Accidental poisoning in children: a single centre case series study in Bangladesh.

BACKGROUND: Accidental poisoning is a leading cause of unintentional injuries among children in low-income and middle-income countries (LMICs). The overall aspect of this unintentional poisoning is poorly understood in Bangladesh. The objectives of this study were (1) to explore the socio-demographic factors and circumstantial context of accidental poisoning and (2) the prevalence of the type of substances causing it. METHODS: A descriptive case series study was conducted from April 2019 to February 2020 at a tertiary level hospital of the capital city Dhaka in Bangladesh. Children under 10 years of age admitted to the hospital with accidental poisoning were enrolled in this study. Parents of hospitalised children were interviewed face-to-face using a structured questionnaire. Descriptive statistics were used for data analysis. RESULTS: A total of 223 children were recruited in this study. Children between 2 and 5 years (60%), men (61%) and children with agility (65.5%) were among the prevalent victims. The majority of cases occurred (65%) in a nuclear family setting. Most mothers (85%) of these children were non-working and most incidents took place in parents' homes (~82%). Nearly 70% of the poisoning incidents took place in the presence of parents and over half of these occurred in the bedroom. Kerosene was the prevalent cause (33%) of accidental poisoning while insecticide/pesticide ranked second (26.5%) followed by medicines (17%) and household chemicals (12). In one-third (31.4%) of the cases, poisoning chemicals were stored in soft drink bottles while two-thirds (67.3%) of the cases were kept in containers other than original ones. Although over 80 parents somewhat knew that chemicals could be harmful to the children if ingested, most of them did not take the safety measures. CONCLUSION: In this present study we found that preschool-aged children were more victims of accidental poisoning mostly by ingesting kerosene and a majority of the incidents took place in the bedroom while parents were present at home. Our study findings would serve as a baseline for designing future intervention studies and policies.

Age-related risk factors and severity of SARS-CoV-2 infection: a systematic review and meta-analysis.

OBJECTIVES: We aimed to estimate the prevalence of reported symptoms and comorbidities, and investigate the factors associated with age of the SARS-CoV-2 infected patients. METHODS: We performed a systematic review with meta-analysis (PROSPERO registration: CRD42020182677) where the databases (PubMed, SCOPUS, EMBASE, WHO, Semantic Scholar, and COVID-19 Primer) were searched for clinical studies published from January to April, 2020. Initially, the pooled prevalence of symptoms and comorbidity of COVID-19 patients were estimated using random effect model and the age -related factors were identified performing multivariate analysis [factor analysis]. RESULTS: Twenty-nine articles with 4,884 COVID-19 patients were included in this study. Altogether, we found 33 symptoms and 44 comorbidities where the most frequent 19 symptoms and 11 comorbidities were included in the meta-analysis. The fever (84%), cough/dry cough (61%), and fatigue/weakness (42%) were found more prevalent while acute respiratory distress syndrome, hypertension and diabetes were the most prevalent comorbid condition. The factor analysis showed positive association between a cluster of symptoms and comorbidities with patients' age. The symptoms comprising fever, dyspnea/shortness of breath, nausea, vomiting, abdominal pain, dizziness, anorexia and pharyngalgia; and the comorbidities including diabetes, hypertension, coronary heart disease, COPD/lung disease and ARDS were the factors positively associated with COVID-19 patient's age. CONCLUSION: As an unique effort, this study found a group of symptoms (fever, dyspnea/shortness of breath, nausea, vomiting, abdominal pain, dizziness, anorexia and pharyngalgia) and comorbidities (diabetes, hypertension, coronary heart disease, COPD/lung disease and ARDS), associated with the age of COVID-19 infected patients.

Insights into the first seven-months of COVID-19 pandemic in Bangladesh: lessons learned from a high-risk country.

South Asian countries have been struggling to control the COVID-19 pandemic despite imposing months of lockdown and other public health measures. This review aims to describe the epidemiological features and shortcomings in public health preparedness to tackle COVID-19 as well as derive lessons from these events in the context of Bangladesh. We have shown that an increase in human mobility was evident throughout the lockdown period. Over 20,000 frontline health workers were affected, and more than 2100 unofficial deaths possibly linked with COVID-19 diagnosis were reported. Males were disproportionately affected in terms of infection (71%) and death (77%) than females. Over 50% of infected cases were reported among young adults (20-40-year age group). After seven months into the pandemic, a downward trend in laboratory test positive percentage was seen, although the number of new deaths per day remained largely unchanged. We believe our findings, observations and recommendations will remain as a valuable resource to facilitate better public health practice and policy for managing current and future infectious disease like COVID-19 in resource-poor developing countries.

The forgotten people with thalassemia in the time of COVID-19: South Asian perspective.

South Asia is the hotspot of beta-thalassemia, with an estimated 200,000 patients whose lives depend on regular blood transfusion. Due to COVID-19 pandemic, many countries have adopted unprecedented lockdown to minimize the spread of transmission. Restriction of nationwide human mobility and fear of COVID-19 infection has put thalassemia patients in a life-threatening situation because of an acute shortage of blood supply. As a public health preparedness strategy during a crisis like COVID-19 pandemic, the plights of thalassemia patients should be considered. Government-sponsored community blood-banks needs to be established or coverage expanded as a safety net for the thalassemia patients in lower- and middle-income countries.