Depression among Bangladeshi diabetic patients: a cross-sectional, systematic review, and meta-analysis study.

AIM: This study aims to assess the prevalence and associated factors of depression among diabetic patients in a cross-sectional sample and perform a systematic review and meta-analysis of the extant studies to date. METHODS: A face-to-face semi-structured interview of established diabetic patients was conducted in four districts of Bangladesh between May 24 to June 24, 2022, and the Patient Health Questionnaire (PHQ-2) was used to detect depression. PRISMA guidelines were followed to conduct a systematic review and meta-analysis, with Bangladeshi articles published until 3rd February 2023. RESULTS: The prevalence of depression among 390 diabetic patients was 25.9%. Having secondary education and using both insulin and medication increased the likelihood of depression, whereas being a business professional and being physically active reduced the likelihood of depression. The systematic review and meta-analysis indicated that the pooled estimated prevalence of depression was 42% (95% CI 32-52%). Females had a 1.12-times higher risk of depression than males (OR = 1.12, 95% CI: 0.99 to 1.25, p < 0.001). CONCLUSIONS: Two-fifths of diabetic patients were depressed, with females at higher risk. Since depression among diabetic patients increases adverse outcomes, improved awareness and screening methods should be implemented to detect and treat depression in diabetic patients.

Predictive factors of vaccination status, knowledge, attitudes, and practice towards prevention of hepatitis B infection among Bangladeshi people: A cross-sectional study.

Background and Aims: Infection with the hepatitis B virus is a serious public health problem that is growing all over the world. Therefore, in this context, there is no exception to public participation in disease burden reduction. Consequently, for the first time in Bangladesh, the current study aims to assess the level of vaccination status, knowledge, attitude, and practice of hepatitis B infection among general people. Methods: A cross-sectional study was carried out between December 15, 2021, and January 17, 2022, including sociodemographic information as well as questions about vaccination status and knowledge, attitude, and practice related to hepatitis B. Data were analyzed using descriptive (frequency) and inferential statistics (Mann-Whitney U, Kruskal-Wallis H, χ 2, binary logistic regression, and spearman's rho correlation coefficient). Results: Results indicated that about one-third (37.9%) of the 807 participants had received hepatitis B vaccine, with an overall mean score of 11.506 ± 5.403 for knowledge, 5.435 ± 1.038 and 4.252 ± 1.776 for attitude and practice, respectively. Risk factors related to vaccination were age, religion, educational qualification, occupation, residence area, marital status, comorbidity, and family member suffering from hepatitis B. Higher level of knowledge was significantly found among the young people aged between 10 and 29; had higher secondary or tertiary education (median = 13); were employed (median = 13.5, interquartile range [IQR] = 8); living in divisional city (median = 13, IQR = 7); were single (media = 13, IQR = 7); and whose family members were suffering from hepatitis B. Besides, poor practice was observed among those aged between 50 and higher (p = 0.004), had no formal education [p < 0.001), a retired or housewife (p < 0.001), divorced or widowed (p < 0.001), absence of comorbidity (p = 0.02), and whose family members were not infected with hepatitis B (p < 0.001). Conclusions: The results exposed that vaccination rates and preventative behavior are unsatisfactory, which will hinder efforts to eradicate hepatitis B worldwide by the year 2030.

Knowledge of breast cancer and breast self-examination practices and its barriers among university female students in Bangladesh: Findings from a cross-sectional study.

Early diagnosis of breast cancer is the best approach towards its control that may result in alleviating related mortality and morbidity. This study aimed to evaluate knowledge about breast cancer and both practices and perceived barriers to breast self-examination among female university students in Bangladesh. A cross-sectional study was carried out with 400 female students of Jahangirnagar University, Bangladesh. Participants were sampled from female dormitories at the university from January to April 2020. Proportionate stratified random sampling was conducted to calculate the study sample from each dormitory. A validated semi-structured self-reported questionnaire was employed to collect data from participants during the survey periods. The questionnaire consisted of demographic variables, items about knowledge about breast cancer, breast self-examination practices and its barriers. We applied descriptive and inferential statistics and data were analyzed using the Statistical Package for the Social Sciences (SPSS). Participants were aged between 18-26 years and comprised university students of first year (20%), second year (24%), third year (22%), fourth year (21%) and Master's (14%). 18% of them reported positive family history (mother, aunt, sister/cousin, grandmother) of breast cancer. The overall mean score of total knowledge items was 15 (SD = 3) out of 43, with an overall correct rate of 34%. The mean score of total knowledge items was significantly higher (p<0.001) among Master's students and students with family members who have had breast cancer. Only one in five students (21%) ever practiced breast self-examination. The mean score of practice of breast self-examination was significantly higher (p<0.001) among participants who reported having family member of breast cancer. Total knowledge score about breast cancer and practice of breast self-examination were significantly correlated with each other (r = 0.54; p<0.001). About 33% participants reported 'lack of knowledge' as the main barrier to practicing breast self-examination followed by 'I do not have the symptoms' (22%), and 'shyness/ uncomfortable feelings' (17%). The study revealed low levels of knowledge about breast cancer and low breast self-examination practices. Our findings highlight the need to develop, implement and promote socially, culturally and demographically appropriate educational interventions programs aimed at breast cancer and breast self-examination awareness and practice in Bangladesh.

Effectiveness of educational intervention on breast cancer knowledge and breast self-examination among female university students in Bangladesh: a pre-post quasi-experimental study.

BACKGROUND: Breast cancer is a global health issue and a leading cause of death among women. Early detection through increased awareness and knowledge on breast cancer and breast cancer screening is thus crucial. The aim of the present study was to assess the effect of an educational intervention program on breast cancer knowledge and the practice of breast self-examination among young female students of a university in Bangladesh. METHODS: A quasi-experimental (pre-post) study design was conducted at Jahangirnagar University in Bangladesh. Educational information on breast cancer and breast self-examination (BSE), demonstration of BSE procedure and leaflets were distributed among 400 female students after obtaining written informed consent. The stepwise procedures of BSE performance were demonstrated with images. Pre-intervention and 15 days post-intervention assessments were conducted to assess the changes in knowledge on breast cancer and practices of BSE. Mc-Nemar's tests and paired sampled t-tests were performed to investigate the differences between pre- and post-test stages. RESULTS: A total of 400 female university students aged 18-26 years were included in the sample. Significant changes were found in knowledge and awareness about breast cancer and BSE practices after the educational intervention. The significant differences were measured in the mean scores of pre-test vs. post-test: breast cancer symptoms (2.99 ± 1.05 vs. 6.35 ± 1.15; p < 0.001), risk factors (3.35 ± 1.19 vs. 7.56 ± 1.04; p < 0.001), treatment (1.79 ± 0.90 vs. 4.63 ± 0.84; p < 0.001), prevention (3.82 ± 1.32 vs. 7.14 ± 1.03; p < 0.001), screening of breast cancer (1.82 ± 0.55 vs. 3.98 ± 0.71; p < 0.001) and process of BSE (1.57 ± 1.86 vs. 3.94 ± 0.93; p < 0.001). Likewise, a significant percentage of change in BSE practices was obtained between pre-test and post-test (21.3% vs. 33.8%; p < 0.001). CONCLUSIONS: Study findings confirm that the study population had inadequate awareness and knowledge at baseline which was improved significantly after educational intervention. A nationwide roll-out with community-based interventions is recommended for the female population in both rural and urban areas.

Prevalence and Factors Associated with Suicidal Ideation Among University Students in Bangladesh.

This study aimed to determine the prevalence of and factors associated with suicidal ideation among university students in Bangladesh. We collected cross-sectional data from 407 students aged between 18 and 27 years at Jahangirnagar University (Dhaka, Bangladesh), using a convenience sampling technique. Of the total sample, 13.8% reported having suicidal ideation during the past 12 months. In multiple logistic regression analysis, being female, being a fifth-year student, lower socioeconomic status, exposure to traumatic events, family suicide history, and depression were associated with suicidal ideation. The findings emphasize the need for appropriate support services for university students with a focus on mental health wellbeing and suicide prevention.

Substance use behavior and its lifestyle-related risk factors in Bangladeshi high school-going adolescents: An exploratory study.

Substance abuse is a major concern worldwide and is increasing rapidly in Bangladesh. However, there are no prior studies concerning lifestyle-related factors that influence adolescents' substance use behavior. Therefore, the present study investigated the prevalence of substance use and its associated sociodemographic and lifestyle-related risk factors among a total of 424 Bangladeshi high school-going adolescents through a structured questionnaire interview study. The survey questionnaire consisted of socio-demographics, lifestyle-related information, and substance use-related questions. For data analysis, descriptive and inferential statistics were performed using SPSS (Statistical Package for Social Science) version 22.0, and a p-value of <0.05 determined statistical significance. Results showed that 21.2%, 14.4%, and 15.1% of the participants reported smoking, using a drug, and consuming alcohol, respectively, at least once during their lifespan; whereas the current (i.e., past-month) rates were reported to be 10.4%, 2.8%, and 3.1%, respectively. Overall, the current substance use risk factors were identified as being male, not being from science academic background, having less family influence on personal life, irregular teeth brushing, being smartphone users, using a smartphone for a longer time, and being late-night sleepers. From the list of identified risk factors of substance use, those that are modifiable may be targeted to evolve a prevention program to manage this problem in Bangladeshi adolescents.

Prevalence of depression, anxiety and associated factors among school going adolescents in Bangladesh: Findings from a cross-sectional study.

BACKGROUND: Common mental disorders in early life represent a major concern as they become more complex and intense with transition into adolescence. Despite global recognition of the significance of adolescent mental health, it remains a neglected area in research and health policy in Bangladesh. This study aimed to investigate the prevalence and factors associated with depression and anxiety among school going adolescents in Bangladesh. METHODS: A cross-sectional survey was conducted among 563 students aged 13-18 years at selected schools (secondary and higher secondary) in Dhaka City. After providing written informed consent, participants completed a survey examining socio-demographic variables, along with the PHQ-9 and GAD-7 scales. Logistic regression was used to examine associations between variables under examination. RESULTS: The prevalence rates of moderate to severe levels of depression and anxiety were 26.5% and 18.1%, respectively. Based on multivariable analyses, unsatisfactory sleep (AOR = 3.17; 95% CI = 1.81-5.53, p < .001), cigarette smoking (AOR = 2.00; 95% CI = 1.01-3.97, p = .048), and anxiety (AOR = 10.47; 95% CI = 6.11-17.95, p < .001) were associated with depression. Anxiety was associated with being 15-16 years (AOR = 2.66; 95% CI = 1.18-6.00, p = .018), not having good perceived relationships with friends (AOR = 2.10; 95% CI = 1.24-3.56, p = .006) and depression (AOR = 10.22; 95% CI = 6.01-17.38, p < .001). CONCLUSIONS: Depression and anxiety were prevalent among school going adolescents in Bangladesh. The findings suggest epidemiological data can direct policy-level decisions regarding evaluation, prevention, and intervention of mental health conditions among school going adolescents in Bangladesh.

Physical inactivity and sedentary behaviors in the Bangladeshi population during the COVID-19 pandemic: An online cross-sectional survey.

This study aimed to determine the prevalence of physical inactivity and sedentary behaviors during the COVID-19 pandemic among Bangladeshi people. An online survey was conducted among 2,028 people over a period of 10 days on June, 2020 during the COVID-19 pandemic at a time that the number of newly diagnosed cases was increasing, lockdown was still in place. Survey questions included socio-demographics and an adapted version of the IPAQ-SF to assess physical activity and sedentary behaviors. The prevalence rates of physical inactivity (<600 MET-minutes/week) and high sedentary behaviors (≥8 h/day) among Bangladeshi people were 37.9% and 20.9%, respectively. Regression analyses revealed that young age, being a student, from a middle-class family, or upper-class family, living with nuclear family, urban living, and suffering from no chronic diseases were all associated with physical inactivity and high sedentary behaviors. Moreover, physical inactivity and high sedentary behavior were strongly interrelated. However, many of the univariate risk factors exhibited interdependency. During the COVID-19 pandemic coinciding with lockdown measures a sizeable proportion of Bangladeshi people were physically inactive and reported sedentary behaviors ≥8 h/day. Public campaigns and media-based interventions encouraging home-based physical activities should be promoted to attenuate the impact of lockdown measures during a pandemic.

Depression literacy and awareness programs among Bangladeshi students: An online survey.

BACKGROUND: Preventing depression and helping individuals to become more resilient to depression, awareness-related programs have been suggested. To implement such programs, depression literacy (D-Lit) assessment is needed. However, little information is known about it in Bangladesh, and this gap was addressed - in the present study. METHODS: An online-based cross-sectional survey was carried out among 404 university students (62.6% male; 69.3% undergraduates, mean age = 22.35 ± 2.69 years). The survey included questions asking about socio-demographics, personal and family depression history, its' stigma and related programs, and the 20-item Bangla Depression Literacy questionnaire. RESULTS: The results showed a mean score of 9.30 (SD = 2.75; out of total 20 scores) on the Bangla D-Lit scale. Participants had very limited knowledge of the psychotic symptoms, impact, and management subscales. Moreover, nine items out of the total twenty-items were answered correctly by at least 50% of the participants. There were no significant D-Lit score differences based on gender and past-year personal history, and family depression history. Structural equation modeling indicated that having knowledge about depression and attending depression seminars were positively related to elevated depression literacy. LIMITATIONS: The study has some limitations due to its cross-sectional study nature and modest sample size. In addition, there the assessment of depression did not use a validated psychometric instrument and the D-Lit comprises multiple-choice responses so the real rate of depression literacy may be even lower than that found because participants could have guessed answers that they did not know. CONCLUSIONS: Findings from this study suggest that depression literacy was low in the population studied and the findings here will help to facilitate mental health literacy awareness programs in the context of Bangladeshi students as well as those outside the country.

Validation and evaluation of the psychometric properties of bangla nine-item Internet Disorder Scale-Short Form.

Online activities such as online gaming and social media use have become very popular and for most individuals, engagement in such activities is highly enjoyable. However, for a small minority of individuals, such behaviors can lead to problematic internet use. There are many screening instruments that assess problematic internet use including the nine-item Internet Disorder Scale-Short-Form (IDS9-SF). The present study translated the IDS9-SF into Bangla and investigated its psychometric properties. The sample comprised 534 adolescents aged 13 to 18 years (61.0% male; mean age 15.7 years (SD = 1.5) from selected schools (secondary and higher secondary) in Dhaka City. The study included confirmatory factor analysis, Cronbach's alpha, and item-total correlation. Results demonstrated that the Bangla IDS9-SF had very good internal validity (Cronbach's alpha = .82), and that IDS score was positively and significantly correlated with scores on depression and anxiety scales. A confirmatory factor analysis showed the model had an excellent fit to the data. Therefore, the Bangla IDS9-SF appears to be a valid and reliable instrument that may be employed in further research on problematic internet use in Bangladesh.

Prevalence and Drivers of Self-Medication Practices among Savar Residents in Bangladesh: A Cross-Sectional Study.

BACKGROUND: Self-medication practice (SMP) is widely adopted among residents of such countries as Bangladesh. However, the major determinants of SMP have only scarcely been evaluated. Therefore, this cross-sectional study aimed to fill this knowledge gap by assessing the prevalence and determining factors of SMP. METHODS: A convenience sample of individuals residing in Savar (Dhaka, Bangladesh) >16 years of age and suffering from an illness >2 months underwent face-to-face interviews during January-February, 2019. RESULTS: Among 520 interviewees fulfilling entry criteria, the prevalence of SMP was reported as 60.2%. Drug shops, previous knowledge or prescription, and consulting with peers (friends or relatives) were the most sought sources of SMP, whereas simple illness, higher consulting fees, unsatisfactory health-care services, and delayed access were reported as the motives. From the regression analysis, the sociodemographic risk factors of SMP were reported as being older (compared to <18 years), married, illiterate (compared to having higher education), having engaged in any occupation (ie, service, business, homemaker, and others compared to student), and suffering from chronic illness. CONCLUSION: SMP is highly prevalent and exhibits significant socioeconomic determinants. Development of proper health care-access systems and public education should be implemented to reduce the rate of SMP.

Does loneliness, self-esteem and psychological distress correlate with problematic internet use? A Bangladeshi survey study.

BACKGROUND: Researchers have claimed that problematic internet use (PIU) and internet addiction (IA) is a global mental health problem. However, little research has addressed this issue in Bangladesh and no previous study has examined the relationship between PIU and potential psychological risk factors. AIM: The present study examined the prevalence of PIU and its associated risk factors including socio-demographic variables, internet use behaviors, and other psychological variables including loneliness, self-esteem, and psychological distress. METHODS: A cross-sectional study was conducted among Bangladeshi students (N = 605). Measures included the Internet Addiction Test (IAT), Rosenberg's Self-Esteem Scale, the UCLA Loneliness Scale, and the General Health Questionnaire. RESULTS: Using a cut-off score of ≤60 (out of 100) on the IAT, the prevalence of PIU was 16.5% (n = 100). Regression analysis showed that sleep disturbance (more or less than 6-7 hours sleeping time), not using internet for academic purposes, and online chatting were risk factors for PIU. Loneliness and psychological distress were positively correlated with PIU, whereas self-esteem was negatively correlated. CONCLUSIONS: The present study highlights that PIU among Bangladeshi university students is an issue of concern and that targeted prevention is needed among emerging adults to help overcome the potentially negative effects of problematic internet use.