Comparison of the first time detected Oesophagostomum asperum with Oesophagostomum columbianum in sheep and goats in Bangladesh based on the trinity: Morphology, morphometry and genetic diversity.

Oesophagostomum spp. (Family: Chabertiidae) is keeping a low profile in terms of severity in Bangladesh while maintaining economic loss through disguise within sheep and goats. The study was performed to identify prevalence, confirmation of species through morphology and morphometry followed by phylogeny using ITS2 and COX1 genes. In total 384 slaughterhouse-sourced small and large intestines were pooled from Mymensingh, Kishoreganj, Netrokona, Sherpur and Tangail districts of Mymensingh division. Followed by isolation, O. columbianum and O. asperum were identified following their key morphological features. Notably, O. asperum was first time detected in Bangladesh. The overall prevalence of Oesophagostomum spp. was found 60.93%. The prevalence of O. columbianum (64.95%) was almost double than that of O. asperum (35.04%). Among several characters, only the distance between anus to tail tip showed a significant morphological disparity in female. The Neighbor-joining (NJ) phylogenic trees based on ITS2 and COX1 genes confirmed the study species. The first time identified O. asperum along with morphometry and phylogeny will add value to the fact that nematodes are invisibly present with high prevalence in this country. This study will help to draw specific attention to command a practical control strategy for intervening in economic loss.

Ascaridia galli, a common nematode in semiscavenging indigenous chickens in Bangladesh: epidemiology, genetic diversity, pathobiology, ex vivo culture, and anthelmintic efficacy.

Ascaridia galli is the most common nematode in chickens. Ascaridia galli is highly prevalent in chickens reared in scavenging or semiscavenging systems. Here, we studied the epidemiology, pathology, genetic diversity, ex vivo culture protocol and anthelmintic sensitivity of A. galli prevalent in indigenous chickens in Bangladesh. Through morphological study and molecular analyses, the isolated worms were confirmed as A. galli. Of the chickens examined, 45.6% (178 out of 390) were found infected. The male and young chickens were significantly (P < 0.05) more prone to A. galli infection. Prevalence of the infection was significantly (P < 0.05) lower in the summer season. In heavy infections, A. galli blocked the small intestine. Marked inflammation, increased mucus production and petechial hemorrhages were evident in the small intestine, particularly in the duodenum. Also, there were desquamation and adhesion of the mucosal villi; degeneration, necrosis of the epithelial cells and goblet cell hyperplasia. The mucosal layer was infiltrated mainly with eosinophils and heterophils. We developed a hen egg white-based long-term ex vivo culture protocol which supported the survival and reproduction of A. galli for more than a week. Levamisole (LEV) and ivermectin (IVM) efficiently killed A. galli. However, albendazole (ABZ), mebendazole (MBZ), and piperazine (PPZ) did not kill the worms even at 120 µg/mL and 1mg/mL concentrations, respectively. Taken together, our results suggest that A. galli is highly prevalent in semiscavenging chickens in Bangladesh. Ascaridia galli can be easily maintained ex vivo in egg white supplemented M199 medium. LEV and IVM, but not ABZ, MBZ and PPZ, can be used for treating and controlling A. galli infections in chickens.

Trends and inequity in improved sanitation facility utilisation in Bangladesh: Evidence from Bangladesh Demographic and Health Surveys.

Improved sanitation is indispensable to human health. However, lack of access to improved sanitation remains one of the most daunting public health challenges of the twenty-first century in Bangladesh. The aim of the study was to describe the trends in access to improved sanitation facilities following the inequity gap among households in different socioeconomic groups in Bangladesh. Data from the Bangladesh Demographic and Health Survey (BDHS) 2007, 2011, 2014, and 2017-18 were extracted for this study. Inequity in access to improved sanitation was calculated using rich-poor ratio and concentration index to determine the changes in inequity across the time period. In Bangladesh, the proportion of households with access to improved sanitation increased steadily from 25.4% to 45.4% between 2007 and 2014, but slightly decreased to 44.0% in 2017-18. Age, educational status, marital status of household head, household wealth index, household size, place of residence, division, and survey year were significantly associated with the utilisation of improved sanitation. There is a pro-rich situation, which means that utilisation of improved sanitation was more concentrated among the rich across all survey years (Concentration Index ranges: 0.40 to 0.27). The government and other relevant stakeholders should take initiatives considering inequity among different socioeconomic groups to ensure the use of improved sanitation facilities for all, hence achieving universal health coverage.

Ascaridia galli infection in chicken: Pathobiology and immunological orchestra.

BACKGROUND: Ascaridia galli is the largest gut-dwelling helminth of chickens, which confers adverse effects on meat and egg production; thus, on the animal protein supply and the economy. Both adult and immature parasites affect gut health, but larval stages play a major role in pathology. AIMS: Here, we present immunology and pathology of A. galli in chickens. MATERIALS AND METHODS: Literatures were surveyed through online platforms such as PubMed, Google Scholar and Researchgate. RESULTS: The larvae cause excessive mucus production, damage to the intestinal gland, hemorrhage, anemia, diarrhea, and malnutrition. The adult worms can cause death by intestinal obstruction and intussusception. Although both cellular and humoral immunity are involved in fighting against ascariasis, the role of naturally acquired immunity is poorly defined. In cellular immunity, Th-2 cytokines (IL-4, IL-5, IL-9, and IL-13), goblet cells (mucin), gut-associated lymphoid tissues, CD8α+ intraepithelial cells, TCRγδ + T cells, and TGF-ß4 form a protective band. Type 2 immunity provides protection by forming a network of endogenous damage-associated molecular patterns, chitin, and parasitic antigens. Among antibodies, IgY is the most prominent in chickens and provides temporary humoral protection. During parasitic infection, infiltration of various immune cells is evident, especially in the intestinal epithelium, lamina propria, and crypts of the duodenum and jejunum. In chickens older than 12 weeks, gradual reduction of worm burden is more successful than the younger birds. Female chickens exert a short-lived but higher level of protection by passing IgY to chicks in the form of egg yolk antibodies. In laying conditions, immunity differs between breeds. This review provides an overview of the silent but inevitable pathological changes induced by A. galli and the interaction of host immunity with the parasite.

Contribution of socio-economic and demographic factors to maternal and child malnutrition in Bangladesh: Insights from a nationwide survey.

Background: Malnutrition is a major global public health issue, especially for under five children and their mothers. Objective: This study examined the relationships between socio-economic and demographic characteristics and under- and over-nutrition in mothers and children of Bangladesh. Method: Using the Nationally representative Bangladesh Demographic and Health Survey (2017-18) data, we performed the multiple logistic regression analysis to assess the relationships between key outcome variables and predictors. The analysis included 8321 children aged 0-59 months and 7800 mothers aged 15-49 years. Findings: The prevalence of stunting, wasting, and overweight among children under five was 30.72%, 8.44%, and 2.21% respectively. About 2.74% of the children were both stunted and wasted, while 0.56% of the children were both stunted and overweight. The prevalence of underweight and overweight among mother was 14.09% and 26.35% respectively. Children who are stunted are significantly associated with the mother's BMI status, mothers' education, fathers' education, and wealth index, while children who are wasted are significantly associated with the mother's BMI status and the child's sex. A child's sex and birth order are significantly associated with children being overweight. Mother's age, mother's education, father's education, place of residence and wealth index are significant determinants for mothers being underweight, whereas mother's age, mother's occupation, father's education, father's occupation, place of residence and wealth index are significant determinants for mothers being overweight. Conclusion: In addition to essential nutrition interventions, it is vital to address the basic social-economic and demographic determinants.

Community-based integrated intervention for skilled maternal health care utilization in riverine remote areas, Bangladesh.

INTRODUCTION: Despite the decrease in maternal mortality ratio, many women in Bangladesh are still at high-risk of death due to pregnancy-related morbidities. Increasing the rate of skilled maternal healthcare service utilization is effective to reduce maternal mortality rate. This paper examines the intervention effect of an integrated community-based maternal healthcare project implemented by a non-government organization, Friendship, aiming to provide maternal health services to women living in the remote riverine regions of Bangladesh. METHODS: We examined the skilled maternal healthcare service utilization before and after project implementation of the mothers with birth experience of 0-6 months from the intervention (N = 1,304) and comparison areas (N = 1,304). A difference-in-differences logistic model measured the effect of the intervention. RESULTS: After the intervention, mothers were three times more likely to receive ≥ 4 ANC visits from skilled providers (AOR: 2.9; 95 % CI: 2.1-4.2), 1.5 times more likely to have skilled birth attendants during deliveries (AOR: 1.5; 95 % CI: 1.1-2.1) and 1.5 times more likely to seek at least one PNC within 42 days after delivery (AOR: 1.5; 95 % CI: 1.1-2.2) as compared to the comparison group. CONCLUSION: The intervention showed positive effect on improving the ANC coverage, skilled delivery, and PNC among the mothers residing the remote riverine areas. Therefore, it opens up the opportunity for adaptation of such integrated community and facility-based interventions by other LMICs.

Diversity and prevalence of gastrointestinal parasites of Black Bengal goats in Natore, Bangladesh.

Objectives: The objective of this work was to estimate the diversity of gastrointestinal (GI) parasite species, their prevalence, and risk factors in Black Bengal goats (BBGs) of Natore, Bangladesh. Materials and Methods: Fecal samples from randomly selected 260 BBGs were processed through Stoll's ova counting method, floatation, and simple sedimentation method. Microscopy-based identification of parasitic eggs, cysts, or oocysts was made. A semi-structured questionnaire-based data on host and management practices were collected from the owner. Data analysis was done using Statistical Package for Social Sciences. Results: The overall prevalence of GI parasites in BBGs was 65.4%, with an individual prevalence of 8.5% for Fasciola gigantica, 21.5% for Paramphistomum spp., 20% for Haemonchus spp., 34.2% for Strongyloides spp., 8.5% for Trichuris spp., and 9.2% for Eimeria spp. No significant effect of host age, gender, body condition, animal rearing system, or housing floor type was observed on parasitism. Animals of young age, female, poorly body-conditioned, living in a free-range system, and housed on a muddy floor had a relatively higher susceptibility to infection. Deworming had a significant impact on reducing the frequency of caprine GI parasitism. Conclusions: Despite the significant effect of anthelmintic, the elevated prevalence of GI parasites in BBGs suggests a critical need for developing effective strategies to prevent caprine parasitoses.

Ex-vivo efficacy of commercially available anthelmintics against blood feeding stomach worm Haemonchus contortus of ruminants.

Haemonchus contortus is the most prevalent and pathogenic gastrointestinal nematodes (GINs) in ruminants causing extensive economic losses. It is essential to estimate the efficacy of common commercially available anthelmintics against Haemonchus contortus parasite. Here, we standardized an ex-vivo culture platform for H. contortus and evaluated the efficacy of commonly used anthelmintics namely, albendazole (ABZ), levamisole (LVM), ivermectin (IVM), closantel (CLS) and rafoxanide (RFX). Adult worms were collected from abomasa of slaughtered animals, cultured in MEM, DMEM, M199 or RPMI with or without 20% FBS for up to 72 h. Cultured worms were incubated with ABZ, LVM, IVM, RFX or CLS in DMEM supplemented with 20% FBS at different concentrations (0.5-50 µg/ml) in triplicates and examined at 0, 3, 6, 12, 24, 36 and 48 h post treatment. Of the culture conditions, DMEM supplemented with 20% FBS supported the survival of H. contortus for (P < 0.001) longer period of time which was used in the evaluation of anthelmintics. The efficacy of CLS and RFX were significantly (P < 0.001) higher than other drugs and 100% mortality was observed at 2 µg/ml of CLS and RFX within 12 h post treatment. However, ABZ, LVM, and IVM showed significant effect at the concentration of 50 µg/ml with 48, 36, and 24 h, respectively. Morphological changes included severe cuticle disruption around the buccal cavity, posterior region and vulva as well as loss of cuticle structure integrity coupled with expulsion and fragmentation of digestive components of parasites when treated with 50 µg/ml of ABZ, LVM, and IVM and 2 µg/ml of RFX and CLS. Collectively, DMEM supplemented with 20% FBS can be used as ex-vivo culture platform for maintenance of H. contortus, and RFX and CLS can be used as the promising drugs for the prevention, control and treatment of H. contortus infections.

Levels and determinants of quality antenatal care in Bangladesh: Evidence from the Bangladesh Demographic and Health Survey.

BACKGROUND: Assessing the quality of antenatal care (ANC) is imperative for improving care provisions during pregnancy to ensure the health of mother and baby. In Bangladesh, there is a dearth of research on ANC quality using nationally representative data to understand its levels and determinants. Thus, the current study aimed to assess ANC quality and identify the sociodemographic factors associated with the usage of quality ANC services in Bangladesh. METHODS: Secondary data analysis was conducted using the last two Bangladesh Demographic and Health Surveys (BDHSs) from 2014 and 2017-18. A total of 8,277 ever-married women were included in the analysis (3,631 from 2014 and 4,646 from 2017-18). The quality ANC index was constructed using a principal component analysis on the following ANC components: weight and blood pressure measurements, blood and urine test results, counselling about pregnancy complications and completion of a minimum of four ANC visits, one of which was performed by a medically trained provider. Multinomial logistic regression was used to determine the strength of the association. RESULTS: The percentage of mothers who received all components of quality ANC increased from about 13% in 2014 to 18% in 2017-18 (p < 0.001). Women from the poorest group, those in rural areas, with no education, a high birth order and no media exposure were less likely to receive high-quality ANC than those from the richest group, those from urban areas, with a higher level of education, a low birth order and media exposure, respectively. CONCLUSION: Although the quality of ANC improved from 2014 to 2017-18, it remains poor in Bangladesh. Therefore, there is a need to develop targeted interventions for different socio-demographic groups to improve the overall quality of ANC. Future interventions should address both the demand and supply-side perspectives.

Dealing with separation or near-to-separation in the model for multinomial response with application to childhood health seeking behavior data from a complex survey.

Separation or monotone-likelihood can be observed in fitting process of a multinomial logistic model using maximum likelihood estimation (MLE) when sample size is small and/or one of the outcome categories is rare and/or there is one or more influential covariates, resulting in infinite or biased estimate of at least one regression coefficient of the model. This study investigated empirically to identify the optimal data condition to define both 'separation' and 'near-to-separation' (partial separation) and explored their consequences in MLE and provided a solution by applying a penalized likelihood approach, which has been proposed in the literature, by adding a Jeffreys prior-based penalty term to the original likelihood function to remove the first-order bias in the MLEs of the multinomial logit model via equivalent Poisson regression. Furthermore, the penalized estimating equation (PMLE) is extended to a weighted estimating equation allowing for survey-weight for analyzing data from a complex survey. The simulation study suggests that the PMLE outperforms the MLE by providing smaller amount of bias and mean squared of error and better coverage. The methods are applied to analyze data on choice of health facility for treatment of childhood diseases.

Indirect effects of the early phase of the COVID-19 pandemic on the coverage of essential maternal and newborn health services in a rural subdistrict in Bangladesh: results from a cross-sectional household survey.

OBJECTIVE: This paper presents the effect of the early phase of COVID-19 on the coverage of essential maternal and newborn health (MNH) services in a rural subdistrict of Bangladesh. DESIGN: Cross-sectional household survey with random sampling. SETTING: Baliakandi subdistrict, Rajbari district, Bangladesh. PARTICIPANTS: Data were collected from women who were on the third trimester of pregnancy during the early phase of the pandemic (111) and pre-pandemic periods (115) to measure antenatal care (ANC) service coverage. To measure birth, postnatal care (PNC) and essential newborn care (ENC), data were collected from women who had a history of delivery during the early phase of the pandemic (163) and pre-pandemic periods (166). EXPOSURE: Early phase of the pandemic included a strict national lockdown between April and June 2020, and pre-pandemic was defined as August-October 2019. OUTCOME OF INTEREST: Changes in the coverage of selected MNH services (ANC, birth, PNC, ENC) during the early phase of COVID-19 pandemic compared with the pre-pandemic period, estimated by two-sample proportion tests. FINDINGS: Among women who were on the third trimester of pregnancy during the early phase of the pandemic period, 77% (95% CI: 70% to 85%) received at least one ANC from a medically trained provider (MTP) during the third trimester, compared with 83% (95% CI: 76% to 90%) during the pre-pandemic period (p=0.33). Among women who gave birth during the early phase of the pandemic period, 72% (95% CI: 66% to 79%) were attended by an MTP, compared with 63% (95% CI: 56% to 71%) during the pre-pandemic period (p=0.08). Early initiation of breast feeding was practised among 38% (95% CI: 31% to 46%) of the babies born during the early phase of the pandemic period. It was 37% (95% CI: 29% to 44%) during the pre-pandemic period (p=0.81). The coverage of ANC, birth, PNC and ENC did not differ by months of pandemic and pre-pandemic periods; only the coverage of at least one ANC from an MTP significantly differed among the women who were 7 months pregnant during the early phase of the pandemic (35%, 95% CI: 26% to 44%) and pre-pandemic (49%, 95% CI: 39% to 58%) (p=0.04). CONCLUSION: The effect of the early phase of the pandemic including lockdown on the selected MNH service coverage was null in the study area. The nature of the lockdown, the availability and accessibility of private sector health services in that area, and the combating strategies at the rural level made it possible for the women to avail the required MNH services.