Association of household fuel use with hypertension and blood pressure among adult women in rural Bangladesh: A cross-sectional study.

OBJECTIVES: This study aimed to determine the association of household fuel use with hypertension, systolic blood pressure (SBP), and diastolic blood pressure (DBP) among adult women. METHODS: A cross-sectional survey through face-to-face interviews and blood pressure (BP) measurement were conducted among 2182 randomly selected women (1236 solid fuel users and 946 clean fuel users) in rural areas of Bangladesh. RESULTS: Overall, 21% of women were hypertensive. Mean SBP and DBP for the study population were 121.27 mmHg (SD ± 15.43) and 76.18 mmHg (SD ± 12.00), respectively. Hypertension was found significantly (p = .006) higher among solid fuel users (23%) compared to clean fuel users (18%). Women using solid fuels have a 35% higher chance (AOR: 1.35, CI: 1.10-1.80) of having hypertension and have more than twice the risk of developing elevated SBP (AOR: 2.01, CI: 1.55-2.95) relative to women using clean fuels for their daily cooking. The probability of hypertension (AOR: 1.39, CI: 1.17-1.60) and elevated SBP (AOR: 1.35, CI: 1.10-1.61) increased significantly for every hour of fuel use. CONCLUSIONS: Using clean fuel, reducing the duration of daily cooking time, and improved cooking facilities may help minimizing hypertension and ultimately cardiovascular disease risk among women.

Inter- and Intra-Individual Variability of Personal Health Risk of Combined Particle and Gaseous Pollutants across Selected Urban Microenvironments.

Exposure surrogates, such as air quality measured at a fixed-site monitor (FSM) or residence, are typically used for health estimates. However, people spend various amounts of time in different microenvironments, including the home, office, outdoors and in transit, where they are exposed to different magnitudes of particle and gaseous air pollutants. Health risks caused by air pollution exposure differ among individuals due to differences in activity, microenvironmental concentration, as well as the toxicity of pollutants. We evaluated individual and combined added health risks (AR) of exposure to PM2.5, NO2, and O3 for 21 participants in their daily life based on real-world personal exposure measurements. Exposure errors from using surrogates were quantified. Inter- and intra-individual variability in health risks and key contributors in variations were investigated using linear mixed-effects models and correlation analysis, respectively. Substantial errors were found between personal exposure concentrations and ambient concentrations when using air quality measurements at either FSM or the residence location. The mean exposure errors based on the measurements taken at either the FSM or residence as exposure surrogates was higher for NO2 than PM2.5, because of the larger spatial variability in NO2 concentrations in urban areas. The daily time-integrated AR for the combined PM2.5, NO2, and O3 (TIARcombine) ranged by a factor of 2.5 among participants and by a factor up to 2.5 for a given person across measured days. Inter- and intra-individual variability in TIARcombine is almost equally important. Several factors were identified to be significantly correlated with daily TIARcombine, with the top five factors, including PM2.5, NO2 and O3 concentrations at 'home indoor', O3 concentrations at 'office indoor' and ambient PM2.5 concentrations. The results on the contributors of variability in the daily TIARcombine could help in targeting interventions to reduce daily health damage related to air pollutants.

Physical distancing implementation, ambient temperature and Covid-19 containment: An observational study in the United States.

Governments may relax physical distancing interventions for coronavirus disease 2019 (Covid-19) containment in warm seasons/areas to prevent economic contractions. However, it is not clear whether higher temperature may offset the transmission risk posed by this relaxation. This study aims to investigate the associations of the effective reproductive number (Rt) of Covid-19 with ambient temperature and the implementation of physical distancing interventions in the United States (US). This study included 50 states and one territory of the US with 4,532,650 confirmed cases between 29 January and 31 July 2020. We used an interrupted time-series model with a state-level random intercept for data analysis. An interaction term of 'physical distancing×temperature' was included to examine their interactions. Stratified analyses by temperature and physical distancing implementation were also performed to analyse the modifying effects. The overall median (interquartile range) Rt was 1.2 (1.0-2.3). The implementation of physical distancing was associated with a 12% decrease in the risk of Rt (relative risk [RR]: 0.88, 95% confident interval [CI]: 0.86-0.89), and each 5 °C increase in temperature was associated with a 2% decrease (RR: 0.98, 95%CI: 0.97-0.98). We observed a statistically significant interaction between temperature and physical distancing implementation, but all the RRs were small (close to one). The containing effects of high temperature were attenuated by 5.1% when physical distancing was implemented. The association of COVID-19 Rt with physical distancing implementation was more stable (0.88 vs. 0.89 in days when temperature was low and high, respectively). Increased temperature did not offset the risk of Covid-19 Rt posed by the relaxation of physical distancing implementation. Our study does not recommend relaxing the implementation of physical distancing interventions in warm seasons/areas.

Nutritional Status and Basic Hygiene Practices of Rural School Age Children of Savar Region, Dhaka, Bangladesh.

INTRODUCTION: School children in the developing countries are susceptible to nutrition related health problems due to demographic and socio-economic factors, as well as limited access to food. Since BMI is a common proxy measure used to evaluate nutritional status, the aim of this study was to investigate the BMI categories in school-aged children in Dhaka, Bangladesh. METHODS: A cross sectional study of 155 children, aged 6-12 years was conducted at Jahangirnagar University School in Dhaka, Bangladesh. The data collection was performed by in-person interviews and semi-structured questionnaires. Descriptive statistics, χ2 test, Fisher's exact test, and One-Way ANOVA test were performed to compare the variables based on BMI percentiles. Data were analyzed using the Microsoft Excel program (version 2010). RESULTS: Mean BMI of the students was 17.27 (SD=3.16). The prevalence of underweight and overweight/obesity was 11.0% and 25.8%, respectively. Categories of BMI percentiles were associated with birth order (p=0.026), personal hygiene practices (washing hands after coming home from outside (p<0.001) and before meal (p=0.045)), brushing teeth (p<0.001), the number of food items consumed daily (p<0.001), and mothers' occupation (p=0.006). In context of basic hygiene practice, 61.3 % of respondents washed hands after coming home from outside, and 93.5 % reported washing hands before the meals. CONCLUSIONS: This study revealed that more than one third of the students had abnormal BMI. BMI screening in rural schools needs to be recommended in early grades for all children.

Prevalence of Tobacco Smoking and Factors Associated with the Initiation of Smoking among University Students in Dhaka, Bangladesh.

INTROUDUCTION: Tobacco smoking is considered to be the key preventable risk factor for morbidity and mortality at the global level. The aim of this study was to determine the prevalence of tobacco smoking and factors associated with the initiation of smoking among university students in Dhaka, Bangladesh. METHODS: A cross-sectional survey study was conducted with 264 students of Jahangirnagar University, Dhaka, Bangladesh in 2015. A standard, self-administered questionnaire consisting of questions on socio-demographic variables, tobacco smoking status, family and peer tobacco smoking history, attitudes and beliefs about tobacco smoking, as well as knowledge about the negative health consequences of tobacco smoking was administered to participants. Data were analyzed using logistic regression models, chi square, and Fisher exact tests. RESULTS: The overall prevalence of tobacco smoking was 60.2%, where males smoked at higher rates than females (68.81% and 19.56%, respectively). The influence of friends was the most significant reason for initiating tobacco smoking (OR: 0.862; CI: 0.810-0.917). Perception regarding tobacco smoking was significantly related to continuing tobacco use. Logistic regression models identified that smoking-related attitudes, potential health problems, and family members dying from cardiovascular disease and cancer were significantly associated with tobacco smoking. CONCLUSION: The current tobacco smoking prevalence among university students in Bangladesh is over 60%. We suggest adopting WHO Framework Convention on Tobacco Control (FCTC) policies, especially for university students.