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Background/Aim: Patients with rifampicin resistant-tuberculosis (RRTB) may remain a source of infection longer than patients with rifampicin sensitive-tuberculosis (RS-TB). This study aimed to detect active cases of RS-TB and RR-TB through systematic screening among household contacts of RR-TB patients in Dhaka, Bangladesh. Methods: This cross-sectional study was conducted among the 355 household contacts (HHCs) of 93 RR-TB primary cases identified from various centres in Dhaka, diagnosed between November 2020 and October 2021. For the identification of active cases of tuberculosis (TB), systematic screening among HHCs was done, where verbal screening was performed to check the presence of symptoms of TB. Those who had at least one symptoms of TB were considered as symptomatic contacts. Later GeneXpert analysis of sputum was done among the screened symptomatic contacts. Data was collected using a pretested, semi-structured, interviewer-administered questionnaire. Results: An estimated 30.4 % of respondents were ≤ 15 years of age. TBlike symptoms were prevalent among 9.9 % of respondents. Loss of appetite (45.7 %), unexplained weight loss (40.0 %) and cough (37.1 %) were the most common symptoms. Among the contacts with TB-like symptoms, 6.7 % were diagnosed as a case of TB (3.35 % were RR-TB and 3.35 % were RS-TB). The number needed to be screened to find an active case of TB was established at 178 among the HHCs of RR-TB. Conclusions: About one in ten RR-TB HHCs showed TB-like symptoms. One in fifteen HHCs with TB-like symptoms was an active case of TB. Regular, effective screening of RR-TB contacts is needed to stop the transmission.

ABSTRACTFrench fries (FF) and fried chicken (FC) are known contributors to overweight and obesity among adolescents worldwide. Top selling five brands for both FF and FC were analyzed to determine their health compromising contents, which were sampled from the markets of Dhaka, Bangladesh. Sodium (Na) was determined by flame photometry, trans fatty acids (TFAs) by gas chromatography and heavy metals like arsenic (As), lead (Pb), cadmium and chromium by graphite furnace atomic absorption spectrophotometry. The median concentration of Na, TFA, As and Pb in FF was 0.45 gm/100 gm, 0.11 gm/100 gm, 0.93 mg/kg and 0.03 mg/kg, respectively. Similarly, in FC the median concentration of Na, TFA, As and Pb was 0.46 gm/100 gm, 0.13 gm/100 gm, 0.053 mg/kg and 0.06 mg/kg, respectively. The study findings suggests that consuming FF and FC impose a health risk among the exposed population.

# Background The application of a gender lens enables the identification of gendered power dynamics that are deeply embedded within structures and institutions. This study delved into a comprehensive analysis of gender norms of male and female adolescents in terms of their health needs, the type of health services offered to them, the barriers and facilitators for utilization of health services at the adolescent-friendly health services (AFHS) across different tiers of government health facilities through a gender lens. # Methods The study was conducted at 23 health facilities across four districts of Bangladesh from February 2022 to June 2022. The study design was cross-sectional with a mixed methods approach. A total of 304 adolescents completed the survey, and 28 adolescents participated in in-depth interviews (IDI). Key-informant interviews (KII) were conducted with 48 key stakeholders, including parents, teachers, health service providers, facility managers, and health managers. Quantitative data were analyzed using descriptive statistics, and qualitative data was analyzed using thematic analysis. # Results Adolescents have different needs for information about services, types of services provided, and use based on gender. There was a significant association between the marital status of adolescents and the need for different types of health services (*P*\

Background: Information on the mortality causes of goldsmiths in Bangladesh is limited. This study aimed to find out the mortality causes in a selected group of goldsmiths. Methods: A World Health Organization recommended questionnaire was adapted to conduct verbal autopsy of 20 deceased goldsmiths. Death-related information was gathered from the family members present during deceased’s illness preceding death. The mortality causes were determined by the interview outcomes and medical records-review. Results: The mean age of the goldsmiths at death was 59.2± 9.3 years. Among then, 70.0% were smokers and 50.0% were alcohol consumers. Cardiovascular diseases (CVD) were the most common immediate and underlying cause of death (60.0% and 45.0%, respectively). Conclusion: The life expectancy of goldsmiths was much lower than the average life expectancy of Bangladeshi population, where CVD was the primary cause of death. Smoking and alcohol consumption were prevalent among them. Awareness about healthy lifestyles should be prioritized for highly CVD prevention among the goldsmiths. Bangabandhu Sheikh Mujib Medical University Journal 2023;16(2): 87-90

Abstract Since child sexual abuse (CSA) is one of the most serious public health issues, how CSA cases and victims are portrayed in the daily newspapers is a major concern to the public health and communication specialists. The purpose of this study was to evaluate the degree of the ethical standard of reporting CSA in Bangladeshi newspapers, as well as to identify the potential risk factors associated with unethical reporting. From January to December 2017, a total of 1093 news stories on CSA were collected from four top circulated Bengali newspapers and two English newspapers of Bangladesh. Berelson’s quantitative content analysis approach (only manifest content) was used to analyze these stories. For the coding and analysis purpose, news items (texts and news with photos) of spot news, editorials, and commentaries were included. Chi-square tests were used to evaluate the bivariate association of different case characteristics with unethical reporting, and multivariate logistic regression models were performed to assess the potential risk factors of disclosing the victim’s identity and needless detail in the news description. This study revealed that more than 40% of news stories on CSA cases did not follow the ethical standard of reporting. Episodic CSA cases were more unethically reported in newspapers, compared to the thematic stories (42.8% vs. 11.6%). Approximately 37% of news stories disclosed at least one identifying information of victims (i.e., name, parents’ name, family member’s name, or school name), and 23% of stories included sensual and/or excessive description of the event. Our adjusted model showed that victim identifiers were most likely to be reported in news stories when the victim was 13–17 years old (AOR 1.86; P = 0.027), the alleged perpetrator held influential social status (AOR 2.44, P = 0.005), the victim was familiar to the perpetrator (AOR 6.85, P

Bangladesh, similar to other countries is experiencing an increased burden of cancer. Absence of a national cancer registry has created a gap in the information regarding the presentation of cancer statistics of the country. The objective of this study was to assess the types and distribution of the cancer patients attending a tertiary academic medical center hospital in Bangladesh. A cross-sectional study was conducted among all the confirmed cancer patients attending the in-patient and out-patient, and daycare facilities in Bangabandhu Sheikh Mujib Medical University in October, 2019. A validated questionnaire, recommended by International Agency for the Cancer Registry was used to collect data. Written informed consent was obtained from every respondent. This study had received its ethical clearance from Institutional Review Board of BSMMU. Among the 1656 respondents, 78.8% were adult and 25.2% were from paediatric age groups. Leading cancer for adult males were lung cancer (9.6%), leukaemia (9.4%) and lymphoma (9.0%); and breast cancer (28.1%), thyroid cancer (16.1%), and cervical cancer (12.2%) for females. Leukaemia was the most frequent cancer in the paediatric group for both males (71.5%) and females (66.5%). Establishing a hospital-based cancer registry with high quality data in an academic medical center setting is feasible and can set the stage for establishing nationwide hospital-based as well as establishing a popula- tion-based cancer registry in Bangladesh, which is necessary to identify and tackle the rising burden of cancer in this country. BSMMU J 2022; 15(1): 43-49

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

Abstract Background Globally, older population (aged ≥60 years) comprise 11% of the total population, and 23% of them are malnourished. Lack of knowledge and education, adverse dietary habits, depression or psychological disorders, poor oral and dental health, disability, and diseases are the reported factors responsible for malnutrition among them. Geriatric people comprise 7.5% of the total population of Bangladesh, and almost a quarter are malnourished. But there is scarce data on the factors associated with the nutritional status of the older population in Bangladesh. Methods A cross-sectional study was conducted among 125 older individuals (male 59, female 66) living in three villages of Uttarkhan, Dhaka, Bangladesh, to identify the factors associated with their nutritional status. The Mini Nutritional Assessment scale, Geriatric Depression Scale-Short Form, and Geriatric Oral Health Assessment Index were used for assessing the nutritional status, mental health status, and oral health quality of the respondents, respectively. Information on socio-demographic characteristics, comorbidities and dietary factors, and food behaviors were gathered by a pretested semi-structured questionnaire. Ethical approval was obtained from the Institutional Review Board of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Results The participants’ mean age was 67.9 ± 7.1 years. Most of them (53.6%) had no formal education. Among the respondents, 22.0% male and 28.8% female were malnourished. The proportion of malnourished and at risk of malnutrition among the respondents living without a partner were 28.6 and 65.3%, respectively. A significantly (p

Abstract Background Little is known regarding the effect of exposure to biomass fuel smoke inhalation on respiratory symptoms in the Bangladeshi population which is a major health hazard in most of the developing countries. This study aims to explore the association between respiratory symptoms and biomass fuel smoke exposure among children under 5 years of age. Methods Data were extracted from the Bangladesh Urban Health Survey conducted in 2013. A total of 10,575 mothers with at least one surviving children were selected. Respiratory symptoms among children under 5 years of age were considered as the primary outcome. Sequential multiple logistic regression models were used to observe the association between respiratory symptoms and biomass fuel smoke exposure adjusting the effect of residential factors and mother and child characteristics. Results Around 40% of the mothers exclusively used biomass fuel irrespective of the kitchen location and 54% of them were habituated in indoor cooking. The prevalence of respiratory symptoms of under-five children among in-house and outdoor biomass fuel users was 23.0% and 21.9%, respectively. Results of fitted multiple logistic regression models showed that the odds of having respiratory symptoms among children under 5 years of age were increased due to in-house biomass fuel use [OR = 1.18; 95% CI, 1.04–1.36] compared with the non-biomass user. An increased risk of respiratory symptoms was also significantly associated with mother’s birth complication [OR = 1.51; 95% CI, 1.36–1.67], non-government organization (NGO) membership of mothers [OR = 1.32; 95% CI, 1.16–1.51], age of the child (6–23m) [OR = 1.29; 95% CI, 1.10–1.52], and nutritional status (stunting) [OR = 1.18; 95% CI, 1.06–1.31]. Conclusion This study found the use of in-house biomass fuel as a significant risk factor associated with respiratory symptoms of children under 5 years of age. More longitudinal studies should be designed to establish a causal relationship between HAP (household air pollution) and respiratory symptoms among children with more direct measures of HAP and clinical procedure.

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.

# Background Bangabandhu Sheikh Mujib Medical University (BSMMU) is a postgraduate medical university in Bangladesh, where health research is an institutional mission. To improve the institutional research culture that contributes to better research capabilities, an assessment of BSMMU’s research output, challenges faced while conducting research, feasible actions to overcome them, and indicators for evaluating the research capacity were identified. # Methods Published manuscripts from BSMMU for the year 2018, registered with PubMed and BanglaJOL, were reviewed to assess the status of research output. Key informant interviews and in-depth interviews were conducted with various members of the academic departments, central library, institutional review board and University journals, to identify research-related challenges, strategies to overcome, and indicators to evaluate the research capacity. # Results In 2018, the total number of scientific articles published was 364, among which 68.4% of the articles were published in local journals and 31.6% in international journals. Journals published by the University lacked indexation into international medical databases and had no impact factor. The majority of the interviewees mentioned about the lack of dedicated time for research, prioritized research agendas and need for research-related trainings to improve research performance as challenges. Establishing policies for research support, development of University’s research infrastructure and better mechanisms to disseminate research findings, were identified as key opportunities for improvement. For future evaluation of research capacity strengthening, individual levels indicators (publication outputs, research grants, awards, number of collaborations) were emphasized. # Conclusions Preference for publishing in the local journals was observed rather than in international peer-reviewed journals. The key challenges for undertaking research included the absence of dedicated time and trainings for skill development. Publication outputs, research grants, awards, number of collaborations were identified as notable indicators for evaluating improvements in research capacity at an individual level. Establishing policies and guidelines for research support, along with the development of appropriate research infrastructure in the University, will enable it to guide national policies and programs.

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

BackgroundAlthough child physical abuse (CPA) is considered as a major global public health problem, it has not yet been recognized as such in Bangladesh. Very few studies have assessed the prevalence and victims' characteristics of multiple forms of CPA.ObjectiveThis population-based study assessed the prevalence of CPA committed by adults in a rural area of Bangladesh and examined its association with demographic and socio-contextual factors.MethodsData were obtained using ISPCAN Child Abuse Screening Tool for Children (ICAST-C) in a random sample of 1416 children (49% girls, 51% boys) aged 11 to 17 years by face-to-face interviews during March-April 2017. The response rate was 91.5%. To estimate predictors of CPA, physical abuse was categorized into frequent and less frequent groups.ResultsThe prevalence of at least one form (≥ 1), two forms (≥2) and three or more forms (≥ 3) of CPA were estimated approximately to 99%, 95% and 83% in their lifetime and 93%, 79%, and 57% in the past year respectively. Hitting (except on buttocks), standing/kneeling and slapping were the most common physical abuse whereas given drugs or alcohol, pinched, burned or scalded, beaten-up and locked up were less reported. Female children were faced severe forms of CPA more than that of males. Male children, younger age groups, witnessing adults using weapons at home, bullied by siblings and low level of maternal education were found to be significant risk factors for both ≥ 1 form and ≥ 2 forms of frequent CPA whereas adding also adult shouting in a frightening way was found as a significant risk factor for ≥ 2 forms of frequent CPA.ConclusionSelf-reported prevalence of CPA is extremely common in the Bangladeshi rural society. The prevalence was associated with demographic and socio-contextual characteristics of the children such as being younger, witnessing domestic violence and maternal low education. The findings provide evidence to support parents and policy-makers to take effective measures to implement policy and programme on alternative up-bringing methods and creating awareness of negative effects of CM which in turn help Bangladesh to line up with UN Convention on the Rights of the Child, which the country signed in 1990.

Background: Evidence suggests that serotonergic psychedelics (e.g. psilocybin), have rapid-acting and long-lasting antidepressant effects after a single dose. However, the mechanism underlying these effects remain unclear. One proposed mechanism is that these drugs promote neuroplasticity. However, this has not been conclusively demonstrated in humans. Aims: We hypothesized that relative to placebo, psilocybin would: (1) increase electroencephalographic (EEG) correlates of neuroplasticity, (2) reduce depression symptoms, and (3) changes in EEG would correlate with improvements in depression. Methods: In this double-blind, placebo-controlled, within-subject study, individuals with major depressive disorder (MDD; n = 19) were administered placebo followed by psilocybin (0.3 mg/kg) in a fixed order (placebo, followed by psilocybin 4 weeks later). EEG indices of neuroplasticity (tetanus-induced long-term potentiation) as assessed via auditory evoked theta (4–8 Hz) power and measures of depression (GRID Hamilton Rating Scale for Depression-17 (GRID-HAM-D-17)) were measured at several time-points after placebo and psilocybin (24 h and 2 weeks after each session). Results: EEG theta power doubled in amplitude 2 weeks after a single psychedelic dose of psilocybin but not after placebo. Further, improvements in depression symptoms 2 weeks after psilocybin were correlated with increases in theta power. Conclusions: The increased theta power observed represents evidence of sustained changes in the brain following psilocybin. Given the correlation with enhancement in depressive symptoms, changes in theta may represent an EEG biomarker of the sustained effects of psilocybin, and may shed light on potential mechanisms of psilocybin's antidepressant effect. Taken together, these results complement the emerging notion that psilocybin, and perhaps other psychedelics, can produce long-term alterations in neuroplasticity. [ABSTRACT FROM AUTHOR]