Assessment of preventive practices towards hepatitis B infection among nursing students in Bangladesh: role of knowledge, attitudes and sociodemographic factors.

BACKGROUND: Globally, hepatitis B infection (HBI) poses a substantial public health concern and healthcare workers, including nursing students, are at a higher risk of contracting this disease. Thus, the study aimed to assess how knowledge, attitudes, and sociodemographic factors are associated with HBI prevention among a sample of Bangladeshi nursing students. METHODS: A cross-sectional survey was performed among 737 nursing students from the nursing institutes of Khulna and Barishal divisions in Bangladesh from January to April 2023. The data were collected by providing questionnaires (structured questionnaire) in the classroom, following a stratified random sampling process. A model of multinomial logistic regression was used to evaluate the factors linked to HBI prevention practices. RESULT: The mean (SD) scores were 11.42 (± 2.88) for knowledge, 4.33 (± 1.91) for attitude and 4.27 (± 2.056) for practice respectively. Participants' low knowledge (adjusted odds ratio, aOR = 2.562, 95% CI: 1.29-5.07) and poor attitude (aOR = 5.730, 95% CI: 3.19-10.28) regarding HBI were significantly associated with higher likelihood of poor practice towards HBI prevention. Moreover, being 2nd year of nursing students (aOR = 2.147, 95% CI: 1.19-3.86), being aged 19-20 years (aOR = 3.038, 95% CI: 1.30-7.09), being married (aOR = 0.320, 95%CI: 0.13-0.82) and having a family history of HBI (aOR = 0.134, 95%CI: 0.05-0.36) were significantly associated with poor practices of HBI prevention among study participants. CONCLUSION: The knowledge, attitude and practice scores of the nursing students on HBI prevention were suboptimal. We advocate for implementing regular HBI prevention education and policies, free or subsidized services, skill development, proper HBI prevention enforcement and strict professional ethics within nursing colleges. Such efforts should predominantly focus on second-year, aged 19-20 and unmarried nursing students.

Internet addiction, depressive symptoms, and anxiety symptoms are associated with the risk of eating disorders among university students in Bangladesh.

The risk of developing an eating disorder among university students is higher than the general population in Bangladesh. Since psychiatric disorders (such as depression and anxiety) and addictive behaviors (e.g., internet addiction) predominantly exist among university students in the country, these may increase their vulnerability to developing an eating disorder. The association of internet addiction, depression, and anxiety with the risk of eating disorders among Bangladeshi university students is relatively unknown; therefore, this study investigates the association. This study was a cross-sectional design. Students (N = 700) from two public universities in Bangladesh completed the Patient Health Questionnaire (PHQ-9) scale, the Generalized Anxiety Disorder (GAD-7) tool, and Orman's Internet Addiction Survey (OIAS) to measure exposure variables. Eating Attitudes Test-26 (EAT-26) assessed the outcome variable. Multivariable logistic regression analysis showed that internet addiction [adjusted odds ratio (aOR) for moderate addiction = 2.15 and severe addiction = 3.95], depressive (aOR 3.04), and anxiety (aOR 2.06) symptoms were associated with an increased risk of eating disorder among study participants. Future longitudinal studies on university students are recommended to gain a better understanding about the causal factors of eating disorder to support intervention initiatives and strategies by public health practitioners and policy experts.

Prevalence and predictors of binge eating disorder symptoms among a sample of university students in Bangladesh: A cross-sectional survey.

Background and Aims: There is a dearth of information about binge eating disorder (BED) among Bangladeshi university students, who may be more susceptible to BED due to the rise in unhealthy lifestyles and food habits. Therefore, the purpose of this study was to assess the prevalence and associated factors of BED symptoms among Bangladeshi university students. Methods: Students (N = 525) from three public universities in Bangladesh participated in this cross-sectional study between November 2022 and March 2023. Face-to-face interviews were conducted using a structured paper-based questionnaire that included two validated survey tools; the binge eating disorder screener and the patient health questionnaire-9. To identify the factors associated with BED symptoms, multiple logistic regression analysis was conducted, with sociodemographic and behavioral information (e.g., age, sex, smoking status, etc.) considered as covariates. Results: The prevalence of BED symptoms among participants (mean age 21.28 years, 50.3% male and 49.7% female) was 20.6%. Male students had a 2.28 times higher likelihood of having BED symptoms compared to female counterparts (adjusted odds ratio [AOR] = 2.28; 95% CI: 1.33-3.89). Older students (AOR = 3.56, 95% CI: 1.80-7.05), students who were overweight or obese (AOR = 3.32, 95% CI: 1.87-5.89), and students reporting higher depressive symptoms (AOR = 2.69, 95% CI: 1.66-4.35) were at greater risk for developing BED compared to their respective counterparts. Conclusions: This study provides new insights into the prevalence of BED symptoms and its contributing factors among Bangladeshi students. Approximately 1-in-5 university students reported having BED symptoms. University students who are older, overweight, or obese, and who report depressive symptoms may be at greatest risk. Future longitudinal studies are needed to determine the causal factors underlying BED. Findings from this study can assist policymakers and public health professionals in developing effective and targeted strategies to mitigate the risks associated with BED among Bangladeshi university students.

Exposure to secondhand smoke is associated with poor sleep quality among non-smoking university students in Bangladesh: a cross-sectional survey.

Although secondhand smoke (SHS) exposure is predominant in Bangladesh, the adverse effect of SHS exposure on health-related behaviors, such as sleep quality, have remained an under-investigated area of the country's public health landscape. Therefore, the purpose of this study was to examine the association between SHS exposure and poor sleep quality among non-smoking university students in Bangladesh. A cross-sectional survey was carried out between May and September 2022. SHS exposure (main predictor variable) and other covariates (e.g., age, sex, etc.) were measured using a self-reported questionnaire and sleep quality (outcome variable) was measured via the Pittsburgh Sleep Quality Index. Multiple logistic regression models investigated the association between SHS exposure and poor sleep quality. The study included 390 students (mean age: 22 years, 53.8% male). Approximately 41.8% of the participants reported SHS exposure, and 50.5% had poor sleep quality. Students exposed to SHS were more likely to have poor sleep quality compared to their counterparts (AOR = 1.61; 95% CI 1.01, 2.58). Subgroup analysis revealed poor sleep quality was 2-times higher among male students exposed to SHS than those male students without SHS exposure (AOR = 2.03; 95% CI 1.05, 3.93). No association was found in female students. Findings from this study warrant increased awareness and public health initiatives on the implications of SHS on health behaviors, such as sleep quality, in non-smoking Bangladeshi university students.

Determinants of health care seeking behavior for childhood infectious diseases and malnutrition: A slum-based survey from Bangladesh.

This study aimed to explore the magnitude and determinants of health care seeking behaviors for common infectious disease and malnutrition among Bangladeshi under-five children living in slum areas. A cross-sectional study of 300 children-caregiver dyads was conducted in an urban slum of Bangladesh. Data were collected via a structured questionnaire with accompanying anthropometric assessments of children administered by research staff. Multiple logistic regression was employed to identify associated factors of health care seeking behaviors. Only 44.7% and 13.0% of respondents sought care for childhood infectious diseases and malnutrition, respectively. Being a male child, 2-5 years old, having ≤5 family members, monthly family income >125$, and living in close proximity to a health facility were found to be potential determinants of health care seeking behavior for childhood infectious diseases. Mother/caregivers with poor nutritional information knowledge and who had a child 2-5 years old reported engaging in less care seeking behaviors regarding their child's malnutrition compared to their counterparts. Caregivers of children under the age of 5 years old reported low participation in health care seeking behaviors in relation to childhood infectious disease and malnutrition. Families living in slums require additional support targeting health and nutritional educational programs.

Prevalence and associated factors of depression among Bangladeshi university students: A cross-sectional study.

Objective:  The study aimed to assess the prevalence of depression and its associated factors among university students in Bangladesh. Participants: A total of 403 undergraduate students from Patuakhali Science and Technology University, and Barisal University participated in the study. Method: A cross-sectional study was conducted using Beck's Depression Inventory (BDI). Result: The prevalence of depression (BDI ≥ 14) was 47.14%. Depression was 3.4 times (95% CI: 1.6-7.1), 3.8 times (95% CI: 1.7-8.6), and 3.9 times (95% CI: 1.5-8.9) higher among 2nd, 3rd, and 4th-year students, respectively than 1st-year students. Students with a history of stressful life events (aOR = 2.7, 95% CI: 1.7-4.4), suicidal attempts (aOR = 3.0, 95% CI: 1.2-7.9), and who received inadequate monthly allowance from their family (aOR = 0.53 95% CI: 0.3-0.9) were more likely to develop depressive symptoms. Conclusion: This study reports a high level of depression among university students which needs further discussion, exploration, and calls for designing appropriate interventions.

Nutritional and in vitro antioxidant activity analyses of formulated soymilk dessert.

Soymilk (SM) is nutritionally nearly equal to milk from cows and is free of cholesterol, gluten, and lactose. This study's objective was to formulate a cholesterol-free soymilk dessert (SOD) and compare it's to commercial desserts (CODs). Results indicated that the CODs contain substantial amounts of cholesterol while SOD does not. Soymilk dessert has more protein, and vitamin E than CODs, but less fat and calcium. In addition, the result also highlighted that SOD has higher number of amino acids compared to CODs. The total antioxidant, flavonoids and phenolics content of SOD were significantly higher than CODs. Furthermore, the in vitro antioxidant activity of SOD and CODs by DPPH and ABTS methods revealed that the IC50 of SODs significantly (p < 0.001) lower than CODs, and lower IC50 indicated the higher free radical scavenging power of SODs than CODs. These findings indicated that this non-dairy SOD may provide beneficial protein, as well as minerals, and antioxidants to support the body's various physiological functions.

Compliance to hand hygiene and its determinant factors among Community Health Care Providers in Community Clinics: an observational study in Bangladesh.

Background: Healthcare-associated infections caused by poor hand hygiene (HH) practices can affect both the care seekers and the health care providers (HCPs) while providing primary health care. No study has been conducted on the compliance of HH practices among the primary level HCPs in Bangladesh. Objective: The study aimed to assess the compliance rates of HH and its determinant factors among Community Health Care Providers (CHCPs) in Community Clinics (CC). Methods: A cross-sectional study was conducted from September 2019 to February 2020 among 150 randomly selected CHCPs with functional HH facilities in Patuakhali district, Bangladesh. Structured interviews and observation tools were used to collect data. Results: Good HH compliance among CHCPs was found to be 16.7% (95% CI: 11.3-21.3). Out of all 1218 possible HH opportunities, only 255 (20.9%) resulted in any HH action. Presence of 70% alcohol-based hand sanitiser at the point of care (aOR: 6.4, 95% CI: 1.1-38.3), HH training (aOR: 4.6, 95% CI: 1.1-18.9), displayed visual cues (aOR: 4.4, 95% CI: 1.1-17.7), knowledge about HH (aOR: 3.8, 95% CI: 1.1-13.6) and number of HH opportunities (aOR: 0.6, 95% CI: 0.4-0.8) were factors associated with HH compliance. Discussion: Overall HH compliance among CHCPs was relatively low. It was recommended to implement multimodal HH improvement strategies, including a continuous training program, supply of alcohol-based hand rub, reminder, provision of five moments of HH in the training modules and feedback on HH performance.

Mathematical Modeling and COVID-19 Forecast in Texas, USA: A Prediction Model Analysis and the Probability of Disease Outbreak.

BACKGROUND: Response to the unprecedented coronavirus disease 2019 (COVID-19) outbreak needs to be augmented in Texas, United States, where the first 5 cases were reported on March 6, 2020, and were rapidly followed by an exponential rise within the next few weeks. This study aimed to determine the ongoing trend and upcoming infection status of COVID-19 in county levels of Texas. METHODS: Data were extracted from the following sources: published literature, surveillance, unpublished reports, and websites of Texas Department of State Health Services (DSHS), Natality report of Texas, and WHO Coronavirus Disease (COVID-19) Dashboard. The 4-compartment Susceptible-Exposed-Infectious-Removal (SEIR) mathematical model was used to estimate the current trend and future prediction of basic reproduction number and infection cases in Texas. Because the basic reproduction number is not sufficient to predict the outbreak, we applied the Continuous-Time Markov Chain (CTMC) model to calculate the probability of the COVID-19 outbreak. RESULTS: The estimated mean basic reproduction number of COVID-19 in Texas is predicted to be 2.65 by January 31, 2021. Our model indicated that the third wave might occur at the beginning of May 2021, which will peak at the end of June 2021. This prediction may come true if the current spreading situation/level persists, i.e., no clinically effective vaccine is available, or this vaccination program fails for some reason in this area. CONCLUSION: Our analysis indicates an alarming ongoing and upcoming infection rate of COVID-19 at county levels in Texas, thereby emphasizing the promotion of more coordinated and disciplined actions by policy-makers and the population to contain its devastating impact.

SARS-CoV-2 and Rohingya Refugee Camp, Bangladesh: Uncertainty and How the Government Took Over the Situation.

Background: Bangladesh hosts more than 800,000 Rohingya refugees from Myanmar. The low health immunity, lifestyle, access to good healthcare services, and social-security cause this population to be at risk of far more direct effects of COVID-19 than the host population. Therefore, evidence-based forecasting of the COVID-19 burden is vital in this regard. In this study, we aimed to forecast the COVID-19 obligation among the Rohingya refugees of Bangladesh to keep up with the disease outbreak's pace, health needs, and disaster preparedness. Methodology and Findings: To estimate the possible consequences of COVID-19 in the Rohingya camps of Bangladesh, we used a modified Susceptible-Exposed-Infectious-Recovered (SEIR) transmission model. All of the values of different parameters used in this model were from the Bangladesh Government's database and the relevant emerging literature. We addressed two different scenarios, i.e., the best-fitting model and the good-fitting model with unique consequences of COVID-19. Our best fitting model suggests that there will be reasonable control over the transmission of the COVID-19 disease. At the end of December 2020, there will be only 169 confirmed COVID-19 cases in the Rohingya refugee camps. The average basic reproduction number (R0) has been estimated to be 0.7563. Conclusions: Our analysis suggests that, due to the extensive precautions from the Bangladesh government and other humanitarian organizations, the coronavirus disease will be under control if the maintenance continues like this. However, detailed and pragmatic preparedness should be adopted for the worst scenario.

Sources of nutrition information and nutritional knowledge among school-going adolescents in Bangladesh.

Objectives: The increasing prevalence of malnutrition among school-going adolescents is a major public health threat in Bangladesh. School studying adolescents are a crucial group suffering from malnutrition. Proper nutrition information can enrich their knowledge, promote their health and also minimize the burden of malnutrition. The study aimed to identify the sources of information and corresponding knowledge level on nutrition among school-going adolescents in Bangladesh. Study design: A school-based cross-sectional survey was carried out from January to August 2019. Methods: A pre-structured questionnaire having 13 validated questions regarding facts panel of packaged food and daily dietary habits was used to assess the knowledge. Scores on nutritional knowledge were calculated by summing up the answer values (Yes â€‹= â€‹1, No â€‹= â€‹0) and, scores below the overall mean were considered low. Logistic regression was employed to identify whether any source was related to respondents' nutritional knowledge. Results: Family members were the most popular (52.4%) source of nutrition information. Majority students (43.2%) trusted professionals as an accurate source. Approximately half (49.1%) of the participants scored low (<9.34) in basic nutrition knowledge assessment. Participants seeking information from family members (AOR: 0.693; 95% CI: 0.555-0.866, p â€‹< â€‹0.05) and online resources (AOR: 0.826, 95% CI: 0.710-0.962, p â€‹< â€‹0.05) were less likely to obtain low scores than those not favored the sources. Conclusion: Knowledge about essential nutrition among school-going adolescents was quite low. The findings of this study are useful to the policymakers to develop and design interventions to improve adolescents' knowledge of nutrition. A school-based nutrition awareness program can be introduced to reduce malnutrition among adolescents in Bangladesh.

Mechanistically derived Toxicant-mediated predator-prey model under Stoichiometric constraints.

Studies in ecological stoichiometry highlight that grazer dynamics are affected by insufficient food nutrient content (low phosphorus (P)/carbon (C) ratio) as well as excess food nutrient content (high P:C). Contaminant stressors affect all levels of the biological hierarchy, from cells to organs to organisms to populations to entire ecosystems. Eco-toxicological modeling under the framework of ecological stoichiometry predicts the risk of bio-accumulation of a toxicant under stoichiometric constraints. In this paper, we developed and analyzed a Lotka-Volterra type predator- prey model which explicitly tracks the environmental toxicant as well as the toxicant in the populations under stoichiometric constraints. Analytic, numerical, slow-fast steady state and bifurcation theory are employed to predict the risk of toxicant bio-accumulation under varying food conditions. In some cases, our model predicts different population dynamics, including wide amplitude limit cycles where producer densities exhibit very low values and may be in danger of stochastic extinction.

Environmental seasonality on predator-prey systems under nutrient and toxicant constraints.

Bioaccumulation of toxicants in aquatic food webs can pose risks to ecosystem function and human health. Toxicant models of aquatic ecosystems can be improved by incorporating realistic environmental impacts such as nutrient availability and seasonality. It is well known that the carrying capacity of predator-prey systems can vary seasonally due to environmental cycles resulting from natural and human activities. As such, incorporating seasonal variation in the carrying capacity of a predator-prey system provides a better understanding of the underlying population dynamics bioaccumulation of toxicants. Here, we develop a seasonally varied predator-prey model subject to concurrent nutrient and toxicant stressors. We investigate the effects of seasonality on population dynamics to increase understanding of the complex governing processes of the trophic transfer of nutrients, energy, and toxicants. We observe that the strength of seasonality can shift solutions from periodic to quasi-periodic and models that neglect environmental seasonality may be under-predicting adverse effects of toxicity.

Effect of excess food nutrient on producer-grazer model under stoichiometric and toxicological constraints.

Accurately assessing the risks of contaminants requires more than an understanding of the effects of contaminants on individual organism, but requires further understanding of complex ecological interactions, elemental cycling, and the interactive effects of natural stressors, such as resource limitations, and contaminant stressors. There is increasing evidence that organisms experience interactive effects of contaminant stressors and food conditions, such as resource stoichiometry, availability and excess of nutrient. Here, we develop and analyze the first producer-grazer population model that incorporates the effects of excess nutrients, as well as nutrient limitations on grazer exposed to toxicants. We use analytical, numerical and bifurcation analysis to reduce and exploremodel parameterized for an aquatic system of algae and zooplankton exposed to methylmercury under varying phosphorus conditions. Under certain environmental conditions, our models predict higher toxicity than previous models that neglect the consequences excess nutrient conditions can have on grazer populations.

Association of good glycemic control and cost of diabetes care: Experience from a tertiary care hospital in Bangladesh.

AIM: The present study was undertaken to assess the cost-effectiveness of good glycemic control in a population of Bangladeshi people with type 2 diabetes mellitus (T2DM). METHODS: A cross-sectional study was conducted among 496 registered patients with >1year duration of diabetes. Glycated hemoglobin A1c level <7% was judged as the cut-off value for good glycemic control. All treatment-related records from the last year were collected from patients' guide books and all cost components were calculated. RESULTS: Among patients, 31% had good glycemic control. The average annual cost was US$ 314 per patient. Patients with poor glycemic control were significantly more likely to have complications [(p=0.049) OR 1.5] and comorbidities [(p=0.02) OR 1.5]. The annual cost increased rapidly with complications/comorbidities. In multivariable logistic regression analysis, gender (p=0.003) and cost of care (p=0.006) were significantly associated with glycemic control, and the presence of any comorbidities/complications was associated with 1.8-fold higher odds of poor glycemic control (p=0.013 95% CI: 1.131-2.786). CONCLUSION: Good glycemic control can lead to substantial cost saving through prevention and control of complications.