Trends in the Prevalence of Hypertension and Type 2 Diabetes in Bangladesh (2010-2020): A Systematic Review and Meta-Analysis.

BACKGROUND: The prevalence of cardiovascular diseases (CVDs) and type 2 diabetes mellitus (T2DM) has increased in Bangladesh. This paper has reviewed published studies on hypertension and T2DM from 2010 to 2020 in Bangladesh and conducted a meta-analysis. METHODS: The PubMed database was used for systematic search. Hypertension and T2DM were considered for measuring pooled prevalence by meta-analysis. The random-effects model was used to calculate the pooled prevalence of hypertension (n = 30) and T2DM (n = 21) in relevant studies. The quality of the reviewed studies was determined by sampling strategy, sample size, and outcome assessment. The meta-analysis protocol was registered at PROSPERO (CRD42020206315). RESULTS: The pooled hypertension and T2DM prevalence was 21.6% (95% CI: 18.8%-24.4%) and 13.6% (95% CI: 10.8%-16.5%), respectively. Females were more hypertensive than males (M vs. F: 18.6% vs. 24.8%), and T2DM was higher in females (M vs. F: 12.4% vs. 13.3%). Urban dwellers were more hypertensive and diabetic than rural people (urban vs. rural: 28.5% vs. 20.3% and 18.8% vs. 14.2%, respectively). An 8% increase in the prevalence of hypertension and T2DM became more than double compared to the 1995-2010 period. CONCLUSION: Future research should focus on the underlying factors that increase the prevalence of these diseases and prevention strategies to reduce the trend of increasing prevalence.

Chemical profiles and pharmacological attributes of Apis cerana indica beehives using combined experimental and computer-aided studies.

The current study sought to determine the anxiolytic, antidepressant, and anti-inflammatory properties of distilled water-soluble extract of beehive (WSE-BH). Gas chromatography-mass spectrometry (GC-MS) studies were used to characterize the chemical compositions obtained from beehives extracted in water and methanol (also fractions). The GC-MS analysis identified 19 compounds in WSE-BH, including high total phenol and flavonoid contents, compared with the methanol extract (21 compounds), ethyl acetate fraction (9 compounds), and CCl4 fraction (27 compounds). The oral administration of WSE-BH (50 and 150 mg/kg) showed significant anxiolytic activities assessed by time spent in (30.80% and 39.47%, respectively) and entry into (47.49% and 55.93%, respectively) the open arms of the elevated plus-maze (EPM). Only the 150 mg/kg dose resulted in a significant effect on the number of head-dipping events in the hole-board test (HBT) (40.2 ± 2.33; p < 0.01) vs. diazepam (64.33 ± 3.16; p < 0.001). Both the 50 and 150 mg/kg doses resulted in significant (p < 0.001) decreases in immobility in the forced swim test (FST) and tail suspensions test (TST), corresponding to the effect of fluoxetine. WSE-BH inhibited histamine-induced paw edema significantly beginning at 60 min, with the 150 mg/kg dose having the highest effect at 180 min. The current findings suggested that WSE-BH had anxiolytic, antidepressant, and anti-inflammatory properties.

Consumption of Fruitflow® lowers blood pressure in pre-hypertensive males: a randomised, placebo controlled, double blind, cross-over study.

In order to investigate whether the angiotensin converting enzyme-inhibitory tomato extract Fruitflow® would lower blood pressure after consumption, we conducted a randomised, double-blinded, placebo-controlled human intervention study, involving 12 pre-hypertensive people in a crossover design. Consuming a single dose of 150 mg Fruitflow® resulted in a significant reduction in 24-hour average blood pressure as well as average wake-period and sleep-period SBP, compared to placebo. Other parameters related to blood pressure, such as 24-hour average mean arterial pressure, pulse pressure, heart rate, central aortic systolic pressure and radial augmentation index were also reduced. In addition, the platelet aggregation response to ADP, measured 24 hours after consuming Fruitflow®, fell significantly compared to baseline, and compared to placebo. This pilot study clearly shows the beneficial effects of Fruitflow® on two important cardiovascular risk factors, high blood pressure and platelet hyperactivity.

Cultural and Economic Motivation of Pig Raising Practices in Bangladesh.

The interactions that pig raisers in Bangladesh have with their pigs could increase the risk of zoonotic disease transmission. Since raising pigs is a cultural taboo to Muslims, we aimed at understanding the motivation for raising pigs and resulting practices that could pose the risk of transmitting disease from pigs to humans in Bangladesh, a predominantly Muslim country. These understandings could help identify acceptable strategies to reduce the risk of disease transmission from pigs to people. To achieve this objective, we conducted 34 in-depth interviews among pig herders and backyard pig raisers in eight districts of Bangladesh. Informants explained that pig raising is an old tradition, embedded in cultural and religious beliefs and practices, the primary livelihood of pig herders, and a supplemental income of backyard pig raisers. To secure additional income, pig raisers sell feces, liver, bile, and other pig parts often used as traditional medicine. Pig raisers have limited economic ability to change the current practices that may put them at risk of exposure to diseases from their pigs. An intervention that improves their financial situation and reduces the risk of zoonotic disease may be of interest to pig raisers.

Infrastructure and contamination of the physical environment in three Bangladeshi hospitals: putting infection control into context.

OBJECTIVE: This paper describes the physical structure and environmental contamination in selected hospital wards in three government hospitals in Bangladesh. METHODS: The qualitative research team conducted 48 hours of observation in six wards from three Bangladeshi tertiary hospitals in 2007. They recorded environmental contamination with body secretions and excretions and medical waste and observed ward occupant handwashing and use of personal protective equipment. They recorded number of persons, number of open doors and windows, and use of fans. They measured the ward area and informally observed waste disposal outside the wards. They conducted nine focus group discussions with doctors, nurses and support staff. RESULTS: A median of 3.7 persons were present per 10 m(2) of floor space in the wards. A median of 4.9 uncovered coughs or sneezes were recorded per 10 m(2) per hour per ward. Floors in the wards were soiled with saliva, spit, mucous, vomitus, feces and blood 125 times in 48 hours. Only two of the 12 patient handwashing stations had running water and none had soap. No disinfection was observed before or after using medical instruments. Used medical supplies were often discarded in open containers under the beds. Handwashing with soap was observed in only 32 of 3,373 handwashing opportunities noted during 48 hours. Mosquitoes and feral cats were commonly observed in the wards. CONCLUSIONS: The physical structure and environment of our study hospitals are conducive to the spread of infection to people in the wards. Low-cost interventions on hand hygiene and cleaning procedures for rooms and medical equipment should be developed and evaluated for their practicality and effectiveness.

Family caregivers in public tertiary care hospitals in Bangladesh: risks and opportunities for infection control.

BACKGROUND: Family caregivers are integral to patient care in Bangladeshi public hospitals. This study explored family caregivers' activities and their perceptions and practices related to disease transmission and prevention in public hospitals. METHODS: Trained qualitative researchers conducted a total of 48 hours of observation in 3 public tertiary care hospitals and 12 in-depth interviews with family caregivers. RESULTS: Family caregivers provided care 24 hours a day, including bedside nursing, cleaning care, and psychologic support. During observations, family members provided 2,065 episodes of care giving, 75% (1,544) of which involved close contact with patients. We observed family caregivers washing their hands with soap on only 4 occasions. The majority of respondents said diseases are transmitted through physical contact with surfaces and objects that have been contaminated with patient secretions and excretions, and avoiding contact with these contaminated objects would help prevent disease. CONCLUSION: Family caregivers are at risk for hospital-acquired infection from their repeated exposure to infectious agents combined with their inadequate hand hygiene and knowledge about disease transmission. Future research should explore potential strategies to improve family caregivers' knowledge about disease transmission and reduce family caregiver exposures, which may be accomplished by improving care provided by health care workers.

Exploring pig raising in Bangladesh: implications for public health interventions.

Pigs are intermediate hosts and potential reservoirs of a number of pathogens that can infect humans. The objectives of this manuscript are to understand pig raising patterns in Bangladesh, interactions between pigs and humans, social stigma and discrimination that pig raisers experience and to explore the implications of these findings for public health interventions. The study team conducted an exploratory qualitative study by interviewing backyard pig raisers and nomadic herders (n=34), observing daily interactions between pigs and humans (n=18) and drawing seasonal diagrams (n=6) with herders to understand the reasons for movement of nomadic herds. Pig raisers had regular close interaction with pigs. They often touched, caressed and fed their pigs which exposed them to pigs' saliva and feces. Herders took their pigs close to human settlements for scavenging. Other domestic animals and poultry shared food and sleeping and scavenging places with pigs. Since pigs are taboo in Islam, a majority of Muslims rejected pig raising and stigmatized pig raisers. This study identified several potential ways for pigs to transmit infectious agents to humans in Bangladesh. Poverty and stigmatization of pig raisers make it difficult to implement health interventions to reduce the risk of such transmissions. Interventions that offer social support to reduce stigma and highlight economic benefits of disease control might interest of pig raisers in accepting interventions targeting pig borne zoonoses.

Pig illnesses and epidemics: a qualitative study on perceptions and practices of pig raisers in Bangladesh.

Zoonoses in swine are increasingly becoming a global public health concern. Understanding how livestock farmers perceive animal illnesses will help to develop locally acceptable and effective public health intervention strategies to control and manage zoonoses. The authors describe Bangladeshi pig raisers' perception of pig illnesses and their behaviour towards sick pigs. We collected qualitative data from August 2007 to September 2008. Included in our study are backyard pig raisers from three districts, namely: Faridpur, Chapainobabgonj and Tangail and nomadic herders from six districts, namely: Mymensingh, Tangail, Sherpur, Sirajgonj, Bogra and Pabna. We conducted in-depth interviews (n=34) and made observations of human interactions with pigs (n=18). Pig raisers reported several illnesses that caused their pigs to suffer and die. They had close contact with sick pigs whilst caring for them. They slaughtered sick pigs and consumed and sold the pork if they thought that the pig might die. They believed that pig illness could be transmitted among pigs but not between pigs and humans. The perception of pig raisers on pig illnesses and their behaviour towards sick pigs places them in close contact with potentially infectious pig secretions and excretions. Such exposure could favour zoonotic transmission of infectious diseases. A better surveillance system for pig diseases would provide an opportunity to identify the transmission of diseases, determine whether they pose a risk to humans, or whether they contribute to the emergence of diseases.