Perceived and actual risks of drought: household and expert views from the lower Teesta River Basin of northern Bangladesh

Disaster risk perception and risk appraisal are essential in formulating an appropriate disaster risk reduction policy. This study examines the actual vs perceived drought risks by constructing risk indices at the household and expert levels using survey data from the lower Teesta River Basin in northern Bangladesh. The survey data were collected from 450 farmers using a structured questionnaire conducted between August and September 2019. A composite drought risk index was developed to understand households’ perceived and actual risks in the designated areas. The results show that the actual and perceived risk values differ significantly among the three case study sites locally known as Ganai, Ismail, and Par Sekh Sundar. The risk levels also differ significantly across the households’ gender, income, occupation, and educational attainment. People with insolvent socioeconomic status are more prone to drought risk compared to others. Results also reveal that the mean level of perceived risk agrees well with the actual risk, whereas females perceive comparatively higher risk than their male counterparts. Expert views on drought risk are similar to the individual household level perceived risk. The outcomes of this study would assist the policymakers and disaster managers to understand the concrete risk scenarios and take timely disaster risk reduction actions for ensuring a drought-resistant society

Diagnosis of chronic conditions with modifiable lifestyle risk factors in selected urban and rural areas of Bangladesh and sociodemographic variability therein

<p>Abstract</p> <p>Background</p> <p>Bangladesh suffers from a lack of healthcare providers. The growing chronic disease epidemic's demand for healthcare resources will further strain Bangladesh's limited healthcare workforce. Little is known about how Bangladeshis with chronic disease seek care. This study describes chronic disease patients' care seeking behavior by analyzing which providers diagnose these diseases.</p> <p>Methods</p> <p>During 2 month periods in 2009, a cross-sectional survey collected descriptive data on chronic disease diagnoses among 3 surveillance populations within the International Center for Diarrheal Disease Research, Bangladesh (ICDDR, B) network. The maximum number of respondents (over age 25) who reported having ever been diagnosed with a chronic disease determined the sample size. Using SAS software (version 8.0) multivariate regression analyses were preformed on related sociodemographic factors.</p> <p>Results</p> <p>Of the 32,665 survey respondents, 8,591 self reported having a chronic disease. Chronically ill respondents were 63.4% rural residents. Hypertension was the most prevalent disease in rural (12.4%) and urban (16.1%) areas. In rural areas chronic disease diagnoses were made by MBBS doctors (59.7%) and Informal Allopathic Providers (IAPs) (34.9%). In urban areas chronic disease diagnoses were made by MBBS doctors (88.0%) and IAP (7.9%). Our analysis identified several groups that depended heavily on IAP for coverage, particularly rural, poor and women.</p> <p>Conclusion</p> <p>IAPs play important roles in chronic disease care, particularly in rural areas. Input and cooperation from IAPs are needed to minimize rural health disparities. More research on IAP knowledge and practices regarding chronic disease is needed to properly utilize this potential healthcare resource.</p

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021

Background Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions. Funding: Bill & Melinda Gates Foundation

Hazards, food insecurity and human displacement in rural riverine Bangladesh: Implications for policy

This paper examines the impacts of climate-induced hazards, especially riverbank erosion, on livelihoods and food security, and the ways in which susceptible households respond. The study uses survey data collected from 380 riverbank erosion-prone rural households in Bangladesh, along with data from focus group discussions involving household heads from severe erosion-prone areas. A Food Security Index (FSI) has been developed to improve understanding of the extent of households' food insecurity where 3 indicates food security and 1 minimal security. Over the past 10 years, about a third of households have lost their homestead more than three times and 57% have lost at least once. The overall FSI value of 2.06 indicates households' difficulties in managing family food requirements throughout the year. Migration co-exists with vulnerable households' food security with households that have no or limited agricultural land, coupled with inadequate employment opportunities, are more inclined to migrate. Households that are struggling to make a living through farming are responding by coping and adaptation. Interventions such as access to institutions and credit facilities, human capital development and a package of technologies through agro-ecological based research for emerging char land (sandbars) are required to build resilience of the riparian households as well as improve their food security and livelihoods.No Full Tex

Status of Price Variations of Fish, Livestock and Poultry Products: A Case Study in Gazipur District of Bangladesh

This study examined the pattern of price variations of major fish, livestock and poultry products in Gazipur district of Bangladesh. The secondary data on the average wholesale and retail prices of ten important commodities for a period of six years (June 2014 to June 2019) were collected from the Department of Agricultural Marketing (DAM) under the Ministry of Agriculture of the Government. The averages were calculated from a total of 1900 wholesalers and 2450 retailers in Gazipur district. Polynomial trend model was used to understand the nature of changes in the prices of the selected commodities and to make short-term forecasting. The model revealed a different pattern of price change for different commodities in both wholesale and retail markets. In case of mutton, egg (chicken), egg (duck), beef, and silver carp fish, it was highly upward sloping which indicates that price of these commodities will increase at an increasing rate in the upcoming years. A moderately increasing rate of price change was observed for katla fish in both the markets while for broiler, indigenous chicken and rohu fish, it was found a downward sloping. On the contrary, the projection indicates that the price of tilapia fish would remain stable in the near future. Such a scenario suggest that market monitoring system should be strengthened by the government to control the extreme increase or decrease in prices so that none of the stakeholders would be the gainer nor looser from the pricing policy in Bangladesh.&#x0D; Ann. Bangladesh Agric. (2020) 24(1) : 99-112</jats:p

Mycotic Aneurysm of Aorta Following Mitral Valve Replacement – A Case Report

The term mycotic aneurysm refers to aneurysm associated with infection by microorganism. Sir William Osler first coined the term mycotic aneurysm in 1885 by disclosing the relation between abnormal cardiac valves and infection with micrococci not with fungi. An 11 years old female from Feni presented with asymptomatic vascular swelling in abdomen referred by a cardiologist.CT angiogram revealed fusiform aneurysm in distal part of abdominal aorta involving ostioproximal part of both common iliac arteries and saccular aneurysm of distal part of superior mesenteric arteries suggestive of mycotic aneurysm. Patient underwent vascular operation aorto biilliac bypass by PTFE graft with excision and ligation of aneurysm of superior mesenteric arteries. Mycotic aneurysm in bacterial endocarditis is rare. It is a challenging job for the cardiologists, infectious disease specialists and vascular surgeon. Time appropriate skilled prompt surgical  management can bring smile for both patients and physicians. DOI: http://dx.doi.org/10.3329/cardio.v5i1.12281 Cardiovasc. j. 2012; 5(1): 107-111</jats:p

Fatty acid composition of oil palm (&lt;i&gt;Elaeis guineensis&lt;/i&gt; Jacq) fruits grown in Bangladesh

This study was undertaken to evaluate the fatty acid composition and other physicochemical properties of oil palm (Elaeis guineensis) fruits grown in Bangladesh and compared these values with crude palm oil (CPO) imported from Malaysia. Ripe and fresh oil palm (Elaeis guineensis) fruits were collected from different districts of Bangladesh and the crude oils were extracted by a screw press machine and was divided into three fractions: crude palm oil (CPO), degummed palm oil (DPO) and degummed bleached palm oil (DBPO). The percent yield, their physico-chemical characteristics, fatty acid composition, β-carotene, tocopherols and tocotrienols of the fractions were determined. Fatty acid composition and other physicochemical properties of Bangladeshi crude palm oil (CPO) were found to be more or less similar to the CPO imported from Malaysia.&#x0D; Bangladesh J. Sci. Ind. Res.55(2), 153-158, 2020</jats:p