Investigating the role of hypothetical protein (AAB33144.1) in HIV-1 virus pathogenicity: A comparative study with FDA-Approved inhibitor compounds through In silico analysis and molecular docking.

Aim and objective: Due to the a lot of unexplored proteins in HIV-1, this research aimed to explore the functional roles of a hypothetical protein (AAB33144.1) that might play a key role in HIV-1 pathogenicity. Methods: The homologous protein was identified along with building and validating the 3D structure by searching several bioinformatics tools. Results: Retroviral aspartyl protease and retropepsin like functional domains and motifs, folding pattern (cupredoxins), and subcellular localization in cytoplasmic membrane were determined as biological activity. Besides, the functional annotation revealed that the chosen hypothetical protein possessed protease-like activity. To validate our generated protein 3D structure, molecular docking was performed with five compounds where nelfinavir showed (-8.2 kcal/mol) best binding affinity against HXB2 viral protease (PDB ID: 7SJX) and main protease (PDB ID: 4EYR) protein. Conclusions: This study suggests that the annotated hypothetical protein related to protease action, which may be useful in viral genetics and drug discovery.

Supporting patients and their carers to participate in infection prevention and control activities: The views of patients, family members, and hospital staff from Bangladesh, Indonesia, and South Korea.

BACKGROUND: Hand hygiene reminders for healthcare workers (HCWs) are commonly used to empower patients. However, this approach overlooks the role of family carers in delivering direct contact care in Asian countries. Limited knowledge exists regarding empowerment strategies for patients and their family carers in infection prevention and control (IPC) recommendations. This study aimed to provide a comprehensive exploration of IPC empowerment within the context of family involvement in care provision across Bangladesh, Indonesia, and South Korea. METHODS: In-depth interviews were conducted in 5 tertiary-level hospitals in Bangladesh, Indonesia, and South Korea. A total of 64 participants were interviewed through 57 interviews, including 6 group interviews, comprising 2 groups: (1) patients and their family and private carers; and (2) HCWs. RESULTS: The study identified barriers to engaging patients and family carers in IPC measures. These included concerns about the patient-HCW hierarchical relationship, lack of knowledge about healthcare-associated infection, IPC, and patient zone, perceptions of IPC as a barrier to family connections, and disempowerment of patients in IPC due to family bonds. CONCLUSIONS: This study provides diverse perspectives on IPC empowerment, revealing challenges faced by patients, family carers, and HCWs. The interlaced relationship established by social norms of family carer provision hinders the empowerment of family carers. Acknowledging the cultural influence on health care arrangements and its implication for IPC empowerment is crucial in mitigating these barriers.

Mental illness stigma in Bangladesh: Findings from a cross-sectional survey.

Background: Mental illness stigma is universally prevalent and a significant barrier to achieving global mental health goals. Mental illness stigma in Bangladesh has gained little attention despite its widespread impact on seeking mental health care in rural and urban areas. This study aimed to investigate mental illness stigma and the associated factors in rural and urban areas of Bangladesh. Methods: The study areas were divided into several clusters from which 325 participants (≥18 years) were recruited with systematic random sampling. The Bangla version of the Days' Mental Illness Stigma Scale was used to collect data. Independent-samples t-test, ANOVA, and multiple regression were performed. Results: Results suggest that gender, age, geographical location, socioeconomic status, and occupation significantly differed across subscales of stigma. Age, gender, seeking treatment of mental illness, having knowledge on mental health, and socioeconomic status were predictive factors of mental illness stigma. The results also showed a high treatment gap in both rural and urban areas. Conclusion: This study supports that mental illness stigma is prevalent in Bangladesh, requiring coordinated efforts. Results can inform the development of contextually tailored mental health strategies to reduce stigma and contribute to the promotion of mental health of individuals and communities across Bangladesh.

Prevalence and incidence of tuberculosis infection among healthcare workers in chest diseases hospitals, Bangladesh: Putting infection control into context.

BACKGROUND: Healthcare workers (HCWs) are at increased risk of tuberculosis infection (TBI). We estimated the prevalence and incidence of TBI and risk factors among HCWs in Bangladeshi hospitals to target TB infection prevention and control (IPC) interventions. METHODS: During 2013-2016, we conducted a longitudinal study among HCWs in four chest disease hospitals. At baseline, we administered a questionnaire on sociodemographic and occupational factors for TB, tuberculin skin tests (TST) in all hospitals, and QuantiFERON ®-TB Gold in-Tube (QFT-GIT) tests in one hospital. We assessed factors associated with baseline TST positivity (induration ≥10mm), TST conversion (induration increase ≥10mm from baseline), baseline QFT-GIT positivity (interferon-gamma ≥0.35 IU/mL), and QFT-GIT conversion (interferon-gamma <0.35 IU/mL to ≥0.35 IU/mL). We included factors with a biologically plausible relationship with TBI identified in prior studies or having an association (p = <0.20) in the bivariate analyses with TST positivity or QFT-GIT positivity in multivariable generalized linear models. The Kaplan-Meier was used to estimate the cumulative TBI incidence rate per 100 person-years. RESULTS: Of the 758 HCWs invited, 732 (97%) consented to participate and 731 completed the one-step TST, 40% had a positive TST result, and 48% had a positive QFT-GIT result. In multivariable models, HCWs years of service 11-20 years had 2.1 (95% CI: 1.5-3.0) times higher odds of being TST-positive and 1.6 (95% CI 1.1-2.5) times higher odds of QFT-GIT-positivity at baseline compared with those working ≤10 years. HCWs working 11-20 years in pulmonary TB ward had 2.0 (95% CI: 1.4-2.9) times higher odds of TST positivity, and those >20 years had 2.5 (95% CI: 1.3-4.9) times higher odds of QFT-GIT-positivity at baseline compared with those working <10 years. TBI incidence was 4.8/100 person-years by TST and 4.2/100 person-years by QFT-GIT. Females had 8.5 (95% CI: 1.5-49.5) times higher odds of TST conversion than males. CONCLUSIONS: Prevalent TST and QFT-GIT positivity was associated with an increased number of years working as a healthcare worker and in pulmonary TB wards. The incidence of TBI among HCWs suggests ongoing TB exposure in these facilities and an urgent need for improved TB IPC in chest disease hospitals in Bangladesh.

Tackling a global epidemic threat: Nipah surveillance in Bangladesh, 2006-2021.

Human Nipah virus (NiV) infection is an epidemic-prone disease and since the first recognized outbreak in Bangladesh in 2001, human infections have been detected almost every year. Due to its high case fatality rate and public health importance, a hospital-based Nipah sentinel surveillance was established in Bangladesh to promptly detect Nipah cases and respond to outbreaks at the earliest. The surveillance has been ongoing till present. The hospital-based sentinel surveillance was conducted at ten strategically chosen tertiary care hospitals distributed throughout Bangladesh. The surveillance staff ensured that routine screening, enrollment, data, and specimen collection from suspected Nipah cases were conducted daily. The specimens were then processed and transported to the reference laboratory of Institute of Epidemiology, Disease Control and Research (IEDCR) and icddr,b for confirmation of diagnosis through serology and molecular detection. From 2006 to 2021, through this hospital-based surveillance platform, 7,150 individuals were enrolled and tested for Nipah virus. Since 2001, 322 Nipah infections were identified in Bangladesh, 75% of whom were laboratory confirmed cases. Half of the reported cases were primary cases (162/322) having an established history of consuming raw date palm sap (DPS) or tari (fermented date palm sap) and 29% were infected through person-to-person transmission. Since the initiation of surveillance, 68% (218/322) of Nipah cases from Bangladesh have been identified from various parts of the country. Fever, vomiting, headache, fatigue, and increased salivation were the most common symptoms among enrolled Nipah patients. Till 2021, the overall case fatality rate of NiV infection in Bangladesh was 71%. This article emphasizes that the overall epidemiology of Nipah virus infection in Bangladesh has remained consistent throughout the years. This is the only systematic surveillance to detect human NiV infection globally. The findings from this surveillance have contributed to early detection of NiV cases in hospital settings, understanding of Nipah disease epidemiology, and have enabled timely public health interventions for prevention and containment of NiV infection. Although we still have much to learn regarding the transmission dynamics and risk factors of human NiV infection, surveillance has played a significant role in advancing our knowledge in this regard.

Mpropred: A machine learning (ML) driven Web-App for bioactivity prediction of SARS-CoV-2 main protease (Mpro) antagonists.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic emerged in 2019 and still requiring treatments with fast clinical translatability. Frequent occurrence of mutations in spike glycoprotein of SARS-CoV-2 led the consideration of an alternative therapeutic target to combat the ongoing pandemic. The main protease (Mpro) is such an attractive drug target due to its importance in maturating several polyproteins during the replication process. In the present study, we used a classification structure-activity relationship (CSAR) model to find substructures that leads to to anti-Mpro activities among 758 non-redundant compounds. A set of 12 fingerprints were used to describe Mpro inhibitors, and the random forest approach was used to build prediction models from 100 distinct data splits. The data set's modelability (MODI index) was found to be robust, with a value of 0.79 above the 0.65 threshold. The accuracy (89%), sensitivity (89%), specificity (73%), and Matthews correlation coefficient (79%) used to calculate the prediction performance, was also found to be statistically robust. An extensive analysis of the top significant descriptors unveiled the significance of methyl side chains, aromatic ring and halogen groups for Mpro inhibition. Finally, the predictive model is made publicly accessible as a web-app named Mpropred in order to allow users to predict the bioactivity of compounds against SARS-CoV-2 Mpro. Later, CMNPD, a marine compound database was screened by our app to predict bioactivity of all the compounds and results revealed significant correlation with their binding affinity to Mpro. Molecular dynamics (MD) simulation and molecular mechanics/Poisson Boltzmann surface area (MM/PBSA) analysis showed improved properties of the complexes. Thus, the knowledge and web-app shown herein can be used to develop more effective and specific inhibitors against the SARS-CoV-2 Mpro. The web-app can be accessed from https://share.streamlit.io/nadimfrds/mpropred/Mpropred_app.py.

COVID-19 Risk Perception and Prevention Practices among High- and Low-Density Populations in Bangladesh: A Mixed-Methods Study.

We aimed to explore coronavirus disease 2019 (COVID-19) risk perception and prevention practices among people living in high- and low-population density areas in Dhaka, Bangladesh. A total of 623 patients with confirmed COVID-19 agreed to participate in the survey. Additionally, we purposively selected 14 participants from diverse economic and occupational groups and conducted qualitative interviews for them accordingly. Approximately 70% of the respondents had low socioeconomic status. Among the 623 respondents, 146 were from low-density areas, and 477 were from high-density areas. The findings showed that study participants perceived COVID-19 as a punishment from the Almighty, especially for non-Muslims, and were not concerned about its severity. They also believed that coronavirus would not survive in hot temperatures or negatively impact Bangladeshis. This study revealed that people were reluctant to undergo COVID-19 testing. Family members hid if anyone tested positive for COVID-19 or did not adhere to institutional isolation. The findings showed that participants were not concerned about COVID-19 and believed that coronavirus would not have a devastating impact on Bangladeshis; thus, they were reluctant to follow prevention measures and undergo testing. Tailored interventions for specific targeted groups would be relevant in mitigating the prevailing misconceptions.

Transmission of SARS-CoV-2 in the Population Living in High- and Low-Density Gradient Areas in Dhaka, Bangladesh.

Community transmission of SARS-CoV-2 in densely populated countries has been a topic of concern from the beginning of the pandemic. Evidence of community transmission of SARS-CoV-2 according to population density gradient and socio-economic status (SES) is limited. In June−September 2020, we conducted a descriptive longitudinal study to determine the community transmission of SARS-CoV-2 in high- and low-density areas in Dhaka city. The Secondary Attack Rate (SAR) was 10% in high-density areas compared to 20% in low-density areas. People with high SES had a significantly higher level of SARS-CoV-2-specific Immunoglobulin G (IgG) antibodies on study days 1 (p = 0.01) and 28 (p = 0.03) compared to those with low SES in high-density areas. In contrast, the levels of seropositivity of SARS-CoV-2-specific Immunoglobulin M (IgM) were comparable (p > 0.05) in people with high and low SES on both study days 1 and 28 in both high- and low-density areas. Due to the similar household size, no differences in the seropositivity rates depending on the population gradient were observed. However, people with high SES showed higher seroconversion rates compared to people with low SES. As no difference was observed based on population density, the SES might play a role in SARS-CoV-2 transmission, an issue that calls for further in-depth studies to better understand the community transmission of SARS-CoV-2.

Preparedness of tertiary care hospitals to implement the national TB infection prevention and control guidelines in Bangladesh: A qualitative exploration.

In high tuberculosis (TB) burden countries, health settings, including non-designated TB hospitals, host many patients with pulmonary TB. Bangladesh's National TB Control Program aims to strengthen TB infection prevention and control (IPC) in health settings. However, there has been no published literature to date that assessed the preparedness of hospitals to comply with the recommendations. To address this gap, our study examined healthcare workers knowledge and attitudes towards TB IPC guidelines and their perceptions regarding the hospitals' preparedness in Bangladesh. Between January to December 2019, we conducted 16 key-informant interviews and four focus group discussions with healthcare workers from two public tertiary care hospitals. In addition, we undertook a review of 13 documents [i.e., hospital policy, annual report, staff list, published manuscript]. Our findings showed that healthcare workers acknowledged the TB risk and were willing to implement the TB IPC measures but identified key barriers impacting implementation. Gaps were identified in: policy (no TB policy or guidelines in the hospital), health systems (healthcare workers were unaware of the guidelines, lack of TB IPC program, training and education, absence of healthcare-associated TB infection surveillance, low priority of TB IPC, no TB IPC monitoring and feedback, high patient load and bed occupancy, and limited supply of IPC resources) and behavioural factors (risk perception, compliance, and self and social stigma). The additional service-level gap was the lack of electronic medical record systems. These findings highlighted that while there is a demand amongst healthcare workers to implement TB IPC measures, the public tertiary care hospitals have got key issues to address. Therefore, the National TB Control Program may consider these gaps, provide TB IPC guidelines to these hospitals, assist them in developing hospital-level IPC manual, provide training, and coordinate with the ministry of health to allocate separate budget, staffing, and IPC resources to implement the control measures successfully.

Barriers to seeking timely treatment for severe childhood pneumonia in rural Bangladesh.

OBJECTIVE: Delays in seeking medical attention for childhood pneumonia may lead to increased morbidity and mortality. This study aimed at identifying the drivers of delayed seeking of treatment for severe childhood pneumonia in rural Bangladesh. METHODS: We conducted a formative study from June to September 2015 in one northern district of Bangladesh. In-depth interviews were conducted with 20 rural mothers of children under 5 years with moderate or severe pneumonia. We analysed the data thematically. RESULTS: We found that mothers often failed to assess severity of pneumonia accurately due to lack of knowledge or misperception about symptoms of pneumonia. Several factors delayed timely steps that could lead to initiation of appropriate treatment. They included time lost in consultation with non-formal practitioners, social norms that required mothers to seek permission from male household heads (eg, husbands) before they could seek healthcare for their children, avoiding community-based public health centres due to their irregular schedules, lack of medical supplies, shortage of hospital beds and long distance of secondary or tertiary hospitals from households. Financial hardships and inability to identify a substitute caregiver for other children at home while the mother accompanied the sick child in hospital were other factors. CONCLUSIONS: This study identified key social, economic and infrastructural factors that lead to delayed treatment for childhood pneumonia in the study district in rural Bangladesh. Interventions that inform mothers and empower women in the decision to seek healthcare, as well as improvement of infrastructure at the facility level could lead to improved behaviour in seeking and getting treatment of childhood pneumonia in rural Bangladesh.

Exploring factors influencing the compliance of patients and family carers with infection prevention and control recommendations across Bangladesh, Indonesia, and South Korea.

Background: Poor compliance with infection prevention and control (IPC) measures has been a longstanding issue globally. To date, healthcare workers (HCWs) have been the primary target for policy and strategy revisions. Recent studies exploring the contributing factors to the spread of COVID-19 across countries in Asia have suggested that the scope of focus should be extended to family carers who provide patient care activities. This study aimed to explore factors affecting patients' and their family carers' IPC compliance in hospitals in Bangladesh, Indonesia, and South Korea. Method: A qualitative study incorporating 57 semi-structured interviews was conducted in five tertiary-level hospitals across the three focus countries between July 2019 and February 2020. Interviews were undertaken with: (1) patients, family carers and private carers; and (2) healthcare workers, including nurses, doctors, and hospital managers. Drawing upon the principles of grounded theory, data were inductively analyzed using thematic analysis. Results: A total of three main themes and eight subthemes are identified. Key themes focused on the assumptions made by healthcare workers regarding the family/private carers' level of understanding about IPC and training received; uncertainty and miscommunication regarding the roles of family/private carers; variations in carer knowledge toward IPC and healthcare-associated infections, and the impact of cultural values and social norms. Conclusion: This exploratory study offers novel findings regarding the factors influencing IPC compliance among patients and their family/private carers across various cultural settings, irrespective of resource availability. The role of cultural values and social norms and their impact on IPC compliance must be acknowledged when updating or revising IPC policies and guidelines.

Examining pulmonary TB patient management and healthcare workers exposures in two public tertiary care hospitals, Bangladesh.

Implementation of tuberculosis (TB) infection prevention and control (IPC) guidelines in public tertiary care general hospitals remain challenging due to limited evidence of pulmonary TB (PTB) patients' duration of hospital stay and management. To fill this evidence gap, this study examined adult PTB patient management, healthcare workers' (HCWs) exposures and IPC practices in two public tertiary care hospitals in Bangladesh.Between December 2017 and September 2019, a multidisciplinary team conducted structured observations, a hospital record review, and in-depth interviews with hospital staff from four adult medicine wards.Over 20 months, we identified 1,200 presumptive TB patients through the hospital record review, of whom 263 were confirmed PTB patients who stayed in the hospital, a median of 4.7 days without TB treatment and possibly contaminated the inpatients wards. Over 141 observation hours, we found a median of 3.35 occupants present per 10 m2 of floor space and recorded a total of 17,085 coughs and 316 sneezes: a median of 3.9 coughs or sneezes per 10 m2 per hour per ward. Only 8.4% of coughs and 21% of sneezes were covered by cloths, paper, tissues, or by hand. The HCWs reportedly could not isolate the TB patients due to limited resources and space and could not provide them with a mask. Further, patients and HCWs did not wear any respirators.The study identified that most TB patients stayed in the hospitals untreated for some duration of time. These PTB patients frequently coughed and sneezed without any facial protection that potentially contaminated the ward environment and put everyone, including the HCWs, at risk of TB infection. Interventions that target TB patients screening on admission, isolation of presumptive TB patients, respiratory hygiene, and HCWs' use of personal protective equipment need to be enhanced and evaluated for acceptability, practicality and scale-up.

Lack of knowledge is the leading key for the growing cervical cancer incidents in Bangladesh: A population based, cross-sectional study.

INTRODUCTION: Cervical cancer is the second most common gynecological cancer in Bangladesh. Lack of awareness of screening methods, risk factors, and symptoms may lead to presenting most cervical cancers at an advanced stage. We investigated knowledge and awareness of cervical cancer (CCa) among females at the Sheikh Hasina Medical College (SHMC) of Tangail district in Bangladesh. METHODS: A cross sectional survey was conducted to collect data via a structured questionnaire from SHMC during the period of February 2019 to January 2020. Data on socio-demographic characteristics and knowledge of cervical cancer were collected. Multivariable logistic regression models were used to identify factors associated with having heard and knowledge of cervical cancer. A p-value <0.05 was considered significant. RESULT: Of all the interviews conducted, only 45.2% (493/1090) had heard of cervical cancer as a disease. Women were more likely to be aware of CCa if they were lived in urban areas, had higher education (university level education) and belong to high income families. The study revealed evidence of significant association between marital, literacy, residence and socio-economic status with women's knowledge on cervical cancer (p< 0.05). CONCLUSION: This study serves to highlight that there was impoverished knowledge about cervical cancer among Bangladeshi women. Hence, this indicates the government should take proper steps to raise awareness and knowledge levels via educational programs and health counseling.

The scenario of knowledge, attitude and practice of the Bangladeshi population towards thalassemia prevention: A nationwide study.

Thalassemia is one of the most common life-threatening yet preventable congenital hemoglobin disorders especially in South Asian regions like Bangladesh. It has become a rising public health concern for Bangladesh as 6-12% of the population are carriers and many of them are unaware of it. The purpose of the study is to inspect the knowledge and attitude towards thalassemia among the general people of Bangladesh. A cross-sectional survey was conducted in eight administrative regions of Bangladesh between January and October of 2020. A structured questionnaire was designed to collect information about thalassemia and socio-demographic characteristics. Multivariate logistic regression models were used to identify factors associated with knowledge of thalassemia. A p-value <0.05 was considered significant. Of the 1,248 participants, only 47.4% had heard of thalassemia. Half of the participants who heard about the disease had no idea that thalassemia was not a transfusion transmitted disease. Only 49.8% of participant correctly identified consanguineous marriages as an important risk factor. Majority of them knew that marriage between two carriers can lead to a child with thalassemia major. About 72.5% knew that blood tests are a diagnosis method to determine thalassemia. Among the socio-demographic variables, the level of education of the respondents was identified as an independent predictor for knowledge (p<0.05) on thalassemia. For example, graduate (aOR: 24.88; 95% CI: 6.238-99.232) or post-graduate (aOR: 33.18; 95% CI: 7.864-140.001) participants were more aware of thalassemia than non-graduates. However, about 68.2% of the participants showed a positive attitude towards premarital screening of themselves or their family members and 85.3% were willing to donate blood to thalassemia patients. The study shows that there is a need to disseminate the information on thalassemia since the knowledge gap is huge among people. These findings will strengthen the implementation of thalassemia major awareness through educational programs, health counseling, premarital screening and campaigning.

Evaluation of knowledge, awareness and attitudes towards breast cancer risk factors and early detection among females in Bangladesh: A hospital based cross-sectional study.

BACKGROUND: Breast cancer (BCa) is a leading cause of mortality among women in Bangladesh. Many young women in Bangladesh have poor knowledge about breast cancer screening, including risk factors, warning signs/symptoms, diagnosis and early detection. We investigated awareness about breast cancer risk factors as a screening tool among women at the Sheikh Hasina Medical College (SHMC) of Tangail district in Bangladesh. METHODS: A cross sectional survey was conducted to collect data via a structured questionnaire from SHMC during the period of February to December 2019. A total of 1,007 participants (aged 33.47 (±12.37 years)) was considered for data analysis. RESULTS: Of the 1,007 women, about 50% were knowledgeable about the risk factors. Pain in the breast was identified as the most commonly warning sign/symptom of breast cancer. Only 32.2% of respondents knew at least one breast cancer screening method. The mean knowledge was scored 3.43 ± 2.25 out of a total possible score of 8. Awareness of BCa was associated with residence, family history of breast cancer, marital, literacy and socio-economic status (p <0.05). Only 14.7% of women who knew about BSE said they were conducting regular breast self-examination. Unmarried women (aOR: 2.971; 95% CI: 1.108-7.968) were more likely to have performed BSE compared to married women (p <0.05). CONCLUSION: Although most participants were aware of breast cancer; knowledge about risk factors, warning signs/symptoms, early diagnosis and detection was relatively poor. Knowledge about performing BSE was particularly low. This highlights the importance of increasing awareness about breast cancer risk factors and early detection among young women in Bangladesh.

Validation of the Bangla WHO-5 Well-being Index.

BACKGROUND: Subjective wellbeing in terms of objective outcome can be useful to determine the level of progress in clinical practice as well as research studies in Bangladesh. Besides, cultural understanding of well-being for Bangladeshi population is also equally important to report. A valid Bangla version of the five-item WHO Well-being Index can be a suitable measure to achieve the purposes. Therefore, the present study aimed at validating the WHO-5 Well-being Index for general population in Bangladesh. METHODS: After following the standard procedures for translation, back-translation, and committee translation, the initial Bangla version of the scale was developed and pretested. Based on the feedback during pretesting, a slight modification was made and the final version was developed. This final version was administered to 269 participants of different socioeconomic backgrounds to find out the reliability and validity of the scale from March 2019 to May 2019. The data analysis was conducted using SPSS 24. RESULTS: The scale demonstrated acceptable internal consistency (α = 0.754) and test-retest reliability (r = 0.713), divergent validity (r = -0.443, p < 0.01 with the Bangla version of Perceived Stress Scale-10) and convergent validity (r = 0.542, p < 0.01 with the Bangla version of Warwick-Edinburgh Mental Well-Being Scale). The data also yielded one-factor structure for the scale in exploratory factor analysis explaining 38.68% of total variance. The factor-structure was further supported in the confirmatory factor analysis (χ2 = 295.852, χ2/df = 2.017, RMSEA = 0.062, CFI = 0.986, TLI = 0.964, and SRMR = 0.0255). CONCLUSION: The findings suggested the Bangla version of the WHO-5 Well-being Index is a psychometrically valid and reliable tool for general adult population in Bangladeshi when it comes to measuring subjective well-being both in clinical practice and research studies.

Mental health and well-being of indigenous people during the COVID-19 pandemic in Bangladesh.

BACKGROUND: The ongoing pandemic caused by the novel coronavirus and the subsequent containment strategies has taken a heavy toll on the mental health of people irrespective of age, gender, race, ethnicity, and geographical location. Studies have documented the mental health status of non-indigenous Bangladeshi people, but little attention has been paid during the pandemic to the investigation of the mental health status of indigenous people living in remote hilly areas. To address this gap the present study aimed at investigating the prevalence and accompanying risk factors of depression, anxiety, stress, and compromised well-being among indigenous people during the pandemic. METHODS: A cross-sectional survey was conducted on 422 indigenous people aged between 16 and 90 using the 21-item Bangla Depression Anxiety Stress Scale (BDASS-21) and the Bangla version of the WHO-5 Well-being Index from January 30 to April 10, 2021. Data were collected by trained research assistants from three remote hilly areas namely Bandarban, Rangamati, and Khagracchari in the Chattogram Hill Tracts (CHT). Chi-squares, logistic regression, and ANOVA were performed to examine the association of variables. RESULTS: The prevalence of moderate to extremely severe depression, anxiety, stress, and low well-being among the indigenous population during the pandemic was found to be 49.3%, 47.2%, 36.7%, and 50.9%, respectively. Risk predictors for depression, anxiety, and stress included age, ethnicity, geographical locations, educational attainment, occupation, and marital status. CONCLUSIONS: The results suggest that the ongoing pandemic has led to the rise of common mental health problems among indigenous people during the pandemic. The results can contribute to the formation of mental health policy for indigenous people and the development of suitable mental health intervention strategies especially during and after the COVID-19 pandemic.

Metabolic profiling, in vitro propagation, and genetic assessment of the endangered rare plant Anarrhinum pubescens.

BACKGROUND: Anarrhinum pubescens Fresen. (Plantaginaceae) is a rare plant, endemic to the Saint Catherine area, of South Sinai, Egypt. Earlier studies have reported the isolation of cytotoxic and anti-cholinesterase iridoid glucosides from the aerial parts of the plant. The present study aimed to investigate the chemical profiling of the wild plant shoots as well as establish efficient protocols for in vitro plant regeneration and proliferation with further assessment of the genetic stability of the in vitro regenerated plants. RESULTS: Twenty-seven metabolites have been identified in wild plant shoots using the Nuclear Magnetic Resonance (NMR) spectroscopy. The metabolites include alkaloids, amino acids, carbohydrates, organic acids, vitamins, and a phenol. In vitro propagation of the plant was carried out through nodal cutting-micropropagation and leaf segment-direct organogenesis. The best results were obtained when nodal cutting explants were cultured on Murashige and Skoog medium with Gamborg B5 vitamins supplemented with 6-benzylaminopurine (BAP) (1.0 mg/L) and naphthaleneacetic acid (NAA) (0.05 mg/L), which gave a shoot formation capacity of 100% and a mean number of shoots of 27.67 ± 1.4/explant. These shoots were successfully rooted and transferred to the greenhouse and the survival rate was 75%. Genetic fidelity evaluation of the micropropagated clones was carried out using random amplified polymorphic DNA (RAPD) and inter simple sequence repeat (ISSR) molecular markers. Jaccard's similarity coefficient indicated a similarity as high as 98% and 95% from RAPD and ISSR markers, respectively. CONCLUSIONS: This study provides the chemical profiling of the aerial part of Anarrhinum pubescens. Moreover, in vitro regeneration through different tissue culture techniques has been established for mass propagation of the plant, and the genetic fidelity of the in vitro regenerated plants was confirmed as well. Our work on the in vitro propagation of A. pubescens will be helpful in ex situ conservation and identification of bioactive metabolites.

A Case Series Describing the Recurrence of COVID-19 in Patients Who Recovered from Initial Illness in Bangladesh.

To date, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has infected over 80 million people globally. We report a case series of five clinically and laboratory confirmed COVID-19 patients from Bangladesh who suffered a second episode of COVID-19 illness after 70 symptom-free days. The International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), is a leading public health research institution in South Asia. icddr, b staff were actively tested, treated and followed-up for COVID-19 by an experienced team of clinicians, epidemiologists, and virologists. From 21 March to 30 September 2020, 1370 icddr,b employees working at either the Dhaka (urban) or Matlab (rural) clinical sites were tested for COVID-19. In total, 522 (38%) were positive; 38% from urban Dhaka (483/1261) and 36% from the rural clinical site Matlab (39/109). Five patients (60% male with a mean age of 41 years) had real-time reverse transcription-polymerase chain reaction (rRT-PCR) diagnosed recurrence (reinfection) of SARS-CoV-2. All had mild symptoms except for one who was hospitalized. Though all cases reported fair risk perceptions towards COVID-19, all had potential exposure sources for reinfection. After a second course of treatment and home isolation, all patients fully recovered. Our findings suggest the need for COVID-19 vaccination and continuing other preventive measures to further mitigate the pandemic. An optimal post-recovery follow-up strategy to allow the safe return of COVID-19 patients to the workforce may be considered.

Implementation status of national tuberculosis infection control guidelines in Bangladeshi hospitals.

In response to the World Health Organization (WHO) recommendation to reduce healthcare workers' (HCWs') exposure to tuberculosis (TB) in health settings, congregate settings, and households, the national TB control program of Bangladesh developed guidelines for TB infection prevention and control (IPC) in 2011. This study aimed to assess the implementation of the TB IPC healthcare measures in health settings in Bangladesh. Between February and June 2018, we conducted a mixed-method study at 11 health settings. The team conducted 59 key-informant interviews with HCWs to understand the status of and barriers impeding the implementation of the TB IPC guidelines. The team also performed a facility assessment survey and examined TB IPC practices. Most HCWs were unaware of the national TB IPC guidelines. There were no TB IPC plans or committees at the health settings. Further, a presumptive pulmonary TB patient triage checklist was absent in all health settings. However, during facility assessment, we observed patient triaging and separation in the TB specialty hospitals. Routine cough-etiquette advice was provided to the TB patients mentioned during the key-informant interviews, which was consistent with findings from the survey. This study identified poor implementation of TB IPC measures in health settings. Limited knowledge of the guidelines resulted in poor implementation of the recommendations. Interventions focusing on the dissemination of the TB IPC guidelines to HCWs along with regular training may improve compliance. Such initiatives should be taken by hospital senior leadership as well as national policy makers.