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.

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.