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The COVID-19 pandemic has caused a global emergence, and the absence of a proven vaccine or medicine has led to the implementation of measures to prevent and control the spread of the virus. Wearing protective equipment like mask and gloves, washing hands via soap, frequent use of antiseptic solution and maintaining social distance are being applied globally to reduce the transmission rate. Therefore, this study was intended to investigate water, sanitation and hygienic (WASH) behaviour, protective equipment use and their disposal practices among Bangladeshi residents amid the COVID-19 pandemic. Based on the study aims, data were collected mainly via an online survey and analysed through a set of statistical tools including T test, one-way ANOVA and principal component analysis (PCA). This study found that almost 89.80% of the respondents reported to know about the COVID-19 and its preventive measures. WASH status of the respondents is found quite good, where 94.60% stated to have available potable water, 99% have improved toilet facilities, 95% wash their hands via soap, and 79.80% clean their house and toilets by antiseptic solutions properly. Moreover, nearly 94.50% and 54.80% people reported to use face mask and hand gloves, respectively, but the disposal practice of these protective equipment is inappropriate. More than 50% of people reported disposing of their used mask, gloves and tissue with other household wastes, which is alarming for public health and environmental perspective. Moreover, the WASH and waste disposal practices of the marginal people were found very poor and not at a satisfactory level. The results of statistical analysis focused on WASH and waste disposal practices as well as the factors which influence these practices. It is found that gender, occupation, area of residence, and level of education of the participants mainly influence the WASH and waste disposal practices. It is expected that this study exposed the necessity to introduce proper infectious waste management policy and also the increase in awareness level among mass people regarding the preventive measures of COVID-19 infection to combat against disease transmission and environmental pollution. Supplementary Information: The online version of this article (10.1007/s10668-020-01151-9) contains supplementary material, which is available to authorized users.
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PURPOSE: The purpose of this study was to conduct focus groups to operationalise the construct of quality of life (QOL) for people living with lymphatic filariasis (LF) in Bangladesh to develop culturally valid items for a Bangladeshi LF QOL tool. METHODS: Ten focus groups were conducted with a stratified purposeful sample (n = 60) of LF patients (3 focus groups, n = 17), doctors (1 focus group, n = 5), nurses (1 focus group, n = 6) and other hospital staff (1 focus group, n = 5), community leaders (2 focus groups, n = 14), community volunteer health workers (1 focus group, n = 5) and Bangladeshi LF researchers and planners (1 focus group, n = 8). Focus group methodology was informed by local culture in consultation with cultural mentors and local advisors, often going against standard focus group procedures. Data were collected through note taking, audio taping, transcripts, observational notes and a reflection diary. Open coding of transcript data was completed until data saturation was achieved. RESULTS: Forty-three constructs were identified through the focus groups that had not previously been identified in the literature, including constructs relating to environmental supports and barriers, activities, participation and psychological impacts. There were marked differences between the impacts reported by different groups, highlighting the need for a comprehensive purposive sample. In particular, contributions from participants who would not traditionally be viewed as "experts" were vital. CONCLUSIONS: The use of focus groups strongly contributed to the operationalisation of the concept of QOL in Bangladesh for people living with LF. Use of literature review or expert opinion alone would have missed vital constructs.
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Filariasis Linfática/psicología , Grupos Focales/estadística & datos numéricos , Calidad de Vida , Encuestas y Cuestionarios/normas , Adulto , Anciano , Bangladesh , Creación de Capacidad/métodos , Agentes Comunitarios de Salud , Competencia Cultural , Documentación/métodos , Documentación/normas , Filariasis Linfática/terapia , Femenino , Alfabetización en Salud , Necesidades y Demandas de Servicios de Salud , Humanos , Masculino , Cuerpo Médico , Persona de Mediana Edad , Relaciones Profesional-Paciente , Investigación Cualitativa , Reproducibilidad de los Resultados , Investigadores , Adulto JovenRESUMEN
This article introduces a primary dataset sourced from diverse marketplaces in Bangladesh, encompassing six distinct banana varieties predominantly consumed locally. The dataset comprises the following banana types: Shagor, Shabri, Champa, Anaji, Deshi, and Bichi. High-resolution images of bananas from each category were acquired using a smartphone camera. A total of 1166 images were captured but did not maintain a uniform distribution. Only the augmented data has 1000 images per category which is a total of 6000 images. The proposed dataset exhibits substantial potential for impact and utility, offering a range of attributes, including but not limited to the representation of six diverse banana varieties, each possessing unique flavors and holding promise for various applications within the agriculture and food manufacturing industries.
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PURPOSE: The purpose of this study was to test the cultural suitability of the WHOQOL-BREF Bangladesh for a rural village population in Bangladesh. METHODS: Participants (n = 35) were purposefully stratified for age, gender, education level and location from the Nilphamari district in northern rural Bangladesh. Cognitive interviews were conducted via an emergent probing method to identify issues with language and constructs within the tool. Data were collected through note taking and recordings of interviews. A coding framework was used to identify key issues with questions, which were analysed using SPSS version 19 and Chi-square analysis using a Fisher's exact test to determine statistically significant variances within the sample. RESULTS: Twenty-two of the 26 questions in the tool were found to be problematic. The majority of problems with questions related to wording and conceptual difficulties. The majority of participants found the tool to be overly formal. Issues with translation appeared to affect the interpretation of a number of questions, and some concepts in the tool were found to be irrelevant in a village setting. There were statistically significant differences between those of different educational backgrounds and between genders. CONCLUSIONS: The study found that the WHOQOL-BREF Bangladesh as it currently stands is not culturally or linguistically suitable for use within a rural northern Bangladeshi population.
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Filariasis Linfática/psicología , Estado de Salud , Lenguaje , Psicometría/instrumentación , Calidad de Vida/psicología , Encuestas y Cuestionarios , Adulto , Bangladesh , Filariasis Linfática/etnología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pruebas Psicológicas/normas , Población Rural , Factores Socioeconómicos , Organización Mundial de la SaludRESUMEN
Snakebite envenoming is a potentially life-threatening global public health issue with Bangladesh having one of the highest rates of snakebite cases. The Bede, a nomadic ethnic group in Bangladesh, traditionally engages in snake-related business such as snake charming. The Bede relies on their own ethnomedicinal practitioners for snakebite treatment while there is a lack of concrete evidence on the effectiveness of such ethnomedicinal treatment. To identify the barriers to the utilization of biomedical treatment for snakebite we conducted interviews with 38 Bede snake charmers, who have experienced snakebite, and six family members of those who died of snakebite. Our results show that four critical barriers, Accessibility, Affordability, Availability, and Acceptability (4As), prevented some of the Bede from seeking biomedical treatment. Moreover, we found that a few Bede died of a snakebite every year. There are survivors of snakebite who were able to receive biomedical treatment by overcoming all of the 4As. Our results provide insights into the current state of snakebite treatment in Bangladesh and can inform the development of more effective and accessible treatment options for those affected. Partnership between the public sector and the Bede community has the potential to make a significant impact in reducing snakebite morbidity and mortality in Bangladesh.
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Mordeduras de Serpientes , Animales , Humanos , Mordeduras de Serpientes/epidemiología , Mordeduras de Serpientes/terapia , Ponzoñas , Bangladesh/epidemiología , Serpientes , Hospitales , Antivenenos/uso terapéuticoRESUMEN
Arctic/Arctic-like rabies virus group 2 spread into Bangladesh ≈32 years ago. Because rabies is endemic to and a major public health problem in this country, we characterized this virus group. Its glycoprotein has 3 potential N-glycosylation sites that affect viral pathogenesis. Diversity of rabies virus might have public health implications in Bangladesh.
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Virus de la Rabia/genética , Rabia/epidemiología , Animales , Bangladesh/epidemiología , Genoma Viral , Humanos , Proteínas de la Nucleocápside/genética , Filogenia , Rabia/transmisión , Virus de la Rabia/clasificación , Proteínas del Envoltorio Viral/genéticaRESUMEN
BACKGROUND: Bangladeshi university students are considered to be highly suicide-prone compared to other populations and cohorts. However, no prior epidemiological studies have assessed the suicidality (i.e., past-year suicidal ideation [SI], lifetime suicide plan [SP], and lifetime suicide attempt [SA]) among Bangladeshi students, including the variables such as past-year stressful life events and family mental health history. This is arguably a major knowledge gap in the country. Therefore, the present study investigated the prevalence and associated risk factors for suicidal behaviors among Bangladeshi university students. METHODS: A cross-sectional study was conducted utilizing a convenience sampling method among a total of 1844 university students between October and November 2019. Data were collected based on the information related to socio-demographics, perceived health-related questions, past-year stressful life events, family mental health history, and suicidal behaviors (i.e., SI, SP, and SA). Chi-square tests and binary logistic regressions were used to analyze the data utilizing SPSS statistical software. RESULTS: The prevalence of past-year suicidal ideation, lifetime suicide plans, and suicide attempts were 13.4%, 6.0%, and 4.4%, respectively. Females reported significantly higher suicidal behavior than males (i.e., 20.6% vs.10.2% SI; 9% vs. 4.6% SP; and 6.4% vs.3.6% SA). Risk factors for SI were being female, year of academic study, residing in an urban area, using psychoactive substances, experiencing both past year physical and mental illness, experiencing any type of stressful past-year life events, experiencing campus ragging (i.e., senior students abusing, humiliating and/or harassing freshers or more junior students), experiencing family mental illness history, and having family suicide attempt history. SP was associated with several factors including being female, year of academic study, using psychoactive substance, experiencing both past-year physical and mental illness, and experiencing any type of stressful past-year life events. Risk factors for SA were being female, year of academic study, using psychoactive substances, experiencing past-year mental illness, experiencing any type of stressful past-year life events, and having family suicide attempt history. CONCLUSIONS: University students appear to be a vulnerable group for experiencing suicidal behaviors. The present findings warrant rigorous action and early intervention programs such as counseling and other mental health professional services by university authorities. Longitudinal studies are highly recommended involving countrywide representative samples.
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Ideación Suicida , Adolescente , Adulto , Bangladesh , Estudios Transversales , Femenino , Humanos , Estudios Longitudinales , Masculino , Salud Mental , Prevalencia , Factores de Riesgo , Estudiantes , Intento de Suicidio , UniversidadesRESUMEN
The recently developed Fear of COVID-19 Scale (FCV-19S) is a seven-item uni-dimensional scale that assesses the severity of fears of COVID-19. Given the rapid increase of COVID-19 cases in Bangladesh, we aimed to translate and validate the FCV-19S in Bangla. The forward-backward translation method was used to translate the English version of the questionnaire into Bangla. The reliability and validity properties of the Bangla FCV-19S were rigorously psychometrically evaluated (utilizing both confirmatory factor analysis and Rasch analysis) in relation to socio-demographic variables, national lockdown variables, and response to the Bangla Health Patient Questionnaire. The sample comprised 8550 Bangladeshi participants. The Cronbach α value for the Bangla FCV-19S was 0.871 indicating very good internal reliability. The results of the confirmatory factor analysis showed that the uni-dimensional factor structure of the FCV-19S fitted well with the data. The FCV-19S was significantly correlated with the nine-item Bangla Patient Health Questionnaire (PHQ-90) (r = 0.406, p < 0.001). FCV-19S scores were significantly associated with higher worries concerning lockdown. Measurement invariance of the FCV-19S showed no differences with respect to age or gender. The Bangla version of FCV-19S is a valid and reliable tool with robust psychometric properties which will be useful for researchers carrying out studies among the Bangla speaking population in assessing the psychological impact of fear from COVID-19 infection during this pandemic.
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BACKGROUND: The inheritable thalassemia and other structural hemoglobinopathies are prevalent globally. In Bangladesh, there is a scarcity of studies concerning thalassemia and other structural hemoglobinopathies. Hence, the present study investigated the prevalence and distribution of ß-thalassemia and other hemoglobinopathies among the university students and ready-made garment (RMG) workers. METHODS: A cross-sectional study was conducted, whereas a total of 989 subjects were selected randomly from 10 garments industries (n=495) and five universities (n=494) for diagnosis and counseling from April 2018 to August 2018. Basic information related to the study and venous blood was collected and subjected to capillary Hb-electrophoresis for each participant. RESULTS: The present study identified thalassemia carriers and other hemoglobinopathies among 13.6% of the participants (14.1% university students and 13.2% RMG workers). The most common form of hemoglobin formation disorder was the Hb-E trait (10.5%), considering both participants' groups. Other forms of hemoglobin formation disorders observed were a ß-thalassemia trait, Hb-D trait, Hb-E disease, and ß-thalassemia major. The hemoglobinopathies were significantly associated with the individuals who had a family history of thalassemia and were not vaccinated against hepatitis B in the total sample. Although not statistically suggestive, the most considerable portion (87.3%) of the carriers was unmarried in the present findings. CONCLUSION: The present study findings are anticipated to help the public health authorities by providing novel data (of a neglected cohort, ie, RGM workers), facilitating the upcoming comprehensive national thalassemia prevention programs.
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PURPOSE: This study examined the role of subject-selection reasons and learning environment factors in students' depression and suicidality. DESIGN AND METHODS: This study surveyed 960 students from five different Bangladeshi universities using questions concerning socio-demographics, lifestyles, subject-selection reasons, learning and academic environment, suicidal behaviors, and the Bangla Patient Health Questionnaire. FINDINGS: Approximately half of the participants were depressed (47.7%), and just over a quarter reported past-year suicidality (28.5%). Risk factors for both depression and suicidal behavior included not studying at their desired institute, selecting subjects based on future career prospects (rather than choosing what they want to study), not having a study-friendly and research-friendly environment, and unsupportive teachers. PRACTICAL IMPLICATIONS: The findings will help in formulating policies for educational institutions as well as providing benchmark data for further studies.
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Depresión , Suicidio , Depresión/epidemiología , Humanos , Factores de Riesgo , Estudiantes , Encuestas y Cuestionarios , UniversidadesRESUMEN
INTRODUCTION: Unemployment has a contributory role in the development of mental health problems and in Bangladesh there is increasing unemployment, particularly among youth. Consequently, the present study investigated depression, anxiety, and stress among recent graduates in a multi-city study across the country. METHODS: A cross-sectional study was conducted among 988 Bangladeshi graduate jobseekers in six major cities of the country between August to November 2019. The measures included socio-demographics and life-style factors, study and job-related information, Economic Hardship Questionnaire, Financial Threat Scale, Financial Well-Being Scale, and Depression Anxiety Stress Scale-21. RESULTS: Depression, anxiety and stress rates among the present sample were 81.1% (n = 801), 61.5% (n = 608) and 64.8% (n = 640) respectively. Factors related to gender, age, socioeconomic conditions, educational background, lack of extra-curricular activities, and high screen activity were significant risk factors of depression, anxiety, and stress. Structural equation modeling indicated that (while controlling for age, daily time spent on sleep study, and social media use), financial threat was moderately positively related to depression, anxiety, and stress. Financial hardship was weakly positively associated with depression, anxiety, and stress, whereas financial wellbeing was weakly negatively associated with depression, anxiety, and stress. LIMITATIONS: Due to the nature of the present study (i.e., cross-sectional study) and sampling method (i.e., convenience sampling), determining causality between the variables is not possible. CONCLUSIONS: The present results emphasized the important detrimental role of financial troubles on young people's mental health by showing that financial problems among unemployed youth predict elevated psychiatric distress in both men and women.
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Depresión , Desempleo , Adolescente , Ansiedad/epidemiología , Bangladesh/epidemiología , Ciudades , Estudios Transversales , Depresión/epidemiología , Femenino , Humanos , Masculino , Estrés Psicológico/epidemiologíaRESUMEN
The present study describes the ethnobotanical, phytochemical, and toxicological evaluations of Xanthium strumarium L. growing in Bangladesh. In toxicity evaluation on rats, the methanol extract of seedlings showed mortality, while both seedling and mature plant extracts raised the serum alanine transaminase and aspartate transaminase values and produced significant abnormalities in the histopathology of liver and kidney of rats. On the other hand, the aqueous soluble fraction of methanol extract of mature plant (LC50 = 0.352 microg/mL) and methanol crude extract of seedlings (LC50 = 0.656 microg/mL) demonstrated significant toxicity in the brine shrimp lethality bioassay. A total of four compounds were purified and characterized as stigmasterol (1), 11-hydroxy-11-carboxy-4-oxo-1(5),2(Z)-xanthadien-12,8-olide (2), daucosterol (3) and lasidiol-10-anisate (4). The present study suggests that X. strumarium is toxic to animal.
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Extractos Vegetales/química , Extractos Vegetales/toxicidad , Xanthium/química , Animales , Bangladesh , Etnobotánica , Femenino , Masculino , Ratas , Ratas Long-EvansRESUMEN
Background: Recent trends suggest that university graduates seeking jobs are more susceptible to common mental disorders, such as depression, anxiety, or stress. However, the mental health issues among unemployed graduates has not been explored in Bangladesh yet. Aims: This study aimed to assess for the first time the prevalence and associated risk factors of depression, anxiety, and stress among Bangladesh Civil Service (BCS) job seekers. Three hundred four graduates residing in Rajshahi, Bangladesh, who were preparing to attend the 40th BCS examination, the most sought-after employment opportunity in the country, were surveyed. Methods: Measures included socio-demographics, field of study, and career-related variables, and the Bangla Depression Anxiety Stress Scale (DASS-21). Chi-square test, Fisher exact test, and binary logistic regression with "depression," "anxiety," and "stress" as the dependent variables were carried out to identify the factors associated with these. Results: Overall, the prevalence of moderate to extremely severe depression, anxiety, and stress was 49.3%, 53.6%, and 28.3%, respectively, with no detectable differences between genders. Insecurity related to a BCS job (OR = 0.41; CI = 0.26-0.65, p < 0.001; ref: job insecurity), family and social pressure to obtain a BCS job (OR = 4.58; CI = 1.67-12.56, p < 0.001), and stress (OR = 8.33; CI = 4.47-15.51, p < 0.001) emerged as independent predictors for depression. In addition, having part-time job was associated with anxiety (OR = 2.38; CI = 1.34-4.23, p = 0.003), and security in a BCS job and serving the nation through this job were negatively associated with stress (OR = 0.59; CI = 0.35-0.98, p = 0.042 vs. OR = 0.59; CI = 0.36-1.00, p = 0.05). Conclusion: The relatively high rates of depression, anxiety, and stress among graduate job seekers should prompt implementation of market force initiatives that incorporate interventions related to the major risk factors uncovered herein.
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The proglucagon gene encodes pancreatic glucagon and the glucagon-like peptides, which exert diverse effects on nutrient absorption and assimilation. The therapeutic potential of glucagon-like peptide-1 (GLP-1) has fostered interest in development of cellular engineering approaches to augment endogenous intestinal-derived GLP-1 for the treatment of type 2 diabetes. We have used adenovirus technology to examine the potential roles of the transcription factors Cdx-2/3 and Pax-6 as activators of endogenous proglucagon gene expression in enteroendocrine cell lines and in nontransformed rat intestinal cells. Adenoviral-expressed Cdx-2/3 and Pax-6 activated proglucagon promoter-luciferase activity in baby hamster kidney (BHK) fibroblasts, HEK 293 cells, and enteroendocrine cell lines. Pax-6, but not Cdx-2/3, induced expression of the endogenous proglucagon gene in enteroendocrine cell lines, but not in heterologous fibroblasts. Furthermore, transduction of primary rat intestinal cell cultures in vitro, or the rat colonic epithelium in vivo, with Ad-Pax-6 activated endogenous proglucagon gene expression. These data demonstrate that Pax-6, but not Cdx-2/3, is capable of activating the endogenous proglucagon gene in both immortalized enteroendocrine cells and the nontransformed intestinal epithelium in vivo.
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Mucosa Gástrica/fisiología , Regulación de la Expresión Génica , Regulación de la Expresión Génica/fisiología , Glucagón/genética , Proteínas de Homeodominio/metabolismo , Mucosa Intestinal/fisiología , Precursores de Proteínas/genética , Animales , Línea Celular , Cricetinae , Cartilla de ADN , Proteínas del Ojo , Fibroblastos/fisiología , Regulación de la Expresión Génica/efectos de los fármacos , Proteínas de Homeodominio/farmacología , Humanos , Ratones , Factor de Transcripción PAX6 , Factores de Transcripción Paired Box , Proglucagón , Ratas , Proteínas Represoras/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
In Sri Lanka, urine ELISA showed high sensitivity and specificity in detecting filaria-specific IgG4. It also produced much higher positive rates than antigen tests in prevalence studies with young children. In this study, we have confirmed the usefulness of urine ELISA in the field of Bangladesh. The ELISA detected 89 of 105 (85%) ICT antigen test positive subjects in endemic areas. With both ICT and microfilaria positives, the sensitivity was 97% (30/31). All of 104 ICT negative people in a non-endemic area were ELISA negative (100% specificity). In a prevalence study with 319 young children (5-10 years) from a low endemic area after five rounds of MDA, seven (2.2%) were detected by the present urine test, but only one (0.3%) by ICT (P=0.075). The satisfactorily high sensitivity, 100% specificity and effective case detection among young ages along with scope for analyzing the titers will indicate urine ELISA to be an effective tool in the post-MDA surveys to confirm elimination or to detect resurgence in Bangladesh.
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Anticuerpos Antihelmínticos/inmunología , Antígenos Helmínticos/inmunología , Filariasis Linfática/diagnóstico , Ensayo de Inmunoadsorción Enzimática/métodos , Inmunoglobulina G/orina , Wuchereria bancrofti/aislamiento & purificación , Adulto , Anciano , Animales , Bangladesh/epidemiología , Niño , Preescolar , Estudios Transversales , Filariasis Linfática/epidemiología , Filariasis Linfática/orina , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proteínas Recombinantes , Sensibilidad y Especificidad , Wuchereria bancrofti/inmunología , Adulto JovenRESUMEN
The use of urine for the immunodiagnosis of lymphatic filariasis has a definite advantage: the sample collection is not invasive and thus well accepted by people. Urine-based ELISA to detect filaria-specific IgG4 has been used successfully. However, ELISA requires equipment such as a microplate reader, which is often not available in most endemic areas. We have developed a new visual immunodiagnosis that detects urinary IgG4 using red-colored latex beads (bead test). The sensitivity was 87.2% when ICT antigen test positive people were regarded as the standard (136/156), and the specificity was 97.2% with the non-endemic people in Japan and Bangladesh, and the urine ELISA negatives in Sri Lanka (1264/1300). In a prevalence study, the bead test could detect filarial infection more effectively than ICT test among young children in Sri Lanka, indicating the usefulness of the visual test in epidemiological studies.
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Filariasis Linfática/diagnóstico , Inmunoglobulina G/orina , Pruebas Inmunológicas/métodos , Microesferas , Adolescente , Animales , Anticuerpos Antihelmínticos/orina , Niño , Preescolar , Filariasis Linfática/orina , Ensayo de Inmunoadsorción Enzimática , Humanos , Sensibilidad y Especificidad , Wuchereria bancrofti/metabolismoRESUMEN
Globally, Bangladesh ranks third in the number of human deaths from rabies. Although dogs are the principal known transmitters of rabies and knowledge of dog populations is essential for effective national control and proper planning, dog control programs are scarce in Bangladesh. Our objective was to count dogs in a rural area to understand the dog population of the country. For this purpose we selected six unions of Raipura upazila in Narsingdi district. Dog counting was done by direct observation following accepted guidelines. We determined the mean density of the dog population in Bangladesh to be 14 dog/km(2) (95% CI 3.7, 24) and the human:dog ratio to be 120 (95% CI 55, 184). Our paper contribute to the literature which shows great variation in the human:dog ratio across regions of the developing world. The human:dog ratio depends on the area's human (as well as dog) population, whereas dog density per unit area indicates the true number of dogs. We propose that extrapolating from the human:dog ratios of other regions not be relied upon for estimating dog populations, unless the ratios can be supplemented by actual counts of dogs within the target area.
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Perros/fisiología , Ambiente , Vigilancia de la Población/métodos , Animales , Bangladesh , Femenino , Humanos , Masculino , Densidad de Población , Rabia/prevención & control , Rabia/veterinaria , Vacunación/veterinariaRESUMEN
The magnitude of animal bite and utilization of rabies vaccine was determined at the Infectious Disease Hospital, Dhaka, Bangladesh. From January 2004 to December 2008, 150,068 patients with animal bite visited the hospital, 86.2% and 13.8% of them received nerve tissue and tissue culture vaccine (TCV), respectively. Dog bite was most frequent, found in 90.7% cases. In 794 rabies cases only 24.4% had a history of post-exposure vaccination. Only a negligible number of patients received rabies immunoglobulin (RIG). To prevent further human deaths and economic losses intra-dermal TCV regime and equine RIG should be immediately introduced in Bangladesh.
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Mordeduras y Picaduras/epidemiología , Vacunas Antirrábicas/administración & dosificación , Rabia/prevención & control , Vacunación/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Bangladesh/epidemiología , Mordeduras y Picaduras/complicaciones , Niño , Preescolar , Perros , Femenino , Humanos , Inmunoglobulina G/uso terapéutico , Lactante , Masculino , Persona de Mediana Edad , Prevalencia , Vacunas Antirrábicas/inmunología , Adulto JovenRESUMEN
In Bangladesh, serological tests have been widely used for the primary screening of visceral leishmaniasis (VL). Several serologic tests are available for the diagnosis of VL. Selection of the best test is important to permit diagnostic differentiation between symptomatic and asymptomatic patients and to reduce cross-reactivity. We evaluated the effectiveness of a new serological test "Onsite Leishmania Ab Rapid Test" as a part of "quality assurance" activities for the kala azar elimination programme of the Government of Bangladesh. Plasma samples of 100 parasitologically confirmed cases of VL along with 101 healthy controls were tested, and "Onsite Leishmania Ab Rapid Test" strip tests were positive in 94 out of 100 confirmed VL cases, whereas four out of 51 healthy subjects from the VL endemic areas also tested positive. All the 50 healthy volunteers tested negative. Thus, the sensitivity and specificity of "Onsite Leishmania Ab Rapid Test" strip test were found to be 94% (95% CI: 87-98) and 96% (95% CI: 90-99), respectively. This study showed that the performance of the "Onsite Leishmania Ab Rapid Test" strip tests was up to the recommended level.
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Miltefosine (target dose of 2.5 mg/kg/day for 28 days) is the recommended treatment for visceral leishmaniasis (kala-azar) in Bangladesh on the basis of data from India. We evaluated miltefosine in a phase IV trial of 977 patients in Bangladesh. At the six-month final follow up, 701 were cured. 24 showed initial treatment failure, and 95 showed treatment failure at 6 months, although 73 of the 95 showed treatment failure solely by the criterion of low hemoglobin values. One hundred twenty-one patients were not assessable. With the conservative assumption that all low hemoglobin values represented treatment failure, the final per protocol cure rate was 85%. Of 13 severe adverse events, 6 led to treatment discontinuation and 7 resulted in deaths, but only 1 death (associated with diarrhea) could be attributed to drug. Nearly all non-serious adverse events were gastrointestinal: vomiting in 25% of patients and diarrhea in 8% of patients. Oral miltefosine is an attractive alternative to intramuscular antimony and intravenous amphotericin B for treatment of kala-azar in Bangladesh.