Social and structural determinants associated with the prevalence of sexually transmitted infections among female commercial sex workers in Dhaka City, Bangladesh.

Female commercial sex workers (FCSWs) bear higher rates of sexually transmitted infections (STIs) among key populations. The association of structural determinants and STIs among FCSWs was not at the forefront of research earlier in Bangladesh. This study examined how structural factors correlate with the prevalence of STIs at physical/social/economic/policy levels among FCSWs in Dhaka city. 495 FCSWs were screened for HIV, hepatitis B, and syphilis. Structural variables (Individual risks, high-risk sexual behaviors, work environments) were extracted from the previous multi-level study on FCSWs and analyzed in 2020 to determine whether macro/micro-structural factors were associated with STIs. The prevalence of STIs was 43.6% (95% CI: 39.1%-48). Most (n = 207/495) FCSWs were infected with Syphilis or Hepatitis B, only 1.8% had co-infection, and none was positive for HIV. Multiple logistic regression revealed that 'Individual risk' factors like age (≤18 years, adjusted odds ratio = AOR = .28; 18.1-29.9 years, AOR = .57), years in the sex industry (<1 year AOR = .15; 1-5 years, AOR = .39), and condoms as contraceptives (AOR = 2.7) were significantly associated with STIs. Considering 'High-risk behaviors' like monthly coitus with regular clients (AOR = .33), performing no anal sex ever (AOR = .03), and consistent condom use (AOR = .13) were less likely to be associated with STIs (P<0.05), while the association of ever group sex with STIs reported to double (AOR = 2.1). 'Work environment' like sex on roads/parks/shrines/markets (AOR = 2.6) and ever HIV-testing (AOR = 2.5) were significantly linked with STIs. However, micro-level factors like experiencing forced sex in the past year (AOR = 1.79) and condoms collected from hotel boys (AOR = .34) were significantly associated with STIs in the 'Hierarchical- model' with increasing model-power. 'Micro-structural' determinants predominated over 'Macro/policy-level factors' and profoundly influenced STIs. FCSWs need comprehensive and integrated interventions to promote accurate condom use perception, eliminate risky sexual behaviors, and provide quality reproductive health care. Necessary steps at the policy level are urgently needed to decriminalize commercial sex work.

Urban-rural difference in factors associated with childhood functional difficulty in Bangladesh: a cross-sectional study.

Objective: Early childhood functional difficulty poses a substantial worldwide public health challenge, leading to adverse effects on children's quality of life and overall productivity. Moreover, it represents a significant social and economic problem in Bangladesh. Therefore, the current study aimed to identify factors contributing to childhood functional difficulty in Bangladesh within the context of urban-rural areas. Methods: A nationally representative cross-sectional survey data from Multiple Indicator Cluster Survey (MICS), 2019 in Bangladesh was used in this study. Chi-square test and multivariable logistic regression analyses were carried out to identify factors associated with childhood functional difficulty. Results: Functional difficulties were found in approximately 3.3% of children 2-4 years of age in urban areas and 2.5% in rural areas. Having a mother with functional difficulties and undernutrition were identified as significant factors common in both urban and rural areas. Further, mothers who had no formal education (AOR = 2.76, 95%CI = 1.18-6.45) and experienced infant death (AOR = 1.94, 95%CI = 1.01-3.70) were identified as significant factors of functional difficulty in urban areas. On the other hand, in rural areas, no access to mass media, children with acute respiratory infection (ARI) (AOR = 2.13, 95%CI = 1.39-3.28), female sex (AOR = 0.69, 95%CI = 0.53-0.91), child undernutrition (AOR = 1.73, 95%CI = 1.32-2.27) and poorer socio-economic status (AOR = 1.95, 95%CI = 1.08-3.55) were found significant factors. Conclusion: Functional difficulty was found to be present in one out of every 35 children age 2 to 4 years in Bangladesh. Childhood functional difficulties were reported slightly higher in urban areas as compared to rural areas. Reducing childhood difficulties in urban areas demands comprehensive strategies: quality healthcare, inclusive education, community support, better information systems, and collaboration. To achieve urban-rural parity in child health, address disparities in economic development, healthcare, and education, especially for girls.

Prevalence and correlates of severe under-5 child anthropometric failure measured by the composite index of severe anthropometric failure in Bangladesh.

Background: Although Bangladesh has made noticeable progress in reducing the prevalence of stunting, wasting, and being underweight among under-5 children, it has not been very successful in reducing overall severe anthropometric failure (SAF) among them. Therefore, the study aims to identify the prevalence and risk factors of SAF measured by the Composite Index of Severe Anthropometric Failure (CISAF) among under-5 children in Bangladesh. Methods: Data was drawn from a cross-sectional Bangladesh Demographic Health Survey (BDHS) conducted in 2017-2018. A bivariate analysis (Chi-square test) and logistic regression analysis were used to estimate the unadjusted, and age and sex-adjusted prevalence of SAF. Odds ratio (OR) and confidence interval (CI) were assessed using logistic regression analysis to identify the various risk factor of SAF. Results: The overall adjusted prevalence of under-5 child SAF was 11.3% (95% CI: 10.6-12.0) and it was highly prevalent among children of uneducated mothers (adjusted, 22%, 95% CI: 17.3-26.8). The key factors associated with SAF were children in the age group 24-35 months (OR: 2.43, 95% CI: 1.83-3.23), children born with low birth weight (OR: 3.14, 95% CI: 2.24-4.97), children of underweight mothers (OR: 1.82, 95% CI: 1.44-2.29), children of parents with no formal education (OR: 2.28, 95% CI: 1.56-3.31) and children from lower socio-economic status (OR: 2.25, 95% CI: 1.55-3.26). Conclusion: Prioritizing and ensuring context-specific interventions addressing individual, community, public policy, and environment level risk factors from policy level to implementation to reduce structural and intermediary determinants of under-5 SAF.

Socioeconomic inequalities in the continuum of care across women's reproductive life cycle in Bangladesh.

We examined the association between socioeconomic status (SES) and continuum of care (CoC) completion rate in maternal, neonatal, and child health among mothers in Bangladesh. We used data from the Bangladesh Demographic Health Survey (BDHS) from 2017 to 2018. Our findings were based on the responses of 1527 married women who had at least one child aged 12 to 23 months at the time of the survey. As a measure of SES, we focused on the standard of living (hereinafter referred to as wealth). The CoC for maternal and child health (MNCH) services is the study's outcome variable. The CoC was calculated using seven MNCH interventions: four or more antenatal care (ANC) visits with a skilled practitioner, delivery by a skilled birth attendant, post-natal care for mothers (PNCM) within two days of giving birth, post-natal care for newborns (PNCM) within two days of birth, immunization, age-appropriate breastfeeding, and maternal current use of modern family planning (FP) methods. Only 18.1% of Bangladeshi women completed all seven MNCH care interventions during the reproductive life span. Participants in the high SES group were 2.30 times (95% confidence interval [CI] 1.61-3.28) more likely than those in the low SES group to have higher composite care index (CCI) scores. Women with secondary or higher secondary education, as well as women who were exposed to mass media at least once a week, women who lived in an urban setting, women who had an intended pregnancy, and women with one parity, are associated with high CCI scores when other sociodemographic variables are considered. The complete CoC for MNCH reveals an extremely low completion rate, which may suggest that Bangladeshi mothers, newborns, and children are not receiving the most out of their present health care. Participants in the high SES group displayed higher CCI values than those in the low SES group, indicating that SES is one of the primary drivers of completion of CoC for MNCH services.

Euphorbia neriifolia Leaf Juice on Mild and Moderate COVID-19 Patients: Implications in OMICRON Era.

Coronavirus disease-2019 (COVID-19) has shattered the public health delivery system of most of the countries of the world. COVID-19 displays variable clinical presentations. The severe COVID-19 represents a fulminant pathological condition and most of the patients run a downhill course if extensive medical measures are not adopted. The major challenges about COVID-19 are related to develop strategies to manage huge populations of mild and moderate cases of COVID-19 with two realistic purposes: (1) early negativity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus and (2) arrest of progression of moderate COVID-19 patients from developing severe complications. Although several medications have been repurposed for these purposes, none of these have passed the test of time in global perspective. Thus, there remains a pressing need to develop new and novel innovative management strategies for these patients as new variants of SARS-CoV-2 have been destroying the normal public health delivery system of different countries from time to time. The study presented here has checked the safety and efficacy of a herbal medication, leaves of Euphorbia neriifolia Linn (E. neriifolia), in mild and moderate COVID-19 patients. Sixty patients (30 mild COVID-19 and 30 moderate COVID-19) were enrolled in the study. Fifteen mild COVID-19 patients received standard of care (SOC) management, and the remaining 15 patients received SOC plus E. neriifolia. The moderate COVID-19 patients similarly received either SOC (N = 15) or SOC plus E. neriifolia (N = 15). Although there were marked diversity regarding biochemical parameters of these patients at entry, the moderate COVID-19 patients receiving E. neriifolia showed decrease in C-reactive protein and D-dimer and increase in oxygen saturation 7 days after trial commencement. However, these improvements were not detected in moderate COVID-19 patients receiving SOC. Hospital staying was significantly lower in both mild and moderate COVID-19 patients receiving SOC plus E. neriifolia than those receiving only SOC. Taken together, it may be proposed that usage of E. neriifolia may have beneficial effects regarding management for COVID-19 patients, especially for those in developing and resource-constrained countries, although a conclusive statement may not be given due to small sample size. This herbal medication is also pertinent in the context of emergence of OMICRON variant of COVID-19 as the overload of SARS-CoV-2-infecetd patients may be addressed considerably by this medication without hospitalization, if proper communication between patients and physicians can be ensured. How to cite this article: Pramanik MEA, Miah MMZ, Ahmed I, et al. Euphorbia neriifolia Leaf Juice on Mild and Moderate COVID-19 Patients: Implications in OMICRON Era. Euroasian J Hepato-Gastroenterol 2022;12(1):10-18.

Urban-rural differences in the associated factors of severe under-5 child undernutrition based on the composite index of severe anthropometric failure (CISAF) in Bangladesh.

INTRODUCTION: Severe undernutrition among under-5 children is usually assessed using single or conventional indicators (i.e., severe stunting, severe wasting, and/or severe underweight). But these conventional indicators partly overlap, thus not providing a comprehensive estimate of the proportion of malnourished children in the population. Incorporating all these conventional nutritional indicators, the Composite Index of Severe Anthropometric Failure (CSIAF) provides six different undernutrition measurements and estimates the overall burden of severe undernutrition with a more comprehensive view. This study applied the CISAF indicators to investigate the prevalence of severe under-5 child undernutrition in Bangladesh and its associated socioeconomic factors in the rural-urban context. METHODS: This study extracted the children dataset from the 2017-18 Bangladesh Demographic Health Survey (BDHS), and the data of 7661 children aged under-5 were used for further analyses. CISAF was used to define severe undernutrition by aggregating conventional nutritional indicators. Bivariate analysis was applied to examine the proportional differences of variables between non-severe undernutrition and severe undernutrition group. The potential associated socioeconomic factors for severe undernutrition were identified using the adjusted model of logistic regression analysis. RESULTS: The overall prevalence of severe undernutrition measured by CISAF among the children under-5 was 11.0% in Bangladesh (rural 11.5% vs urban 9.6%). The significant associated socioeconomic factors of severe undernutrition in rural areas were children born with small birth weight (AOR: 2.84), children from poorest households (AOR: 2.44), and children aged < 36 months, and children of uneducated mothers (AOR: 2.15). Similarly, in urban areas, factors like- children with small birth weight (AOR: 3.99), children of uneducated parents (AOR: 2.34), poorest households (APR: 2.40), underweight mothers (AOR: 1.58), mothers without postnatal care (AOR: 2.13), and children's birth order ≥4 (AOR: 1.75), showed positive and significant association with severe under-5 undernutrition. CONCLUSION: Severe undernutrition among the under-5 children dominates in Bangladesh, especially in rural areas and the poorest urban families. More research should be conducted using such composite indices (like- CISAF) to depict the comprehensive scenario of severe undernutrition among the under-5 children and to address multi-sectoral intervening programs for eradicating severe child undernutrition.

Socio-demographic risk factors for severe malnutrition in children aged under five among various birth cohorts in Bangladesh.

Tackling malnutrition is a major health priority for a developing country like Bangladesh. This study explored the differences in prevalence of having only one form, and multiple forms, of severe malnutrition (stunting, wasting and underweight) among under-5 children in Bangladesh, and aimed to identify the important factors affecting these. Data were extracted from the Bangladesh Demographic Health Surveys conducted in 2007, 2011 and 2014. The outcome measures were 'only one form' and 'multiple forms' of severe malnutrition in children aged under 5 years. A Chi-squared test was performed to find the association of outcome variables with selected socio-demographic factors and logistic regression models were applied to identify risk factors. A total of 19,874 children aged under 5 years were included in the analysis. The overall proportion with one form of severe child malnutrition was approximately 12%, and the proportion with multiple forms was 8%. Age, mother's education, father's occupation, mother currently working, watching television, source of water, solid waste used in cooking, intimate partner violence (IPV), wealth index, urban/rural place of residence and birth cohort were found to be significant factors for both having only one and having multiple forms of severe child malnutrition. Children with an uneducated mother of poor socioeconomic class had a higher risk of severe malnutrition. Children of fathers with a professional occupation were at lower risk of having multiple forms of severe malnutrition. The proportions of children aged under 5 years with one or multiple forms of severe malnutrition were shown to be high in Bangladesh. The prevention of malnutrition in the country should be seen as a significant public health issue and given top priority.

Determinants of the Psychological States of Mothers of Children With Cerebral Palsy: A Cross-sectional Study in Bangladesh

@#Introduction: Cerebral palsy is a group of early childhood chronic mobility disorders. Parenting a child with cerebral palsy is often challenging, especially for mothers. This research aimed to identify the determinants of the psychological states of mothers of children with cerebral palsy in Bangladesh. Methods: A cross-sectional study was conducted from December 2019 to February 2020. A total of 344 mothers of children with cerebral palsy was recruited using a simple random sampling technique and guided questionnaires. The data were analysed using the Chi-square test and logistic regression models. Results: The overall response rate was 98.29%. The median (IQR) age of respondents and the children with cerebral palsy were 30 (13) and 6 (6), respectively. The proportions of mothers with good knowledge on cerebral palsy and having higher negative family impact were 57.8% and 41.9%, respectively. Fifty-nine per cent of mothers of children with cerebral palsy had higher levels of maternal psychological stress. The predictors of maternal psychological stress were the mother’s age, marital status, types of family, family income, age of children, gender, and higher levels of the negative maternal appraisal. Conclusions: Mothers of children with cerebral palsy in Bangladesh had a higher level of maternal psychological stress. The factors identified in this study could help to develop policies and strategies to minimise maternal psychological stress associated with parenting children with cerebral palsy in Bangladeshi households.

Novel Mutations in NSP1 and PLPro of SARS-CoV-2 NIB-1 Genome Mount for Effective Therapeutics

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), the etiologic agent of Coronavirus Disease-2019 (COVID-19), is rapidly accumulating new mutations. Analysis of these mutations is necessary for gaining knowledge regarding different aspects of therapeutic development. Recently, we have reported a Sanger method based genome sequence of a viral isolate named SARS-CoV-2 NIB-1, circulating in Bangladesh. The genome has four novel mutations in V121D, V843F, A889V and G1691C positions. V121D substitution has the potential to destabilize the Non-Structural Protein (NSP-1) which inactivates the type-1 Interferon-induced antiviral system hence this mutant could be the basis of attenuated vaccines against SARS-CoV-V843F, A889V and G1691C are all located in NSP3. G1691C can decrease the flexibility of the protein while V843F and A889V changed the binding pattern of SARS-CoV-2 Papain-Like protease (PLPro) inhibitor GRL0617. V843F PLPro showed reduced affinity for Interferon Stimulating Gene-15 (ISG-15) protein whereas V843F+A889V double mutants exhibited the same binding affinity as wild type PLPro. Here, V843F is a conserved position of PLPro that damaged the structure but A889V, a less conserved residue, most probably neutralized that damage. Mutants of NSP1 could provide attenuated vaccines against coronavirus. Also, these mutations of PLPro could be targeted to develop anti-SARS therapeutics.

A cross-sectional study on nutritional status and dietary patterns of children with autism

@#Introduction: Literature revealed that individuals with Autism Spectrum Disorders (ASD) experience significantly more feeding problems and obesity compared to their peers. This study was designed to investigate the nutritional status and dietary patterns of children with autism in different age groups in Dhaka city, Bangladesh. Methods: This cross-sectional study was conducted among 193 individuals with ASD. A questionnaire was used as a tool to collect information from the mother of the respondents and anthropometric assessments were conducted by measuring height and weight. The dietary patterns of the respondents were taken using a food frequency questionnaire. Results: The age range of the participants were between 3-18 years. It was found that 11.9%, 19.7% and 23.3% of the participants were underweight, overweight and obese, respectively according to Body Mass Index (BMI)-for-age. About 70% of the respondents had medium Individual Dietary Diversity Score (IDDS). In addition, the association between IDDS and obesity was significantly correlated (p=0.00). Individuals with ASD exhibited similar food preferences across most age groups with little changes. Conclusion: Our study figured out that the prevalence of overweight increased in accordance with age among children with ASD. They have a tendency to prefer likeness and routine in their diet, which expands the tendency to have an imbalanced diet. A dietary guideline including seven food groups should be followed to improve their nutritional status and dietary practices.

Does parental migration have any impact on nutritional disorders among left-behind children in Bangladesh?

OBJECTIVE: Rates of migration have increased substantially in recent years and so has the number of left-behind children (LBC). We investigated the impact of parental migration on nutritional disorders of LBC in Bangladesh. DESIGN: We analysed data from the nationally representative cross-sectional Multiple Indicator Cluster Survey 2012-2013. Child stunting, wasting and underweight were used as measures of nutritional disorders. Descriptive statistics were used to describe characteristics of the respondents and to compare nutritional outcomes based on status of parental migration. Multivariate logistic regression models were used to examine the associations between parental migration and child nutritional disorders. SETTING: Bangladesh.ParticipantsData of 23 402 children (aged <5 years), their parents and households. RESULTS: In the unadjusted models, parental migration was found significantly protective for stunting, wasting and underweight - both separately and jointly. After potential confounders were controlled for, no difference was found between LBC and non-LBC in any of these three nutritional outcome measures. Household wealth status and maternal educational status were found to significantly influence the nutritional development of the children. CONCLUSIONS: At the population level there is no negative impact of parental migration on stunting, wasting and underweight of LBC in Bangladesh. Remittance from parental migration might enhance affordability of better foods, health care and supplies for a cleaner environment. This affordability is crucial for the poorest section of the society.

Correlates of healthy life expectancy in low- and lower-middle-income countries.

BACKGROUND: Healthy life expectancy (HALE) at birth is an important indicator of health status and quality of life of a country's population. However, little is known about the determinants of HALE as yet globally or even country-specific level. Thus, we examined the factors that are associated with HALE at birth in low- and lower-middle-income countries. METHODS: In accordance with the World Bank (WB) classification seventy-nine low- and lower-middle-income countries were selected for the study. Data on HALE, demographic, socioeconomic, social structural, health, and environmental factors from several reliable sources, such as the World Health Organization, the United Nations Development Program, Population Reference Bureau, WB, Heritage Foundation, Transparency International, Freedom House, and International Center for Prison Studies were obtained as selected countries. Descriptive statistics, correlation analysis, and regression analysis were performed to reach the research objectives. RESULTS: The lowest and highest HALE were observed in Sierra Leone (44.40 years) and in Sri Lanka (67.00 years), respectively. The mean years of schooling, total fertility rate (TFR), physician density, gross national income per capita, health expenditure, economic freedom, carbon dioxide emission rate, freedom of the press, corruption perceptions index, prison population rate, and achieving a level of health-related millennium development goals (MDGs) were revealed as the correlates of HALE. Among all the correlates, the mean years of schooling, TFR, freedom of the press, and achieving a level of health-related MDGs were found to be the most influential factors. CONCLUSION: To increase the HALE in low- and lower-middle-income countries, we suggest that TFR is to be reduced as well as to increase the mean years of schooling, freedom of the press, and the achievement of a level of health-related MDGs.

Urban-rural differences in disability-free life expectancy in Bangladesh using the 2010 HIES data.

BACKGROUND: Research on health expectancy has been carried out in Bangladesh but none of it has examined the differences in Disability-Free Life Expectancy (DFLE) between urban and rural setting in context of rapid urbanization of Bangladesh in past decades. OBJECTIVES: The present study aims to estimate DFLE for people of all ages living in urban and rural areas in Bangladesh, and to examine the differences in DFLE between these two areas. METHODS: Data from the Sample Vital Registration System 2010 and the Bangladesh Household Income and Expenditure Survey (HIES) 2010 were used in this study. The Sullivan method was applied to estimate DFLE in Bangladesh. RESULTS: Higher rates of mortality and disability were observed in rural areas compared to urban areas with few exceptions. Statistically significant differences in DFLE were revealed from birth to age 15 years for both sexes between urban and rural areas. Urban males had a longer life expectancy (LE), longer DFLE and shorter LE with disability both in number and proportion when compared to rural males. Rural females at age 20+ years had a longer LE than urban females but urban females had a longer DFLE and a shorter LE with disability in both number and proportion at all ages than did rural females. CONCLUSION: This study demonstrates that there were clear inequalities in LE, DFLE and LE with disability between rural and urban areas of Bangladesh along with age-specific differences as well. These findings may serve as useful and benchmark for intervention and policy implications for reducing the gap in health outcomes.

Vibration upshot of operating mechanical sewing machine: an insight into common peroneal nerve conduction study

BACKGROUND: Most of the people associated with tailoring occupation in Nepal are still using mechanical sewing machine as an alternative of new technology for tailoring. Common peroneal nerves of both right and left legs are exposed to strenuous and chronic stress exerted by vibration and paddling of mechanical sewing machine. METHODS: The study included 30 healthy male tailors and 30 healthy male individuals. Anthropometric variables as well as cardio respiratory variables were determined for each subject. Standard Nerve Conduction Techniques using constant measured distances were applied to evaluate common peroneal nerve (motor) in both legs of each individual. Data were analyzed and compared between study and control groups using Man Whitney U test setting the significance level p ≤ 0.05. RESULTS: Anthropometric and cardio respiratory variables were not significantly altered between the study and control groups. The Compound muscle action potential (CMAP) latency of common peroneal nerves of both right [(11.29 ± 1.25 vs. 10.03 ± 1.37), P < 0.001] and left [(11.28 ± 1.38 vs. 10.05 ± 1.37), P < 0.01] legs was found to be significantly prolonged in study group as compared to control group. The Amp-CMAP of common peroneal nerves of both right [(4.57 ± 1.21 vs. 6.22 ± 1.72), P < 0.001] and left [(4.31 ± 1.55 vs. 6.25 ± 1.70), P < 0.001] legs was found significantly reduced in study group as compared to control group. Similarly, the motor nerve conduction velocity (MNCV) of common peroneal nerves of both right [(43.72 ± 3.25 vs. 47.49 ± 4.17), P < 0.001] and left [(42.51 ± 3.82 vs. 46.76 ± 4.51), P < 0.001] legs was also found to be significantly reduced in study group in comparison to control group. CONCLUSION: Operating mechanical sewing machine by paddling chronically and arduously could have attributed to abnormal nerve conduction study parameters due to vibration effect of the machine on right and left common peroneal nerves. The results of present study follow the trend towards presymptomatic or asymptomatic neuropathy similar to subclinical neuropathy.

Feature Fusion Based SVM Classifier for Protein Subcellular Localization Prediction.

For the importance of protein subcellular localization in different branches of life science and drug discovery, researchers have focused their attentions on protein subcellular localization prediction. Effective representation of features from protein sequences plays a most vital role in protein subcellular localization prediction specially in case of machine learning techniques. Single feature representation-like pseudo amino acid composition (PseAAC), physiochemical property models (PPM), and amino acid index distribution (AAID) contains insufficient information from protein sequences. To deal with such problems, we have proposed two feature fusion representations, AAIDPAAC and PPMPAAC, to work with Support Vector Machine classifiers, which fused PseAAC with PPM and AAID accordingly. We have evaluated the performance for both single and fused feature representation of a Gram-negative bacterial dataset. We have got at least 3% more actual accuracy by AAIDPAAC and 2% more locative accuracy by PPMPAAC than single feature representation.

Prevalence and Determinants of Contraceptive use among Employed and Unemployed Women in Bangladesh.

BACKGROUND: Contraceptive use plays a significant role in controlling fertility, particularly in reaching the replacement level of fertility. The association between women's employment status and contraceptive use is poorly studied and understood in Bangladesh. The aim of this study was to determine the factors that influence contraceptive use among employed and unemployed women in Bangladesh. METHODS: Data and necessary information of 16,616 married women were extracted from the Bangladesh Demographic and Health Survey (BDHS) 2011. The cross sectional data has been used for univariate analysis, to carry out the description of the variables; bivariate analysis, to find the associations among the variables; and binary logistic regression analysis, to evaluate the effects of selected sociodemographic factors on contraceptive use. RESULTS: The results revealed that the contraceptive use was found higher among employed women (67%) than that of unemployed women. Women's age, education, region, number of living children, and child preference were found to be significantly associated with current use of contraception among employed women. On the other hand, women's age, education, husband's education, region, residence, religion, number of living children, ever heard about family planning, and child preference were identified as the significant predictors of contraceptive use among unemployed women. CONCLUSION AND GLOBAL HEALTH IMPLICATIONS: A gap in using contraceptives among employed and unemployed women is identified. By creating employment opportunities for women to be enhanced the contraceptive use. Moreover, the sociodemographic factors need to be taken into consideration in formulating policies and implementing programs to increase the contraceptive prevalence rate among women.

Determinant factors of tobacco use among ever-married men in Bangladesh.

BACKGROUND: The burden of tobacco use is shifting from developed to developing countries. This study aimed to explore the different types of tobacco use, and to identify the determinant factors associated with the tobacco use among ever-married men in Bangladesh. DATA AND METHODS: Data of 3,771 ever-married men, 15-54 years of age were extracted from the Bangladesh Demographic and Health Survey 2007. Prevalence rate, chi-square (χ(2)) test, and binary logistic regression analysis were used as the statistical tools to analyze the data. RESULTS: Tobacco use through smoking (58.68%) was found to be higher than that of chewing (21.63%) among men, which was significantly more prevalent among the poorest, less educated, and businessmen. In bivariate analysis, all the socioeconomic factors were found significantly associated with tobacco use; while in multivariate analysis, age, education, wealth index, and occupation were identified as the significant predictors. CONCLUSION: Tobacco use was found to be remarkably common among males in Bangladesh. The high prevalence of tobacco use suggests that there is an urgent need for developing intervention plans to address this major public health problem in Bangladesh.

Social Impact of Stigma Regarding Tuberculosis Hindering Adherence to Treatment: A Cross Sectional Study Involving Tuberculosis Patients in Rajshahi City, Bangladesh.

Stigma, considered a social disease, is more apparent in developing societies which are driven by various social affairs, and influences adherence to treatment. The aim of the present study was to examine levels of social stigma related to tuberculosis (TB) in sociodemographic context and identify the effects of sociodemographic factors on stigma. The study sample consisted of 372 TB patients. Data were collected using stratified sampling with simple random sampling techniques. T tests, chi-square tests, and binary logistic regression analysis were performed to examine correlations between stigma and sociodemographic variables. Approximately 85.9% of patients had experienced stigma. The most frequent indicator of the stigma experienced by patients involved problems taking part in social programs (79.5%). Mean levels of stigma were significantly higher in women (55.5%), illiterate individuals (60.8%), and villagers (60.8%) relative to those of other groups. Chi-square tests revealed that education, monthly family income, and type of patient (pulmonary and extrapulmonary) were significantly associated with stigma. Binary logistic regression analysis demonstrated that stigma was influenced by sex, education, and type of patient. Stigma is one of the most important barriers to treatment adherence. Therefore, in interventions that aim to reduce stigma, strong collaboration between various institutions is essential.

Awareness, treatment, and control of diabetes in Bangladesh: a nationwide population-based study.

OBJECTIVES: To examine awareness, treatment, and control of diabetes mellitus among the adult population in Bangladesh. METHODS: The study used data from the 2011 nationally representative Bangladesh Demographic and Health Survey (BDHS). The BDHS sample is comprised of 7,786 adults aged 35 years or older. The primary outcome variables were fasting blood glucose, diagnosis, treatment, and control of diabetes. Multilevel logistic regression models were used to identify the risk factors for diabetes awareness. RESULTS: Overall, age-standardized prevalence of diabetes was 9.2%. Among subjects with diabetes, 41.2% were aware of their condition, 36.9% were treated, and 14.2% controlled their condition. A significant inequality in diabetes management was found from poor to wealthy households: 18.2% to 63.2% (awareness), 15.8% to 56.6% (treatment), and 8.2% to 18.4% (control). Multilevel models suggested that participants who had a lower education and lower economic condition were less likely to be aware of their diabetes. Poor management was observed among non-educated, low-income groups, and those who lived in the northwestern region. CONCLUSIONS: Diabetes has become a national health concern in Bangladesh; however, treatment and control are quite low. Improving detection, awareness, and treatment strategies is urgently needed to prevent the growing burden associated with diabetes.