Wastewater based surveillance system to detect SARS-CoV-2 genetic material for countries with on-site sanitation facilities: an experience from Bangladesh

The presence of SARS-CoV-2 genetic materials in wastewater has become a matter of grave for many countries of the world. Wastewater based epidemiology, in this context, emerged as an important tool in developed countries where proper sewage system is available. Due to the recent shift in the spread of the infection from urban to rural areas, it is now equally important to develop a similar mechanism for rural areas as well. Considering the urgency of the issue a study was conducted in 14 districts of Bangladesh and a total of 238 sewage samples were collected in two different periods from December 2020 to January 2021. We are the first to propose a surveillance system for both urban and rural areas where a proper sewage system is absent. Based on RT-PCR analysis of the water samples, in more than 92% of cases, we found the presence of the SARS-COV-2 gene (ORF1ab, N, and Internal Control-IC). The trend of Ct value varies for different study locations. The spread of genetic material for on-site ({Delta}m = 0.0749) sanitation system was found more prominent than that of off-site sewage system ({Delta}m = 0.0219); which indicated the shift of genetic material from urban to rural areas. Wastewater samples were also measured for physicochemical parameters, including pH (6.30 - 12.50) and temperature (22.10 - 32.60) {o}C. The highest viral titer of 1975 copy/mL in sewage sample was observed in a sample collected from the isolation ward of the SARS-COV-2 hospital. Additionally, a correlation was found between bacterial load and SARS-CoV-2 genetic materials. The results indicated the association of increased Ct values with decreasing number of patients and vice versa. The findings reported in this paper contributed to the field of wastewater-based epidemiology dealing with SARS-COV-2 surveillance for developing countries where proper sewage system is absent and highlighting some of the challenges associated with this approach in such settings. HighlightsO_LIDevelopment of wastewater-based surveillance system based on on-site sanitation system for developing countries. C_LIO_LIAssociation of different environmental parameters with the presence of SARS CoV-2 genetic material in wastewater. C_LIO_LIPrediction of the viral concentration of sewage system using viral load and copy number parameter. C_LI Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=122 SRC="FIGDIR/small/21261347v2_ufig1.gif" ALT="Figure 1"> View larger version (25K): org.highwire.dtl.DTLVardef@1f7847dorg.highwire.dtl.DTLVardef@11b2c93org.highwire.dtl.DTLVardef@10b9fe1org.highwire.dtl.DTLVardef@2d9e8d_HPS_FORMAT_FIGEXP M_FIG C_FIG

Sex-specific epidemiological and clinical characteristics of Covid-19 patients in the southeast region of Bangladesh

BackgroundCOVID-19 has become a global pandemic with a high growth rate of confirmed cases. In Bangladesh, both mortality and affected rates are increasing at an alarming rate. Therefore, more comprehensive studies of the epidemiological and clinical characteristics of COVID-19 are required to control this pandemic. PurposeThe present study aimed to compare and analyze the sex-specific epidemiological, clinical characteristics, comorbidities, and other information of confirmed COVID-19 patients from the southeast region in Bangladesh for the first time. Methods385 lab-confirmed cases were studied out of 2,471 tested samples between 5 June and 10 September 2020. RT-PCR was used for COVID-19 identification and SPSS (version 25) for statistical data analysis. ResultsWe found that male patients were roughly affected compared to females patients (male 74.30% vs. female 25.7%) with an average age of 34.86 {+/-} 15.442 years, and B (+ve) blood group has been identified as a high-risk factor for COVID-19 infection. Workplace, local market, and bank were signified as sex-specific risk zone (p < 0.001). Pre-existing medical conditions such as diabetes, hypertension, cardiovascular and respiratory diseases were identified among the patients. Less than half of the confirmed COVID-19 cases in the southeast region were asymptomatic (37.73%) and more prevalent among females than males (male vs. female: 36.84% vs. 40.51%, p = 0.001). ConclusionsThe findings may help health authorities and the government take necessary steps for identification and isolation, treatment, prevention, and control of this global pandemic.

Determinants of COVID-19 vaccine acceptance and encountered side-effects among the vaccinated in Bangladesh

Objective: To identify the acceptance of the vaccine based on factors influencing the vaccination program and the side effects from vaccinated people. Methods: A cross-sectional online survey of 1 529 Bangladeshi adults (≥18 years) was conducted between 17 April, 2021 and 26 April, 2021. Statistical analysis of the data included Chi-square test and multinomial logistic regression analysis. Results: In total, 67.04% of the participants were willing to accept a COVID-19 vaccine, and 45.00% of them in our study had already received. Overall Bangladeshi people were more likely to accept COVID-19 vaccine if the vaccine reduces risk of infectious disease and has no associated health risk after receiving it. Among the respondents, religions, education level, living area (urban), belif that vaccines protect against infectious diseases and vaccines do not have health-related risk and vaccination was significantly associated with the acceptance of COVID-19 vaccines. Conversely, people's perception on development of natural immunity rather than receiving vaccines was also positively reflected. More than half (57.41%) reported minor side effects such as fever, muscle pain and headache after getting vaccine shots. Conclusions: This study revealed that the acceptance rate was influenced by socio-demographic and health-related characteristics and people are not afraid of this vaccine if they faced minor side effects after receiving it. These findings might help the government and policymakers of Bangladesh to implement necessary steps to accomplish this vaccination program effectively.

First detection of SARS-CoV-2 genetic material in the vicinity of COVID-19 isolation centre through wastewater surveillance in Bangladesh

In the course of a COVID-19 pandemic, 0.33 million people got infected in Bangladesh, we made the first and successful attempt to detect SARS-CoV-2 viruses genetic material in the vicinity wastewaters of an isolation centre i.e. Shaheed Bhulu Stadium, situated at Noakhali. The idea was to understand the genetic loading variation, both temporal and distance-wise in the nearby wastewater drains when the number of infected COVID-19 patients is not varying much. Owing to the fact that isolation center, in general, always contained a constant number of 200 COVID-19 patients, the prime objective of the study was to check if several drains carrying RNA of coronavirus are actually getting diluted or accumulated along with the sewage network. Our finding suggested that while the temporal variation of the genetic load decreased in small drains over the span of 50 days, the main sewer exhibited accumulation of SARS-CoV-2 RNA. Other interesting finding displays that probably distance of sampling location in meters is not likely to have a significant impact on gene detection concentration, although the quantity of the RNA extracted in the downstream of the drain was higher. These findings are of immense value from the perspective of wastewater surveillance of COVID-19, as they largely imply that we do not need to monitor every wastewater system, and probably major drains monitoring may illustrate the city health. Perhaps, we are reporting the accumulation of SARS-CoV-2 genetic material along the sewer network i.e. from primary to tertiary drains. The study sought further data collection in this line to simulate conditions prevailed in the most of south Asian country and to shed further light on the temporal variation and decay/accumulation processes of the genetic load of the SARS-COV-2. HIGHLIGHTSO_LIFirst detection report of SARS-CoV-2 RNA in the wastewaters of Bangladesh. C_LIO_LIWe traced the genetic load in the vicinity of the isolation center with 200 COVID-19 patients. C_LIO_LIAbout 75% of positive samples were found during the monitoring period. C_LIO_LIMain sewer and canal exhibit temporal accumulation of genetic load of SARS-CoV-2 C_LIO_LIIn general, shredding shows a variable trend during the sampling tenure. C_LI

Physiotherapy in Bangladesh: Inequality Begets Inequality.

BACKGROUND: The demand for health services in developing countries often outweighs provision. This article describes the present condition of physiotherapy in Bangladesh. Physiotherapy is not recognized as a profession by the government. There is no single registration and regulation body. The health-related and economic benefits of physiotherapy are not felt by the majority of Bangladeshi citizens. AREAS COVERED: The burden of disease is changing, and Bangladesh needs a profession that specializes in physical rehabilitation to face these challenges. This article outlines the benefits to patients and the wider economy from a broad physiotherapy regime for all Bangladeshi citizens. It describes the many barriers the profession faces. CONCLUSION: Physiotherapy is efficacious in many post-trauma situations and long-term conditions. Economic evidence supports the provision physiotherapy as a cost-effective treatment which should be considered as part of the provision of a universal health-care service. Official recognition of the protected "physiotherapist" title and a single registration and regulation agency are recommended.

Profile of stroke patients treated at a rehabilitation centre in Bangladesh.

OBJECTIVE: Stroke is the leading cause of death and disability in Bangladesh. Rehabilitation services have not yet been integrated into the Bangladesh health system. Only a few non-governmental organisations provide rehabilitation for stroke patients. The demographic profile of these patients has not yet been established. The aim of this study was to identify and evaluate the socio-demographic data, risk factors, place of primary management and cost of stroke for those who attended rehabilitation at the Centre for the Rehabilitation of the Paralysed (CRP), Bangladesh. A cross-sectional survey was carried out among 103 conveniently selected stroke patients who attended CRP between December 2015 and May 2016. RESULTS: The mean age of the participants was 49 years. The majority (68%) originated from urban areas. About 85% of the patients had a history of hypertension prior to their stroke. Following the stroke, most patients received their initial treatment in a general clinic or hospital by registered physicians. Only 22% of the patients were advised to pursue follow-up rehabilitation services by their physicians. All patients interviewed in the survey received unpaid full-time care from their family members. The reported cost of rehabilitation was approximately US $328 per month per patient.

Mental health and psychosocial aspects of disaster preparedness in Bangladesh.

The aim of this paper is to highlight the activities and observations of some NGOs and some dedicated researchers in the field of psychosocial consequences of disaster in Bangladesh, particularly in the coastal areas and the tornado-affected areas of the district of Tangile and Jamalpur during the last two decades. Some of the advantages of the non-governmental organizations' (NGOs) work in relief and development were their linkages with grass-roots people ensuring access to the community and community participation, the flexible approach of work, ability and willingness to learn from people and ability to connect people's lives with their realities. The most remarkable survey carried out by the Social Assistance and Rehabilitation for the Physically Vulnerable (SARPV-Bangladesh) after the 1996 tornado showed, on average, that women are more affected psychologically than men; 66% of the total sample in the disaster area were psychologically traumatized and required emergency services. The study supports the ideas that any disaster will have mental health consequences. Providing scientific psychological services is essential for real recovery from such a disaster. In developing countries like Bangladesh, limitations of mental health professionals and inadequate knowledge and practice about disaster mental health among the medical and paramedical staff, may lead to delays in the psychosocial management and rehabilitation of the survivors. To respond properly to a serious type of disaster like a cyclone or a tornado or recurrent devastating flood, the disaster mental health team should be aware of the socio-economic status, local culture, tradition, language and local livelihood patterns. Integration of the team with the network of various governmental and non-governmental organizations is essential to provide mental health services effectively.