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Hossain MS, Ahmed TS, Haque MA, Chowdhury MAB, Uddin MJ. Prevalence of unqualified sources of antimalarial drug prescription for children under the age of five: A study in 19 low- and middle-income countries. PLoS One 2024; 19:e0300347. [PMID: 38512855 PMCID: PMC10956821 DOI: 10.1371/journal.pone.0300347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Antimalarial drug resistance poses a severe danger to global health. In Low- and Middle-Income Countries (LMICs), there is a lack of reliable information on antimalarial prescriptions for recent malarial fever in children under five. Our study aims to determine the prevalence of unqualified sources of antimalarial drug prescription for children under the age of five in 19 low- and middle-income countries. METHODS We performed a cross-sectional study of the Malaria Indicator Survey (MIS) datasets (n = 106265) across 19 LMICs. The recent MIS datasets were used, and the study only included children under five who had taken an antimalarial drug for a recent malarial fever. The outcome variable was classified into two distinct categories: those who had taken antimalarial drugs for malarial fever from qualified sources and those who did not. FINDINGS Among LMICs, we found that 87.1% of children under five received an antimalarial prescription from unqualified sources who had recently experienced malarial fever. In several LMICs (Tanzania, Nigeria, and Ghana), a substantial portion of recent antimalarial prescriptions for malaria was taken from unqualified sources (about 60%). Some LMICs (Guinea (31.8%), Mali (31.3%), Nigeria (20.4%), Kenya (2.6%), and Senegal (2.7%)) had low rates of antimalarial drug consumption even though children under five received a high percentage of antimalarial prescriptions from qualified sources for a recent malarial fever. Living in rural areas, having mothers with higher education, and having parents with more wealth were frequently taken antimalarial from qualified sources for recent malarial fever in children under five across the LMICs. INTERPRETATION The study draws attention to the importance of national and local level preventative strategies across the LMICs to restrict antimalarial drug consumption. This is because antimalarial prescriptions from unqualified sources for recent malarial fever in children under five were shockingly high in most LMICs and had high rates of unqualified prescriptions in certain other LMICs.
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Affiliation(s)
- Md Sabbir Hossain
- Biostatistics, Epidemiology and Public Health Research Team, Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Talha Sheikh Ahmed
- Department of Geography and Environment, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Mohammad Anamul Haque
- Biostatistics, Epidemiology and Public Health Research Team, Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Muhammad Abdul Baker Chowdhury
- Biostatistics, Epidemiology and Public Health Research Team, Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Md Jamal Uddin
- Biostatistics, Epidemiology and Public Health Research Team, Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
- Department of General Educational and Development, Daffodil International University, Dhaka, Bangladesh
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Hasan MN, Khalil I, Chowdhury MAB, Rahman M, Asaduzzaman M, Billah M, Banu LA, Alam MU, Ahsan A, Traore T, Uddin MJ, Galizi R, Russo I, Zumla A, Haider N. Two decades of endemic dengue in Bangladesh (2000-2022): trends, seasonality, and impact of temperature and rainfall patterns on transmission dynamics. J Med Entomol 2024; 61:345-353. [PMID: 38253990 PMCID: PMC10936167 DOI: 10.1093/jme/tjae001] [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] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 12/17/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024]
Abstract
The objectives of this study were to compare dengue virus (DENV) cases, deaths, case-fatality ratio [CFR], and meteorological parameters between the first and the recent decades of this century (2000-2010 vs. 2011-2022) and to describe the trends, seasonality, and impact of change of temperature and rainfall patterns on transmission dynamics of dengue in Bangladesh. For the period 2000-2022, dengue cases and death data from Bangladesh's Ministry of Health and Family Welfare's website, and meteorological data from the Bangladesh Meteorological Department were analyzed. A Poisson regression model was performed to identify the impact of meteorological parameters on the monthly dengue cases. A forecast of dengue cases was performed using an autoregressive integrated moving average model. Over the past 23 yr, a total of 244,246 dengue cases were reported including 849 deaths (CFR = 0.35%). The mean annual number of dengue cases increased 8 times during the second decade, with 2,216 cases during 2000-2010 vs. 18,321 cases during 2011-2022. The mean annual number of deaths doubled (21 vs. 46), but the overall CFR has decreased by one-third (0.69% vs. 0.23%). Concurrently, the annual mean temperature increased by 0.49 °C, and rainfall decreased by 314 mm with altered precipitation seasonality. Monthly mean temperature (Incidence risk ratio [IRR]: 1.26), first-lagged rainfall (IRR: 1.08), and second-lagged rainfall (IRR: 1.17) were significantly associated with monthly dengue cases. The increased local temperature and changes in rainfall seasonality might have contributed to the increased dengue cases in Bangladesh.
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Affiliation(s)
- Mohammad Nayeem Hasan
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh
| | - Ibrahim Khalil
- Department of Livestock Services, Ministry of Fisheries and Livestock, Bangladesh, Dhaka, Bangladesh
| | | | - Mahbubur Rahman
- The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, UK
- Institute of Epidemiology, Disease Control and Research (IEDCR), Ministry of Health and Family Welfare, Mohakhali, Dhaka, Bangladesh
| | - Md Asaduzzaman
- School of Digital, Technologies, and Arts, Staffordshire University, Stoke on Trent ST4 2DE, UK
| | - Masum Billah
- School of Digital, Technologies, and Arts, Staffordshire University, Stoke on Trent ST4 2DE, UK
| | - Laila Arjuman Banu
- Department of Anatomy, Bangabandhu Sheik Mujib Medical University, Dhaka, Bangladesh
| | - Mahbub-Ul Alam
- Environmental Intervention Unit, International Centre for Diarrhoeal Diseases Research, Bangladesh (ICDDR,B), Dhaka 1212, Bangladesh
| | - Atik Ahsan
- Environmental Intervention Unit, International Centre for Diarrhoeal Diseases Research, Bangladesh (ICDDR,B), Dhaka 1212, Bangladesh
| | - Tieble Traore
- Emergency Preparedness and Response Programme, WHO Regional Office for Africa, Dakar Hub, Dakar, Senegal
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh
- Department of General Educational and Development, Daffodil International University, Dhaka, Bangladesh
| | - Roberto Galizi
- School of Life Sciences, Faculty of Natural Sciences, Keele University, Keele, Staffordshire ST5 5BG, UK
| | - Ilaria Russo
- School of Medicine, Faculty of Medicine and Health Sciences, Keele University, Staffordshire ST5 5BG, UK
| | - Alimuddin Zumla
- Division of Infection and Immunity, Centre for Clinical Microbiology, University College London and NIHR-BRC, University College London Hospitals, London, UK
| | - Najmul Haider
- School of Life Sciences, Faculty of Natural Sciences, Keele University, Keele, Staffordshire ST5 5BG, UK
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Michel M, Peart R, Yan SC, Still MEH, Melnick K, San A, Gonzalez B, Hodges TR, Newman WC, Mbabuike N, Ashley WW, Chowdhury MAB, Rahman M. Academic accomplishments of Black neurosurgeons in the United States. J Neurosurg 2024:1-8. [PMID: 38427994 DOI: 10.3171/2023.12.jns231451] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 12/07/2023] [Indexed: 03/03/2024]
Abstract
OBJECTIVE Neurosurgery has remained relatively homogeneous in terms of racial and gender diversity, trailing behind national demographics. Less than 5% of practicing neurosurgeons in the United States identify as Black/African American (AA). Research and academic productivity are highly emphasized within the field and are crucial for career advancement at academic institutions. They also serve as important avenues for mentorship and recruitment of diverse trainees and medical students. This study aimed to summarize the academic accomplishments of AA neurosurgeons by assessing publication quantity, h-index, and federal grant funding. METHODS One hundred thirteen neurosurgery residency training programs accredited by the Accreditation Council for Graduate Medical Education in 2022 were included in this study. The American Society of Black Neurosurgeons registry was reviewed to analyze the academic metrics of self-identified Black or AA academic neurosurgeons. Data on the academic rank, leadership position, publication quantity, h-index, and race of neurosurgical faculty in the US were obtained from publicly available information and program websites. RESULTS Fifty-five AA and 1393 non-AA neurosurgeons were identified. Sixty percent of AA neurosurgeons were fewer than 10 years out from residency training, compared to 37.4% of non-AA neurosurgeons (p = 0.001). AA neurosurgeons had a median 32 (IQR 9, 85) publications compared to 52 (IQR 22, 122) for non-AA neurosurgeons (p = 0.019). AA neurosurgeons had a median h-index of 12 (IQR 5, 24) compared to 16 (IQR 9, 31) for non-AA colleagues (p = 0.02). Following stratification by academic rank, these trends did not persist. No statistically significant differences in the median amounts of awarded National Institutes of Health funding (p = 0.194) or level of professorship attained (p = 0.07) were observed between the two cohorts. CONCLUSIONS Racial disparities between AA and non-AA neurosurgeons exist in publication quantity and h-index overall but not when these groups are stratified by academic rank. Given that AA neurosurgeons comprise more junior faculty, it is expected that their academic accomplishments will increase as more enter academic practice and current neurosurgeons advance into more senior positions.
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Affiliation(s)
| | - Rodeania Peart
- 1College of Medicine, University of Florida, Gainesville
| | - Sandra C Yan
- 2Department of Neurosurgery, University of Florida, Gainesville, Florida
| | - Megan E H Still
- 2Department of Neurosurgery, University of Florida, Gainesville, Florida
| | - Kaitlyn Melnick
- 2Department of Neurosurgery, University of Florida, Gainesville, Florida
| | - Ali San
- 3Kansas City University College of Osteopathic Medicine, Kansas City, Missouri
| | - Brandon Gonzalez
- 4Tilman J. Fertitta Family College of Medicine, University of Houston, Texas
| | - Tiffany R Hodges
- 5Department of Neurosurgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - William C Newman
- 6Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nnenna Mbabuike
- 7Department of Neurological Surgery, Ascension St. Mary's Hospital, Saginaw, Michigan; and
| | - William W Ashley
- 8Department of Neurosurgery, Sinai Hospital and LifeBridge Health System, Baltimore, Maryland
| | | | - Maryam Rahman
- 2Department of Neurosurgery, University of Florida, Gainesville, Florida
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Cowdery C, Halloran D, Henderson R, Allen MAKM, O’Shea K, Woodward K, Rifai S, Cohen SA, Chowdhury MAB, Zeretzke-Bien C, Walter LA, Elie-Turenne MC. User Experience of Access to Sexual Assault Nurse Examiner and Emergency Contraception in Emergency Departments in the United States: A National Survey. West J Emerg Med 2024; 25:291-300. [PMID: 38596932 PMCID: PMC11000551 DOI: 10.5811/westjem.18405] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/28/2023] [Accepted: 12/05/2023] [Indexed: 04/11/2024] Open
Abstract
Background Despite the prevalence of sexual assault presentations to emergency departments (ED) in the United States, current access to sexual assault nurse examiners (SANE) and emergency contraception (EC) in EDs is unknown. Methods In this study we employed a "secret shopper," cross-sectional telephonic survey. A team attempted phone contact with a representative sample of EDs and asked respondents about the availability of SANEs and EC in their ED. Reported availability was correlated with variables including region, urban/rural status, hospital size, faith affiliation, academic affiliation, and existence of legislative requirements to offer EC. Results Over a two-month period in 2019, 1,046 calls to hospitals were attempted and 960 were completed (91.7% response rate). Of the 4,360 eligible hospitals listed in a federal database, 960 (22.0%) were contacted. Access to SANEs and EC were reported to be available in 48.9% (95% confidence interval [CI] 45.5-52.0) and 42.5% (95% CI 39.4-45.7) of hospitals, respectively. Access to EC was positively correlated with SANE availability. The EDs reporting SANE and EC availability were more likely to be large, rural, and affiliated with an academic institution. Those reporting access to EC were more likely to be in the Northeast and in states with legislative requirements to offer EC. Conclusion Our results suggest that perceived access to sexual assault services and emergency contraception in EDs in the United States remains poor with regional and legislative disparities. Results suggest disparities in perceived access to EC and SANE in the ED, which have implications for improving ED practices regarding care of sexual assault victims.
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Affiliation(s)
- Colleen Cowdery
- University of Florida College of Medicine, Gainesville, Florida
| | - Diana Halloran
- University of Florida College of Medicine, Gainesville, Florida
| | | | - MA Kathleen M. Allen
- University of Florida College of Public Health and Health Professions, Gainesville, Florida
| | - Kelly O’Shea
- University of Florida College of Medicine, Gainesville, Florida
| | | | - Susan Rifai
- University of Florida College of Medicine, Gainesville, Florida
| | - Scott A. Cohen
- University of Florida College of Public Health and Health Professions, Gainesville, Florida
- Department of Emergency Medicine University of Florida, Gainesville, Florida
| | | | | | - Lauren A. Walter
- Department of Emergency Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Marie-Carmelle Elie-Turenne
- Department of Emergency Medicine University of Florida, Gainesville, Florida
- Department of Emergency Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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Hakim S, Chowdhury MAB, Uddin MJ, Leslie HH. Availability of basic infection control items and personal protection equipment in 7948 health facilities in eight low- and middle-income countries: Evidence from national health system surveys. J Glob Health 2024; 14:04042. [PMID: 38426844 PMCID: PMC10906347 DOI: 10.7189/jogh.14.04042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
Background Hundreds of millions of people become infected globally every year while seeking care in health facilities that lack basic needs like infection control measures and personal protective equipment (PPE). We aimed to evaluate the availability of infection control items and PPE in eight low- and middle-income countries and identify disparities in the availability of those items. Methods In this study, we combined publicly available nationally representative cross-sectional health system surveys (Service Provision Assessments by the Demographic and Health Survey Programme) conducted in eight countries between 2013 and 2018: Afghanistan, Bangladesh, the Democratic Republic of the Congo, Haiti, Malawi, Nepal, Senegal, and Tanzania. The availability of infection control items was evaluated using a list of six items (a waste receptacle, a sharps container, disinfectant, single-use disposable or auto-disposable syringes, soap and running water, or an alcohol-based hand rub, and guidelines for standard precautions). PPE includes four items: gloves, medical masks, gowns, and eye protection. We considered these items available in a facility if they were observed in general outpatient areas or any service-specific area (i.e. delivery room). Results We analysed data from 7948 health facilities (694 hospitals and 7254 health centres/clinics). Overall, among the infection control items and PPE, most surveyed facilities had high availability of single-use disposable or auto-disposable syringes (91.40%) and latex gloves (92.56%). Of infection control measures, guidelines for infection control were the least available during the survey, with the lowest (6.15%) in Nepal and the highest (68.18%) in Malawi. Of the PPE items, eye protection was the least available during the survey, with the lowest (5.4% in Senegal) and the highest (28.17%) in Haiti. Only 1567 (19.71%) facilities looked to have all the basic infection control materials, and 1023 (12.87%) of the analysed facilities possessed all of the PPE. Within the same country, the availability of items varied more between hospitals and health centres/clinics than between them. Conclusions All eight of our study countries experience shortages of the most fundamental standard precaution items to avert infection. Steps must be taken in each of these countries to reduce inadequacies and disparities and enhance efficiency in the conversion of health-system inputs into the facility's availability of standard precaution items for infection control - to curb the risk of infectious disease transmission.
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Affiliation(s)
- Shariful Hakim
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
- Chander Hat Degree College, Nilphamari, Bangladesh
| | | | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
- Department of General Educational and Development, Daffodil International University, Dhaka, Bangladesh
| | - Hannah H Leslie
- Division of Prevention Science, Department of Medicine, University of California San Francisco (UCSF), San Francisco, California, USA
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Hossain MS, Ahmed TS, Sultana N, Chowdhury MAB, Uddin MJ. Examining the disparities of anti-malarial drug consumption among children under the age of five: a study of 5 malaria-endemic countries. Malar J 2023; 22:370. [PMID: 38049847 PMCID: PMC10696736 DOI: 10.1186/s12936-023-04805-x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/23/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Malaria is one of the most prominent illnesses affecting children, ranking as one of the key development concerns for many low- and middle-income countries (LMICs). There is not much information available on the use of anti-malarial drugs in LMICs in children under five. The study aimed to investigate disparities in anti-malarial drug consumption for malaria among children under the age of five in LMICs. METHODS This study used recent available cross-sectional data from the Malaria Indicator Survey (MIS) datasets across five LMICs (Guinea, Kenya, Mali, Nigeria, and Sierra Leone), which covered a portion of sub-Saharan Africa. The study was carried out between January 2, 2023, and April 15, 2023, and included children under the age of five who had taken an anti-malarial drug for malaria 2 weeks before the survey date. The outcome variable was anti-malarial drug consumption, which was classified into two groups: those who had taken anti-malarial drugs and those who had not. RESULTS In the study of LMICs, 32,397 children under five were observed, and among them, 44.1% had received anti-malarial drugs. Of the five LMICs, Kenya had the lowest (9.2%) and Mali had the highest (70.5%) percentages of anti-malarial drug consumption. Children under five with malaria are more likely to receive anti-malarial drugs if they are over 1 year old, live in rural areas, have mothers with higher education levels, and come from wealthier families. CONCLUSION The study emphasizes the importance of developing universal coverage strategies for anti-malarial drug consumption at both the national and local levels. The study also recommends that improving availability and access to anti-malarial drugs may be necessary, as the consumption of these drugs for treating malaria in children under the age of five is shockingly low in some LMICs.
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Affiliation(s)
- Md Sabbir Hossain
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh
| | - Talha Sheikh Ahmed
- Department of Geography and Environment, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh
| | - Nahid Sultana
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh
| | | | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh.
- Faculty of Graduate Studies, Daffodil International University, Savar, Dhaka, 1216, Bangladesh.
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Patel D, Dodd WS, Lucke‐Wold B, Chowdhury MAB, Hosaka K, Hoh BL. Neutrophils: Novel Contributors to Estrogen-Dependent Intracranial Aneurysm Rupture Via Neutrophil Extracellular Traps. J Am Heart Assoc 2023; 12:e029917. [PMID: 37889179 PMCID: PMC10727420 DOI: 10.1161/jaha.123.029917] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 08/22/2023] [Indexed: 10/28/2023]
Abstract
Background Intracranial aneurysms (IAs) are more prevalent in women than men, and aneurysmal subarachnoid hemorrhage disproportionately affects postmenopausal women. These sex differences suggest estrogen protects against IA progression that can lead to rupture, but the underlying mechanisms are not fully understood. Although studies have demonstrated estrogen regulates inflammatory processes that contribute to IA pathogenesis, the role of neutrophils remains to be characterized. Using a murine model, we tested our hypothesis that neutrophils contribute to IA pathophysiology in an estrogen-dependent manner. Methods and Results We compared neutrophil infiltration in C57BL/6 female mice that develop IAs to those with a normal circle of Willis. Next, we investigated the estrogen-dependent role of neutrophils in IA formation, rupture, and symptom-free survival using a neutrophil depletion antibody. Finally, we studied the role of neutrophil extracellular trap formation (NETosis) as an underlying mechanism of aneurysm progression. Mice that developed aneurysms had increased neutrophil infiltration compared with those with a normal circle of Willis. In estrogen-deficient female mice, both neutrophil depletion and NETosis inhibition decreased aneurysm rupture. In estrogen-deficient female mice treated with estrogen rescue and estrogen-intact female mice, neither neutrophil depletion nor NETosis inhibition affected IA formation, rupture, or symptom-free survival. Conclusions Neutrophils contribute to aneurysm rupture in an estrogen-dependent manner. NETosis appears to be an underlying mechanism for neutrophil-mediated IA rupture in estrogen deficiency. Targeting NETosis may lead to the development of novel therapeutics to protect against IA rupture in the setting of estrogen deficiency.
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Affiliation(s)
- Devan Patel
- Department of NeurosurgeryUniversity of FloridaGainesvilleFLUSA
| | - William S. Dodd
- Department of NeurosurgeryUniversity of FloridaGainesvilleFLUSA
| | | | | | - Koji Hosaka
- Department of NeurosurgeryUniversity of FloridaGainesvilleFLUSA
| | - Brian L. Hoh
- Department of NeurosurgeryUniversity of FloridaGainesvilleFLUSA
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Findlay MC, Grandhi R, Nelson JR, Lucke-Wold B, Chowdhury MAB, Hoh BL, Steinberg J, Santiago-Dieppa D, Khalessi A, Ikeda DS, Ravindra VM. How do children fare compared with adults? Comparing relative outcomes after thrombectomy for acute ischemic stroke due to large-vessel occlusion. J Stroke Cerebrovasc Dis 2023; 32:107350. [PMID: 37717373 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107350] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/25/2023] [Accepted: 09/07/2023] [Indexed: 09/19/2023] Open
Abstract
OBJECTIVE Safety and efficacy data for endovascular thrombectomy for acute ischemic stroke secondary to large-vessel occlusion in children are lacking compared with those for adults. We undertook an updated systematic review and meta-analysis of endovascular thrombectomy in children and compared their outcomes with adult data. METHODS We searched PubMed, Medline, and EMBASE databases to identify prospective and retrospective studies describing patients <18 years treated with endovascular thrombectomy for acute ischemic stroke due to large-vessel occlusion. RESULTS Eight pediatric studies were included (n = 192). Most patients were male (53.1 %), experienced anterior circulation large-vessel occlusion (81.8 %), and underwent endovascular thrombectomy by stent retreiver (70.7 %). The primary outcome was change in National Institutes of Health Stroke Scale score from presentation to 24 h after thrombectomy. Secondary outcomes included modified Rankin scale score improvement and 90-day score, recanalization rates, procedural complications, and mortality rates. After treatment, 88.5% of children had successful recanalization; the mean National Institutes of Health Stroke Scale score reduction was 7.37 (95 % CI 5.11-9.63, p < 0.01). The mean reduction of 6.87 (95 %CI 5.00-8.73, p < 0.01) for adults in 5 clinical trials (n = 634) was similar (Qb = 0.11; p = 0.74). Children experienced higher rates of good neurological outcome (76.1 % vs. 46.0 %, p < 0.01) and revascularization (88.5 % vs. 72.3 %, p < 0.01), fewer major periprocedural complications (3.6 % vs. 30.4 %, p < 0.01), and lower mortality (1.0 % vs. 12.9 %, p < 0.01). CONCLUSIONS Endovascular thrombectomy may be safe and effective treatment for acute ischemic stroke due to large-vessel occlusion in children. The aggregated data demonstrated high rates of revascularization, favorable long-term neurological outcomes, and low complication rates.
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Affiliation(s)
- Matthew C Findlay
- School of Medicine, University of Utah, 30 North 1900 East, Salt Lake City, UT 84132, USA
| | - Ramesh Grandhi
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Dr. E, Salt Lake City, UT 84132, USA
| | - Jayson R Nelson
- School of Medicine, University of Utah, 30 North 1900 East, Salt Lake City, UT 84132, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, 1505 SW Archer Rd., Gainesville, FL 32608, USA
| | | | - Brian L Hoh
- Department of Neurosurgery, University of Florida, 1505 SW Archer Rd., Gainesville, FL 32608, USA
| | - Jeffrey Steinberg
- Department of Neurosurgery, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA
| | - David Santiago-Dieppa
- Department of Neurosurgery, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA
| | - Alexander Khalessi
- Department of Neurosurgery, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA
| | - Daniel S Ikeda
- Department of Neurosurgery, Walter Reed National Military Medical Center, 4494 Palmer Rd. N, Bethesda, MD 20814, USA
| | - Vijay M Ravindra
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Dr. E, Salt Lake City, UT 84132, USA; Department of Neurosurgery, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA; Department of Neurological Surgery, Naval Medical Center San Diego, 34800 Bob Wilson Dr., San Diego, CA 92134, USA.
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Hossain MS, Islam MF, Arka PB, Rohman M, Ahmed TS, Ahammed T, Chowdhury MAB, Uddin MJ. Antibiotic prescription from qualified sources for children with fever/cough: cross-sectional study from 59 low- and middle-income countries. EClinicalMedicine 2023; 61:102055. [PMID: 37434742 PMCID: PMC10331812 DOI: 10.1016/j.eclinm.2023.102055] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/06/2023] [Accepted: 06/06/2023] [Indexed: 07/13/2023] Open
Abstract
Background Children in low and middle-income countries (LMICs) receive a staggering number of antibiotic prescriptions, many of which are inappropriate. We aimed to explore the proportion of antibiotic prescriptions from qualified sources of children under five who had a fever/cough in the two weeks prior to the survey in LMICs. Methods We used data from cross-sectional studies of the latest Demographic and Health Survey (DHS) datasets (n = 43,166) in 59 LMICs covering Sub-Saharan Africa, North Africa-West Asia-Europe, Central Asia, South & Southeast Asia, Oceania, and Latin America & the Caribbean regions. The study was conducted from March 2, 2020 to October 15, 2022. We only included the latest available surveys by country, and children under five who had taken antibiotics for fever/cough were included in the study. Finally, the outcome variable was classified into two distinct categories: those who had taken antibiotics from qualified sources and those who did not. Findings About three in four children (74.0%) received antibiotics from qualified sources. Tanzania (22.4%) and Malawi (99.9%) had the lowest and highest percentages of antibiotic prescriptions by qualified sources, respectively. Oceania had the highest percentage of qualified antibiotic prescriptions with 88.9% and Central Asia had the lowest percentage with 56.3%. Interpretation As unqualified sources of antibiotics for fever/cough in children under five were alarmingly high in some of the LMICs, the study emphasises the importance of nationwide efforts to regulate antibiotics prescriptions. Funding None.
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Affiliation(s)
- Md Sabbir Hossain
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh
| | - Md. Fakrul Islam
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh
| | - Prosenjit Basak Arka
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh
| | - Mahfuzer Rohman
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh
| | - Talha Sheikh Ahmed
- Department of Geography and Environment, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh
| | - Tanvir Ahammed
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh
| | | | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh
- Department of General Educational and Development, Daffodil International University, Dhaka, Bangladesh
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Haider N, Hasan MN, Khalil I, Tonge D, Hegde S, Chowdhury MAB, Rahman M, Hossain Khan M, Ansumana R, Zumla A, Uddin MJ. The 2022 dengue outbreak in Bangladesh: hypotheses for the late resurgence of cases and fatalities. J Med Entomol 2023:7172758. [PMID: 37202843 DOI: 10.1093/jme/tjad057] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/02/2023] [Accepted: 05/10/2023] [Indexed: 05/20/2023]
Abstract
Bangladesh reported the highest number of annual deaths (n = 281) related to dengue virus infection in 2022 since the virus reappeared in the country in 2000. Earlier studies showed that >92% of the annual cases occurred between the months of August and September. The 2022 outbreak is characterized by late onset of dengue cases with unusually higher deaths in colder months, that is, October-December. Here we present possible hypotheses and explanations for this late resurgence of dengue cases. First, in 2022, the rainfall started late in the season. Compared to the monthly average rainfall for September and October between 2003 and 2021, there was 137 mm of additional monthly rainfall recorded in September and October 2022. Furthermore, the year 2022 was relatively warmer with a 0.71°C increased temperature than the mean annual temperature of the past 20 yr. Second, a new dengue virus serotype, DENV-4, had recently reintroduced/reappeared in 2022 and become the dominant serotype in the country for a large naïve population. Third, the post-pandemic return of normalcy after 2 yr of nonpharmaceutical social measures facilitates extra mosquito breeding habitats, especially in construction sites. Community engagement and regular monitoring and destruction of Aedes mosquitoes' habitats should be prioritized to control dengue virus outbreaks in Bangladesh.
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Affiliation(s)
- Najmul Haider
- School of Life Sciences, Faculty of Natural Sciences, Keele University, Staffordshire ST5 5BG, UK
| | - Mohammad Nayeem Hasan
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh
| | - Ibrahim Khalil
- Department of Livestock Services, Ministry of Fisheries and Livestock, Dhaka, Bangladesh
| | - Daniel Tonge
- School of Life Sciences, Faculty of Natural Sciences, Keele University, Staffordshire ST5 5BG, UK
| | - Shivanand Hegde
- School of Life Sciences, Faculty of Natural Sciences, Keele University, Staffordshire ST5 5BG, UK
| | | | - Mahbubur Rahman
- Department of Pathobiology and Population Sciences, The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, UK
- Institute of Epidemiology, Disease Control and Research (IEDCR), Ministry of Health and Family Welfare, Mohakhali, Dhaka, Bangladesh
| | - Manjur Hossain Khan
- Institute of Epidemiology, Disease Control and Research (IEDCR), Ministry of Health and Family Welfare, Mohakhali, Dhaka, Bangladesh
| | - Rashid Ansumana
- Department of Community Health and Clinical Studies, School of Community Health Sciences, Njala University, Bo City, Sierra Leone
| | - Alimuddin Zumla
- Division of Infection and Immunity, Centre for Clinical Microbiology, University College London and NIHR-BRC, University College London Hospitals, London, UK
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh
- Department of General Educational and Development, Daffodil International University, Dhaka, Bangladesh
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Hasan MN, Babu MR, Chowdhury MAB, Rahman MM, Hasan N, Kabir R, Uddin MJ. Early childhood developmental status and its associated factors in Bangladesh: a comparison of two consecutive nationally representative surveys. BMC Public Health 2023; 23:687. [PMID: 37046226 PMCID: PMC10099688 DOI: 10.1186/s12889-023-15617-8] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/06/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Inadequate cognitive and socio-emotional development in children leads to physical and mental illness. We aimed to investigate the status of early childhood development (ECD) and its associated factors. Additionally, aimed to compare the changes of significantly associated factors using two multiple indicator cluster surveys (MICS) in Bangladesh. METHODS We used data from the Multiple Indicator Cluster Surveys (MICS) 2012 and 2019 nationally representative surveys. A total of 17,494 children aged 36-59 months were included in the analysis. The outcome variable was ECD status: either developmentally on-track or not. We used bivariable analysis and crude and adjusted multivariable logistic models to assess the ECD status and its associated factors. RESULTS Comparing both MICS surveys, the overall and individual domains of ECD status improved from 2012 (65.46%) to 2019 (74.86%), and the indicators of child literacy-numeracy domain improved from 21.2 to 28.8%, physical domain improved from 92.2 to 98.4%, and social-emotional domain improved from 68.4 to 72.7%. The learning approach domain was 87.5% in 2012 and increased to 91.4% in 2019. According to the adjusted logistic model in both surveys (2012 and 2019), the age of 4 years had an adjusted odds ratio (AOR) of 1.61 and 1.78 times higher developmentally on track than the age of 3. Female children were 1.42 (in 2012) and 1.44 (in 2019) times more developmentally on track than males. Compared to mothers with only primary education, children raised by mothers with secondary or higher education were 1.77 and 1.50 times more on track in their development. Moreover, Children from affluent families had 1.32- and 1.26 times higher odds- on track than those from the poorest families. Families with books had 1.50 and 1.53 times higher developmentally on track than their counterparts. CONCLUSION AND RECOMMENDATION In summary, our study shows that the overall ECD status improved between MICS 2012 and MICS 2019. Important factors influence ECD status, including early childhood education programs, families' possession of children's books, mothers' educational level, and wealth index. The findings of our study will help making necessary public health-related initiatives in Bangladesh to improve ECD program.
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Affiliation(s)
- Mohammad Nayeem Hasan
- Department of Statistics, Shahjalal University of Science and Technology, 3114, Sylhet, Bangladesh
| | - Md Rashed Babu
- Department of Statistics, Shahjalal University of Science and Technology, 3114, Sylhet, Bangladesh
| | | | | | - Nafiul Hasan
- Department of Statistics, Shahjalal University of Science and Technology, 3114, Sylhet, Bangladesh
| | - Russell Kabir
- School of Allied Health, Anglia Ruskin University, Essex, UK
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science and Technology, 3114, Sylhet, Bangladesh.
- Department of General Educational Development (GED), Daffodil International University, Dhaka, Bangladesh.
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Ahmed NU, Chowdhury MAB, Rodriguez A, Azim SI, Taskin T, Ahmed S. Disparities in Compliance with Colorectal Cancer Screening: Evidence from Two US National Surveys. Asian Pac J Cancer Prev 2023; 24:1173-1180. [PMID: 37116138 DOI: 10.31557/apjcp.2023.24.4.1173] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Indexed: 04/30/2023] Open
Abstract
OBJECTIVE Colorectal cancer (CRC) is the most preventable cancer if adherence to its screening guidelines through compliance with physician recommendations are met. Lack of access to care is the most significant barrier which was decreased by the Affordable Care Act (ACA), that may influence healthcare behaviors/practices. The aim of this study was to determine the factors affecting compliance with recommendations for CRC screening between two US National Health Interview Surveys (NHIS) in 2010 and 2015. METHODS We used individual data of adults aged ≥50 years from the Cancer Module of NHIS that repeats every-5-years. Multiple logistic regression analyses were employed to identify the compliance associated factors and their changes after five years. RESULTS We included final data of 1,553 and 2259 and individual from 2010 and 2015, respectively. Overall, compliance to physician recommendations for colorectal cancer was 85.70% in 2010 and 81.54%. Men compiled more in 2010 than women which was reversed in 2015. The multivariable-adjusted odds of compliance were increased with age; lower for female [Odds ratio (OR)= 0.45 Confidence Interval (CI 95% 0.27, 0.75), having a family history of CRC [OR=3.05 CI:1.02, 9.05], having insurance [OR 3.58 CI:1.4, 9.12], and Odds increased with the number of doctor visit in 2010. However, in 2015 the odds were substantially increased with the increasing age, reversed odds for female [OR= 3.49 CI: 1.67, 7.29)], increased for non-Hispanic Blacks [OR= 4.87 CI: 2.05, 11.55] and lower for Asian [OR=0.33 CI:0.15, 0.74], higher for family history of colorectal cancer [OR=3.31 CI:1.92, 5.69]. Although insurance coverage and the number of doctor visits were significant predictors of compliance in 2010, those became non-significant in 2015. CONCLUSIONS Compliance disparities by gender and access to healthcare either reduced in strength or reversed between 2010 and 2015. The non-Hispanic Black significantly higher in compliance than other race-ethnicities in 2015.
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Affiliation(s)
- Nasar U Ahmed
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
| | | | - Anny Rodriguez
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
| | - Syeda Ishra Azim
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Tanjila Taskin
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
| | - Shyfuddin Ahmed
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
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13
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Hasan MN, Tambuly S, Trisha KF, Haque MA, Chowdhury MAB, Uddin MJ. Knowledge of HIV/AIDS among married women in Bangladesh: analysis of three consecutive multiple indicator cluster surveys (MICS). AIDS Res Ther 2022; 19:68. [PMID: 36577995 PMCID: PMC9795636 DOI: 10.1186/s12981-022-00495-8] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 12/19/2022] [Indexed: 12/29/2022] Open
Abstract
Married women have a higher risk of contracting human immunodeficiency virus (HIV) or develop acquired immune deficiency syndrome (AIDS) than men. Knowledge of HIV/AIDS contributes significantly to describing the prevalence and consequences of such virus/disease. The study aimed to investigate the level of HIV/AIDS knowledge and the socio-demographic variables that influence HIV/AIDS knowledge among married women in Bangladesh. We used three waves of Multiple Indicator Cluster Survey (MICS), which included 33,843, 20,727, and 29,724 married women from 2006, 2012, and 2019 MICS. A score was prepared through their interrogation to determine the level of knowledge and logistic regression models were used for analyzing the data. This study found that the prevalence of knowledge level of HIV/AIDS in different questions increased from 55.20% in 2006 to 58.69% in 2019. In our study, respondents having highest education had 4.03 (95% CI 3.50-4.64) times more chance to obtain "High Score" in 2019 MICS which is 5.30 times in 2012 MICS (95% CI 4.41-6.37) and 2.58 times in 2006 MICS (95% CI 2.28-2.93) compared to illiterate married women. Moreover, respondents from urban area were 1.13 times more likely to obtain "High Score" in 2019 MICS which is 1.14 times in 2012 MICS and 1.16 times in 2006 MICS, respectively than the rural married women. This study also found respondent's age, division, mass media access, and wealth status have played an important role in HIV/AIDS knowledge. Although a significant proportion of women had adequate knowledge of HIV/AIDS, more knowledge is still required to protect against such viruses/diseases. Thus, we advocate for the implementation of educational program in the curriculum, counselling, particularly in rural areas, and mass media access to ensure quality knowledge throughout the country.
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Affiliation(s)
- Mohammad Nayeem Hasan
- grid.412506.40000 0001 0689 2212Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| | - Sumi Tambuly
- grid.412506.40000 0001 0689 2212Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| | - Kaniz Fatema Trisha
- grid.412506.40000 0001 0689 2212Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| | - Md. Ashiqul Haque
- grid.21613.370000 0004 1936 9609Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Muhammad Abdul Baker Chowdhury
- grid.15276.370000 0004 1936 8091Department of Neurosurgery, University of Florida College of Medicine, Gainesville, FL USA
| | - Md Jamal Uddin
- grid.412506.40000 0001 0689 2212Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh ,grid.442989.a0000 0001 2226 6721Department of General Educational Development (GED), Daffodil International University, Dhaka, Bangladesh
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14
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Anjum A, Ahammed T, Hasan MM, Chowdhury MAB, Uddin MJ. Mother's functional difficulty is affecting the child functioning: Findings from a nationally representative MICS 2019 cross-sectional survey in Bangladesh. Health Sci Rep 2022; 6:e1023. [PMID: 36582634 PMCID: PMC9793826 DOI: 10.1002/hsr2.1023] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 12/09/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022] Open
Abstract
Background Functional difficulties in children can be transmitted from mother to child, which is a major concern. We sought to determine whether there was a correlation between a mother's functional difficulty and functional difficulty in kids between the ages of 2-4 and 5-17. We also want to evaluate other fundamental aspects that influence on child's functionality. Methods We used Multiple Indicator Cluster Survey (MICS) data sets. For two different age groups, the children's difficulty status was evaluated. The sociodemographic factors served as explanatory variables in this study. We used χ 2 tests and survey logistic regression models to analyze the data. Results Functional difficulties were less common in children aged 2-4 years (2.78%) but 8.27% in those aged 5-17 years. The study specifies that the mother's functional difficulty (odds ratio [OR]: 2.66, confidence interval [CI]: 1.35-5.24 for children aged 2-4 years and OR: 3.36, CI: 2.80-4.03 for children aged 5-17 years) were significantly associated with the functional difficulty of both age groups' children. Not attending early childhood education programs (OR: 1.89, CI: 1.16-3.10 for children aged 2-4 years and OR: 2.66, CI: 2.19-3.22 for children aged 5-17 years) and divisions were also significantly affecting the functional difficulty of both age groups' children. Moreover, area of residence and gender were significant factors for the older age group. Conclusions The prevalence of difficulty among children in Bangladesh is high. Children's functional difficulty, regardless of age, is greatly influenced by the functional difficulty of their mothers, their absence from early childhood education programs, and divisions. Reducing the prevalence of child functioning difficulties will be more successful if the government and NGOs consider these factors while developing appropriate intervention programs.
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Affiliation(s)
- Aniqua Anjum
- Department of StatisticsShahjalal University of Science and TechnologySylhetBangladesh
| | - Tanvir Ahammed
- Department of StatisticsShahjalal University of Science and TechnologySylhetBangladesh
| | - Md Mahedi Hasan
- Faculty of Business StudiesBangladesh University of Professionals (BUP)DhakaBangladesh,Department of Mathematics and StatisticsWashington State UniversityPullmanWashingtonUSA
| | - Muhammad Abdul Baker Chowdhury
- Department of StatisticsShahjalal University of Science and TechnologySylhetBangladesh,Department of NeurosurgeryUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Md. Jamal Uddin
- Department of StatisticsShahjalal University of Science and TechnologySylhetBangladesh,Department of General Educational Development (GED)Daffodil International UniversityDhakaBangladesh
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Deleyrolle P, Dagra A, Mohamed S, Chowdhury MAB, McGrew N, Rahman M. QOL-05. OPIATE UTILIZATION AND PREDICTIVE FACTORS IN PATIENTS UNDERGOING SURGERY FOR GLIOMAS. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac209.933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
INTRODUCTION
Opiate dependence is a national crisis. The use of opiate in patients diagnosed with gliomas undergoing surgery is not well understood.
OBJECTIVE
The objective of this study was to evaluate opiate use in patients undergoing surgery for gliomas and risk factors for prolonged opiate use.
METHODS
A retrospective chart review was conducted on patients ≥ 18 years who underwent surgery for glioma from 1/2016 to 1/2020. Clinical data was collected and opiate dose was calculated as morphine equivalent dose (MED). Clinical data prior to surgery, during surgery, and post-operative setting were collected. Descriptive statistics (means, frequencies, and percentages) were used to characterize the study population. Chi-square, with Fisher’s exact test, was used to determine associations for categorical variables. Linear and negative binomial regression models were used to predict MED doses with patient characteristics.
RESULTS
180 patients were included in the analysis. The median MED at the time of surgery was 23.5 (IQR: 1.6, 72.5). 57 patients (46.04%) continued to take opiates after surgery. During adjuvant treatment the median MED was 45 (IQR: 45- 45) and the median length patients remaining on opiates was 59 days (IQR: 33- 168.5), with the longest usage being 1459 days. History of substance use, chronic headaches and other pain syndromes were not associated with increased use of opiates at the time of surgery. However, these factors were associated with higher morphine use after surgery. Male had a slightly higher dose (< 0.001) at the time of surgery compared to women. Peri-operative use at the time of surgery did not predict the MED and length of opiate use as outpatient.
CONCLUSION
Nearly half of the patients continued to use opiate beyond the peri-operative setting as outpatient at a higher median MED on median period of 59 days suggesting opportunities for improvement in opiate management post operatively.
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Affiliation(s)
| | - Abeer Dagra
- University of Florida , Gainesville, FL , USA
| | | | | | - Nina McGrew
- University of Florida , Gainesville, FL , USA
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Murphy TW, Cohen SA, Hwang CW, Avery KL, Balakrishnan MP, Balu R, Chowdhury MAB, Crabb DB, Elmelige Y, Maciel CB, Gul SS, Han F, Becker TK. Cardiac arrest: An interdisciplinary scoping review of clinical literature from 2020. J Am Coll Emerg Physicians Open 2022; 3:e12773. [PMID: 35845142 PMCID: PMC9282171 DOI: 10.1002/emp2.12773] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 05/15/2022] [Accepted: 06/02/2022] [Indexed: 11/08/2022] Open
Abstract
Objectives The Interdisciplinary Cardiac Arrest Research Review (ICARE) group was formed in 2018 to conduct an annual search of peer-reviewed literature relevant to cardiac arrest. Now in its third year, the goals of the review are to highlight annual updates in the interdisciplinary world of clinical cardiac arrest research with a focus on clinically relevant and impactful clinical and population-level studies from 2020. Methods A search of PubMed using keywords related to clinical research in cardiac arrest was conducted. Titles and abstracts were screened for relevance and sorted into 7 categories: Epidemiology & Public Health Initiatives; Prehospital Resuscitation, Technology & Care; In-Hospital Resuscitation & Post-Arrest Care; Prognostication & Outcomes; Pediatrics; Interdisciplinary Guidelines & Reviews; and a new section dedicated to the coronavirus disease 2019 (COVID-19) pandemic. Screened manuscripts underwent standardized scoring of methodological quality and impact on the respective fields by reviewer teams lead by a subject matter expert editor. Articles scoring higher than 99 percentiles by category were selected for full critique. Systematic differences between editors' and reviewers' scores were assessed using Wilcoxon signed-rank test. Results A total of 3594 articles were identified on initial search; of these, 1026 were scored after screening for relevance and deduplication, and 51 underwent full critique. The leading category was Prehospital Resuscitation, Technology & Care representing 35% (18/51) of fully reviewed articles. Four COVID-19 related articles were included for formal review that was attributed to a relative lack of high-quality data concerning cardiac arrest and COVID-19 specifically by the end of the 2020 calendar year. No significant differences between editor and reviewer scoring were found among review articles (P = 0.697). Among original research articles, section editors scored a median 1 point (interquartile range, 0-3; P < 0.01) less than reviewers. Conclusions Several clinically relevant studies have added to the evidence base for the management of cardiac arrest patients including methods for prognostication of neurologic outcome following arrest, airway management strategy, timing of coronary intervention, and methods to improve expeditious performance of key components of resuscitation such as chest compressions in adults and children.
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Affiliation(s)
- Travis W. Murphy
- Division of Critical Care MedicineDepartment of Emergency MedicineUniversity of FloridaGainesvilleFloridaUSA
- Cardiothoracic Critical CareMiami Transplant InstituteUniversity of MiamiMiamiFloridaUSA
- Department of Emergency MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Scott A. Cohen
- Department of Emergency MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Charles W. Hwang
- Department of Emergency MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - K. Leslie Avery
- Division of Pediatric Critical CareDepartment of PediatricsUniversity of FloridaGainesvilleFloridaUSA
| | | | - Ramani Balu
- Division of Neurocritical CareDepartment of NeurologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | | | - David B. Crabb
- Department of Emergency MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Yasmeen Elmelige
- Department of Emergency MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Carolina B. Maciel
- Division of Neurocritical CareDepartment of NeurologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Department of NeurologyYale UniversityNew HavenConnecticutUSA
- Division of Neurocritical CareDepartment of NeurologyUniversity of FloridaGainesvilleFloridaUSA
| | - Sarah S. Gul
- Department of SurgeryYale UniversityNew HavenConnecticutUSA
| | - Francis Han
- Department of Emergency MedicineUniversity of FloridaGainesvilleFloridaUSA
- Lake Erie College of Osteopathic MedicineBradentonFloridaUSA
| | - Torben K. Becker
- Division of Critical Care MedicineDepartment of Emergency MedicineUniversity of FloridaGainesvilleFloridaUSA
- Department of Emergency MedicineUniversity of FloridaGainesvilleFloridaUSA
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Hakim S, Chowdhury MAB, Ahmed Z, Uddin MJ. Are Bangladeshi healthcare facilities prepared to provide antenatal care services? Evidence from two nationally representative surveys. PLOS Glob Public Health 2022; 2:e0000164. [PMID: 36962302 PMCID: PMC10021659 DOI: 10.1371/journal.pgph.0000164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 06/17/2022] [Indexed: 06/18/2023]
Abstract
Identifying high-risk pregnancies through antenatal care (ANC) is considered the cornerstone to eliminating child deaths and improving maternal health globally. Understanding the factors that influence a healthcare facility's (HCF) preparedness to provide ANC service is essential for assisting maternal and newborn health system progress. We aimed to evaluate the preparedness of HCFs to offer ANC services among childbearing women in Bangladesh and investigate the facility characteristics linked to the preparedness. The data for this study came from two waves of the Bangladesh Health Facilities Survey (BHFS), conducted in 2014 and 2017 using a stratified random sample of facilities. The study samples were 1,508 and 1,506 HCFs from the 2014 and 2017 BHFS, respectively. The outcome variable "ANC services preparedness" was calculated as an index score using a group of tracer indicators. Multinomial logistic regression models were used to identify the significant correlates of ANC service preparedness. We found that private hospitals had a lower chance of having high preparedness than district and upazila public facilities in 2014 (RRR = 0.04, 95% CI: 0.01-0.22, p-value = <0.001) and 2017 (RRR = 0.23, 95% CI: 0.07-0.74, p-value = 0.01), respectively. HCFs from the Khulna division had a 2.84 (RRR = 2.84, CI: 1.25-6.43, p-value = 0.01) and 3.51 (RRR = 3.51, CI: 1.49-8.27, p-value = <0.001) higher likelihood of having medium and high preparedness, respectively, for ANC service compared to the facilities in the Dhaka division in 2017. The facilities that had a medium infection prevention score were 3.10 times (RRR = 3.10, 95% CI: 1.65-5.82; p-value = <0.001) and 1.89 times (RRR = 1.89, 95% CI: 1.09-3.26, p-value = 0.02) more likely to have high preparedness compared to those facilities that had a low infection prevention score in 2014 and 2017 respectively. Facilities without visual aids for client education on pregnancy and ANC were less likely to have high (RRR = 0.29, 95% CI: 0.16-0.53, p-value = <0.001) and (RRR = 0.55, 95% CI: 0.30-0.99, p-value = 0.04) preparedness, respectively, than those with visual aids for client education on pregnancy and ANC in both the surveys. At all two survey time points, facilities that did not maintain individual client cards or records for ANC clients were less likely to have high (RRR = 0.53, 95% CI: 0.31-.92, p-value = 0.02) and (RRR = 0.41, 95% CI: 0.25-0.66, p-value = <0.001) preparedness, respectively, compared to their counterparts. We conclude that most facilities lack adequate indicators for ANC service preparedness. To improve the readiness of ANC services, government authorities could focus on union-level facilities, community clinics, private facilities, and administrative divisions. They could also make sure that infection control items are available, maintain individual client cards or records for ANC clients, and also ensure ANC clients have access to visual aids.
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Affiliation(s)
- Shariful Hakim
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
- Chander Hat Degree College, Nilphamari, Bangladesh
| | | | - Zobayer Ahmed
- Department of Economics, Selcuk University, Selçuklu, Turkey
- Department of Economics & Banking, International Islamic University Chittagong, Kumira, Bangladesh
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
- Department of General Educational and Development, Daffodil International University, Dhaka, Bangladesh
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Laurent D, Lucke-Wold B, Dodd WS, Martinez M, Chowdhury MAB, Hosaka K, Motwani K, Hoh B. Combination release of chemokines from coated coils to target aneurysm healing. J Neurointerv Surg 2022:neurintsurg-2022-018710. [PMID: 35609975 PMCID: PMC10116990 DOI: 10.1136/neurintsurg-2022-018710] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/13/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Monocyte chemoattractant protein 1 (MCP-1) and osteopontin (OPN) have been identified separately as key mediators of the aneurysm healing process following coil embolization in the rodent model. The ability of protein coated coils to accelerate this process is currently unknown.To create coils coated with both MCP-1 and OPN to target aneurysm healing. METHODS We uses a polymer (poly(glycolide-co-caprolactone)) (Rao pharmaceuticals) (CG910) to test whether coils could be dual coated with active proteins with sequential reliable release. Coils were coated with poly-DL-lactic glycolic acid (PLGA), CG910, and subsequently dipped with protein OPN (inner layer for delayed release) and MCP-1 (outer layer for initial release). Release assays were used to measure protein elution from coils over time. To test in vivo feasibility, coated coils were implanted into carotid aneurysms to determine the effect on aneurysm healing. RESULTS The in vitro protein release assay demonstrated, a significant amount of OPN and MCP-1 release within 2 days. Using a 200 µg/µL solution of MCP-1 in phosphate-buffered saline, we showed that CG910 coated coils provide effective release of MCP over time. In the carotid aneurysm model, MCP-1 and OPN coated coils significantly increased tissue ingrowth (74% and 80%) compared with PLGA and CG910 coated coils alone (58% and 53%). To determine synergistic impact of dual coating, we measured ingrowth for MCP-1/OPN coils (63%) as well as overlap coefficients for NOX4 and NFκB with CD31. CONCLUSIONS This study demonstrates that MCP-1 and OPN coated coils are viable and may promote early aneurysm healing. Dual coated coils may have synergistic benefit given different location of protein interaction measured in vivo. Further work is warranted.
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Affiliation(s)
- Dimitri Laurent
- Lillian S Wells Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Brandon Lucke-Wold
- Lillian S Wells Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - William S Dodd
- Lillian S Wells Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Melanie Martinez
- Lillian S Wells Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | | | - Koji Hosaka
- Lillian S Wells Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Kartik Motwani
- Lillian S Wells Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Brian Hoh
- Lillian S Wells Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
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Hakim S, Chowdhury MAB, Ahmed NU, Uddin MJ. The availability of essential medicines for diabetes at health facilities in Bangladesh: evidence from 2014 and 2017 national surveys. BMC Health Serv Res 2022; 22:377. [PMID: 35317808 PMCID: PMC8941751 DOI: 10.1186/s12913-022-07738-4] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 03/01/2022] [Indexed: 11/12/2022] Open
Abstract
Background Bangladesh ranks among the world’s top ten countries in the number of diabetic patients. The prevention of this disease requires treating patients with essential medicines, and the first crucial step in the uptake of these medicines is availability. We aimed to assess the availability of essential medicines for diabetes (EM-Diabetes) and to explore health facility characteristics associated with the availability of those medicines. Methods We performed the analysis using nationally representative data from the two waves of the cross-sectional Bangladesh Health Facility Survey (BHFS) in 2014 and 2017. Data are available for 1548 and 1524 health facilities in the 2014 and 2017 BHFS. Study samples of this study were 217 facilities (73 from 2014 and 144 from 2017) that offer diabetes diagnosis and treatment services. The outcome variable ‘EM-Diabetes availability’ was calculated as a counting score of the tracer medicines: metformin, glibenclamide, injectable insulin, and injectable glucose solution. A multivariable Poisson regression model was used to identify the health facility characteristics (such as, managing authority, location, external supervision, regular quality assurance activities, national guidelines for diagnosis and management of diabetes, etc.) associated with EM-Diabetes availability. Results Since 2014, there have been minimal increases in Bangladeshi health facilities that provide diabetes screening and treatment services (from 4.7% to 9.4%). Among facilities offering diabetes services, 64.5% (BHFS 2014) and 55.7% (BHFS 2017) facilities had no EM-Diabetes on-site at all. Between 2014 and 2017, the availability of metformin increased (from 27.5% to 40.1%), but there was a decrease in the availability of glibenclamide (from 16.5% to 9.1%), injectable insulin (from 20.4% to 11.4%), and injectable glucose solution (from 20.4% to 19.2%). Furthermore, publicly owned facilities [relative risk (RR) = 0.44, 95% confidence interval (CI): 0.25–0.78 for 2014 and RR= 0.54, 95% CI: 0.41–0.71 for 2017] and facilities in rural settings [RR= 0.26, 95% CI: 0.12–0.55 for 2014 and RR= 0.60, 95% CI: 0.44–0.81 for 2017] were significantly associated with decreased availability of EM-Diabetes in both survey years. Moreover, routine user fees [RR=3.70, 95% CI: 1.86–7.38] and regular quality assurance activities [RR= 1.62, 95% CI: 1.12–2.34] were also significantly associated with increased EM-Diabetes availability in 2017 only. Conclusions Overall, the health facilities in Bangladesh had insufficient essential medicines for treating diabetes. In general, the availability of EM-Diabetes declined from 2014 to 2017, except for metformin. Policymakers should consider a wide range of policy implications, focusing on the management of public facilities, rural facilities, routine user fees, and quality assurance activities to improve the availability of EM-Diabetes at health facilities in Bangladesh.
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Affiliation(s)
- Shariful Hakim
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, 3114, Bangladesh.,Chander Hat Degree College, Nilphamari, Bangladesh
| | | | - Nasar U Ahmed
- Department of Epidemiology, Florida International University, Miami, FL, USA
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, 3114, Bangladesh.
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Murphy TW, Snipes G, Chowdhury MAB, McCall-Wright P, Aleong E, Taylor N, Messina MM, Carrazana G, Maciel CB, Becker TK. Review of novel therapeutics in cardiac arrest (ReNTICA): systematic review protocol. BMJ Open 2022; 12:e053304. [PMID: 34980619 PMCID: PMC8724734 DOI: 10.1136/bmjopen-2021-053304] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Cardiac arrest remains a common and devastating cause of death and disability worldwide. While targeted temperature management has become standard of care to improve functional neurologic outcome, few pharmacologic interventions have shown similar promise. METHODS/ANALYSIS This systematic review will focus on prospective human studies from 2015 to 2020 available in PubMed, Web of Science and EMBASE with a primary focus on impact on functional neurologic outcome. Prospective studies that include pharmacologic agents given during or after cardiac arrest will be included. Study selection will be in keeping with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. If sufficient data involving a given agent are available, a meta-analysis will be conducted and compared with current evidence for therapies recommended in international practice guidelines. ETHICS AND DISSEMINATION Formal ethical approval will not be required as primary data will not be collected. The results will be disseminated through peer-reviewed publication, conference presentation and lay press. PROSPERO REGISTRATION NUMBER International Prospective Register for Systematic Reviews (CRD42021230216).
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Affiliation(s)
- Travis W Murphy
- Department of Emergency Medicine, University of Florida, Gainesville, Florida, USA
| | - Garrett Snipes
- Internal Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
| | | | - Patti McCall-Wright
- Health Science Center Libraries, University of Florida Clinical and Translational Science Institute (CTSI), Gainesville, Florida, USA
| | | | | | | | | | - Carolina B Maciel
- Neurology and Neurosurgery, University of Florida Health, Gainesville, Florida, USA
| | - Torben K Becker
- Emergency Medicine, University of Florida Health, Gainesville, Florida, USA
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21
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Johnston B, Leung A, Jones J, Chowdhury MAB, Hwang C, Fitzpatrick D, Meurer D, Buck A, Becker T. 1355: MEDICATION-FACILITATED ADVANCED AIRWAY MANAGEMENT WITH FIRST-LINE USE OF A SUPRAGLOTTIC DEVICE. Crit Care Med 2022. [DOI: 10.1097/01.ccm.0000811744.86016.d9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Hakim S, Chowdhury MAB, Haque MA, Ahmed NU, Paul GK, Uddin MJ. The availability of essential medicines for cardiovascular diseases at healthcare facilities in low- and middle-income countries: The case of Bangladesh. PLOS Glob Public Health 2022; 2:e0001154. [PMID: 36962886 PMCID: PMC10021517 DOI: 10.1371/journal.pgph.0001154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 10/24/2022] [Indexed: 11/29/2022]
Abstract
Long-term, often lifelong care for cardiovascular disease (CVD) patients requires consistent use of medicine; hence, the availability of essential medicine for CVD (EM-CVD) is vital for treatment, quality of life, and survival. We aimed to assess the availability of EM-CVD and explore healthcare facility (HCF) characteristics associated with the availability of those medicines in Bangladesh. This study utilized publicly available cross-sectional data from the 2014 and 2017 waves of the Bangladesh Health Facilities Survey (BHFS). The analysis included 204 facilities (84 from the 2014 BHFS and 120 from the 2017 BHFS) that provide CVD diagnosis and treatment services. The outcome variable "EM-CVD availability" was calculated as a counting score of the following tracer medicines: angiotensin-converting enzyme (ACE) inhibitors (enalapril), thiazide, beta-blockers (atenolol), calcium channel blockers (amlodipine and nifedipine), aspirin, and simvastatin/atorvastatin. A multivariable Poisson regression model was used to identify the HCF characteristics associated with EM-CVD availability. The number of Bangladeshi HCFs that provide CVD screening and treatment services increased just a little between 2014 and 2017 (from 5.4% to 7.9%). Since 2014, there has been an increase in the availability of calcium channel blockers (from 37.5% to 38.5%), aspirin (from 25.3% to 27.9%), and simvastatin/atorvastatin (from 8.0% to 30.7%), whereas there has been a decrease in the availability of ACE inhibitors (enalapril) (from 12.5% to 6.5%), thiazide (from 15.7% to 11.1%), and beta-blockers (from 42.5% to 32.5%). The likelihood of EM-CVD being available was higher among private and urban facilities than among public and rural facilities. Furthermore, facilities that had 24-hour staff coverage and performed quality assurance activities had a higher chance of having EM-CVD available than those that did not have 24-hour staff coverage and did not undertake quality assurance activities. Government authorities should think about a wide range of policy implications, such as putting more emphasis on public and rural facilities, making sure staff is available 24 hours a day, and performing quality assurance activities at facilities to make EM-CVD more available.
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Affiliation(s)
- Shariful Hakim
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
- Chander Hat Degree College, Nilphamari, Bangladesh
| | | | - Md Ashiqul Haque
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Nasar U Ahmed
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, Florida, United States of America
| | - Gowranga Kumar Paul
- Department of Statistics, Mawlana Bhashani Science and Technology University, Santosh, Tangail, Bangladesh
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
- Department of General Educational and Development, Daffodil International University, Dhaka, Bangladesh
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23
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Huesgen KW, Elmelige YO, Yang Z, Chowdhury MAB, Gul S, Maciel CB, Elie-Turenne MC, Becker TK, Cohen SA, Holland A, Montero C, Zhu T, Wang KK, Tyndall JA. Ultra-early serum concentrations of neuronal and astroglial biomarkers predict poor neurological outcome after out-of-hospital cardiac arrest-a pilot neuroprognostic study. Resusc Plus 2021; 7:100133. [PMID: 34223394 PMCID: PMC8244405 DOI: 10.1016/j.resplu.2021.100133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/27/2021] [Accepted: 04/24/2021] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES To assess ultra-early neuroprognostic significance of GFAP, NF-L, UCH-L1, tau, and S100B concentrations, change trajectory, and combination profile after Out-of-Hospital Cardiac Arrest (OHCA). METHODS Prospective enrollment of 22 OHCA and 10 control patients at an academic tertiary care center between May 1, 2017 and January 28, 2020. Blood was collected within one hour of return of spontaneous circulation (ROSC) (H0), at hours 6 (H6), 12, 18, 24, and daily or until discharge or death. Biomarker concentrations, multifactor score, and trajectory change were assessed and compared to final neurologic status (good vs poor Cerebral Performance Category; CPC 1-2 vs CPC 3-5, respectively). RESULTS 10 patients had good and 12 had poor neurologic outcomes. Poor outcome patients had higher biomarker concentrations and combined biomarker scores at early time points. The earliest significant difference between good and poor outcome patients' serum biomarkers were at H12 for GFAP (good median: 425 pg/mL [IQR:370-630] vs poor: 5954[1712-65,055] pg/mL; p < 0.001), H12 for NF-L (64[41-69] vs 898[348-1990] pg/mL; p < 0.001), H0 for Tau (31[8-51] vs 124[53-238] pg/mL; p = 0.025), H0 for UCH-L1 (898[375-1600] vs 2475[1898-4098] pg/mL; p = 0.008), and H6 for S100B (123[70-290] vs 895[360-1199] pg/mL; p = 0.002). Four biomarker composite scores differed by H12 (78.03[52.03-111.25] vs 749 [198.46-4870.63] pg/mL; p = 0.003). Machine-learning approach also identified that four-marker score trajectory group memberships are in concordance with patient outcome. CONCLUSIONS Ultra-early serial serum concentrations of neuronal and astroglial biomarkers may be of neuroprognostic significance following OHCA.
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Affiliation(s)
- Karl W. Huesgen
- Department of Emergency Medicine, University of Florida, 1329 SW 16 Street, Gainesville, FL 32608, USA
| | - Yasmeen O. Elmelige
- Department of Emergency Medicine, University of Florida, 1329 SW 16 Street, Gainesville, FL 32608, USA
| | - Zhihui Yang
- Program for Neurotrauma, Neuroproteomics & Biomarker Research, McKnight Brain Institute, University of Florida, 1149 Newell Drive, Gainesville, FL 32610, USA
| | | | - Sarah Gul
- Department of Emergency Medicine, University of Florida, 1329 SW 16 Street, Gainesville, FL 32608, USA
| | - Carolina B. Maciel
- Department of Neurology, University of Florida, 1149 Newell Drive, Gainesville, FL 32611, USA
| | | | - Torben K. Becker
- Department of Emergency Medicine, University of Florida, 1329 SW 16 Street, Gainesville, FL 32608, USA
| | - Scott A. Cohen
- Department of Emergency Medicine, University of Florida, 1329 SW 16 Street, Gainesville, FL 32608, USA
| | - Amy Holland
- Department of Emergency Medicine, University of Florida, 1329 SW 16 Street, Gainesville, FL 32608, USA
| | - Cindy Montero
- Department of Emergency Medicine, University of Florida, 1329 SW 16 Street, Gainesville, FL 32608, USA
| | - Tian Zhu
- Program for Neurotrauma, Neuroproteomics & Biomarker Research, McKnight Brain Institute, University of Florida, 1149 Newell Drive, Gainesville, FL 32610, USA
| | - Kevin K. Wang
- Department of Emergency Medicine, University of Florida, 1329 SW 16 Street, Gainesville, FL 32608, USA
- Program for Neurotrauma, Neuroproteomics & Biomarker Research, McKnight Brain Institute, University of Florida, 1149 Newell Drive, Gainesville, FL 32610, USA
| | - Joseph A. Tyndall
- Department of Emergency Medicine, University of Florida, 1329 SW 16 Street, Gainesville, FL 32608, USA
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Mkuu RS, Gilreath TD, Barry AE, Nafukho FM, Rahman J, Chowdhury MAB, Wekullo C, Harvey IS. Identifying individuals with multiple non-communicable disease risk factors in Kenya: a latent class analysis. Public Health 2021; 198:180-186. [PMID: 34461453 DOI: 10.1016/j.puhe.2021.07.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 06/16/2021] [Accepted: 07/26/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Non-communicable diseases (NCDs) are the leading causes of death globally. In Kenya, the number of deaths resulting from NCDs is projected to surpass malaria and tuberculosis by 2030. Studies in Kenya show increasing NCDs; the aim of the present study is to examine the clustering of NCDs and risk factors in Kenya. STUDY DESIGN This is a cross-sectional study using data from the 2015 Kenya STEPwise Survey. METHODS This study examined relationships between NCDs (e.g. obesity, hypertension and diabetes) and health behaviours (e.g. sedentary activity, and fruit and vegetable consumption). Survey probability weights, which estimated the sampling design effect, were applied to consider the sampling units, and stratifications were used during sampling so that the results could be generalisable to the national adult Kenyan population. In total, 4350 adults were included in the study sample. RESULTS Overall, 24.43% of participants were classified as having hypertension, 1.88% as having type 2 diabetes, and 27.94% were classified as being overweight or obese. The best-fit model was a four-class solution. Class 1 is best described as 'young with high NCD risk' and had the highest sedentary activity. Class 2 is best described as 'poor rural with lower NCD risk' with a high chance of smoking and alcohol consumption. Class 3 is best described as 'rural with high NCD risk' and had the highest fruit and vegetable consumption. Class 4 is best described as 'wealthy young urban dwellers with high NCD risk' with a high chance of alcohol consumption and smoking. Individuals in Class 4 had the highest chance (40%) of being overweight/obese, a 2% chance of type 2 diabetes and a 23% chance of having hypertension. CONCLUSIONS NCDs are clustered in groups with high-risk behaviours. The group with the highest chance of having NCDs also had the highest chance of engaging in high-risk behaviours. The findings of this study suggest that smoking and alcohol consumption increase NCD risk in rural areas. Tailored and targeted interventions are needed to curb the increasing NCD prevalence in Kenya.
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Affiliation(s)
- R S Mkuu
- University of Florida, College of Medicine, Gainesville, FL, USA.
| | - T D Gilreath
- Texas A&M University, Transdisciplinary Center for Health Equity Research, College Station, TX, USA.
| | - A E Barry
- Texas A&M University, Department of Health and Kinesiology, College Station, TX, USA.
| | - F M Nafukho
- Texas A&M University, College of Education and Human Development, College Station, TX, USA.
| | - J Rahman
- BRAC University, Dhaka, Bangladesh.
| | - M A B Chowdhury
- University of Florida, College of Medicine, Gainesville, FL, USA.
| | - C Wekullo
- Masinde Muliro University of Science and Technology, Kakamega, Kenya.
| | - I S Harvey
- Texas A&M University, Department of Health and Kinesiology, College Station, TX, USA.
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Mohammad M, Chowdhury MAB, Islam MN, Ahmed A, Zahan FN, Akter MF, Mila SN, Tani TA, Akter T, Islam T, Uddin MJ. Factors associated with body mass index among university students in Bangladesh. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-019-01124-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Al Kibria GM, Crispen R, Chowdhury MAB, Rao N, Stennett C. Correction: Disparities in absolute cardiovascular risk, metabolic syndrome, hypertension, and other risk factors by income within racial/ethnic groups among middle-aged and older US people. J Hum Hypertens 2021; 35:645. [PMID: 33795834 DOI: 10.1038/s41371-021-00527-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Reese Crispen
- University of Maryland School of Medicine, Baltimore, MD, USA
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27
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Kibria GMA, Crispen R, Chowdhury MAB, Rao N, Stennett C. Disparities in absolute cardiovascular risk, metabolic syndrome, hypertension, and other risk factors by income within racial/ethnic groups among middle-aged and older US people. J Hum Hypertens 2021:10.1038/s41371-021-00513-8. [PMID: 33674704 DOI: 10.1038/s41371-021-00513-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 02/05/2021] [Accepted: 02/18/2021] [Indexed: 11/09/2022]
Abstract
This cross-sectional study determined income disparities in age-adjusted prevalence and trends of 10-year high absolute cardiovascular disease (CVD) risk, metabolic syndrome, hypertension, diabetes, obesity, chronic kidney disease (CKD), leisure-time physical activity (LTPA), and current tobacco smoking within racial/ethnic groups in the US. National Health and Nutrition Examination Survey 2001-2016 data of 40-79-year-old people were analyzed. Survey periods were grouped as 2001-2006, 2007-2012, and 2013-2016. Race/ethnicity was grouped as non-Hispanic whites, non-Hispanic blacks, and other races/ethnicities. Three equal-sized strata (low-, middle-, and high income) were made from the family income-to-poverty ratio. Of the 25,777 participants (mean age: 55.6 years, 48% males), a majority of the studied prevalence was higher in most survey years among non-Hispanic blacks compared to non-Hispanic whites. Most studied prevalence was also higher among low-income people than middle-/high-income people. Within racial/ethnic groups, the prevalence also differed by income for high CVD risk, metabolic syndrome, hypertension, diabetes, obesity, CKD, LTPA, and tobacco smoking (P < 0.05) in most survey periods. After stratifying by race/ethnicity, the prevalence of many conditions remained disproportionately higher among low- and middle-income people, compared to those with high income during most survey periods in all racial/ethnic groups. These results reveal income in addition to race/ethnicity to be an important correlate of cardiovascular health and underscore the need to consider each when controlling for risk factors.
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Affiliation(s)
| | - Reese Crispen
- University of Maryland School of Medicine, Baltimore, MD, USA
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Al-Amin S, Hassan MZ, Saif-Ur-Rahman K, Chowdhury MAB, Morrison SD, Donevant SB, Chowdhury F. Pattern of antibiotic use for acute respiratory infections among out-patients in South Asian Region: Protocol for a systematic review. Medicine (Baltimore) 2021; 100:e22398. [PMID: 33530153 PMCID: PMC7850708 DOI: 10.1097/md.0000000000022398] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND South Asian region has been experiencing the increasing burden of antimicrobial resistance (AMR) primarily due to over and irrational prescribing of antibiotics. Acute respiratory infections (ARIs) are the leading cause of out-patients' visits in the region. Despite commonly known viral aetiology, ARI is the single largest reason for antibiotic prescriptions contributing the exponential growth of AMR in the region. Collated data on antibiotic consumption for ARI at outpatients and resistance pattern of respiratory pathogen are lacking in the region. METHODS MEDLINE, Cochrane, CINAHL Plus (EBSCO), and Web of Science will be searched for eligible papers. Titles and abstracts, and full texts of the relevant studies will be screened by 2 independent reviewers against the inclusion criteria. Data extraction and quality of the studies will be assessed by 2 reviewers independently using the JBI Critical Appraisal Tools. A third reviewer will resolve any disagreement at any point between 2 reviewers. RESULTS The review will assess proportions of ARI patients receiving antibiotic therapy and types of antibiotics prescribed among outpatients of all ages in South Asia. This review will also assess the pattern of antimicrobial resistance among respiratory pathogens causing ARI in the region. CONCLUSIONS This systematic review will evaluate published literature, summarize the existing data on the antibiotic prescribing patterns for outpatients with ARI in South Asia. The holistic finding of the proportion of patients receiving antibiotic therapy for ARI, proportion of different types of antibiotic received, and resistance against respiratory pathogen might guide future research. This underscores a need for formulating regional and national policy for AMR mitigation strategy, and revising clinical practice guidelines for the clinician to ensure rational use of antibiotics for ARI. PROSPERO registration no: CRD42018116658.
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Affiliation(s)
- Saif Al-Amin
- Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC
| | - Md Zakiul Hassan
- Programme for Emerging Infections, Infectious Diseases Division
- Nuffield Department of Medicine, University of Oxford
| | - K.M. Saif-Ur-Rahman
- Health Systems and Population Studies Division, ICDDRB, Dhaka, Bangladesh
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | | | - Sharon D. Morrison
- Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC
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29
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Hwang CW, Chowdhury MAB, Curtis DZ, D Wiese J, Agarwal A, Climenhage BP, Becker TK. A descriptive analysis of cross-sectional imaging findings in patients after non-traumatic sudden cardiac arrest. Resusc Plus 2021; 5:100077. [PMID: 34223343 PMCID: PMC8244399 DOI: 10.1016/j.resplu.2021.100077] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 01/06/2021] [Accepted: 01/06/2021] [Indexed: 12/01/2022] Open
Abstract
Introduction Cross-sectional imaging is frequently obtained after sudden cardiac arrest (SCA) to determine the aetiology. Although imaging studies may reveal acute and/or chronic findings that may impact downstream medical management, lack of standardized guidelines results in significant practice variability. We aimed to perform a descriptive analysis and to report on radiographic findings after SCA. Methods This was a retrospective observational descriptive study that included all adult SCA patients who presented to our emergency department (ED) over a 6-year period, achieved sustained return of spontaneous circulation, and subsequently received cross-sectional imaging while in the ED. Each imaging study was reviewed and graded based on a predefined scale, and significant radiographic findings were tabulated. Results 1573 patients were identified, and 452 patients remained after applying predefined exclusion criteria. A total of 298, 184, and 113 computed tomography (CT) studies were performed of the head, chest, and abdomen, respectively. For head, chest, and abdominal imaging, 13 (4.4%), 23 (12.5%), and 6 (5.3%) studies had radiographic findings that likely contributed to SCA, respectively. Altogether, 42 (7.1%) radiographic studies had findings that likely contributed to SCA. Eighty (13.4%) studies (head [n = 38, 12.8%], chest [n = 26, 14.1%], abdomen [n = 16, 14.2%]) resulted in a change of clinical care (e.g. specialty consultation or procedures). Conclusion Given the clinical uncertainty and relative instability during the post-SCA phase, cross-sectional imaging frequently reveals important acute and chronic diagnostic findings.
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Key Words
- ACLS, advanced cardiac life support
- ACS, acute coronary syndrome
- CT, computed tomography
- Cross-Sectional imaging
- ED, emergency department
- MR, Imagnetic resonance imaging
- OHCA, out-of-hospital cardiac arrest
- PEA, pulseless electrical activity
- Post-Cardiac arrest management
- ROS, Creturn of spontaneous circulation
- Resuscitation
- SCA, sudden cardiac arrest
- Sudden cardiac arrest
- VF, ventricular fibrillation
- VT, ventricular tachycardia
- WBCT, whole body computed tomography
- eCPR, extracorporeal cardiopulmonary resuscitation
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Affiliation(s)
- Charles W Hwang
- Department of Emergency Medicine UF Health, 1329 SW 16th Street PO Box 100186 Gainesville, FL 32610-0186, USA
| | | | - Dru Z Curtis
- Department of Emergency Medicine UF Health, 1329 SW 16th Street PO Box 100186 Gainesville, FL 32610-0186, USA
| | - Jon D Wiese
- Department of Emergency Medicine UF Health, 1329 SW 16th Street PO Box 100186 Gainesville, FL 32610-0186, USA
| | - Apara Agarwal
- Department of Emergency Medicine UF Health, 1329 SW 16th Street PO Box 100186 Gainesville, FL 32610-0186, USA
| | - Brandon P Climenhage
- Department of Emergency Medicine UF Health, 1329 SW 16th Street PO Box 100186 Gainesville, FL 32610-0186, USA
| | - Torben K Becker
- Department of Emergency Medicine UF Health, 1329 SW 16th Street PO Box 100186 Gainesville, FL 32610-0186, USA
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Hasan MN, Chowdhury MAB, Jahan J, Jahan S, Ahmed NU, Uddin MJ. Cesarean delivery and early childhood diseases in Bangladesh: An analysis of Demographic and Health Survey (BDHS) and Multiple Indicator Cluster Survey (MICS). PLoS One 2020; 15:e0242864. [PMID: 33270671 PMCID: PMC7714212 DOI: 10.1371/journal.pone.0242864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/10/2020] [Indexed: 12/02/2022] Open
Abstract
Introduction The rate of cesarean delivery (C-section) has been increasing worldwide, including Bangladesh, and it has a negative impact on the mother and child's health. Our aim was to examine the association between C-section and childhood diseases and to identify the key factors associated with childhood diseases. Methods We used four nationally representative data sets from multiple indicator cluster survey (MICS, 2012 and 2019) and Bangladesh Demographic and Health Survey (BDHS, 2011and 2014) and analyzed 25,270 mother-child pairs. We used the frequency of common childhood diseases (fever, short or rapid breaths, cough, blood in stools, and diarrhea) as our outcome variable and C-section as exposure variable. We included mother’s age, place of residence, division, mother’s education, wealth index, child age, child sex, and child size at birth as confounding variables. Negative binomial regression model was used to analyze the data. Results In the BDHS data, the prevalence of C-section increased from 17.95% in 2011 to 23.33% in 2014. Also, in MICS, the prevalence almost doubled over an eight-year period (17.74% in 2012 to 35.41% in 2019). We did not observe any significant effect of C-section on childhood diseases in both surveys. Only in 2014 BDHS, we found that C-section increases the risk of childhood disease by 5% [Risk Ratio (RR): 1.05, 95% CI: 0.95, 1.17, p = 0.33]. However, the risk of childhood disease differed significantly in all survey years by division, child's age, and child’s size at birth after adjusting for important confounding variables. For example, children living in Chittagong division had a higher risk [(2011 BDHS RR: 1.22, 95% CI: 1.08, 1.38) and (2019 MICS RR: 1.21, 95% CI: 1.08, 1.35)] of having disease compared to Dhaka division. Maternal age, education, and wealth status showed significant differences with the outcome in some survey years. Conclusion Our study shows that C-section in Bangladesh continued to increase over time, and we did not find significant association between C-section and early childhood diseases. High C-section rate has a greater impact on maternal and child health as well as the burden on the health care system. We recommend raising public awareness of the negative impact of unnecessary C-section in Bangladesh.
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Affiliation(s)
- Mohammad Nayeem Hasan
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| | | | - Jenifar Jahan
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| | - Sumyea Jahan
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| | - Nasar U. Ahmed
- Department of Epidemiology, Florida International University, Miami, FL, United States of America
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
- * E-mail:
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Chowdhury MAB, Epnere K, Haque MA, Mkuu RS. Urban rural differences in prevalence and risk factors of self-reported hypertension among Kenyan women: a population-based study. J Hum Hypertens 2020; 35:912-920. [PMID: 33159141 DOI: 10.1038/s41371-020-00435-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/28/2020] [Accepted: 10/20/2020] [Indexed: 01/21/2023]
Abstract
This study investigated rural-urban variation in the prevalence of self-reported hypertension and its risk factors among reproductive-age women in Kenya. The 2014 nationally representative Kenya Demographic and Health Survey (KDHS) data were used in this analysis. The survey adopted a multistage, geographically clustered, and probability-based sampling approach. Multivariable logistic regression was performed to assess the association between risk factors and self-reported hypertension. Overall, 9.38% of the women were hypertensive with higher prevalence among urban 11.61%, compared to rural women, 7.86%. Older age, obesity, having diabetes, and increased the odds of hypertension in both rural and urban areas. We also observed that the odds of hypertension differed by ethnic group. High wealth status was a significant correlate only among urban women with women from rich and richest wealth groups had 2-2.3 times higher odds of hypertension compared to the poor and poorest wealth groups. Women with diabetes had 22 times higher odds of hypertension in both in rural and urban areas compared to women without diabetes. In conclusion, our study found that an estimated 1 out of 10 Kenyan women have hypertension. We believe that this study contributes to better understanding of regional variation of hypertension prevalence and risk factors for reproductive women in Kenya. Future studies should seek to develop evidence-based hypertension prevention and management interventions that are targeted and tailored for urban and rural women in Kenya.
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Affiliation(s)
| | - Katrina Epnere
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Md Aminul Haque
- Department of Population Sciences, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Rahma S Mkuu
- Department of Health Outcomes & Biomedical Informatics, University of Florida, Gainesville, FL, 32608, USA
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Al-Ani M, Gul SS, Khatri A, Chowdhury MAB, Drabin M, Murphy T, Allen B, Aranda JM, Vilaro J, Jeng EI, Arnaoutakis GJ, Parker AM, Meece LE, Ahmed MM. Patterns of emergency department utilization for LVAD patients compared with non-LVAD patients. Int J Cardiol Heart Vasc 2020; 30:100617. [PMID: 32904266 PMCID: PMC7452580 DOI: 10.1016/j.ijcha.2020.100617] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 07/27/2020] [Accepted: 08/05/2020] [Indexed: 11/16/2022]
Abstract
Background Left ventricular assist device (LVAD) patients are vulnerable to over-utilization of resources. Methods and results We explored the pattern of emergency department (ED) presentations of LVAD patients and their costs compared with non-LVAD heart failure patients. ED visits between 7/2008 and 7/2017 were reviewed to identify 145 LVAD patients, and 435 patients with known heart failure were selected using propensity score matching for age and sex. ED evaluation metrics, hospitalization cost, and length of stay (LOS) were analyzed. Although the most common ED presentations and their frequency differed between groups, few were LVAD specific. LVAD patients were more likely to have taken personal vehicles or be flown to the ED. They had similar times to triage, rooming, and physician evaluation compared with non-LVAD patients. However, LVAD patients were noted to have a shorter time from physician assessment to disposition (109.8 min vs. 177.0 min, p < 0.001) and, overall, LVAD patients had shorter ED LOS (6.33 vs. 9.82 hrs, p = 0.0001). For patients admitted, no significant difference was found between groups in hospital LOS (6.67 vs 6.58 days, p = 0.928) or total cost ($28,766 vs $21,524, p = 0.087). Conclusion Shorter disposition times without increases in LOS or costs may identify a created healthcare disparity among LVAD patients.
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Affiliation(s)
- Mohammad Al-Ani
- Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, United States
| | - Sarah S Gul
- Department of Surgery, Baystate Medical Center, University of Massachusetts Medical School, Springfield, MA, United States
| | - Abhishek Khatri
- Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, United States
| | | | - Matthew Drabin
- Department of Emergency Medicine, University of Florida, Gainesville, FL, United States
| | - Travis Murphy
- Department of Emergency Medicine, University of Florida, Gainesville, FL, United States
| | - Brandon Allen
- Department of Emergency Medicine, University of Florida, Gainesville, FL, United States
| | - Juan M Aranda
- Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, United States
| | - Juan Vilaro
- Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, United States
| | - Eric I Jeng
- Division of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, FL, United States
| | - George J Arnaoutakis
- Division of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, FL, United States
| | - Alex M Parker
- Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, United States
| | - Lauren E Meece
- Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, United States
| | - Mustafa M Ahmed
- Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, United States
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Gul SS, Cohen SA, Avery KL, Balakrishnan MP, Balu R, Chowdhury MAB, Crabb D, Huesgen KW, Hwang CW, Maciel CB, Murphy TW, Han F, Becker TK. Cardiac arrest: An interdisciplinary review of the literature from 2018. Resuscitation 2020; 148:66-82. [PMID: 31945428 DOI: 10.1016/j.resuscitation.2019.12.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/23/2019] [Accepted: 12/15/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVES The Interdisciplinary Cardiac Arrest Research Review (ICARE) group was formed in 2018 to conduct a systematic annual search of peer-reviewed literature relevant to cardiac arrest (CA). The goals of the review are to illustrate best practices and help reduce knowledge silos by disseminating clinically relevant advances in the field of CA across disciplines. METHODS An electronic search of PubMed using keywords related to CA was conducted. Title and abstracts retrieved by these searches were screened for relevancy, separated by article type (original research or review), and sorted into 7 categories. Screened manuscripts underwent standardized scoring of overall methodological quality and importance. Articles scoring higher than 99 percentiles by category-type were selected for full critique. Systematic differences between editors and reviewer scores were assessed using Wilcoxon signed-rank test. RESULTS A total of 9119 articles were identified on initial search; of these, 1214 were scored after screening for relevance and deduplication, and 80 underwent full critique. Prognostication & Outcomes category comprised 25% and Epidemiology & Public Health 17.5% of fully reviewed articles. There were no differences between editor and reviewer scoring. CONCLUSIONS The total number of articles demonstrates the need for an accessible source summarizing high-quality research findings to serve as a high-yield reference for clinicians and scientists seeking to absorb the ever-growing body of CA-related literature. This may promote further development of the unique and interdisciplinary field of CA medicine.
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Affiliation(s)
- Sarah S Gul
- Department of Surgery, Yale University, New Haven, CT, United States
| | - Scott A Cohen
- Department of Emergency Medicine, University of Florida, Gainesville, FL, United States
| | - K Leslie Avery
- Division of Pediatric Critical Care, Department of Pediatrics, University of Florida, Gainesville, FL, United States
| | | | - Ramani Balu
- Division of Neurocritical Care, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | | | - David Crabb
- Department of Emergency Medicine, University of Florida, Gainesville, FL, United States
| | - Karl W Huesgen
- Department of Emergency Medicine, University of Florida, Gainesville, FL, United States
| | - Charles W Hwang
- Department of Emergency Medicine, University of Florida, Gainesville, FL, United States
| | - Carolina B Maciel
- Division of Neurocritical Care, Department of Neurology, University of Florida, Gainesville, FL, United States; Department of Neurology, Yale University, New Haven, CT, United States
| | - Travis W Murphy
- Department of Emergency Medicine, University of Florida, Gainesville, FL, United States
| | - Francis Han
- Department of Emergency Medicine, University of Florida, Gainesville, FL, United States
| | - Torben K Becker
- Department of Emergency Medicine, University of Florida, Gainesville, FL, United States.
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Chowdhury MAB, Fiore AJ, Cohen SA, Wheatley C, Wheatley B, Balakrishnan MP, Chami M, Scieszka L, Drabin M, Roberts KA, Toben AC, Tyndall JA, Grattan LM, Morris JG. Health Impact of Hurricanes Irma and Maria on St Thomas and St John, US Virgin Islands, 2017-2018. Am J Public Health 2019; 109:1725-1732. [PMID: 31622150 PMCID: PMC6836793 DOI: 10.2105/ajph.2019.305310] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2019] [Indexed: 11/04/2022]
Abstract
Objectives. To assess the health impact of Hurricane Irma and Hurricane Maria on St Thomas, US Virgin Islands.Methods. We collected data from interviews conducted 6 and 9 months after the hurricanes, a review of 597 randomly selected emergency department (ED) encounters, and administrative records from 10 716 ED visits 3 months before, between, and 3 months after the hurricanes.Results. Informants described damaged hospital infrastructure, including flooding, structural damage, and lost staff. The greatest public health impact was on the elderly and persons with chronic diseases. In the setting of loss of the electronic medical record system, ED chart reviews were limited by problems with missing data. ED administrative data demonstrated that posthurricane patients, compared with prehurricane patients, were older and had less severe complaints. There was a significant increase in patients being seen for diabetes-related and respiratory complaints, especially asthma. Suboptimal recordkeeping for medical evacuees limited the ability to assess outcomes for patients with severe illnesses.Conclusions. Hurricanes Irma and Maria caused major disruptions to health care on St Thomas. Emphasis should be given to building a resilient health care system that will optimally respond to future hurricanes.
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Affiliation(s)
- Muhammad Abdul Baker Chowdhury
- Muhammad Abdul Baker Chowdhury, Scott A. Cohen, Meenakshi Puthucode Balakrishnan, Michael Chami, Laura Scieszka, Matthew Drabin, and J. Adrian Tyndall are with the Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville. Andrew J. Fiore is with the Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville. Clayton Wheatley and Barnard Wheatley are with Schneider Regional Medical Center, St Thomas, US Virgin Islands. Kelsey A. Roberts, Alexandra C. Toben, and Lynn M. Grattan are with the Department of Neurology, School of Medicine, University of Maryland, Baltimore. J. Glenn Morris Jr is with the Emerging Pathogens Institute, University of Florida, Gainesville
| | - Andrew J Fiore
- Muhammad Abdul Baker Chowdhury, Scott A. Cohen, Meenakshi Puthucode Balakrishnan, Michael Chami, Laura Scieszka, Matthew Drabin, and J. Adrian Tyndall are with the Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville. Andrew J. Fiore is with the Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville. Clayton Wheatley and Barnard Wheatley are with Schneider Regional Medical Center, St Thomas, US Virgin Islands. Kelsey A. Roberts, Alexandra C. Toben, and Lynn M. Grattan are with the Department of Neurology, School of Medicine, University of Maryland, Baltimore. J. Glenn Morris Jr is with the Emerging Pathogens Institute, University of Florida, Gainesville
| | - Scott A Cohen
- Muhammad Abdul Baker Chowdhury, Scott A. Cohen, Meenakshi Puthucode Balakrishnan, Michael Chami, Laura Scieszka, Matthew Drabin, and J. Adrian Tyndall are with the Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville. Andrew J. Fiore is with the Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville. Clayton Wheatley and Barnard Wheatley are with Schneider Regional Medical Center, St Thomas, US Virgin Islands. Kelsey A. Roberts, Alexandra C. Toben, and Lynn M. Grattan are with the Department of Neurology, School of Medicine, University of Maryland, Baltimore. J. Glenn Morris Jr is with the Emerging Pathogens Institute, University of Florida, Gainesville
| | - Clayton Wheatley
- Muhammad Abdul Baker Chowdhury, Scott A. Cohen, Meenakshi Puthucode Balakrishnan, Michael Chami, Laura Scieszka, Matthew Drabin, and J. Adrian Tyndall are with the Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville. Andrew J. Fiore is with the Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville. Clayton Wheatley and Barnard Wheatley are with Schneider Regional Medical Center, St Thomas, US Virgin Islands. Kelsey A. Roberts, Alexandra C. Toben, and Lynn M. Grattan are with the Department of Neurology, School of Medicine, University of Maryland, Baltimore. J. Glenn Morris Jr is with the Emerging Pathogens Institute, University of Florida, Gainesville
| | - Barnard Wheatley
- Muhammad Abdul Baker Chowdhury, Scott A. Cohen, Meenakshi Puthucode Balakrishnan, Michael Chami, Laura Scieszka, Matthew Drabin, and J. Adrian Tyndall are with the Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville. Andrew J. Fiore is with the Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville. Clayton Wheatley and Barnard Wheatley are with Schneider Regional Medical Center, St Thomas, US Virgin Islands. Kelsey A. Roberts, Alexandra C. Toben, and Lynn M. Grattan are with the Department of Neurology, School of Medicine, University of Maryland, Baltimore. J. Glenn Morris Jr is with the Emerging Pathogens Institute, University of Florida, Gainesville
| | - Meenakshi Puthucode Balakrishnan
- Muhammad Abdul Baker Chowdhury, Scott A. Cohen, Meenakshi Puthucode Balakrishnan, Michael Chami, Laura Scieszka, Matthew Drabin, and J. Adrian Tyndall are with the Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville. Andrew J. Fiore is with the Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville. Clayton Wheatley and Barnard Wheatley are with Schneider Regional Medical Center, St Thomas, US Virgin Islands. Kelsey A. Roberts, Alexandra C. Toben, and Lynn M. Grattan are with the Department of Neurology, School of Medicine, University of Maryland, Baltimore. J. Glenn Morris Jr is with the Emerging Pathogens Institute, University of Florida, Gainesville
| | - Michael Chami
- Muhammad Abdul Baker Chowdhury, Scott A. Cohen, Meenakshi Puthucode Balakrishnan, Michael Chami, Laura Scieszka, Matthew Drabin, and J. Adrian Tyndall are with the Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville. Andrew J. Fiore is with the Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville. Clayton Wheatley and Barnard Wheatley are with Schneider Regional Medical Center, St Thomas, US Virgin Islands. Kelsey A. Roberts, Alexandra C. Toben, and Lynn M. Grattan are with the Department of Neurology, School of Medicine, University of Maryland, Baltimore. J. Glenn Morris Jr is with the Emerging Pathogens Institute, University of Florida, Gainesville
| | - Laura Scieszka
- Muhammad Abdul Baker Chowdhury, Scott A. Cohen, Meenakshi Puthucode Balakrishnan, Michael Chami, Laura Scieszka, Matthew Drabin, and J. Adrian Tyndall are with the Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville. Andrew J. Fiore is with the Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville. Clayton Wheatley and Barnard Wheatley are with Schneider Regional Medical Center, St Thomas, US Virgin Islands. Kelsey A. Roberts, Alexandra C. Toben, and Lynn M. Grattan are with the Department of Neurology, School of Medicine, University of Maryland, Baltimore. J. Glenn Morris Jr is with the Emerging Pathogens Institute, University of Florida, Gainesville
| | - Matthew Drabin
- Muhammad Abdul Baker Chowdhury, Scott A. Cohen, Meenakshi Puthucode Balakrishnan, Michael Chami, Laura Scieszka, Matthew Drabin, and J. Adrian Tyndall are with the Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville. Andrew J. Fiore is with the Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville. Clayton Wheatley and Barnard Wheatley are with Schneider Regional Medical Center, St Thomas, US Virgin Islands. Kelsey A. Roberts, Alexandra C. Toben, and Lynn M. Grattan are with the Department of Neurology, School of Medicine, University of Maryland, Baltimore. J. Glenn Morris Jr is with the Emerging Pathogens Institute, University of Florida, Gainesville
| | - Kelsey A Roberts
- Muhammad Abdul Baker Chowdhury, Scott A. Cohen, Meenakshi Puthucode Balakrishnan, Michael Chami, Laura Scieszka, Matthew Drabin, and J. Adrian Tyndall are with the Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville. Andrew J. Fiore is with the Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville. Clayton Wheatley and Barnard Wheatley are with Schneider Regional Medical Center, St Thomas, US Virgin Islands. Kelsey A. Roberts, Alexandra C. Toben, and Lynn M. Grattan are with the Department of Neurology, School of Medicine, University of Maryland, Baltimore. J. Glenn Morris Jr is with the Emerging Pathogens Institute, University of Florida, Gainesville
| | - Alexandra C Toben
- Muhammad Abdul Baker Chowdhury, Scott A. Cohen, Meenakshi Puthucode Balakrishnan, Michael Chami, Laura Scieszka, Matthew Drabin, and J. Adrian Tyndall are with the Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville. Andrew J. Fiore is with the Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville. Clayton Wheatley and Barnard Wheatley are with Schneider Regional Medical Center, St Thomas, US Virgin Islands. Kelsey A. Roberts, Alexandra C. Toben, and Lynn M. Grattan are with the Department of Neurology, School of Medicine, University of Maryland, Baltimore. J. Glenn Morris Jr is with the Emerging Pathogens Institute, University of Florida, Gainesville
| | - J Adrian Tyndall
- Muhammad Abdul Baker Chowdhury, Scott A. Cohen, Meenakshi Puthucode Balakrishnan, Michael Chami, Laura Scieszka, Matthew Drabin, and J. Adrian Tyndall are with the Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville. Andrew J. Fiore is with the Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville. Clayton Wheatley and Barnard Wheatley are with Schneider Regional Medical Center, St Thomas, US Virgin Islands. Kelsey A. Roberts, Alexandra C. Toben, and Lynn M. Grattan are with the Department of Neurology, School of Medicine, University of Maryland, Baltimore. J. Glenn Morris Jr is with the Emerging Pathogens Institute, University of Florida, Gainesville
| | - Lynn M Grattan
- Muhammad Abdul Baker Chowdhury, Scott A. Cohen, Meenakshi Puthucode Balakrishnan, Michael Chami, Laura Scieszka, Matthew Drabin, and J. Adrian Tyndall are with the Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville. Andrew J. Fiore is with the Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville. Clayton Wheatley and Barnard Wheatley are with Schneider Regional Medical Center, St Thomas, US Virgin Islands. Kelsey A. Roberts, Alexandra C. Toben, and Lynn M. Grattan are with the Department of Neurology, School of Medicine, University of Maryland, Baltimore. J. Glenn Morris Jr is with the Emerging Pathogens Institute, University of Florida, Gainesville
| | - J Glenn Morris
- Muhammad Abdul Baker Chowdhury, Scott A. Cohen, Meenakshi Puthucode Balakrishnan, Michael Chami, Laura Scieszka, Matthew Drabin, and J. Adrian Tyndall are with the Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville. Andrew J. Fiore is with the Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville. Clayton Wheatley and Barnard Wheatley are with Schneider Regional Medical Center, St Thomas, US Virgin Islands. Kelsey A. Roberts, Alexandra C. Toben, and Lynn M. Grattan are with the Department of Neurology, School of Medicine, University of Maryland, Baltimore. J. Glenn Morris Jr is with the Emerging Pathogens Institute, University of Florida, Gainesville
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Hassan MZ, Chowdhury MAB, Hassan I, Chowdhury F, Schaefer N, Chisti MJ. Respiratory viral infection in early life and development of asthma in childhood: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e15419. [PMID: 31045799 PMCID: PMC6504274 DOI: 10.1097/md.0000000000015419] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 04/04/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Respiratory viruses are the leading cause of early life wheezing that may contribute to the development of childhood asthma leading to increasing morbidity and socioeconomic burden. The aim of this review is to identify whether respiratory viral infections during first year of life were associated with development of childhood asthma. METHODS We will search major scientific databases (MEDLINE, CINAHL, Web of Science, Cochrane Library, and ClinicalTrials.gov) using truncated and phrase-searched keywords and relevant subject headings. Observational studies including case-control studies, cohort studies, and randomized control trails published in English will be included in this review. Case reports, qualitative studies, and narrative overviews will be excluded. Exposure will be defined as laboratory-confirmed viral respiratory tract infection in the first year of life and outcome will be defined as development of asthma between ages 5 and 18 years. Effect sizes in bivariate and multivariate analyses will be presented as odds or prevalence ratios. We will explore for heterogeneity of the standard errors across the studies, and if appropriate, we will perform a meta-analysis using a random-effects model to present a summary estimate of the odds or prevalence ratios. RESULTS This review will assess whether respiratory viral infections during first year of life increases the risk of childhood asthma development. CONCLUSIONS This systematic review will evaluate published literature, assessing the link between early life viral infection and childhood asthma. Pooled data may provide evidence that infantile respiratory viral infection results in higher incidence of recurrent wheezing and asthma, thereby stimulating further research into the cost-effectiveness of pharmaceutical interventions such as vaccines and nonpharmaceutical interventions such as hand-washing and respiratory hygiene promotion to young children. Implementing the results of such research may then reduce the burden of acute viral respiratory infections and subsequent recurrent wheezing and asthma. SYSTEMATIC REVIEW REGISTRATION This systematic review has been registered on PROSPERO (CRD42018105519).
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Affiliation(s)
- Md Zakiul Hassan
- Respiratory Infections Research Group, Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | | | - Imran Hassan
- Laboratory Sciences and Services Division, icddr,b, Dhaka, Bangladesh
| | - Fahmida Chowdhury
- Respiratory Infections Research Group, Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Nancy Schaefer
- Health Science Center Libraries, University of Florida, Gainesville, Florida
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Mohammad M, Chowdhury MAB, Islam MN, Ahmed A, Zahan FN, Akter MF, Mila SN, Tani TA, Akter T, Islam T, Uddin MJ. Health awareness, lifestyle and dietary behavior of university students in the northeast part of Bangladesh. Int J Adolesc Med Health 2018; 33:/j/ijamh.ahead-of-print/ijamh-2018-0105/ijamh-2018-0105.xml. [PMID: 30864409 DOI: 10.1515/ijamh-2018-0105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 08/19/2018] [Indexed: 11/15/2022]
Abstract
INTRODUCTION University students generally face a variety of challenges. During this period of life, they practice some unhealthy eating patterns and lifestyles. Therefore, we aimed to assess the health awareness status of university students from the northeast part of Bangladesh and to evaluate its associated factors. METHODS We conducted a cross-sectional study using a stratified random sampling among public and private university students from the northeast region of Bangladesh and interviewed 1143 students. We used a self-reported questionnaire, including questions related to awareness status, lifestyle practice, dietary habit and socio-demographic factors. To assess students' health awareness status and its association with their lifestyle practices and socio-demographic factors, we used logistic regression models. RESULTS The majority (61%) of the students were not aware of better health status and their dietary habits were not adequate. Smokers [odds ratio (OR): 0.66; 95% confidence interval (CI): 0.44, 0.99] were less likely to be aware of better health status. The participants who thought that they were leading a healthy lifestyle were less likely (OR: 0.71; CI: 0.56, 0.92) to be aware. Moreover, frequency of participating in sports and the psychological factors related to eating behaviors were significantly (p < 0.05) associated with health awareness status. CONCLUSION Our study findings may help to create a foundation for possible interventional programs on health awareness and nutritional education to improve the health awareness status and dietary behavior of university students. To prevent students from poor eating habits while feeling happy, effective programs (e.g. seminars, projects and media campaigns) should be held, which may include enhancing healthy and recommended amounts of food consumption.
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Affiliation(s)
- Mahmuda Mohammad
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | | | - Md Nazrul Islam
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | - Arifa Ahmed
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | - Farha Nusrat Zahan
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | - Mst Farzana Akter
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | - Shamima Naznin Mila
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | - Tania Akhter Tani
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | - Tanjila Akter
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | - Tanjila Islam
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
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Haque MA, Hossain MSN, Chowdhury MAB, Uddin MJ. Factors associated with knowledge and awareness of HIV/AIDS among married women in Bangladesh: evidence from a nationally representative survey. SAHARA J 2018; 15:121-127. [PMID: 30249174 PMCID: PMC6161619 DOI: 10.1080/17290376.2018.1523022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Women in Bangladesh share a greater risk of Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) infection compared to men. Levels of knowledge and awareness largely contribute to the prevalence of the HIV epidemic and its consequences. So, it is required to conduct studies based on most recent data to explore the determinants of HIV awareness. Therefore, we aimed to find the awareness level and factors influencing HIV related awareness among the married women in Bangladesh. We used data from 2014 Bangladesh Demographic and Health Survey (BDHS). About two-third of total respondents who heard about the HIV/AIDS were selected and interviewed successfully (n = 12,593) about 11 basic questions related to individual’s awareness. A score of the respondent’s knowledge and awareness was determined based on these questions. We used logistic regression models for analysing the data. We found about 62% of the respondents had an adequate knowledge and consciousness about the HIV/AIDS. Respondents’ education status, mass-media access, place of living, and working status played significant role on the awareness. As expected, respondents with higher education were more aware than those with no education (odds ratio (OR) = 3.56, 95% confidence interval (CI): 2.99–4.23). Moreover, respondents who had access to the mass media were more likely to be aware compared to those who did not have the access (OR = 1.14, 95% CI: 1.04–1.26). Although a sizeable proportion of women had an adequate knowledge and awareness regarding the HIV/AIDS, we recommend implementing educational programmes related to HIV/AIDS in the curriculum to ensure a standard level of awareness throughout the nation. Since the respondents from rural areas scored significantly lower than the urban areas, awareness through mass media, particularly in rural areas, is of prime concern for raising awareness.
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Affiliation(s)
- Md Ashiqul Haque
- a Department of Statistics , Shahjalal University of Science and Technology , Sylhet , Bangladesh
| | - Md Sha Newaj Hossain
- a Department of Statistics , Shahjalal University of Science and Technology , Sylhet , Bangladesh
| | | | - Md Jamal Uddin
- a Department of Statistics , Shahjalal University of Science and Technology , Sylhet , Bangladesh
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Abstract
BACKGROUND Multimorbidity among the elderly is a major public health problem in most of the developing countries, including Bangladesh, where the population is moving towards aging. Multimorbidity was defined as the co-occurrence of at least two chronic diseases in a person whether as a coincidence or not. Little attention has been paid to the study of the prevalence of multimorbidity among the elderly in Bangladesh. OBJECTIVE The objectives of this study were to estimate the prevalence of multimorbidity among hospitalized elderly. METHODS A cross-sectional study was conducted in two tertiary level hospitals with a sample of 566 adults aged 60 years or more. Data were collected from medical examination reports at the hospital and using a semi-structured interview schedule through an in-person interview. Descriptive statistics were used to measure the prevalence of multimorbidity. RESULTS The overall prevalence of multimorbidity among the elderly was 56.4% and the prevalence was higher among females (64.18%) than males (54.17%). The most prevalent conditions were hypertension (33.0%), diabetes (27.6%), ischemic heart disease (12.0%), and chronic obstructive pulmonary disease (9%). CONCLUSION A high prevalence of multimorbidity suggests that there is an urgent need to develop geriatric health-care services. Policymakers should pay attention to developing effective intervention strategies and programs to reduce the burden of multimorbidity.
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Affiliation(s)
- Hasna Hena Sara
- Department of Population SciencesUniversity of DhakaDhakaBangladesh
| | | | - Md. Aminul Haque
- Department of Population SciencesUniversity of DhakaDhakaBangladesh
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Chowdhury MAB, Adnan MM, Hassan MZ. Trends, prevalence and risk factors of overweight and obesity among women of reproductive age in Bangladesh: a pooled analysis of five national cross-sectional surveys. BMJ Open 2018; 8:e018468. [PMID: 30030307 PMCID: PMC6059314 DOI: 10.1136/bmjopen-2017-018468] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To determine the trends, prevalence and risk factors of overweight and obesity among Bangladeshi women of reproductive age from 1999 to 2014. DESIGN We analysed nationally representative data from the 1999, 2004, 2007, 2011 and 2014 cross-sectional Bangladesh Demographic and Health Surveys. SETTING Bangladesh. PARTICIPANTS Women aged 15-49 years. PRIMARY OUTCOME Overweight/obesity. RESULTS A total of 58 192 women were included in the analysis. The prevalence of overweight and obesity among women of reproductive age increased significantly from 7.53% (95% CI 6.83 to 8.29) and 1.82% (95% CI 1.48 to 2.24) in 1999 to 28.37% (95% CI 27.49 to 29.28) and 10.77% (95% CI 10.22 to 11.35) in 2014, respectively. Age, education, wealth index, watching television and contraceptive use were associated with overweight and obesity in both urban and rural areas. CONCLUSIONS Overweight and obesity prevalence increased significantly among Bangladeshi women of reproductive age between 1999 and 2014. Development of effective low-cost strategies to address the increasing burden of obesity should be a high priority.
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Affiliation(s)
| | - Md Mohiuddin Adnan
- Department of Data Science, School of Population Health, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Md Zakiul Hassan
- Programme for Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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Hakim S, Chowdhury MAB, Uddin MJ. Correlates of attempting to quit smoking among adults in Bangladesh. Addict Behav Rep 2018; 8:1-7. [PMID: 30062100 PMCID: PMC6062856 DOI: 10.1016/j.abrep.2018.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 04/21/2018] [Accepted: 04/21/2018] [Indexed: 11/29/2022] Open
Abstract
Background Quit attempts are very essential in population-based smoking cessation. Little is known about the correlates of making a quit attempt of smoking in Bangladesh. We aimed to examine correlates of making a quit attempt of smoking among adults in Bangladesh. Methods We used data from the 2009 Global Adult Tobacco Survey, Bangladesh. A total of 2217 adult current smokers (2141 males and 76 females) aged 15 years and older who participated in the survey were included. We compared socio-demographic, behavioral, motivational, knowledge and attitudes towards smoking, quitting methods utilized, use of social media to quit smoking, and environmental characteristics of current smokers who made an attempt to quit with those who made no quit attempt during the previous 12 months of the survey. We applied multivariable logistic regression models for analyzing the data. Results Among the 2217 current smokers, 1058 (47.72%) made attempt to quit. We found respondents who smoked their first cigarette within 6 to 30 min of waking up were more likely to make an attempt to quit than those who smoked their first cigarette within 5 min of waking. Moreover, among daily current smokers who smoked 10–19 manufactured cigarettes per day were less likely to make a quit attempt. We also found intention to quit smoking, smoking rules inside the home, and exposure to anti-smoking advertisements as significant correlates of making a quit attempt of smoking among adults in Bangladesh. Conclusions Policymakers should consider our findings when implementing tobacco control programs in Bangladesh. Quit attempts are very essential in population-based smoking cessation. Among the 2233 current smokers, 1058 individuals attempted to quit smoking. Smokers who don't smoke quickly after waking were more likely to make quit attempt. Smokers who lived in a smoke-free home were also more likely to make quit attempt.
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Affiliation(s)
- Shariful Hakim
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet 3114, Bangladesh
| | | | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet 3114, Bangladesh
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Abstract
Introduction Overweight and obesity are associated with increased rates of chronic disease
and death globally. In Kenya, the prevalence of overweight and obesity among
women is high and may be growing. This study aimed to determine the national
prevalence and predictors of overweight and obesity among women in
Kenya. Methods We used cross-sectional data from the 2014 Kenya Demographic and Health
Survey (KDHS). Data on body mass index for 13,048 women (aged 15–49
y) were analyzed by using multivariable logistic regression models.
Overweight and obesity were classified by using World Health Organization
categories (normal weight, 18.5 to <24.9; overweight, 25.0 to <29.9;
and obese, ≥30.0). Results The prevalence of overweight was 20.5%, and the prevalence of obesity, 9.1%.
Women aged 35 to 44 (odds ratio [OR] = 3.14; 95% confidence interval [CI],
2.58−3.81), with more than a secondary education (OR = 1.43; 95% CI,
1.05–1.95), married or living with a partner (OR = 1.73; 95% CI,
1.42−2.08), not working (OR = 1.27; 95% CI, 1.10–1.48), in the
richest category (OR = 6.50; 95% CI, 5.08–8.30), and who used
hormonal contraception (OR = 1.24; 95% CI, 1.07–1.43) were
significantly more likely to be overweight or obese. Conclusion A high proportion of women in Kenya are overweight or obese. Our study
indicates that women from urban areas and women with high socioeconomic
status make up the largest proportion of women who are overweight or obese.
Targeted and tailored studies and interventions are needed to identify
evidence-based obesity prevention strategies for high-risk women in
Kenya.
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Affiliation(s)
- Rahma S Mkuu
- Department of Health and Kinesiology, Texas A&M University, College Station, Texas
| | | | - Muhammad Abdul Baker Chowdhury
- Department of Emergency Medicine, University of Florida College of Medicine, Gainesville, Florida.,PO Box 100186, Gainesville, FL 32610-0186.
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Alam S, Fahim SM, Chowdhury MAB, Hassan MZ, Azam G, Mustafa G, Ahsan M, Ahmad N. Prevalence and risk factors of non-alcoholic fatty liver disease in Bangladesh. JGH Open 2018; 2:39-46. [PMID: 30483562 PMCID: PMC6206991 DOI: 10.1002/jgh3.12044] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 12/18/2017] [Accepted: 01/31/2018] [Indexed: 12/18/2022]
Abstract
Background and Aim Non‐alcoholic fatty liver disease (NAFLD) is a significant cause of hepatic dysfunction and liver‐related mortality. As there is a lack of population‐based prevalence data in a representative sample of general population, we aimed to estimate the prevalence and risk factors of NAFLD in Bangladesh. Methods A cross‐sectional study was conducted both in urban and rural areas of Bangladesh from December 2015 to January 2017. Data were collected using a pretested structured questionnaire followed by ultrasonography of hepatobiliary system for screening of NAFLD. Multivariate logistic regression was used to estimate the risk factors of NAFLD. Results A total of 2782 (1694 men and 1088 women) participants were included in the study, with a mean age of 34.21 (±12.66) years. The overall prevalence of NAFLD was 33.86% (95% confidence interval [CI]: 32.12, 35.64). Females living in the rural areas and midlife adults (45–54 years) had the highest prevalence of NAFLD (P < 0.05). Multivariable logistic regression model demonstrated that increasing age, diabetes, elevated body mass index, and married individuals are significantly associated with NAFLD. Individuals with diabetes (adjusted odds ratio: 2.71, 95% CI: 1.85, 3.97) and hypertension were at a higher risk of having NAFLD. The odds of having NAFLD were 4.51 (95% CI: 3.47, 5.86) and 10.71 (95% CI: 7.80, 14.70) times higher among overweight and obese participants, respectively, as compared to normal‐weight participants. Conclusions About one‐third of the population of Bangladesh is affected by NAFLD. Individuals with higher body mass index (overweight and obese), diabetics, midlife adults, married individuals, and rural women were more at risk of having NAFLD than others.
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Affiliation(s)
- Shahinul Alam
- Department of HepatologyBangabandhu Sheikh Mujib Medical UniversityDhakaBangladesh
| | - Shah Mohammad Fahim
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | | | - Md. Zakiul Hassan
- Programme for Emerging Infections, Infectious Diseases DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b)DhakaBangladesh
| | - Golam Azam
- Department of Gastrointestinal Hepatobiliary and Pancreatic disorders (GHPD)BIRDEMDhakaBangladesh
| | - Golam Mustafa
- Department of HepatologyBangabandhu Sheikh Mujib Medical UniversityDhakaBangladesh
| | - Mainul Ahsan
- Department of Radiology and ImagingBangabandhu Sheikh Mujib Medical UniversityDhakaBangladesh
| | - Nooruddin Ahmad
- Department of HepatologyBangabandhu Sheikh Mujib Medical UniversityDhakaBangladesh
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Hakim S, Chowdhury MAB, Uddin MJ. Correlates of unsuccessful smoking cessation among adults in Bangladesh. Prev Med Rep 2017; 8:122-128. [PMID: 29021949 PMCID: PMC5633848 DOI: 10.1016/j.pmedr.2017.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 08/14/2017] [Accepted: 08/27/2017] [Indexed: 12/21/2022] Open
Abstract
Having 21.9 million adult smokers, Bangladesh ranks among the top ten heaviest smoking countries in the world. Correlates of unsuccessful smoking cessation remain unknown. We aimed to identify the correlates of unsuccessful smoking cessation among adults in Bangladesh. We used data from the 2009 Global Adult Tobacco Survey (GATS) for Bangladesh. We compared socio-demographic, belief about health effect of smoking, and environmental characteristics of current smokers who had a recent failed quit attempt during the past 12 months of the survey (unsuccessful quitters) with those former smokers who had quit ≥ 12 months earlier of the survey and had not relapsed (successful quitters). Data were analyzed using logistic regression model and generalized estimating equations. A total of 1552 smokers (1058 unsuccessful quitters and 494 successful quitters) aged 15 years and older who participated in the survey was included in this study. Among the smokers, 1058 (68%) were unsuccessful quitters. Our analysis showed that older aged, female, and higher educated smokers were less likely to quit unsuccessfully. Moreover, who believed that smoking causes serious illness were also less likely to quit unsuccessfully. For the interaction between place of residence and smoking rules inside home, we found that among the smoker's, in those house smoking was allowed, and who lived in urban place were less likely to be unsuccessful in quitting than those who lived in rural place. Our findings suggest a cessation program that requires integrated approach with a view to considering these findings in setting up. The interaction effects for smoking cessation has been rarely investigated. Almost 70% of adult smokers were unsuccessful quitters. Older aged, female, and educated smokers were less likely to quit unsuccessfully. Belief about harmful effect of smoking associated with unsuccessful smoking cessation Interaction between smoking rules inside home and place of residence was observed.
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Affiliation(s)
- Shariful Hakim
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet 3114, Bangladesh
| | | | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet 3114, Bangladesh
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Haque MA, Dash SK, Chowdhury MAB. Maternal health care seeking behavior: the case of Haor (wetland) in Bangladesh. BMC Public Health 2016; 16:592. [PMID: 27430897 PMCID: PMC4949891 DOI: 10.1186/s12889-016-3296-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 06/24/2016] [Indexed: 11/29/2022] Open
Abstract
Background The state of maternal healthcare (MHC) in Bangladesh is a grave concern especially in the remote haor areas. In this study, we aimed to determine the factors affecting the utilization of MHC services in the haor areas, to discover mothers’ knowledge of MHC, and explore their attitudes toward MHC as well as practices in seeking MHC services. Method In this cross-sectional survey (n = 400), we randomly selected mothers (aged 15–49 years) from haor areas of the Habiganj district of Bangladesh. The study participants’ socio demographic information as well as the extent of their knowledge about MHC, their attitudes, and practices in seeking MHC services were ascertained. The degree of association between the respondents’ socio-demographic characteristics and their health-seeking behavior (before, during, and after childbirth) was assessed by the odds ratio (OR) with 95 % confidence intervals (CI) estimated from the bivariate and multivariable logistic regression analyses. Results The mean age of the study participants was 27.26 years. Respondents had an average of 2.64 children, and 88.6 % had at best a primary education or less. Among the study participants, 61 % of mothers had no knowledge about the availability of MHC in the study area, and only 36 % received any antenatal care (ANC). Also, 47 % sought ANC from government healthcare institutions. Irrespective of complications and potential danger signs, 95 % of births were delivered at home with the assistance of untrained birth attendants. Only 19.75 % of mothers and 12.3 % of infants received postnatal care (PNC). Moreover, mothers who had a secondary or tertiary education level had a higher likelihood of receiving ANC (OR: 3.48, 95 % C.I: 1.49–7.63) compared to mothers with no education. Also, mothers aged 25 years or older were less likely (OR: 0.24, 95 % C.I: 0.06–0.095) to give birth in a health facility than mothers who were younger than 25. The low utilization of MHC services can be attributed to many factors such as a lack of communication, a lack of knowledge about MHC services, low income, decision making, and the lack of a companion with whom to visit health services. Conclusion To improve MHC utilization, to reach national targets and to save the lives of mothers and newborns, boat or ship-based special healthcare and educational programs should be implemented in the haor areas.
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Affiliation(s)
- Md Aminul Haque
- Department of Population Sciences, University of Dhaka, Dhaka, 1000, Bangladesh.
| | - Surjya Kanta Dash
- Department of Population Sciences, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Muhammad Abdul Baker Chowdhury
- Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, 33199, USA
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Chowdhury MAB, Uddin MJ, Haque MR, Ibrahimou B. Hypertension among adults in Bangladesh: evidence from a national cross-sectional survey. BMC Cardiovasc Disord 2016; 16:22. [PMID: 26809175 PMCID: PMC4727356 DOI: 10.1186/s12872-016-0197-3] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 01/15/2016] [Indexed: 12/23/2022] Open
Abstract
Background Hypertension is an increasing problem in Southeast Asia, particularly in Bangladesh. Although some epidemiological studies on hypertension have been conducted in Bangladesh, the factors associated with hypertension in this nation remain unclear. We aimed to determine the factors associated with hypertension among the adults in Bangladesh. Methods We conducted a cross-sectional study using data from the nationally representative 2011 Bangladesh Demographic and Health Survey (BDHS). A total of 7,839 (3,964 women and 3,875 men) adults aged 35 years and older who participated in the survey was included. Hypertension was defined by a systolic blood pressure ≥ 140 mmHg and/or, diastolic blood pressure ≥ 90 mmHg and/or, receipt of an anti-hypertensive medication at time of the survey. The degree of association between the risk factors and the outcome was assessed by the odd ratio (OR) obtained from the bivariate and multivariable logistic regression models. Results The overall prevalence of hypertension was 26.4 %, and the prevalence was higher in women (32.4 %) than men (20.3 %). Study participants with the age group of 60–69 years had higher odds of having hypertension (AOR: 3.77, 95 % CI: 3.01–4.72) than the age group 35–39 years. Moreover, individuals who had higher educational attainment (AOR: 1.63, 95 % C.I: 1.25–2.14) and higher wealth status (AOR = 1.91, 95 % CI: 1.54–2.38) had higher odds of having hypertension than the individuals with no education and lower social status, respectively. The analysis also showed that high BMI (AOR: 2.19, 95 % C.I: 1.87–2.57) and having diabetes (AOR: 1.54, 95 % C.I: 1.31–1.83) were associated with the increasing risk of hypertension. Conclusions Our study shows that the risk of hypertension was significantly associated with older age, sex, education, place of residence, working status, wealth index, BMI, and diabetes. Moreover, hypertension is largely untreated, especially in rural settings. The health system needs to develop appropriate strategies including early diagnosis, awareness via mass media, and health education programs for changing lifestyles should be initiated for older age, wealthy, and/or higher educated individuals in Bangladesh. Moreover, area-specific longitudinal research is necessary to find out the underlying causes of regional variations.
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Affiliation(s)
- Muhammad Abdul Baker Chowdhury
- Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA.
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh.
| | - Md Rabiul Haque
- Department of Population Sciences, University of Dhaka, Dhaka, Bangladesh.
| | - Boubakari Ibrahimou
- Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA.
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Chowdhury MAB, Uddin MJ, Khan HMR, Haque MR. Type 2 diabetes and its correlates among adults in Bangladesh: a population based study. BMC Public Health 2015; 15:1070. [PMID: 26483053 PMCID: PMC4610042 DOI: 10.1186/s12889-015-2413-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 10/12/2015] [Indexed: 12/30/2022] Open
Abstract
Background Type 2 diabetes is one of the most prevalent non-communicable diseases in Bangladesh. However, the correlates of type 2 diabetes among adults in Bangladesh remain unknown. We aimed to investigate the correlates of type 2 diabetes among the adults in Bangladesh. Methods We conducted a cross-sectional study using data from the nationally representative 2011 Bangladesh Demographic and Health Survey. A random sample of 7,543 (3,823 women and 3,720 men) adults of age 35 years and older from both urban and rural areas, who participated in the survey was included. Diabetes was defined as having a fasting plasma blood glucose level of ≥ 7 mm/L or taking diabetes medication during the survey. Hypothesized factors, e.g., age, sex, education, place of residence, social status, body mass index, and hypertension were considered in the analyses. Multivariable logistic regression models were used to identify the important correlates of type 2 diabetes. Results Among the respondents, the overall prevalence of diabetes was 11 %, and the prevalence was slightly higher in women (11.2 %) than men (10.6 %). Respondents with the age group of 55–59 years had higher odds of having diabetes (odds ratios (OR) = 2.37, 95 % confidence interval (CI): 1.76–3.21) than the age group of 35–39 years. Moreover, respondents who had higher educational attainment (OR = 1.67, 95 % CI: 1.18–2.36) and higher social status (OR = 2.01, 95 % CI: 1.50–2.70) had higher odds of having diabetes than the respondents with no education and lower social status, respectively. We also found socioeconomic status, place of residence (rural or urban), regions of residence (different divisions), overweight and obesity, and hypertension as significant correlates of type 2 diabetes in Bangladesh. Conclusions Our study shows that older age, higher socioeconomic status, higher educational attainment, hypertension, and obesity were found to be significant correlates of type 2 diabetes. Need-based policy program strategies including early diagnosis, awareness via mass media, and health education programs for changing lifestyles should be initiated for older age, wealthy, and/or higher educated individuals in Bangladesh. Moreover, area-specific longitudinal research is necessary to find out the underlying causes of regional variations.
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Affiliation(s)
- Muhammad Abdul Baker Chowdhury
- Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA.
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, 3114, Bangladesh.
| | - Hafiz M R Khan
- Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX, 79430, USA.
| | - Md Rabiul Haque
- Department of Population Sciences, University of Dhaka, Dhaka, 1000, Bangladesh.
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