The Direct and Indirect Impact of SARS-CoV-2 Infections on Neonates: A Series of 26 Cases in Bangladesh.

BACKGROUND: The impact of SARS-CoV-2 on neonates remains largely unknown in low- and middle-income countries (LMICs). We provide an epidemiologic and clinical report of SARS-CoV-2 infections in neonates hospitalized in Bangladesh. METHODS: Outborn neonates admitted to Dhaka Shishu Hospital, a tertiary-care referral hospital, between 29 March and 1 July were screened for SARS-CoV-2. We reviewed clinical data, including chest radiograph and laboratory reports, and conducted SARS-CoV-2 genome sequencing. Patients were followed-up for 27-75 days. A subset of caregivers was also tested. RESULTS: Of 83 neonates tested, 26 were positive (median age 8 days). Most neonates were admitted with diagnosis unrelated to SARS-CoV-2: 11 presented with serious non-communicable diseases, 7 with early-onset sepsis, 5 with late-onset sepsis and 2 with pneumonia. In 3 of 5 chest radiograph, infiltrates and ground-glass or patchy opacities were noted. Two neonates developed metabolic acidosis, one developed disseminated intravascular coagulation. Most SARS-CoV-2 positive neonates were referred to government-designated COVID-19 hospitals, leading to gaps in treatment. Twenty-three neonates could be followed-up: 12 were healthy, 8 died and 3 were still seeking medical care. Of 9 caregivers tested, 8 were positive. CONCLUSIONS: SARS-CoV-2 may have serious adverse effects on children born in LMICs. The virus likely contributed directly to two deaths, but the remaining 6 neonates who died had serious comorbidities. Positive SARS-CoV-2 test results led to gaps in immediate clinical care for other morbidities, which likely contributed to adverse outcomes. This case series emphasizes the need to understand COVID-19 in neonates in LMICs and its indirect impacts.

Prevalence of cardiovascular disease among Bangladeshi adult population: a systematic review and meta-analysis of the studies.

BACKGROUND: Cardiovascular disease (CVD) is a group of conditions affecting the functioning of the heart or blood vessels and is one of the leading causes of death globally. Like other countries, CVD prevalence is also rising among the adults in Bangladesh. Epidemiological studies have shown not only a high CVD prevalence but also a significant increase in its prevalence in Bangladesh in the last few decades. To have a better understanding of the current CVD prevalence scenario, we conducted this systematic review and meta-analysis. Our objective was to assess the prevalence of CVD among the Bangladeshi adult population using evidence from the published scientific literature. METHODS: Electronic databases such as MEDLINE, Embase and PubMed were searched. We also manually checked the references of all relevant publications that describe the prevalence of CVD in Bangladeshi adults. To pool the CVD prevalence, we used random-effects meta-analysis. We assessed heterogeneity using both the formal tests and the subgroup analyses. We also assessed study quality and examined publication bias. RESULTS: We retrieved 755 potentially relevant papers through searches of electronic and gray literature, of which only 13 met inclusion criteria after the screening and were included in this review. Of the studies that met inclusion criteria, three were carried out in rural populations, five in both urban and rural populations and two in strictly urban populations. Male and female participation in the studies was almost equal. The weighted pooled prevalence of CVD was 5.0%, regardless of the types of CVD, gender and geographical location of the study participants. There was also a high heterogeneity in the observed CVD prevalence. Weighted pooled prevalence of overall CVD in the Bangladeshi population was higher in urban areas (8%) compared to rural areas (2%). However, no such difference was observed in terms of gender (3% for both males and females). The highest reported prevalence (21%) was for heart disease, while the lowest reported prevalence (1%) was for stroke. Sources of heterogeneity were often unexplained. The criteria used to assess study quality were fulfilled by only a few studies, and adequate sample size criteria was missed by almost all of them. In addition, there was evidence of small-study effects. CONCLUSION: A high CVD prevalence along with an upward trend was observed in Bangladeshi adults. Proper strategies are required for primary prevention of CVD so that a further increase can be alleviated and the morbidity and mortality associated with it can be reduced.

Prevalence of metabolic syndrome in Bangladesh: a systematic review and meta-analysis of the studies.

BACKGROUND: Metabolic syndrome (MS) is a cluster of health problems that set the stage for serious health conditions and places individuals at higher risk of cardiovascular disease, diabetes and stroke. The worldwide prevalence of MS in the adult population is on the rise and Bangladesh is no exception. According to some epidemiological study, MS is highly prevalent in Bangladesh and has increased dramatically in last few decades. To provide a clear picture of the current situation, we conducted a systematic review and meta-analysis with an objective to assess the prevalence of metabolic syndrome among the Bangladeshi population using data already published in the scientific literature. METHODS: We searched MEDLINE, EMBASE and PubMed and manually checked references of all identified relevant publications that described the prevalence of MS in Bangladesh. Random effects meta-analysis was used to pool the prevalence. Heterogeneity was explored using formal tests and subgroup analyses. Study quality and publication bias was also explored. RESULTS: Electronic and grey literature search retrieved 491 potentially relevant papers. After removing duplicates, reviewing titles and abstracts and screening full texts, 10 studies were finally selected. Most of the studies were conducted in rural populations and study participants were mostly females. The weighted pooled prevalence of metabolic syndrome regardless of gender and criteria used to define metabolic syndrome, was 30.0% with high heterogeneity observed. Weighted pooled prevalence of metabolic syndrome is higher in females (32%) compared to males (25%) though not statistically significant (p = 0.434). Prevalence was highest (37%) when Modified NCEP ATP III criteria was used to define MS, while it was lowest (20%) when WHO criteria was used. In most cases, geographical area (urban/rural) was identified as a source of heterogeneity between the studies. Most of the studies met study quality assessment criteria's except adequate sample size criteria and evidence of small study effect was also detected. CONCLUSIONS: The prevalence of metabolic syndrome is high and rising in Bangladesh. Strategies aimed at primary prevention are required to mitigate a further increase in the prevalence and for the reduction of the morbidity and mortality associated with metabolic syndrome.