Knowledge attitude and convenience on self-medication practices among university students in Bangladesh exploration using structural equation modeling approach.

Self-medication is a prevalent practice among university students globally and is a significant public health concern. However, previous research has been limited in scope, focusing primarily on adolescents or the general public, leaving a gap in understanding the causal relationships associated with self-medication; thus, this study aimed to investigate the factors influencing self-medication practices among university students in Bangladesh by developing a comprehensive causal model. Data from 417 students across five public universities were collected using the simple random walk technique by a team of 10 members. The study utilized constructs of knowledge, attitude, and convenience related to self-medication as independent variables, while self-medication practice as the dependent variable. One-way ANOVA and structural equation modeling (SEM) were employed to develop a causal model of self-medication practice among university students in Bangladesh. The findings revealed that students with better medication knowledge and adverse drug reactions (ADRs) were more likely to practice self-medication. A positive attitude towards self-medication and ADRs was also significantly associated with higher self-medication practice scores. Additionally, those who perceived self-medication as convenient and prescribed medication as inconvenient had higher self-medication practice scores. The attitude towards self-medication had the most substantial negative effect on self-medication practice, followed by the inconvenience of prescribed medication and the convenience of self-medication. The model explained 87% of the variance in self-medication practice, indicating a good fit for the data. University students in Bangladesh possess intermediate knowledge of medication and primary knowledge of ADRs. They exhibit a positive attitude towards self-medication and ADRs. Physical convenience favors self-medication, while the inconvenience of prescribed medication contributes to its lower preference. Policymakers should focus on evidence-based guidelines to reduce the extent of unnecessary self-medication practice and to enhance the quantity and accessibility of prescribed medications to address the issue effectively.

Socioeconomic inequalities in utilizing maternal health care in five South Asian countries: A decomposition analysis.

BACKGROUND: High maternal mortality rates still today remain a significant public health concern in South Asian countries. The majority of maternal deaths occur during pregnancy, and these deaths may typically be avoided by ensuring that women have access to reliable maternity care such as antenatal care (ANC) and facility delivery. The objectives of this research were to assess socioeconomic disparities in the utilization of health care services by mothers and to determine the factors influencing this utilization among women aged 15 to 49 in five South Asian countries. METHODS: For this study, nationally representative data from the Demographic and Health Survey (DHS) were analyzed. This research included a total of 262,531 women between the ages of 15 and 49. To determine the likely causes of maternal health care utilization, simple bivariate statistics and binary logistic regression were applied, and decomposition analysis and the concentration curve were used to quantify disparity (Lorenz curve). RESULTS: ANC and institutional delivery were both prevalent in 59.27% and 86.52% of cases, respectively. Among the five nations, Maldives has the greatest ANC (96.83%) and institutional delivery (99.39%), while Bangladesh has the lowest ANC (47.01%) and institutional delivery (49.81%). Women's and husbands' education, household wealth status, BMI, and urban residents are the most important factors influencing maternal health service utilization, whereas higher education level, affluent wealth quintiles, and place of residence are the major contributors to socioeconomic inequalities in access to maternal health care that favor the wealthy. CONCLUSION: Maternal health care services must be utilized properly in order to promote optimal health and prevent maternal mortality. Several socioeconomic and sociodemographic variables of the individual population, as well as policy issues, all have an impact on maternal mortality. This research recommends for concerted action to enhance how successfully women use maternity care services.

Socio-economic inequalities in and factors associated with minimum dietary diversity among children aged 6-23 months in South Asia: a decomposition analysis.

OBJECTIVE: This study aimed to determine the factors associated with minimum dietary diversity (MDD) and estimate the socioeconomic inequalities in MDD among children from five South Asian countries. DESIGN: Cross-sectional. SETTING: The study used the most recent round of secondary databases of Demographic Health Survey data of Bangladesh (2017-2018), India (2019-2021), Maldives (2016-2017), Nepal (2018) and Pakistan (2017-2018). PARTICIPANTS: This study used information on MDD and other explanatory variables from a total of 136 980 (weighted) children aged 6-23 months. METHODS: Multivariable logistic regression was employed to identify the factors associated with MDD and concentration index (CIX) and Lorenz curve were used to measure the socioeconomic inequalities in MDD. RESULTS: The overall weighted prevalence of MDD in South Asia was 23.37%. The highest prevalence of MDD was found among children from Maldives (70.7%), while the lowest was in Pakistan (14.2%). Living in affluent versus poor households, having a mother who is employed versus a mother who is unemployed, exposure to various forms of media (newspapers and magazines), seeking antenatal care (ANC) more than four times compared with those who sought ANC less than four times and having children older than 4 years old are the most common significant factors associated with MDD deficiency. This study found the value of the CIX for MDD (MDD: CI=0.0352; p<0.001) among children with a higher socioeconomic status, suggesting inequality in MDD in favour of the more among well-off households. CONCLUSION: Inequality in the prevalence of MDD favours the affluent. Health policy and intervention design should prioritise minimising socioeconomic inequalities concerning the MDD. In addition, policy-makers should prioritise the associated factors of MDD such as education, wealth status, employment, media exposure while designing intervention or policies.

Emerging burdens of adolescent psychosocial health problems: a population-based study of 202 040 adolescents from 68 countries.

BACKGROUND: Psychosocial health problems are major public health burdens for adolescents. Identifying risk factors is essential to containing negative health implications. AIMS: This study aimed to estimate the burden of psychosocial health problems among adolescents, and identify potential risk and protective factors. METHOD: We used the Global School-based Student Health Survey data from 68 countries across six World Health Organization regions. We computed the overall, national- and regional-level weighted estimates of the mean number of psychosocial health problems. Adjusted Poisson regression models examined the factors associated with psychosocial health problems. RESULTS: Our sample totalled 202 040 adolescents aged 11-17 years (mean age 14.6 [s.d. 1.18] years), composed of 95 589 (47.31%) boys and 104 191 (51.57%) girls (2260 (1.12%) missing answers). Samoa had the highest mean number of psychosocial health problems (mean 2.64 [s.d. 1.41]), and Niue had the lowest (mean 0.33 [s.d. 0.72]). In the pooled analysis, the following factors were associated with higher rates of psychosocial health problems in adolescents globally: ≥13 years of age, being female, experiencing food insecurity, experiencing physical violence, having been bullied, engagement in physical altercation, experiencing serious injury, missing school without parental permission, lack of parental support or monitoring, parents who were not understanding of their child's problems and high sedentary behaviour. Being female, food insecurity, bullying, physical attacks or serious injury were all significantly associated with higher rates of psychosocial health problems in each of the six regions separately. CONCLUSIONS: The prevalence of psychosocial health problems is high among adolescents, although there are country-level variations. Health promotion strategies should consider the identified factors to promote adolescents' health and well-being.

The burden of chronic diseases, disease-stratified exploration and gender-differentiated healthcare utilisation among patients in Bangladesh.

BACKGROUND: Chronic diseases are considered one of the major causes of illness, disability, and death worldwide. Chronic illness leads to a huge health and economic burden, especially in low- and middle-income countries. This study examined disease-stratified healthcare utilisation (HCU) among Bangladesh patients with chronic diseases from a gender perspective. METHODS: Data from the nationally representative Household Income and Expenditure Survey 2016-2017 consisting of 12,005 patients with diagnosed chronic diseases was used. Gender differentiated chronic disease stratified-analytical exploration was performed to identify the potential factors to higher or lower utilisation of healthcare services. Logistic regression with step-by-step adjustment for independent confounding factors was the method used. RESULTS: The five most prevalent chronic diseases among patients were gastric/ulcer (Male/Female, M/F: 16.77%/16.40%), arthritis/rheumatism (M/F: 13.70%/ 13.86%), respiratory diseases/asthma/bronchitis (M/F: 12.09% / 12.55%), chronic heart disease (M/F: 8.30% / 7.41%), and blood pressure (M/F: 8.20% / 8.87%). Eighty-six percent of patients with chronic diseases utilised health care services during the previous 30 days. Although most patients received outpatient healthcare services, a substantial difference in HCU among employed male (53%) and female (8%) patients were observed. Chronic heart disease patients were more likely to utilise health care than other disease types, which held true for both genders while the magnitude of HCU was significantly higher in males (OR = 2.22; 95% CI:1.51-3.26) than their female counterparts (OR = 1.44; 1.02-2.04). A similar association was observed among patients with diabetes and respiratory diseases. CONCLUSION: A burden of chronic diseases was observed in Bangladesh. Patients with chronic heart disease utilised more healthcare services than patients experiencing other chronic diseases. The distribution of HCU varied by patient's gender as well as their employment status. Risk-pooling mechanisms and access to free or low-cost healthcare services among the most disadvantaged people in society might enhance reaching universal health coverage.

Factors influencing and changes in childhood vaccination coverage over time in Bangladesh: a multilevel mixed-effects analysis.

INTRODUCTION: This study aimed to investigate the associated factors and changes in childhood vaccination coverage over time in Bangladesh. METHODS: Bangladesh's Demographic and Health Surveys from 2011, 2014, and 2017-18 provided data for this study on vaccination coverage among children aged 12 to 35 months. For three survey periods, multilevel binary logistic regression models were employed. RESULTS: The overall prevalence (weighted) of full vaccination among children aged 12-35 months were 86.17% in 2011, 85.13% in 2014, and 89.23% in 2017-18. Children from families with high wealth index, mothers with higher education, and over the age of 24 and who sought at least four ANC visits, as well as children from urban areas were more likely to receive full vaccination. Rangpur division had the highest change rate of vaccination coverage from 2011 to 2014 (2.26%), whereas Sylhet division had the highest change rate from 2014 to 2017-18 (34.34%). CONCLUSION: To improve immunization coverage for Bangladeshi children, policymakers must integrate vaccine programs, paying special attention to mothers without at least a high school education and families with low wealth index. Increased antenatal care visits may also aid in increasing the immunization coverage of their children.

Prevalence and factors associated with chronic school absenteeism among 207,107 in-school adolescents: Findings from cross-sectional studies in 71 low-middle and high-income countries.

BACKGROUND: Despite the negative impact of chronic school absenteeism on the psychological and physical health of adolescents, data on the burden of adolescent chronic school absenteeism (ACSA) and interventions and programs to address it are lacking. We estimated the global, regional and national level prevalence of ACSA and its correlation with violence and unintentional injury, psychosocial, protective, lifestyle, and food security-related factors among in-school adolescents across low and middle-income, and high-income countries (LMICs-HICs). OBJECTIVES: This study aimed to estimate the prevalence of chronic school absenteeism (CSA) as well as to determine its associated factors among in-school adolescents across 71 low-middle and high-income countries. METHODS: We used data from the most recent Global School-based Student Health Survey of 207,107 in-school adolescents aged 11-17 years in 71 LMICs-HICs countries across six WHO regions. We estimated the weighted prevalence of ACSA from national, regional and global perspectives. Multiple binary logistic regression analyses were used to estimate the adjusted effect of independent factors on ACSA. RESULTS: The overall population-weighted prevalence of CSA was 11·43% (95% confidence interval, CI: 11·29-11·57). Higher likelihood of CSA was associated with severe food insecurity, peer victimisation, loneliness, high level of anxiety, physically attack, physical fighting, serious injury, poor peer support, not having close friends, lack of parental support, being obese, and high levels of sedentary behaviours. Lower likelihood of CSA was associated with being female (odds ratio, OR = 0·76, 95% CI: 0·74-0·78). CONCLUSION: Our findings indicate that a combination of different socio-economic factors, peer conflict and injury factors, factors exacerbate CSA among adolescents. Interventions should be designed to focus on these risk factors and should consider the diverse cultural and socioeconomic contexts.

Parental role and peer support in adolescent suicidal behavior in eight South-East Asian countries.

BACKGROUND: This study aimed to estimate the prevalence of suicidal behaviors, i.e. suicidal ideation (SI), suicidal plan (SP), and suicidal attempt (SA) among adolescents with a focus on parental and peer support in eight South-East Asian countries including Bangladesh, Bhutan, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka and Thailand. METHOD: Data were drawn from Global School-based Student Health Survey (GSHS) covering 42,888 adolescents aged 11-17 years. Weighted prevalence of SI, SP, and SA along with country specific prevalence was computed and binary logistic regression was used to identify associated risk factors. RESULTS: Among 42,888 adolescents 19,113 (44.9%) were males and 23,441 (55.1%) females. Overall prevalence of SI, SP and SA is 9.10%, 10.42% and 8.54%, respectively. Myanmar demonstrated the lowest SI (1.07%) and SP (0.18%) whereas lowest SA was found in Indonesia (3.79%). Maldives had the highest prevalence of SI, SP and SA which were 14.13%, 19.02% and 13.38% respectively. Overall suicidal behaviors were associated with being female [AOR: SI-1.26 (1.06,1.50), SP-1.34 (1.14,1.57)], high levels of sedentary behavior [AOR: SI-2.08 (1.62,2.66), SP-1.86 (1.49,2.32), SA-1.96 (1.45,2.64)], involvement in physical fighting [AOR: SI-1.30 (1.07,1.58), SP-1.37 (1.14,1.65), SA-1.50 (1.17,1.90)], being seriously injured [AOR: SI-1.40 (1.17,1.67), SP-1.44 (1.22,1.69), SA-1.74 (1.39,2.17)], being bullied [AOR: SI- 1.68 (1.39,2.02), SP-1.34 (1.12,1.60), SA-1.88 (1.50,2.36)], feeling lonely (most of time or always) [AOR: SI-3.41(2.60,4.46), SP-1.92 (1.48,2.47), SA-2.25 (1.62,3.13)], lack of parental support (never checking homework) [AOR: SI-1.59 (1.25,2.02), SP-1.52 (1.22,1.90)] and not having close friends [AOR: SI-2.19 (1.66,2.89), SP-2.26 (1.74,2.94), SA-4.23 (3.10,5.78)]. CONCLUSION: Though prevalence of suicidal behaviors varies, a range of cross-cutting risk factors exists that warrant further examination. We recommend focusing on strengthening parental and peer support, targeted programs addressing physical activity, bullying, loneliness and mental-health of adolescents.

Prevalence of and factors associated with early initiation of breastfeeding in Bangladesh: a multilevel modelling.

BACKGROUND: Early initiation breastfeeding (EIBF) is a sign of good health for both the mother and the newborn baby. The objective of this study was to estimate the prevalence of EIBF among mothers in Bangladesh and to identify its associated factors. METHODS: The study used the most recent Bangladesh Demographic and Health Survey 2017-2018 data. A total of 4776 (weighted) respondents were included in the final analysis. The association between the outcome and the independent variables was determined using multilevel (mixed effects) logistic regression analysis. RESULTS: The overall weighted prevalence of EIBF among Bangladeshi mothers was 61.19% (confidence interval [CI] 59.80 to 62.56). The study shows that non-poor wealth status (adjusted odds ratio [AOR] 0.81 [95% CI 0.68 to 0.95]), institutional delivery (AOR 0.77 [95% CI 0.61 to 0.96]) and caesarean delivery (AOR 0.31 [95% CI 0.26 to 0.38]) were associated with the lower odds of EIBF. Mother's secondary education (AOR 1.34 [95% CI 1.01 to 1.83]), at least four antenatal care visits (AOR 1.36 [95% CI 1.04 to 1.53]), normal birthweight (AOR 1.42 [95% CI 1.09 to 1.85]) and placed on mother's chest and bare skin after birth (AOR 1.33 [95% CI 1.11 to 1.60]) were associated with higher odds of EIBF. CONCLUSION: In order to enhance EIBF in Bangladesh, health professionals should emphasise skin-to-skin contact after delivery.

Socio-economic inequalities in minimum dietary diversity among Bangladeshi children aged 6-23 months: a decomposition analysis.

This study aimed to measure the socio-economic inequalities in having minimum dietary diversity (MDD) among Bangladeshi children aged 6-23 months as well as to determine the factors that potentially contribute to the inequity. The Bangladesh Demographic and Health Survey (BDHS) 2017-2018 data were used in this study. A sample of 2405 (weighted) children aged 6-23 months was included. The overall weighted prevalence of MDD was 37.47%. The concentration index (CIX) value for inequalities in MDD due to wealth status was positive and the concentration curve lay below the line of equality (CIX: 0.1211, p < 0.001), where 49.47% inequality was contributed by wealth status, 25.06% contributed by the education level of mother, and 20.41% contributed by the number of ante-natal care (ANC) visits. Similarly, the CIX value due to the education level of mothers was also positive and the concentration curve lay below the line of equality (CIX: 0.1341, p < 0.001), where 52.68% inequality was contributed by the education level of mother, 18.07% contributed by wealth status, and 14.69% contributed by the number of ANC visits. MDD was higher among higher socioeconomic status (SES) groups. Appropriate intervention design should prioritize minimizing socioeconomic inequities in MDD, especially targeting the contributing factors of these inequities.

Prevalence and determinants of contraceptive method use among Bangladeshi women of reproductive age: a multilevel multinomial analysis.

BACKGROUND: Much scholarly debate has centered on Bangladesh's family planning program (FPP) in lowering the country's fertility rate. This study aimed to investigate the prevalence of using modern and traditional contraceptive methods and to determine the factors that explain the contraceptive methods use. METHODS: The study used data from the 2017-18 Bangladesh Demographic and Health Survey (BDHS), which included 11,452 (weighted) women aged 15-49 years in the analysis. Multilevel multinomial logistic regression was used to identify the factors associated with the contraceptive method use. RESULTS: The prevalence of using modern contraceptive methods was 72.16%, while 14.58% of women used traditional methods in Bangladesh. In comparison to women in the 15-24 years age group, older women (35-49 years) were more unwilling to use modern contraceptive methods (RRR: 0.28, 95% CI: 0.21-0.37). Women who had at least a living child were more likely to use both traditional and modern contraceptive methods (RRR: 4.37, 95% CI: 3.12-6.11). Similarly, given birth in the previous 5 years influenced women 2.41 times more to use modern method compared to those who had not given birth (RRR: 2.41, 95% CI: 1.65-3.52). Husbands'/partners' decision for using/not using contraception were positively associated with the use of both traditional (RRR: 4.49, 95% CI: 3.04-6.63) and modern methods (RRR: 3.01, 95% CI: 2.15-4.17) rather than using no method. This study suggests rural participants were 21% less likely to utilize modern methods than urban participants (RRR: 0.79, 95% CI: 0.67-0.94). CONCLUSION: Bangladesh remains a focus for contraceptive use, as it is one of the most populous countries in South Asia. To lower the fertility rate, policymakers may design interventions to improve awareness especially targeting uneducated, and rural reproductive women in Bangladesh. The study also highlights the importance of male partners' decision-making regarding women's contraceptive use.

Trends and patterns of inequalities in using facility delivery among reproductive-age women in Bangladesh: a decomposition analysis of 2007-2017 Demographic and Health Survey data.

OBJECTIVES: The prime objectives of the study were to measure the prevalence of facility delivery, assess socioeconomic inequalities and determine potential associated factors in the use of facility delivery in Bangladesh.DesignCross-sectional. SETTING: The study involved investigation of nationally representative secondary data from the Bangladesh Demographic and Health Survey between 2007 and 2017-2018. PARTICIPANTS: The participants of this study were 30 940 (weighted) Bangladeshi women between the ages of 15 and 49. METHODS: Decomposition analysis and multivariable logistic regression were both used to analyse data to achieve the study objectives. RESULTS: The prevalence of using facility delivery in Bangladesh has increased from 14.48% in 2007 to 49.26% in 2017-2018. The concentration index for facility delivery utilisation was 0.308 with respect to household wealth status (p<0.001), indicating that use of facility delivery was more concentrated among the rich group of people. Decomposition analysis also indicated that wealth quintiles (18.31%), mothers' education (8.78%), place of residence (7.75%), birth order (5.56%), partners' education (4.30%) and antenatal care (ANC) seeking (8.51%) were the major contributors to the prorich socioeconomic inequalities in the use of facility delivery. This study found that women from urban areas, were overweight, had any level of education, from wealthier families, had ANC, and whose partners had any level of education and involved in business were more likely to have facility births compared with their respective counterparts. CONCLUSIONS: This study found a prorich inequality in the use of facility delivery in Bangladesh. The socioeconomic disparities in facility delivery must be addressed if facility delivery usage is to increase in Bangladesh.

Socioeconomic inequalities in utilizing facility delivery in Bangladesh: A decomposition analysis using nationwide 2017-2018 demographic and health survey data.

BACKGROUND: In many low- and middle-income countries (LMICs), including Bangladesh, socioeconomic inequalities in access to maternity care remain a substantial public health concern. Due to the paucity of research, we attempted to determine the factors affecting the facility delivery, quantify wealth-related inequality, and identify potential components that could explain the inequality. METHODS: We used the latest Bangladesh Demographic and Health Survey (BDHS 2017-18) data in this study. We utilized logistic regression to investigate the associated factors of facility delivery. The concentration curves (CC), concentration index (CIX) and decomposition of CIX techniques were used to analyze the inequality in-facility delivery. RESULTS: Women living in the urban areas, age at first birth after (18-24 years ≥25 years), being overweight/obese, having secondary and higher-level education of the women and their husband, seeking four or more ANC, coming from more affluent households, and women with high enlightenment were significant determinants of facility delivery. The concentration curve was below the line of equality, and the relative concentration index (CIX) was 0.205 (p <0.001), indicating that women from wealthy groups were disproportionately more prevalent to facility delivery. The decomposition analysis reveals that wealth status of women (57.40%), age at first birth (10.24%), husband's education (8.96%), husband's occupation (7.35%), education of women (7.13%), women's enlightenment (6.15%), residence (8.64%) and ANC visit (6.84%) are the most major contributors to the inequalities in utilizing facility delivery. CONCLUSION: The study demonstrates a clear disparity in the use of facility delivery among Bangladeshi women; hence, immediate action is required to lower the inequalities, with a special emphasis on the contributing factors.

Stigma toward people with COVID-19 among Bangladeshi older adults.

The onset of the coronavirus disease (COVID-19) pandemic and its overwhelming physical and mental health burden can result in stigmatization toward the disease and those affected. This study aimed to measure the prevalence of COVID-19-related stigma and its associated factors among older people in Bangladesh. This cross-sectional study was conducted among 1,045 Bangladeshi older adults aged 60 years and above through telephone interviews in September 2021. The outcome was measured using an eight-point Stigma Scale, adapted to the Bengali language. Level of stigma was indicated by the cumulative score of the eight-items, ranging from 0 to 8, with a higher score indicating a higher level of stigma. On average, participants had stigmas on three of the eight items, and 62.6% had a high stigma score. The most prevalent stigmas were as follows: COVID-19 is a punishment from God (79.3%), patients with previous COVID-19 must be isolated (67.3%), and people infected with COVID-19 did not meet hygiene standards (63.9%). Participants who lived in rural areas (ß: 0.67, 95% CI: 0.39 to 0.95) and who perceived needing additional care during the pandemic (ß: 0.35, 95% CI: 0.09 to 0.60) had a higher average stigma score, whereas stigma scores were lower among unemployed/retired participants (ß: -0.22, 95% CI: -0.45 to 0.00). The study findings suggest implementing interventions to raise awareness through appropriate health literacy interventions and mass media campaigns.

Socioeconomic inequalities in the risk factors of noncommunicable diseases (hypertension and diabetes) among Bangladeshi population: Evidence based on population level data analysis.

BACKGROUND: Noncommunicable diseases (NCDs) such as hypertension and diabetes are among the most fatal disease and prevalent among the adult population worldwide, including Bangladesh, and pose a public health threat. Understanding the socioeconomic inequalities linked to NCD risk factors can aid in the development of effective strategies to reduce the disease's recurrence. However, the literature on socioeconomic inequalities in hypertension and diabetes prevalence in Bangladesh is scant. Therefore, this study seeks to assess the inequality in hypertension and diabetes prevalence and to identify factors that may contribute to socioeconomic inequalities in Bangladesh. METHODS: The current study incorporated data from a recent round of Bangladesh Demographic and Health Survey (BDHS 2017-18). The age-standardized prevalence rates of hypertension and diabetes were reported, and the log-binomial regression technique was used to identify the relevant confounders. Additionally, socioeconomic inequalities were quantified using a regression-based decomposition technique in which the concentration index (CIX) and Concentration curve were produced to determine the socioeconomic factors contributing to inequality. RESULTS: Hypertension and diabetes were shown to have an age-standardized prevalence of (11.29% 95% CI: 11.13-11.69) and (36.98% 95% CI: 36.79-37.16), respectively. Both hypertension and diabetes were shown to be pointedly linked to the respondents' age, wealth status, being overweight or obese, and a variety of respondents' administrative divisions (p <0.001). In Bangladesh, household wealth status accounted for approximately 25.71% and 43.41% of total inequality in hypertension and diabetes, respectively. While BMI played a significant role in the emergence of inequality, the corresponding percentages for diabetes and hypertension are 4.95 and 83.38, respectively. In addition, urban areas contributed 4.56% inequality to increase diabetes among Bangladeshi inhabitants while administrative region contributed 4.76% of the inequality of hypertension. CONCLUSION: A large proportion of Bangladesh's adult population suffers from hypertension and diabetes. It is critical to recognize the value of equity-based initiatives in order to optimize the benefit-risk ratio and cost effectiveness of preventive health programmes. Integrating equity considerations into interventions is critical for policies and programmes to achieve their objectives. As a result, these findings can be taken into account when making existing and prospective policy decisions, as well as following its progression with economic development of Bangladesh.

Proportion and associated factors of the utilisation of complementary and alternative medicine exclusively in a hospital in Bangladesh.

BACKGROUND: Complementary and alternative medicine (CAM) has played a critical role in ensuring universal access to basic health care services around the world. In Bangladesh, conventional medicine is a common approach for health care practices, yet, due to Bangladesh's high out-of-pocket payment, millions of people utilise CAM-based healthcare services for illnesses. In Bangladesh, there is a scarcity of data on how CAM is perceived and utilised. The goal of this study was to determine the proportion and correlates of the utilisation of CAM among patients visiting a tertiary level hospital, in Bangladesh. METHODS: A cross-sectional survey involving 1,183 patients who received health care from a hospital in Bangladesh was interviewed for this study. The associated factors on utilising CAM were identified using multivariable logistic regression analysis. RESULTS: Thirty-three percent of patients utilised CAM exclusively to treat their illnesses, whereas the rest utilised conventional medicine before CAM. Young adult patients aged 26 to 45 years (AOR = 6.26, 95% CI:3.24-12.07), patients without education (AOR = 2.99, 1.81-4.93), and married patients (AOR = 1.79, 1.08-2.97) were the most likely to be only CAM users. The most common reasons for using CAM were belief in its effectiveness, less adverse effects, affordability and lower costs. CONCLUSION: In Bangladesh, CAM plays a significant role in health care delivery, with high-levels of patient satisfaction and health benefits. Patients who are older and have a higher level of education are more hesitant to use CAM for their illness, yet CAM has the potential to play a significant role in reducing hospitalisation by providing high reliability and low costs.

HGSORF: Henry Gas Solubility Optimization-based Random Forest for C-Section prediction and XAI-based cause analysis.

A stable predictive model is essential for forecasting the chances of cesarean or C-section (CS) delivery, as unnecessary CS delivery can adversely affect neonatal, maternal, and pediatric morbidity and mortality, and can incur significant financial burdens. Limited state-of-the-art machine learning models have been applied in this area in recent years, and the current models are insufficient to correctly predict the probability of CS delivery. To alleviate this drawback, we have proposed a Henry gas solubility optimization (HGSO)-based random forest (RF), with an improved objective function, called HGSORF, for the classification of CS and non-CS classes. Real-world CS datasets can be noisy, such as the Pakistan Demographic and Health Survey (PDHS) dataset used in this study. The HGSO can provide fine-tuned hyperparameters of RF by avoiding local minima points. To compare performance, Gaussian Naive Bayes (GNB), linear discriminant analysis (LDA), K-nearest neighbors (KNN), gradient boosting classifier (GBC), and logistic regression (LR) have been considered in this research. The ADAptive SYNthetic (ADASYN) algorithm has been used to balance the model, and the proposed HGSORF has been compared with other classifiers as well as with other studies. The superior performance was achieved by HGSORF with an accuracy of 98.33% for the PDHS dataset. The hyperparameters of RF have also been optimized by using commonly used hyperparameter-optimization algorithms, and the proposed HGSORF provided comparatively better performance. Additionally, to analyze the causes of CS and their significance, the HGSORF is explained locally and globally using eXplainable artificial intelligence (XAI)-based tools such as SHapely Additive exPlanation (SHAP) and Local Interpretable Model-Agnostic Explanations (LIME). A decision support system has been developed as a potential application to support clinical staffs. All pre-trained models and relevant codes are available on: https://github.com/MIrazul29/HGSORF_CSection.

Association of dietary risks, behavioural and lifestyle factors, and the magnitude of disability burden among Australian cancer patients: An observational epidemiology study.

BACKGROUND: Cancer patients are confronted with a variety of other health-related issues, including physical disability, poor quality of life, and psychological challenges. This study aims to quantify the association of dietary, behavioural and lifestyle risk factors and comorbidities on the magnitude and distribution of disability burden among cancer patients in Australia. METHODS: This study comprised a sample of 2283 cancer patients drawn from the latest nationwide Australian National Health Survey conducted in 2017-18. Negative binomial regression models were used to estimate the incidence rate ratio (IRR) of the number of disabilities and its associations. RESULTS: Forty-five percent of cancer patients experienced at least one disability. The magnitude of disability was significantly associated with sugar-sweetened drink consumption ≥ 3 days per week (IRR= 1.12, 95% CI: 1.02-1.26), a lack of physical activity (IRR = 1.69, 1.38-2.07), frequent or regular alcohol consumption (IRR = 1.95, 1.84-2.08), poor health status (IRR = 1.99, 1.78-2.24) and the presence of five or more chronic comorbid conditions (IRR = 3.59, 2.90-4.46). Cancer patients who consumed vegetables at least two or more times per day had a 10% lower risk of disability burden (IRR = 0.90, 0.82-0.99). CONCLUSIONS: This study shows the association of diet, behavioural, and lifestyle risk factors on the degree of disability burden among cancer patients, highlighting the need for bold and effective policies. The findings will inform the implementation of evidence-based lifestyle interventions and offer a foundation for evaluating their influence on cancer survivors' health.

Trends in the prevalence and associated factors of prediabetes and diabetes in Bangladesh: Evidence from population-based cross-sectional surveys.

AIMS: Diabetes is a major health problem in Bangladesh, but nationally representative studies on its trends and associated factors are scarce to guide policy formulation. Therefore, the study aims to determine trends in the prevalence and associated factors of prediabetes and diabetes in Bangladesh. METHODS: The study included two population-based cross-sectional surveys from Bangladesh Demographic and Health Survey (n = 7,505 in 2011 and n = 11,959 in 2017-18). Chi-square association tests were performed to determine the associated factors. Logistic regression models (univariate and multivariable) were used to estimate unadjusted and adjusted relative risks of having diabetes, reported with odds ratios. Age-adjusted prevalence was also reported for both surveys. RESULTS: The overall age-adjusted prevalence of prediabetes and diabetes decreased from 52.77% (95% CI: 52.61-52.92) and 10.43% (95% CI: 10.33-10.53) in 2011 to 34.10% (95% CI: 33.43-34.78) and 8.50% (95% CI: 8.11-8.90) in 2017-18. Compared to males, females had a higher odds of diabetes in 2011, but in 2017-18 a significant inverse result was observed. In both surveys, the odds of prediabetes and diabetes increased with advancing age, obesity, better wealth status, and hypertension. CONCLUSION: The study shows that the prevalence of prediabetes and diabetes is high in Bangladesh despite decreasing trends. Therefore, the study recommends promoting healthy lifestyles and regular screening for non-communicable diseases.

Determinants of Sick and Dead Pig Waste Recycling-A Case Study of Hebei, Shandong, and Henan Provinces in China.

Improper handling of sick and dead pigs may seriously affect public health, socio-economic conditions, and eventually cause environmental pollution. However, effective promotion of sick and dead pig (SDP) waste recycling has become the prime focus of current rural governance. Therefore, the study explores the impact of commitment, rewards, and punishments to capture the recycling behavior of farmers' sick and dead pig waste management. The study employs factor analysis, the probit model, and the moderating effect model to craft the findings. The study's empirical setup comprises the survey data collected from the Hebei, Shandong, and Henan provinces, representing the major pig-producing provinces in China. The study found that the commitment, reward, and punishment mechanisms are essential factors affecting the farmers' decision-making on recycling sick and dead pig waste. The marginal effect analysis found that the reward and punishment mechanism is more effective than the farmers' commitment. The study confirmed that in the recycling treatment of sick and dead pig waste, the farmers' commitment and the government's reward and punishment policy are the main factors that influence farmers to manage sick and dead pig waste properly. Therefore, the government should highlight the importance of effective waste management, and training facilities should also be extended firmly. The government should impose strict rules and regulations to restrict the irresponsible dumping of farm waste. Monitoring mechanisms should be put in place promptly.