Urban-rural differences in the associated factors of severe under-5 child undernutrition based on the composite index of severe anthropometric failure (CISAF) in Bangladesh.

INTRODUCTION: Severe undernutrition among under-5 children is usually assessed using single or conventional indicators (i.e., severe stunting, severe wasting, and/or severe underweight). But these conventional indicators partly overlap, thus not providing a comprehensive estimate of the proportion of malnourished children in the population. Incorporating all these conventional nutritional indicators, the Composite Index of Severe Anthropometric Failure (CSIAF) provides six different undernutrition measurements and estimates the overall burden of severe undernutrition with a more comprehensive view. This study applied the CISAF indicators to investigate the prevalence of severe under-5 child undernutrition in Bangladesh and its associated socioeconomic factors in the rural-urban context. METHODS: This study extracted the children dataset from the 2017-18 Bangladesh Demographic Health Survey (BDHS), and the data of 7661 children aged under-5 were used for further analyses. CISAF was used to define severe undernutrition by aggregating conventional nutritional indicators. Bivariate analysis was applied to examine the proportional differences of variables between non-severe undernutrition and severe undernutrition group. The potential associated socioeconomic factors for severe undernutrition were identified using the adjusted model of logistic regression analysis. RESULTS: The overall prevalence of severe undernutrition measured by CISAF among the children under-5 was 11.0% in Bangladesh (rural 11.5% vs urban 9.6%). The significant associated socioeconomic factors of severe undernutrition in rural areas were children born with small birth weight (AOR: 2.84), children from poorest households (AOR: 2.44), and children aged < 36 months, and children of uneducated mothers (AOR: 2.15). Similarly, in urban areas, factors like- children with small birth weight (AOR: 3.99), children of uneducated parents (AOR: 2.34), poorest households (APR: 2.40), underweight mothers (AOR: 1.58), mothers without postnatal care (AOR: 2.13), and children's birth order ≥4 (AOR: 1.75), showed positive and significant association with severe under-5 undernutrition. CONCLUSION: Severe undernutrition among the under-5 children dominates in Bangladesh, especially in rural areas and the poorest urban families. More research should be conducted using such composite indices (like- CISAF) to depict the comprehensive scenario of severe undernutrition among the under-5 children and to address multi-sectoral intervening programs for eradicating severe child undernutrition.

Socio-demographic and injury-related factors contributing to activity limitations and participation restrictions in people with spinal cord injury in Bangladesh.

STUDY DESIGN: Cross-sectional study. OBJECTIVES: To identify socio-demographic and injury-related factors that contribute to activity limitations and participation restrictions in people with spinal cord injury (SCI) in Bangladesh. SETTING: Centre for the Rehabilitation of the Paralysed (CRP), Savar, Dhaka, Bangladesh. METHODS: This study involved 120 (83% men) participants with SCI; their median (interquartile range) age and injury duration were 34 (25-43) years and 5 (2-10) years, respectively. Data were collected from the follow-up records kept by the Community Based Rehabilitation (CBR) unit of CRP and a subsequent home visit that included interview-administered questions, questionnaires, and a neurological examination. The dependent variables were activity limitations and participation restrictions, assessed with the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0, scored 0-100; a high score indicates greater activity limitations and participation restrictions). Independent variables included socio-demographic factors (i.e., age, sex, marital status, educational level, monthly household income, employment status, and place of residence) and injury-related factors (i.e., injury duration, cause of injury, injury severity, and type of paralysis). Multivariable linear regression analyses were performed to identify the factors that independently contributed to activity limitations and participation restrictions. RESULTS: Three significant independent variables explained 20.7% of the variance in activity limitations and participation restrictions (WHODAS 2.0 score), in which tetraplegia was the strongest significant contributing factor, followed by rural residence and complete injury. CONCLUSIONS: This study would indicate that tetraplegia, complete injury, and residing in a rural area are the major contributions in limiting the activity and participation following SCI in Bangladesh.

Low maternal education and socio-economic status were associated with household food insecurity in children under five with diarrhoea in Bangladesh.

AIM: Household food insecurity (HFI) is insufficient access to nutritionally safe and adequate foods to meet the dietary needs for an active and healthy life. We examined the prevalence and determinants of HFI in Bangladeshi children under five with diarrhoea. METHODS: This study included 365 children (55% boys) who had diarrhoea in the two weeks before the 2011 Bangladesh Demographic Health Survey (BDHS-2011). The Household Food Insecurity Access Scale (HFIAS) was used to assess HFI and Pearson's chi-square test and binary logistic regression analysis were used to investigate the association between HFI and multilevel factors. RESULTS: The prevalence of HFI among children under five with diarrhoea in the two weeks prior to the BDHS-2011 survey was 48%. HFI was significantly higher among the children of uneducated mothers, who were two times more likely to experience HFI, with an adjusted odds ratio (OR) of 2.14 and children who were from the lowest socio-economic status families, who were more than seven times more likely to experience HFI, with an adjusted OR of 7.55. CONCLUSION: Low maternal education and low socio-economic status were significantly associated with HFI in Bangladeshi children under five with diarrhoea and public health campaigns should take this into account.

The prevalence and socio-demographic risk factors of coexistence of stunting, wasting, and underweight among children under five years in Bangladesh: a cross-sectional study.

BACKGROUND: Childhood stunting, wasting and underweight are significant public health challenges. There is a gap in knowledge of the coexistence of stunting, wasting, and underweight among children under five years (under-5) in Bangladesh. This study aims to (i) describe the prevalence of the coexistence of stunting, wasting, and underweight and ii) examine the risk factors for the coexistence of stunting, wasting, and underweight among children under-5 in Bangladesh. METHODS: This study included 6,610 and 7,357 under-5 children from Bangladesh Demographic Health Surveys (BDHS) 2014 and 2017/18, respectively. The associations between the coexistence of stunting, wasting, and underweight and independent variables were assessed using the Chi-square test of independence. The effects of associated independent variables were examined using negative binomial regression. RESULTS: The prevalence of coexistence of stunting, wasting, and underweight gradually declined from 5.2% in 2014 to 2.7% in 2017/18. Children born with low birth weight ((adjusted incidence rate ratios, aIRR) 2.31, 95% CI 1.64, 3.24)); children of age group 36-47 months (aIRR 2.26, 95% CI 1.67, 3.08); children from socio-economically poorest families (aIRR 2.02, 95% CI 1.36, 2.98); children of mothers with no formal education (aIRR 1.98, 95% CI 1.25, 3.15); and children of underweight mothers (aIRR 1.73, 95% CI 1.44, 2.08) were the most important risk factors. Further, lower incidence among children with the coexistence of stunting, wasting, and underweight was observed in the 2017-18 survey (aIRR 0.59, 95% CI 0.49, 0.70) compared to children in the 2014 survey. CONCLUSIONS: One out of thirty-five under-5 children was identified to have coexistence of stunting, wasting, and underweight in Bangladesh. The burden of coexistence of stunting, wasting, and underweight was disproportionate among children born with low birth weight, socio-economically poorest, a mother with no formal education, and underweight mothers, indicating the need for individual, household, and societal-level interventions to reduce the consequences of coexistence of stunting, wasting, and underweight.

We have the injury prevention exercise programme, but how well do youth follow it?

OBJECTIVES: Describe the exercise fidelity and utilisation fidelity of the Knee Control injury prevention exercise programme (IPEP) in youth floorball alongside an intervention RCT. DESIGN: Observation study METHODS: 20 floorball team training groups (12 male, 8 female, age 12-17 years) from the intervention arm of an RCT were included. The Knee Control IPEP was implemented at the beginning of the season. A research team member attended a team training session twice in the season (first and second half of 26 week season) with a total 31 training sessions observed. An IPEP specific exercise fidelity checklist was used to assess how the programme was used. RESULTS: Of 535 individual Knee Control exercises observed (76% of observations in males), 58% were performed correctly. Exercise fidelity was higher in females than in males (71% vs 54%, proportion difference 16%, 95% CI 7-25%, P=0.001). The full Knee Control IPEP (7 exercises x 3 sets) was completed only during 4 of 31 (13%) training sessions observed. The utilisation fidelity did not differ between sexes, and the mean number of completed exercises performed during the observations was 11 (SD 5). CONCLUSIONS: The exercise fidelity to an IPEP in youth floorball players was low, with only three out of five exercises performed according to instructions. Furthermore, only half of the IPEP exercises were executed on average. To make IPEPs effective in youth floorball and other similar team-ball sports, more work is needed to understand the reasons for low exercise and utilisation fidelity.

Does the addiction in online pornography affect the behavioral pattern of undergrad private university students in Bangladesh?

OBJECTIVES: Anecdotal reports from Bangladesh indicated that some young adults were becoming addicted to online pornography similar to how others become addicted to gambling, drugs, and alcohol. Such behaviors can have social, academic, and behavioral implications in this population. This study investigated the association between consumption of online pornography and sociobehavioral patterns among students from a private university in Bangladesh. METHODS: In total, 299 undergraduate students (70.6% male) at the First Capital University of Bangladesh were interviewed using a structured questionnaire. The questions included sociodemographic characteristics, online-based pornography consumption habits and sociobehavioral characteristics. Chi-square test and binary logistic regression analysis were performed to examine correlations between online pornography addiction and sociobehavioral factors such as socializing habits, nature of interactions, university attendance and study focus, sleeping habits, and consumption of main meals. RESULTS: The use of pornography was significantly higher among students who gathered late nights with their friends (58.4%, P < 0.001). Furthermore, those who frequently argue/fight with their friends (51.0%, P = 0.001) frequently fooled around with their friends (48.4%, P < 0.001) and those who did not go to bed on time (57.7%, P < 0.001) reported greater consumption of pornography. Students who fooled around with their friends and those did not go to bed on time were more than twice as likely to watch pornography than students who did not fool around, and those went to bed on time. CONCLUSION: The study provides the first overview of online pornography consumption. A significant proportion of male students consumed erotic materials online than females. Students who did not go to bed emerged to consume online pornography. Such behaviors can have negative impacts on studies education outcomes as well as wider social and moral impacts for students and the society as a whole. In this digital era, technology has invaded every aspect of our lives, with increasing access to the internet. Therefore, it is imperative to provide specifically designed pornography addiction education programs to educate students about the adverse effects of pornography. Furthermore, targeted treatment programs for sexual addiction, sexual abuse, and pornography abuse are needed to support the individuals who are addicted to pornography.

Socio-economic and nutritional determinants of low birth weight in India.

BACKGROUND: Low birth weight (LBW) is an important risk factor for childhood morbidity and mortality, consequently an important public health concern. AIM: This study aims to identify significant socio-economic and nutritional determinants associated with LBW in India. MATERIALS AND METHODS: Data from 2005 to 2006 National Family Health Survey-3 (NFHS-3) of India was analyzed. A total of 20,946 women (15-49 years) who gave birth at least once 5 years preceding the NFHS-3 were included in this study. Infant's LBW (<2500 grams) as outcome variable was examined in association with all independent predictors as infant's sex, maternal household wealth status, caste, age, education, body mass index (BMI), stature, anemia level, parity, inter-pregnancy interval, antenatal care received, and living place. RESULTS: Almost 20% of the infants were born with LBW. Mother's low education level, BMI <18.5, short stature (height <145 centimeters) and lack of antenatal visits (<4 visits) were significant predictors of LBW. Male gender has a protective effect against LBW. CONCLUSION: Maternal education, nutritional status and antenatal care received are key determinants that need to be addressed to reduce prevalence of LBW in India. Continue implementation of multifaceted health promotion interventions are needed to address these factors effectively.