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1.
Health Care Women Int ; 44(2): 175-197, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-34582312

RESUMO

We examined intra-regional variations and contextual influences on institutional delivery of women using the nationally representative 2014 Bangladesh Demographic and Health Survey data. Due to the hierarchical structure of the data, we employed multi-level logistic regression analysis. Of the women who had had a live birth in the last three years preceding the survey, only 38% availed the opportunity of institutional delivery. From the findings of this study, we observed that women of the Eastern region were less likely and those of the Western region were more likely to use FBD compared to the women of the Central region. Both individual- and community-level factors influence women to use facility-based delivery. Community-level programs aimed at improving availability and easy accessibility to economically deprived and geographically disadvantaged areas may increase safe motherhood practices among women.


Assuntos
Serviços de Saúde Materna , Gravidez , Feminino , Humanos , Bangladesh , Inquéritos e Questionários , Instalações de Saúde , Parto Obstétrico , Fatores Socioeconômicos , Cuidado Pré-Natal
2.
Biomed Res Int ; 2022: 2696916, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35411308

RESUMO

Growth of malignant tumors in the breast results in breast cancer. It is a cause of death of many women across the world. As a part of treatment, a woman might have to go through painful surgery and chemotherapy that may further lead to severe side effects. However, it is possible to cure it if it is diagnosed in the initial stage. Recently, many researchers have leveraged machine learning (ML) techniques to classify breast cancer. However, these methods are computationally expensive and prone to the overfitting problem. A simple single-layer neural network, i.e., functional link artificial neural network (FLANN), is proposed to overcome this problem. Further, the F-score is used to reduce the issue of overfitting by selecting features having a higher significance level. In this paper, FLANN is proposed to classify breast cancer using Wisconsin Breast Cancer Dataset (WBCD) (with 699 samples) and Wisconsin Diagnostic Breast Cancer (WDBC) (with 569 samples) datasets. Experimental results reveal that the proposed models can diagnose breast cancer with higher performance. The proposed model can be used in the early breast cancer diagnosis with 99.41% accuracy.


Assuntos
Neoplasias da Mama , Algoritmos , Mama , Neoplasias da Mama/diagnóstico , Feminino , Humanos , Aprendizado de Máquina , Redes Neurais de Computação
3.
J Obstet Gynaecol ; 42(5): 1186-1191, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35164647

RESUMO

Despite pervasiveness of child marriage in South Asian countries, its association with the usage of Maternal Health Care Services (MHCS) is poorly explored. In this study, we examined the impact of child marriage on MHCS utilisation among the prime reproductive aged women of five South Asian countries Afghanistan, Bangladesh, India, Nepal and Pakistan. Data for this study are extracted from the most recent Demographic and Health Surveys. The effect of child marriage on the use of MHCS was assessed by the multivariate logistic regression analysis. Findings reveal that in the South Asian region, the prevalence of child marriage is more common in Bangladesh, followed by Afghanistan, Nepal, India and Pakistan. Child marriage significantly (p< .01) deters the usage of MHCS - at least once antenatal care (ANC) visit, at least four ANC visit, Institutional delivery and seeking assistance from skilled birth assistance (SBA), though the effect size was somewhat different across the countries. Findings stipulate to remain girls in schooling more and the marriage acts of the countries should be enacted properly to diminish child marriage not only for increasing MHCS use, also for individual wellbeing and overall development of each country.Impact StatementWhat is already known on this subject? Child marriage in South Asian countries is commonplace despite substantial improvements of socioeconomic status. Although child marriage have many adverse reproductive and health outcomes, empirical evidence and systematic studies, particularly the association of child marriage with the usage of Maternal Health Care Services (MHCS) in the South Asian women are few.What do the results of this study add? Findings of this study affirm that prevalence of child marriage in South Asian region is still common. Although every country has set out minimum age at first marriage by acts, the acts are poorly followed, which adversely impacts the usage of MHCS among married women.What are the implications of these findings for clinical practice and/or future research? The study findings provide important insights of the consequence of child marriage on the skilled MHCS utilisation. The marriage acts of the countries should be enacted properly to restrict child marriage not only for increasing MHCS, also for individual wellbeing and overall development of each country. Study has important implications for planners, organisation managers and policy makers.


Assuntos
Casamento , Serviços de Saúde Materna , Adulto , Bangladesh , Criança , Utilização de Instalações e Serviços , Feminino , Humanos , Saúde Materna , Gravidez , Cuidado Pré-Natal , Fatores Socioeconômicos
4.
Comput Intell Neurosci ; 2022: 2832400, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35103054

RESUMO

Pulmonary fibrosis is a severe chronic lung disease that causes irreversible scarring in the tissues of the lungs, which results in the loss of lung capacity. The Forced Vital Capacity (FVC) of the patient is an interesting measure to investigate this disease to have the prognosis of the disease. This paper proposes a deep learning-based FVC-Net architecture to predict the progression of the disease from the patient's computed tomography (CT) scan and the patient's metadata. The input to the model combines the image score generated based on the degree of honeycombing for a patient identified based on segmented lung images and the metadata. This input is then fed to a 3-layer net to obtain the final output. The performance of the proposed FVC-Net model is compared with various contemporary state-of-the-art deep learning-based models, which are available on a cohort from the pulmonary fibrosis progression dataset. The model showcased significant improvement in the performance over other models for modified Laplace Log-Likelihood (-6.64). Finally, the paper concludes with some prospects to be explored in the proposed study.


Assuntos
Aprendizado Profundo , Fibrose Pulmonar Idiopática , Humanos , Pulmão/diagnóstico por imagem , Estudos Retrospectivos , Capacidade Vital
5.
Health Care Women Int ; 43(7-8): 914-930, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-34669548

RESUMO

In this study, we examined the relationship between marital violence(MV) and reproductive and sexual health outcomes of women of Bangladesh, India, Nepal and Pakistan. The lifetime MV inflicted by husbands on their wives was highest at 53% in Bangladesh, India(37%), Pakistan(28%) and Nepal(28%) respectively. Overall, our results in this study suggest that MV perpetrated by husbands on their wife is significantly associated with unintended pregnancy, pregnancy termination, current use of any modern contraceptive methods and sexually transmitted infections, but inconsistent associations are appeared across countries. Lifetime sexual violence and physical-sexual force were significantly and positively associated with unintended pregnancy and pregnancy termination respectively, whereas, all types of MV were significantly and positively related with the symptom of sexually transmitted diseases in the women. Appropriate measures should be undertaken to combat Violence against women(VAW) and necessary services should be provided to the victimized women to uphold their reproductive and sexual rights.


Assuntos
Comportamento Sexual , Infecções Sexualmente Transmissíveis , Bangladesh/epidemiologia , Feminino , Humanos , Avaliação de Resultados em Cuidados de Saúde , Gravidez , Gravidez não Planejada , Violência
6.
J Biosoc Sci ; : 1-22, 2021 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-33998419

RESUMO

The co-existence of under- and overweight at population level around the globe is well documented. However, this has yet to be explored using suitable statistical techniques in the context of Bangladesh. This study aimed to examine the prevalence and risk factors for being underweight and overweight or obese compared with normal weight in ever-married non-pregnant women aged 15-49 years in Bangladesh using data from the most recent Bangladesh Demographic and Health Survey conducted in 2014. Multilevel multinomial logistic regression (MLMLR) and quantile regression models were fitted to examine the associations of socioeconomic and individual-, household- and community-level factors on the nutritional status of women as measured by BMI. Overall, the prevalences of underweight, normal weight, overweight and obese women were 19%, 58%, 19% and 4%, respectively, in 2014. The MLMLR analysis revealed that women of young age, widowed/divorced/separated, having a larger family size and children aged ≤5 years in the household, currently amenorrhoeic and members of non-government organizations were at significantly increased risk of being underweight; those of older age, having higher parity, more educated, frequently watched TV and non-poor were more likely to be overweight or obese relative to normal BMI. Women from more affluent communities and urban areas were more likely to be overweight or obese relative to normal BMI than their counterparts from less-affluent and rural communities. Women's nutritional status was found to be heterogeneous across the regions of the country. The findings indicate that, along with individual-level factors, community-level characteristics are also important in explaining women's BMI in Bangladesh. The issue of under- and overweight or obesity among women in Bangladesh requires the immediate adoption of a public health policy for its mitigation. When developing intervention programmes, important determinants and uniform development of regions should be taken into consideration to combat the dual burden of under- and overweight among women in Bangladesh.

7.
PLoS One ; 10(9): e0138340, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26394045

RESUMO

BACKGROUND: Development of new tuberculosis (TB) drugs and alternative treatment strategies are urgently required to control the global spread of TB. Previous results have shown that vitamin D3 (vitD3) and 4-phenyl butyrate (PBA) are potent inducers of the host defense peptide LL-37 that possess anti-mycobacterial effects. OBJECTIVE: To examine if oral adjunctive therapy with 5,000IU vitD3 or 2x500 mg PBA or PBA+vitD3 to standard chemotherapy would lead to enhanced recovery in sputum smear-positive pulmonary TB patients. METHODS: Adult TB patients (n = 288) were enrolled in a randomized, double-blind, placebo-controlled trial conducted in Bangladesh. Primary endpoints included proportions of patients with a negative sputum culture at week 4 and reduction in clinical symptoms at week 8. Clinical assessments and sputum smear microscopy were performed weekly up to week 4, fortnightly up to week 12 and at week 24; TB culture was performed at week 0, 4 and 8; concentrations of LL-37 in cells, 25-hydroxyvitamin D3 (25(OH)D3) in plasma and ex vivo bactericidal function of monocyte-derived macrophages (MDM) were determined at week 0, 4, 8, 12 and additionally at week 24 for plasma 25(OH)D3. RESULTS: At week 4, 71% (46/65) of the patients in the PBA+vitD3-group (p = 0.001) and 61.3% (38/62) in the vitD3-group (p = 0.032) were culture negative compared to 42.2% (27/64) in the placebo-group. The odds of sputum culture being negative at week 4 was 3.42 times higher in the PBA+vitD3-group (p = 0.001) and 2.2 times higher in vitD3-group (p = 0.032) compared to placebo. The concentration of LL-37 in MDM was significantly higher in the PBA-group compared to placebo at week 12 (p = 0.034). Decline in intracellular Mtb growth in MDM was earlier in the PBA-group compared to placebo (log rank 11.38, p = 0.01). CONCLUSION: Adjunct therapy with PBA+vitD3 or vitD3 or PBA to standard short-course therapy demonstrated beneficial effects towards clinical recovery and holds potential for host-directed-therapy in the treatment of TB. TRIAL REGISTRATION: clinicaltrials.gov NCT01580007.


Assuntos
Colecalciferol/uso terapêutico , Fenilbutiratos/uso terapêutico , Tuberculose Pulmonar/tratamento farmacológico , Administração Oral , Adulto , Peptídeos Catiônicos Antimicrobianos/genética , Peptídeos Catiônicos Antimicrobianos/metabolismo , Antituberculosos/uso terapêutico , Proteína C-Reativa/análise , Calcifediol/sangue , Cálcio/sangue , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Humanos , Leucócitos Mononucleares/metabolismo , Modelos Logísticos , Macrófagos/citologia , Macrófagos/imunologia , Macrófagos/metabolismo , Efeito Placebo , RNA Mensageiro/metabolismo , Escarro/microbiologia , Resultado do Tratamento , Tuberculose Pulmonar/microbiologia , Tuberculose Pulmonar/patologia , Catelicidinas
8.
J Health Popul Nutr ; 33(1): 92-105, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25995726

RESUMO

The discourse of dual burden caused through underweight and overweight is well-documented globally but this issue and its connection with women's health in Bangladesh is yet to be explored widely. To enrich the current debate, this study, in the context of Bangladesh, examines the patterns, prevalence, and socioeconomic factors influencing the ever-married women of being underweight and overweight over normal weight. Data used in this study have been extracted from the most recent 2011 Bangladesh Demographic and Health Survey. To achieve results connected with the research objectives, both bivariate and multivariate statistical analyses have been employed. In bivariate analysis, we used seven categories of BMI cutoff points for Asian countries as prescribed by World Health Organization (WHO). Multinomial logistic regression model was constructed to investigate the net effect of socioeconomic factors on underweight, pre-overweight, and overweight over normal weight. The results confirm the co-existence of underweight and overweight among women as we found the prevalence of underweight, normal weight, pre-overweight, overweight, and obesity to be 24.1%, 46.7%, 12.8%, 13.5%, and 2.9% respectively. Compared to the richest, the women from the poorest households were significantly (p<0.001) most likely to be underweight (OR=2.75, 95% CI 2.27-3.35) and least likely to be overweight (OR=0.15, 95% CI 0.12-0.19) over normal weight. The urban women, compared to their rural counterparts, were significantly (p<0.001) less likely to be underweight (OR=0.80, 95% CI 0.71-0.91) and more likely to be overweight (OR=1.33, 95% CI 1.18-1.51) than normal weight. The other socioeconomic grades that were most marked to be underweight and overweight are age, women's education, marital status, age at first childbirth, parity, number of children aged ≤ 5 years at the household, and food security. The findings confirm the dual burden of both under- and overweight. Systematic and regular monitoring and surveillance of the social trajectory of nutritional status of women and men in Bangladesh is crucial to develop opposite strategy that addresses the persistent and chronic problem of underweight and the emerging problem of overweight. The dual existence of both types of malnutrition among women in Bangladesh must be taken into consideration so that public health interventions may be adopted through appropriate policy.


Assuntos
Efeitos Psicossociais da Doença , Sobrepeso/epidemiologia , Magreza/epidemiologia , Adolescente , Adulto , Bangladesh/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Adulto Jovem
9.
J Biosoc Sci ; 47(1): 120-39, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24480489

RESUMO

This study examines the trends and determinants of child marriage among women aged 20-49 in Bangladesh. Data were extracted from the last six nationally representative Demographic and Health Surveys conducted during 1993-2011. Simple cross-tabulation and multivariate binary logistic regression analyses were adopted. According to the survey conducted in 2011, more than 75% of marriages can be categorized as child marriages. This is a decline of 10 percentage points in the prevalence of child marriage compared with the survey conducted in 1993-1994. Despite some improvements in education and other socioeconomic indicators, Bangladeshi society still faces the relentless practice of early marriage. The mean age at first marriage has increased by only 1.4 years over the last one and half decades, from 14.3 years in 1993-1994 to 15.7 years in 2011. Although the situation on risk of child marriage has improved over time, the pace is sluggish. Both the year-of-birth and year-of-marriage cohorts of women suggest that the likelihood of marrying as a child has decreased significantly in recent years. The risk of child marriage was significantly higher when husbands had no formal education or little education, and when the wives were unemployed or unskilled workers. Muslim women living in rural areas have a greater risk of child marriage. Women's education level was the single most significant negative determinant of child marriage. Thus, the variables identified as important determinants of child marriage are: education of women and their husbands, and women's occupation, place of residence and religion. Programmes to help and motivate girls to stay in school will not only reduce early marriage but will also support overall societal development. The rigid enforcement of the legal minimum age at first marriage could be critical in decreasing child marriage.


Assuntos
Casamento/etnologia , Adolescente , Adulto , Fatores Etários , Bangladesh , Criança , Coleta de Dados , Demografia/estatística & dados numéricos , Escolaridade , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Masculino , Casamento/estatística & dados numéricos , Casamento/tendências , Pessoa de Meia-Idade , Ocupações , Análise de Regressão , Religião , População Rural/tendências , Fatores Socioeconômicos , Adulto Jovem
10.
Asia Pac J Public Health ; 27(2): NP1467-80, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24097925

RESUMO

This study investigates the factors affecting the timing of antenatal care (ANC) seeking among Bangladeshi women using the 2007 Bangladesh Demographic and Health Survey data. Overall, 52% of the most recently pregnant women sought skilled ANC. The most pronounced reason for not receiving the services was that it was "not needed." Of the women who sought ANC, 57% entered for ANC at the fourth month or later. The multivariate regression analysis revealed that maternal age, women's education, residence, wealth index, pregnancy intention status, child's birth order, and wanting more children were the important determinants of ANC services utilization. Wanting more children and contraception use were no longer independent contributors to late ANC entry. These barriers should also be addressed as part of health interventions through information education and communication programs to early entry to ANC. The need to reduce financial barriers to care is a major implication of this study.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Cuidado Pré-Natal/psicologia , Cuidado Pré-Natal/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Bangladesh , Feminino , Inquéritos Epidemiológicos , Humanos , Pessoa de Meia-Idade , Gravidez , Trimestres da Gravidez , Características de Residência , Fatores Socioeconômicos , Adulto Jovem
11.
Asia Pac J Public Health ; 27(2): NP1492-506, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24097938

RESUMO

This study examines the prevalence of child marriage and its effect on reproductive outcomes among women in Bangladesh using the most recent 2011 Bangladesh Demographic and Health Survey data. Both bivariate and multivariate statistical techniques used in the study yielded quantitatively important and reliable estimates of child marriage and its impact on adverse reproductive and health outcomes. Overall, 77% of the marriages among women aged 20 to 49 years old took place before the age of 18 years. Women's education is the most single significant determinant of child marriage. Findings revealed that after being adjusted for sociodemographic factors, child marriage significantly (P < .001) increases the likelihood of stillbirth/miscarriage (odds ratio [OR] = 1.80; 95% confidence interval [CI] = 1.45-2.24) and pregnancy termination (OR = 1.24; 95% CI = 1.12-1.38). Programs should aim to retain girls in school for longer periods not only to raise the age at first marriage but also for sound reproductive health and overall social development of Bangladesh.


Assuntos
Casamento , Complicações na Gravidez/epidemiologia , Saúde Reprodutiva , Aborto Induzido , Adolescente , Adulto , Bangladesh/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Casamento/estatística & dados numéricos , Pessoa de Meia-Idade , Razão de Chances , Gravidez , Prevalência , Mudança Social , Adulto Jovem
12.
Asia Pac J Public Health ; 27(2): NP2661-76, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21914707

RESUMO

This article explores the socioeconomic factors affecting contraceptive use and method choice among women of urban slums using the nationally representative 2006 Bangladesh Urban Health Survey. Both bivariate and multivariate statistical analyses were applied to examine the relationship between a set of sociodemographic factors and the dependent variables. Overall, the contraceptive prevalence rate was 58.1%, of which 53.2% were modern methods. Women's age, access to TV, number of unions, nongovernmental organization membership, working status of women, number of living children, child mortality, and wealth index were important determinants of contraceptive use and method preference. Sex composition of surviving children and women's education were the most important determinants of contraceptive use and method choice. Programs should be strengthened to provide nonclinical modern methods free of cost among the slum dwellers. Doorstep delivery services of modern contraceptive methods may raise the contraceptive prevalence rate among the slum dwellers in Bangladesh.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Bangladesh , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Áreas de Pobreza , Prevalência , Fatores Socioeconômicos , População Urbana , Adulto Jovem
13.
Asia Pac J Public Health ; 27(2): NP1106-17, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22186392

RESUMO

This study aims to investigate the effect of adolescent motherhood on neonatal mortality in Bangladesh using data from the nationally representative 2007 Bangladesh Demographic and Health Survey. Both univariate and multivariate statistical analyses were used to assess the relationship between neonatal mortality and sociodemographic contextual factors focusing on maternal age, in particular, adolescent and adult motherhood. The statistical analyses yielded quantitatively important and reliable estimates of neonatal death. The sequential multivariate logistic regression analyses yielded significantly increased risk of neonatal mortality among children of adolescent mothers than of adult mothers. Maternal education, religion, birth rank, and antenatal care seeking are also important determinants of neonatal death. Programs should aim to support girls to stay in schooling for a longer period to be higher educated. Delaying the age at first marriage may be also a valuable strategy to promote and improve infants' health and survival status.


Assuntos
Mortalidade Infantil , Idade Materna , Adolescente , Adulto , Bangladesh/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Casamento , Pessoa de Meia-Idade , Análise Multivariada , Fatores Socioeconômicos , Adulto Jovem
14.
Asia Pac J Public Health ; 27(2): NP1321-32, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23572376

RESUMO

This study examines the inequality of the use of skilled delivery assistance by the rural women of Bangladesh using the 2007 Bangladesh Demographic and Health Survey data. Simple cross-tabulation and univariate and multivariate statistical analyses were employed in the study. Overall, 56.1% of the women received at least one antenatal care visit, whereas only 13.2% births were assisted by skilled personnel. Findings revealed apparent inequality in using skilled delivery assistance by socioeconomic strata. Birth order, women's education, religion, wealth index, region and antenatal care are important determinants of seeking skilled assistance. To ensure safe motherhood initiative, government should pay special attention to reduce inequality in seeking skilled delivery assistance. A strong focus on community-based and regional interventions is important in order to increase the utilization of safe maternal health care services in rural Bangladesh.


Assuntos
Disparidades em Assistência à Saúde/estatística & dados numéricos , Serviços de Saúde Materna/estatística & dados numéricos , População Rural/estatística & dados numéricos , Adolescente , Adulto , Bangladesh , Feminino , Inquéritos Epidemiológicos , Humanos , Pessoa de Meia-Idade , Cuidado Pré-Natal/estatística & dados numéricos , Características de Residência , Fatores Socioeconômicos , Adulto Jovem
15.
Asia Pac J Public Health ; 27(2): NP1372-88, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23666835

RESUMO

This study examines the factors that influence institutional delivery among women in Bangladesh extracting data from 2007 Bangladesh Demographic and Health Survey. We employed both bivariate and multivariate statistical analyses in this study. Findings revealed that, only 14.7% of the women went for institutional delivery and 28.8% births were delivered by trained birth attendance. The multivariate logistic regression analysis yielded quantitatively important and reliable estimates of facility delivery. The likelihood of institutional delivery was significantly higher for first-order pregnancy, couples' higher education, the richest, higher autonomy, TV ownership, non-Muslims, who received antenatal care services, pregnancy complications, and urban residents. Government should ensure quality of care, easy accessibility, and availability of all facilities free of cost in the public medical institutions. Women should be informed regarding the long-term benefit of institutional delivery through information, education, and communication program.


Assuntos
Parto Obstétrico/estatística & dados numéricos , Adolescente , Adulto , Bangladesh , Feminino , Inquéritos Epidemiológicos , Humanos , Pessoa de Meia-Idade , Gravidez , Complicações na Gravidez/epidemiologia , Cuidado Pré-Natal/estatística & dados numéricos , Características de Residência , Fatores Socioeconômicos , Adulto Jovem
16.
Asia Pac J Public Health ; 27(2): NP2410-22, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24345848

RESUMO

This study examines safer sex negotiation and its association with condom use among clients of female sex workers (FSWs) in Bangladesh. Data were collected from 484 FSWs living in Dhaka city following a convenient sampling procedure. Overall, 47% of the clients were suggested to use condom during last sexual intercourse and 21% did so. Both bivariate and multivariable binary logistic regression analyses yielded significantly increased risk of negotiation for safer sex with clients among FSWs with higher education. The power bargaining significantly (P < .001) increased the risk of condom use by 2.15 times (95% confidence interval = 1.28-3.59). The odds of condom use were significantly higher among the FSWs with higher education, unmarried, hotel-based, and among those with higher level of HIV/AIDS-related knowledge. The Bangladeshi FSWs have little control over their profession. HIV prevention programs should aim to encourage FSWs through information, education, and communication program to insist on condom use among clients.


Assuntos
Preservativos/estatística & dados numéricos , Negociação , Sexo Seguro , Profissionais do Sexo , Adulto , Bangladesh , Comunicação , Estudos Transversais , Feminino , Infecções por HIV/prevenção & controle , Humanos , Pessoa de Meia-Idade , Parceiros Sexuais , Inquéritos e Questionários
17.
BMC Pulm Med ; 13: 23, 2013 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-23590701

RESUMO

BACKGROUND: We earlier showed that 4-phenylbutyrate (PB) can induce cathelicidin LL-37 expression synergistically with 1,25-dihydroxyvitamin D3 in a lung epithelial cell line. We aimed to evaluate a therapeutic dose of PB alone or in combination with vitamin D3 for induction of LL-37 expression in immune cells and enhancement of antimycobacterial activity in monocyte-derived macrophages (MDM). METHODS: Healthy volunteers were enrolled in an 8-days open trial with three doses of PB [250 mg (Group-I), 500 mg (Group-II) or 1000 mg (Group-III)] twice daily (b.d.) together with vitamin D3 {5000 IU once daily (o.d.)}, PB (500 mg b.d.) (Group-IV) or vitamin D3 (5000 IU o.d.) (Group-V), given orally for 4 days. Blood was collected on day-0, day-4 and day-8; plasma was separated, peripheral blood mononuclear cells (PBMC), non-adherent lymphocytes (NAL) and MDM were cultured. LL-37 transcript in cells and peptide concentrations in supernatant were determined by qPCR and ELISA, respectively. In plasma, 25-hydorxyvitamin D3 levels were determined by ELISA. MDM-mediated killing of Mycobacterium tuberculosis (Mtb) (H37Rv) was performed by conventional culture method. RESULTS: MDM from Group-II had increased concentration of LL-37 peptide and transcript at day-4, while Group-I showed increased transcript at day-4 and day-8 compared to day-0 (p < 0.05). Both Group-I and -II exhibited higher levels of transcript on day-4 compared to Group-III and Group-V (p < 0.035). Increased induction of peptide was observed in lymphocytes from Group-II on day-4 compared to Group-I and Group-IV (p < 0.05), while Group-IV showed increased levels on day-8 compared to Group-I and Group-III (p < 0.04). Intracellular killing of Mtb on day-4 was significantly increased compared to day-0 in Group-I, -II and -V (p < 0.05). CONCLUSION: The results demonstrate that 500 mg b.d. PB with 5000 IU o.d. vitamin D3 is the optimal dose for the induction of LL-37 in macrophages and lymphocytes and intracellular killing of Mtb by macrophages. Hence, this dose has potential application in the treatment of TB and is now being used in a clinical trial of adults with active pulmonary TB (NCT01580007).


Assuntos
Peptídeos Catiônicos Antimicrobianos/metabolismo , Colecalciferol/administração & dosagem , Macrófagos/efeitos dos fármacos , Mycobacterium tuberculosis/efeitos dos fármacos , Fenilbutiratos/administração & dosagem , Tuberculose/tratamento farmacológico , Administração Oral , Adolescente , Adulto , Peptídeos Catiônicos Antimicrobianos/genética , Peptídeos Catiônicos Antimicrobianos/imunologia , Antineoplásicos/administração & dosagem , Cálcio/sangue , Células Cultivadas , Colecalciferol/sangue , Relação Dose-Resposta a Droga , Quimioterapia Combinada , Feminino , Humanos , Imunidade Inata/efeitos dos fármacos , Imunidade Inata/imunologia , Macrófagos/citologia , Macrófagos/microbiologia , Masculino , Pessoa de Meia-Idade , RNA Mensageiro/metabolismo , Regulação para Cima/efeitos dos fármacos , Regulação para Cima/imunologia , Vitaminas/administração & dosagem , Vitaminas/sangue , Adulto Jovem , Catelicidinas
18.
J Health Popul Nutr ; 31(1): 96-109, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23617210

RESUMO

In Bangladesh, preference for place of delivery and socioeconomic factors associated with caesarean section are not well-understood. This paper examines the socioeconomic correlates of preference for institutional delivery and caesarean sections in Bangladesh. The study used data from the nationally-representative 2007 Bangladesh Demographic and Health Survey. Both bivariate and multivariate binary logistic regression models were constructed to assess the effect of sociodemographic factors on the use of medical facilities and caesarean section for childbirth. Overall, 15% of women underwent institutional delivery, and 8% deliveries were performed by caesarean sections. Both institutional deliveries and caesarean sections have increased in recent years. The bivariate and multivariate analyses both confirmed that place of residence, religion, birth order, frequent pregnancy, antenatal care-seeking, and wealth index were important predictors of the use of medical facilities and caesarean sections for childbirth. Women's education appeared as the most single significant determinant for the use of both services. The findings underlie the importance of monitoring caesarean section as well as professional attendance for safe motherhood. Programmes should aim to inform women highlighting the benefits of the use of skilled maternal healthcare services and demerits of home-delivery practices.


Assuntos
Cesárea/estatística & dados numéricos , Parto Obstétrico/estatística & dados numéricos , Serviços de Saúde Materna/métodos , Serviços de Saúde Materna/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adolescente , Adulto , Bangladesh , Ordem de Nascimento , Escolaridade , Emprego/estatística & dados numéricos , Feminino , Parto Domiciliar/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Paridade , Gravidez , Religião , População Rural , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos , Adulto Jovem
19.
J Family Reprod Health ; 7(1): 11-22, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24971097

RESUMO

OBJECTIVE: This paper explores the relationship between domestic violence against women inflicted by husbands, unwanted pregnancy and pregnancy termination of Bangladeshi urban women. MATERIALS AND METHODS: The study used the nationally representative 2007 Bangladesh Demographic and Health Survey (BDHS) data. The BDHS covered a representative sample of 10,996 ever married women from rural and urban areas. The BDHS used a separate module to collect information from women regarding domestic violence. The survey gathered information of domestic violence from 1,013 urban women which are the basis of the study. Simple cross tabulation, bivariate and multivariate statistical analyses were performed to analyzing data. RESULTS: Overall, the lifetime prevalence of domestic violence was 47.5%. Of the most recent pregnancies, 15.6% were unwanted and 16.0% of the women terminated pregnancy in their marital life. The multivariate binary logistic regression analyses yielded quantitatively important and reliable estimate of unwanted pregnancy and pregnancy termination. The regression analyses yielded significantly (p < 0.05) increased risk of unwanted pregnancy only for physical violence (OR = 2.35, 95% CI = 1.28-4.32) and for both physical and sexual violence (OR = 2.27, 95% CI = 1.02-5.28), and higher risk of pregnancy termination for only physical violence (OR = 1.41, 95% CI = 0.95-2.10) and for both physical and sexual violence (OR = 1.81, 95% CI = 1.07-3.04) than women who were never abused. Current age, higher parity and early marriage are also important determinants of unwanted pregnancy and pregnancy termination. CONCLUSION: Violence against women inflicted by husbands is commonplace in Bangladesh. Any strategy to reduce the burden of unwanted pregnancy and induced abortion should include prevention of violence against women and strengthening women's sexual and reproductive health.

20.
J Family Reprod Health ; 7(2): 73-86, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24971107

RESUMO

OBJECTIVE: To examine the relationship between socioeconomic factors affecting contraceptive use among tribal women of Bangladesh with focusing on son preference over daughter. MATERIALS AND METHODS: The study used data gathered through a cross sectional survey on four tribal communities resided in the Rangamati Hill District of the Chittagong Hill Tracts, Bangladesh. A multistage random sampling procedure was applied to collect data from 865 currently married women of whom 806 women were currently married, non-pregnant and had at least one living child, which are the basis of this study. The information was recorded in a pre-structured questionnaire. Simple cross tabulation, chi-square tests and logistic regression analyses were performed to analyzing data. RESULTS: The contraceptive prevalence rate among the study tribal women was 73%. The multivariate analyses yielded quantitatively important and reliable estimates of likelihood of contraceptive use. Findings revealed that after controlling for other variables, the likelihood of contraceptive use was found not to be significant among women with at least one son than those who had only daughters, indicating no preference of son over daughter. Multivariate logistic regression analysis suggests that home visitations by family planning workers, tribal identity, place of residence, husband's education, and type of family, television ownership, electricity connection in the household and number of times married are important determinants of any contraceptive method use among the tribal women. CONCLUSION: The contraceptive use rate among the disadvantaged tribal women was more than that of the national level. Door-step delivery services of modern methods should be reached and available targeting the poor and remote zones.

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