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Background Children globally, including in Bangladesh, are facing various forms of online sexual abuse including sextortion, exploitation, body shaming, and blackmail. They are also coerced into engaging in intimate activities, harassed through the sending of sexual content, among other forms of abuse. We aimed to explore the root cause of online child sexual abuse (OCSA) in Bangladesh. Methods This qualitative research design utilized in-depth interviews (IDIs) and key informant interviews (KIIs) between February and April 2022. The study sample comprised 21 school-going children aged 13−17 years, selected from two different geographical settings (10 from rural areas and 11 from urban areas) in Bangladesh using purposive sampling techniques. They participated in in-depth interviews (IDIs) while additional data was obtained through key informant interviews (KIIs) with 11 multidisciplinary stakeholders. Results Children from both rural and urban areas reported facing abuse in various ways, such as being asked to send naked photos, being invited to be naked in video calls, and being invited to have virtual sex, among others, over the internet. Conclusions The government should consider integrating OCSA education into secondary levels. Additionally, there should be efforts to ensure a safe online environment through content scrutiny, promotion of outdoor activities, and community campaigns. An anonymous reporting system must be implemented, and strict measures under the Children's Act must be enforced against perpetrators. Further intervention studies are needed to ensure effective child protection measures in Bangladesh.

Background Children globally, including in Bangladesh, are facing various forms of online sexual abuse including sextortion, exploitation, body shaming, and blackmail. They are also coerced into engaging in intimate activities, harassed through the sending of sexual content, among other forms of abuse. We aimed to explore the root cause of online child sexual abuse (OCSA) in Bangladesh. Methods This qualitative research design utilized in-depth interviews (IDIs) and key informant interviews (KIIs) between February and April 2022. The study sample comprised 21 school-going children aged 13−17 years, selected from two different geographical settings (10 from rural areas and 11 from urban areas) in Bangladesh using purposive sampling techniques. They participated in in-depth interviews (IDIs) while additional data was obtained through key informant interviews (KIIs) with 11 multidisciplinary stakeholders. Results Children from both rural and urban areas reported facing abuse in various ways, such as being asked to send naked photos, being invited to be naked in video calls, and being invited to have virtual sex, among others, over the internet. Conclusions The government should consider integrating OCSA education into secondary levels. Additionally, there should be efforts to ensure a safe online environment through content scrutiny, promotion of outdoor activities, and community campaigns. An anonymous reporting system must be implemented, and strict measures under the Children's Act must be enforced against perpetrators. Further intervention studies are needed to ensure effective child protection measures in Bangladesh.

Background: Prehypertension and hypertension are the leading risk factors for cardiovascular diseases and are increasingly prevalent among young adults. This study aimed to assess the prevalence of prehypertension and hypertension among medical students of public medical colleges in Dhaka city, Bangladesh. Methods: This cross-sectional study was done among 293 medical students of four public medical colleges in Dhaka city. Data on age, sex, physical activity, smoking, alcohol consumption, height, weight, and blood pressure were obtained. Systolic blood pressure (SBP) of 120–139 mmHg or diastolic blood pressure (DBP) of 80–89 mmHg was considered prehypertensive, while SBP ≥140 mmHg or DBP ≥90 mmHg was classified as hypertensive. Results: The average age was 21.6 years. More than one-fourth (28.0%) were prehypertensive, and 4.8% were hypertensive. Multinomial logistic regression identified male sex (adjusted odds ratio, 4.6; 95% confidence interval, 2.5–8.3) and overweight (aOR 2.0; 95% CI 1.1–3.5) as the risk factors of prehypertension. For hypertension, the risk factors were male sex (aOR 9.7; 95% CI 2.3–42.0), ever alcohol consumption (aOR 18.0; 95% CI 1.3–249.8), and overweight (aOR 6.6; 95% CI 1.3–32.6). Conclusion: We report that one-third of the medical students have prehypertension and hypertension. Overweight and alcohol consumers should be considered for targeted intervention.

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Background: The prevalence of verbal and physical violence against healthcare workers (HCWs) is reportedly high in Bangladesh. We aimed to determine the prevalence and risk factors associated with violence against HCWs in Bangladesh. Methods: This cross-sectional study was done in May-June 2021 among 378 physicians and nurses working in 19 randomly selected rural government health facilities. A self-administered validated Bangla version of the WHOQOL-BREF questionnaire on workplace violence (WPV) and the quality of life (QoL) was used. Multiple logistic regression analyses were done to find out the independent risk factors of WPV. Results: The prevalence of overall WPV was about 48.0% (psychological 46.6%, physical 5.0%, and sexual harassment 1.9%). However, the WPV reporting rate was very low (27.8%). Being a male (aOR= 2.18; 95% confidence interval: 1.22−3.90) and a physician (aOR = 2.93; 95% CI: 1.56−5.52) had increased the likelihood of experiencing WPV. HCWs who were encouraged to report WPV were less likely to experience WPV (aOR = 0.36; 95% CI: 0.18−0.70). Study participants exposed to WPV had sig-nificantly lower QoL (P

Background Children globally, including in Bangladesh, are facing various forms of online sexual abuse including sextortion, exploitation, body shaming, and blackmail. They are also coerced into engaging in intimate activities, harassed through the sending of sexual content, among other forms of abuse. We aimed to explore the root cause of online child sexual abuse (OCSA) in Bangladesh. Methods This qualitative research design utilized in-depth interviews (IDIs) and key informant interviews (KIIs) between February and April 2022. The study sample comprised 21 school-going children aged 13−17 years, selected from two different geographical settings (10 from rural areas and 11 from urban areas) in Bangladesh using purposive sampling techniques. They participated in in-depth interviews (IDIs) while additional data was obtained through key informant interviews (KIIs) with 11 multidisciplinary stakeholders. Results Children from both rural and urban areas reported facing abuse in various ways, such as being asked to send naked photos, being invited to be naked in video calls, and being invited to have virtual sex, among others, over the internet. Conclusions The government should consider integrating OCSA education into secondary levels. Additionally, there should be efforts to ensure a safe online environment through content scrutiny, promotion of outdoor activities, and community campaigns. An anonymous reporting system must be implemented, and strict measures under the Children's Act must be enforced against perpetrators. Further intervention studies are needed to ensure effective child protection measures in Bangladesh.

Background: Over the last two decades, there has been a gender shift in undergraduate medical education in Bangladesh with different influencing factors in specialty choice as a career. We aimed to determine the gender and other influencing factors in specialty choice among post-graduate medical students of Bangladesh. Methods: This cross-sectional study was carried out at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Secondary data regarding students’ enrollment from 2016 to 2020 were acquired from the registry of the Information Technology Cell of BSMMU. Face-to-face interviews were conducted with 118 postgraduate medical students to learn about the motivation behind their specialty selections. Results: From 2016 to 2020, 9,112 postgraduate medical students were enrolled in 73 post-graduate medical programmes across the five faculties (Surgery, Medicine, Basic Science and Para Clinical Science, Pediatrics, and Preventive and Social Medicine) of BSMMU. There was a gradual increase in female students from 41.6% in 2016 to 49.3% in 2020. Male dominancy was found in the faculties of Surgery (61.2%) and Medicine (69.7%), whereas the faculties of Basic Science and Paraclinical Science (74.6%), Pediatrics (53.7%), and Preventive and Social Medicine (66.9%) were dominated by female students. Significant differences in the sex distribution among postgraduate medical students were observed in the faculties of Surgery and Pediatrics. The most frequently mentioned influencing factors for medical students' choice of specialization were 'personal interest' (86.3%), followed by 'future career potential' (74.6%) and 'demand for the specialty' (73.7%). Significant gender variations in these influencing factors existed. Conclusion: Over the years, the percentage of female postgraduate medical students has increased in all five faculties of BSMMU. Gender differences in specialty choice can assist policymakers in making equitable distributions of the healthcare workforce. Bangabandhu Sheikh Mujib Medical University Journal 2023;16(3): 152-159

Background: In Bangladesh, there is a scarcity of nationally representative data on the burden of chronic obstructive pulmonary disease (COPD). Methods: To estimate the COPD prevalence in rural settings, this cross-sectional, population-based study was conducted in all eight administrative divisions of Bangladesh, and involved adults aged 40 years and above. By using multi-stage random sampling, 2,458 individuals were enrolled. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines were used to diagnose COPD based on post-bronchodilator lung function, while additional participant data was gathered through computer-assisted personal interviews. Results: A 2% COPD prevalence (95% CI: 1.45, 2.55) was found in the study sample with a statistically significant difference between males (2.7%; 95% CI: 1.8, 3.6) and females (1.2%; 95% CI: 0.59, 1.81). Increasing age significantly inflated the odds of having COPD irrespective of sex (OR: 1.03; 95% CI: 1.00, 1.05; P value < 0.05). Furthermore, prevalence of COPD was higher among manual workers, cigarette smokers, and those that used the indoor kitchen and did not have a primary education. Sex-based analysis showed that smokeless tobacco consumption was significantly associated with COPD occurrence among males (OR: 2.14; 95% CI: 1.05, 4.37; P value < 0.05), but not females. Further, using an indoor kitchen increased the odds of developing COPD by 400% among female participants (OR: 4.39; 95% CI: 1.37, 14.10; P value < 0.05). Conclusion: This study provides a comprehensive sex-based estimation of COPD prevalence among rural population and imparts significant contribution to the growing database on COPD prevalence in Bangladesh.

Background: Zinc deficiency is evident in chronic diseases, but little is known about its association with multi-drug resistant tuberculosis (MDRTB). We aimed to measure serum zinc level in MDRTB patients and explore its association with MDRTB compared to drug-sensitive tuberculosis (DSTB). Methods: We recruited 107 MDRTB and 87 DSTB patients from a tuberculosis referral hospital in Bangladesh. After overnight fasting, 5 ml venous blood was collected from each patient to measure serum zinc level through graphite furnace atomic absorption spectrophotometry method. Multivariate logistic regression was done to measure its association with MDRTB. Results: The mean age of all patients was 36 years, where 70% were male. About 27% MDRTB patients and 2.3% DSTB patients had low serum zinc level (P < 0.0001). An inverse correlation was observed between serum zinc level and duration of anti-TB therapy (r-value: −0.252, P < 0.01). Reduced serum zinc level (odds ratio, 0.957; 95% confidence interval 0.923–0.992) was found as a significant associating factor for MDRTB after adjusted with age, sex, occupation, residence, tobacco consumption, Bacillus Calmette–Guérin-vaccination, and duration of anti-TB therapy. Conclusion: A lower serum zinc level is significantly associated with MDRTB. The tuberculosis control program should address this in the MDRTB control strategy.

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, we conducted this study 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: We conducted a two-phased explanatory sequential mixed-method study among physicians and nurses from randomly selected tertiary healthcare facilities in Dhaka, the capital of Bangladesh. In the first phase, we assessed the general pattern and quantifiable measures of risk perception, risk communication, and infection prevention practices quantitatively. We performed multiple linear regression analyses to explore how much variability of risk perception was predicted by risk communication methods and contents. In the second phase, we collected qualitative data for in-depth understanding and exploration of participants’ experiences and insights regarding COVID-19 risk through interviews and document reviews. We manually performed thematic content analysis of the qualitative data. Finally, we triangulated findings from both phases to illustrate the research objectives. Discussion: Based on the psychometric dimensions of risk perception and psycho-social theory of the health belief model, perceptions of COVID-19 risk among healthcare providers were evaluated in this study. The relationship between risk perception and infection prevention and control practices among healthcare providers were also 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 for the healthcare providers

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.