H9N2 avian influenza virus dispersal along Bangladeshi poultry trading networks.

Avian influenza virus subtype H9N2 is endemic in Bangladesh's poultry population. The subtype affects poultry production and poses a potential zoonotic risk. Insufficient understanding of how the poultry trading network shapes the dissemination of avian influenza viruses has hindered the design of targeted interventions to reduce their spread. Here, we use phylodynamic analyses of haemagglutinin sequences to investigate the spatial spread and dispersal patterns of H9N2 viruses in Bangladesh's poultry population, focusing on its two largest cities (Dhaka and Chattogram) and their poultry production and distribution networks. Our analyses suggest that H9N2 subtype avian influenza virus lineage movement occurs relatively less frequently between Bangladesh's two largest cities than within each city. H9N2 viruses detected in single markets are often more closely related to viruses from other markets in the same city than to each other, consistent with close epidemiological connectivity between markets. Our analyses also suggest that H9N2 viruses may spread more frequently between chickens of the three most commonly sold types (sunali-a cross-bred of Fayoumi hen and Rhode Island Red cock, deshi-local indigenous, and exotic broiler) in Dhaka than in Chattogram. Overall, this study improves our understanding of how Bangladesh's poultry trading system impacts avian influenza virus spread and should contribute to the design of tailored surveillance that accommodates local heterogeneity in virus dispersal patterns.

Mapping the Antimicrobial Supply Chain in Bangladesh: A Scoping-Review-Based Ecological Assessment Approach.

INTRODUCTION: Maintaining access to antimicrobials while preventing misuse is essential to combating the threat of antimicrobial resistance (AMR). The study objectives are to propose a framework of 16 indicators that can be used at the national level to assess the capacity to ensure access and curtail inappropriate use and to profile the antimicrobial supply chain for Bangladesh. METHODS: Using a framework based on a rational construct, we assessed the antimicrobial supply chain of Bangladesh, with a focus on key players and products using a scoping review to obtain and describe information on 16 indicators. With players, we mapped linkages, manufacturers' production capacity, and ownership, among others, and demand point characteristics-pharmacy and pharmacist density, pharmacy/medicine outlets dispersion, veterinary clinic/hospitals, veterinarians' density, product quality, and regulation. We assessed product characteristics including listing on the World Health Organization (WHO) Model Essential Medicines List (EML) and WHO Access, Watch, and Reserve (AWaRe) classification of the major (top 10) antibiotics for human use; the proportion of medically important antimicrobials (MIAs) in veterinary use; and pricing. Production capacity and price controls were used to assess access and listing on the WHO EML, AWaRe/MIA classification, and a calculated pharmacy-to-pharmacist ratio to assess use. RESULTS: Bangladesh has a high (98%) local antibiotic production capacity with pricing controls indicating the ability to ensure access. The presence of a high proportion of medicine outlets not under the control of pharmacists (4:1) and the high percentages of WHO Watch (54%) and MIAs (90%) of the major antibiotics are indicators of possible misuse. DISCUSSION: Most of the data used in the framework were publicly available. Bangladesh has the capacity to ensure access but needs to strengthen its ability to regulate the quality of antimicrobials and prevent their inappropriate use through antimicrobial stewardship at the community (medicine outlet) levels to check AMR. There may also be a need for more regulations on licensing of MIAs.

New introduction of clade 2.3.2.1 avian influenza virus (H5N1) into Bangladesh.

Since the first outbreak of highly pathogenic H5N1 avian inafluenza (HPAI) in Bangladesh in February 2007, a total of 519 disease events have been reported till 22 October 2011. Partial HA gene sequences of 11 selected H5N1 HPAI isolates of 2007 to 2011 were determined and subjected to phylogenetic analysis. The study revealed a recent introduction of clade 2.3.2 and 2.3.4 viruses into Bangladesh in 2011 in addition to clade 2.2 viruses that had been in circulation since 2007. Clade 2.3.2 virus isolates from Bangladesh are phylogenetically related to the newly designated clade 2.3.2.1 viruses, reported recently from Asia and Eastern Europe.

Medical information prior to invasive medical procedures in otorhinolaryngology-head and neck surgery in France.

Based on a review of the medical literature (PubMed database, keywords: medical information, informed consent), the authors analyse the main medicolegal aspects concerning the patient information that must be provided in France prior to any invasive diagnostic or therapeutic medical procedures in otorhinolaryngology head and neck surgery, as well as the patient's perception and recall of the information provided, the quality of the information provided and problems encountered in providing this information. In the light of this review, several solutions are recommended to improve this essential phase prior to obtaining the patient's informed consent.

Noise level in different places of Dhaka Metropolitan City (DMC) and noise-induced hearing loss (NIHL) in Dhaka City dwellers.

A cross sectional, exploratory study was designed at "National Center for Hearing and Speech for Children" (NCHSC), Dhaka, Bangladesh, from May 2001 to June 2002, with a view to determine the average noise level in different places of Dhaka Metropolitan City (DMC), and also aiming at evaluating the extent of Noise-induced Hearing Loss (NIHL) in different groups of city dwellers and finally a base line information. A total of 32 places in DMC were selected randomly. The highest noise level recorded 104 dB at Sayedabad bus terminal and the lowest 68 dB in Banani and Baridhara residential area. In silent zone of DMC, average noise level was 79 dB, in residential zone 72 dB, in commercial zone 90 dB, and in mixed zone average noise level was recorded at 91 dB. Measured noise levels were more than acceptable and permissible levels in all places of DMC. A total of 312 persons aged between 15-45 years (mean age- 24.64 years) were enrolled for the study as per inclusion criteria. Gender-wise male were 211(67.62%) and female were 101(32.57%). Profession-wise Automobile drivers were 57(18.26 %), Garment workers 58(18.55 %), City dwellers 72(23.07%), Students 72(23.07%), Traffic polices 12(3.85%), Hawkers and Road side shopkeepers were 41(13.1%). Definite noise notch (>25dB) at 4KHz observed in 33(10.58%) audiogram of persons under study. Automobile drivers, Traffic polices, Road side hawkers and Shop keepers, Garment workers are mostly affected were 17.54%, 16.4%, 12.09% and 12.06% respectively. A total of 201 persons (64.42%) were not aware of their hearing impairment, 244(78%) of the person had poor level of knowledge regarding bad effects of noise on health and about protective means available. Amongst persons (33) found to have NIHL did not use any protective device.

Sero-epidemiological studies on Toxoplasma gondii infection in man and animals in Bangladesh.

Sera from randomly selected 49 professional blood donors, 617 pregnant women, 14 butchers, 528 slaughtered goats and 24 domestic cats in the district of Mymensingh were tested for the presence of T. gondii antibodies using a Latex agglutination test (LAT). Overall 12.4% blood donors, 11.18% pregnant women, 50.00% butchers, 12.88% slaughtered goats and 33.33% cats had diagnostically significant antibody titers (> or = 1:64) to T. gondii. Epidemiological studies on T. gondii infection with LAT were conducted in 25 family members with sero-positive cats and 9 family members with 2 sero-positive women without cats in the family. Significantly (p < 0.01) higher sero-positivity rate was recorded in the family members (24.00%) with positive cats in comparison to family members (11.11%) without cats. The epidemiologic study indicates that infected cats and goat meat might be significant sources of T. gondii infection for humans in Bangladesh.

Seroprevalence of Toxoplasma gondii in domestic ruminants in Bangladesh.

Sera from 205 cattle, 17 sheep and 306 goats were tested for Toxoplasma gondii antibodies by using a commercial latex agglutination test. Titres considered diagnostically significant (> or = 1:64) were detected in 16.10% of cattle, 17.65% of sheep and 12.09% of goats. Results indicate that T. gondii infection in domestic ruminants in Bangladesh is widespread.

Serological diagnosis of Toxoplasma gondii infection in women associated with gyneco-obstetric problems.

The latex agglutination test (Toxoreagent) was used to detect the sero-prevalence of Toxoplasma gondii in 302 Bangladeshi women who were under treatment for various gyneco-obstetric problems at the Mymensingh Medical College during January to June 1991. The over-all sero-prevalence rate was 15.89%, of which 6.25% reacted at 1:32, 33.33% at 1:64, 16.67% at 1:128, 22.92% at 1:256, 6.25% at 1:512 and 14.58% at 1:1024. The positivity rate of 18.60% recorded in women between 31 and 40 years was insignificantly (p > 0.05) higher than that of 15.44% in women between 17 and 30 years of age. Over-all 26.49% of infections resulted in abortion, 6.62 in stillbirths and 30.79% in dystocia, of which 20.0%, 30.0% and 7.53% women had positive titers to T. gondii, respectively, whereas 17.43% women with normal live births had also positive titers to T. gondii. The over-all prevalence rate of abortion in association with T. gondii infection was 5.30% which was higher than the rates of stillbirths (1.99%) and perinatal death (0.66%). It is concluded that toxoplasmosis can cause abortion, stillbirths and perinatal death in Bangladeshi women.

Effect of Raillietina echinobothrida infection on blood values and intestinal tissues of domestic fowls of Bangladesh.

An examination of the blood profile of domestic fowls infected with Raillietina echinobothrida revealed anaemia with a significant increase of total leukocyte counts and decrease of total serum protein. The pathological changes in the intestines were characterised by villous atrophy, enteritis with cellular infiltration and formation of characteristic granulomas.

Anthrax in man and cattle in Bangladesh.

The occurrence of anthrax in 62 cattle and 27 humans in Pabna milk shed areas of Bangladesh was recorded during 1980-84. There were 62 sick animals: 43 (69%) died, 14 (23%) recovered with penicillin treatment and only five (8%) were slaughtered in a moribund stage, for human consumption. All 27 people who developed malignant pustules were cured with penicillin treatment within 14 days.

T- and B-lymphoid cell population in calves immunized against Theileria annulata.

Distribution of T- and B-lymphoid cells in peripheral blood, lymph node, spleen and bone marrow of normal healthy calves and valves immunized against Theileria annulata followed by challenge on Day 50 post-immunization were studied by rosette tests. Significantly increased percentages of T- and B-lymphoid cells were recorded in immunized calves.