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Background: Increasing levels of urbanization and digitization in Bangladesh may be adversely associated with children's weight status and related movement behaviors. This study examined the prevalence of obesity, physical activity (PA), sedentary behavior, and sleep among young children from a district town in northern Bangladesh and identified factors associated with unhealthy weight status. Methods: Population‐based cross‐sectional study involving all kindergarten schools in Jamalpur District town. Schools and children aged 4–7 years were randomly selected and had their weight and height measured. Mothers completed a questionnaire on their child's PA, recreational screen time, and sleep and sociodemographic factors. Children's weight status was based on World Health Organization (WHO) categories. Meeting the PA recommendation was based on the WHO guidelines for children and adolescents, and meeting the sedentary behavior and sleep recommendations was based on the Canadian/Australian 24‐hour movement guidelines for children and young people. Results: A total of 585 children and their parents were included in the study. Overall, 15% of children were overweight or obese. Three‐quarters of children met the sleep guideline, and 50% met the PA guideline. Less than one third of children (31%) met the recreational screen time guideline, whereas 15% met all three guidelines. However, when adjusted for all predictors in the model, maternal education, family income, and child's age were significantly associated with overweight/obesity. Children with higher maternal education level were 2.3 times (AOR = 2.33, 95% CI: 1.19–4.78) more likely to be overweight/obese. Children in families with a higher monthly income had 1.9 times (AOR = 1.95, 95% CI: 1.14, 3.35) higher risk of being overweight/obese. Conclusions: Prioritizing maternal education (mother‐centric interventions) can help address the high levels of childhood obesity in Bangladesh. [ABSTRACT FROM AUTHOR]

Background: Suicide among medical students is a global public health concern; however, it is often addressed poorly in developing countries like Bangladesh. This study aims to examine suicidal behaviors among undergraduate medical students in Bangladesh. Methods: This cross-sectional analytical study was conducted between February and July of 2019. Data were collected from 583 MBBS students at Bangladesh's public and private medical colleges. A convenience sampling method was used, and data were collected through a pretested semi-constructed questionnaire. Results: A lifetime suicidal ideation was found among 23.8% of the participants. Significant associations were found among lifetime suicidal ideation, plan and attempt with depression, comorbidity, and family history. Multivariable logistic regression models revealed that a family history of suicide attempts or death by suicide increased the odds six-fold for ideation, over sixfold for a plan, and threefold for an attempt. Females were twice likely to be susceptible to suicide ideation, plan, and attempt. Conclusion: Suicidality appears high among medical students in Bangladesh. Levels of depression, comorbidities, as well as substance abuse affect lifetime suicide ideation. A previous history of attempting or committing suicide in the respondent's family increases the individual risk for ideation, plan, and attempt. Females are more vulnerable than males. [ABSTRACT FROM AUTHOR]

Efforts to mitigate public health concerns are showing encouraging results over the time but disparities across the geographic regions still exist within countries. Inadequate researches on the regional disparities of health indicators based on representative and comparable data create challenges to develop evidence-based health policies, planning and future studies in developing countries like Bangladesh. This study examined the disparities among districts on various maternal and child health indicators in Bangladesh. Cluster analysis–an unsupervised learning technique was used based on nationally representative dataset originated from Multiple Indicator Cluster Survey (MICS), 2012–13. According to our results, Bangladesh is classified into two clusters based on different health indicators with substantial variations in districts per clusters for different sets of indicators suggesting regional variation across the indicators. There is a need to differentially focus on community-level interventions aimed at increasing maternal and child health care utilization and improving the socioeconomic position of mothers, especially in disadvantaged regions. The cluster analysis approach is unique in terms of the use of health care metrics in a multivariate setup to study regional similarity and dissimilarity in the context of Bangladesh. [ABSTRACT FROM AUTHOR]

Background: Chikungunya virus causes mosquito-transmitted infection that leads to extensive morbidity affecting substantial quality of life. Disease associated morbidity, quality of life, and financial loss are seldom reported in resources limited countries, such as Bangladesh. We reported the acute clinical profile, quality of life and consequent economic burden of the affected individuals in the recent chikungunya outbreak (May to September 2017) in Dhaka city, Bangladesh. Methods: We conducted a cross-sectional study during the peak of chikungunya outbreak (July 24 to August 5, 2017) to document the clinical profiles of confirmed cases (laboratory test positive) and probable cases diagnosed by medical practitioners. Data related to clinical symptoms, treatment cost, loss of productivity due to missing work days, and quality of life during their first two-weeks of symptom onset were collected via face to face interview using a structured questionnaire. World Health Organization endorsed questionnaire was used to assess the quality of life. Results: A total of 1,326 chikungunya cases were investigated. Multivariate analysis of major clinical variables showed no statistically significant differences between confirmed and probable cases. All the patients reported joint pain and fever. Other more frequently reported symptoms include headache, loss of appetite, rash, myalgia, and itching. Arthralgia was polyarticular in 56.3% of the patients. Notably, more than 70% patients reported joint pain as the first presenting symptom. About 83% of the patients reported low to very low overall quality of life. Nearly half of the patients lost more than 10 days of productivity due to severe arthropathy. Conclusions: This study represents one of the largest samples studied so far around the world describing the clinical profile of chikungunya infection. Our findings would contribute to establish an effective syndromic surveillance system for early detection and timely public health intervention of future chikungunya outbreaks in resource-limited settings like Bangladesh. [ABSTRACT FROM AUTHOR]

Thalassemias are emerging as a global public health concern. Due to remarkable success in the reduction of childhood mortality by controlling infectious diseases in developing countries, thalassemias are likely to be a major public health concern in the coming decades in South Asia. Despite the fact that Bangladesh lies in the world's thalassemia belt, the information on different aspects (epidemiology, clinical course, mortality, complications and treatment outcomes) of thalassemias is lacking. In this comprehensive review, the aim is to to depict the epidemiological aspects of thalassemias, mutation profile and current treatment and management practices in the country by sharing the experience of dealing with 1178 cases over 2009-2014 time periods in a specialized thalassemia treatment centre. We have also discussed the preventative strategies of thalassemias from the context of Bangladesh which could be effective for other developing countries. [ABSTRACT FROM AUTHOR]

Background: Cancer burden among children and adolescents is largely unknown in Bangladesh. This study aims to provide a comprehensive overview on childhood and adolescent cancers and to contribute to the future strategies to deal with these diseases in Bangladesh.Methods: Data on malignant neoplasms in patients aged less than 20 years diagnosed between 2001 and 2014 (N = 3143) in Bangladesh was collected by the National Institute of Cancer Research and Hospital and ASHIC Foundation. The age pattern and distribution of cancer types were analysed and the incidence rates were calculated.Results: The age-standardised incidence rate was 7.8 per million person-years for children (0-14 years) in the last time period (2011-2014). Retinoblastoma (25%) and leukaemia (18%) were the most common childhood cancers. For adolescents (15-19 years), the age-specific incidence rate was 2.1 per million person-years in the same time period. Most common adolescent cancers were malignant bone tumours (38%), germ cell and gonadal tumours (17%), and epithelial tumours (16%). There were more boys affected (M: F ratio 2.0 in children and 1.4 in adolescents) than girls.Conclusion: Cancer incidences were lower than expected most likely due to a low level of awareness about cancer among clinicians and the population, inadequate access to health care, lack of diagnostic equipment and incomplete recording of cases. Improvements on different levels should be made to get a better epidemiologic insight and to detect cancer earlier resulting in a better outcome for affected children and adolescents. [ABSTRACT FROM AUTHOR]

South Asian countries are facing a hidden breast cancer epidemic. A significant proportion of the breast cancer cases occur in premenopausal women. Knowledge of the various aspects of breast cancer in different geographical regions is limited in South Asia. In this article, we review the Bangladeshi perspective of the epidemiology, risk factors, pathology, diagnosis and treatment of breast cancer. As in other developing countries, because of the lack of breast cancer awareness in Bangladeshi population and inadequate access to health care, most patients are diagnosed at an advanced stage of the disease. Early detection has a crucial impact on overall treatment outcomes. To battle against breast cancer in resource-limited countries like Bangladesh, it is not feasible to set up a parallel health service system solely dedicated to cancer. Therefore, a cost-effective public health strategy is needed which could reach a large number of women in the country. Considering all these issues, we propose an innovative femalebased primary healthcare approach focused on awareness, screening and early detection of breast cancer in Bangladesh. This preventive strategy could be a model for other resource-limited developing countries. [ABSTRACT FROM AUTHOR]

Background The global burden from cancer is rising, especially as low-income countries like Bangladesh observe rapid aging. So far, there are no comprehensive descriptions reporting diagnosed cancer group that include hematological malignancies in Bangladesh. Methods This was a multi-center hospital-based retrospective descriptive study of over 5000 confirmed hematological cancer cases in between January 2008 to December 2012. Morphological typing was carried out using the "French American British" classification system. Results A total of 5013 patients aged between 2 to 90 years had been diagnosed with malignant hematological disorders. A 69.2% were males (n = 3468) and 30.8% females (n = 1545), with a male to female ratio of 2.2:1. The overall median age at diagnosis was 42 years. Acute myeloid leukemia was most frequent (28.3%) with a median age of 35 years, followed by chronic myeloid leukemia with 18.2% (median age 40 years), non-Hodgkin lymphoma (16.9%; median age 48 years), acute lymphoblastic leukemia (14.1%; median age 27 years), multiple myeloma (10.5%; median age 55 years), myelodysplastic syndromes (4.5%; median age 57 years) and Hodgkin's lymphoma (3.9%; median age 36 years). The least common was chronic lymphocytic leukemia (3.7%; median age 60 years). Below the age of 20 years, acute lymphoblastic leukemia was predominant (37.3%), followed by acute myeloid leukemia (34%). Chronic lymphocytic leukemia and multiple myeloma had mostly occurred among older patients, aged 50-over. Conclusions For the first time, our study presents the pattern and distribution of diagnosed hematological cancers in Bangladesh. It shows differences in population distributions as compared to other settings with possibly a lower presence of non-Hodgkin lymphoma. There might be under-reporting of affected women. Further studies are necessary on the epidemiology, genetics and potential environmental risk factors within this rapidly aging country. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Bangladesh is a high tuberculosis burden country. It is always challenging to diagnose active pulmonary tuberculosis (PTB) cases in rural areas where the setting up of conventional microscopic and cultural diagnostic tools is difficult. The objective of the present study is to find a feasible, reliable and easily accessible alternative diagnostic approach for PTB in the rural areas of Bangladesh. Methods: A total of 86 sputum samples were collected from clinically suspected PTB patients of Anantapur village, an underdeveloped remote area of Netrokona district, Bangladesh. Sputum samples were screened by Ziehl-Neelsen (Z-N) and fluorescence staining methods and were categorized as smear-positive active PTB cases (n =50) and smear-negative controls (n =36); then the performance of three popular immunological tests were evaluated, including ICT, ELISA and Mantoux tests (MT). Results: The sensitivity of ICT, ELISA, and MT (10mm induration size) was 68%, 84% and 96%, respectively, and the specificity of these tests was 94.4%, 80.6% and 52.8%, respectively. When the cut-off size of induration in MT was changed from 10 to ⩾15mm, the sensitivity and specificity of MT became 92% and 83.3%, respectively. It was also found that the interpretation of MT was not significantly affected by BCG vaccination when ⩾15mm induration was taken as a cut-off value. Conclusion: Considering the resource-constraints of rural and remote areas, the Mantoux test could be an alternative tool for the diagnosis of active PTB. [Copyright &y& Elsevier]