Reproductive health care seeking behavior in Bangladesh: A systematic literature review.

BACKGROUND: Maternal health, in terms of pregnancy and childbirth, is an important aspect of women's reproductive health and remains a public health concern in underdeveloped countries of the world. Reproductive health care seeking behavior (RHSB), in both men and women in society, is influenced by a variety of social and environmental factors that needs to be summarized. OBJECTIVES: This review aims to enhance understanding and perception of services in relation to RHSBs in several domains such as antenatal care (ANC), delivery care, postnatal care (PNC), and family planning (FP) services, for married women of reproductive age in Bangladesh. SEARCH STRATEGY: In major databases, for example, Medline, Ovid, PubMed, Web of Science, ProQuest and Google Scholar following keywords, timeline set as 2010 up to December 30, 2022. SELECTION CRITERIA: Articles that included discussion on married women of reproductive age, and their type of care seeking behavior for reproductive health. DATA COLLECTION AND ANALYSIS: A systematic literature search was carried out and expected outcome was health care seeking behavior in the aspects of ANC, delivery care, PNC, and FP services. A data extraction form and quality appraisal form were used for data on RHSB of married women of the reproductive age group in Bangladesh and associated factors. MAIN RESULTS: A total of 245 articles were retrieved from databases; stepwise screening was done and finally 23 full-text articles were included for analysis. Descriptive statistics were used based on the included articles for narrative synthesis. In the selected articles, 17 (73.91%) were cross-sectional studies and more than half discussed both urban and rural women. Ante- and postnatal visits have proven to have positively influenced overall RHSB, as seen in Bangladesh. Grass root level workers play a major role in upgrading RHSB in women. Many factors limit rural access to mother and child health services including distance of the health facility and cost of the health service. CONCLUSIONS: In particular, education level, women's autonomy in family decision making and distance from health service can be considered as factors influencing RHSBs in Bangladesh. Exposure to mass media and TV watching are likely to positively impact RHSB patterns for women in Bangladesh.

Molecular Characterization of Multidrug-Resistant and Extended-Spectrum ß-Lactamases-Producing Salmonella enterica Serovars Enteritidis and Typhimurium Isolated from Raw Meat in Retail Markets.

In the present study, a total of 720 samples were collected from retail raw meat from 13 upazilas in Sylhet District, Bangladesh, of which 225 samples were from cattle meat, 210 samples were from goat meat, and 285 samples were from chicken meat. Salmonella enterica serovars Typhimurium and Enteritidis were screened for extended-spectrum ß-lactamase (ESBL) genes using multiplex PCR. Among the 720 samples, Salmonella spp. was detected in 28.06% (202 out of 720) of the samples, with S. Enteritidis and S. Typhimurium were identified in 11.53% (83 out of 720) and 12.22% (88 out of 720) of the samples, respectively. It was found that all Salmonella enterica serovars isolated from cattle meat displayed multidrug resistance (MDR) based on antimicrobial susceptibility testing. Notably, a significant proportion of S. Enteritidis isolates and all S. Typhimurium isolates from goat meat demonstrated complete resistance to multiple drugs (ampicillin, cefuroxime, and ceftazidime). Regarding chicken meat, out of 89 isolates encompassing both S. Typhimurium and S. Enteritidis, 57 isolates (64.04%) exhibited MDR. Additionally, blaCTX-M-1 exhibited the highest occurrence at 15.69% for S. Typhimurium and 7.89% for S. Enteritidis in chicken meat. Moreover, blaCTX-M-9 was only detected at 3.92% for S. Enteritidis in chicken meat. Furthermore, blaOXA had the highest prevalence rate of 19.04% for S. Enteritidis and 25.80% for S. Typhimurium in cattle meat, followed by chicken meat. These findings highlight the urgency for monitoring ESBL-producing Salmonella in retail raw meat and the need for strict measure to manage antibiotic use to prevent the spread of multidrug-resistant and ESBL-producing Salmonella strains, thereby protecting humans and reducing public health risks.

SARS-CoV-2 Variants and COVID-19 in Bangladesh-Lessons Learned.

The coronavirus infectious disease-2019 (COVID-19) in Bangladesh is a paradigm for how one of the most densely populated countries in the world, with 1270 people per square kilometer, managed to cope with the COVID-19 pandemic under extraordinary circumstances. This review highlights the SARS-CoV-2 variants in Bangladesh and the timeline of their detection in the context of the global experience with the management of vaccination and natural SARS-CoV-2 infection. The motivation to overcome the COVID-19 vaccine dilemma and track Bangladeshi SARS-CoV-2 sub-variants underscores the potential for a low-income country to excel in international medical science, despite having stressed health care services and limited availability of resources for SARS-CoV-2 testing and gene sequencing.

Is gender a factor in socioeconomic disparities in undiagnosed, and untreated hypertension in Bangladesh?

Our objectives were to ascertain the following: (1) the prevalence and socioeconomic distribution of hypertension (HTN), undiagnosed for HTN, and untreated cases of HTN-diagnosed individuals; (2) the relationship between SES and the prevalence of HTN, undiagnosed for HTN, and untreated for HTN; and (3) whether sex moderate this association. Data from the 2017-18 Bangladesh Demographic Health Survey were used. 11,776 participants who were 18 years of age or older responded to our analysis. The age-adjusted prevalence of HTN, undiagnosed for HTN, and untreated cases was 25.1%, 57.2%, and 12.3%. Compared to females, males were less likely to have HTN but more likely to have undiagnosed HTN. People in the rich SES groups had a higher odd of (adjusted odds ratio [aoR] 1.25; 95% confidence interval [CI] 1.08-3.45) of having HTN compared to those in the poor SES group. When compared to individuals in the poor SES group, those in the rich SES group had lower odds of undiagnosed (aoR 0.57; 95% CI 0.44-0.74) and untreated (aoR 0.56; 95% CI 0.31-0.98) for HTN. Sex moderated the association between SES and HTN prevalence, which showed that men from rich SES were more likely to suffer from HTN than men from poor SES. According to this study, the government and other pertinent stakeholders should concentrate more on developing suitable policy measures to reduce the risk of HTN, particularly for men in rich socioeconomic groups. They should also concentrate on screening and diagnosing HTN in socioeconomically disadvantaged populations, regardless of sex.

Effectiveness of soil remediation intervention in abandoned used lead acid battery (ULAB) recycling sites to reduce lead exposure among the children.

Lead (Pb) is a neurotoxin, and children are vulnerable due to their evolving physiology and high-risk behaviours. Soil remediation interventions have proven effective in reducing Pb exposure. The primary objective is to measure the effectiveness of soil remediation at abandoned used lead acid battery (ULAB) recycling sites, nearby household cleaning, and community awareness in reducing blood lead levels (BLLs) in children. Additionally, this study aims to examine associations of Pb exposure with hematological, cardiovascular, renal, immunological, and endocrinological parameters in children aged 0-12 years. This study employs a quasi-experimental design, with abandoned ULAB sites as intervention sites and two control sites in Bangladesh. The intervention includes soil remediation coupled with community education. Data will be collected prior to the intervention and at a 12-month follow-up, including a comprehensive Pb exposure survey and collect environmental, turmeric samples, and blood from the child. Pb concentrations in environmental samples and turmeric samples will be determined using XRF analyser. Child BLL will be measured using Graphite Furnace Atomic Absorption Spectrometry (GF-AAS) and proposed biochemical parameters will be analysed using routine laboratory methods. This study could provide valuable insights for designing targeted interventions in similar settings and mitigating exposure to Pb.

Exploring the impact of occupational factors on low back pain in ride-sharing motorbike drivers in Bangladesh: A comprehensive cross-sectional analysis.

Objective: Low back pain (LBP) is a major global public health issue, prevalent among various occupational groups worldwide. However, existing studies have predominantly focused on sedentary workers in developed nations, leaving a gap in understanding LBP prevalence and associated factors among occupational cohorts in low- and middle-income countries like Bangladesh. This study aimed to determine the prevalence and occupational factors contributing to LBP among ride-sharing motorbike drivers (RSMD) in Bangladesh. Methods: A cross-sectional study was conducted in Dhaka city from May 20 to August 08, 2023. Data were collected from Bangladeshi adult RSMD using a paper-based questionnaire developed by Eriksen et al. Chi-square or Fisher's Exact tests compared categorical variables with and without LBP, and multiple logistic regression analyses were performed with LBP as the dependent variable and various predictors to compute adjusted odds ratios with a 95% confidence interval. Results: The one-month prevalence of LBP was 58.8%. Regression analysis revealed elevated adjusted odds of experiencing LBP among participants with hypertension, those using multiple ride-sharing operators, commuter and older bike users, and non-users of riding kits. Additionally, increased adjusted odds of LBP were observed among participants of higher age, higher body mass index, and those covering longer distances per week. Conclusion: This study underscores a significantly higher prevalence of LBP among RSMD in Bangladesh, with occupational factors strongly predicting LBP. Implementing strategies such as regular physical exercise, weight reduction, using sports and newer motorbikes, and reducing working hours per week may help mitigate the prevalence of LBP within this cohort.

Family-Oriented Living Organ Donation in Bangladesh: A Bioethical Defence.

This study focuses on issues related to living organ donation for transplantation in Bangladesh. The policy and practice of living organ donation for transplantation in Bangladesh is family-oriented: close relatives (legal and genetic) are the only ones allowed to be living donors. Unrelated donors, altruistic donors (directed and non-directed), and paired/pooled or non-directed altruistic living donor chains-as many of these are implemented in other countries-are not legally allowed to serve as living donors in Bangladesh. This paper presents normative arguments explaining why the family-oriented nature of regulations and practices surrounding living organ donation for transplantation is essential for Bangladesh. In this article, I specifically argue that if the Bangladesh government revises the current biomedical policy robustly beyond relatives and allows unrelated donors to donate organs legally, this may foster organ selling due to the poverty and corruption problems in Bangladesh. The family-oriented requirement of the living organ donation policy and practice is defensible and morally justifiable as it preserves common notions of the family unit and family bonding in Bangladesh. Maintaining the current living-donation regulations and promoting deceased donation is the way forward, as this safely preserves the family values, protects against organ selling, and increases access to organ transplantation.

Differences in Associated Factors of Underweight and Overweight According to Rural-Urban Residence Strata among Ever-Married Non-Pregnant Women of Reproductive Age in Bangladesh.

Background: This study sought to compare the prevalence of underweight and overweight among ever-married, non-pregnant women of reproductive age in Bangladesh by urban or rural residency status. Methods: This study used Bangladesh Demographic and Health Survey (BDHS), 2017 data. Cross-sectional study design with two-stage stratified sampling method was employed. A sample of ever-married non-pregnant women of reproductive age was selected and multinomial logistic regression was utilised in analysis. Results: It was found that around half of rural women (45.0%, N = 4,934) and more than half of urban women (60.3%, n = 3,913) were overweight. Nearly one in seven rural women (14.0%, n = 1,537) and 1 in 12 urban women (9.0%, n = 564) were reported as underweight. Our analyses revealed that being overweight was substantially connected with age, husband's occupation, economic status, television access, and division for both urban and rural areas. Women from poor households were significantly more likely to be underweight than women from middle- income households for both urban (P < 0.05; OR: 1.41; 95% CI: 1.03, 1.94) and rural (P < 0.05; OR: 1.23; 95% CI: 1.04, 1.46) areas. Interestingly, women without television access both in urban (P < 0.001; OR = 0.78; 95% CI: 0.67, 0.91) and rural (P < 0.001; OR = 0.75; 95% CI: 0.68, 0.84) areas had an inverse association with overweight/obesity compared to women with television access. In both areas, women in Sylhet and Mymensingh had higher likelihood of being underweight than Barisal division. Additionally, in both residential zones, women in Sylhet had lower likelihood of being overweight than Barisal division. Conclusion: This study reveals that multiple characteristics are linked to both overweight and underweight among ever-married, non-pregnant women of reproductive age in Bangladesh. Addressing these variables should be a priority in public health efforts to combat the dual challenge of malnutrition in Bangladesh.

Exploring the alteration of environmental radioactivity in terms of compositional elements of heavy minerals in an anthropogenically affected urban river: Radiological and ecological risks assessment.

This study explored the alteration of naturally occurring radioactive materials (NORMs: 226Ra (≈238U), 232Th, 40K) in an anthropogenically disrupted urban river-basin (Turag, Bangladesh) in terms of constitutional substances (Sc, Ti, V, Fe, La, Ce, Sm, Eu, Tb, Dy, Ho, Yb, Lu, Hf, Ta, W, Th, U) of heavy-minerals. Average activity concentrations of 226Ra (≈238U), 232Th, and 40K were 41.5 ± 12.9, 72.1 ± 27.1, and 639 ± 100 Bqkg-1, respectively which were relatively higher compared to crustal origin. ∑REEs, Ta, W, Th, and U were ~2 times higher compared to crustal values with Ce and Eu-anomalies. APCS-MLR and PMF receptor models were used to determine the various anthropogenic and/or geogenic sources of NORMs and elements. Layer-wise variations of NORMs and elements were observed to trace the response of sedimentary processes towards the incoming pollution load. Presence of REEs indicates moderate degree of ecological risk to aquatic biota. However, carcinogenic risk (3.84 × 10-4 Sv-1) were significantly higher than threshold limit.

Influence of climate variability and land cover dynamics on the spatio-temporal NDVI patterns in western hydrological regions of Bangladesh.

Analyzing vegetation greenness considering climate and land cover changes is crucial for Bangladesh given the historically drier North-West and South-West regions of Bangladesh have shown prominent climatic and hydrological variations. Therefore, this study assessed the spatial and temporal variation of NDVI and its relationship with climate and land cover changes from 2000 to 2022 for these regions. In this study, Moran's I and Getis Ord Gi* were employed for spatial autocorrelation and Mann-Kendall, Sen's slope test along with Innovative Trend Analysis were deployed to identify temporal trends of NDVI. RMSE, MAE and R-squared values were assessed between computed and observed PET. Correlation of NDVI with climate variables were assessed through multivariate correlation analysis and correlation mapping. Additionally, Pearson product moment correlation was applied between different types of land cover and NDVI. Spatial autocorrelation outcomes showed that NDVI values have been clustered in distinct hotspots and cold-spots over the years. Temporal trend detection results indicate that NDVI values are rising significantly all over the regions. Multivariate correlation analysis identified no climate variable to be the limiting factor for NDVI changes. Similarly, the precipitation-NDVI correlation map displayed no significant correlation. Nonetheless, temperature-NDVI correlation map illustrated varying degrees of mostly moderate and strong positive correlations with distinct negative correlation results in the Sundarbans of South-West region. Land cover pattern analysis with NDVI showed a positive correlation to forest, cropland and vegetation area increasing and negative correlation to grassland and barren area decreasing. In this regard, Rangpur division exhibited stronger correlations than Rajshahi division in North-West. The findings indicate that NDVI changes in the regions are largely dependent on land cover changes in comparison to climate trends. This can instigate further research in other hydrological regions to explore the natural and man-made factors that can affect the greenery and vegetation density in specific regions.

Exposure to metal mixtures and telomere length in Bangladeshi children.

Telomere length is associated with chronic diseases and in younger populations, may represent a biomarker of disease susceptibility. As growing evidence suggests that environmental factors, including metals, may impact telomere length, we investigated the association between 17 metals measured in toenail samples and leukocyte relative telomere length (RTL), among 472 five- to seven-year-old children enrolled in the Bangladesh Environmental Research in Children's Health (BiRCH) cohort. In single exposure linear regression models, a doubling of arsenic (As) and mercury (Hg) (µg/g) were associated with a -0.21 (95%CI: -0.032, -0.010; p=0.0005) and -0.017 (95%CI: -0.029, -0.004; p=0.006) difference in RTL, respectively. In Bayesian Kernel Machine Regression (BKMR) mixture models, the overall metal mixture was inversely associated with RTL (P-for-trend <0.001). Negative associations with RTL were observed with both log2-As and log2-Hg, while an inverted U-shaped association was observed for log2-zinc (Zn) with RTL. We found little evidence of interaction among metals. Sex-stratification identified stronger associations of the overall mixture and log2-As with RTL among females, compared to males. Our study suggests that As and Hg may independently influence RTL in mid-childhood. Further studies are needed to investigate potential long-term impacts of metal-associated telomere shortening in childhood on health outcomes in adult life.

Inequalities in large-scale breastfeeding programmes in Bangladesh, Burkina Faso and Vietnam.

Inequalities in breastfeeding programmes and practices have slowed global progress in providing the life-saving protection of breastfeeding for millions of infants despite well-known life-long impacts. As breastfeeding interventions are scaled up, inequalities in coverage and breastfeeding practices should be tracked, particularly in disadvantaged groups, who are likely to suffer the most serious health and developmental impacts of poor childhood nutrition. The literature provides evidence of inequalities in breastfeeding practices, but research is limited on socioeconomic disparities in the coverage of breastfeeding interventions. This paper (1) compares inequalities in breastfeeding practices in intervention and nonintervention areas and (2) documents inequalities in programme coverage by type of intervention. We disaggregated endline evaluation surveys in Bangladesh, Burkina Faso and Vietnam, where rigorous evaluations had documented significant overall improvements, and analysed whether inequalities in breastfeeding practices and programme coverage differed by treatment areas. We used Erreygers index to quantify inequalities and found that breastfeeding practices were largely pro-poor; intervention coverage was not consistently pro-poor. While counselling coverage often favoured women from the poorest quintile, public education/media coverage consistently favoured better-off women. Inequalities favoured more educated mothers in the coverage of combined interventions. None of the programmes had explicit equality objectives. The results indicate the need for introducing specific actions to reduce inequalities in breastfeeding policies and programmes. This is a priority unfinished agenda for nutrition programming.

Incidence of Hospitalization due to Influenza-Associated Severe Acute Respiratory Infection During 2010-2019 in Bangladesh.

BACKGROUND: Global influenza-associated acute respiratory infections contribute to 3-5 million severe illnesses requiring hospitalization annually, with 90% of hospitalizations occurring among children < 5 years in developing countries. In Bangladesh, the inadequate availability of nationally representative, robust estimates of influenza-associated hospitalizations limits allocation of resources for prevention and control measures. METHODS: This study used data from the hospital-based influenza surveillance (HBIS) system in Bangladesh from 2010 to 2019 and healthcare utilization surveys to determine hospital utilization patterns in the catchment area. We estimated annual influenza-associated hospitalization numbers and rates for all age groups in Bangladesh using WHO methods, adjusted for a 6-day-a-week enrollment schedule, selective testing of specimens from children under five, and healthcare-seeking behavior, based on the proportion of symptomatic community participants seeking healthcare within the past week. We then estimated national hospitalization rates by multiplying age-specific hospitalization rates with the corresponding annual national census population. RESULTS: Annual influenza-associated hospitalization rates per 100,000 population for all ages ranged from 31 (95% CI: 27-36) in 2011 to 139 (95% CI: 130-149) in 2019. Children < 5 years old had the highest rates of influenza-associated hospitalization, ranging from 114 (95% CI: 90-138) in 2011 to 529 (95% CI: 481-578) in 2019, followed by adults aged ≥ 65 years with rates ranging from 46 (95% CI: 34-57) in 2012 to 252 (95% CI: 213-292) in 2019. The national hospitalization estimates for all ages during 2010-2019 ranged from 47,891 to 236,380 per year. CONCLUSIONS: The impact of influenza-associated hospitalizations in Bangladesh may be considerable, particularly for young children and older adults. Targeted interventions, such as influenza vaccination for these age groups, should be prioritized and evaluated.

Does the implementation of revised American College of Cardiology and American Heart Association (ACC/AHA) guidelines improve the identification of stillbirths and preterm births in hypertensive pregnancies: a population-based cohort study from South Asia and sub-Saharan Africa.

BACKGROUND: Hypertensive disorders of pregnancy (HDP) are a significant cause of maternal mortality worldwide. The classification and treatment of hypertension in pregnancy remain debated. We aim to compare the effectiveness of the revised 2017 ACC/AHA blood pressure threshold in predicting adverse pregnancy outcomes. METHODS: We conducted a secondary data analysis of the Alliance for Maternal and Newborn Health Improvement (AMANHI) biorepository study, including 10,001 pregnant women from Bangladesh, Pakistan, and Tanzania. Blood pressure was measured using validated devices at different antenatal care visits. The blood pressure readings were categorized as: normal blood pressure (systolic blood pressure (sBP) < 120 mm Hg and diastolic blood pressure (dBP) < 80 mm Hg), elevated blood pressure (sBP 120-129 and dBP < 80), stage 1 hypertension (sBP 130-139 or dBP 80-89, or both), and stage 2 hypertension (sBP ≥ 140 or dBP ≥ 90, or both). We estimated risk ratios for stillbirths and preterm births, as well as diagnostic test properties of both the pre-existing JNC7 (≥ 140/90) and revised ACC/AHA (≥ 130/80) thresholds using normal blood pressure as reference group. RESULTS: From May 2014 to June 2018, blood pressure readings were available for 9,448 women (2,894 in Bangladesh, 2,303 in Pakistan, and 4,251 in Tanzania). We observed normal blood pressure in 70%, elevated blood pressure in 12.4%, stage 1 hypertension in 15.2%, and stage 2 hypertension in 2.5% of the pregnant women respectively. Out of these, 310 stillbirths and 9,109 live births were recorded, with 887 preterm births. Using the ACC/AHA criteria, the stage 1 hypertension cut-off revealed 15.3% additional hypertension diagnoses as compared to JNC7 criteria. ACC/AHA defined hypertension was significantly associated with stillbirths (RR 1.8, 95% CI 1.4, 2.3). The JNC 7 hypertension cut-off of ≥ 140/90 was significantly associated with a higher risk of preterm births (RR 1.6, 95% CI 1.2, 2.2) and stillbirths (RR 3.6, 95% CI 2.5, 5.3). Both criteria demonstrated low sensitivities (8.4 for JNC-7 and 28.1 for ACC/AHA) and positive predictive values (11.0 for JNC7 and 5.2 for ACC/AHA) in predicting adverse outcomes. CONCLUSION: The ACC/AHA criteria (≥ 130/80) identified additional cases of hypertension but had limited predictive accuracy for stillbirths and preterm births, highlighting the ongoing need for improved criteria in managing pregnancy-related hypertension.

Cervical cancer risk in association with TNF-alpha gene polymorphisms in Bangladeshi women.

BACKGROUND: Tumor necrosis factor-alpha (TNF-α) is among the vital pro-inflammatory cytokines that potentially exerts a significant influence on the immune response, hence potentially regulating the advancement of cervical lesions. OBJECTIVE: Our study objective was to examine the relationship between two single nucleotide polymorphisms (SNPs) (rs1799724 and rs1800629) of TNF-α and the risk of cervical cancer in women from Bangladesh. METHODS: We recruited 133 patients with cervical cancer and 126 healthy individuals for this study. Genotyping was performed using real-time PCR SNP genotyping assay. Multivariate logistic regression analysis was used to determine the odds ratio (OR) along with 95% confidence intervals (CI) and p-values. RESULTS: For rs1799724 (C > T) polymorphism, TT mutant homozygous genotype carried 3.26 times increased risk of developing cervical cancer (OR = 3.26, 95% CI = 1.15-9.28, p = 0.027). Polymorphism of rs1800629 (G > A) was also related to an elevated risk of cervical cancer. Individuals with the AG heterozygous genotype (OR = 2.85, 95% CI = 1.20-6.74, p = 0.017) and AA mutant homozygous genotype (OR = 4.55, 95% CI = 1.24-16.60, p = 0.022) also had a higher likelihood of having cervical cancer. Moreover, we found that injectable contraceptives increase the risk of cervical cancer. Individuals who smoked and/or had first-degree relatives with cancer were more likely to carry the risk allele, which increases the likelihood of developing cervical cancer. CONCLUSION: TNF-α polymorphisms in rs1799724 and rs1800629 increase the susceptibility of developing cervical cancer in women from Bangladesh.

Religious minority status and risk of hypertension in women: Evidence from Bangladesh.

Discrimination based on religion and communal violence against religious minorities have been on the rise worldwide. Despite growing incidences of violence against religious minorities, little is known on the relationship between minority status and population health outcomes in the low-and-middle income countries (LMICs). This study intends to fill this gap by assessing the prevalence of hypertension among religious minority women in Bangladesh, a South Asian country with high levels of social hostilities involving religion. Using data from the Bangladesh Demographic and Health Survey (BDHS) 2017-18, we examined whether religious minority women had a differential risk of having hypertension. We estimated logistic regression models to obtain the odds in favor of being hypertensive among women aged 18-49 years and compared the odds for religious minority women with that of their non-minority counterparts. We then estimated linear regression models to examine how average systolic- and diastolic-blood pressure measures differ across minority and non-minority women. We found that the odds of being hypertensive for minority women were 1.43 (95 % CI: 1.14-1.79) times that of their non-minority counterparts. The adjusted odds ratio was very similar, 1.45 (95 % CI: 1.14-1.84), when various sociodemographic and other risk factors were accounted for. The conditional average SBP and DBP levels were respectively 3.42 mmHg (95 % CI: 1.64-5.20) and 1.44 mmHg (95 % CI: 0.37-2.51) higher among minority women. Thus, we found evidence that religious minority women in Bangladesh had a disproportionately higher risk of having hypertension compared to their non-minority peers. These results call for further research on psychological distress from systematic discrimination and collective trauma among religious minorities in Bangladesh.

Antibiotic usage patterns in COVID-19 patients in five tertiary hospitals from Bangladesh: A countrywide picture.

Objectives: Irrational and injudicious use of antibiotics in COVID-19 patients could be detrimental in a tropical country with a weak antibiotic stewardship policy such as Bangladesh. This study aimed to focus on the antibiotic usage patterns in COVID-19 patients in Bangladesh. Methods: This prospective observational study was performed from July 2020 to June 2021 in five tertiary hospitals in Bangladesh. Data on demographic profile, disease severity, and antibiotic usage were collected directly from the patients' hospital documents. Results: A total of 3486 (94.4%) patients were treated with at least one antibiotic; 3261 (93.6%) patients received a single antibiotic, and 225 (6.5%) received multiple antibiotics. The most used antibiotics were ceftriaxone (37.3%), co-amoxiclav (26.3%), azithromycin (10.6%), and meropenem (10.3%). According to the World Health Organization AWaRe categorization, most (2260; 69.6%) of the antibiotics prescribed in this study belonged to the "Watch" group. Culture and sensitivity reports were available in 111 cases from one center. Only 18.9% of the patients were found to be co-infected with multi-drug-resistant bacteria (52.4% yield from sputum, 28.6% from urine, and 14.3% from blood). Conclusions: Strict antibiotic prescribing policy and antibiotic stewardship should be implemented immediately to limit the future threat of antimicrobial resistance in countries such as Bangladesh.

Hypertension, diabetes, and hypercholesterolemia in Bangladesh: Evaluating role of physical activity from cross-sectional STEPS 2018 survey.

Background and Aims: The objective of this study was to assess current condition of three noncommunicable diseases (NCDs)-diabetes, hypertension, and hypercholesterolemia and vulnerable cohorts among adults in Bangladesh. Methods: The STEPwise Approach to the NCD Risk Factor Surveillance survey of 2018 was analyzed to evaluate the association between NCDs and sociodemographic factors, levels of physical activity, and behavioral measurements. Complex survey weight-adjusted logistic models were fitted. Results: From 6875 samples, prevalence of diabetes, hypertension and hypercholesterolemia were 27.3%, 9.8%, and 30.2%, respectively. The prevalence of the three NCDs were higher among older respondents. Low occupational activity with obese-BMI status people was more prone to NCDs. Lower prevalence of hypercholesterolemia was observed in Rangpur, Rajshahi, and Mymensingh, whereas lesser diabetes in Khulna region. Likelihood of NCDs were higher among highly educated, urban residents with low physical activity. Lesser physical activity, and lack of weight maintenance were found to be key factors in higher rates of NCDs in Bangladesh. Conclusion: Greater education and less strenuous profession led to a higher chance of NCDs. Overall, physical activity and maintenance of weight seem to be factors driving higher rates of NCDs in Bangladesh. As a preventive measure against NCDs, an active lifestyle is to be encouraged, particularly to the most vulnerable cohort.

Unhealthy Food and Sugar-Sweetened Beverage Consumption Among Bangladeshi Elderly People and Their Sociodemographic Determinants: Findings From a Nationally Representative Cross-Sectional Study.

BACKGROUND: Savory crispy or fried snack (SCFS), sugary snack (SS), and sugar-sweetened beverage (SSB) consumption are associated with a higher prevalence of obesity and non-communicable diseases. So, we estimated the consumption of SCFS, SS, and SSB among elderly males and females in Bangladesh. We also reported the factors associated with their consumption using data from a nationwide cross-sectional study. METHODS: We interviewed 2,482 (51.52%) elderly males and 2,335 (48.47%) elderly females for the recall for the past seven days on the intake of SCFS, SS, and SSB from 82 randomly selected clusters from rural, non-slum urban, and slum areas in Bangladesh. Sociodemographic and anthropometry data were also collected. RESULTS: Consumption of SCFS, SS, and SSB for ≥1 time per week was reported by 884 (31.5%), 1,696 (66.1%), and 1,911 (69.3%) of the elderly males and 516 (20.1%), 1,367 (53.9%), and 1,171 (34.1%) of the elderly females, respectively. Both elderly males and females from slum and non-slum urban areas consumed more SSB than their rural counterparts. Higher level of television viewing was associated with increased frequency of intake of SCFS, SS, and SSB among elderly males and SSB intake among elderly females. Nutritional status was not associated with the consumption of these foods and drinks among the elderly; however, overweight males consumed SSB less frequently. CONCLUSION: In Bangladesh, elderly males and females frequently consume unhealthy snacks and drinks. Considering their detrimental effect on health, it is necessary to reduce their consumption through policy and program measures and promote healthier foods and beverages.

Experience and side effects of COVID-19 vaccine uptake among university students: a cross-sectional survey study.

Introduction: Many people expressed concern over coronavirus vaccinations' reliability and side effects. This research aimed to assess university students' perceptions and experiences regarding the side effects of the COVID-19 vaccines in Bangladesh. Method: We conducted an online cross-sectional survey to collect responses from university students vaccinated with any vaccines administered in Bangladesh between November 2021 to April 2022. Bangladeshi university students over the age of 18 and having an internet connection was included in the study. A binary logistic regression analysis along with Pearson's Chi-square test were used to identify COVID-19 vaccine-related side effects predictors after receiving the first dose. Results: A total of 1,176 participants responded voluntarily to the online study, and most were vaccinated. More than half of the participants received the Sinopharm vaccine (56.5%), while others received Covishield (8.9%), Moderna (7.3%), and Pfizer (5.8%) vaccine. Around 32% of the participants reported side effects after receiving the first dose of the vaccine, including pain and edema (78.4%), body temperature (20.3%), and headache (14.5%), while a few experienced allergy, anxiety, and uneasy feelings. About 17% of the participants reported experiencing side effects after the second dose of the vaccine, including pain and edema (7.5%), body temperature (8.8%), and headache (7.3%). Most side effects were significantly associated with the Moderna vaccine (p < 0.001). Female students and those previously infected with COVID-19 were significantly associated with the side effects after taking the first dose of the vaccine. Conclusion: We found that side effects are mild and did not pose a significant challenge to Bangladesh's effort in managing and reducing the risk associated with the COVID-19 pandemic.