In-house environmental factors and childhood acute respiratory infections in under-five children: a hospital-based matched case-control study in Bangladesh.

BACKGROUND: Acute respiratory infection (ARI) is one of the leading causes of morbidity and mortality among children under five globally, particularly in regions like South Asia and sub-Saharan Africa. Bangladesh has made substantial progress in reducing child mortality, yet pneumonia remains a significant contributor to under-five deaths. This study aimed to investigate the association between in-house environmental factors and childhood ARI, considering factors such as household crowding, smoking, and sanitation facilities. METHODS: This case-control study was conducted at a tertiary-level children's hospital in Dhaka, Bangladesh, from March to September 2019. The study included children aged 6-59 months. Cases were children with ARI symptoms, while controls were children without such symptoms. Rigorous matching by age and gender was employed to ensure comparability. Data were collected through structured questionnaires, and bivariate and conditional logistic regression analyses were performed. RESULTS: Several household environmental factors were significantly associated with childhood ARIs. Children from overcrowded households (AOR = 2.66, 95% CI = 1.52-4.71; p < 0.001), those using unclean cooking fuels (OR = 2.41, 95% CI: 1.56, 3.73; p = < 0.001), those exposed to in-house smoking (AOR = 1.74, 95% CI = 1.01, 3.05; p = 0.04) and those with unimproved sanitation facilities faced higher odds (AOR = 4.35, 95% CI = 2.14-9.26) of ARIs. Additionally, preterm birth and higher birth order were associated with an increased risk of ARI. In contrast, exclusive breastfeeding was a protective factor. CONCLUSION: In-house environmental factors, including sanitation, crowding and in-house smoking, significantly influence childhood ARIs. Additionally, birth order and preterm birth play a crucial role. Promoting exclusive breastfeeding is associated with a lower ARI risk among under-five children in Bangladesh. These findings can guide interventions to reduce ARIs in low-income regions, particularly in South Asia.

Insomnia and job stressors among healthcare workers who served COVID-19 patients in Bangladesh.

BACKGROUND: The global outbreak of COVID-19 has created unprecedented havoc among health care workers, resulting in significant psychological strains like insomnia. This study aimed to analyze insomnia prevalence and job stressors among Bangladeshi health care workers in COVID-19 units. METHODOLOGY: We conducted this cross-sectional study to assess insomnia severity from January to March 2021 among 454 health care workers working in multiple hospitals in Dhaka city with active COVID-dedicated units. We selected 25 hospitals conveniently. We used a structured questionnaire for face-to-face interviews containing sociodemographic variables and job stressors. The severity of insomnia was measured by the Insomnia Severity Scale (ISS). The scale has seven items to evaluate the rate of insomnia, which was categorized as the absence of Insomnia (0-7); sub-threshold Insomnia (8-14); moderate clinical Insomnia (15-21); and severe clinical Insomnia (22-28). To identify clinical insomnia, a cut-off value of 15 was decided primarily. A cut-off score of 15 was initially proposed for identifying clinical insomnia. We performed a chi-square test and adjusted logistic regression to explore the association of different independent variables with clinically significant insomnia using the software SPSS version 25.0. RESULTS: 61.5% of our study participants were females. 44.9% were doctors, 33.9% were nurses, and 21.1% were other health care workers. Insomnia was more dominant among doctors and nurses (16.2% and 13.6%, respectively) than others (4.2%). We found clinically significant insomnia was associated with several job stressors (p < 0.05). In binary logistic regression, having sick leave (OR = 0.248, 95% CI = 0.116, 0.532) and being entitled to risk allowance (OR = 0.367, 95% CI = 0.124.1.081) showed lower odds of developing Insomnia. Previously diagnosed with COVID-19-positive health care workers had an OR of 2.596 (95% CI = 1.248, 5.399), pointing at negative experiences influencing insomnia. In addition, we observed that any training on risk and hazard increased the chances of suffering from Insomnia (OR = 1.923, 95% CI = 0.934, 3.958). CONCLUSION: It is evident from the findings that the volatile existence and ambiguity of COVID-19 have induced significant adverse psychological effects and subsequently directed our HCWs toward disturbed sleep and insomnia. The study recommends the imperativeness to formulate and implement collaborative interventions to help HCWs cope with this crisis and mitigate the mental stresses they experience during the pandemic.

Prevalence of insomnia among the post-menopausal women who suffered from COVID-19 in Bangladesh: A nationwide cross-sectional study.

Objectives: The impact of the pandemic on sleeping problems in all age groups has been widely reported, but insomnia in post-menopausal women has been understudied worldwide. The study sought to determine the prevalence and associated factors for insomnia in post-menopausal women who were infected with COVID-19 in Bangladesh. Material and methods: A cross-sectional telephonic survey was conducted from August to December 2021 among post-menopausal women with a history of COVID-19 infection in Bangladesh. Data on socio-demographic factors, lifestyle and behavioral factors, COVID-19-associated factors, and self-reported pre-existing co-morbidities were collected. A validated scale Insomnia Severity Index (ISI) was applied to assess the level of insomnia . Bivariate and multiple linear regression analyses were performed to assess the associated factors with insomnia. Results: Of the total 900 participants, the prevalence of insomnia was reported at 70%, with 33.67% moderately severe, 25.11% subthreshold, and 11.22% severe insomnia. Participants with increased ISI scores were significantly more likely to be retired, had 2-4 children, felt disturbed by COVID-19 related news, hospitalized for COVID-19 management, receieved the first dose of vaccine, and experienced post COVID-19 symptoms such as fatigue, lack of concentration, and memory loss. On the other hand, living in a nuclear family and taking care of COVID-19-infected family members were significantly negatively associated with insomnia. Conclusions: Our findings indicate the need to safeguard the well-being considerations of post-menopausal women through a well-designed comprehensive social safety net program for the present pandemic and similar crises in the future.

A Community-Based Cross-Sectional Study about the Knowledge, Attitude, and Practices of Food Safety Measures among Rural Households in Bangladesh.

Background: Food handlers have been found to play essential roles in transmitting foodborne diseases and can pose a significant public health problem. Our study aimed to assess the knowledge, attitude, and practices (KAP) of food safety measures among the rural households of Bangladesh. Materials and Methods: We conducted this community-based cross-sectional study among women above 18 years involved with food preparation in rural households of four villages in Bangladesh. A total of 400 respondents were selected using the multistage cluster sampling technique. Data were collected using pretested and predesigned questionnaires based on the World Health Organization's (WHO) five keys for food safety. We used Stata (Version 16) for all statistical analyses. Results: The mean age of the participants was 42.09 ± 12.96 years. The median KAP scores [interquartile range (IQR)] were 7 (21-10), 16 (5-18), and 26 (9-30), respectively. We found the median KAP scores were significantly lower in the age group >55 years than in age groups of 18-25, 26-35, 36-45, and 46-55 years (P < 0.05 for all). In addition, the median KAP scores were significantly higher in respondents who were married, literate, employed/active, living in pakka/semipakka house, and with a monthly family income of >5,000 BDT (P < 0.05 for all). Among all, 33.75%, 80.25%, and 69.00% had good (≥80% of total) KAP scores, respectively. Multivariable regression analysis revealed that monthly family income >5,000 BDT was a significant predictor of good knowledge [Adjusted Odds Ratio (aOR): 3.51, 95%CI: 1.55-7.98], good attitude (aOR: 5.82, 95%CI: 2.80-11.70), and good practice (aOR: 3.18, 95%CI: 1.67-6.07). Age >55 years was a significant predictor of good attitude (aOR: 0.38, 95%CI: 0.17-0.81) and good practice (aOR: 0.48, 95%CI: 0.21-0.89). Having ≤4 members in the family was a significant predictor of good practice (aOR: 1.85, 95%CI: 1.13-3.03) regarding food safety measures. Conclusion: The study found that KAP among rural Bangladeshi women regarding food safety were relatively satisfactory. However, having a poor monthly income and living in a large family were impediments to good food-safety practices where work can be done. The findings of this study may help develop health intervention programs for food handlers to further improve KAP toward food safety, thereby reducing foodborne illness in households.

Hand hygiene products and adverse skin reactions: A cross-sectional comparison between healthcare and non-healthcare workers of Bangladesh during COVID-19 pandemic.

Background: The deadly COVID-19 pandemic has swept the globe since December 2019. Due to the significant risk of infection, frontline health workers had to use Personal Protective Equipment and hand hygiene products, to help prevent transmission of infection. The present study aims to compare the adverse skin responses between healthcare workers (HCW) and non-healthcare workers (NHCW). Materials and methods: A descriptive, cross-sectional study of HCW and NHCW throughout the country wa executed. A self-structured questionnaire was utilized to gather data from 404 HCWs and 826 NHCWs during a two-month period using multistage sampling. STATA (v16) was used to analyse the data. Results: 41.87% of the study participants experienced adverse skin reactions, which were more prevalent amongs HCW (65.10%) than NHCW (30.51%). The most frequently reported skin condition was skin dryness (34.39%), followed by skin peeling (11.71%). Users of alcohol-based hand sanitizers (ABHS) were more likely to get itch (8.13%), whereas soap water users were more likely to suffer from skin peeling (35.74%) and rash (7.46%). There was a significant (p < 0.001) association between occupation and adverse skin responses, with HCW being 3.5 times more likely to have adverse skin manifestations than NHCW. Conclusion: The research showed that healthcare workers were at a greater risk to developing skin reactions than the overall population with frequent use of hand hygiene measures being a significant risk factor.

Leptospirosis and COVID-19 co-infection case in Bangladesh.

Introduction: Leptospirosis, a zoonotic illness, is comparable to COVID-19 in that the majority of infections are mild or asymptomatic, and only a tiny percentage of those infected experience multiple system affected. Leptospirosis coinfection and the pathogenesis of SARS-CoV-2(Severe Acute Respiratory Syndrome Coronavirus 2) play a significant part in the emergence and progression of SARS-CoV-2 infection by enhancing the difficulty of identification, management, and outcome of COVID-19 well as worsening disease severity and death. Case report: We presented a 47-year-old individual with Leptospirosis diagnosed with SARS-CoV-2. A rapid test for IgM antibodies was used to confirm Leptospirosis. Reverse-transcription Polymerase Chain Reaction was used to establish COVID-19 (RTPCR). During the COVID-19 emergent crisis in Chattogram, Bangladesh, the person was diagnosed and treated with functional, supportive care for COVID-19 and antibiotic therapy for leptospirosis. The patient was given medication and guidance before being discharged from the hospital.To highlight the importance of microbial coinfection in COVID-19, we outline the coinfection of bacteria with SARS-CoV-2, their effects on COVID-19, the grounds for coinfection, and their identification.

Mental health status of married women during COVID-19 pandemic in Bangladesh: A cross-sectional study.

AIM: The uncontrolled spread of COVID-19 has demanded unparalleled measures, from the imposition of quarantine to the declaration as a public health emergency of international concern. COVID-19 poses a severe threat to our day-to-day life as well as physical and mental health. This study explores mental health status among married women that remain understudied in Bangladesh during the COVID-19 pandemic. METHODOLOGY: A cross-sectional study was conducted among 597 married women via face-to-face interview, maintaining all safety protocols. A semi-structured questionnaire was assembled that included socio-demographics and the DASS-21 scale. Descriptive analysis and logistic regression were performed to examine the associations between variables. RESULT: Almost 35% of the respondents had stress, 20% had anxiety, and 44% had depression ranging from mild to extremely severe. Metropolitan city inhabitants, being housewives, higher educational status, number of children, financial condition, comorbidities, family members assistance in household activities, relocation during COVID-19, social media use, concern about family, infected family members, tendency to get COVID-19 updates had been found significant in multivariable and univariate regression analysis with depression, anxiety, and stress. CONCLUSION: In this study, we found high rates of stress, anxiety, and depression among the study participants. These findings provide us with an epidemiological picture of the mental health status of our target population that could be a key benchmark for identifying high-risk groups and developing policies as well. Results could also be used to formulate psychological interventions that might be helpful during the COVID-19 period and later.

Prevalence and factors associated with depression among the mothers of school-going children in Dhaka city, Bangladesh: A multi stage sampling-based study.

BACKGROUND: Motherhood is associated with extra stress, and mothers of young children are particularly prone to developing depression and mental health problems. METHODOLOGY: This analytical cross-sectional study was conducted in Dhaka city, Bangladesh, from June to December 2019. Mothers of school-going children were recruited through a multistage sampling technique. Dhaka city was divided into two divisions and then further subdivided into public and private sectors. Six schools were selected from each sector by using a simple random sampling technique. A list of class five to eight students were collected from each school by systematic random sampling. Data were collected through face-to-face interviews using semi-structured questionnaires. The rate of depressive symptoms was measured by the validated Zung Self-Rating Depression Scale (SDS). RESULT: A total of 324 women participated in this study; the majority of the women (85.5%) were Muslim, 67.0% were housewives, and 53.1% had a girl child. Among the women, 15.4% had mild, 22.2% had moderate, and 20.1% had severe depression. Most of the child's behavioral and lifestyle factors were associated with the mother's depression. Adjusted analyses indicate that if a child is often unhappy, depressed, or tearful [(OR (95%CI = 22.27 (8.39-59.11)], gets nervous in new situations or easily loses confidence [(OR (95%CI) = 5.45 (2.96-10.00)], often lies or cheats [(OR (95%CI) = 8.93 (3.76-21.22)], gets afraid easily [(OR (95%CI) = 7.09 (3.79-13.24)], watches television for 3 h or more [(OR (95%CI) = 23.77 (6.46-87.48)] browses the internet for 3 h or more [(OR (95%CI = 7.37 (2.76-19.67)] were associated with mother's depression. CONCLUSION: The study concludes that depression among the mothers of school-going children in Dhaka city of Bangladesh is high. Several lifestyles and behavioral factors of school-going children are significantly associated with the mothers' depression.

Patterns of injuries and injury severity among hospitalized road traffic injury (RTI) patients in Bangladesh.

BACKGROUND: Road traffic injuries (RTIs) are one of the key public health issues worldwide causing 1.3 million deaths every year. This study aimed to determine the patterns of injuries due to road traffic accidents (RTAs), the severity of injuries, and factors associated with injury severity. METHODOLOGY: A cross-sectional study was conducted among RTA victims, who attended two large tertiary care hospitals located inside the Dhaka metropolitan area, through structured interview between 28 January and 22 March 2020. RESULTS: Among 375 RTI patients, a total of 1390 injuries were recorded among interviewed patients, yielding a mean of 3.7 injuries per patient. The most frequently injured systems were external (n = 351), lower limb (n = 235), head and neck (n = 151), and face (n = 150). The mean ISS were 20.96 ± 12.027 with a maximum of 65 and a minimum of 4. Among patients, 87 (23.20%) had a severe injury, and 37 (9.87%) patients were critically injured. A statistically significant variation in ISS was observed in ANOVA among various categories of age, education, occupation, and purpose of going outside, vehicle type and fitness, accident type, road type, times required in hospitalization, and death history (p < 0.05). CONCLUSIONS: Our study has revealed several important findings which will help stakeholders and policymakers devise better policies to reduce RTA and RTA related injuries in Bangladesh.

Level of patient satisfaction at government Unani & Ayurvedic Medical College Hospital in Dhaka, Bangladesh.

Objectives: This study was aimed to assess the level of patient satisfaction at Government Unani & Ayurvedic Medical College Hospital in Dhaka, Bangladesh. Study design: This was a cross-sectional study conducted among 165 patients attended at the out-patient department of Government Unani & Ayurvedic Medical College Hospital, Dhaka, Bangladesh. Patients who were equally or more than 18 years with a history of at least two referral visits were eligible to participate in the study. Methods: Patients satisfaction was measured by the Patient Satisfaction Questionnaire (PSQ-18), composed of 18 items translated in Bangla. Results: Among 165 out-patients, 135 (81.8%) were satisfied and 30 (18.2%) were dissatisfied with medical services. The mean and standard deviation of total patient satisfaction was 69.1 (±16.9). Financial aspects were the major area of patient dissatisfaction 29 (17.6%) towards Unani and Ayurvedic treatment due to lack of free medicine supply and high cost of medicine. Conclusion: The results would shed light on the present conditions of medical services at Government Unani & Ayurvedic Medical College Hospital which could be used to influence the outlook of the policymakers of our country.