Knowledge and attitudes of thalassaemia among high-risk indigenous university students in Bangladesh: A pilot study.

BACKGROUND AND OBJECTIVES: Thalassaemia is an inherited life-threatening but preventable haemoglobin disorder. South Asian countries, including Bangladesh, are the hotspots of the world's thalassaemia belt. Indigenous communities are underprivileged and vulnerable to genetic disorders, including thalassaemia. Understanding the perspectives of thalassaemia of future community leaders (indigenous university students) is critical for developing a tailor-made preventive strategy relevant to their communities. In this study, we aimed to assess the level of knowledge and attitudes towards thalassaemia among indigenous university students and determine their thalassaemia carrier status. METHODS: A cross-sectional survey was conducted among 251 tribal university students using a published questionnaire between May and October 2018. The main survey instrument consisted of 22 anonymous questions. Descriptive and inferential statistical procedures were used for data analysis. RESULTS: More than half (55%) of the indigenous students had never heard the term 'thalassaemia'. Around half (49%) of the marriages in their communities were consanguineous. The mean knowledge score was abysmal (4.91±2.65 out of a 12-point scale), which was not associated with the consanguinity of their parent but home districts. Multiple linear regression of demographic variables on the total knowledge score revealed that the overall knowledge is significantly associated with their home district (p< 0.05). Participants from science disciplines scored more than 1 point than their counterparts from Arts and Humanities (p = 0.08615). CONCLUSIONS: For the first time, this study has identified knowledge gaps and misperceptions about thalassaemia among university students from indigenous communities in the southeastern region of Bangladesh. This study serves as a baseline for future interventions (premarital and prenatal screening) targeting future community leaders.

Excess mortality during the COVID-19 pandemic (2020-2021) in an urban community of Bangladesh.

Measuring COVID-19-related mortality is vital for making public health policy decisions. The magnitude of COVID-19-related mortality is largely unknown in low- and middle-income countries (LMICs), including Bangladesh, due to inadequate COVID-19 testing capacity and a lack of robust civil registration and vital statistics systems. Even with the lack of data, cemetery-based death records in LMICs may provide insightful information on potential COVID-19-related mortality rates; nevertheless, there is a dearth of research employing cemetery-based death records. This study aimed to assess the excess mortality during the COVID-19 pandemic in an urban setting in Bangladesh using a cemetery-based death registration dataset. A total of 6,271 deaths recorded between January 2015 and December 2021 were analysed using a Bayesian structural time series model. Exploratory analysis found that the average monthly number of deaths was 69 during the pre-COVID-19 period (January 2015-February 2020), but significantly increased to 92 during the COVID-19 period (March 2020-December 2021). The increase in male deaths was twice as large as the increase in female deaths. Model-based results were not statistically significant (relative effect 17%, 95% credible interval: -18%, 57%), but there was an overall increasing trend during the COVID-19 period, and specific months or shorter periods had a substantial increase. This first-of-its-kind study in Bangladesh has assessed the excess mortality in an urban community during the COVID-19 pandemic. Cemetery-based death registration appears to aid in tracking population mortality, especially in resource-limited countries where collecting data on the ground is challenging during crisis periods; however, additional large-scale research is required.

24-hour movement guidelines and weight status among preschool-aged children in Bangladesh: A community-level cross-sectional study.

BACKGROUND: Increasing levels of urbanization and digitization in Bangladesh may be adversely associated with children's weight status and related movement behaviors. This study examined the prevalence of obesity, physical activity (PA), sedentary behavior, and sleep among young children from a district town in northern Bangladesh and identified factors associated with unhealthy weight status. METHODS: Population-based cross-sectional study involving all kindergarten schools in Jamalpur District town. Schools and children aged 4-7 years were randomly selected and had their weight and height measured. Mothers completed a questionnaire on their child's PA, recreational screen time, and sleep and sociodemographic factors. Children's weight status was based on World Health Organization (WHO) categories. Meeting the PA recommendation was based on the WHO guidelines for children and adolescents, and meeting the sedentary behavior and sleep recommendations was based on the Canadian/Australian 24-hour movement guidelines for children and young people. RESULTS: A total of 585 children and their parents were included in the study. Overall, 15% of children were overweight or obese. Three-quarters of children met the sleep guideline, and 50% met the PA guideline. Less than one third of children (31%) met the recreational screen time guideline, whereas 15% met all three guidelines. However, when adjusted for all predictors in the model, maternal education, family income, and child's age were significantly associated with overweight/obesity. Children with higher maternal education level were 2.3 times (AOR = 2.33, 95% CI: 1.19-4.78) more likely to be overweight/obese. Children in families with a higher monthly income had 1.9 times (AOR = 1.95, 95% CI: 1.14, 3.35) higher risk of being overweight/obese. CONCLUSIONS: Prioritizing maternal education (mother-centric interventions) can help address the high levels of childhood obesity in Bangladesh.

Demographic characteristics, clinical symptoms, biochemical markers and probability of occurrence of severe dengue: A multicenter hospital-based study in Bangladesh.

Establishing reliable early warning models for severe dengue cases is a high priority to facilitate triage in dengue-endemic areas and optimal use of limited resources. However, few studies have identified the complex interactive relationship between potential risk factors and severe dengue. This research aimed to assess the potential risk factors and detect their high-order combinative effects on severe dengue. A structured questionnaire was used to collect detailed dengue outbreak data from eight representative hospitals in Dhaka, Bangladesh, in 2019. Logistic regression and machine learning models were used to examine the complex effects of demographic characteristics, clinical symptoms, and biochemical markers on severe dengue. A total of 1,090 dengue cases (158 severe and 932 non-severe) were included in this study. Dyspnoea (Odds Ratio [OR] = 2.87, 95% Confidence Interval [CI]: 1.72 to 4.77), plasma leakage (OR = 3.61, 95% CI: 2.12 to 6.15), and hemorrhage (OR = 2.33, 95% CI: 1.46 to 3.73) were positively and significantly associated with the occurrence of severe dengue. Classification and regression tree models showed that the probability of occurrence of severe dengue cases ranged from 7% (age >12.5 years without plasma leakage) to 92.9% (age ≤12.5 years with dyspnoea and plasma leakage). The random forest model indicated that age was the most important factor in predicting severe dengue, followed by education, plasma leakage, platelet, and dyspnoea. The research provides new evidence to identify key risk factors contributing to severe dengue cases, which could be beneficial to clinical doctors to identify and predict the severity of dengue early.

Accidental poisoning in children: a single centre case series study in Bangladesh.

BACKGROUND: Accidental poisoning is a leading cause of unintentional injuries among children in low-income and middle-income countries (LMICs). The overall aspect of this unintentional poisoning is poorly understood in Bangladesh. The objectives of this study were (1) to explore the socio-demographic factors and circumstantial context of accidental poisoning and (2) the prevalence of the type of substances causing it. METHODS: A descriptive case series study was conducted from April 2019 to February 2020 at a tertiary level hospital of the capital city Dhaka in Bangladesh. Children under 10 years of age admitted to the hospital with accidental poisoning were enrolled in this study. Parents of hospitalised children were interviewed face-to-face using a structured questionnaire. Descriptive statistics were used for data analysis. RESULTS: A total of 223 children were recruited in this study. Children between 2 and 5 years (60%), men (61%) and children with agility (65.5%) were among the prevalent victims. The majority of cases occurred (65%) in a nuclear family setting. Most mothers (85%) of these children were non-working and most incidents took place in parents' homes (~82%). Nearly 70% of the poisoning incidents took place in the presence of parents and over half of these occurred in the bedroom. Kerosene was the prevalent cause (33%) of accidental poisoning while insecticide/pesticide ranked second (26.5%) followed by medicines (17%) and household chemicals (12). In one-third (31.4%) of the cases, poisoning chemicals were stored in soft drink bottles while two-thirds (67.3%) of the cases were kept in containers other than original ones. Although over 80 parents somewhat knew that chemicals could be harmful to the children if ingested, most of them did not take the safety measures. CONCLUSION: In this present study we found that preschool-aged children were more victims of accidental poisoning mostly by ingesting kerosene and a majority of the incidents took place in the bedroom while parents were present at home. Our study findings would serve as a baseline for designing future intervention studies and policies.

Clinical spectrum and predictors of severity of dengue among children in 2019 outbreak: a multicenter hospital-based study in Bangladesh.

BACKGROUND: The mosquito-borne arboviral disease dengue has become a global public health concern. However, very few studies have reported atypical clinical features of dengue among children. Because an understanding of various spectrums of presentation of dengue is necessary for timely diagnosis and management, we aimed to document the typical and atypical clinical features along with predictors of severity among children with dengue during the largest outbreak in Bangladesh in 2019. METHODS: We conducted a cross-sectional study between August 15 and September 30, 2019. in eight tertiary level hospitals in Dhaka city. Children (aged < 15 years) with serologically confirmed dengue were conveniently selected for data collection through a structured questionnaire. Descriptive, inferential statistics, and multivariable logistic regression were used to analyze data. RESULTS: Among the 190 children (mean age 8.8 years, and male-female ratio 1.22:1) included in the analysis, respectively 71.1 and 28.9% children had non-severe and severe dengue. All children had fever with an average temperature of 103.3 ± 1.2 F (SD). Gastrointestinal symptoms were the most common associated feature, including mostly vomiting (80.4%), decreased appetite (79.5%), constipation (72.7%), and abdominal pain (64.9%). Mouth sore, a less reported feature besides constipation, was present in 28.3% of children. Atypical clinical features were mostly neurological, with confusion (21.3%) being the predominant symptom. Frequent laboratory abnormalities were thrombocytopenia (87.2%), leucopenia (40.4%), and increased hematocrit (13.4%). Age (AOR 0.86, 95%CI 0.75-0.98, p = 0.023), mouth sore (AOR 2.69, 95%CI 1.06-6.96, p = 0.038) and a decreased platelet count (< 50,000/mm3) with increased hematocrit (> 20%) (AOR 4.94, 95%CI 1.48-17.31, p = 0.01) were significant predictors of severity. CONCLUSIONS: Dengue in children was characterized by a high severity, predominance of gastrointestinal symptoms, and atypical neurological presentations. Younger age, mouth sores, and a decreased platelet with increased hematocrit were significant predictors of severity. Our findings would contribute to the clinical management of dengue in children.

Age-related risk factors and severity of SARS-CoV-2 infection: a systematic review and meta-analysis.

OBJECTIVES: We aimed to estimate the prevalence of reported symptoms and comorbidities, and investigate the factors associated with age of the SARS-CoV-2 infected patients. METHODS: We performed a systematic review with meta-analysis (PROSPERO registration: CRD42020182677) where the databases (PubMed, SCOPUS, EMBASE, WHO, Semantic Scholar, and COVID-19 Primer) were searched for clinical studies published from January to April, 2020. Initially, the pooled prevalence of symptoms and comorbidity of COVID-19 patients were estimated using random effect model and the age -related factors were identified performing multivariate analysis [factor analysis]. RESULTS: Twenty-nine articles with 4,884 COVID-19 patients were included in this study. Altogether, we found 33 symptoms and 44 comorbidities where the most frequent 19 symptoms and 11 comorbidities were included in the meta-analysis. The fever (84%), cough/dry cough (61%), and fatigue/weakness (42%) were found more prevalent while acute respiratory distress syndrome, hypertension and diabetes were the most prevalent comorbid condition. The factor analysis showed positive association between a cluster of symptoms and comorbidities with patients' age. The symptoms comprising fever, dyspnea/shortness of breath, nausea, vomiting, abdominal pain, dizziness, anorexia and pharyngalgia; and the comorbidities including diabetes, hypertension, coronary heart disease, COPD/lung disease and ARDS were the factors positively associated with COVID-19 patient's age. CONCLUSION: As an unique effort, this study found a group of symptoms (fever, dyspnea/shortness of breath, nausea, vomiting, abdominal pain, dizziness, anorexia and pharyngalgia) and comorbidities (diabetes, hypertension, coronary heart disease, COPD/lung disease and ARDS), associated with the age of COVID-19 infected patients.

Insights into the first seven-months of COVID-19 pandemic in Bangladesh: lessons learned from a high-risk country.

South Asian countries have been struggling to control the COVID-19 pandemic despite imposing months of lockdown and other public health measures. This review aims to describe the epidemiological features and shortcomings in public health preparedness to tackle COVID-19 as well as derive lessons from these events in the context of Bangladesh. We have shown that an increase in human mobility was evident throughout the lockdown period. Over 20,000 frontline health workers were affected, and more than 2100 unofficial deaths possibly linked with COVID-19 diagnosis were reported. Males were disproportionately affected in terms of infection (71%) and death (77%) than females. Over 50% of infected cases were reported among young adults (20-40-year age group). After seven months into the pandemic, a downward trend in laboratory test positive percentage was seen, although the number of new deaths per day remained largely unchanged. We believe our findings, observations and recommendations will remain as a valuable resource to facilitate better public health practice and policy for managing current and future infectious disease like COVID-19 in resource-poor developing countries.

Model and variable selection using machine learning methods with applications to childhood stunting in Bangladesh.

Childhood stunting is a serious public health concern in Bangladesh. Earlier research used conventional statistical methods to identify the risk factors of stunting, and very little is known about the applications and usefulness of machine learning (ML) methods that can identify the risk factors of various health conditions based on complex data. This research evaluates the performance of ML methods in predicting stunting among under-5 aged children using 2014 Bangladesh Demographic and Health Survey data. Besides, this paper identifies variables which are important to predict stunting in Bangladesh. Among the selected ML methods, gradient boosting provides the smallest misclassification error in predicting stunting, followed by random forests, support vector machines, classification tree and logistic regression with forward-stepwise selection. The top 10 important variables (in order of importance) that better predict childhood stunting in Bangladesh are child age, wealth index, maternal education, preceding birth interval, paternal education, division, household size, maternal age at first birth, maternal nutritional status, and parental age. Our study shows that ML can support the building of prediction models and emphasizes on the demographic, socioeconomic, nutritional and environmental factors to understand stunting in Bangladesh.

The forgotten people with thalassemia in the time of COVID-19: South Asian perspective.

South Asia is the hotspot of beta-thalassemia, with an estimated 200,000 patients whose lives depend on regular blood transfusion. Due to COVID-19 pandemic, many countries have adopted unprecedented lockdown to minimize the spread of transmission. Restriction of nationwide human mobility and fear of COVID-19 infection has put thalassemia patients in a life-threatening situation because of an acute shortage of blood supply. As a public health preparedness strategy during a crisis like COVID-19 pandemic, the plights of thalassemia patients should be considered. Government-sponsored community blood-banks needs to be established or coverage expanded as a safety net for the thalassemia patients in lower- and middle-income countries.

Outcomes of adolescents compared with young adults after bariatric surgery: an analysis of 227,671 patients using the MBSAQIP data registry.

BACKGROUND: Obesity in the United States is increasingly prevalent in adolescents. Metabolic and bariatric surgery is offered at select sites to adolescents (<18 yr). Controversy exists regarding the safety of performing metabolic and bariatric surgery in adolescents. OBJECTIVES: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program registry was employed to compare outcomes of adolescents with adults (18-40 yr) undergoing sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB). SETTING: Academic Teaching Institution. METHODS: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Participant User Files were reviewed for patients undergoing SG or RYGB (2015-2018). Patients were stratified by age and outcomes for adolescents versus adults compared. A bivariate analysis was performed on propensity-matched data. RESULTS: After exclusion criteria were applied, 227,671 patients <40 years remained, of whom 1005 were adolescents. For those undergoing RYGB (13.8% adolescents, 25.3% adults), demographic characteristics were similar. Adolescent SG patients were more likely to be male and Hispanic, but less likely to be smokers or have preoperative co-morbidities. There were no differences in infection rates, mortality, major complications, reoperation, readmission, or other interventions for RYGB and SG groups. For both adult SG and adolescent SG, patients' operative times were less than adult and adolescent RYGB, respectively. However, operative times were shorter for adolescent RYGB versus adult RYGB patients, yet longer for adolescent SG patients versus adult SG patients. CONCLUSIONS: Metabolic and bariatric surgery is as safe for adolescents undergoing an SG or RYGB as adults. Currently, SG is more commonly performed in adolescents than RYGB, and adolescent SG patients have similar outcomes and shorter operating room times compared with adolescent RYGB patients.

Epidemiology, clinical features, and impact of food habits on the risk of hepatocellular carcinoma: A case-control study in Bangladesh.

Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third most common cause of cancer mortality worldwide. Infection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) is the most predominant cause of HCC. Concerns arise for the presence of additional risk factors, as there is still a large proportion of patients without HBV or HCV infection. Previous studies have reported that higher intake of fruits and vegetables and reduced consumption of red/processed meat might play a protective role in HCC etiology, though the nationwide proof is limited. Hence, we studied multiple risk factors including food habit, lifestyle, and clinical implications of HCC patients in Bangladeshi. Demographic, clinical, and biochemical data, as well as data on food habits, were collected in this study. Our results indicated that a high intake of rice (AOR 4.28, 95% CI 1.48 to 14.07, p = 0.011), low intake of fruits (AOR = 4.41 95% CI 1.48-15.46; p = 0.012), leafy vegetables (AOR = 2.80, 95% CI 1.32-6.08; p = 0.008), and fish (AOR = 4.64 95% CI 2.18-10.23; p<0.001) increased the HCC risk. Moreover, a high intake of eggs (AOR = 2.07 95% CI 0.98-4.43; p = 0.058) also showed an increased risk. Roti, non-leafy vegetables, red meat, and tea were found to have no association with HCC risk. This study revealed that food habit patterns and lifestyle may have a profound effect on HCC development among Bangladeshi patients in addition to well established risk factors.

Bariatric surgery outcomes when assisted by fellows and residents: an MBSAQIP analysis of 477,670 patients.

BACKGROUND: Previous reports of bariatric surgery outcomes when cases are assisted by residents and/or fellows have been inconclusive. OBJECTIVE: To compare bariatric surgery outcomes for cases with surgical trainees (ST; residents and fellows) versus nonsurgical trainees (nST; all other assistants) using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Registry. SETTING: Academic teaching. METHODS: The MBSAQIP Registry was reviewed (2015-2017) for Roux-en-Y gastric bypass, sleeve gastrectomy, and revision surgery based on ST and nST status. Univariate, multivariate logistic regression, and propensity matching analyses were performed. RESULTS: Of 477,670 cases, 26.8% were performed with ST. For ST patients 79.9% were female (versus 80.3% nST) and mean body mass index was 45.2 ± 8 kg/m2 (versus 45.0 ± 8.1 kg/m2 nST). Overall, 31.7% of patients underwent Roux-en-Y gastric bypass (versus 25.7% nST), 65.9% underwent sleeve gastrectomy (versus 71.6% nST), and 2.4% of patients had revision surgery (versus 2.7% nST). After matching, no difference in 30-day mortality was observed between groups. However, ST patients had higher incidence of deep vein thrombosis (P = .004), pulmonary embolism (P = .005), superficial surgical site infection (P < .0001), postoperative sepsis (P = .005), blood transfusions (P = .0307), nonoperative interventions (P = .004), 30-day readmission rates (P < .0001), and longer operative times (P < .0001), but lower 30-day reoperation rates (P = .0001). CONCLUSION: Overall, there was no difference observed in 30-day mortality between the ST and nST groups. However, despite lower 30-day reoperation rates, ST patients exhibited higher rates of postoperative deep vein thrombosis, pulmonary embolism, superficial surgical site infection, postoperative sepsis, blood transfusions, 30-day readmission rates, and longer operative times than nST patients.

Lack of knowledge and misperceptions about thalassaemia among college students in Bangladesh: a cross-sectional baseline study.

BACKGROUND: Thalassaemia is a potentially life-threatening yet preventable inherited hemoglobin disorder. Understanding local socio-cultural context and level of public awareness about thalassaemia is pivotal for selecting effective prevention strategies. This study attempted to assess knowledge and perceptions about thalassaemia among college students in Bangladesh. METHODS: A supervised cross-sectional survey was conducted on 1578 college students using a self-administered structured questionnaire. The survey took place from 15 February 2018 to 17 March 2018 in the Jamalpur district in Bangladesh. Besides the attitude-related questions, the study asked a total of 12 knowledge-related questions, which were scored on a scale of 0-12 points. RESULTS: Over two-thirds (67%) of the college students had never heard of thalassaemia. The urban-rural dichotomy was observed among those familiar with the term; (46.4% from urban vs. 25.8% from rural colleges). A similar pattern was observed for knowledge score; 5.07 ± 1.87 for students from the urban colleges compared to 3.69 ± 2.23 for rural colleges. Students from the science background had the highest knowledge score (5.03 ± 1.85), while those from arts and humanities background scored lowest (3.66 ± 2.3). Nearly 40% of the students were not sure or did not want to be a friend of a thalassaemia patient. Whereas 39% either declined or remained hesitant about helping thalassaemia patients by donating blood. However, most of the respondents (88%) showed a positive attitude towards 'premarital' screening to prevent thalassaemia. CONCLUSIONS: This study has identified critical knowledge gaps and societal misperceptions about thalassaemia. A better understanding of these aspects will be pivotal for disseminating thalassaemia related information. As the first study of this kind in Bangladesh, findings from this study has generated baseline data that would contribute to developing effective intervention strategies in Bangladesh and other countries with a comparable socio-cultural setting.

Manifestations of Atypical Symptoms of Chikungunya during the Dhaka Outbreak (2017) in Bangladesh.

Chikungunya (CHIK) has emerged as a major public health concern worldwide. Recently, atypical manifestations are drawing special attention because these might be associated with various complications. Information on atypical manifestations of CHIK is still limited. Here, we analyzed a dataset of 1,326 cases from our recent Dhaka outbreak study to explore the demographics and distributions of atypical manifestations. About 80% of cases reported at least one atypical symptom. Among all atypical symptoms, the most common and unique atypical symptom was joint pain before fever (90.2%), occurred predominantly in female respondents. Other common symptoms included red eye (68.2%), oral ulcer (37.7%), and dermatological manifestations (27.1%). More than two-thirds of patients reported multiple atypical symptoms. Atypical manifestations were not significantly different across age groups, except ocular complications. This study would be an important resource for clinicians and epidemiologists to understand the diversity of Chikungunya infection and, thus, help in better patient management.

Regional disparities in maternal and child health indicators: Cluster analysis of districts in Bangladesh.

Efforts to mitigate public health concerns are showing encouraging results over the time but disparities across the geographic regions still exist within countries. Inadequate researches on the regional disparities of health indicators based on representative and comparable data create challenges to develop evidence-based health policies, planning and future studies in developing countries like Bangladesh. This study examined the disparities among districts on various maternal and child health indicators in Bangladesh. Cluster analysis-an unsupervised learning technique was used based on nationally representative dataset originated from Multiple Indicator Cluster Survey (MICS), 2012-13. According to our results, Bangladesh is classified into two clusters based on different health indicators with substantial variations in districts per clusters for different sets of indicators suggesting regional variation across the indicators. There is a need to differentially focus on community-level interventions aimed at increasing maternal and child health care utilization and improving the socioeconomic position of mothers, especially in disadvantaged regions. The cluster analysis approach is unique in terms of the use of health care metrics in a multivariate setup to study regional similarity and dissimilarity in the context of Bangladesh.

Is Childhood Overweight/Obesity Perceived as a Health Problem by Mothers of Preschool Aged Children in Bangladesh? A Community Level Cross-Sectional Study.

Childhood obesity is rapidly rising in many developing countries such as Bangladesh; however, the factors responsible for this increase are not well understood. Being the primary caregivers of children, particularly in developing countries, maternal perceptions and knowledge could be important factors influencing the weight status of children. This study aimed to assess maternal perceptions of childhood obesity and associated socio-demographic factors in Bangladesh. A cross-sectional study using stratified random sampling was conducted among 585 mothers whose children aged 4 to 7 years attended preschools in a district town. Body Mass Index of the children was calculated and weight status categorized according to the Centers for Disease Control (CDC) criteria. Maternal perceptions were assessed using a self- or interviewer-administered questionnaire. Multinomial logistic regression was used to obtain crude and adjusted odds ratios. Fourteen percent of children were overweight or obese and approximately 30% were underweight. Only 3.1% of children were perceived as overweight/obese by their mothers. Over one-third (35%) of mothers perceived that childhood overweight/obesity could be a health problem and over two-thirds (68.6%) were not aware of any health consequences of childhood obesity. Maternal perceptions were significantly associated with maternal education, family income, and weight status of the child but were not associated with the sex of the child. We have identified knowledge gaps regarding maternal perception of childhood obesity and its contributing factors in a developing country. These findings can be used to develop and test parent-focused educational interventions for preventing childhood obesity in Bangladesh.