production in Bangladesh. [ABSTRACT FROM AUTHOR]

Aim: Malnutrition in pregnant women significantly affects both mother and child health. This research aims to identify the best machine learning (ML) techniques for predicting the nutritional status of pregnant women in Bangladesh and detect the most essential features based on the best-performed algorithm. Methods: This study used retrospective cross-sectional data from the Bangladeshi Demographic and Health Survey 2017–18. Different feature transformations and machine learning classifiers were applied to find the best transformation and classification model. Results: This investigation found that robust scaling outperformed all feature transformation methods. The result shows that the Random Forest algorithm with robust scaling outperforms all other machine learning algorithms with 74.75% accuracy, 57.91% kappa statistics, 73.36% precision, 73.08% recall, and 73.09% f1 score. In addition, the Random Forest algorithm had the highest precision (76.76%) and f1 score (71.71%) for predicting the underweight class, as well as an expected precision of 82.01% and f1 score of 83.78% for the overweight/obese class when compared to other algorithms with a robust scaling method. The respondent's age, wealth index, region, husband's education level, husband's age, and occupation were crucial features for predicting the nutritional status of pregnant women in Bangladesh. Conclusion: The proposed classifier could help predict the expected outcome and reduce the burden of malnutrition among pregnant women in Bangladesh. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to observe the associated risk factors of lower back pain and the factors that increase the pain severity. So, the main objective of this research is to identify the factors which may cause the lower back pain and the causal effect on the pain severity and respective treatment. This study also tries to determine the demographical characteristics of the low back pain patients and determine the inter relationship of psychological health, work stress and treatment effect with the pain disability index. Study design: In this cross-sectional study, 200 patients with lower back pain were interviewed who were taking treatments from the physiotherapy department at the Center for the Rehabilitation of the Paralysed, Savar, Dhaka, Bangladesh. Methods: A quantitative research model has been performed to observe the relationship between different causes of low back pain effects on the patients. Different statistical analysis including structural equation modeling have been performed to observe their pain severity and treatment effect. Results: The study found 64% (128) of the total participants as male and 36% (72) as female among 200 patients of low back pain. The study also observed the highest portion of the patients belong to the age group 39 to 45 years (21.5%). On the basis of BMI, obese weight respondents were 26.5% (53), overweight respondents were 37% (74), normal weight respondents were 33% (66), and underweight respondents were only 3.5% (7). Here, sex, body mass index (BMI), living place and educational status have significant association with pain disability index (PDI). On the other hand, smoking tendency of patients has insignificant relationship (p>0.05) with pain disability index (PDI). The path coefficients of the structural equation model identified that all the null hypotheses of no significant relationship have been rejected for 5% level of significance. The hypothesis of psychological health is positively related to pain severity of a patient has an acceptable strength (β = 0.745, p<0.001) and a positive direction. Another hypothesis (Psychological health is positively related to the treatment of a patient) shows an acceptable strength (β = 0.401, p <0.001) and a positive direction. Work stress is also found to be positively related to pain severity of a patient with an acceptable strength (β = 0.544, p < 0.001) and a positive direction. The hypothesis (Work stress is positively related to the treatment of a patient) has an acceptable strength (β = 0.322, p< 0.05) and a positive direction. The hypothesis (pain severity is positively related to the treatment of patients) shows an acceptable strength (β = 0.801, p < 0.001) and a positive direction. Conclusion: The research found out the psychological health situation and work stress of patients are significantly related with pain severity with acceptable strength. Also, Pain severity is significantly associated with treatment scheme intensity. [ABSTRACT FROM AUTHOR]

We investigate the hierarchical structure of Dhaka stocks' financial networks, known as an emerging market, from 2008 to 2020. To do so, we determine correlations from the returns of the firms over a one-year time window. Then, we construct a minimum spanning tree (MST) from correlations and calculate the hierarchy of the tree using the hierarchical path. We find that during the unprecedented crisis in 2010–11, the hierarchy of this emerging market did not sharply increase like in developed markets, implying the absence of a compact cluster in the center of the tree. Noticeably, the hierarchy fell before the big crashes in the Bangladeshi local market, and the lowest value was found in 2010, just before the 2011 Bangladesh market scam. We also observe a lower hierarchical MST during COVID-19, which implies that the network is fragile and vulnerable to financial crises not seen in developed markets. Moreover, the volatility in the topological indicators of the MST indicates that the network is adequately responding to crises and that the firms that play an important role in the market during our analysis periods are financial, particularly the insurance companies. We notice that the largest degrees are minimal compared to the total number of nodes in the tree, implying that the network nodes are somewhat locally compact rather than globally centrally coupled. For this random structure of the emerging market, the network properties do not properly reflect the hierarchy, especially during crises. Identifying hierarchies, topological indicators, and significant firms will be useful for understanding the movement of an emerging market like Dhaka Stock exchange (DSE), which will be useful for policymakers to develop the market. [ABSTRACT FROM AUTHOR]

Heat waves significantly impact people's lives and livelihoods and are becoming very alarming and recognized as hot topics worldwide, including in Bangladesh. However, much less is understood regarding recent hotspots, the frequency of heat waves over time, and their underlying causes in Bangladesh. The objective of the study is to explore the current scenario and frequency of heat waves and their possible causes across Bangladesh. The Mann-Kendall and Sen's slope techniques were used to determine seasonal and annual temperature trend patterns of heat wave frequencies. Daily maximum temperature datasets collected from the Bangladesh Meteorological Department (BMD) during 1991–2021 are applied. The frequency of days with Tmax≥ 36°C as the threshold was used to compute different types of heat waves based on the BMD's operational definition. The results show that the mild heat wave (MHW) days followed the subsequent hotspot order: Rajshahi (103) > Chuadanga (79), Ishurdi (60), and Jessore (58), respectively. The frequency of days with Tmax≥36°C was persistence for many days in 2014, especially in the western part of Bangladesh compared to other parts. Similarly, the heat waves condition shown its deadliest event by increasing more days in 2021. The highest increasing trend was identified at the Patuakhali site, with a rate of 0.516 days/year, while the highest decreasing trend was noticed at the Chuadanga site, with a rate of -0.588 days/year. The frequency of days (Tmax≥36°C) is an increasing trend in the south-western part of Bangladesh. The synoptic condition in and around Bangladesh demonstrates that the entrance of heat waves in Bangladesh is due to the advection of higher temperatures from the south/southwest of the Bay of Bengal. The outcomes will guide the national appraisal of heatwave effects, shedding light on the primary causes of definite heatwave phenomena, which are crucial for developing practical adaptation tools. [ABSTRACT FROM AUTHOR]

This study investigates the relationship between Foreign Direct Investment (FDI) inflows and economic growth at sectoral levels in Bangladesh, employing a panel study framework. Utilizing sectoral-level panel data spanning six sectors from 2007–08 to 2018–19, the analysis is conducted using Panel Vector Error Correction Model (Panel VECM). Results from panel unit root tests confirm that all variables are integrated of order one I (1), indicating stationarity. The Pedroni panel co-integration test further supports the presence of co-integration among the variables. Notably, the Panel VECM reveals evidence of a unidirectional causal relationship from Real Gross Domestic Product (RGDP) to Real Foreign Direct Investment (RFDI) across all six sectors of Bangladesh. The findings underscore the significance of formulating pragmatic policies and implementing them effectively to attract FDI across sectors, thereby contributing to the overall economic growth of Bangladesh. [ABSTRACT FROM AUTHOR]

Colistin resistance is a global concern warning for a one health approach to combat the challenge. Colistin resistant E. coli and their resistance determinants are widely distributed in the environment, and rats could be a potential source of these isolates and resistant determinants to a diverse environmental setting. This study was aimed to determine the presence of colistin resistant E. coli (CREC) in wild rats, their antimicrobial resistance (AMR) phenotypes, and genotypic analysis of mcr-1 CREC through whole genome sequencing (WGS). A total of 39 rats were examined and CREC was isolated from their fecal pellets onto MacConkey agar containing colistin sulfate (1 μg/ mL). AMR of the CREC was determined by disc diffusion and broth microdilution was employed to determine MIC to colistin sulfate. CREC were screened for mcr genes (mcr-1 to mcr-8) and phylogenetic grouping by PCR. Finally, WGS of one mcr-1 CREC was performed to explore its genetic characteristics especially resistomes and virulence determinants. 43.59% of the rats carried CREC with one (2.56%) of them carrying CREC with mcr-1 gene among the mcr genes examined. Examination of seventeen (17) isolates from the CREC positive rats (n = 17) revealed that majority of them belonging to the pathogenic phylogroup D (52.94%) and B2 (11.76%). 58.82% of the CREC were MDR on disc diffusion test. Shockingly, the mcr-1 CREC showed phenotypic resistance to 16 antimicrobials of 8 different classes and carried the ARGs in its genome. The mcr-1 gene was located on a 60 kb IncI2 plasmid. On the other hand, ARGs related to aminoglycosides, phenicols, sulfonamides, tetracyclines and trimethoprims were located on a 288 kb mega-plasmid separately. The mcr-1 CREC carried 58 virulence genes including genes related to adhesion, colonization, biofilm formation, hemolysis and immune-evasion. The isolate belonged to ST224 and closely related to E. coli from different sources including UPEC clinical isolates from human based on cgMLST analysis. The current research indicates that rats might be a possible source of CREC, and the presence of mcr-1 and other ARGs on plasmid increases the risk of ARGs spreading and endangering human health and other environmental components through this infamous pest. [ABSTRACT FROM AUTHOR]

Background: Diarrhoea is a global health problem. More than a quarter of diarrhoeal deaths occur among children less than five years. Different literatures analyzed presentation and outcomes of less than five diarrhoeal children. The world has made remarkable progress in reducing child mortality. So, older children are growing in number. Our aim was to identify clinical differentials and variations of pathogens among younger (less than five) and older (five to nine years) diarrhoeal children. Method: Data were extracted from the diarrhoeal disease surveillance system (DDSS) of Dhaka Hospital (urban site) and Matlab Hospital (rural site) of the International Centre for Diarrhoeal Disease Research, Bangladesh for the period of January 2012 to December 2021. Out of 28,781 and 12,499 surveillance patients in Dhaka and Matlab Hospital, 614 (2.13%) and 278 (2.22%) children were five to nine—years of age, respectively. Among under five children, 2456 from Dhaka hospital and 1112 from Matlab hospital were selected randomly for analysis (four times of five to nine years age children, 1:4). Results: Vomiting, abdominal pain, and dehydrating diarrhoea were significantly higher in older children in comparison to children of less than five years age (p-value <0.05) after adjusting study site, gender, antibiotic use before hospitalization, diarrhoeal duration < 24 hours, intake of oral rehydration fluid at home, parental education, WASH practice and history of cough. Vibrio. cholerae, Salmonella, and Shigella were the common fecal pathogen observed among older children compared to under five after adjusting for age, gender and study site. Conclusion: Although percentage of admitted diarrhoeal children with five to nine years is less than under five years children but they presented with critical illness with different diarrhoeal pathogens. These observations may help clinicians to formulate better case management strategies for children of five to nine years that may reduce morbidity. [ABSTRACT FROM AUTHOR]

According to the 2018 WHO R&D Blueprint, Nipah virus (NiV) is a priority disease, and the development of a vaccine against NiV is strongly encouraged. According to criteria used to categorize zoonotic diseases, NiV is a stage III disease that can spread to people and cause unpredictable outbreaks. Since 2001, the NiV virus has caused annual outbreaks in Bangladesh, while in India it has caused occasional outbreaks. According to estimates, the mortality rate for infected individuals ranges from 70 to 91%. Using immunoinformatic approaches to anticipate the epitopes of the MHC-I, MHC-II, and B-cells, they were predicted using the NiV glycoprotein and nucleocapsid protein. The selected epitopes were used to develop a multi-epitope vaccine construct connected with linkers and adjuvants in order to improve immune responses to the vaccine construct. The 3D structure of the engineered vaccine was anticipated, optimized, and confirmed using a variety of computer simulation techniques so that its stability could be assessed. According to the immunological simulation tests, it was found that the vaccination elicits a targeted immune response against the NiV. Docking with TLR-3, 7, and 8 revealed that vaccine candidates had high binding affinities and low binding energies. Finally, molecular dynamic analysis confirms the stability of the new vaccine. Codon optimization and in silico cloning showed that the proposed vaccine was expressed to a high degree in Escherichia coli. The study will help in identifying a potential epitope for a vaccine candidate against NiV. The developed multi-epitope vaccine construct has a lot of potential, but they still need to be verified by in vitro & in vivo studies. [ABSTRACT FROM AUTHOR]

To obtain information on the cultivation of tuberoses in Bangladesh's Jashore district, a study has been carried out to evaluate the economic and social standing of cultivators and examine the methods employed in production and farmers' attitudes towards field disease. The majority of surveyed farmers were men, aged between 30 and 40 years. Only 7.41% had a high level of education, and most had less than five years of experience in tuberose cultivation. On an annual basis, the total production cost amounted to Tk. 27,200 (bigha/year), yielding a net profit of Tk. 1,20,000 (bigha/year). 31.48% of farmers expressed the belief that diseases affecting tuberose originated from contaminated planting materials. A significant proportion (64.81%) of farmers used PGR to combat diseases affecting tuberose production. Government Agriculture Officers played a crucial role in assisting farmers with knowledge and guidance. Yet, most participants highlighted that the key to preventing diseases lies in the effective application of pesticides. The findings of this study can guide policymakers in implementing measures to enhance tuberose production and fortify the floriculture industry in Bangladesh. [ABSTRACT FROM AUTHOR]

The field of fish microbiome research has rapidly been advancing, primarily focusing on farmed or laboratory fish species rather than natural or marine fish populations. This study sought to reveal the distinctive gut bacteriome composition and diversity within the anadromous fish species Tenualosa ilisha (hilsa), which holds the status of being the national fish of Bangladesh. We conducted an analysis on 15 gut samples obtained from 15 individual hilsa fishes collected from three primary habitats (e.g., freshwater = 5, brackish water = 5 and marine water = 5) in Bangladesh. The analysis utilized metagenomics based on 16S rRNA gene sequencing targeting the V3-V4 regions. Our comprehensive identification revealed a total of 258 operational taxonomic units (OTUs). The observed OTUs were represented by six phyla, nine classes, 19 orders, 26 families and 40 genera of bacteria. Our analysis unveiled considerable taxonomic differences among the habitats (freshwater, brackish water, and marine water) of hilsa fishes, as denoted by a higher level of shared microbiota (p = 0.007, Kruskal-Wallis test). Among the identified genera in the gut of hilsa fishes, including Vagococcus, Morganella, Enterobacter, Plesiomonas, Shigella, Clostridium, Klebsiella, Serratia, Aeromonas, Macrococcus, Staphylococcus, Proteus, and Hafnia, several are recognized as fish probiotics. Importantly, some bacterial genera such as Sinobaca, Synechococcus, Gemmata, Serinicoccus, Saccharopolyspora, and Paulinella identified in the gut of hilsa identified in this study have not been reported in any aquatic or marine fish species. Significantly, we observed that 67.50% (27/40) of bacterial genera were found to be common among hilsa fishes across all three habitats. Our findings offer compelling evidence for the presence of both exclusive and communal bacteriomes within the gut of hilsa fishes, exhibiting potential probiotic properties. These observations could be crucial for guiding future microbiome investigations in this economically significant fish species. [ABSTRACT FROM AUTHOR]

This study aimed to explore the prevalence and determinants of discrimination against or harassment among Bangladeshi women. The nationally representative cross-sectional data of the Multiple Indicator Cluster Survey 2019 were employed in the study. Women aged 15-49 were asked whether they felt discrimination or harassment due to seven potential reasons in the last twelve months before the survey. The outcome was a binary variable indicating whether a woman has experienced discrimination or harassment for any of the seven reasons. Responses were obtained from 64378 women and analysed through bivariate and multivariate procedures. The data had a hierarchical structure since women were nested within the clusters. A mixed-effects logistic regression model was used to analyse the data appropriately. A strong association between discrimination or harassment was seen with the functional difficulties of women. Notably, women with functional difficulties were 1.629 times more likely to experience discrimination or harassment than women without such difficulties. Other significant factors were the respondents' area, age, education, current marital status, wealth index quintile and ethnicity. The study concludes that education, marital status, functional difficulties and wealth index are the most important determinants of discrimination or harassment of women. [ABSTRACT FROM AUTHOR]

Saltwater intrusion in the coastal areas of Bangladesh is a prevalent phenomenon. However, it is not conducive to activities such as irrigation, navigation, fish spawning and shelter, and industrial usage. The present study analyzed 45 water samples collected from 15 locations in coastal areas during three seasons: monsoon, pre-monsoon, and post-monsoon. The aim was to comprehend the seasonal variation in physicochemical parameters, including water temperature, pH, electrical conductivity (EC), salinity, total dissolved solids (TDS), hardness, and concentrations of Na+, K+, Mg2+, Ca2+, Fe2+, HCO3-, PO43-, SO42-, and Cl-. Additionally, parameters essential for agriculture, such as soluble sodium percentage (SSP), sodium absorption ratio (SAR), magnesium absorption ratio (MAR), residual sodium carbonate (RSC), Kelly's ratio (KR), and permeability index (PI), were examined. Their respective values were found to be 63%, 16.83 mg/L, 34.92 mg/L, 145.44 mg/L, 1.28 mg/L, and 89.29%. The integrated water quality index was determined using entropy theory and principal component analysis (PCA). The resulting entropy water quality index (EWQI) and SAR of 49.56% and 63%, respectively, indicated that the samples are suitable for drinking but unsuitable for irrigation. These findings can assist policymakers in implementing the Bangladesh Deltaplan-2100, focusing on sustainable land management, fish cultivation, agricultural production, environmental preservation, water resource management, and environmental protection in the deltaic areas of Bangladesh. This research contributes to a deeper understanding of seasonal variations in the hydrochemistry and water quality of coastal rivers, aiding in the comprehension of salinity intrusion origins, mechanisms, and causes. [ABSTRACT FROM AUTHOR]

Objective: To estimate the prevalence of Type 2 Diabetes (T2D) in urban and rural settings and identify the specific risk factors for each location. Method: We conducted this study using data from the 2017–18 Bangladesh Demographic and Health Survey (BDHS), sourced from the DHS website. The survey employed a stratified two-stage sampling method, which included 7,658 women and 7,048 men aged 18 and older who had their blood glucose levels measured. We utilized chi-square tests and ordinal logistic regression to analyze the association between various selected variables in both urban and rural settings and their relationship with diabetes and prediabetes. Results: The prevalence of T2D was 10.8% in urban areas and 7.4% in rural areas, while pre-diabetes affected 31.4% and 27% of the populations in these respective settings. The study found significant factors influencing diabetes in both urban and rural regions, particularly in the 55–64 age group (Urban: AOR = 1.88, 95% CI [1.46, 2.42]; Rural: AOR = 1.87, 95% CI [1.54, 2.27]). Highly educated individuals had lower odds of T2D, while wealthier and overweight participants had higher odds in both areas. In rural regions, T2D risk was higher among caffeinated drink consumers and those not engaged in occupation-related physical activity, while these factors did not show significant influence in urban areas. Furthermore, urban participants displayed a significant association between T2D and hypertension. Conclusion: Our study outlines a comprehensive strategy to combat the increasing prevalence of T2D in both urban and rural areas. It includes promoting healthier diets to control BMI level, encouraging regular physical activity, early detection through health check-ups, tailored awareness campaigns, improving healthcare access in rural regions, stress management in urban areas, community involvement, healthcare professional training, policy advocacy like sugary drink taxation, research, and monitoring interventions. These measures collectively address the T2D challenge while accommodating the distinct features of urban and rural settings. [ABSTRACT FROM AUTHOR]

Background: Globally, undernutrition is the leading cause of mortality among under-five children. Bangladesh and India were in the top ten countries in the world for under-five mortality. The aim of the study was to investigate the nutritional status of Bengali under-five children. Methods: Data on 25938 under-five children were retrieved from the Bangladesh Demographic and Health Survey 2017–18 (BDHS) and the National Family Health Survey of India 2015–16 (NFHS-4). Stunting, wasting, underweight and thinness were considered to understand the nutritional status of under-five children. Binary logistic regression was used to identify associated factors of undernutrition among children. Results: Over one-quarter of Bengali under-five children were found to be suffering from the problem of stunting (31.9%) and underweight (28.1%), while other nutritional indicators raised serious concern and revealed inter-country disparities. In the cases of wasting, underweight and thinness, the mean z-scores and frequency differences between Bangladesh and India were significant. The nutritional status of Bengali under-five children appeared to have improved in Bangladesh compared to India. Child undernutrition had significant relations with maternal undernutrition in both countries. Girls in Bangladesh had slightly better nutritional status than boys. In Bangladesh, lack of formal education among mothers was a leading cause of child undernutrition. Stunting and underweight coexist with low household wealth index in both counties. Conclusions: The research revealed that various factors were associated with child undernutrition in Bengalis. It has been proposed that programmes promoting maternal education and nutrition, along with household wealth index be prioritised. The study recommends that the Governments of Bangladesh and India should increase the budget for health of children so as to reach the sustainable development goals. [ABSTRACT FROM AUTHOR]

Purpose: Since the coronavirus (COVID-19) was announced as being a global pandemic on 11 March, governments from all parts of the world declared a quarantine period, during which people were prohibited from leaving their homes (except for essential activities) to contain the spread of the virus. Since then, the population has faced different levels of restrictions (i.e., mobility, social activities) that limited participation in normal daily routines. Consequently, these restrictions may have adversely changed physical activity, diet, sleep patterns, and screen time or work routine. So, the pandemic has had profound influence on the mental health of the entire societies. As the mental health status of Bangladeshi patients living in rural area that have recovered from COVID-19 has not been previously studied, this gap is addressed through the present investigation focusing on one rural Bangladeshi community. Methods: A convenience sampling method was employed to recruit participants for this cross-sectional study. Data was gathered by conducting face-to-face interviews with 243 recovered COVID-19 patients (as confirmed by a positive Reverse Transcription PCR test) attending a local primary health care facility center and instructed to consider how they felt in the preceding week Results: By administering a validated Bengali version of the Depression, Anxiety, and Stress Scale (DASS-21) to measure participants' mental health status, we noted that 24% of the sample exhibited depressive symptoms. In addition, 30.9% and 21.8% of the participants experienced stress symptoms and reported anxiety, respectively. Sociodemographic factors such as female sex, lower educational level, living away from family, smaller living accommodations, and lower economic status significantly predicted mental health outcomes in multivariate logistic regressions. Conclusion: These results may help health care providers formulate proper mental health interventions and preventive measures to minimize the mental health problems among patients that have recovered from COVID-19. [ABSTRACT FROM AUTHOR]

Background: With half a female population, empowering women can be a key factor in our country's global advancement. Focusing on household decision-making and attitudes toward wife beating, our study addresses the dearth of research exploring how different socio-economic and demographic factors associated with women's empowerment evolve over the past decade in Bangladesh (from BDHS 2007 to BDHS 2017–18). Methods: Data from four waves of Bangladesh Demographic and Health Survey (BDHS, 2007 to BDHS, 2017–18) were used in this study. We put forth two domains—household decision-making and attitudes toward domestic violence—to assess women's empowerment. Principal component analysis (PCA) was employed to create women's empowerment index. To assess the unadjusted association between the selected covariates and women's empowerment, Pearson Chi-square test and ANOVA F test have been used, while adjusted association has been analyzed through proportional odds model (POM). Results: In BDHS 2017–18, women from urban areas experienced 'high' empowerment than women in rural areas (56.08% vs. 45.69%). A notable change has been observed in the distribution of women's empowerment index by education over the survey years. Findings also showed that in all the survey years, division, place of residence, education level, number of living children, media exposure, wealth index, working status, and relationship with household head have been found to have significant association with women's empowerment index. For instance, women who completed secondary education in 2007, 2011, 2014, and 2017–18, respectively have 14.4%, 31.8%, 24.6%, and 39.6% higher odds of having empowerment compared to those who were uneducated. Further, age at first marriage, spousal age gap, NGO membership etc. emerged as a contributing factor in specific survey years. Conclusion: Our study affirmed that, over a ten-year period, women were more likely to protest against physical violence and to participate in various decision-making regarding their personal and social life. Empowerment is notably higher among women in urban residents, those with secondary education, 1–2 children, media exposure, and employment. Policy recommendations should emphasize targeted measures to raise awareness and empower uneducated, unemployed, economically disadvantaged, and physically oppressed women. [ABSTRACT FROM AUTHOR]

Functional difficulty in children is a crucial public health problem still undervalued in developing countries. This study explored the socio-demographic factors and anthropometry associated with children's functional difficulty in Bangladesh. Data for 2-4-year-old children, obtained from Multiple Indicator Cluster Survey 2019, were used in this study. The mixed-effects logistic regression model was used to analyse the data. Children whose mothers had functional difficulty were found to be 2.75 times more likely to have functional difficulty than children whose mothers had no functional difficulty (95% CI 1.63-4.63). Male children were more likely to experience functional difficulty than female children (OR = 1.48). Furthermore, stunting was found to be significantly associated with functional difficulty (OR = 1.50). The study also revealed that division and mother's education, specifically, children with mothers having higher secondary + education, had significant association with the outcome variable. The findings provided a vital overview of child disability in a developing country. [ABSTRACT FROM AUTHOR]