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.

Prevalence and correlates of anxiety and depression in frontline healthcare workers treating people with COVID-19 in Bangladesh.

BACKGROUND: Healthcare workers (HCWs) who are in the frontline during the COVID-19 pandemic are often under significant pressures that may predispose them to symptoms of poor mental health. This study aimed to investigate the prevalence of anxiety and depression among HCWs and factors correlated with mental health concerns during the COVID-19 pandemic in Bangladesh. And, it also aimed to evaluate the psychometric properties of the Bangla version of the Hospital Anxiety and Depression Scale (HADS). METHODS: A cross-sectional survey was conducted between July and August, 2020. A self-reported online questionnaire was utilized to collect data. The survey included questions concerning socio-demographic, lifestyle, and work setting, as well as the HADS. A confirmatory factor analysis (CFA) and multiple linear regression analysis were performed. RESULTS: Data from 803 HCWs (50.7% male; mean age: 27.3 [SD = 6.9]; age range: 18-58 years) were included in the final analysis. The Bangla HADS was psychometrically sound, and demonstrated good internal consistency and reliability (α = 0.83), and excellent construct validity. Prevalence estimates of anxiety and depression were 69.5%, and 39.5%, respectively, for less severe symptomology (at least borderline abnormal), and 41.2% and 15.7% for more severe (at least abnormal) symptomology. Regression analyses with the total HADS score as a dependent variable revealed significant (p < 0.05) associations with female gender, moderate and poor health status, infrequent physical exercising, smoking, having had regrets about one's profession because of the pandemic and associated experiences, not updating on the latest COVID-19-related research, experiencing discrimination in the workplace, and facing social problems due to working in a lab or hospital during the COVID-19 pandemic. CONCLUSIONS: Symptoms of anxiety and depression are prevalent among HCWs during the COVID-19 pandemic in Bangladesh. The findings suggest a need for screening for mental health concerns, and employing early intervention to help these individuals.

Regulating tobacco retail outlets in Bangladesh: retailers' views and implications for tobacco control advocacy.

BACKGROUND: Tobacco products are ubiquitously available in Bangladesh. There are currently no restrictions on who can sell tobacco products and where they are allowed to be sold. The objective of this study was to explore tobacco retailers' views regarding tobacco retail licensing (TRL) in Bangladesh. METHODS: A two-stage cluster sampling procedure was used to collect data from a representative sample of 472 tobacco retailers (97% response rate) in Dhaka city in 2018 through face-to-face interviews using a semistructured questionnaire. Data were analysed using descriptive statistics, X2 tests and logistic regression. RESULTS: The majority (79%) of the retailers reported that they would support TRL, and 68% were interested in applying for TRL if adopted. Support for TRL was higher among those with a university degree (OR 2.1, 95% CI 0.8 to 5.3) and among those with knowledge about existing tobacco control regulations (OR 1.8, 95% CI 1.1 to 2.8). Furthermore, support for TRL was significantly higher among those who believed that it would restrict tobacco retailing locations (AOR 1.9, 95% CI 1.3 to 3.0) and prevent tobacco sales to minors (AOR 3.5, 95% CI 2.2 to 5.5). CONCLUSION: This sample of tobacco retailers in Bangladesh supported TRL. TRL advocacy efforts could draw on this support.

The COVID-19 pandemic and serious psychological consequences in Bangladesh: A population-based nationwide study.

BACKGROUND: As with other countries worldwide, lockdown measures during the COVID-19 outbreak in Bangladesh were sudden and unexpected, and have the capacity to elicit serious psychological consequences. The present study examined the psychological consequences of COVID-19 in Bangladesh during the lockdown period. METHODS: A nationwide online cross-sectional survey study recruited 10,067 individuals covering all 64 districts in Bangladesh via social media (April 1-10, 2020). The survey comprised questions concerning socio-demographics, knowledge of COVID-19, behavior towards COVID-19, fear of COVID-19, insomnia, depression, and suicidal ideation. Logistic regression and structural equation modeling (SEM) analyses were performed to identify the risk factors depression and suicidal ideation. Geographical information system (GIS)-based spatial analysis was used to identify district-wise susceptibility to depression and suicidal ideation. FINDINGS: The prevalence rate of depression and suicidal ideation related to COVID-19 was 33% and 5%%. Common risk factors for suicidal ideation and depression included being young, being female, being a cigarette smoker, having comorbid diseases, having high scores on the Fear COVID-19 Scale, and having insomnia symptoms. GIS-based maps detected high depression and suicidal ideation in the capital of Bangladesh and the districts near the capital as well as coastal areas where COVID-19 prevalence was high, as compared with districts with no reported cases. LIMITATIONS: Self-reported scales and cross-sectional design of the study. CONCLUSION: COVID-19 is associated with major psychological impact across Bangladesh, underlining the need of strategically located psychological support measures and improved access to mental health services, especially among women and younger people.

Puff or pass: do social media and social interactions influence smoking behaviour of university students? A cross-sectional mixed methods study from Dhaka, Bangladesh.

OBJECTIVE: To determine whether the odds of being a smoker differ based on social media use and social interactions among urban university students in Bangladesh. HYPOTHESIS: Social media use and social interactions influence the smoking behaviour of Bangladeshi university students, particularly in starting and maintaining cigarette smoking. DESIGN AND SETTING: A cross-sectional study using mixed methods on 600 student smokers and non-smokers recruited from two public and two private universities in Dhaka, Bangladesh, a lower middle-income country with limited resources. Exclusion criteria were those who did not use any form of social media and PhD students. RESULTS: Odds of smoking were significantly higher for those who socialised more than 4 hours/day (p<0.05; OR 1.75; 95% CI 1.12 to 2.75) and typically at night (p<0.05; OR 2.80; 95% CI 1.95 to 4.00). Odds of smoking were also higher for those who liked (p<0.05; OR 4.85; 95% CI 3.32 to 7.11), shared (p<0.05; OR 20.50; 95% CI 13.02 to 32.26) and followed (p<0.05; OR 2.88; 95% CI 1.36 to 6.11) tobacco-related content on social media. Qualitative analysis resulted in emergent themes of smokers imitating tobacco-related photos or videos seen on social media and peers as an influence for smoking initiation. CONCLUSION: This study suggests social media and social interactions may influence smoking behaviour in university students in Dhaka, Bangladesh. Future research should continue to investigate the roles social media and social interaction have on smoking in order to explore social media-based smoking cessation interventions or dissemination of smoking health hazards through social media.

Trace Metals in Vegetables and Associated Health Risks in Industrial Areas of Savar, Bangladesh.

BACKGROUND: The occurrence of high levels of trace metals in foodstuffs represents a significant threat to human health. Vegetables grown in metal-contaminated soil or irrigated with wastewater can accumulate metals and bioaccumulate in the food chain affecting animals and humans. OBJECTIVES: The present study aimed to measure the levels of lead (Pb), cadmium (Cd), chromium (Cr) and cobalt (Co) in common vegetables grown in the industrial areas of Savar, Bangladesh, and to determine their potential health risks. METHODS: Five vegetables species: jute (Corchorus capsularis), red amaranth (Amaranthus gangeticus), okra (Abelmoschus esculentus), zucchini (Luffa aegyptiaca) and stem amaranth (Amaranthus viridis) were sampled randomly from agricultural fields across each study site. Vegetable samples were digested in a microwave digestion system (Berghof Microwave MWS-2, Germany). Metal concentrations were determined using an atomic absorption spectrophotometer (AA-7000, Shimadzu Corporation, Japan). RESULTS: The range of Pb, Cd, Cr and Co in analyzed vegetables was 0.643-3.362, 0.041-0.049, 1.681-2.431 and 1.612-2.492 mg/kg, respectively. The target hazard quotient (THQ) of Pb in zucchini and stem amaranth and the THQs of Cr in all analyzed vegetables was greater than one. The target carcinogenic risk (TCR) of Pb and Cd for all analyzed vegetables was in the unacceptable range. In all vegetable samples, lead content was detected to be higher than the maximum permissible limits. The THQ values indicate the possibility of non-carcinogenic health risk through consumption of these vegetables. In addition, the TCR values of Pb and Cd indicate a lifetime carcinogenic health risks to consumers. CONCLUSIONS: Consumption of vegetables grown in this area may pose long-term health risks. COMPETING INTERESTS: The authors declare no competing financial interests.

Review of Cadmium Pollution in Bangladesh.

BACKGROUND: Exposure to cadmium (Cd) is a global public health concern. The primary Cd exposure pathways are inhalation and ingestion. Globally, Cd production and consumption has increased, along with nickel-cadmium battery production, alloys, anticorrosive coatings, pigments, polyvinyl chloride stabilizers, semiconductors for solar cells, etc. After the end use of these elements, improper management may cause Cd pollution in different spheres of the environment and living organisms that eventually lead to adverse effects on human health. OBJECTIVES: The aim of the present study is to demonstrate the sources and routes of Cd that enter different environmental spheres, their concentrations, and describe associated human health impacts in Bangladesh. METHODS: The present study searched a total of 304 peer-reviewed articles in the National Center for Biotechnology Information database, Science Direct, Web of Science, Springer Link, BanglaJOL, and university libraries and ultimately selected 71 articles. Afterwards, the relevant findings on Cd exposure through inhalation and diet and age-based impacts (i.e., adults, women, children and infants) in Bangladesh were combined. Finally, the results were processed with a cross-tabulation technique. RESULTS: The present study found that Cd concentration in the local diet and river water is within the World Health Organization and Bangladesh Standard Testing Institute guidelines. DISCUSSION: The concentration of Cd in sediments is comparatively higher than in river water in Bangladesh. Cadmium has been found in samples of foods, including leafy and non-leafy vegetables collected from different places in Bangladesh and may ultimately enter the human body via dietary intake of these foods. Consequently, individuals may be exposed to Cd and may be suffering from long-term adverse health effects. CONCLUSIONS: The comparison of concentrations in this study with national and international standards will assist with the formulation of effective pollution mitigation measures in Bangladesh. COMPETING INTERESTS: The authors declare no competing financial interests.

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

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