Factors associated with road traffic injury in a high-risk zone of Bangladesh: a mixed-method study.

INTRODUCTION: Road traffic injuries are a significant public health issue in low-income and middle-income countries. This study was designed to explore the pattern and factors associated with road traffic injury in a high-risk zone of Bangladesh. METHOD: This mixed-method study included a total of 363 road traffic injury victims for the quantitative component, and 10 traffic-related officials and 10 drivers for the qualitative element. Data were collected using a pretested questionnaire, key informant interviews and a focus group discussion using a focus group discussion guide. Quantitative and qualitative analyses were done using Stata V.17 and NVivo V.12, respectively. RESULTS: Most participants were male, illiterate and young (<30 years) with age averaging 31.50±9.16 years. Of all road traffic injury victims, most had mild (45.18%) injuries, and the least had severe (5.79%) injuries, with head being the most common site (34.44%). The highest proportion of injuries were sustained by motor vehicle drivers (57.58%), followed by cyclists/rickshaw pullers (22.59%) and passengers (19.83%). Most vehicles were new (75.21%), and the rest were old (24.79%). Nearly one-third of the participants did not know about driving rules. The presence of knowledge was associated with less severe injury (p=0.031) compared with the absence of knowledge. The qualitative component of the study identified several factors related to road traffic injury, including driver factors (lack of sleep, bad driving habits and lack of helmets), driving activity factors (ignoring rules, overtaking, crossing speed limits and using bright headlights), road-related factors (broken roads, unplanned curves and angles, the need for spacious streets and the lack of appraisal of previous crash records) and traffic control factors (stringent traffic rules, effective implementation and training on using speed guns). CONCLUSION: The factors related to road traffic injury identified in this study could be used to plan targeted interventions for road safety improvement.

Factors associated with low childhood immunization coverage among Rohingya refugee parents in Cox's Bazar, Bangladesh.

INTRODUCTION: Immunization campaigns and Expanded Program on Immunization (EPI) were launched by Government of Bangladesh (GoB) in collaboration with WHO and other Non-governmental Organizations (NGOs) to tackle the increased risk of vaccine preventable disease outbreak in the Rohingya refugee camps. Immunization coverage was found to be lower than expected. However, a few studies explored the factors behind low vaccine uptake among Refugee children. Therefore, this study was aimed. METHODS: A cross sectional study was carried out among Rohingya parents living in registered camps and makeshift settlements located in Teknaf and Ukhiya upazilla of Cox's Bazar, Bangladesh. A total of 224 Rohingya parents were conveniently selected (122 parents from each type of camps). Data was collected using a pretested interviewer-administered semi-structured questionnaire with the help of bilingual volunteers who understand Rohingya dialect. All statistical analyses were carried out in IBM SPSS Version 26 (New York, USA). RESULTS: Total 63.1% of Rohingya parents had good practice regarding childhood immunization (completed EPI vaccination) as per schedule. Of all, 74.6% had good knowledge and 94.7% had positive attitude towards EPI vaccination. Good practice regarding vaccination was significantly more common among parents living in registered camps (77%) than those living in makeshift settlements (49.2%, p<0.001). Multivariable logistic regression analysis revealed that living in registered camps (Adjusted Odds Ratio [aOR]: 2.99; 95% Confidence Interval [CI]: 1.41-6.32) and good knowledge level (aOR: 2.88; 95%CI: 1.32-15.82) were independent determinants of good practice. A separate analysis in both type of camps revealed that in registered camps, good knowledge level (aOR: 3.62; 95%CI: 1.45-9.04) and having >2 children (aOR: 3.71; 95%CI: 1.34-10.27), and in makeshift settlements, father's employment (aOR: 2.33; 95%CI: 1.34-6.72), father's education (aOR: 3.00; 95%CI: 1.34-6.72) and presence of any electronic device (e.g., radio, television, mobile phone) (aOR: 4.01; 95%CI: 0.96-16.84) were significant determinants of good childhood immunization practice. CONCLUSION: Health education and promotion strategies should be implemented to increase knowledge and awareness about EPI immunization benefits among Rohingya parents to ensure greater coverage.

Quality of life of COVID-19 recovered patients: a 1-year follow-up study from Bangladesh.

BACKGROUND: The COVID-19 pandemic posed a danger to global public health because of the unprecedented physical, mental, social, and environmental impact affecting quality of life (QoL). The study aimed to find the changes in QoL among COVID-19 recovered individuals and explore the determinants of change more than 1 year after recovery in low-resource settings. METHODS: COVID-19 patients from all eight divisions of Bangladesh who were confirmed positive by reverse transcription-polymerase chain reaction from June 2020 to November 2020 and who subsequently recovered were followed up twice, once immediately after recovery and again 1 year after the first follow-up. The follow-up study was conducted from November 2021 to January 2022 among 2438 individuals using the World Health Organization Quality of Life Brief Version (WHOQOL-BREF). After excluding 48 deaths, 95 were rejected to participate, 618 were inaccessible, and there were 45 cases of incomplete data. Descriptive statistics, paired-sample analyses, generalized estimating equation (GEE) analysis, and multivariable logistic regression analyses were performed to test the mean difference in participants' QoL scores between the two interviews. RESULTS: Most participants (n = 1710, 70.1%) were male, and one-fourth (24.4%) were older than 46. The average physical domain score decreased significantly from baseline to follow-up, and the average scores in psychological, social, and environmental domains increased significantly at follow-up (P < 0.05). By the GEE equation approach, after adjusting for other factors, we found that older age groups (P < 0.001), being female (P < 0.001), having hospital admission during COVID-19 illness (P < 0.001), and having three or more chronic diseases (P < 0.001), were significantly associated with lower physical and psychological QoL scores. Higher age and female sex [adjusted odd ratio (aOR) = 1.3, 95% confidence interval (CI) 1.0-1.6] were associated with reduced social domain scores on multivariable logistic regression analysis. Urban or semi-urban people were 49% less likely (aOR = 0.5, 95% CI 0.4-0.7) and 32% less likely (aOR = 0.7, 95% CI 0.5-0.9) to have a reduced QoL score in the psychological domain and the social domain respectively, than rural people. Higher-income people were more likely to experience a decrease in QoL scores in physical, psychological, social, and environmental domains. Married people were 1.8 times more likely (aOR = 1.8, 95% CI 1.3-2.4) to have a decreased social QoL score. In the second interview, people admitted to hospitals during their COVID-19 infection showed a 1.3 times higher chance (aOR = 1.3, 95% CI 1.1-1.6) of a decreased environmental QoL score. Almost 13% of participants developed one or more chronic diseases between the first and second interviews. Moreover, 7.9% suffered from reinfection by COVID-19 during this 1-year time. CONCLUSIONS: The present study found that the QoL of COVID-19 recovered people improved 1 year after recovery, particularly in psychological, social, and environmental domains. However, age, sex, the severity of COVID-19, smoking habits, and comorbidities were significantly negatively associated with QoL. Events of reinfection and the emergence of chronic disease were independent determinants of the decline in QoL scores in psychological, social, and physical domains, respectively. Strong policies to prevent and minimize smoking must be implemented in Bangladesh, and we must monitor and manage chronic diseases in people who have recovered from COVID-19.

Knowledge, practice and associated factors of breast self-examination among female university students of Bangladesh.

Background: Breast cancer is the most common cancer and leading cause of death worldwide. Breast self-examination (BSE) is a cost-effective tool for self-assessment and for potential early detection of breast cancer in low-resource settings. This study aimed to explore knowledge, practice and associated factors of BSE among female university students of Bangladesh. Methods: A cross-sectional study was conducted among 400 conveniently selected female students aged ≥18 years from four universities. A pre-tested semi-structured self-administered questionnaire was used for data collection. Univariate and multivariable logistic regression and simple and multiple linear regression analysis was used to assess determinants of knowledge and practice regarding BSE. Results: A total of 400 students participated from two private and two public universities (100 from each university). The average age of the participants was 20.89 ± 1.72 years (±SD). Of all, 60.5% had presence of knowledge (i.e., heard) about BSE. The average knowledge score was 7.41 ± 3.27 (in a scale of 0-15). Among those who had knowledge about BSE only 10.7% participants practiced it monthly. Being in public university (Adjusted Odds Ratio [aOR]: 3.42, 95% Confidence Interval [CI] 1.73-6.74) and years of education (aOR: 1.42, 95%CI: 1.02-1.97) were significant determinant of presence of knowledge regarding BSE. Moreover, studying in public university (ß: 0.99, 95%CI 0.16-1.82) and education years passed (ß: 0.51; 95%CI: 0.18-0.85) were associated with a higher knowledge score. Practice of BSE was negatively associated with students' rural living prior to admission (aOR: 0.26, 95%CI: 0.08-0.79), and positively associated with level of knowledge regarding BSE (aOR: 1.48; 95%CI 0.08-0.79). Conclusion: This study revealed a general lack of knowledge and practice regarding BSE among female university students. As knowledge and practice of BSE would increase breast cancer awareness and screening acceptance, authorities should address the issue with properly planned strategies.