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Rahman M, Khan SR, Alamgir ASM, Kennedy DS, Hakim F, Evers ES, Afreen N, Alam AN, Islam MS, Paul D, Bhuiyan R, Islam R, Moureen A, Salimuzzaman M, Billah MM, Sharif AR, Akter MK, Sultana S, Khan MH, von Harbou K, Zaman MM, Shirin T, Flora MS. Seroprevalence of SARS-CoV-2 antibodies among Forcibly Displaced Myanmar Nationals in Cox's Bazar, Bangladesh 2020: a population-based cross-sectional study. BMJ Open 2022; 12:e066653. [PMID: 36410810 PMCID: PMC9679871 DOI: 10.1136/bmjopen-2022-066653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/01/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The study aimed to determine the seroprevalence, the fraction of asymptomatic infections, and risk factors of SARS-CoV-2 infections among the Forcibly Displaced Myanmar Nationals (FDMNs). DESIGN It was a population-based two-stage cross-sectional study at the level of households. SETTING The study was conducted in December 2020 among household members of the FDMN population living in the 34 camps of Ukhia and Teknaf Upazila of Cox's Bazar district in Bangladesh. PARTICIPANTS Among 860 697 FDMNs residing in 187 517 households, 3446 were recruited for the study. One individual aged 1 year or older was randomly selected from each targeted household. PRIMARY AND SECONDARY OUTCOME MEASURES Blood samples from respondents were tested for total antibodies for SARS-CoV-2 using Wantai ELISA kits, and later positive samples were validated by Kantaro kits. RESULTS More than half (55.3%) of the respondents were females, aged 23 median (IQR 14-35) years and more than half (58.4%) had no formal education. Overall, 2090 of 3446 study participants tested positive for SARS-CoV-2 antibody. The weighted and test adjusted seroprevalence (95% CI) was 48.3% (45.3% to 51.4%), which did not differ by the sexes. Children (aged 1-17 years) had a significantly lower seroprevalence 38.6% (95% CI 33.8% to 43.4%) compared with adults (58.1%, 95% CI 55.2% to 61.1%). Almost half (45.7%, 95% CI 41.9% to 49.5%) of seropositive individuals reported no relevant symptoms since March 2020. Antibody seroprevalence was higher in those with any comorbidity (57.8%, 95% CI 50.4% to 64.5%) than those without (47.2%, 95% CI 43.9% to 50.4%). Multivariate logistic regression analysis of all subjects identified increasing age and education as risk factors for seropositivity. In children (≤17 years), only age was significantly associated with the infection. CONCLUSIONS In December 2020, about half of the FDMNs had antibodies against SARS-CoV-2, including those who reported no history of symptoms. Periodic serosurveys are necessary to recommend appropriate public health measures to limit transmission.
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Affiliation(s)
- Mahbubur Rahman
- Epidemiology, Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh
| | - Samsad Rabbani Khan
- Epidemiology, Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh
| | - A S M Alamgir
- Virology, Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh
| | - David S Kennedy
- WHO Emergency Sub-Office, World Health Organization, Cox's Bazar, Bangladesh
| | - Ferdous Hakim
- Research and Publication, World Health Organization Bangladesh, Dhaka, Bangladesh
| | - Egmond Samir Evers
- WHO Emergency Sub-Office, World Health Organization, Cox's Bazar, Bangladesh
| | - Nawroz Afreen
- Epidemiology, Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh
| | - Ahmed Nawsher Alam
- Virology, Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh
| | - Md Sahidul Islam
- Research and Publication, World Health Organization Bangladesh, Dhaka, Bangladesh
| | - Debashish Paul
- WHO Emergency Sub-Office, World Health Organization, Cox's Bazar, Bangladesh
| | - Rijwan Bhuiyan
- Co-ordination Center, Ministry of Health and Family Welfare, Cox's Bazar, Bangladesh
| | - Raisul Islam
- WHO Emergency Sub-Office, World Health Organization, Cox's Bazar, Bangladesh
| | - Adneen Moureen
- IEDCR Field Laboratory, World Health Organization, Cox's Bazar, Bangladesh
| | - M Salimuzzaman
- Zoonosis, Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh
| | - Mallick Masum Billah
- Epidemiology, Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh
| | - Ahmed Raihan Sharif
- Epidemiology, Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh
| | - Mst Khaleda Akter
- Research and Publication, World Health Organization Bangladesh, Dhaka, Bangladesh
| | - Sharmin Sultana
- Virology, Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh
| | - Manjur Hossain Khan
- Virology, Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh
| | - Kai von Harbou
- WHO Emergency Sub-Office, World Health Organization, Cox's Bazar, Bangladesh
| | | | - Tahmina Shirin
- Director, Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh
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Abstract
AIM To explore and provide understanding of the barriers to quality of work life among registered nurses in Bangladesh. BACKGROUND Globally, there is growing interest in the working environments of nurses, especially at a time of nursing shortages and with the focus on safety and care quality in health systems. In a low socio-economic country like Bangladesh, nurses struggle in a grossly underfunded healthcare system to deliver care to the people but no studies have been conducted on their quality of work life. METHODS This qualitative descriptive study was conducted at three Bangladeshi tertiary hospitals in May 2015-January 2016. Three focus group discussions were held with 30 registered nurses exploring their perceived barriers to quality of work life. Data were analysed with content analysis. FINDINGS Seven barriers to their work-life arose: heavy workloads; lack of government accommodation and transportation; poor health status; lack of support from nursing supervisors; lack of promotion opportunities; incomplete hospital policies and procedures; and lack of night shift and risk allowances. DISCUSSION Participants described many issues and barriers impacting on their work-life. They perceived little reward for their hard work, felt that their health suffered from their working conditions and described a low QWL. CONCLUSION AND POLICY IMPLICATIONS Findings provide information for nursing and health policymakers and leaders to reduce barriers to improve work-life quality among nurses that can contribute better to quality of nursing care, and nursing retention and satisfaction. Work policies and practices, and funding and other resources need to be scrutinized to ensure better working conditions for Bangladeshi nurses. LIMITATIONS Interviews were conducted with nurses only in tertiary hospitals in the Bangladeshi capital, and understanding of barriers to work-life quality of nurses in other health settings and regions needs to be explored.
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Affiliation(s)
- N Akter
- Fouzder Hat Nursing College, Chittagong, Bangladesh
| | - M K Akter
- Nursing Institute Mitford, Dhaka, Bangladesh
| | - S Turale
- Chiang Mai University, Chiang Mai, Thailand
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