Awareness of HPV vaccine and its socio-demographic determinants among the parents of eligible daughters in Bangladesh: A nationwide study.

Background: Vaccination against Human papillomavirus (HPV) is recommended to avoid HPV infections and its associated diseases, including cervical cancer. However, there is no awareness study among Bangladeshi population. Hence, this nationwide study was conducted to explore HPV vaccine awareness and its determinants among parents of eligible adolescent girls. Methods: This study was conducted among the parents of daughters aged 9-15 years from 42 out of 64 randomly selected districts of Bangladesh between June 28 to August 2, 2023. A multistage sampling method was used to enroll 2151 study participants from all eight divisions of Bangladesh. A semi-structured questionnaire was used for face-to-face interviews in this study. The statistical software Stata (Version 17) was used for statistical analyses. Results: The average age of the participants was 38.18 (±5.86) years. Only 22.32 % of the participants were aware of the HPV vaccine. Every additional year of age increased the likelihood of being aware of the HPV vaccine by 3 % (AOR: 1.03; 95%CI: 1.00-1.06). Participants residing in the urban area had 3.56 times higher odds of awareness than rural and semi-urban people. Businessmen and housewives had 60 % (AOR: 0.40; 95 % CI: 0.22-0.69) and 77 % (AOR: 0.23; 95 % CI: 0.16-0.33) lower odds in comparison to job holders. The lower-income group exhibited significantly higher odds of awareness (AOR: 0.25, 95%CI: 0.16-0.39) compared to the middle and the higher-income group. Participants who never went through routine health check-ups had 77 % lower odds of being aware than those who availed of regular routine check-ups (AOR: 0.23; 95%CI: 0.16-0.34). Conclusion: Awareness of the HPV vaccine among the general population of Bangladesh is very low. Age, residence, occupation, monthly income, and routine medical check-ups were associated with HPV vaccine awareness. A nationwide awareness campaign would increase this awareness level among the Bangladeshi population, especially among the parents of daughters.

The impact of comorbidity on the quality of life of people who recovered from COVID-19 in Bangladesh.

Objectives: COVID-19 affects the quality of life (QoL) in a reverse way after recovery, which might be multiplied by the comorbid non-communicable diseases. This study explored the relationship between comorbidities and the QoL of people who recovered from COVID-19 in Bangladesh. Methods: The cross-sectional study was conducted among 3244 participants between June 2020 and November 2020 using a pre-tested questionnaire through over-the-phone interviews. The WHOQOL-BREF was used to explore the QoL among the study participants. A multivariable linear regression model was conducted to identify the effects of the number of comorbidities on QoL scores of all four domains. Results: Of 3244 patients who recovered from COVID-19, over one-third (39.4%) had one or more chronic diseases, such as hypertension, diabetes mellitus, ischemic heart disease, bronchial asthma/chronic obstructive pulmonary disease, chronic kidney disease, and cancer. Around 46.85% of the participants aged above 40 years presented with one to two chronic diseases, and 16.33% had three or more chronic diseases. Among all comorbidities, the participants with cancer and chronic kidney disease were found to have relatively lower scores in all four domains than other comorbidities. The lowest QoL scores were observed in the psychological domain. Those with three or more simultaneous chronic comorbidities had the lowest QoL score in all four domains: physical, psychological, social relationship, and environmental. Conclusions: Persons who recovered from COVID-19 with comorbidities undergo a lower QoL. Therefore, special attention is required to these vulnerable groups to ensure their smooth recuperation.

Quality of life of COVID-19 recovered patients: a 1-year follow-up study from Bangladesh.

BACKGROUND: The COVID-19 pandemic posed a danger to global public health because of the unprecedented physical, mental, social, and environmental impact affecting quality of life (QoL). The study aimed to find the changes in QoL among COVID-19 recovered individuals and explore the determinants of change more than 1 year after recovery in low-resource settings. METHODS: COVID-19 patients from all eight divisions of Bangladesh who were confirmed positive by reverse transcription-polymerase chain reaction from June 2020 to November 2020 and who subsequently recovered were followed up twice, once immediately after recovery and again 1 year after the first follow-up. The follow-up study was conducted from November 2021 to January 2022 among 2438 individuals using the World Health Organization Quality of Life Brief Version (WHOQOL-BREF). After excluding 48 deaths, 95 were rejected to participate, 618 were inaccessible, and there were 45 cases of incomplete data. Descriptive statistics, paired-sample analyses, generalized estimating equation (GEE) analysis, and multivariable logistic regression analyses were performed to test the mean difference in participants' QoL scores between the two interviews. RESULTS: Most participants (n = 1710, 70.1%) were male, and one-fourth (24.4%) were older than 46. The average physical domain score decreased significantly from baseline to follow-up, and the average scores in psychological, social, and environmental domains increased significantly at follow-up (P < 0.05). By the GEE equation approach, after adjusting for other factors, we found that older age groups (P < 0.001), being female (P < 0.001), having hospital admission during COVID-19 illness (P < 0.001), and having three or more chronic diseases (P < 0.001), were significantly associated with lower physical and psychological QoL scores. Higher age and female sex [adjusted odd ratio (aOR) = 1.3, 95% confidence interval (CI) 1.0-1.6] were associated with reduced social domain scores on multivariable logistic regression analysis. Urban or semi-urban people were 49% less likely (aOR = 0.5, 95% CI 0.4-0.7) and 32% less likely (aOR = 0.7, 95% CI 0.5-0.9) to have a reduced QoL score in the psychological domain and the social domain respectively, than rural people. Higher-income people were more likely to experience a decrease in QoL scores in physical, psychological, social, and environmental domains. Married people were 1.8 times more likely (aOR = 1.8, 95% CI 1.3-2.4) to have a decreased social QoL score. In the second interview, people admitted to hospitals during their COVID-19 infection showed a 1.3 times higher chance (aOR = 1.3, 95% CI 1.1-1.6) of a decreased environmental QoL score. Almost 13% of participants developed one or more chronic diseases between the first and second interviews. Moreover, 7.9% suffered from reinfection by COVID-19 during this 1-year time. CONCLUSIONS: The present study found that the QoL of COVID-19 recovered people improved 1 year after recovery, particularly in psychological, social, and environmental domains. However, age, sex, the severity of COVID-19, smoking habits, and comorbidities were significantly negatively associated with QoL. Events of reinfection and the emergence of chronic disease were independent determinants of the decline in QoL scores in psychological, social, and physical domains, respectively. Strong policies to prevent and minimize smoking must be implemented in Bangladesh, and we must monitor and manage chronic diseases in people who have recovered from COVID-19.

Occupational Health Hazards Among Traffic Police in South Asian Countries: Protocol for a Scoping Review.

BACKGROUND: Occupational health hazards and injuries are an alarming concern among traffic police. Occupational injuries affect the physical, social, and mental well-being of police personnel, which has various public health implications. The evaluation of occupational health and safety policies and regulations for the traffic police relies on their occupational exposure and health hazard statistics and assessments. OBJECTIVE: The purpose of this scoping review is to systematically explore, analyze, and describe relevant findings from all studies conducted on occupational exposure and associated health hazards among traffic police in South Asia. METHODS: The scoping review will include studies that assessed occupational exposure prevalence, types, knowledge, predisposing factors, and prevention strategies. Databases like PubMed, Springer Link, EBSCOhost, the Cochrane library, and Google Scholar will be used to obtain both published and unpublished works in the English language. Relevant gray literature, including governmental and international organization reports, will be examined. After removing duplicates and screening titles and abstracts, the full-text analysis will begin. Arksey and O'Malley's methodology framework for scoping reviews will be followed. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews, the scoping review will be reported. Two qualified reviewers will independently conduct article screening and data extraction. The extracted data will then be tabulated and accompanied by an explanation to facilitate comprehension. We will extract relevant article results using NVivo (version 10; QSR International) and thematic content analysis. The included articles will be evaluated using the mixed methods appraisal tool (version 2018). RESULTS: The scoping review will provide insight into how occupational health hazards affect traffic police physically and psychologically in South Asia. The theoretical conceptualization of different aspects of the occupational health of traffic police will emphasize future studies in this region, which will inform policy makers to revise their occupational health and safety policies and principles. It will have implications for taking necessary preventive measures in the future to reduce occupational injuries and fatalities resulting from different types of occupational hazards. CONCLUSIONS: This scoping review will describe the overview of occupational hazards among South Asian traffic police and will provide insights for policy makers to implement changes and to adapt new strategies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/42239.

Human monkeypox and preparedness of Bangladesh: A knowledge and attitude assessment study among medical doctors.

OBJECTIVE: The recent increasing incidence of human monkeypox cases highlights the necessity of early detection, prompt response and preventive management to stop it in its tracks, and healthcare workers play the most crucial role here. This study aims at assessing the preparedness of Bangladeshi medical doctors by assessing their knowledge and attitude regarding monkeypox. METHODOLOGY: This cross-sectional study was conducted among the practicing medical doctors all over Bangladesh. The data was collected from 26th May to 4th June of 2022 using a semi-structured and self-administered questionnaire which was distributed through the internet, and a total of 389 data was collected. The cut-off points for defining good knowledge and positive attitude towards human monkeypox were considered as 70% and 80% of total values, respectively. Multivariable logistic regression analyses were carried out to identify the factors associated with good knowledge and a positive attitude. Statistical software R version 4.2.0 was used for data analysis. RESULT: Of all, 330 (84.83%) doctors displayed a positive attitude towards preventive practices, but only 119 (30.59%) participants had good knowledge regarding monkeypox. In multivariable logistic regression analysis, getting any information about monkeypox in the medical curriculum and learning about monkeypox within the last one month had a significant association with good knowledge. Apart from the participant's age, no other variables revealed any significant association with a positive attitude toward preventive practices. Good knowledge showed a significant association with positive attitude (p < 0.05). CONCLUSION: Knowledge regarding human monkeypox among medical doctors in Bangladesh was comparatively lower than the attitude towards its preventive measures. Developing and implementing practical sessions regarding the virus to enhance the knowledge and capacity of the medical doctors could be an effective strategy to get prepared for the monkeypox outbreak in Bangladesh.

Oral health knowledge, practice, and oral health status among rohingya refugees in Cox's Bazar, Bangladesh: A cross-sectional study.

Oral health is a critical component of human health but is sometimes forgotten, particularly during humanitarian crises. This research aimed to ascertain the state of oral health among Rohingya refugees living in one of the largest refugee camps and evaluate their knowledge and practice of oral health. A multicenter cross-sectional survey was conducted among 477 participants from July to September 2021 using a structured questionnaire. There were 34 Rohingya camps and out of those 14 camps were accessible for data collection. The study participants were between 18-82 years residing in the refugee camps under Cox's Bazar. The majority of participants (53.88%) were female and between the ages of 25 and 45. Around 46.12% of respondents did not have basic oral health knowledge, while 53.67% were in need of dental care. Nearly half of the participants demonstrated poor oral health practices. Participants' age and educational level were positively associated with oral health knowledge (p = 0.02 and p<0.001). Furthermore, the knowledge level was positively associated with oral health practice (p = .025). Participants with a history of teeth pain and discomfort in the last 12 months were ten times more likely to seek treatment (OR = 9.93, CI: 5.591-17.64). The study indicated a growing demand for dental care among Rohingya refugees staying in Bangladesh. To reduce the severity of oral health issues, use of minimally invasive restorative procedures can be suggested in camps. New oral health promotion campaigns should be emphasized and proper education, ideally in their original language, can be beneficial.

Factors affecting intention to take COVID-19 vaccine among Pakistani University Students.

BACKGROUND: Widespread vaccination coverage is essential for reducing the COVID-19 havoc and regarded as a crucial tool in restoring normal life on university campuses. Therefore, our research aimed to understand the intention to be vaccinated for COVID-19 among Pakistani university students. METHODS: This cross-sectional study was conducted in five administrative units of Pakistan, i.e., Punjab, Sindh, Balochistan, Azad Jammu and Kashmir, and Khyber Pakhtunkhwa. We obtained data from 2,865 university students between 17th January and 2nd February, 2021, using a semi-structured and self-administered questionnaire. We used Stata (version 16.1, StataCorp LLC) for data management and analysis. RESULTS: The majority (72.5%) of our respondents were willing to take COVID-19 vaccine. The current level of education had a statistically significant relationship with the intention to be vaccinated (p < 0.05). Respondents answered 11 questions encompassing five different domains of the Health Belief Model (HBM). All the items of HBM were significantly associated with the positive intention towards receiving the vaccine (p < 0.05). We conducted a multivariable logistic regression analysis to assess the relative contribution of different factors towards the intention to receive COVID-19 vaccine. Multiple factors such as belief that vaccination should be mandatory for everyone (AOR: 3.99, 95% CI: 3.20-4.98) and willingness to take vaccine even if it is not free (AOR: 3.91, 95% CI: 3.18-4.81) were observed to be associated with high odds of showing willingness to be vaccinated against COVID-19. CONCLUSION: Most of our study participants intended to take vaccines based on their belief regarding the high effectiveness of COVID-19 vaccine. But as rumor-mongers are generating and spreading conspiracy theories daily, the health department and policymakers need to undertake evidence-based campaigns through electronic and social media to ensure expected countrywide vaccination coverage. In this case, our study findings can serve as a foundation for them to ensure mass vaccination coverage among university students, which is crucial now to reopen the dormitories and restore everyday life on campuses.

COVID-19 vaccine acceptance in South Asia: a multi-country study.

OBJECTIVES: With COVID-19 vaccination underway, this study aimed to understand belief, attitude and intention of the people in the South Asia region towards the vaccine. METHODS: We conducted a cross-sectional study using semi-structured questionnaires among 18201 individuals in four South Asian countries; Bangladesh, India, Pakistan, and Nepal between January 17 and February 2, 2021. We used the Health Belief Model (HBM) to identify the predictors related to vaccine acceptance. STATA (v16.1) was used for all analyses. RESULTS: The percentage of respondents willing to be vaccinated against COVID-19 was 65%, 66%, 72% and 74% for Bangladesh, India, Pakistan and Nepal, respectively. Perceived destructive impact of COVID-19, positive perception of vaccines and concern about possible side effects were significant in modifying respondents' intentions.. In multivariable logistic regression, age, sex, marital status, education, comorbidities, worry about getting infected, perceived COVID-19 impact, belief regarding vaccine efficacy, positive attitude towards mandatory measures, and vaccine availability were found to be associated with vaccine acceptance across countries. CONCLUSION: Nearabout two-third of the respondants were willing to take COVID-19 vaccine in the four South Asia countries.

Quality of life of COVID-19 recovered patients in Bangladesh.

Coronavirus Disease-2019 (COVID-19) quickly surged the whole world and affected people's physical, mental, and social health thereby upsetting their quality of life. Therefore, we aimed to investigate the quality of life (QoL) of COVID-19 positive patients after recovery in Bangladesh. This was a study of adult (aged ≥18 years) COVID-19 individuals from eight divisions of Bangladesh diagnosed and confirmed by Reverse Transcription-Polymerase Chain Reaction (RT-PCR) from June 2020 to November 2020. Given a response rate of 60% in a pilot study, a random list of 6400 COVID-19 patients was generated to recruit approximately 3200 patients from eight divisions of Bangladesh and finally a total of 3244 participants could be recruited for the current study. The validated Bangla version of the World Health Organization Quality of Life Brief (WHOQOL-BREF) questionnaire was used to assess the QoL. Data were analyzed by STATA (Version 16.1) and R (Version 4.0.0). All the procedures were conducted following ethical approval and in accordance with the Declaration of Helsinki. The mean scores of QoL were highest for the physical domain (68.25±14.45) followed by social (65.10±15.78), psychological (63.28±15.48), and environmental domain (62.77±13.07). Psychological and physical domain scores among females were significantly lower than the males (p<0.001). The overall quality of life was lower in persons having a chronic disease. Participants over 45 years of age were 52% less likely to enjoy good physical health than the participants aged below 26 years (AOR: 0.48, CI: 0.28-0.82). The quality of life of employed participants was found 1.8 times higher than the unemployed (AOR: 1.80, CI: 1.11-2.91). Those who were admitted to hospitals during infection had a low QoL score in physical, psychological, and socials domains. However, QoL improved in all aspect except the psychological domain for each day passed after the diagnosis. These findings call for a focus on the quality of life of the COVID-19 affected population, with special emphasis given to females, older adults, unemployed, and people with comorbidities.

A case of acute encephalopathy and non-ST segment elevation myocardial infarction following mRNA-1273 vaccination: possible adverse effect?

A 77-year-old man with a past medical history of type 2 diabetes mellitus, peripheral neuropathy, and chronic obstructive pulmonary disease was admitted to the intensive care unit of Bangladesh Medical College Hospital with acute encephalopathy and non-ST segment elevation myocardial infarction (NSTEMI). The patient was on antidiabetic medicine along with H2 blocker and multivitamins for his existing diseases. The patient's attendant reported that the patient had received his first dose of the Moderna coronavirus disease 2019 (COVID-19) vaccine just 2 days ago. Physical examination revealed that he had a Glasgow Coma Scale of 8/15; a pulse of 106 beats/min; a respiratory rate of 30 breaths/min; oxygen saturation of 80% on room air, which became with 10 L of oxygen and blood pressure of 90/60 mm Hg at the time of admission. During the hospital stay, the patient was treated conservatively with intravenous antibiotics and other necessary medication. Although we have observed the onset of encephalopathy and NSTEMI following COVID vaccination for this patient, we, as healthcare professionals, cannot directly attribute the cause of the complications to the Moderna vaccine without further epidemiological studies with large samples.

Acceptance of COVID-19 vaccine and its determinants: evidence from a large sample study in Bangladesh.

AIM: Our study aimed to understand the acceptance level of the COVID-19 vaccine and its determinants among the adult Bangladeshi population. METHODOLOGY: This cross-sectional study was conducted in all eight divisions of Bangladesh. Data from 7,357 adult respondents were collected between January 17 and February 2, 2021, using a self-administered semi-structured questionnaire. Statistical software STATA (Version 16.1) was used for all analyses. RESULTS: The majority of study participants were from the Dhaka division (34.24%). The most common age group was ≤30 years (46.18%). Almost two-thirds of respondents were male (65.50%) and married (67.76%). A large portion (79.85%) of people who had positive vaccine intentions believed that vaccination should be made mandatory for everyone. The majority of the respondents thought that the vaccine would work against COVID-19 infection (67%). In the binary logistic regression analysis, participants who had the education level of graduation or above (AOR = 1.80), age ≥50 years (AOR = 1.97), students (AOR = 2.98), monthly income ≥41,000 BDT (AOR = 2.22), being resident of rural area (AOR = 2.24), respondents from Khulna division (AOR = 6.43) were more likely to receive a COVID-19 vaccine. Those who had family members diagnosed with COVID-19 (AOR = 1.24), presence of chronic disease (AOR = 0.72), and those who were vaccinated in the last few years (AOR = 1.32) were also more likely to accept the COVID-19 vaccine. CONCLUSION: Most of the respondents were willing to be vaccinated based on the belief that the vaccine will work against COVID-19. As rumors are generating daily, there is a need for policy-level initiative and evidence-based mass media promotion to keep inspired the general Bangladeshi people to accept the COVID-19 vaccine whenever it will be available at the individual level.

Healthcare Workers' Knowledge, Attitude, and Practice Regarding Personal Protective Equipment for the Prevention of COVID-19.

PURPOSE: Adequate knowledge, positive attitude, and proper practice of personal protective equipment by healthcare workers are necessary to get protection from COVID-19 infection. But this area is yet to be explored. Hence, we aimed to assess the knowledge, attitude, and practice (KAP) regarding personal protective equipment (PPE) among healthcare workers, along with a survey of the possible determinants. SUBJECTS AND METHODS: For this cross-sectional study, online and offline surveys were conducted among a sample of 393 healthcare workers from five different districts of Bangladesh. A validated self-administered questionnaire comprising five sections (socio-demography, work-related information, knowledge, attitude, and practice) was used for data collection. Multivariate stepwise forward logistic regression was applied to find significant factors associated with good attitude, and practice using SPSS version 25. RESULTS: The average age of the 393 participants was 28.9±5.2 years with a male-female ratio of one. Of them, 99.5% (n=391) had good knowledge, 88.8% (n=349) had positive attitude and 51.7% (n=203) had good practice regarding PPE. Results revealed that being a physician and living at home were significantly associated with a positive attitude. While being a non-physician, having lower education, working in private hospitals, and using office transport were associated with good practice regarding PPE. CONCLUSION: The findings demonstrated that the healthcare workers had an overall good knowledge and a positive attitude but a poor practice regarding PPE. This study also highlighted the factors influencing KAP towards PPE that must be addressed in future education, awareness, and counseling programs.