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

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

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

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

Labor migration has a profound effect on families, but evidence documenting the impact of migration on women left behind is still lacking. Utilizing the Matlab Health and Socioeconomic Surveys, we examined the roles of migration and families in four domains of empowerment for women in Bangladesh. We found that women with international migrant spouses saw significant improvements in economic empowerment, mobility, and decision-making relative to women with coresident spouses (p <.0001). However, women who lived in multigenerational households with their parents or in-laws experienced significant reductions in empowerment across these three domains. Both having a migrant spouse and living in a multigenerational household had negative effects on beliefs about gender equivalence and reduced joint decision-making for women. Results, which were robust to migration selection controls (including propensity approaches), indicate that the benefits of migration for women left behind might be diluted by family structures that perpetuate unequal gender dynamics. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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