Patterns of eating behaviors, physical activity, and lifestyle modifications among Bangladeshi adolescents during the COVID-19 pandemic.

BACKGROUND: Several safety measures like movement restrictions, closure of educational institutions, and social distancing measures continue over the world including Bangladesh during the COVID-19 pandemic. This study aimed to examine the patterns of eating behaviors, physical activity, and lifestyle modifications among adolescents during the COVID-19 pandemic residing in Bangladesh. METHODS: A cross-sectional study was performed among 490 adolescents in Bangladesh from December 2020 to May 2021. The survey was carried out through a semi-structured web-based questionnaire that asked questions about socio-demographics (i.e., age, sex, marital status, education, residence), perceived health status and quality of life, anthropometrics (i.e., height, weight), dietary habits (i.e., frequency of eating, daily intake of certain foods, number of meals eaten daily), and physical activity (i.e., modified version of the International Physical Activity Questionnaire Short Form [IPAQ-SF]), as well as, pre- and during COVID-19 information on stress, and sleep. RESULTS: During the pandemic, 43.7% participants reported weight gain; and 23.5% reported an increased number of meals per day during COVID-19. Additionally, the participants' eating habits diverged from the local balanced diet principles and were more akin to 'unhealthy' eating patterns. Though, during the COVID-19 pandemic, physical exercise slightly increased (>3 times/ week: 8.2% vs. 13.5%; p<0.001) compared to pre-COVID-19 period, the screen time for entertainment increased drastically (>5 hours/ week: 12.2% vs. 27.3%; p<0.001). Compared to the pre-pandemic, a sizeable proportion of individuals experienced more physical tiredness, emotional exhaustion, irritation, and stress (p<0.001) during the pandemic. During the pandemic, 47.5% of participants experienced different sleep difficulties. CONCLUSIONS: Although lockdowns and social distancing are important safety measures to protect people from COVID-19, findings reveal that they might cause a variety of lifestyle changes, physical inactivity, and psychological issues in Bangladeshi adolescents.

Public knowledge, belief, and preventive practices regarding dengue: Findings from a community-based survey in rural Bangladesh.

BACKGROUND: Dengue fever, the most prevalent mosquito-borne viral infection, is a recurrent public health threat in Bangladesh. Despite the government's efforts, dengue outbreaks are on the upswing, and people's knowledge, belief, and preventive practices regarding the disease at the rural community level are unclear. OBJECTIVE: The objective of this study was to assess the level of knowledge, belief and preventive practices regarding dengue and associated factors among community people from rural Bangladesh. METHODS: A cross-sectional survey was conducted involving 401 people using a convenient sampling technique from three unions of Savar from August to September 2021. Participants' responses were collected through face-to-face interviews using a pre-tested structured questionnaire that included information related to socio-demographics, dengue-related knowledge, preventive practices, and the health belief model (HBM) constructs. Multiple linear regression analysis was performed to determine the factors associated with the knowledge and preventive practices of dengue. RESULTS: Overall, participants (mean age = 33.47 ± 12.96 years; age range = 18-75 years) correctly answered 66.15% of the knowledge questions regarding dengue. Higher education, travel to dengue-risk regions, and self-efficacy under the HBM construct were all shown to be strongly associated with dengue knowledge. Regarding HBM constructs, about 80% of the participants perceived dengue as dangerous, but less than half (41.4%) believed themselves susceptible to dengue. Considering perceived barriers, 73.07% of the participants believed their residential area was not suitable for Aedes mosquito breeding. Nearly all (93.52%) believed they always kept their surrounding area clean as part of self-efficacy. Moreover, on average participants engaged in 53.69% of all dengue preventive practices. Being older, female, having a higher education, being a service holder, having a good quality of house structure, and perceived susceptibility as well as self-efficacy under the HBM construct were all factors in participants' dengue prevention activities. Participants' dengue preventative practices were shown to be significantly influenced by their knowledge. CONCLUSIONS: The findings of this study found a moderate level of knowledge regarding dengue among the participants. Regarding dengue prevention, although participants scored highly in several indicators, the overall preventive practices were not satisfactory. This suggests that there is a pressing need for expanded education outreach aimed at increasing public awareness of dengue and encourage preventive practices within rural communities in Bangladesh.

Assessment of knowledge, attitudes and practices towards COVID-19 among rural adolescents in Thakurgaon district, Bangladesh: an interview-based study.

OBJECTIVES: To evaluate the understanding, opinions and actions concerning COVID-19, referred to as knowledge, attitudes and practices (KAP), among rural adolescents in Bangladesh. Additionally, the study aimed to identify the determinants that may influence adolescents' KAP. DESIGN: An interview-based cross-sectional study. SETTING: The study area was the Thakurgaon district, which was located in the northwestern region of Bangladesh. PARTICIPANTS: A total of 266 rural adolescents were selected using a non-probability (convenience sampling) technique. MAIN OUTCOME MEASURES: Sociodemographic characteristics, source of information, COVID-19-related KAP, and their associated factors. RESULTS: The majority of the respondents were females and reported that mass media (eg, television channels and papers) was the main source of information to learn about COVID-19. The mean score for knowledge was 7.15±3, whereas the scores were 10.5±2.8, and 8.78±2.66 for attitude and practice, respectively. Among the adolescents, only 11% had adequate knowledge, a positive attitude (27%) and good practices (31%). The predictive factors related to adolescents' knowledge and attitude were their religion, educational level and family income. Adolescents who were from the Islamic religion and who had secondary education were more knowledgeable and encompassed more positive attitudes. Besides, poor KAP towards COVID-19 was significantly higher among the participants with the lowest family income (less than 10 000 BDT). Moreover, their knowledge was significantly associated with their attitudes and practices. CONCLUSION: The study found that adolescents in rural areas lacked sufficient knowledge of COVID-19 and engaged in unsatisfactory preventative behaviour. Therefore, the development of effective health education programmes that incorporate consideration of KAP-modifying factors is needed. In addition, the result would be helpful for other similar types of pandemics.

Corrigendum to "Impact of COVID-19 pandemic on the mental health of children in Bangladesh: A cross-sectional study" [Child. Youth Serv. Rev. 117 (2020) 105277].

[This corrects the article DOI: 10.1016/j.childyouth.2020.105277.].

Perception and experiences regarding COVID-19 pandemic among urban young adults in Bangladesh: a mixed-method study.

Aim: This study aimed at exploring the perception and experiences with regard to the COVID-19 pandemic among Bangladeshi urban young adults. Subject and methods: Using a mixed-method approach, an online cross-sectional survey among 315 participants and in-depth interviews (IDI) among 20 young adults were conducted from May 1 to May 25, 2020. Descriptive statistics and chi-square tests were performed for quantitative data, along with the thematic analysis for qualitative data. Results: The mean (± SD) age of the participants was 26.54 (± 3.05), and the majority were male (54.9%). About 81.6% of the participants reported COVID-19 as a viral disease, transmitted through droplets of sneezing and coughing, and close contact with another person (90.8%). Nearly 40% of participants reported news channels as a reliable source of information for COVID-19. Participants who were male were less likely to be aware than females in terms of mode of transmission of COVID-19 such as going outside of the home (82.7% male vs 90.8% female; p < 0.05). Male participants thought they were perfectly healthy and more reluctant to agree with maintaining social distance compared to female participants (72.8% male vs 90.1% female; p < 0.001). Participant's satisfaction level with services provided by the government was also significantly different and higher among females than male participants (39.9% male vs 53.5% female; p < 0.05). The majority of the participants reported suffering due to financial uncertainty, psychological distress, and inadequate health facilities. Dissatisfaction was reported with the existing health services as creating several misconceptions, lacking testing facilities, and debasement by the health professionals. Conclusion: This study found a better perception regarding COVID-19 among the young adults, but they had poor preventive practices. Health education intervention with the rapid response should be implemented targeting this vulnerable group to improve their preventive practices.

Knowledge, attitudes, and practices related to the COVID-19 pandemic among Bangladeshi youth: a web-based cross-sectional analysis.

Aim: This study aimed to assess knowledge, attitudes, and practices (KAP) toward COVID-19 among youth in Bangladesh. Subject and methods: A cross-sectional survey was conducted from 5 May to 25 May 2020. People aged between 18 and 35 years were approached via social media to complete an online questionnaire that consisted of socio-demographic information and KAP toward COVID-19. Descriptive statistics, t-tests, one-way analysis of variance (ANOVA), and logistic regression analyses were conducted. Results: Out of 707 survey participants, 57.1% were male, the majority were students (60.3%), aged 24-29 years (61.5%), having a bachelor's degree (57%), having family income 25,000-50,000 BDT (40.5%) and living in urban areas (64.4%). Participants gathered information on COVID-19 mostly through social media (70.4%). Overall, 61.2% had adequate knowledge with 78.9% having a positive attitudes toward COVID-19 and only 51.6% had good practices. Most (86.8%) of the participants were confident that COVID-19 will be successfully controlled and Bangladesh was handling the COVID-19 health crisis well (84.2%). Only 75.2% of participants always washed their hands with soap or hand-sanitizer, and 70.6% wore a mask when going outside the home. Factors associated with adequate knowledge were being female, having a master's degree and above, and living in an urban area (p < 0.05). Participants having adequate knowledge of COVID-19 had higher likelihood of positive attitudes (OR: 6.41, 95% CI = 2.34-25.56, p < 0.001) and good practices (OR: 8.93, 95% CI = 3.92-38.42, p < 0.001). Conclusion: The findings highlight the need for tailored education programs for COVID-19 which incorporates consideration of associated factors to improve the level of public knowledge, attitudes, and practices.

Correction to: Knowledge, attitudes, and practices related to the COVID-19 pandemic among Bangladeshi youth: a web-based cross-sectional analysis.

[This corrects the article DOI: 10.1007/s10389-020-01432-7.].

Perception regarding health and barriers to seeking healthcare services among rural rickshaw pullers in Bangladesh: A qualitative exploration.

Background: Understanding health in daily life can vary from person to person. The concept of health arises from the perspective of an individual's experience. People face several kinds of barriers while seeking healthcare services, where rickshaw pullers are one of the most vulnerable groups to meet their basic health needs. This study aimed to investigate Bangladeshi rural rickshaw pullers' perception regarding health and what obstacles they face while seeking healthcare services. Methods: This study followed a qualitative approach conducted in-depth interviews involving 20 rickshaw pullers in rural Bangladesh from 4th to 15th December 2020. Participants were selected through purposive and snowball sampling techniques. The verbatim transcription was performed, and the thematic analysis was done through manual coding and NVivo version 12. Results: According to the study's findings, participants' perception regarding health were mainly based on physical, nutritional, and social points of view. The financial hardship to convey medical costs, long waiting time in receiving healthcare services, social class inequality, low trustworthiness on diagnostic services, and mastery of broker in the hospital setting were acknowledged as prevailing barriers to seeking healthcare services. Conclusion: Several health perceptions existed among the rural rickshaw pullers. They faced different kinds of barriers while seeking healthcare services, and those obstacles made them hopeless and worried about getting quality healthcare services. Concerned authorities, including government and private organizations, should take effective strategies to ensure that healthcare services are available, reliable, and affordable.

General psychiatric symptoms among Bangladeshi people approximately one year after the onset of the COVID-19 pandemic.

BACKGROUND: Coronavirus disease-2019 (COVID-19) has had negative physical and mental impacts on people globally. The current study examined general psychiatric symptoms (fear, anxiety, depression, and insomnia) and loneliness, and their interrelationships and correlates among Bangladeshi individuals approximately 1 year after the onset of the COVID-19 outbreak. METHODS: An internet-based cross-sectional survey was conducted among 1004 Bangladeshi people (51.8% male; mean age: 25.41 ± 7.80; age range: 18-60 years). Data were collected using a semi-structured e-questionnaire including informed consent, socio-demographics, lifestyle measures, and psychometric tools assessing loneliness, anxiety, depression, insomnia, and fear of COVID-19. RESULTS: Sizeable participants screened positive for loneliness (63.5%), anxiety (26.3%), depression (46.4%), and insomnia (50.7%). Considerable numbers of respondents also reported fear of COVID-19. In hierarchical regression analyses, loneliness, anxiety, depression, insomnia, and fear of COVID-19 were associated with socio-demographic and lifestyle factors. Loneliness, anxiety, depression, insomnia, and fear of COVID-19 were positively correlated with each other (p < 0.001). In exploratory path analyses, anxiety, depression, and insomnia mediated the relationship between loneliness and fear of COVID-19. CONCLUSIONS: The findings indicate that many people in Bangladesh have experienced psychiatric concerns approximately 1 year after the onset of the COVID-19 outbreak. Investigation into empirically supported interventions and their implementation is needed.

Beliefs, barriers and hesitancy towards the COVID-19 vaccine among Bangladeshi residents: Findings from a cross-sectional study.

BACKGROUND: COVID-19 vaccination acceptance is important, and combating hesitancy which is generally based on the individuals' beliefs and perceptions is essential in the present pandemic. This study assesses COVID-19 vaccine hesitancy and associated factors, beliefs and barriers associated with COVID-19 vaccination. METHODS: A cross-sectional study was carried out among 492 Bangladeshi residents (76% male; mean age = 24.21 ± 4.91 years; age range = 18-50 years) prior to the nationwide mass COVID-19 vaccination campaign (September 28, 2021). A semi-structured e-questionnaire included three sections (demographic variables, beliefs around the vaccination, and perceived barriers regarding COVID-19 vaccination). RESULTS: More than a quarter of participants (26.42%) were hesitant, 70.33% reported to accept the vaccine, and 3.25% refused to be vaccinated. While (54%) believed that mass vaccination would be the most effective method to combat the COVID-19 pandemic, concerns regarding the side effects of the vaccine (58%), inadequate vaccine trials before human administration (43%), commercial profiteering (42%), and mistrust of the benefits of the vaccine (20%) were also reported. In addition, other barriers including a short supply of vaccines, unknown future adverse effects (55%), low confidence in the health system (51%), doubts regarding its effectiveness (50%) and safety (45%), and insufficient information regarding potential adverse effects (44.7%) were reported. In bivariate analysis, variables such as current political affiliation, previous vaccination history, and health status were significantly associated with the COVID-19 vaccine uptake variable (acceptance, hesitancy, refusal). Regression analysis showed that participants who identified with the opposing current political parties, and not having been vaccinated since the age of 18 years were significantly more likely to report vaccine hesitancy. CONCLUSIONS: The current findings relating to COVID-19 vaccination demonstrate that government and policy makers need to take all necessary measures to ensure the effectiveness of the vaccination program among the Bangladeshi people.

Forecasting the incidence of dengue in Bangladesh-Application of time series model.

Background: Dengue is an alarming public health concern in terms of its preventive and curative measures among people in Bangladesh; moreover, its sudden outbreak created a lot of suffering among people in 2018. Considering the greater burden of disease in larger epidemic years and the difficulty in understanding current and future needs, it is highly needed to address early warning systems to control epidemics from the earliest. Objective: The study objective was to select the most appropriate model for dengue incidence and using the selected model, the authors forecast the future dengue outbreak in Bangladesh. Methods and Materials: This study considered a secondary data set of monthly dengue occurrences over the period of January 2008 to January 2020. Initially, the authors found the suitable model from Autoregressive Integrated Moving Average (ARIMA), Error, Trend, Seasonal (ETS) and Trigonometric seasonality, Box-Cox transformation, ARMA errors, Trend and Seasonal (TBATS) models with the help of selected model selection criteria and finally employing the selected model make forecasting of dengue incidences in Bangladesh. Results: Among ARIMA, ETS, and TBATS models, the ARIMA model performs better than others. The Box-Jenkin's procedure is applicable here and it is found that the best-selected model to forecast the dengue outbreak in the context of Bangladesh is ARIMA (2,1,2). Conclusion: Before establishing a comprehensive plan for future combating strategies, it is vital to understand the future scenario of dengue occurrence. With this in mind, the authors aimed to select an appropriate model that might predict dengue fever outbreaks in Bangladesh. The findings revealed that dengue fever is expected to become more frequent in the future. The authors believe that the study findings will be helpful to take early initiatives to combat future dengue outbreaks.

Child marriage and its association with morbidity and mortality of under-5 years old children in Bangladesh.

INTRODUCTION: Child marriage is a significant social and health concern in many low- and middle-income countries (LMICs). This harmful practice violates children's rights and continues to be widespread across developing nations like Bangladesh. This study investigated the mortality trend among Bangladeshi children and the impact of child marriage on under-5 children morbidity and mortality in Bangladesh. METHODS AND MATERIALS: A sample of 8,321 children under-5 years old was analyzed using bivariate and multivariate statistical techniques collected from the recent 2017-18 BDHS data. Chi-square test and logistic regression (unadjusted and adjusted) were used to determine the influence of covariates on the target variable. RESULTS: Results revealed that child mortality was significantly higher among children whose mothers married at an early age than their counterparts. Although the general trend in the prevalence of different childhood mortality in Bangladesh was declining gradually from 1993 to 2018, it was still high in 2018. Also, marriage after 18 years lessens likelihood of diarrhea (adjusted OR = 0.93; 95% CI: 0.76-1.16) and cough (adjusted OR = 0.91; 95% CI: 0.78-1.17) among children. Furthermore, findings reveal that likelihood of different child mortality is higher among early married women. CONCLUSION: Immediate intervention through rigorous enforcement of policies and different programs to raise the age at marriage and by lessening socioeconomic disparities can combat the prevalence of high morbidity and mortality of under-5 years old children. Findings from this study will be helpful to accelerate strategies for achieving the Sustainable Development Goals (SDGs) related to child and maternal health by 2030.

Investigating Bangladeshi Rural Women's Awareness and Knowledge of Cervical Cancer and Attitude Towards HPV Vaccination: a Community-Based Cross-Sectional Analysis.

Cervical cancer remains a significant disease burden and contributes to prominent cancer-related mortality among women. This study aimed to assess awareness and knowledge of cervical cancer and attitude towards HPV vaccination among rural women in Bangladesh. A cross-sectional study was carried out from September 2019 to January 2020 involving 600 women selected using multi-stage sampling from six rural areas of Bangladesh. Face-to-face interviews were conducted using a semi-structured questionnaire consisting of socio-demographic information, knowledge (20-items) and, attitudes (5-items). Most of the participants (71.8%) were aware of cervical cancer. Women's awareness was significantly associated with marital status, education level, employment status, and internet/social media use (p < 0.05). Mass media was the main source of information and 2.3% of the women had previously undergone cervical cancer screening. Knowledge regarding symptoms, risk factors, and preventive measures was limited with a mean knowledge score of 8.73 (SD: 2.68). Only 5.3% of women had vaccinated against HPV, but the willingness to receive the HPV vaccine was high (76.6%) among those who were not vaccinated. The cost of the HPV vaccine (40.1%) and lack of adequate knowledge (34.3%) were the main reasons behind women's unwillingness to receive the vaccine. Higher odds of willingness to receive the HPV vaccine were found among women aged 15-29 years (aOR: 1.92, CI = 1.21-3.04, p = 0.006), had high education (aOR: 1.93, CI = 1.25-4.42, p = 0.005), and internet/social media users (aOR: 2.32, CI: 1.51-3.56, p < 0.001). These results highlight the urgent need for educational intervention on cervical cancer and the institution of national policies providing HPV vaccination coverage.

Regional education and wealth-related inequalities in malnutrition among women in Bangladesh.

OBJECTIVES: This paper examines the associations of socio-economic and demographic correlates with malnutrition among women and investigates education and wealth-related inequalities in malnutrition among women by region. DESIGN: We utilise a two-level mixed-effects logistic regression model to evaluate the associations and employ the concentration, Wagstaff and Erreygers's correction indices to measure socio-economic inequalities in malnutrition among women. SETTING: Bangladesh Demographic and Health Survey data. PARTICIPANTS: Non-pregnant women aged 15-49 years. RESULTS: We find evidence of a significant cluster effect in the data. Women's age, marital status, total children ever born, education level, husband's/partner's education level, residence and wealth index appear to be significantly associated with women underweight and overweight/obesity status. Underweight status is higher among less-educated women and women from poor households, whereas overweight/obesity is more concentrated among higher educated women and women from wealthy households. The southwestern region of the country demonstrates lower education and wealth-related inequalities in malnutrition among women. In contrast, the central and the northeastern areas apparently experience the highest education and wealth-related inequalities in malnutrition among women. The regional differences in predicted probabilities of being underweight shrink at higher education level and the richest quintile, whereas the differences in overweight/obese diminish at the primary education level and lower quintile households. CONCLUSIONS: Our findings strengthen the evidence base for effective regional policy interventions to mitigate education and wealth-related inequalities in malnutrition among women. There is a need for developing regional awareness programmes and establishing regional monitoring cells to ensure proper health and nutrition facilities in underprivileged regions.

Assessing the mental health condition of home-confined university level students of Bangladesh due to the COVID-19 pandemic.

Aim: The COVID-19 pandemic drove the Government of Bangladesh to shut down educational institutions, which had an enormous effect on the psychological health of students. This study aimed to assess the mental health status of Bangladeshi university students during the lockdown period. Subject and methods: Through an online-based questionnaire, information was collected from 509 university students of Bangladesh from June 19, 2020, to June 28, 2020, using convenient sampling. K-means clustering was applied to organize students according to their psychological health score, and confirmatory factor analysis (CFA) was also conducted to determine the association among the student's activities and their mental health during the pandemic. In addition, these associations were examined through chi-square test and ordinal logistic regression. Results: Students were categorized into four categories where 4.32% had mild, 72.7% had moderate, 12.57% had moderately severe, and 10.41% suffered from severe mental health imbalance. The results showed that having family members affected by the coronavirus, facing insecurity, using social media, and smoking habits increased the mental health imbalances of students; in contrast, being worried about studying, future career, spending more time with family members, and participation in household chores reduced the mental health disturbances of students. On the other hand, the results of the ordinal logistic regression indicated that sleeping time and participation in household chores were preventive factors for students. Conclusion: This study reveals that a large proportion of University students of Bangladesh suffered from mental health disturbances during the lockdown period. Implementing mental health plans and providing job security, improved communication approaches toward family members, not flattening illusive news, and preoccupation in household activities may assist to enhance the mental health status of the university students. The authors believe that this study's findings will be helpful to expedite the rate of attaining the sustainable development goal associated with health status in Bangladesh.

Psychological Impact of COVID-19 Among People from the Banking Sector in Bangladesh: a Cross-Sectional Study.

Despite the pandemic, the Government of Bangladesh decided to keep the banks open to a limited extent to keep the country's economy afloat. The aim of this study is to assess the psychological impact of COVID-19 among the bankers who are usually more exposed to random people that put them at great risk to be affected. A total of 248 bankers willingly answered our questionnaire consisting of DASS-21 and relevant questions. Cronbach's reliability coefficient for the DASS-21 scale ranges from 0.84 to 0.90 which advocates that DASS-21 scales are highly reliable measures for this study. Results show that among participants, 11.1% were severe to extremely stressed, 10.6% of bankers were severe to extremely anxious, and 12.1% of them were severe to extremely depressed. The study illustrated, among the Bankers whose colleagues were infected (B=2.251, 95% CI: - 1.473, 3.029), who smoking more (B= 1.505, 95% CI: 0.411, 2.599), who wake up from sleep having a bad dreams (B = 1.018, 95% CI: 0.057, 1.979), their fear of getting infected (B = 1.717, 95% CI: 0.392, 3.04), who use public transportation (B = 1.378, 95% CI: 0.430, 2.236), who misbehave with family members (B = 1.033, 95% CI: 0.071, 1.995) and who beaten children (B = 1.210, 95% CI: 0.141, 2.279) were responsible for higher stress, depression and anxiety scores respectively. Whereas, taking nutritious food (B = -0.229, 95% CI: -0.30, 1.763), doing physical exercises (B = -0.325, 95% CI: -1.158, 0.508) reduced depression, stress and anxiety scores. The authors believed that the result of the study will be beneficial for the government and its policymakers to take psychological intervention strategies and to make certain sufficient corporal settlement of the banking professionals.

Understanding the determinants of COVID-19 vaccination intention and willingness to pay: findings from a population-based survey in Bangladesh.

BACKGROUND: Several coronavirus disease (COVID-19) vaccines have already been authorized and distributed in different countries all over the world, including Bangladesh. Understanding public acceptance of such a novel vaccine is vital, but little is known about the topic. OBJECTIVES: This study aimed to investigate the determinants of intention to receive a COVID-19 vaccine and willingness to pay (WTP) among people in Bangladesh. METHODS: An anonymous and online-based survey of Bangladeshi people (mean age = 29.96 ± 9.15 years; age range = 18-60 years) was conducted using a self-reported questionnaire consisting of socio-demographics, COVID-19 experience, and vaccination-related information as well as the health belief model (HBM). Multivariable logistic regression was performed to determine the factors influencing COVID-19 vaccination intent and WTP. RESULTS: Of the 894 participants, 38.5% reported a definite intention to receive a COVID-19 vaccine, whereas 27% had a probable intention, and among this intent group, 42.8% wanted to get vaccinated as soon as possible. Older age, feeling optimistic about the effectiveness of COVID-19 vaccination, believing that vaccination decreases worries and risk of COVID-19 infection, and being less concerned about side effects and safety of COVID-19 vaccination under the HBM construct were found to be significant factors in COVID-19 vaccination intention. Most of the participants (72.9%) were willing to pay for a COVID-19 vaccine, with a median (interquartile range [IQR]) amount of BDT 400/US$ 4.72 (IQR; BDT 200-600/US$ 2.36-7.07) per dose. Factors associated with higher WTP were younger age, being male, having higher education, residing in an urban area, having good self-rated health status, positivity towards COVID-19 vaccination's effectiveness, and being worried about the likelihood of getting infected with COVID-19. Participants who were COVID-19 vaccination intent preferred an imported vaccine over a domestically-made vaccine (22.9% vs. 14.8%), while 28.2% preferred a routine immunization schedule. CONCLUSION: The findings indicate a considerable proportion of Bangladeshi people intended to get vaccinated and had WTP for the COVID-19 vaccine. However, urgent education and awareness programs are warranted to alleviate public skepticism regarding the COVID-19 vaccination.

Financial and Mental Health Concerns of Impoverished Urban-Dwelling Bangladeshi People During COVID-19.

Background: The COVID-19 pandemic has impacted the physical, mental and financial health of many individuals. Individuals living in impoverished crowded settings may be particularly vulnerable to COVID-19-related stressors. How substantially marginalized groups like impoverished urban-dwelling individuals have been impacted during this pandemic is poorly understood. The present study aimed to investigate the associated factors of financial concerns and symptoms of depression and posttraumatic stress disorder (PTSD) during the COVID-19 pandemic among impoverished urban-dwelling individuals residing in Dhaka, Bangladesh. Methods: A cross-sectional survey was conducted between August and September 2020 using face-to-face interviews in six disadvantaged neighborhoods ("slums") in Dhaka. Individuals were interviewed using a semi-structured questionnaire consisting of questions assessing socio-demographics, lifestyle, financial well-being relating to the COVID-19 pandemic, depression, and PTSD. Results: Four-hundred-and-thirty-five individuals (male = 54.7%; mean age = 45.0 ± 12.0 years; age range = 18-85 years) participated. Most (96.3%) reported that their household income decreased due to the COVID-19 pandemic. Factors associated with decreased household incomes included female gender, primary education, joblessness, food scarcity and depression. Depression symptoms were linked to female gender, joblessness, divorce, living in a joint family, excessive sleep and smoking. Low incomes, excessive sleep, joblessness and food scarcity were positively associated with PTSD symptoms. In contrast, less sleep appeared protective against PTSD. Conclusions: Public health initiatives, in particular mental health services that target stress and biocentric approaches that consider how humans interact with multiple facets of nature, should be introduced to mitigate against potential financial and psychological effects of the pandemic on impoverished urban-dwelling individuals in Bangladesh.

Knowledge, attitudes and practices associated with the COVID-19 among slum dwellers resided in Dhaka City: a Bangladeshi interview-based survey.

BACKGROUND: The emergent COVID-19 has impacted unprecedentedly to all classes of people. Slum-dwellers' knowledge, attitudes and practices (KAP) toward COVID-19 are currently poorly understood. The present study aimed to investigate the KAP toward COVID-19 among slum dwellers resided in Dhaka City, Bangladesh. METHODS: A cross-sectional offline survey was carried out enrolling 406 slum dwellers (53.2% male; mean age = 44.9 years [SD = 12.1]; age range = 18-85 years) between August and September, 2020. The face to face interview was conducted to collect data from six selected slum areas in Dhaka City using convenience sampling. The questionnaire consisted of informed consent along with questions concerning observational checklists, socio-demographics and KAP. RESULTS: A sizeable minority were observed without wearing face masks during the survey periods (18.2%) and a vast portion (97.5%) without any hand protection. The mean scores of KAP were 6.1 ± 2.6 (out of 17), 12.3 ± 1.7 (out of 14) and 9.8 ± 1.6 (out of 12), respectively. Moreover, the KAP were strongly and positively correlated with each other. CONCLUSIONS: The findings revealed that the majority of slum dwellers in Bangladesh have limited knowledge of COVID-19. Poor practices (i.e. face mask and hand protection) were directly observed during the survey. The findings suggest the immediate implementation of health education programs and adequate interventions.

Predictors Associated With Knowledge and Practice of Helminthic Infection Prevention Among Rural School-Aged Children's Parents in Bangladesh: A Cross-Sectional Study.

Background: Parasitic infection has become a major public health concern in light of its increasing prevalence in developing countries, particularly in rural settings. Helminthic infections disproportionately affect children, and therefore appropriate parental knowledge and practical approaches to transmission prevention are essential. The objective of this study was to evaluate the level of knowledge and implementation measures aimed at preventing helminthic infection among rural school-aged children's parents in Bangladesh. Methods: A cross-sectional survey was conducted among the parents of 449 rural school-aged children residing in 17 villages of the Cumilla district in Bangladesh. Participants completed the survey examining socio-demographic variables as well as questions regarding knowledge and practice of helminthic infection prevention (HIP). Results: Local knowledge about children's HIP was inadequate among their parents (81.5%). Furthermore, actual implementation of HIP measures was poor (42.1%). Knowledge of HIP was significantly associated with parental religion, education, occupation, number of family members, family income, housing conditions, and sanitation system. In addition, practice of HIP was significantly associated with the aforementioned factors, as well as with water source and knowledge of HIP. Conclusion: Lack of concern about parasitic infection among children's parents and their untoward effects on children's health is pervasive in rural parental settings, along with ignorance on helminthic transmission and its prevention. Public education programs aimed at addressing these glaring HIP awareness deficits are needed in Bangladesh.