RESUMO
Histoplasmosis is uncommon in many parts of the world, including Bangladesh, where, in recent years, cases are increasingly reported. We sought to describe the sociodemographic characteristics, clinical presentation, investigations, treatment, and outcome of histoplasmosis in Bangladesh. We conducted a retrospective data review of published literature from 1962 to 2017, containing information on histoplasmosis in and/or from Bangladesh. Unpublished, well-documented histoplasmosis cases were also included. A total of 26 male patients aged 8-75 years, with a diagnosis of histoplasmosis were included; nine were farmers, seven had diabetes, one was a renal transplant recipient, and four had HIV/AIDS. Fever (n = 20), weight loss (n = 17), anemia (n = 15), lymphadenopathy (n = 9), and hepatosplenomegaly (n = 7) were common. Eleven patients had bilateral adrenal enlargement. Diagnosis was confirmed by histo/cytopathology from skin (n = 1), oropharyngeal ulcers (n = 8), lymph nodes (n = 3), adrenal glands (n = 11), paravertebral soft tissue (n = 2), and bone marrow (n = 4). Cultures of representative samples and antibodies were detected in three and two cases, respectively. Twenty-two patients had disseminated histoplasmosis and four patients had localized oropharyngeal disease. Nine patients were prescribed anti-tuberculosis drugs empirically before establishing the diagnosis of histoplasmosis. Treatment consisted of amphotericin B and itraconazole. Six patients died in hospital, 14 patients recovered with relapse in two cases, and the outcome of the other patients could not be ascertained. Histoplasmosis is thought to be endemic in Bangladesh, but few cases are reported to date, which may be due to many asymptomatic, undiagnosed, misdiagnosed, or under-reported cases. Histoplasmosis should be considered as a differential in appropriate clinical scenarios.
RESUMO
AbstractBackground Alcohol use is a risk factor for the development of noncommunicable diseases. National dataare needed to assess the prevalence of alcohol use in the Bangladeshi population. The objective of this studywas to describe the prevalence and patterns of alcohol use among men and women of rural and urban areasof Bangladesh. Additionally, predictors of ever alcohol use were also identified.Methods A nationally representative cross-sectional survey (STEPS 2010) was conducted on 9275 adultsbetween November 2009 and April 2010. Participants were selected using multi-stage random clustersampling. Data on several risk factors for noncommunicable diseases, including alcohol use, were collectedby an interviewer-administered questionnaire.Results Among the total population, 5.6% (n = 519) reported to have ever drunk alcohol and 94.4% (8756)were lifetime abstainers; 2.0% (n = 190) of participants reported to have drunk alcohol within the last12 months. Of these, 94.7% (n = 180) were men. Only 0.9% (n = 87) of the total population had drunk alcoholwithin the last 30 days and were categorized as current drinkers. Among current drinkers, 77.0% (n = 67)were defined as binge drinkers, having had at least one episode of heavy drinking in this time period; 92.0%(n = 80) were current smokers and 59.8% (n = 52) had either no formal education or less than primary schooleducation. Ever alcohol use was more common among men, those who live in urban areas and smokers.Conclusion Alcohol use is low in Bangladesh; however, those who do use alcohol frequently binge drink,which is a public health concern. Targeted efforts should be made on these specific groups, to control andprevent the continued use of alcohol in Bangladesh.
