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Introduction Exclusive breastfeeding is balanced nutrition for growth and development of the infant, prevents stunting as well as protects from infectious and chronic diseases and has also potential to reduce infant mortality. Thus, the study aimed to assess maternal knowledge, attitudes and other factors associated with exclusive breastfeeding practices. Methods A cross-sectional study was conducted among 385 mothers of children aged ≤12 months in Mother and Child Hospital in Dhaka city, Bangladesh, from June to December 2019 using a structured questionnaire. Data were collected by face-to-face interview from hospital’s outdoors, following simple random sampling process from hospital register list. Chi-squared test and multiple logistic regression models were used to explore the association. Results The prevalence of exclusive breastfeeding was 63.4% for mothers with children aged ≤12 months. Good knowledge (p

Introduction Menstrual hygiene practices refers to maintaining specific hygiene during menstrual periods. Excused or unexcused school absenteeism can be attributed to adopted menstrual hygiene practices. This study aimed to assess the prevalence of school absenteeism during menstrual cycle and to explore the association of menstrual hygiene practices with school absenteeism among schoolgoing adolescent girls in Bangladesh. Methods A cross-sectional study was conducted from April to November 2019 based on a sample of 442 school-going adolescent girls (aged 10–19 years) from randomly selected nine Girls’ Schools in the Dhaka division, Bangladesh. Data were collected by an interviewer-administered questionnaire and a multiple regression model was applied to assess factors associated with school absenteeism. Results The prevalence of school absenteeism was (35.1%) among school-going adolescent girls in Bangladesh. Factors associated with school absenteeism included older adolescent girls (AOR=2.97; 95% CI: 1.66–5.24, p

Early initiation of breastfeeding (EIBF) is crucial for mothers as well as children’s health, and also has the potential to prevent neonatal mortality. Thus, this study aimed to assess the prevalence and factors associated with EIBF among mothers in Dhaka City, Bangladesh. A cross-sectional study was conducted from January to July 2019, based on a sample of 422 mothers of children aged under 6 months. Data were collected by in-person interviews from a hospital’s outdoor through a structured questionnaire consisted of demographic, reproductive, and healthcare utilization information. Association between variables was assessed by multiple logistic regression. The prevalence of EIBF among mothers was 48.3% [95% CI: 43.4–53.3]. Multiple logistic regression showed that being a housewife, having family income of > 10,000 BDT (Bangladeshi currency) per month, mothers education level, being multiparous, normal delivery, ANC (antenatal care) visits for ≥ 3 times, counseling prior to conception, and skin-to-skin contact after delivery significantly increased the likelihood of EIBF among mothers. Besides, mothers who gave birth to low-weight babies and provided pre-lacteal feeds to them were negatively associated with EIBF. EIBF has improved in Bangladesh during MDG era, but progress still remains slower. Key modifiable factors such as maternal education, normal delivery, ANC visits, skin-to-skin contact, and pre-lacteal feeding need to be improved to enhance the EIBF for reducing child malnutrition and mortality.

Diarrhea is a leading cause of death among under five children in developing countries. The burden of child diarrhea in Bangladesh is still significant. Safe water, sanitation, and hygiene (WASH) can limit the events. This study aimed to assess the effectiveness of WASH education of mothers or caregivers on child diarrhea. A community-based randomized control trial was conducted in the selected households of a rural community in Dumki Upazila, Patuakhali from March–June 2019. A total of 202 mothers/caregivers received intervention and 202 did not receive intervention. A pre-structured questionnaire was used to gather information on household WASH activities and diarrheal cases. Baseline data were collected first from the intervention group before providing education. WASH messages were given to the intervention group by face-to-face discussion. Both groups were followed up for diarrheal episodes for 3 months. Diarrheal prevalence of intervening group is compared with that of baseline and control. The results revealed that diarrheal prevalence was 11.4% (95% CI: 7.4–16.59%), 4.0% (95% CI: 1.7–7.65%), and 14.9% (95% CI: 10.25–20.52%) in baseline, intervention, and control group, respectively. Also, diarrhea was found lower in the intervention group than baseline (Z = − 2.524; P value = 0.012) and control (Z = − 1.85; P value = 0.04). WASH interventions were found effective to reduce the diarrheal episodes among under five children in rural community. Further investigation is necessary to assess the long-term effect of such intervention in other similar settings.

Diarrhea causes major childhood morbidity and mortality globally. This study aimed to investigate the prevalence and associated factors of childhood diarrhea among under-five children in Southern coastal area of Bangladesh. A community-based cross-sectional study conducted from April to June 2018 among 202 randomly selected children. A structured questionnaire used to collect information on a three month diseases occurrence and other covariates. The association of diarrhea with socio economy, personal and food hygiene practices observed using multivariate logistic regression after adjusting for potential confounders. Prevalence of childhood diarrhea was 10.9%. In bivariate analysis, mother’s education, family income, father’s occupation, hand washing of child before feeding and refrigerator associated with outcomes. In multivariate analysis, father’s occupation, hand washing of child by soap before feeding and having refrigerator in households was associated with childhood diarrhea after controlling the socio-demographic factors (age and gender). Child of unemployed fathers were more likely to have diarrhea than employed father (AOR=0.206; 95% CI: 0.070-0.610).Child do not wash hand before feeding (AOR=0.393; 95% CI =0.102-0.511) and households not having refrigerator (AOR= 0.072; 95% CI: 0.007-0.745) had higher odds of diarrhea. The load of diarrhea in this setting was almost double to the national rate. Poor hand washing of child and refrigerator are major risk factor high burden of the disease. Health promotion strategies on proper food storage and child feeding practices are recommended for the prevention of childhood diarrhea. Asian Australas. J. Food Saf. Secur. 2018, 2(2), 93-99

The extent of nutritional status affecting Rohingya refugee under-five children has become a major health issues in Bangladesh. This study aimed to investigate the nutritional status and its effect on under-five Rohingya children in comparison with the areas of Bangladesh. A cross-sectional study of 300 under-five children were conducted by structured questionnaire from Rohingya camp (100), Cox’s Bazar (100) and Dumki (100) applying simple random method. Anthropometric indices (weight, height, mid-upper arm circumference (MUAC)) were measured in children aged 6-59 months. Indices were reported in z-scores and compared with WHO 2005 reference population. Data were analyzed by WHO Anthro-Plus Software and SPSS. About 41% Rohingya, 43% surrounding areas, and 46% Dumki were stunting in height-for-age z-score (HAZ) score respectively. Near about 13%, 11% and 4% were wasting in weight-for-height z-score (WHZ) score and 18%, 15% and 10% were underweight in weight for age Z-score (WAZ) score respectively. Food groups, Disease, worm infestation among 3 study areas were statistically significant (P< .05). Moreover, handwashing practice, vitamin-A consumption and worm infestation effects among diseases were statistically significant. In this study population, there was high prevalence of malnutrition among Rohingya children, especially wasting and underweight compared to other areas. Prevention of malnutrition plays an important role for having a healthy society of Rohingya Refugees.

Objectives: The increasing prevalence of malnutrition among school-going adolescents is a major public health threat in Bangladesh. School studying adolescents are a crucial group suffering from malnutrition. Proper nutrition information can enrich their knowledge, promote their health and also minimize the burden of malnutrition. The study aimed to identify the sources of information and corresponding knowledge level on nutrition among school-going adolescents in Bangladesh. Study design: A school-based cross-sectional survey was carried out from January to August 2019. Methods: A pre-structured questionnaire having 13 validated questions regarding facts panel of packaged food and daily dietary habits was used to assess the knowledge. Scores on nutritional knowledge were calculated by summing up the answer values (Yes ​= ​1, No ​= ​0) and, scores below the overall mean were considered low. Logistic regression was employed to identify whether any source was related to respondents’ nutritional knowledge. Results: Family members were the most popular (52.4%) source of nutrition information. Majority students (43.2%) trusted professionals as an accurate source. Approximately half (49.1%) of the participants scored low (

The present study attempts to identify the nutrition profile of the destitute women and children living in a rehabilitation center, Shishu Polli Plus (SPP), Gazipur. The vision of SPP is to serve underprivileged orphan children and destitute women and rehabilitate them by providing education and skill training. Information on anthropometric data, dietary intake, prevalence of morbidity and health and nutrition knowledge of SPP beneficiaries were collected by visiting the rehabilitation center. Dietary intake was calculated using dietary weighing of 7 consecutive days. Mean energy intake of SPP inmates was 1759 Kcal (86% of RDA). Mean intake of other nutrients were- protein 43 g, fat 33g, CHO 325g, calcium 307mg, iron 17mg, vitamin A 4120 IU, thiamine l.21mg, riboflavin 0.59mg and vitamin C 61 mg. They fulfilled the RDA for protein (96%), vitamin A (240%), and thiamine (ll8%). They were deficient in calcium (61% of RDA), iron (77% of RDA), riboflavin (48% of RDA) and vitamin C (130% of RDA; without considering cooking loss). Anthropometric assessments of the inmates indicated the presence of double burden of malnutrition at SPP. The great majority of the children (specially under-5) were undernourished; while at the same time about 9% of all adult women were found obese (BMI >25). Overall one in five children in SPP was found to be stunted. The situation however changes dramatically with age. A higher prevalence of stunting was reported with the lower age group of children. According to the weight for age and weight for height classification of nutritional status, about 30 per cent of all children residing at SPP were underweight and one quarter of all SPP children were, wasted. SPP environmental hygiene was much appreciated and the personal hygiene of SPP was far better than those of their counterparts in rural areas. The morbidity reporting was very few except for skin diseases. But SPP inmates' knowledge on nutrition and health was very poor. The study findings are encouraging in that the dietary intakes, anthropometry and the knowledge base (nutrition and health) of the SPP beneficiaries are comparable to those of their counterparts in the rural Bangladesh. This implies that without SPP interventions and attention the real life situation for these inmates would have been different. SPP has been trying very hard to bring meaningful changes in the life and living of these destitute.

Background Child undernutrition remains high in South Asian and sub-Saharan African countries. Rapid declines in nutritional status occur before the age of 2 years, particularly during the period of complementary feeding. Improving complementary feeding practices is a neglected area in nutrition programs. Objective To understand community perspectives on complementary feeding practices in order to inform the design of future interventions for improved complementary feeding. Methods From May through August 2009, data were collected in two rural locations and one urban location in Bangladesh through semistructured interviews, food attributes exercises, 24-hour dietary recalls, opportunistic observations, and trials of improved practices (TIPs). Key informant interviews and focus group discussions were also carried out among family members and community opinion leaders. Results Lay perceptions about complementary feeding differ substantially from international complementary feeding recommendations. A large proportion of children do not consume sufficient amounts of complementary foods to meet their energy and micronutrient needs. There was a gap in knowledge about appropriate complementary foods in terms of quality and quantity and strategies to convert family foods to make them suitable for children. Complementary feeding advice from family members, peers, and health workers, the importance given to feeding young children, and time spent by caregivers in feeding influenced the timing, frequency, types of food given, and ways in which complementary feeding occurred. Conclusions Perceptions and practices related to complementary feeding need to be effectively addressed to improve the levels of child undernutrition. Lack of understanding of children's nutritional needs and insufficient time for feeding children are key barriers to complementary feeding.

A comprehensive, multiround survey of local food systems in a rickets-endemic area of Bangladesh was conducted to identify household-level risk factors for rickets.A household-level, case-control study was conducted in a rickets-endemic area, Chakaria, with planned comparisons between households with one or more rachitic child and neighboring households with no affected children.A rickets-endemic area of southeastern Bangladesh, Chakaria.An interview-based survey was conducted in six villages in Chakaria with 199 households with at least one child showing physical signs consistent with rickets and 281 households with no affected children.Households with rachitic children in Chakaria had more children, more pregnant or lactating women, and fewer adults than unaffected households in that community. Affected households tended to rely on farming for their livelihood and tended to have less economic activity as indicated by less outstanding debt than their neighbors. Households with rickets were at significantly greater risk of pneumonia than were other households. Calcium undernutrition was severe and widespread in Chakaria due to a food system that offered very little of the element in accessible forms. Household diets were based on cereals and starchy vegetables. Rice and fish constituted the major source of calcium for most households, although dairy products, when used, were very important calcium sources, particularly for young children. In fact, the use of dairy products was the only household choice that led to substantial increases in the calcium intakes of children, and households that used dairy products tended to show increased calcium intakes for all of their members.The risk of a Chakarian household having a child with rickets appeared to be related to its economic status. Although this might be expected to be manifest as limitations in food access and/or use, rickets households failed to show a dietary pattern associated with rickets. Calcium undernutrition was prevalent and, thus, would appear to be a predisposing factor for rickets; however, calcium undernutrition was prevalent in Chakarian households with and without rickets. Therefore, it is probable that another precipitating factor(s) play a role(s) in the etiology of rickets in Chakaria.

Background In Bangladesh, many programs and projects have been promoting breastfeeding since the late 1980 s. Breastfeeding practices, however, have not improved accordingly. Methods For identifying program-relevant issues to improve breastfeeding in infancy, quantitative data were collected through visits to households (n = 356) in rural Chittagong and urban slums in Dhaka, and qualitative data from sub-samples by applying semi-structured in-depth interviews (n = 42), focus group discussions (n = 28), and opportunistic observations (n = 21). Trials of Improved Practices (TIPs) (n = 26) were conducted in the above sites and rural Sylhet to determine how best to design further interventions. Our analysis focused on five breastfeeding practices recommended by the World Health Organization: putting baby to the breast within the first hour of birth, feeding colostrum and not giving fluids, food or other substances in the first days of life, breastfeeding on demand, not feeding anything by bottle, and exclusive breastfeeding for the first six months. Results The biggest gaps were found to be in putting baby to the breast within the first hour of birth (76% gap), feeding colostrum and not giving other fluids, foods or substances within the first three days (54% gap), and exclusive breastfeeding from birth through 180 days (90% gap). Lack of knowledge about dangers of delaying initiation beyond the first hour and giving other fluids, foods or substances, and the common perception of "insufficient milk" were main reasons given by mothers for these practices. Health workers had talked to only 8% of mothers about infant feeding during antenatal and immunization visits, and to 34% of mothers during sick child visits. The major providers of infant feeding information were grandmothers (28%). Conclusions The findings showed that huge gaps continue to exist in breastfeeding behaviors, mostly due to lack of awareness as to why the recommended breastfeeding practices are beneficial, the risks of not practicing them, as well as how to practice them. Health workers' interactions for promoting and supporting optimal breastfeeding are extremely low. Counseling techniques should be used to reinforce specific, priority messages by health facility staff and community-based workers at all contact points with mothers of young infants.

In 1985–86 a food consumption survey covering about 4000 people was carried out in 11 locations of Dhaka city. Comparison of the results with those of the 1962–64 study revealed a deteriorating food and nutrition situation of the urban population. Among food groups, consumption of pulses and food from animal sources in particular have greatly declined. Among nutrients the foremost deficiency was of energy in which 68% of families consumed less than the requirement. A similar percentage of families consumed inadequate protein, but in 23% of them there would not have been a protein problem had there been an adequate supply of other sources of food energy. Among the micronutrients the severest deficiencies were of riboflavin and vitamin A. Forty two percent of families consumed less than the recommended level of ascorbic acid. A comparison of intake patterns in urban and rural areas shows several differences, even though the pattern of intake of dietary consituents was similar.

The rice-based diet in Bangladesh in the context of food and nutrition security Bangladesh is experiencing a situation with both food and nutrition insecurity. Bangladesh has developed a national plan of action within the food and nutrition area following the international plans of action. Examples of different ongoing programmes and projects related to food and nutrition security are described, including a more detailed description of the authors's own research activities. Research components pertinent to the Bangladesh rice-based diet comprise dietary surveys in rural Bangladesh in villages with different production patterns, perception studies of the commonly consumed foods, studies of the nutritional quality of the most important foods (rice, fish and vegetables) and bioavailability studies of starch from rice and calcium from small indigenous fish. Results are presented along with needs for future research.

BackgroundChronic exposure to high level of inorganic arsenic in drinking water has been associated with Type 2 Diabetes (T2D). Most research has been ecological in nature and has focused on high levels of arsenic exposure with few studies directly measuring arsenic levels in drinking water as an index of arsenic exposure. The effect of low to moderate levels of arsenic exposure on diabetes risk is largely unknown thus our study is adding further knowledge over previous works.MethodsThis cross sectional study was conducted in 1004 consenting women and men from 1682 eligible participants yielding a participation rate of 60%. These participants are aged>30 years and were living in Bangladesh and had continuously consumed arsenic-contaminated drinking water for at least 6 months. T2D cases were diagnosed using glucometer following the new diagnostic criteria (Fasting Blood Glucose>126 mg/dl) from the WHO guideline (WHO 2006), or a self-reported physician diagnosis of type 2 diabetes. Association between T2D and chronic arsenic exposure was estimated by multiple logistic regression with adjustment for age, sex, education, Body Mass Index (BMI) and family history of T2D.ResultsA total of 1004 individuals participated in the study. The prevalence of T2D was 9% (95% CI 7-11%). After adjustment for diabetes risk factors, an increased risk of type 2 diabetes was observed for arsenic exposure over 50 μg/L with those in the highest category having almost double the risk of type 2 diabetes (OR=1.9 ; 95% CI 1.1-3.5). For most levels of arsenic exposure, the risk estimates are higher with longer exposure; a dose–response pattern was also observed.ConclusionsThese findings suggest an association between chronic arsenic exposure through drinking water and T2D. Risks are generally higher with longer duration of arsenic exposure. The risk of T2D is highest among those who were exposed to the highest concentration of arsenic for more than 10 years.

The influence of seasonal variations in dietary intakes and nutritional status was examined in two rural villages of Bangladesh covering a population of 600. The results suggest considerable seasonal variations in intakes and prevalence of malnutrition depending on agricultural productivity. Intakes of almost all food was found to be the lowest in late October‐early November and May‐June period, the months preceding the two major rice (aman and aus) harvests. A higher incidence of malnutrition was accordingly seen during these periods. Alternative strategies in food production and availability seem to be needed to eliminate the severe consequences of malnutrition and to assist in alleviating rural poverty.

In 1981–82 a nationwide food consumption survey covering 4000 people was carried out in 12 statistically selected rural locations of Bangladesh. Comparison of the results with those of the 1975–76 and 1962–64 studies revealed an alarming food and nutrition situation in the country. Intakes of almost all foods and nutrients had decreased. Consumption of pulses and food from animal sources in particular had seriously declined. The foremost deficiency was of energy in which 76% of families consumed less than the requirement. Seventy‐seven percent of families consumed inadequate protein, but in 25% there would not have been a protein problem had there been an adequate supply of nonprotein sources of energy. Of the micronutrients the severest deficiencies were riboflavin and retinol. Eighty‐seven percent of families consumed less than the recommended level of ascorbic acid.