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Bangladesh, similar to other countries is experiencing an increased burden of cancer. Absence of a national cancer registry has created a gap in the information regarding the presentation of cancer statistics of the country. The objective of this study was to assess the types and distribution of the cancer patients attending a tertiary academic medical center hospital in Bangladesh. A cross-sectional study was conducted among all the confirmed cancer patients attending the in-patient and out-patient, and daycare facilities in Bangabandhu Sheikh Mujib Medical University in October, 2019. A validated questionnaire, recommended by International Agency for the Cancer Registry was used to collect data. Written informed consent was obtained from every respondent. This study had received its ethical clearance from Institutional Review Board of BSMMU. Among the 1656 respondents, 78.8% were adult and 25.2% were from paediatric age groups. Leading cancer for adult males were lung cancer (9.6%), leukaemia (9.4%) and lymphoma (9.0%); and breast cancer (28.1%), thyroid cancer (16.1%), and cervical cancer (12.2%) for females. Leukaemia was the most frequent cancer in the paediatric group for both males (71.5%) and females (66.5%). Establishing a hospital-based cancer registry with high quality data in an academic medical center setting is feasible and can set the stage for establishing nationwide hospital-based as well as establishing a popula- tion-based cancer registry in Bangladesh, which is necessary to identify and tackle the rising burden of cancer in this country. BSMMU J 2022; 15(1): 43-49

The purpose of the research was to assess emotional and behavioral presentation among adolescents during the COVID-19 pandemic visiting outpatient departments of Bangabandhu Sheikh Mujib Medical University (BSMMU) and to compare the extent of emotional and behavioral symptoms among adolescents with key factors related to COVID-19. A cross-sectional study was conducted among adolescents from 11–17 years of age attending six outpatient departments of Bangabandhu Sheikh Mujib Medical University (BSMMU) from October to December 2020. A purposive sampling technique was applied and total 146 samples were selected. A validated Bangla SDQ scale of youth self-report measure (11 to 17 years) baseline version was used for data collection. Data were collected by a face-to-face interview. The study protocol was approved by Institutional Review Board (IRB) of Bangabandhu Sheikh Mujib Medical University (BSMMU). Both descriptive and inferential statistics were executed for data analysis by using SPSS-25 and MS Excel Software. On basis of SDQ-25 scale, among the three variables, around one–third respondents (34%) had emotional symptoms while 31% and 17% had conduct symptoms and hyperactivity symptoms respectively during the COVID-19 pandemic. Among the adolescents who had a history of positive symptoms for COVID-19, 26.5% had hyperactivity symptoms, on the other hand adolescents who had no history of positive symptoms for COVID-19, only 9.8% had significant hyperactivity symptoms. There was a highly significant association (p=0.004) present between behavioral (hyperactivity) symptoms and having a history of positive symptoms for COVID-19. Adolescents who had wariness about uncertainty of COVID-19 pandemic, 25% had significant emotional symptoms on the other hand who had no wariness about uncertainty of COVID-19 pandemic, 14.3% had emotional symptoms. There was significant association (p=0.048) present between emotional symptoms with ‘felt wariness about uncertainty of COVID -19 pandemic. There was also an association (p=0.035) present between behavioral (hyperactivity) symptoms with ‘relationship status among friends. A higher proportion of female adolescents had emotional and hyperactivity symptoms than male adolescents. However, male adolescents suffered mostly for conduct symptom compared to female. Adolescents attending in selected outpatient departments of BSMMU, were especially vulnerable to emotional and behavioral problem based on symptoms developing during COVID-19 pandemic.

Background: Nutrition has a significant impact on the health of post-menopausal women. An appropriate dietary plan provides women with the necessary nutrients to maximize their activity and help minimize chronic diseases that may arise after menopause. The objective of the study was to assess the nutritional knowledge and dietary diversity of post-menopausal women in the rural area of Bangladesh. Materials and methods: A cross-sectional study was conducted among post-menopausal women aged 45 to 60. A sampling frame of 167 post-menopausal women was created by visiting each household, and 101 participants were chosen randomly from this frame. Face-to-face interviews were used to gather data. The body mass index (BMI) was used to evaluate nutritional status. To gather dietary data and calculate dietary diversity scores, a 24-hour dietary recall questionnaire was used. Knowledge score was used to gauge nutrition-related knowledge. Result: The average nutrition knowledge score was 8.55 out of 13. Knowledge has a statistically significant effect on the dietary diversity of post-menopausal women (P< 0.015). In this study, BMI was 41 percent, within the normal range, 35 percent were overweight, and 22 percent were obese. Around 45 percent of the respondents had a low dietary diversity score. There was a weak association between BMI and dietary diversity (P> 0.077). Almost 90 percent of women experienced menopausal problems, and 25 percent had inadequate knowledge about menopause. Conclusion: Knowledge of nutrition is associated with post-menopausal women's dietary diversity. Nutrition knowledge can improve the dietary diversity of post-menopausal women.

Background The national tuberculosis control program in Bangladesh is progressing to end tuberculosis (TB) epidemic by 2035. Despite improved diagnostic and treatment facilities, the disease burden remains high. This mixed-method study aimed to identify existing challenges for successfully implementing the tuberculosis control program in primary healthcare centers (PHCs) of Bangladesh. Methods Qualitative data were collected by observing six PHCs and interviewing TB patients (n = 12) and healthcare providers (n = 12). Quantitative data were collected by interviewing 94 TB patients. Data were integrated through a narrative approach. Results Mean patient and health system delay were 99.0 (SD = 98.7) and 42.9 (SD = 79.9) days respectively. Patient delay was related to poor care-seeking behavior, unfamiliarity with tuberculosis symptoms, and unavailability of healthcare facilities. About 74 percent of patients sought initial treatment from village doctors or drug vendors. Health system delay was related to inadequate manpower, unskilled staff, and limited diagnostic facilities. Every second patient reported non-adherence to the directly observed treatment short-course (DOTS) guideline. DOTS provider's inaccessibility, inadequate incentive, and unreasonable patient demand lead to non-adherence. Insufficient administrative and structural facilities for infection control were observed at the selected facilities. Conclusions This study provides an insight into the recent challenges in TB control at PHCs in Bangladesh.

A cross-sectional, descriptive study was done at a rural high school in Zakiganj Upazila of Sylhet District, Bangladesh, between January and December of 2014, to determine knowledge and practice of oral health and hygiene and oral health status among school going adolescents. Students from three classes: class VIII, IX and X, and aged 12-16 years were taken for the study. Study samples were collected by using simple random sampling technique. A total of 90 students were divided into two age groups: 12-14 years and 15-16 years. A pre-designed, self-administered questionnaire was used for demographic survey and knowledge of oral health and hygiene (a 10-point questionnaire) and practice (a 7-point questionnaire). Then a plane mouth mirror and periodontal probe was used for examining oral health status in those school children. Oral hygiene status was measured by simplified Green and Vermillion Oral Hygiene Index. The mean age of the respondents was 14.37±0.50 years. Females were 68 (75.6%) and males were 22 (24.4%). 31 (34.4%) were from class VIII, 30 (33.3%) from class IX and 29 (32.2%) were from class X. 33.3% of the respondents have scored below the mean of the total knowledge score while 66.7% has scored above the mean (6.86±2.05). Pearson’s correlation coefficient (+0.342) revealed that an increase in knowledge score would lead to increase in practice score. The younger group had higher mean knowledge score than older group (7.15+1.35 vs. 6.58+2.54; P=0.017); however, no significant difference was found between males and females (6.90±1.74 vs. 6.85±2.15; P=0.432). There was no significant difference in Debris Index (DI), Calculous Index (CI) and Oral Health Index (OHI) scores in between age groups and genders. On educational status, significant difference was observed only in OHI score (P=0.001) among those three classes of students. Overall, only 31% had good oral hygiene, while 59% respondents had fair and 10% had poor oral hygiene status. CBMJ 2021 January: vol. 10 no. 01 P: 30-36

Supplemental material, sj-docx-1-jop-10.1177_02698811231154852 for Psilocybin-assisted therapy for major depressive disorder: An exploratory placebo-controlled, fixed-order trial by Jordan Sloshower, Patrick D. Skosnik, Hamideh Safi-Aghdam, Surbhi Pathania, Shariful Syed, Brian Pittman and Deepak Cyril D’Souza in Journal of Psychopharmacology

Supplemental material, sj-docx-2-jop-10.1177_02698811231154852 for Psilocybin-assisted therapy for major depressive disorder: An exploratory placebo-controlled, fixed-order trial by Jordan Sloshower, Patrick D. Skosnik, Hamideh Safi-Aghdam, Surbhi Pathania, Shariful Syed, Brian Pittman and Deepak Cyril D’Souza in Journal of Psychopharmacology

Supplemental material, sj-docx-2-jop-10.1177_02698811231154852 for Psilocybin-assisted therapy for major depressive disorder: An exploratory placebo-controlled, fixed-order trial by Jordan Sloshower, Patrick D. Skosnik, Hamideh Safi-Aghdam, Surbhi Pathania, Shariful Syed, Brian Pittman and Deepak Cyril D’Souza in Journal of Psychopharmacology

Introduction: The media is an important source of health-related information for patients, general public, policymakers and health professionals and has a large influence on their knowledge and opinions. No studies so far have explored the content, nature and quality of health journalism in Bangladesh. Objectives: To i) explore the nature and quality of media coverage of health stories in Bangladeshi newspapers, ii) understand the perceptions of reporters about medical- and health journalism, including the perceived barriers and facilitators, and iii) identify factors influencing health reporting. Methods: In a mixed-method pilot study, during a five-month period, all medical and healthcare related news articles published in three leading Bangladeshi daily newspapers (N=461), were content analyzed, and journalists were asked in a questionnaire about their knowledge and medical skills. Results: Only 44% of the articles reported in a positive tone on health services aspects, while 27.1% were related to malpractice or treatment errors. Many articles contained questionable medical information (49.9%), mostly regarding unregistered clinicians (67.5%), often referred to as ‘doctor’. Treatment errors by unregistered clinicians were reported seven times more often than those by registered physicians (p

Children with disabilities are at an increased risk of experiencing child maltreatment (CM). We aimed to estimate the prevalence of different forms of CM among children with autism spectrum disorder (ASD) in Bangladesh. We interviewed 45 randomly selected mothers of ASD children who attended a tertiary care hospital in Dhaka, Bangladesh, to treat their children. Data regarding CM was collected using a standard screening tool recommended by the International Society for the Prevention of Child Abuse and Neglect (ISPCAN). We asked mothers to report about their child-rearing practices to identify CM, including physical, psychological, and sexual abuse, and neglect, along with their non-violent disciplinary practices. The children's age range was 3 to 9 years, and approximately 82 percent were boys. All children were found to have experiences of physical and psychological abuse throughout their childhood. Seventy-three percent of children experienced neglect during the past year while 82 percent during their entire childhood. The reported prevalence of sexual abuse was 4.4 percent in the past year and 8.9 percent during their childhood. However, all parents followed non-violent disciplinary practices, and the prevalence of maltreatment did not differ between boys and girls. Higher instances of CM in Bangladesh, especially among ASD children, raise concern for its adverse social consequences and calls for appropriate mitigation practices as proclaimed by the United Nations Child Rights Charter.

ObjectivesTo assess healthcare workers’ (HCWs) compliance with the infection prevention and control (IPC) practices and identify the factors influencing this compliance using the Health Belief Model as the theoretical framework.DesignQuantitative data from an explanatory sequential mixed-methods study were employed in this research.Participants and settingsFrom 17 May to 30 August 2020, 604 physicians and nurses working at six randomly selected tertiary care facilities in Dhaka City in Bangladesh took part in this study.Primary and secondary outcome measuresCompliance with the WHO’s guidance on IPC measures, as well as the associated factors, was the primary outcome.ResultsA mean compliance score of 0.49 (±0.25) was observed on a 0–1 scale. HCWs were most compliant with the medical mask wearing guidelines (81%) and were least compliant with the high-touch surface decontamination regulations (23%). Compliance with the IPC guidance was significantly associated with increasing age, female sex, working as a nurse, having non-communicable diseases and history of exposure to patients with COVID-19. Perceived benefits (B=0.039, 95% CI 0.001 to 0.076), self-efficacy (B=0.101, 95% CI 0.060 to 0.142) and cues to action (B=0.045, 95% CI 0.002 to 0.088) were positively associated with compliance. Compliance with IPC guidance was 0.061 times greater among participants who reported low perceived barriers compared with those with high perceived barriers.ConclusionOverall, compliance with IPC guidance among HCWs was unsatisfactory. As self-efficacy exerted the greatest contribution to compliance, it should be emphasised in any endeavour to improve HCWs’ IPC adherence. Such interventions should also focus on perceived barriers, including unreliability of the information sources, unsafe working places and unavailability of protective equipment and cues to action, including trust in the administration and availability of adequate IPC guidance.

Background Gender is an important biological, behavioral, societal and cultural factor influencing affecting health and health care utilization. In medical education, gender tends to be less prioritized and limiting gender sensitivity among medical professionals leading to compromised and substandard health care. Our study aims to investigate the gender perceptions among medical students and practitioners identifying possibilities and challenges in better integrating gender into medical curriculum. Method Quantitative data were collected from 249 respondents (151 medical students, 33 service providers and 65 service recipients) by using structured questionnaires. Descriptive and univariate analysis were conducted to assess socio-demographic characteristics and gender perceptions of participants respectively. To determine the relations of mean perception score with socio-demographic variables, we used one-way ANOVA tests. Finally, we performed multivariate linear regression to determine socio-demographic variables predicting perceptions of respondents towards gender. SPSS version 25 was used for analysis. For qualitative data 16 key informants (6 administrative staffs, 2 policy makers and 8 teaching staffs) were interviewed. The interviews were analyzed manually using thematic analysis procedure. Result Mean score of perception on ‘gender’ among medical students and medical professionals were 10.29 (SD = 2.70) with 52% positive perception and 9.94 (SD = 2.98) with 50% positive perception out of 20 respectively. Significantly greater perception was found among female compared to male. Mean perception score was found significantly higher among respondents aged 20–25 years and students studying in Government medical college. In terms of opinion regarding gender integration in medical or dental curriculum, maximum respondents (91%) thought that inclusion may initiate gender sensitive attitude and respectful behavior and 85% respondents thought people’s health care rights will be ensured. Regarding challenges of integrating greater gender content in medical curriculum, majority service providers (42%) said there are no challenges, but 70% of students responded that due to the huge syllabus, it may create an extra burden to students. The majority of respondents recommended to start reviewing curriculum by a review board (91%) and to develop an intention module (85%). Qualitative findings supported the quantitative results. Conclusion An early sensitization on gender among medical personnel and it’s influence on health care system could contribute in ensuring gender equitable health services and achieving SDGs.

Despite the enormous disruption of tuberculosis (TB) services reported globally, Bangladesh’s impact is not well documented. We aimed to assess the effect of the COVID-19 pandemic on the TB control program in Bangladesh from patients’ and service providers’ perspectives. We conducted a cross-sectional study from November–December 2021 at six conveniently selected Upazila Health Complexes (UHC) of the Dhaka division, Bangladesh. We conducted face-to-face interviews among 180 pulmonary TB service recipients and all TB service providers working in the selected UHC. We also reviewed TB registries from each UHC. All data were summarized using descriptive statistics tools. We found a 31% reduction in presumptive TB cases during 2021 compared to 2020. Other TB services, such as testing, were reduced by 16–36% during the same period. Service receivers reported a lack of transportation (95%), and a lack of adequate human resources (89%) as critical barriers to receiving and providing TB service, respectively. The findings of our study showed substantial interruption of TB service delivery during the COVID-19 pandemic, threatening the recent progress and pushback from achieving the 2035 End TB targets. Early mitigation of TB service delivery through adopting remote follow-ups using digital health technology and integrating COVID-19 and TB screening is essential for the continuity of essential TB services and achieving global TB targets.

Background Bangabandhu Sheikh Mujib Medical University (BSMMU) is a postgraduate medical university in Bangladesh, where health research is an institutional mission. To improve the institutional research culture that contributes to better research capabilities, an assessment of BSMMU’s research output, challenges faced while conducting research, feasible actions to overcome them, and indicators for evaluating the research capacity were identified. Methods Published manuscripts from BSMMU for the year 2018, registered with PubMed and BanglaJOL, were reviewed to assess the status of research output. Key informant interviews and in-depth interviews were conducted with various members of the academic departments, central library, institutional review board and University journals, to identify research-related challenges, strategies to overcome, and indicators to evaluate the research capacity. Results In 2018, the total number of scientific articles published was 364, among which 68.4% of the articles were published in local journals and 31.6% in international journals. Journals published by the University lacked indexation into international medical databases and had no impact factor. The majority of the interviewees mentioned about the lack of dedicated time for research, prioritized research agendas and need for research-related trainings to improve research performance as challenges. Establishing policies for research support, development of University’s research infrastructure and better mechanisms to disseminate research findings, were identified as key opportunities for improvement. For future evaluation of research capacity strengthening, individual levels indicators (publication outputs, research grants, awards, number of collaborations) were emphasized. Conclusions Preference for publishing in the local journals was observed rather than in international peer-reviewed journals. The key challenges for undertaking research included the absence of dedicated time and trainings for skill development. Publication outputs, research grants, awards, number of collaborations were identified as notable indicators for evaluating improvements in research capacity at an individual level. Establishing policies and guidelines for research support, along with the development of appropriate research infrastructure in the University, will enable it to guide national policies and programs.

Since child sexual abuse (CSA) is one of the most serious public health issues, how CSA cases and victims are portrayed in the daily newspapers is a major concern to the public health and communication specialists. The purpose of this study was to evaluate the degree of the ethical standard of reporting CSA in Bangladeshi newspapers, as well as to identify the potential risk factors associated with unethical reporting. From January to December 2017, a total of 1093 news stories on CSA were collected from four top circulated Bengali newspapers and two English newspapers of Bangladesh. Berelson’s quantitative content analysis approach (only manifest content) was used to analyze these stories. For the coding and analysis purpose, news items (texts and news with photos) of spot news, editorials, and commentaries were included. Chi-square tests were used to evaluate the bivariate association of different case characteristics with unethical reporting, and multivariate logistic regression models were performed to assess the potential risk factors of disclosing the victim’s identity and needless detail in the news description. This study revealed that more than 40% of news stories on CSA cases did not follow the ethical standard of reporting. Episodic CSA cases were more unethically reported in newspapers, compared to the thematic stories (42.8% vs. 11.6%). Approximately 37% of news stories disclosed at least one identifying information of victims (i.e., name, parents’ name, family member’s name, or school name), and 23% of stories included sensual and/or excessive description of the event. Our adjusted model showed that victim identifiers were most likely to be reported in news stories when the victim was 13–17 years old (AOR 1.86; P = 0.027), the alleged perpetrator held influential social status (AOR 2.44, P = 0.005), the victim was familiar to the perpetrator (AOR 6.85, P P

Hypertension is the single biggest cause of various cardiovascular complications and at the same time one of the most preventable phenomena. Low- and middle-income countries (LMICs) are facing increasing prevalence of hypertension which is imposing a huge burden on morbidity, premature mortality, and catastrophic health expenditure. This systematic review searched for the nonpharmacological interventions for prevention of hypertension among normotensive people in LMICs considering the period 1990-2016. This review has been conducted following standard methodology of Cochrane review involving two independent reviewers in screening, quality appraisal, and data extraction. Narrative synthesis of included articles was demonstrated using tables and meta-analysis was conducted to pool the estimates of studies which fulfilled the criteria. Total seven trials were included in the review with 6046 participants from eight LMICs. Two cluster randomized trials were pooled and there was a statistically significant effect (Systolic Blood Pressure: mean difference -2.35 [95% CI: -4.31 to -0.38], Diastolic Blood Pressure: mean difference -2.11 [95% CI: -3.20 to -1.02]) of home based health education in reducing blood pressure. Three individual studies reported reduction of blood pressure as a result of restricted dietary sodium intake. None of the studies was appraised as low risk of bias due to poor methodological quality. Non-pharmacological interventions can play important role in preventing the development of hypertension among normotensive people. Further trials with longer follow-up period and robust methods are recommended for getting stronger evidence on these interventions.

Background: Periodontitis is one of the most common oral diseases and is one of the widest spread chronic diseases all over the world. If a person maintains a good oral hygiene, he/she can control periodontitis easily. Periodontitis is a preventable disease. Objectives: This study was aimed to know the current pattern, the possible causes and the attitude towards periodontitis among adult patients attending at outdoor of dental faculty of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Methodology: This cross-sectional study was carried out in the OPD of Dental faculty of BSMMU, Dhaka fromJanuary 2013 to December 2013 over a period of one year. One hundred twenty patients with any sort of dental problem were enrolled in this study. Results: The current study depicted that 68.3% of the patients were from age group of 18 to 40 years and 59.2% were male while 40.8% were female. Most of the respondents (65.8%) lived in urban area. This study showed that 80.8% experienced bleeding from gums and 59.2% had knowledge about cleaning teeth before going to bed and after breakfast. It was found that 77.5%of the respondents used tooth brush and tooth paste for cleaning their teeth. Only 15.8% of the respondents visited dentist for oral and dental check-up regularly. According to life style related habit, 53(44.2%) respondents were smoker, 55 (45.8%) respondents chewed betel leaf and 30 (25%) of the respondents hewed betel leaf with Jarda or SadaPata. Majority 104 (86.7) had calculus, defective margins and restorations. Most of the respondents (95.0%) had bleeding on probing. Conclusion: In this study a significant number of respondents have periodontitis who have attended outdoor of dental faculty. Older age, smoking, betel, jarda/sadapata, diabetes mellitus and presence of calculus and restorations are the risk factors for developing periodontitis. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 76-80

Background: Information on the mortality causes of goldsmith workers in Bangladesh is very limited. This study was conducted to find out the causes of death in this group of population.Methods: The study subject was deceased goldsmith workers where face-to-face interviews were conducted with the family members who were present during the deceased's illness preceding death. A World Health Organization recommended questionnaire was adapted to conduct 20 deceased goldsmith workers' verbal autopsy. Causes of death were determined by reviewing the outcomes of the interviews by the expert physicians.Results: The mean age of the goldsmith workers at death was 59.2 ± 9.3 years. Among the deceased goldsmith workers, 70.0% were smokers, and 50.0% of them were alcohol consumers. Cardiovascular diseases (CVD) were the most common immediate and underlying cause of death (55.0% and 45.0%, respectively). Acute ischemic heart disease was the single most common (30.0%) immediate cause of death among the deceased goldsmith workers, whereas, for underlying causes of death, it was both acute and chronic ischemic heart diseases (35.0%).Conclusions: The life expectancy of goldsmith workers was much lower than the average life expectancy of Bangladesh, where CVD was the common cause of death. Smoking and alcohol consumption were prevalent among the majority of the deceased goldsmith workers. Awareness of healthy lifestyles should be prioritized for a successful CVD control program for this population. Trial registration: Not applicable.

Background Globally, older population (aged ≥60 years) comprise 11% of the total population, and 23% of them are malnourished. Lack of knowledge and education, adverse dietary habits, depression or psychological disorders, poor oral and dental health, disability, and diseases are the reported factors responsible for malnutrition among them. Geriatric people comprise 7.5% of the total population of Bangladesh, and almost a quarter are malnourished. But there is scarce data on the factors associated with the nutritional status of the older population in Bangladesh. Methods A cross-sectional study was conducted among 125 older individuals (male 59, female 66) living in three villages of Uttarkhan, Dhaka, Bangladesh, to identify the factors associated with their nutritional status. The Mini Nutritional Assessment scale, Geriatric Depression Scale-Short Form, and Geriatric Oral Health Assessment Index were used for assessing the nutritional status, mental health status, and oral health quality of the respondents, respectively. Information on socio-demographic characteristics, comorbidities and dietary factors, and food behaviors were gathered by a pretested semi-structured questionnaire. Ethical approval was obtained from the Institutional Review Board of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Results The participants’ mean age was 67.9 ± 7.1 years. Most of them (53.6%) had no formal education. Among the respondents, 22.0% male and 28.8% female were malnourished. The proportion of malnourished and at risk of malnutrition among the respondents living without a partner were 28.6 and 65.3%, respectively. A significantly (p Conclusions More than two-thirds of the older population were malnourished or at risk of malnutrition, where the female respondents were more vulnerable. Depression, inadequate oral health, and lack of education were negatively associated with the nutritional status of the older population.

This study explores the differences in factors associated with hypertension between younger and older subjects in an urban slum community in Bangladesh. We analyzed the data of 1,008 men and 1,001 women obtained from a cross-sectional survey conducted between October 2015 and April 2016. Multivariable logistic regression models were stratified by age (18 to 44 and 45 to 64 years) in men and women separately. The multivariable model included age (continuous) and the following categorical variables simultaneously: education duration, marital status, tobacco smoking, smokeless tobacco use, total physical activity, body mass index (BMI), waist circumference, and the blood levels of glycated hemoglobin (HbA1c), triglycerides, high- and low-density lipoprotein (HDL and LDL) cholesterol. Hypertension was defined as the presence of either blood pressure ≥140/90 mmHg or the use of antihypertensive medication. The prevalence of hypertension was 13.0% (younger men), 14.6% (younger women), 35.6% (older men), and 38.7% (older women). In younger men, higher waist circumference and increased LDL cholesterol levels were significantly associated with hypertension. In older men, physical activity was the only significant factor that was inversely associated with hypertension. In younger women, higher BMI, increased HbA1c, triglycerides, and LDL cholesterol levels were associated with hypertension. In older women, a higher HbA1c was the only factor significantly associated with hypertension. These findings suggest that public health interventions to prevent hypertension may require different approaches according to sex and age groups within the poor urban population in Bangladesh.

BackgroundThe outbreak of novel coronavirus disease (COVID-19), started from Wuhan, China, at the end of December 2019, hits almost the entire world. In Bangladesh, the first case was officially reported on March 8, 2020. We estimated the basic reproductive number, R0, of COVID-19 for Bangladesh using the first 65-day data of the outbreak.MethodsWith time-varying disease reporting rate, epidemic curves were estimated using the exponential growth model utilizing daily COVID-19 diagnosis data in Bangladesh from March 8 to May 11, 2020. We estimated R0 using the estimated intrinsic growth rate (γ). Serial intervals (SI) have been used from two well-known coronaviruses’ outbreaks, SARS and MERS; and the early estimate of SI of COVID-19 in Wuhan, China.ResultsThe COVID-19 epidemic in Bangladesh followed an exponential growth model. We found the R0 to be 1.84 [95% CI: 1.82–1.86], 1.82 [95% CI: 1.81–1.84], and 1.94 [95% CI: 1.92–1.96], for MERS, COVID-19, and SARS SI respectively without adjusting reporting rate. With the adjusted reporting rate, R0 reduced to 1.63 [95% CI: 1.62–1.65], 1.62 [95% CI: 1.61–1.64], and 1.71 [95% CI: 1.70–1.73] for a five-fold increase. Inverse association between the reporting rate and the basic reproduction number was observed.ConclusionThe R0 was found to be 1.87 for existing cases and was reduced to 1.65 for the five-fold increase of the early reporting rate. Findings suggest a continued COVID-19 outbreak in Bangladesh and immediate steps need to be taken to control.

Background: Any public health emergency demands adequate risk communication with the vulnerable population along with their optimized perception about the impending risk to ensure proper risk management and crisis control. Hence, this study will be conducted to explore healthcare providers’ perceptions regarding risks of coronavirus disease 2019 (COVID-19), as well as how they are being communicated to about the risk, and how they practice risk reduction measures. Methods: A two-phased explanatory sequential mixed-method study will be conducted among physicians and nurses from randomly selected tertiary healthcare facilities in Dhaka, the capital of Bangladesh. In the first phase, the general pattern and quantifiable measures of risk perception, risk communication, and infection prevention practices will be assessed quantitatively. Multiple linear regression analyses will be performed to explore how much variability of risk perception is predicted by risk communication methods and contents. In the second phase, qualitative data will be collected for in-depth understanding and exploration of participants’ experiences and insights regarding COVID-19 risk through interviews and document reviews. Thematic content analysis of the qualitative data will be done manually. Findings from both quantitative and qualitative phases will then be triangulated to illustrate the research objectives. Discussion: Based on the psychometric dimensions of risk perception and psycho-social theory of the health belief model, perception of COVID-19 risk among healthcare providers will be evaluated in this study. The relationship between risk perception and infection prevention and control practices among healthcare providers will also be investigated. The explanatory sequential design of this study is expected to generate hypotheses on how risk perception is being shaped in a time of uncertainty and thus, will help to build a proper risk communication strategy to minimize risk perception among healthcare providers.

Aminur Rahman,1,2 Sadika Akhter,1 Monjura Khatun Nisha,3 Syed Shariful Islam,4 Fatema Ashraf,5 Monjur Rahman,1 Nazneen Begum,6 Mahbub Elahi Chowdhury,1 Anne Austin,7 Iqbal Anwar1 1International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; 2College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand; 3Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; 4Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, 5Department of Gyenaecology and Obstetric, Shaheed Suhrawardi Medical College and Hospital, 6Department of Gyenaecology and Obstetric, Dhaka Medical College and Hospital, Dhaka, Bangladesh; 7JSIResearch & Training Institute, Inc., Boston, MA, USA Purpose: Of the 99% maternal deaths that take place in developing countries, one-fourth is due to postpartum hemorrhage (PPH). PPH accounts for one-third of all blood transfusions in Bangladesh where the transfusion process is lengthy as most facilities do not have in-house blood bank facilities. In this context, the location where blood is obtained and the processes of obtaining blood products are not standardized, leading to preventable delays in collecting blood, when it is needed. This study evaluated the effectiveness of an online Blood Information Management Application (BIMA) system for reducing lag time in the blood transfusion process.Patients and methods: The study was conducted in a public medical college hospital in Dhaka, Bangladesh, and in two proximate, licensed blood banks between January 2014 and March 2015, using a before after design. A total of 310 women (143 before and 177 after), who needed emergency blood transfusion during their perinatal period, as determined by a medical professional, were included in the study. A median linear regression model was employed to assess the adjusted effect of BIMA on transfusion time.Results: After the introduction of BIMA, the median duration between the identified need for blood and blood transfusion reduced from 152 to 122minutes (P

Household air pollution (HAP) is a global public health problem and less well-studied in developing countries. The overall goal of Bangladesh Hub is to conduct a population-based study (n=600) ...

Although child physical abuse is considered a major public health and social problem in Bangladesh, few studies have assessed the prevalence of multiple forms of child physical abuse. This population-based study estimated the prevalence of child physical abuse by adult in rural Bangladesh and examined its association with demographic and socio-contextual factors of the children. Data were mainly obtained by administering ISPCAN Child Abuse Screening Tool for Children (ICAST-C) from a random sample of 1416 children (49% female) aged 11 to 17 years by face-to-face interview during March -April in 2017 with a response rate of 91.5%. Physical abuse was categorized into ‘frequent (≥3 occurrences past year)’ and ‘less frequent to none’ and risk factors for the frequent category were estimated. Prevalence of at least one form, two forms and three or more forms of child physical abuse were estimated approximately 99%, 95% and 83% in their lifetime and 93%, 79% and 57% in the past year respectively. Hitting (without buttock), standing/kneeling and slapping were the most common physical abuse whereas giving drugs/alcohol, pinched, burned/scalded, beat-up and locked-up reported minimum. Male children, younger age groups, witness of domestic violence with weapons, bullied by siblings and low maternal education were found significant risk factors for at least one form of ‘frequent’ physical violence, whereas male children, younger age groups, adult shouted in a frightening way, witnessed adults using weapons at home, bullied by siblings, low maternal education were found as significant risk factors for ≥2 forms of frequent child physical abuse. Self-reported prevalence of child physical abuse was extremely common in Bangladeshi rural society. The prevalence was associated with demographic and socio-contextual characteristics of the children. The findings provide empirical evidence to support public health professionals and policy-makers to take effective measure to reduce child physical abuse in Bangladesh.

Background The job pattern of the office executives is presumed to be sedentary in nature, requiring very low occupation related physical activity. This makes them more vulnerable to develop inactivity related non-communicable diseases e.g. metabolic and cardiovascular diseases, mental diseases and even cancers. Executives are the fastest growing labor force in Bangladesh. However, there is lack of study focusing on the physical activity status of this worker group leaving them …

Introduction In recent times, hypertension has become one of the major public health concerns in both the developed and the developing world and is responsible for death due to heart diseases and stroke. The increasing trend of the prevalence of hypertension in low-income and middle-income countries (LMICs) and it’s catastrophic consequences have made the phenomenon important to continue to investigate interventions for its prevention and control. Different dietary and lifestyle-related approaches have been recommended for the prevention of hypertension. The aim of this proposed review is to explore the available non-pharmacological interventions tried for the prevention of hypertension in LMICs. Methods and analysis Eight electronic databases will be searched covering the period between 1990 and 2016 to identify relevant studies and will be screened by two independent reviewers. The searched articles will be included for full-text extraction applying definitive inclusion and exclusion criteria. Appropriate critical appraisal tools including the Cochrane Handbook for Systematic Reviews of Interventions will be used to assess the risk of bias. Disagreement between the two reviewers will be resolved by a third reviewer. Narrative synthesis of the findings will be provided along with summaries of the intervention effect. A meta-analysis will be undertaken using the random-effects model where applicable. Heterogeneity between the studies will be assessed, and sensitivity analysis will be conducted based on study quality. Ethics and dissemination Approval from the institutional review board has been taken for this review. Findings will be summarised in a single manuscript. This review is an attempt to explore the available non-pharmacological approaches for the prevention of hypertension in LMICs. Findings from the review will highlight effective non-pharmacological measures for the prevention of hypertension to guide policy for future strategies. PROSPERO registration number CRD42017055423.

ObjectivesThis study aims to describe the prevalence of non-communicable disease (NCD) risk factors among the urban poor in Bangladesh.DesignWe conducted a community-based cross-sectional epidemiological study.SettingThe study was conducted in a shantytown in the city of Dhaka. There were 8604 households with 34 170 residents in the community. Those households were categorised into two wealth strata based on the housing structure.ParticipantsThe study targeted residents aged 18–64 years. A total of 2986 eligible households with one eligible individual were selected by simple random sampling stratified by household wealth status. A total of 2551 residents completed the questionnaire survey, and 2009 participated in the subsequent physical and biochemical measurements.Outcome measuresA modified WHO survey instrument was used for assessing behavioural risk factors and physical and biochemical measurements, including glycated haemoglobin (HbA1c). The prevalence of NCD risk factors, such as tobacco use, fruit and vegetable intake, overweight/obesity, hypertension, diabetes (HbA1c ≥6.5%) and dyslipidaemia, was described according to household wealth status and gender differences.ResultsThe prevalence of current tobacco use was 60.4% in men and 23.5% in women. Most of them (90.8%) consumed more than 1 serving of fruits and vegetables per day; however, only 2.1% consumed more than 5 servings. Overweight/obesity was more common in women (39.2%) than in men (18.9%), while underweight was more common in men (21.0%) than in women (7.1%). The prevalence of hypertension was 18.6% in men and 20.7% in women. The prevalence of diabetes was 15.6% in men and 22.5% in women, which was much higher than the estimated national prevalence (7%). The prevalence of raised total cholesterol (≥190 mg/dL) was 25.7% in men and 34.0% in women.ConclusionThe study identified that tobacco use, both overweight and underweight, diabetes, hypertension and dyslipidaemia were prevalent among the urban poor in Bangladesh.