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1.
Chemosphere ; 287(Pt 1): 132048, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34478961

RESUMO

Exposure to dust particles enriched with arsenic (As) is a significant health threat for populations living in Southeast Asian megacities. The mineralogical composition of dust particles is the key factor that controls the retention and release of As. This study investigated the degree of metal(oid)s pollution (As, Ca, Fe, K, Ga, Rb, Sr, Ti, V, Y, and Zr) in road dust of Dhaka city, Bangladesh. Enrichment factor and geoaccumulation index suggested that the road dust was heavily enriched with As, which triggers a comprehensive investigation of its controlling mechanisms and potential health risks by combining physicochemical and mineralogical information with multivariate analysis and a simulated probabilistic risk estimation model. Alkaline road dust (pH1:5 ranges from 8.02 to 10.34) in Dhaka city was found to have significant enrichment of As. Dust alkalinity was possibly controlled by the presence of carbonate minerals, such as calcite. Quartz was identified as the dominant mineral phase followed by magnesium carbon arsenide (MgCAs2). Carbonate mineral driven alkaline pH conditions in road dust would potentially trigger the release and mobilization of As to the environment. However, organic complexation can stabilize As on particle surfaces. Monte Carlo simulation-based health risk forecast suggested that the probability of As associated cancer risk has greatly exceeded the threshold value of 1E-4 for adults and children, and children are more vulnerable than adults. According to sensitivity analysis, the concentration of As and exposure duration (ED) posed the most significant impact (>58%) on risk estimation.


Assuntos
Arsênio , Metais Pesados , Adulto , Bangladesh , Criança , Cidades , Poeira/análise , Monitoramento Ambiental , Humanos , Metais Pesados/análise , Medição de Risco
2.
Artigo em Inglês | MEDLINE | ID: mdl-34769612

RESUMO

In low- and middle-income countries, most latrines are not accessible to young children. We explored how to modify existing pit latrines to make them child friendly. We conducted four focus group discussions with mothers to explore barriers to child latrine use. We then enrolled 20 households with a child aged 3-7 years old to test six enabling technologies developed based on the identified barriers. Two to three weeks after installing the selected enabling technologies in each household, researchers conducted 19 in-depth interviews with caregivers to explore the technologies' acceptance and feasibility. Common barriers included the discomfort of squatting on a large pan, fear of darkness, and fear of a slippery floor. Of the potential solutions, a ring to stabilize the child while squatting in the latrine was preferred by children and was affordable and available. A wooden board with a smaller hole than the usual pan reduced fears of falling and helped eliminate discomfort but was inconvenient to handle and clean. A transparent fiberglass roof tile was affordable, available, increased visibility, and kept the latrine floor dry. In conclusion, the fiberglass roof tile and stability ring were two affordable and locally available technologies that facilitated latrine use by children aged 3-7 years.


Assuntos
Saneamento , Toaletes , Bangladesh , Criança , Pré-Escolar , Características da Família , Feminino , Grupos Focais , Humanos
3.
Sensors (Basel) ; 21(22)2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34833546

RESUMO

This paper shows the efficacy of a novel urban categorization framework based on deep learning, and a novel categorization method customized for cities in the global south. The proposed categorization method assesses urban space broadly on two dimensions-the states of urbanization and the architectural form of the units observed. This paper shows how the sixteen sub-categories can be used by state-of-the-art deep learning modules (fully convolutional network FCN-8, U-Net, and DeepLabv3+) to categorize formal and informal urban areas in seven urban cities in the developing world-Dhaka, Nairobi, Jakarta, Guangzhou, Mumbai, Cairo, and Lima. Firstly, an expert visually annotated and categorized 50 × 50 km Google Earth images of the cities. Each urban space was divided into four socioeconomic categories: (1) highly informal area; (2) moderately informal area; (3) moderately formal area, and (4) highly formal area. Then, three models mentioned above were used to categorize urban spaces. Image encompassing 70% of the urban space was used to train the models, and the remaining 30% was used for testing and validation of each city. The DeepLabv3+ model can segment the test part with an average accuracy of 90.0% for Dhaka, 91.5% for Nairobi, 94.75% for Jakarta, 82.0% for Guangzhou city, 94.25% for Mumbai, 91.75% for Cairo, and 96.75% for Lima. These results are the best for the DeepLabv3+ model among all. Thus, DeepLabv3+ shows an overall high accuracy level for most of the measuring parameters for all cities, making it highly scalable, readily usable to understand the cities' current conditions, forecast land use growth, and other computational modeling tasks. Therefore, the proposed categorization method is also suited for real-time socioeconomic comparative analysis among cities, making it an essential tool for the policymakers to plan future sustainable urban spaces.


Assuntos
Aprendizado Profundo , Bangladesh , Cidades , Quênia , Urbanização
4.
Zootaxa ; 5027(2): 211-230, 2021 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-34811234

RESUMO

To evaluate the species diversity and strengthen the taxonomic identification of elasmobranchs in the Bay of Bengal, Bangladesh, a study was conducted in the southeast coastal region between January 2016 and March 2018. Using morphological and genetic identification techniques, this study presents 22 species from the region. Thirteen of these are new records. The new records consist of eight species from the family Dasyatidae, and one each from Mobulidae, Rhinobatidae, Narcinidae, Hemiscylliidae and Triakidae. Furthermore, four occurrences are first verified reports, and five are potential new records requiring further taxonomic investigation.


Assuntos
Elasmobrânquios , Rajidae , Animais , Bangladesh , Baías
5.
JAMA Netw Open ; 4(11): e2132777, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34779849

RESUMO

Importance: A slow or incomplete civil registry makes it impossible to determine excess mortality due to COVID-19 and difficult to inform policy. Objective: To quantify the association of the COVID-19 pandemic with excess mortality and household income in rural Bangladesh in 2020. Design, Setting, and Participants: This repeated survey study is based on an in-person census followed by 2 rounds of telephone calls. Data were collected from a sample of 135 villages within a densely populated 350-km2 rural area of Bangladesh. Household data were obtained first in person and subsequently over the telephone. For the analysis, mortality data were stratified by month, age, sex, and household education. Mortality rates were modeled by bayesian multilevel regression, and the strata were aggregated to the population by poststratification. Data analysis was performed from February to April 2021. Exposures: Date and cause of any changes in household composition, as well as changes in income and food availability. Main Outcomes and Measures: Mortality rates were compared for 2019 and 2020, both without adjustment and after adjustment for nonresponse and differences in demographic variables between surveys. Income and food availability reported for January, May, and November 2020 were also compared. Results: Enumerators collected data from an initial 16 054 households in January 2020; 14 551 households (91%) responded when contacted again by telephone in May 2020, and 11 933 households (74%)responded when reached again over the telephone in November 2020, for a total of 58 806 individuals (29 726 female participants [50.5%]; mean [SD] age, 26.4 [19.8] years). A total of 276 deaths were reported between February and the end of October 2020 for the subset of the population that could be contacted twice over the telephone, slightly below the 289 deaths reported for the same population over the same period in 2019. After adjustment for survey nonresponse and poststratification, 2020 mortality changed by -8% (95% CI, -21% to 7%) compared with an annualized mortality of 6.1 deaths per 1000 individuals in 2019. However, in May 2020, salaried primary income earners reported a 40% decrease in monthly income (from 17 485 to 10 835 Bangladeshi Taka), and self-employed earners reported a 60% decrease in monthly income (23 083 to 8521 Bangladeshi Taka), with only a small recovery observed by November 2020. Conclusions and Relevance: In this study of households in rural Bangladesh, all-cause mortality was lower in 2020 compared with 2019. Restrictions imposed by the government may have limited the scale of the COVID-19 pandemic in rural areas, although economic data suggest that these restrictions need to be accompanied by expanded welfare programs.


Assuntos
COVID-19 , Causas de Morte , Características da Família , Renda , Pandemias , População Rural , Adolescente , Adulto , Bangladesh , Teorema de Bayes , COVID-19/mortalidade , Criança , Escolaridade , Emprego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Fatores Socioeconômicos , Adulto Jovem
6.
J Infect Dev Ctries ; 15(10): 1388-1395, 2021 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-34780360

RESUMO

INTRODUCTION: Immunization, as a process of fighting against the COVID-19, has gained important research appeal, but very limited endeavor has been paid for vaccine behavioral studies in underdeveloped and developing countries. This study explores the vaccine demand, hesitancy, and nationalism as well as vaccine acceptance and domestic vaccine preference among young adults in Bangladesh. METHODOLOGY: This quantitative study followed the snowball sampling technique and collected responses from 1,018 individuals from various social media platforms. The analysis covered both descriptive and inferential statistics including chi-square, F-statistic, and logistic regression. RESULTS: The findings of the fully-adjusted regression model suggest that the individuals who had more vaccine demand were 3.29 times (95% confidence interval = 2.39-4.54; p < 0.001) higher to accept vaccine compared to those who had no vaccine demand. Conversely, vaccine hesitancy was negatively associated with vaccine acceptance. Here, the odds ratio was found 0.70 (95% confidence interval = 0.62-0.80; p < 0.001), which means that those who had higher vaccine hesitancy were about 30% less likely to accept vaccines than those who had no hesitancy. In addition, the persons who had vaccine nationalism were 1.75 times (95% confidence interval = 1.62-1.88; p < 0.001) more prone to prefer domestic vaccine. CONCLUSIONS: This study suggests that policymakers may take initiatives for making people aware and knowledgeable about the severity and vulnerability to specific health threats. In this concern, perception and efficacy-increasing programs may take part in increasing protection motivation behaviors like vaccine acceptance and (domestic) vaccine preference.


Assuntos
Atitude Frente a Saúde , Vacinas contra COVID-19/administração & dosagem , Conhecimentos, Atitudes e Prática em Saúde , Motivação , Aceitação pelo Paciente de Cuidados de Saúde , Vacinação/psicologia , Adolescente , Bangladesh , Estudos Transversais , Feminino , Humanos , Masculino , População Rural/estatística & dados numéricos , SARS-CoV-2/patogenicidade , Inquéritos e Questionários , População Urbana/estatística & dados numéricos , Recusa de Vacinação/psicologia , Adulto Jovem
7.
Sci Rep ; 11(1): 21342, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34725409

RESUMO

Community-wide lockdowns in response to COVID-19 influenced many families, but the developmental cascade for children with autism spectrum disorder (ASD) may be especially detrimental. Our objective was to evaluate behavioral patterns of risk and resilience for children with ASD across parent-report assessments before (from November 2019 to February 2020), during (March 2020 to May 2020), and after (June 2020 to November 2020) an extended COVID-19 lockdown. In 2020, our study Mobile-based care for children with ASD using remote experience sampling method (mCARE) was inactive data collection before COVID-19 emerged as a health crisis in Bangladesh. Here we deployed "Cohort Studies", where we had in total 300 children with ASD (150 test group and 150 control group) to collect behavioral data. Our data collection continued through an extended COVID-19 lockdown and captured parent reports of 30 different behavioral parameters (e.g., self-injurious behaviors, aggression, sleep problems, daily living skills, and communication) across 150 children with ASD (test group). Based on the children's condition, 4-6 behavioral parameters were assessed through the study. A total of 56,290 behavioral data points was collected (an average of 152.19 per week) from parent cell phones using the mCARE platform. Children and their families were exposed to an extended COVID-19 lockdown. The main outcomes used for this study were generated from parent reports child behaviors within the mCARE platform. Behaviors included of child social skills, communication use, problematic behaviors, sensory sensitivities, daily living, and play. COVID-19 lockdowns for children with autism and their families are not universally negative but supports in the areas of "Problematic Behavior" could serve to mitigate future risk.


Assuntos
Transtorno do Espectro Autista/psicologia , COVID-19/prevenção & controle , Uso do Telefone Celular , Comportamento Infantil/psicologia , Cuidado da Criança/métodos , Quarentena/psicologia , SARS-CoV-2 , Atividades Cotidianas , Agressão , Transtorno do Espectro Autista/epidemiologia , Bangladesh/epidemiologia , COVID-19/epidemiologia , COVID-19/virologia , Criança , Pré-Escolar , Estudos de Coortes , Comunicação , Feminino , Humanos , Masculino , Comportamento Autodestrutivo/psicologia , Sono , Habilidades Sociais
8.
BMC Res Notes ; 14(1): 422, 2021 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-34814930

RESUMO

OBJECTIVES: Gold standard cause of death data is critically important to improve verbal autopsy (VA) methods in diagnosing cause of death where civil and vital registration systems are inadequate or poor. As part of a three-country research study-Improving Methods to Measure Comparable Mortality by Cause (IMMCMC) study-data were collected on clinicopathological criteria-based gold standard cause of death from hospital record reviews with matched VAs. The purpose of this data note is to make accessible a de-identified format of these gold standard VAs for interested researchers to improve the diagnostic accuracy of VA methods. DATA DESCRIPTION: The study was conducted between 2011 and 2014 in the Philippines, Bangladesh, and Papua New Guinea. Gold standard diagnoses of underlying causes of death for deaths occurring in hospital were matched to VAs conducted using a standardized VA questionnaire developed by the Population Health Metrics Consortium. 3512 deaths were collected in total, comprised of 2491 adults (12 years and older), 320 children (28 days to 12 years), and 702 neonates (0-27 days).


Assuntos
Autopsia , Adulto , Bangladesh , Causas de Morte , Criança , Humanos , Recém-Nascido , Filipinas , Inquéritos e Questionários
9.
BMC Infect Dis ; 21(1): 1139, 2021 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-34743683

RESUMO

BACKGROUND: The alarming rise in multi-drug resistant (MDR) zoonotic pathogens, including Campylobacter spp., has been threatening the health sector globally. In Bangladesh, despite rapid growth in poultry sector little is known about the potential risks of zoonotic pathogens in homestead duck flocks. The aim of this study was to understand the occurrence, species diversity, and multi-drug resistance in Campylobacter spp., and identify the associated risk factors in duck farms in Bangladesh. METHODS: The study involved 20 duck farms at 6 sub-districts of Mymensingh, Bangladesh. Monthly occurrence of Campylobacter spp. in potential sources at the farms during February-September, 2018, was detected by culture and PCR-based methods. Campylobacter isolates were examined for resistance to different antimicrobials. Risk factors, concerning climatic and environmental disposition, farm management, and anthropogenic practices, of Campylobacter infection were estimated by participatory epidemiological tools. RESULTS: Occurrence of Campylobacter spp. was detected in overall 36.90% (155/420) samples, more frequently in drinking water (60%, 30/50), followed by cloacal swab (37.50%, 75/200), egg surface swab (35%, 35/100) and soil of the duck resting places (30%, 15/50) but was not detected in feed samples (n = 20). PCR assays distinguished the majority (61.30%, 95/155) of the isolates as C. coli, while the rest (38.70%, 60/155) were C. jejuni. Notably, 41.7% (25/60) and 31.6% (30/95) strains of C. jejuni and C. coli, respectively, were observed to be MDR. The dynamics of Campylobacter spp., distinctly showing higher abundance during summer and late-monsoon, correlated significantly with temperature, humidity, and rainfall, while sunshine hours had a negative influence. Anthropogenic management-related factors, including, inadequate hygiene practices, use of untreated river water, wet duck shed, flock age (1-6 months), and unscrupulous use of antimicrobials were identified to enhance the risk of MDR Campylobacter infection. CONCLUSION: The present study clearly demonstrates that duck farms contribute to the enhanced occurrence and spread of potentially pathogenic and MDR C. coli and C. jejuni strains and the bacterial dynamics are governed by a combined interaction of environmental and anthropogenic factors. A long-term holistic research at the environment-animal-human interface would be integral to divulge health risk reduction approaches tackling the spread of Campylobacter spp. from duck farms.


Assuntos
Infecções por Campylobacter , Campylobacter coli , Campylobacter jejuni , Campylobacter , Doenças das Aves Domésticas , Animais , Bangladesh/epidemiologia , Campylobacter/genética , Infecções por Campylobacter/epidemiologia , Infecções por Campylobacter/veterinária , Galinhas , Resistência a Múltiplos Medicamentos , Patos , Fazendas , Humanos , Lactente , Doenças das Aves Domésticas/epidemiologia , Fatores de Risco
10.
Front Public Health ; 9: 628931, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34746068

RESUMO

Background: To develop an effective countermeasure and determine our susceptibilities to the outbreak of COVID-19 is challenging for a densely populated developing country like Bangladesh and a systematic review of the disease on a continuous basis is necessary. Methods: Publicly available and globally acclaimed datasets (4 March 2020-30 September 2020) from IEDCR, Bangladesh, JHU, and ECDC database are used for this study. Visual exploratory data analysis is used and we fitted a polynomial model for the number of deaths. A comparison of Bangladesh scenario over different time points as well as with global perspectives is made. Results: In Bangladesh, the number of active cases had decreased, after reaching a peak, with a constant pattern of death rate at from July to the end of September, 2020. Seventy-one percent of the cases and 77% of the deceased were males. People aged between 21 and 40 years were most vulnerable to the coronavirus and most of the fatalities (51.49%) were in the 60+ population. A strong positive correlation (0.93) between the number of tests and confirmed cases and a constant incidence rate (around 21%) from June 1 to August 31, 2020 was observed. The case fatality ratio was between 1 and 2. The number of cases and the number of deaths in Bangladesh were much lower compared to other countries. Conclusions: This study will help to understand the patterns of spread and transition in Bangladesh, possible measures, effectiveness of the preparedness, implementation gaps, and their consequences to gather vital information and prevent future pandemics.


Assuntos
COVID-19 , Pandemias , Adulto , Bangladesh/epidemiologia , Surtos de Doenças/prevenção & controle , Humanos , Masculino , Pandemias/prevenção & controle , SARS-CoV-2 , Adulto Jovem
11.
Geospat Health ; 16(2)2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34726034

RESUMO

Every year Bangladesh faces enormous damages due to flooding. Facing these damages the Government adopts various recovery approaches. However, the psychological dimension of any disaster is generally overlooked in disaster management. Researchers have found that the spatial distribution of post-disaster mental health can help the authorities to apply recovery procedures where they are most needed. For this research, Posttraumatic Stress Checklist (PCL-5), Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to estimate posttraumatic stress, major depressive disorder and anxiety following three episodes of severe floods in 2017 that affected at least 8 million people. To better understand the spatial pattern of psychological vulnerability and reach a comprehensive scenario of post-disaster mental health, Moran's I was applied for spatial autocorrelation and Pearson's correlation and regression analysis for a study of the relationship between the psychological aspects. It was found that psychological vulnerability showed a spatial clustering pattern and that there was a strong positive linear relationship among psychological aspects in the study area. This research might help to adopt disaster management policies that consider the psychological dimension and spatial distribution of various psychological aspects to identify areas characterized by high vulnerability and risk so that they can be reached without delay.


Assuntos
Transtorno Depressivo Maior , Desastres , Transtornos de Estresse Pós-Traumáticos , Bangladesh/epidemiologia , Inundações , Humanos , Saúde Mental , Transtornos de Estresse Pós-Traumáticos/epidemiologia
12.
J Emerg Manag ; 19(7): 165-176, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34723377

RESUMO

The main purpose of this study was to explore people's perception on using social media for crowdsourcing both information and support as part of COVID-19 response. Also, the study tried to find the possibility of social media contributions to disaster management activities. A systematic research survey has been conducted using a quantitative research approach with a sample of 437 respondents. The results indicated that social media played an important role in crowdsourcing information and support during the COVID-19 pandemic. People regularly depended on social media platforms to get updated information and to contribute to different disaster management response activities. According to the findings, social media can greatly contribute to all the phases of disaster management. Use of social media can be more comprehensive for managing disasters in future.


Assuntos
COVID-19 , Desastres , Mídias Sociais , Bangladesh , Humanos , Pandemias , SARS-CoV-2
13.
Artigo em Inglês | MEDLINE | ID: mdl-34770105

RESUMO

Atopic dermatitis (AD) is the foremost non-fatal skin-related disease that affects all age groups. Despite the growing prevalence of AD in low- and middle-income countries, its physiological consequences remain overlooked in countries like Bangladesh. Therefore, we aim to assess and characterize the influence of AD on the health-related quality of life (HRQoL) in Bangladeshi patients. A cross-sectional study comprising 184 eligible adults (83 men and 101 women; mean age, 33.46 ± 15.44 years) was conducted at the dermatology outpatient department of Shaheed Suhrawardy Medical College Hospital (a tertiary hospital in Dhaka, Bangladesh). AD was determined using the UK Working Party criteria. A structured questionnaire, Eczema Area and Severity Index (EASI), and Dermatology Life Quality Index (DLQI) were administered to obtain information on patient characteristics, AD severity, and HRQoL. The mean DLQI score for the entire sample was 11.29 ± 5.27 (range, 1-26), and 51.60% reported the disease greatly affected their lives. Bivariate analysis revealed significant differences in self-rated health measures of DLQI scores in terms of self-reported AD severity, overall health, and the EASI. In multivariable regression models adjusted for patient characteristics, the self-perceived severe AD group reported significantly higher DLQI scores (coefficient = 2.72; 95% confidence interval (CI) = 0.38-5.05; p = 0.022) than the mild group. Concurrently, we observed a substantial increase in the DLQI scores among patients with moderate and severe EASI scores (coefficient = 1.96, 95% CI = 0.08-3.92, p < 0.05 and coefficient = 4.35, 95% CI = 1.98-6.72, p < 0.001, respectively) than in those with mild EASI scores, suggesting that HRQoL was markedly influenced by greater AD severity. These findings highlight the need for a more patient-centric approach to the management of AD in order to alleviate patient suffering and, thereby, improve HRQoL.


Assuntos
Dermatite Atópica , Eczema , Adolescente , Adulto , Bangladesh/epidemiologia , Estudos Transversais , Dermatite Atópica/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Índice de Gravidade de Doença , Centros de Atenção Terciária , Adulto Jovem
14.
J Occup Health ; 63(1): e12289, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34751983

RESUMO

OBJECTIVES: Despite previous research aimed at identifying factors linked to musculoskeletal health issues, there was no evidence about the relationship between road traffic delays (RTDs) and musculoskeletal health in sedentary employees. As a result, the aim of our research was to understand such a correlation among bank employees in Dhaka, Bangladesh. METHODS: A cross-sectional analysis was conducted with bank employees who worked in sedentary settings. The Eriksen subjective health complaints scale was used to measure the eight items of musculoskeletal health complaints (MHCs), and RTDs were measured using principal component analysis using variables commute time, distance, and traffic congestion experience to work. The association between RTDs and MHCs was identified using a multilevel model after adjusting potential confounders. RESULTS: A total of 628 employees (mean[SD] age, 36.1[7.0] years; 254[40.5%] women) participated in the study. Among the employees, the one-month prevalence of MHCs was 57.2%. The highest prevalence of MHCs was low-back pain (36.6%), followed by neck pain (22.9%) and upper-back pain (21.2%). Also, 136(21.7%) employees reported long-RTDs in commuting workplace and 81% of them had MHCs. The multilevel analysis identified that long-RTDs had a significant relationship with MHCs (adjusted odds ratio, AOR = 10.20, 95%CI = 5.41-16.91). Private transportation commuters reported 70% reduced odds of MHCs (AOR = 0.30, 95%CI = 0.15-0.59) and walking or bicycling commuters had 84% fewer MHCs (AOR = 0.16, 95%CI = 0.10-0.28) compared to public bus commuters. CONCLUSIONS: Sedentary employees with long-RTDs reported increased MHCs, emphasizing the importance of including musculoskeletal exercise in office facilities. Findings of this study also highlight the need for a sound public transportation system in Dhaka city.


Assuntos
Automóveis , Doenças Musculoesqueléticas , Comportamento Sedentário , Viagem , Local de Trabalho , Adolescente , Adulto , Bangladesh , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/epidemiologia , Adulto Jovem
16.
Health Syst Reform ; 7(1): e1991550, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780314

RESUMO

The COVID-19 pandemic poses an extraordinary threat to the health, safety, and freedom of temporary foreign workers (TFWs). Highly effective vaccines against COVID-19 may hold an outsized benefit for TFWs, particularly those living in congregate settings where protective measures such as social distancing are not possible. While some studies of migrant destination countries have included migrants, no study to date has sought to understand variations in vaccine hesitancy among individuals in a single migrant source population across different destinations. Such a design is critical for understanding how the context of immigration affects levels of hesitancy among migrants from similar conditions of origin. This observational study leverages longitudinal data from an ongoing monthly rapid-response survey of TFWs from Bangladesh (n = 360). Overall vaccine hesitancy was 25%, with significant variation by host country. Multivariate analyses confirmed that immigration system factors and threat perception are the strongest predictors of COVID-19 vaccine hesitancy for TFWs. The predicted probability of hesitancy for an undocumented TFW was 0.405, while the predicted probability for those with valid visas was 0.207 (p < .01). The probability of being hesitant for TFWs who were worried about getting COVID-19 was 0.129 compared to 0.305 (p < .01) for those who were not worried. Results reveal low vaccine hesitancy among TFWs from Bangladesh with differences in location, undocumented status, COVID-19 threat perception, and level of worry about side effects. There could be relatively high returns for targeting vaccine access and distribution to TFWs because of their high levels of vaccine acceptance.


Assuntos
COVID-19 , Vacinas , Bangladesh , Vacinas contra COVID-19 , Humanos , Pandemias , SARS-CoV-2 , Vacinação , Vacinas/efeitos adversos
17.
BMC Health Serv Res ; 21(1): 1234, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34775968

RESUMO

BACKGROUND: Undernourished children in low- and middle-income countries remain at elevated risk of death following hospital discharge, even when treated during hospitalisation using World Health Organisation recommended guidelines. The role of community health workers (CHWs) in supporting post-discharge recovery to improve outcomes has not been adequately explored. METHODS: This paper draws on qualitative research conducted as part of the Childhood Acute Illnesses and Nutrition (CHAIN) Network in Bangladesh and Kenya. We interviewed family members of 64 acutely ill children admitted across four hospitals (a rural and urban hospital in each country). 27 children had severe wasting or kwashiorkor on admission. Family members were interviewed in their homes soon after discharge, and up to three further times over the following six to fourteen months. These data were supplemented by observations in facilities and homes, key informant interviews with CHWs and policy makers, and a review of relevant guidelines. RESULTS: Guidelines suggest that CHWs could play a role in supporting recovery of undernourished children post-discharge, but the mechanisms to link CHWs into post-discharge support processes are not specified. Few families we interviewed reported any interactions with CHWs post-discharge, especially in Kenya, despite our data suggesting that opportunities for CHWs to assist families post-discharge include providing context sensitive information and education, identification of danger signs, and supporting linkages with community-based services and interventions. Although CHWs are generally present in communities, challenges they face in conducting their roles include unmanageable workloads, few incentives, lack of equipment and supplies and inadequate support from supervisors and some community members. CONCLUSION: A multi-pronged approach before or on discharge is needed to strengthen linkages between CHWs and children vulnerable to poor outcomes, supported by clear guidance. To encourage scale-ability and cost-effectiveness of interventions, the most vulnerable, high-risk children, should be targeted, including undernourished children. Intervention designs must also take into account existing health worker shortages and training levels, including for CHWs, and how any new tasks or personnel are incorporated into hospital and broader health system hierarchies and systems. Any such interventions will need to be evaluated in carefully designed studies, including tracking for unintended consequences.


Assuntos
Agentes Comunitários de Saúde , Alta do Paciente , Assistência ao Convalescente , Bangladesh , Criança , Hospitais , Humanos , Quênia , Pesquisa Qualitativa
18.
Sex Reprod Health Matters ; 29(1): 1991116, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34749591

RESUMO

The rapid growth of Bangladesh's ready-made garment sector has transformed the country's economy while also employing a predominantly female workforce. Companies have begun collaborating with NGOs to provide health messages to and expand health services for workers. This study evaluates the effect of the Health Enables Return (HER) health model's approach of using peer health educators to deliver health messages and increased availability of health products. Using repeated cross-sectional data from female workers in HERhealth and comparison factories between May 2015 and March 2017, baseline (n = 1704) and endline (n = 1503) samples were matched on eight characteristics and then difference-in-differences estimations were used to determine the effect of the HERhealth model on knowledge and behaviours. The average changes over time in knowledge and behaviours were statistically different between the HERhealth and comparison factories. Knowledge of when a woman is at higher risk for pregnancy during her menstrual cycle increased from baseline to endline in both groups but was 12 percentage points greater in the HERhealth factories than in the comparison. An increase in family planning use among ever-married women was observed in the HERhealth factories but decreased in the comparison factories leading to a 12 percentage point difference-in-differences. The greatest effect of the HERhealth model was observed on women's use of sanitary products for menstrual management which significantly increased in both groups, but the increase was 35% greater in the HERhealth factories. The HERhealth model is effective in increasing knowledge and in improving health behaviours when health products are available in factory infirmaries.


Assuntos
Serviços de Planejamento Familiar , Menstruação , Bangladesh , Estudos Transversais , Feminino , Humanos , Gravidez
19.
Glob Health Res Policy ; 6(1): 39, 2021 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-34635184

RESUMO

BACKGROUND: Access to and utilization of health services have remained major challenges for people living in low- and middle-income countries, especially for those living in impaired public health environment such as refugee camps and temporary settlements. This study presents health problems and utilization of health services among Forcibly Displaced Myanmar Nationals (FDMNs) living in the southern part of Bangladesh. METHODS: A mixed-method (quantitative and qualitative) approach was used. Altogether 999 household surveys were conducted among the FDMNs living in makeshift/temporary settlements and host communities. We used a grounded theory approach involving in-depth interviews (IDIs), focus group discussions (FGDs), and key informant interviews (KIIs) including 24 IDIs, 10 FGDs, and 9 KIIs. The quantitative data were analysed with STATA. RESULTS: The common health problems among the women were pregnancy and childbirth-related complications and violence against women. Among the children, fever, diarrhoea, common cold and malaria were frequently observed health problems. Poor general health, HIV/AIDS, insecurity, discrimination, and lack of employment opportunity were common problems for men. Further, 61.2% women received two or more antenatal care (ANC) visits during their last pregnancy, while 28.9% did not receive any ANC visit. The majority of the last births took place at home (85.2%) assisted by traditional birth attendants (78.9%), a third (29.3%) of whom suffered pregnancy- and childbirth-related complications. The clinics run by the non-governmental organizations (NGOs) (76.9%) and private health facilities (86.0%) were the most accessible places for seeking healthcare for the FDMNs living in the makeshift settlements. All participants heard about HIV/AIDS. 78.0% of them were unaware about the means of HIV transmission, and family planning methods were poorly used (45.2%). CONCLUSIONS: Overall, the health of FDMNs living in the southern part of Bangladesh is poor and they have inadequate access to and utilization of health services to address the health problems and associated factors. Existing essential health and nutrition support programs need to be culturally appropriate and adopt an integrated approach to encourage men's participation to improve utilization of health and family planning services, address issues of gender inequity, gender-based violence, and improve women empowerment and overall health outcomes.


Assuntos
Refugiados , Bangladesh/epidemiologia , Criança , Feminino , Humanos , Masculino , Homens , Mianmar/epidemiologia , Gravidez , Cuidado Pré-Natal
20.
Glob Health Sci Pract ; 9(3): 532-547, 2021 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-34593580

RESUMO

INTRODUCTION: Maintaining access to antimicrobials while preventing misuse is essential to combating the threat of antimicrobial resistance (AMR). The study objectives are to propose a framework of 16 indicators that can be used at the national level to assess the capacity to ensure access and curtail inappropriate use and to profile the antimicrobial supply chain for Bangladesh. METHODS: Using a framework based on a rational construct, we assessed the antimicrobial supply chain of Bangladesh, with a focus on key players and products using a scoping review to obtain and describe information on 16 indicators. With players, we mapped linkages, manufacturers' production capacity, and ownership, among others, and demand point characteristics-pharmacy and pharmacist density, pharmacy/medicine outlets dispersion, veterinary clinic/hospitals, veterinarians' density, product quality, and regulation. We assessed product characteristics including listing on the World Health Organization (WHO) Model Essential Medicines List (EML) and WHO Access, Watch, and Reserve (AWaRe) classification of the major (top 10) antibiotics for human use; the proportion of medically important antimicrobials (MIAs) in veterinary use; and pricing. Production capacity and price controls were used to assess access and listing on the WHO EML, AWaRe/MIA classification, and a calculated pharmacy-to-pharmacist ratio to assess use. RESULTS: Bangladesh has a high (98%) local antibiotic production capacity with pricing controls indicating the ability to ensure access. The presence of a high proportion of medicine outlets not under the control of pharmacists (4:1) and the high percentages of WHO Watch (54%) and MIAs (90%) of the major antibiotics are indicators of possible misuse. DISCUSSION: Most of the data used in the framework were publicly available. Bangladesh has the capacity to ensure access but needs to strengthen its ability to regulate the quality of antimicrobials and prevent their inappropriate use through antimicrobial stewardship at the community (medicine outlet) levels to check AMR. There may also be a need for more regulations on licensing of MIAs.


Assuntos
Anti-Infecciosos , Gestão de Antimicrobianos , Antibacterianos/uso terapêutico , Bangladesh , Hospitais , Humanos
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