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Objective To directly estimate how much smoking contributes to cause-specific mortality in Bangladesh. Methods A case-control study was conducted with surveillance data from Matlab, a rural subdistrict. Cases (n = 2213) and controls (n = 261) were men aged 25 to 69 years who had died between 2003 and 2010 from smoking-related and non-smoking-related causes, respectively. Cause-specific odds ratios (ORs) were calculated for 'ever-smokers' versus 'never-smokers', with adjustment for education, tobacco chewing status and age. Smoking-attributable deaths among cases, national attributable fractions and cumulative probability of surviving from 25 to 69 years of age among ever-smokers and never-smokers were also calculated. Findings The fraction of ever-smokers was about 84% among cases and 73% among controls (OR: 1.7; 99% confidence interval, CI: 1.1-2.5). ORs were highest for cancers and lower for respiratory, vascular and other diseases. A dose-response relationship was noted between age at smoking initiation and daily number of cigarettes or bidis smoked and the risk of death. Among 25-year-old Bangladeshi men, 32% of ever-smokers will die before reaching 70 years of age, compared with 19% of never-smokers. In 2010, about 25% of all deaths observed in Bangladeshi men aged 25 to 69 years (i.e. 42000 deaths) were attributable to smoking. Conclusion Smoking causes about 25% of all deaths in Bangladeshi men aged 25 to 69 years and an average loss of seven years of life per smoker. Without a substantial increase in smoking cessation rates, which are low among Bangladeshi men, smoking- attributable deaths in Bangladesh are likely to increase. Methodes Une etude cas-temoins a ete menee avec les donnees de surveillance de Matlab, un sous-district rural. Les cas (n = 2213) et les controles (n = 261) etaient des hommes ages de 25 a 69 ans decedes entre 2003 et 2010 des suites ou non du tabagisme, respectivement. Les rapports des cotes (RC) par cause ont ete calcules pour les <> par rapport aux <>, avec un ajustement pour I'education, la consommation de tabac a macher et l'age. On a egalement calcule les deces attribuables au tabagisme parmi les cas, les fractions attribuables a la population nationale et la probabilite de survie de 25 a 69 a ns chez les fumeurs depuis toujours et chez les non-fumeurs. Resultats La fraction des fumeurs depuis toujours etait d'environ 84% chez les cas et de 73% chez les controles (RC: 1,7; intervalle de confiance de 99%, IC: 1,1-2,5). Les rapports de cotes etaient les plus eleves pour les cancers et plus bas pour les maladies respiratoires, vasculaires et autres. Une relation dose-reponse a ete notee entre l'age de l'initiation au tabagisme et le nombre de cigarettes ou de <> fumees chaque jour et le risque de mortalite. Chez les hommes du Bangladesh de 25 ans, 32% des rumeurs depuis toujours mourront avant l'age de 70 ans, par rapport a 19% pour les nomfumeurs. En 2010, environ 25% de tous les deces observes chez les hommes du Bangladesh ages de 25 a 69 ans (c'est-a-dire 42 000 deces) etaient attribuables au tabagisme. Conclusion Le tabagisme est a l'origine de 2.5% de tous les deces chez les hommes du Bangladesh ages de 25 a 69 ans, et d'une perte moyenne de 7 annees de vie pour les rumeurs. Sa ns une augmentation importante des taux d'abandon du tabac, qui sont faibles chez les hommes du Bangladesh, les deces attribuables au tabagisme augmenteront probablement dans ce pays. Objetivo Estimar directamente la medida en la que el tabaquismo contribuye a la mortalidad por causa especifica en Bangladesh. Metodos Se realizo un estudio de casos y controles con datos de vigilancia de Matlab, un subdistrito rural. Los casos (n=2213) y los controles (n=261) se trataron de hombres de edades entre 25 y 69 anos que habian fallecido entre 2003 y 2010 por causas relacionadas y no relacionadas con el tabaquismo, respectivamente. Las razones de posibilidades por causa especifica se calcularon para los <> frente a los <>, ajustando la educacion, el consumo de tabaco de mascar y la edad. Tambien se calcularon las muertes atribuibles al tabaquismo entre los casos, las fracciones nacionales atribuibles y la probabilidad acumulada de sobrevivir de los 25 a los 69 anos de edad entre los fumadores de siempre y los nunca fumadores. Resultados La fraccion de fumadores de siempre fue de aproximadamente el 84% entre los casos y el 73% entre los controles (razon de posibilidades: 1,7; intervalo de confianza 99%: 1,1-2,5). Las razones de posibilidades fueron las mayores en casos de canceres y menores en casos de enfermedades vasculares, respiratorias y de otros tipos. Se senalo una relacion dosis-respuesta entre la edad de la iniciacion en el tabaquismo y el numero diario de cigarrillos o bidis fumados y el riesgo de muerte. Entre los hombres de Bangladesh de 2.5 anos, el 32% de los fumadores de siempre falleceran antes de alcanzar los 70 anos, comparado con el 19% de los nunca fumadores. En 2010, aproximadamente el 25% de las muertes observadas en los hombres de Bangladesh de entre 25 y 69 anos (42 000 muertes) fueron atribuibles al tabaquismo. Conclusion El tabaquismo causa aproximadamente el 25% de todas las muertes en los hombres de Bangladesh de entre 25 y 69 anos y una perdida media de siete anos de vida en cada fumador. Sin un aumento significativo en las tasas de abandono del tabaquismO, que son bajas entre los hombres de Bangladesh, es probable que aumenten las muertes atribuibles al tabaquismo en Bangladesh., Introduction Deaths attributable to smoking are projected to increase substantially throughout the 21st century and much of the increase will occur in low- and middle-income countries (1) such as Bangladesh, [...]

This study examined the cross-sectional association of bone and joint diseases with health-related quality of life (HRQoL) among 850 randomly sampled people aged 60 or more years in a rural area of Bangladesh. Information about arthritis, back and joint pain was collected through self-reports and two physicians' assessments at a health centre. Health-related quality of life was measured using a multi-dimensional generic instrument designed for older people that has questions on the construct's physical, psychological, social, economic, spiritual and environmental dimensions. Bivariate analyses showed that the most negative effects of bone and joint diseases were on the physical and psychological dimensions. Hierarchical linear regression analyses revealed that joint pain, whether doctor-diagnosed or self-reported, and self-reported back pain were all associated with lower HRQoL scores and accounted for almost 20 per cent of the variation (adjusted for age, sex, education, marital status, household size, income, expenditure and occupation). The analyses further revealed that women with self-reported back pain had significantly lower psychological, environmental and overall HRQoL scores than equivalent men, while self-reported joint pain was associated with significantly lower scores only for the environmental dimension. The strong association of bone and joint diseases with HRQoL underscores the importance of regarding these illnesses as public health problems. KEY WORDS--bone and joint diseases, HRQoL, older people, developing countries, Bangladesh.

BACKGROUND: The objective of this population-based case-referent study in Matlab, Bangladesh, was to assess the susceptibility to arsenic-induced skin lesions by age and sex, in a population drinking water from [...]