RESUMEN
BACKGROUND: Menstruation is a normal physiological process for women during their reproductive cycle, typically beginning during adolescence. During this stage, lack of knowledge, social taboos, and shyness act as barriers to proper menstrual hygiene management, rendering adolescent girls more vulnerable. This issue is highly prevalent in low- and middle-income countries. In rural areas of Bangladesh, there is a deficiency in menstrual hygiene management due to inadequate information and knowledge among adolescent girls. Therefore, this study aims to assess the effect of mHealth education on the knowledge and practices of menstrual hygiene management among school-going adolescent girls in rural Bangladesh. METHODS: This is a quasi-experimental study conducted from early June to December 2023 at a secondary high school in Chandpur, Bangladesh. Participants' data will be collected through face-to-face interviews using a structured questionnaire covering socioeconomics, knowledge of menstrual hygiene management, and practices. Pre-test data will be collected at baseline, followed by a 6-month mHealth education intervention. Afterward, post-test data will be collected using the same questionnaire. The data will be analyzed as frequency and percentage for descriptive statistics, and a paired t-test will be used to compare the pre-and post-test data. RESULTS: In the study, 172 participants were enrolled at baseline. Among them, 69.8% were aged 10-14 years. The outcome of this study will be published in a peer-reviewed journal. The findings will provide evidence-based information for the government, researchers, and policymakers on menstrual hygiene management using mobile health technology. CONCLUSION: mHealth education can be posited as a significant tool for increasing knowledge and practices related to menstrual hygiene management in rural regions of Bangladesh.
RESUMEN
BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) in HIV infected individuals is a serious threat to global efforts to combat tuberculosis. Inconsistent findings on the association between HIV infection and MDR-TB were present in many studies. We aimed to review existing data on the relationship between HIV infection and MDR-TB systematically to assess the contribution of HIV on MDR-TB worldwide. We also investigated the patterns of MDR-TB by age, country-wise income, study designs, and global regions. METHODS: We utilized PubMed, Google Scholar, and ScienceDirect databases to select eligible studies for meta-analysis that were published between January 12,010, and July 30, 2020. The random-effects model was used to obtain the pooled odds ratio of the crude association between HIV and MDR-TB with a 95% confidence interval. We investigated the potential publication-bias by checking funnel plot asymmetry and using the Egger's test. Moreover, we assessed the heterogeneity using the I2 statistic. Sensitivity analysis was performed based on sample size and adjustment factors. The protocol was registered with PROSPERO-CRD42019132752. RESULTS: We identified 1603 studies through a database search, and after subsequent eliminations we selected 54 studies including 430,534 TB patients. The pooled odds of MDR-TB was 1.42 times higher in HIV-positive patients than HIV-negative patients (OR=1.42,CI=1.17-1.71, I2=75.8%). Subgroup analysis revealed that the estimated pooled odds for South-East Asian countries was 1.86, which is the highest in WHO regions (OR=1.86,CI=1.30-2.67, I2=0.00%), followed by Europe and Africa. The effect estimate was found to be higher for primary MDR-TB (OR=2.76,CI=1.70-4.46, I2=0.00%). There was also a trend towards increased odds of MDR-TB for HIV patients older than 40 years (OR=1.56,CI=1.17-2.06). The association was found to be significant in high-burden TB countries (OR=1.75, CI=1.39-2.19) and in high-income countries (OR=1.55, CI=1.06-2.27). CONCLUSION: Such findings indicate that HIV infection raises the risk of MDR-TB, and after contrasting it with the results of the earlier pooled study, it appeared to be an upward risk trend. Moreover, we found that the risk is the highest in the South-East Asian region. A balanced allocation of resources is needed to halt both primary and secondary MDR-TB, particularly in HIV infected people with 40 years of age and older.