RESUMO
BACKGROUND: Worldwide, a significant number of girls become mothers during adolescence. In Bangladesh, adolescent childbirth is highly prevalent and has adverse effects on children's health and undernutrition. We aimed to identify the relationship between the undernutrition of children and adolescent motherhood, the factors associated with adolescent mothers' age at first birth, and to examine the programmatic factors and gaps influencing children's undernutrition in Bangladesh. METHODS: We analysed the 'Bangladesh Demographic and Health Survey' BDHS-17-18 data and desk review. To examine the factors associated with adolescent motherhood and its impact on child undernutrition, data from 7,643 mother-child pairs were selected. Child stunting, wasting, and underweight were measured according to the World Health Organisation (WHO) median growth guidelines based on z-scores - 2. Univariate, bivariate, simple, and multiple logistic regressions were used for analyse. We followed the systematic procedures for the literature review. RESULTS: Approximately, 89% of adolescents aged ≤ 19 years were married and 71% of them gave their first childbirth. Children of adolescent mothers (≤ 19 years) were significantly 1.68 times more wasted (aOR: 1.68; 95% CI: 1.08 to 2.64), 1.37 times more underweight (aOR: 1.37; 95% CI: 1.01 to 1.86) and either form 1.32 times more stunting, wasting or underweight (aOR:1.32; 95% Cl: 1.05 to 1.66) compared to the children of adult mothers (> 19 years) after adjusting potential confounders. The factors associated with mothers' first childbirth during adolescence were the age gap between husband and wife 5-10 years (aOR: 1.81; 95% Cl: 1.57-2.10) and age gap > 10 years (aOR: 2.41; 95% Cl: 1.96-2.97) compared with the age group < 5 years, and husbands' education (aOR: 1.29; 95% Cl: 1.04-1.61) compared with the uneducated husbands. In the literature review, we found potential gaps in focusing on the Adolescent Sexual and Reproductive Health (ASRH) program in Bangladesh, from thirty-two programmes only half of them focused on adolescents aged 10-19 years, and eleven programmes focused only on girls. CONCLUSION: Children of adolescent mothers are at risk of wasting, underweight, and any form of undernutrition. For effective policies and interventions in Bangladesh, it is important to emphasise delaying adolescent pregnancy and prioritising child undernutrition.
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Gravidez na Adolescência , Humanos , Adolescente , Bangladesh/epidemiologia , Feminino , Gravidez na Adolescência/estatística & dados numéricos , Adulto Jovem , Transtornos da Nutrição Infantil/epidemiologia , Gravidez , Criança , Pré-Escolar , Lactente , Fatores Socioeconômicos , Adulto , Inquéritos Epidemiológicos , Fatores Sociodemográficos , Mães/estatística & dados numéricos , Mães/psicologia , Magreza/epidemiologia , MasculinoRESUMO
Background: Climate change affects the transmission of vector-borne diseases like dengue, posing a substantial public health threat. Bangladesh, with its favorable conditions for Dengue transmission, has experienced periodic outbreaks. This study explores the relationship between climate change knowledge, perceptions of the Dengue-climate link, and the associated factors among Bangladeshi youth. Methods: In the Dhaka district of Bangladesh, a cross-sectional study was conducted between September and October 2023, involving face-to-face interviews with 1,358 participants. Convenient (non-probability) sampling was utilized for participant selection. Data collection involved the administration of a semi-structured questionnaire encompassing informed consent, socio-demographic information, and inquiries pertaining to climate change-related knowledge (13 items) and perception (11 items). Data analysis utilized STATA (Version 15.0) and SPSS (Version 26.0). Results: The mean scores for knowledge and perceptions were determined to be 7.10 ± 3.20 (out of 13) and 26.60 ± 4.12 (out of 33) respectively. Participants had a mean age of 22.02 ± 1.58 years. The study revealed that unmarried status, living in a nuclear family, being a non-smoker, good self-perception of physical health, regular sleep patterns, moderate social media usage, older age, unemployment, and daily media consumption are factors associated with higher knowledge and perception regarding the Dengue-climate change link. Moreover, a positive association was observed between knowledge of climate change and favorable attitudes toward the Dengue-climate connection. Conclusion: This study underscores the importance of tailored climate change education for youth in Bangladesh and highlights key variables influencing their knowledge and perceptions. Notably, there exists a positive association between climate change knowledge and favorable attitudes toward the Dengue-climate connection. These insights underscore the importance of targeted educational campaigns and policy interventions aimed at enhancing climate consciousness among the youth population, thereby fostering proactive measures to mitigate the impact of Dengue fever in the context of climate change.
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Mudança Climática , Dengue , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Bangladesh/epidemiologia , Dengue/epidemiologia , Masculino , Feminino , Estudos Transversais , Adulto Jovem , Inquéritos e Questionários , Adolescente , AdultoRESUMO
BACKGROUND: Bangladesh is one of the most densely populated countries in the world, with more than one-third of its people living in cities, and its air quality is among the worst in the world. The present study aimed to measure knowledge, attitudes and practice (KAP) towards air pollution and health effects among the general population living in the large cities in Bangladesh. METHODS: A cross-sectional e-survey was conducted between May and July 2022 among eight divisions in Bangladesh. A convenience sampling technique was utilized to recruit a total of 1,603 participants (55.58% males; mean age: 23.84 ± 5.93 years). A semi-structured questionnaire including informed consent, socio-demographic information, as well as questions regarding knowledge (11-item), attitudes (7-item) and practice (11-item) towards air pollution, was used to conduct the survey. All analyses (descriptive statistics and regression analyses) were performed using STATA (Version 15.0) and SPSS (Version 26.0). RESULTS: The mean scores of the knowledge, attitudes, and practice were 8.51 ± 2.01 (out of 11), 19.24 ± 1.56 (out of 21), and 12.65 ±5.93 (out of 22), respectively. The higher scores of knowledge, attitudes, and practice were significantly associated with several socio-demographic factors, including educational qualification, family type, residential division, cooking fuel type, etc. CONCLUSIONS: The present study found a fair level of knowledge and attitudes towards air pollution; however, the level of practice is not particularly noteworthy. The finding suggests the need to create more awareness among the general population to increase healthy practice to reduce the health effects of air pollution.
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Poluição do Ar , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Bangladesh , Masculino , Feminino , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Estudos Transversais , Adulto , Adulto Jovem , Inquéritos e Questionários , Adolescente , Pessoa de Meia-IdadeRESUMO
Introduction: Cardiovascular diseases (CVDs) stand as the foremost contributor to global mortality, claiming roughly 17.9 million lives each year, constituting 32.1% of total fatalities. Their impact is notably profound in economies such as Bangladesh, exacting a substantial economic burden. Consequently, grasping the landscape of knowledge, attitudes, and practices is essential for timely identification and prevention strategies. Methods: This cross-sectional study, carried out between January and May 2023 in the rural regions of Zirani, Savar Upazila, Dhaka, Bangladesh, utilized convenient sampling and conducted face-to-face interviews using a semi-structured questionnaire. It encompassed socio-demographic factors, as well as knowledge, attitudes, and practices concerning CVDs. Data analysis employed descriptive statistics, chi-square tests, and regression analyses, utilizing both the R programming language and SPSS (Version 26). Result: A total of 424 participants aged 60 years and above were included. The majority were male (60.8%), and the mean age was 71.21 ± 9.21 years, 57.3% were between 60 and 70 years old. Factors such as education, monthly family income, high blood pressure, diabetes, and non-smoking. Were significantly associated with higher knowledge, attitudes and practices scores. Conclusion: This study illuminates CVD-related KAP among rural Older Individuals in Bangladesh, revealing significant associations between factors such as education, monthly family income, high blood pressure, and non-smoking, with higher scores in knowledge, attitudes, and practices regarding cardiovascular health. These insights underscore the importance of addressing socio-economic factors and health behaviors in developing targeted interventions for the prevention and management of cardiovascular diseases in this demographic.
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Doenças Cardiovasculares , Conhecimentos, Atitudes e Prática em Saúde , Entrevistas como Assunto , População Rural , Humanos , Bangladesh , Masculino , Feminino , População Rural/estatística & dados numéricos , Idoso , Pessoa de Meia-Idade , Estudos Transversais , Inquéritos e Questionários , Idoso de 80 Anos ou maisRESUMO
Background: Digital health records have emerged as vital tools for improving health care delivery and patient data management. Acknowledging the gaps in data recording by a paper-based register, the emergency obstetric and newborn care (EmONC) register used in the labour ward was digitised. In this study, we aimed to assess the implementation outcome of the digital register in selected public health care facilities in Bangladesh. Methods: Extensive collaboration with stakeholders facilitated the development of an android-based electronic register from the paper-based register in the labour rooms of the selected district and sub-district level public health facilities of Bangladesh. We conducted a study to assess the implementation outcome of introducing the digital EmONC register in the labour ward. Results: The digital register demonstrated high usability with a score of 83.7 according to the system usability scale, and health care providers found it highly acceptable, with an average score exceeding 95% using the technology acceptance model. The adoption rate reached an impressive 98% (95% confidence interval (CI) = 98-99), and fidelity stood at 90% (95% CI = 88-91) in the digital register, encompassing more than 80% of data elements. Notably, fidelity increased significantly over the implementation period of six months. The digital system proved a high utility rate of 89% (95% CI = 88-91), and all outcome variables exceeded the predefined benchmark. Conclusions: The implementation outcome assessment underscores the potential of the digital register to enhance maternal and newborn health care in Bangladesh. Its user-friendliness, improved data completeness, and high adoption rates indicate its capacity to streamline health care data management and improve the quality of care.
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Sistema de Registros , Humanos , Bangladesh , Gravidez , Feminino , Recém-Nascido , Serviços Médicos de Emergência/organização & administração , Registros Eletrônicos de Saúde , Instalações de SaúdeRESUMO
OBJECTIVES: This study aims to evaluate the prevalence and associated factors of lower back pain (LBP) among farmers, rickshaw pullers and office workers in Bangladesh, while also investigating potential contributors within these occupational groups. DESIGN: This cross-sectional study aimed to determine the prevalence of LBP, associated factors and management procedures among farmers, rickshaw pullers and office workers in Bangladesh through face-to-face interviews. SETTING: The study was conducted in different parts of the Bogura district in Bangladesh. PARTICIPANTS: A total of 396 participants were included in the final analysis, all the participants were men and adult in age. MAIN OUTCOME MEASUREMENTS: Data were collected using a semi-structured questionnaire based on previous research. Bivariate and multivariable logistic regression analyses were performed to identify significant associations. RESULTS: The prevalence of LBP was found to be 42.7% among the participants. Farmers and rickshaw pullers had approximately four-times and three-times higher odds of experiencing LBP compared with office workers. Other significant factors associated with LBP included living in a nuclear family, having a normal body weight, lacking professional training, having a chronic disease, having a family history of LBP and experiencing numbness in the legs or feet. The majority of respondents sought medical attention and took medication for their LBP. CONCLUSION: The study underscores occupational differences in LBP prevalence, emphasising the necessity for tailored interventions and occupational health policies. Identifying specific risk factors and management practices in these professions can aid in developing effective prevention strategies and enhancing healthcare services.
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Dor Lombar , Doenças Profissionais , Adulto , Masculino , Humanos , Feminino , Dor Lombar/epidemiologia , Dor Lombar/etiologia , Prevalência , Bangladesh/epidemiologia , Estudos Transversais , Doenças Profissionais/epidemiologia , Inquéritos e Questionários , Fatores de RiscoRESUMO
Dengue fever is a global public health concern, especially in countries like Bangladesh. This study examines youth perceived dengue risk, and preventive practices, providing valuable insights into their behavior regarding this mosquito-borne disease. A cross-sectional survey was undertaken in various regions of the Dhaka district in Bangladesh. Face-to-face interviews were conducted with 1,358 participants using convenience sampling, spanning the period from September 2 to October 10, 2023. A semi-structured questionnaire covered informed consent, socio-demographic data, and questions about perceived dengue risk scale (12 items), and prevention practice (13 items). Participants' mean age was 22.02 ± 1.58 years. The average scores for perceived dengue risk, and prevention practices were found to be 51.39 ± 12.01 (out of 96), and 55.57 ± 14.55 (out of 104) respectively. Previous dengue history, history of other vector-borne diseases, gender, educational level, father's educational qualification, employment status, adequate sleep duration, father's occupation, etc. are factors associated with higher risk and prevention practices regarding dengue. The research underscores the importance of tailoring prevention strategies for different demographics, raising awareness, and promoting active engagement in preventive measures. These insights are crucial for developing effective public health policies and campaigns to combat dengue.
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Dengue , Animais , Humanos , Adolescente , Adulto Jovem , Adulto , Dengue/epidemiologia , Dengue/prevenção & controle , Estudos Transversais , Bangladesh/epidemiologia , Saúde Pública , Inquéritos e Questionários , Conhecimentos, Atitudes e Prática em SaúdeRESUMO
BACKGROUND: In low- and middle-income countries, households mainly use solid fuels like wood, charcoal, dung, agricultural residues, and coal for cooking. This poses significant public health concerns due to the emission of harmful particles and gases. To address these issues and support Sustainable Development Goals (SDGs), adopting cleaner cooking fuels like electricity and gas are acknowledged as a viable solution. However, access to these cleaner fuels is limited, especially in rural areas. METHODS: This study conducted a face-to-face survey with 1240 individuals in rural Bangladesh to explore the link between health issues and cooking fuel type, as well as barriers to transitioning to clean cooking. Using a convenient sampling technique across four divisions/regions, the survey gathered socio-demographic and health data, along with information on clean cooking barriers through a semi-structured questionnaire. Binary and multivariable logistic regression analyses were then employed to identify significant associations between cooking fuel type and health problems. RESULTS: The study revealed that a majority of participants (73.3%) relied on solid fuel for cooking. The use of solid fuel was significantly correlated with factors such as lower education levels, reduced family income, location of residence, and the experience of health issues such as cough, chest pressure while breathing, eye discomfort, diabetes, asthma, and allergies. Economic challenges emerged as the foremost obstacle to the adoption of clean cooking, accompanied by other contributing factors. CONCLUSION: The use of solid fuel in rural Bangladeshi households poses substantial health risks, correlating with respiratory, eye, cardiovascular, and metabolic issues. Lower education and income levels, along with specific residential locations, were associated with higher solid fuel usage. Economic challenges emerged as the primary obstacle to adopting clean cooking practices. These findings emphasize the need for implementing strategies to promote clean cooking, address barriers, and contribute to achieving Sustainable Development Goal targets for health and sustainable energy access in Bangladesh.
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Poluição do Ar em Ambientes Fechados , Humanos , Bangladesh , Poluição do Ar em Ambientes Fechados/análise , Características da Família , Carvão Mineral , Culinária/métodos , Gases/análiseRESUMO
We conducted a critical review of the article "Effects on Children's Physical and Mental Well-Being of a Physical-Activity-Based School Intervention Program: A Randomized Study", published in the International Journal of Environmental Research and Public Health in 2023 as part of the Special Issue "Psychomotricity and Physical Education in School Health". We identified multiple mistakes in the statistical analyses applied. First, the authors claim to have found a statistically significant association between the proposed intervention and change in body composition (body mass index (BMI) percentiles, relative fat mass, and BMI classes) by way of exhibiting differences in nominal significance between the pre- and post-intervention changes within the control and intervention groups, instead of exhibiting a significant difference between groups. Furthermore, the analysis described fails to account for clustering and nesting in the data. The reporting of the statistical methods and results include multiple elements that are variously incorrect, incoherent, or impossible. Revised statistical analyses are proposed which can render the study's methods valid and its results substantiated, whereas the current methods and results are invalid and unsubstantiated, respectively.
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Exercício Físico , Saúde Pública , Criança , Humanos , Índice de Massa Corporal , Instituições AcadêmicasRESUMO
Background: Poor menstrual hygiene practices during menstruation increases the risk of reproductive tract infections, absenteeism, and negative impact on school performance. Despite being a global problem, there is a lack of knowledge and misconceptions about menstrual hygiene among women of all ages, especially in developing countries like Bangladesh. The study aims to assess the knowledge, attitudes, and practices toward menstrual hygiene among early reproductive-aged women in Bangladesh to help policymakers and planners take effective initiatives. Methodology: A cross-sectional survey was conducted between July and December 2022 in Dhaka, Rajshahi, Chittagong, Sylhet, and Barisal regions of Bangladesh. A convenience sampling technique was utilized to recruit a total of 1,214 participants (100% female; mean age: 22.87 ± 2.64 years). A semi-structured questionnaire including informed consent, socio-demographic information, as well as questions regarding knowledge (6-item), attitudes (7-item), and practices (6-item) toward menstruation and menstrual hygiene practices, was used to conduct the survey. All analyses were performed using the STATA (Version 15.0) and Statistical Package for the Social Sciences (SPSS version 25.0). Result: The mean scores of the knowledge, attitudes, and practices were 4.9 ± 1.51 (out of 6), 12.58 ± 1.58 (out of 14), and 8.80 ± 1.87 (out of 12), respectively. The higher scores of knowledge, attitudes, and practices were significantly associated with several socio-demographic and menstruation-related factors (education, family type, type of menstruation, duration of menstruation, etc.). Conclusion: This study identified several key factors associated with improved knowledge, attitudes, and practices related to menstrual hygiene, including higher education levels, student status, younger age, non-alcohol consumption, and regular menstrual cycles. To enhance menstrual hygiene practices among women, it is crucial to implement targeted interventions that address knowledge disparities and tackle social and environmental influences.
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Conhecimentos, Atitudes e Prática em Saúde , Menstruação , Feminino , Humanos , Adulto , Adulto Jovem , Masculino , Estudos Transversais , Higiene , Bangladesh , EstudantesRESUMO
This study aimed to estimate the prevalence of illegal kidney sales in Kalai Upazila, Bangladesh, using the Network Scale-Up Method (NSUM), an ego-centric network survey-based technique used to estimate the size of hidden populations. The study estimated the size of the kidney seller population, analysed the profiles of kidney sellers and kidney brokers and investigated the characteristics of villagers who are more likely to be connected to kidney sellers to identify possible biases of the NSUM estimate. The study found that the prevalence of kidney trafficking in Kalai Upazila was between 1.98% and 2.84%, which is consistent with the estimates provided by a local leader and reporters, but with much narrower bounds. The study also found that a large proportion of kidney sellers and brokers were men (over 70% and 90%, respectively) and relatively young (mean age of 33 and 39, respectively). Specific reasons for kidney sales included poverty (83%), loan payment (4%), drug addiction (2%) and gambling (2%). While most reported male sellers were farmers (56%) and female sellers were housewives (78%) in need of money, most reported brokers were characterised as rich, well-known individuals.
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Rim , Pobreza , Adulto , Feminino , Humanos , Masculino , Bangladesh , Prevalência , Inquéritos e Questionários , Obtenção de Tecidos e ÓrgãosRESUMO
BACKGROUND: Mastalgia, or breast pain, is a prevalent and distressing condition experienced by women, impacting their daily lives and causing complications. It is common among women of reproductive age, with associations found with premenstrual syndrome, fibrocystic breast disease, psychological distress, and, in rare cases, breast cancer. While Western societies have high frequencies of Mastalgia, it is less diagnosed in Asian cultures including Bangladesh. This study aimed to investigate the prevalence and factors associated with Mastalgia among early reproductive-aged women in Bangladesh. METHODS: A cross-sectional survey was conducted, and data were collected from different regions of the country. A convenience sampling method was used to take 1,214 participants for the study. A pre-tested semi-structured questionnaire was used to collect data. Bivariate and multivariate analyses were conducted to ascertain factors that were significantly associated with Mastalgia. The data were analyzed using the SPSS software 26 version. RESULTS: All the participants were female (mean age: 22.87 ± 2.64 years; age ranges: 18-35 years). The prevalence of Mastalgia was found to be 35.5%. The study was conducted using a self-reported semi-structured questionnaire. Participants with a higher education level and higher income were more likely to experience Mastalgia. A family history of breast cancer and severe abdominal pain during menstruation were also identified as associated factors for Mastalgia (p < 0.05). CONCLUSIONS: This study enhances our understanding of Mastalgia in Bangladesh, offering insights for healthcare and policy. Further research is required to uncover its root causes and develop effective interventions. The study highlights the prevalence of mastalgia and its related factors, emphasizing the necessity for increased awareness and support for affected women.
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Neoplasias da Mama , Mastodinia , Adolescente , Adulto , Feminino , Humanos , Adulto Jovem , Bangladesh/epidemiologia , Estudos Transversais , Mastodinia/epidemiologia , PrevalênciaRESUMO
In this correspondence, we explain the reasoning for invalidity of the analysis choices by Kolberg et al., and provide the results produced using correct statistical procedures for their study design. Reassuringly, we could verify the original conclusions. That is, results of the corrected statistical models are similar to the results of the original analysis. Regardless of the magnitude of difference that corrected statistical methods make, results and conclusions that are derived from invalid methods are unsubstantiated. By verifying the results, we allow the readers to be assured that the published conclusions in the study by Kolberg et al. now rest on a sound evidential basis.
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Sintomas Afetivos , Demência , Humanos , Resolução de Problemas , Análise por Conglomerados , Modelos Estatísticos , Demência/terapiaRESUMO
Wang et al. [...].
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Aptidão Física , Saúde Pública , Pré-Escolar , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Exercício Físico , Terapia por ExercícioRESUMO
Background: Information on the mortality rate and proportional cause-specific mortality is essential for identifying diseases of public health importance, design programmes, and formulating policies, but such data on women of reproductive age in Bangladesh is limited. Methods: We analysed secondary data from the 2001, 2010, and 2016 rounds of the nationally representative Bangladesh Maternal Mortality and Health Care Survey (BMMS) to estimate mortality rates and causes of death among women aged 15-49 years. We collected information on causes of death three years prior to each survey using a country-adapted version of the World Health Organization (WHO) verbal autopsy (VA) questionnaire. Trained physicians independently reviewed the VA questionnaire and assigned a cause of death using the International Classification of Diseases (ICD) codes. The analysis included mortality rates and proportional mortality showing overall and age-specific causes of death. Results: The overall mortality rates for women aged 15-49 years decreased over time, from 190 per 100 000 years of observation in the 2001 BMMS, to 121 per 100 000 in the 2010 BMMS, to 116 per 100 000 in the 2016 BMMS. Age-specific mortality showed a similar downward pattern. The three diseases contributing the most to mortality were maternal causes (13-20%), circulatory system diseases (15-23%), and malignancy (14-24%). The relative position of these three diseases changed between the three surveys. From the 2001 BMMS to the 2010 BMMS and subsequently to the 2016 BMMS, the number of deaths from non-communicable diseases (e.g. cardiovascular diseases and malignancies) increased from 29% to 38% to 48%. Maternal causes led to the highest proportion of deaths among 20-34-year-olds in all three surveys (25-32%), while suicide was the number one cause of death for teenagers (19-22%). Circulatory system diseases and malignancy were the two leading causes of death for older women aged 35-49 years (40%-67%). Conclusions: There was a gradual shift in the causes of death from communicable to non-communicable diseases among women of reproductive age in Bangladesh. Suicide as the primary cause of death among teenage girls demands urgent attention for prevention.
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Doenças Cardiovasculares , Doenças não Transmissíveis , Adolescente , Feminino , Humanos , Idoso , Causas de Morte , Bangladesh/epidemiologia , Pesquisas sobre Atenção à SaúdeRESUMO
BACKGROUND: Although Bangladesh has made significant improvements in maternal, neonatal, and child health, the disparity between rich and poor remains a matter of concern. OBJECTIVE: The study aimed to increase coverage of skilled maternal healthcare services while minimising the inequity gap among mothers in different socioeconomic groups. METHODS: We implemented an integrated maternal and neonatal health (MNH) intervention between 2009 and 2012, in Shahjadpur sub-district of Sirajganj district, Bangladesh. The study was quasi-experimental in design for the evaluation. Socioeconomic status was derived from household assets using principal component analysis. Inequity in maternal healthcare utilisation was calculated using rich-poor ratio and concentration index to determine the changes in inequity between the baseline and the endline time period. RESULT: The baseline and endline surveys included 3,158 (mean age 23.5 years) and 3,540 (mean age 24.3 years) recently delivered mothers respectively. Reduction in the rich-poor ratio was observed in the utilisation of skilled 4+ antenatal care (ANC) (2.4:1 to 1.1:1) and related concentration index decreased from 0.220 to 0.013 (p < 0.001). The rich-poor ratio for skilled childbirth reduced from 1.7:1 to 1.0:1 and the related concentration index declined from 0.161 to -0.021 (p < 0.001). A similar reduction was also observed in the utilisation of skilled postnatal care (PNC); where the rich-poor gap decreased from 2.5:1 to 1.0:1 and the related concentration index declined from 0.197 to -0.004 (p < 0.001). CONCLUSION: The MNH intervention was successful in reducing inequity in receiving skilled 4+ ANC, delivery, and PNC in rural Bangladesh.
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Jardinagem , Verduras , Humanos , Projetos Piloto , Nicarágua , Abastecimento de Alimentos , Segurança AlimentarRESUMO
Accurate 3D structures of membrane proteins are essential for comprehending their mechanisms of action and designing specific ligands to modulate their activities. However, these structures are still uncommon due to the involvement of detergents in the sample preparation. Recently, membrane-active polymers have emerged as an alternative to detergents, but their incompatibility with low pH and divalent cations has hindered their efficacy. Herein, we describe the design, synthesis, characterization, and application of a new class of pH-tunable membrane-active polymers, NCMNP2a-x. The results demonstrated that NCMNP2a-x could be used for high-resolution single-particle cryo-EM structural analysis of AcrB in various pH conditions and can effectively solubilize BcTSPO with the function preserved. Molecular dynamic simulation is consistent with experimental data that shed great insights into the working mechanism of this class of polymers. These results demonstrated that NCMNP2a-x might have broad applications in membrane protein research.