Risk factors of bronchial asthma in two contrasting settings–metropolitan and coastal areas of Bangladesh: A case control study.

Background. Seven million people are suffering from bronchial asthma in Bangladesh. But scanty data is available to explain the risk factors for asthma in Bangladesh. Methods. This population-based, age, sex, and economic status matched case-control study was conducted to identify the risk factors responsible for the development of bronchial asthma in two contrasting settings, the metropolitan capital city and coastal area of Bangladesh. A structured pre-tested questionnaire was filled up by face-to-face interviews with the patients or parents of patients with bronchial asthma and the normal controls after a respiratory physician confirmed the diagnosis on the basis of history, physical examination and spirometry. Results. Presence of allergic problems was recognised as risk factors for the development of bronchial asthma. Concomitant existence of atopic diseases, like allergic rhinitis, eczema and allergic conjunctivitis were found to be significant risk factors in both the settings. History of early childhood lung infections, like pneumonia, bronchiolitis and intake of antibiotics and paracetamol in last 12 months were also observed to be the risk factors in both the areas. Though most of the so-called allergic foods were statistically found to be a protective factor in both the settings [odds ratio (OR) 0.48, 95% confidence intervals (CI) 0.37-0.63 in city area and OR 0.80, 95% CI 0.66-0.96 in coastal area], this was considered to be an artifact. Conclusions. Several common risk factors for the development of bronchial asthma were identified in both city and coastal areas of Bangladesh. Bronchial asthma prevention campaign in Bangladesh may focus on sensitising the people on these risk factors.

Incidence of pulmonary tuberculosis in garments workers of Dhaka City, Bangladesh.

This study was conducted to find out the incidence of Pulmonary Tuberculosis (PT) in garments workers of Dhaka city and to find-out the relationship between the incidence of PT and socio-demographic factors of the respondents. From all garments factories of Dhaka city, 30 factories were included by stratified random sampling method. Then workers were selected by simple random sampling technique. Following selection, detailed history was taken and recorded in a pre-tested questionnaire. Chest X-ray, Sputum for AFB, M.T and ESR were done in the suspected cases. PT was diagnosed when any patient fulfilled predefined inclusion criteria. Out of 2400 selected workers, 2281 workers were studied finally. A total of 22 (9.6 per 1000) definite PT cases were identified. Sputum positive were 4/2281 (1.75 per 1000) cases. All were diagnosed as new cases; none had received any treatment of tuberculosis in the past. The study concludes that PT among the garments workers is a more alarming health issue than among the general population of Bangladesh. Improved and regular health check-up system and 'directly observed treatment shortcourse' (DOTS) should be implemented in the working places particularly where clusters of workers are working together.