Mortality causes in goldsmiths of Bangladesh: Findings from verbal autopsy

Background: Information on the mortality causes of goldsmiths in Bangladesh is limited. This study aimed to find out the mortality causes in a selected group of goldsmiths. Methods: A World Health Organization recommended questionnaire was adapted to conduct verbal autopsy of 20 deceased goldsmiths. Death-related information was gathered from the family members present during deceased’s illness preceding death. The mortality causes were determined by the interview outcomes and medical records-review. Results: The mean age of the goldsmiths at death was 59.2± 9.3 years. Among then, 70.0% were smokers and 50.0% were alcohol consumers. Cardiovascular diseases (CVD) were the most common immediate and underlying cause of death (60.0% and 45.0%, respectively). Conclusion: The life expectancy of goldsmiths was much lower than the average life expectancy of Bangladeshi population, where CVD was the primary cause of death. Smoking and alcohol consumption were prevalent among them. Awareness about healthy lifestyles should be prioritized for highly CVD prevention among the goldsmiths.  Bangabandhu Sheikh Mujib Medical University Journal 2023;16(2): 87-9

Types and distribution of cancer patients attending in a tertiary care hospital of Bangladesh

Bangladesh, similar to other countries is experiencing an increased burden of cancer. Absence of a national cancer registry has created a gap in the information regarding the presentation of cancer statistics of the country. The objective of this study was to assess the types and distribution of the cancer patients attending a tertiary academic medical center hospital in Bangladesh. A cross-sectional study was conducted among all the confirmed cancer patients attending the in-patient and out-patient, and daycare facilities in Bangabandhu Sheikh Mujib Medical University in October, 2019. A validated questionnaire, recommended by International Agency for the Cancer Registry was used to collect data. Written informed consent was obtained from every respondent. This study had received its ethical clearance from Institutional Review Board of BSMMU. Among the 1656 respondents, 78.8% were adult and 25.2% were from paediatric age groups. Leading cancer for adult males were lung cancer (9.6%), leukaemia (9.4%) and lymphoma (9.0%); and breast cancer (28.1%), thyroid cancer (16.1%), and cervical cancer (12.2%) for females. Leukaemia was the most frequent cancer in the paediatric group for both males (71.5%) and females (66.5%). Establishing a hospital-based cancer registry with high quality data in an academic medical center setting is feasible and can set the stage for establishing nationwide hospital-based as well as establishing a popula- tion-based cancer registry in Bangladesh, which is necessary to identify and tackle the rising burden of cancer in this country. BSMMU J 2022; 15(1): 43-4

COVID-19 Testing: Perceived Barriers Among the Urban Slum Dwellers of Dhaka, Bangladesh

Background: Urban slum dwellers are unduly affected by COVID-19, and low testing rates among them are worsening their situation. This study aimed to explore the perceived barriers to COVID-19 testing in the slums, which is crucial to its surveillance, tracking, and allocating resources to combat the pandemic. Methods: A quantitative study with a cross-sectional design was conducted among 149 urban slum dwellers (≥11 years of age), who had previously experienced COVID-19 like symptoms. They were identified from an existing slum cohort at Bauniabadh, Dhaka. Information related to their testing status and perceived barriers was acquired by a telephone survey from October to November 2020. Results: The mean age of the respondents was 34.4±15.6 years, and 58.4% of them were female. Fever (79.2%) and cough (74.5%) were the most common symptoms mentioned. Only 6.7% of the respondents had undergone COVID-19 testing. Fast relief (within 1-3 days) from symptoms (87.6%) was the most prevailing barrier to testing, seen across all age and education groups. Negative advocacy regarding the testing from family and friends (46.7%), participants uncertainty about the guidelines, site, cost, and schedule of testing (15.3%), and a general belief that ‘COVID-19 is not a disease of slum people instead, it is an affliction of the rich folk’ (20.4%), were the other cited barriers. Conclusions: The COVID-19 testing rate remained very low among the urban slum dwellers. To remove the barriers to testing, tailored behavioral change communication and augmenting the resources for testing are necessary to curb the spread in the slums.</p

COVID-19 Testing: Perceived Barriers Among the Urban Slum Dwellers of Dhaka, Bangladesh

Background: Urban slum dwellers are unduly affected by COVID-19, and low testing rates among them are worsening their situation. This study aimed to explore the perceived barriers to COVID-19 testing in the slums, which is crucial to its surveillance, tracking, and allocating resources to combat the pandemic. Methods: A quantitative study with a cross-sectional design was conducted among 149 urban slum dwellers (≥11 years of age), who had previously experienced COVID-19 like symptoms. They were identified from an existing slum cohort at Bauniabadh, Dhaka. Information related to their testing status and perceived barriers was acquired by a telephone survey from October to November 2020. Results: The mean age of the respondents was 34.4±15.6 years, and 58.4% of them were female. Fever (79.2%) and cough (74.5%) were the most common symptoms mentioned. Only 6.7% of the respondents had undergone COVID-19 testing. Fast relief (within 1-3 days) from symptoms (87.6%) was the most prevailing barrier to testing, seen across all age and education groups. Negative advocacy regarding the testing from family and friends (46.7%), participants uncertainty about the guidelines, site, cost, and schedule of testing (15.3%), and a general belief that ‘COVID-19 is not a disease of slum people instead, it is an affliction of the rich folk’ (20.4%), were the other cited barriers. Conclusions: The COVID-19 testing rate remained very low among the urban slum dwellers. To remove the barriers to testing, tailored behavioral change communication and augmenting the resources for testing are necessary to curb the spread in the slums.</jats:p

Motivators for Adherence and Drivers of Taboo‐Breaking Behaviour Regarding Food Taboos Among Rural Pregnant Women in Bangladesh: Findings From Formative Research

ABSTRACT Understanding the influence of cultural practices on maternal health is crucial in addressing the nutritional challenges faced by pregnant women in rural Bangladesh. Despite improvements in maternal and child health indicators, food taboos remain prevalent, impacting nutritional and health outcomes of vulnerable populations. This qualitative study explored food taboos and factors related to their adherence or breaking, among rural pregnant women in Bangladesh, where a total of 90 participants, including 21 pregnant women, 23 mothers‐in‐law, 20 husbands, and 26 healthcare workers, were interviewed through 29 in‐depth interviews and 11 focus group discussions. Nearly half of the participants adhered to food taboos, citing beliefs about their negative consequences on pregnancy and baby health. Commonly restricted animal source foods included white carp, trout, duck meat, and mutton, due to fears of convulsions, speech disorders, or undesirable traits in the baby. Raw papayas and pineapples were avoided due to beliefs they could cause miscarriage. Adherence to these taboos was related to the pregnant mother's desire to avoid harm to her child, preference for vaginal delivery, avoid financial stress of caesarean section, profound respect for her elders, early age at marriage, and primiparity. Factors enabling the breaking of food taboos included nutritional counselling by healthcare workers, increased family understanding of maternal nutrition, reduced reinforcement of taboos, and the lack of negative consequences from consuming tabooed foods. The findings underscore the need to use scientific evidence to challenge food taboos by enhancing nutritional counselling programmes and engaging family members and community elders to foster dietary changes for pregnant women

Factors associated with the nutritional status of the older population in a selected area of Dhaka, Bangladesh

Abstract Background Globally, older population (aged ≥60 years) comprise 11% of the total population, and 23% of them are malnourished. Lack of knowledge and education, adverse dietary habits, depression or psychological disorders, poor oral and dental health, disability, and diseases are the reported factors responsible for malnutrition among them. Geriatric people comprise 7.5% of the total population of Bangladesh, and almost a quarter are malnourished. But there is scarce data on the factors associated with the nutritional status of the older population in Bangladesh. Methods A cross-sectional study was conducted among 125 older individuals (male 59, female 66) living in three villages of Uttarkhan, Dhaka, Bangladesh, to identify the factors associated with their nutritional status. The Mini Nutritional Assessment scale, Geriatric Depression Scale-Short Form, and Geriatric Oral Health Assessment Index were used for assessing the nutritional status, mental health status, and oral health quality of the respondents, respectively. Information on socio-demographic characteristics, comorbidities and dietary factors, and food behaviors were gathered by a pretested semi-structured questionnaire. Ethical approval was obtained from the Institutional Review Board of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Results The participants’ mean age was 67.9 ± 7.1 years. Most of them (53.6%) had no formal education. Among the respondents, 22.0% male and 28.8% female were malnourished. The proportion of malnourished and at risk of malnutrition among the respondents living without a partner were 28.6 and 65.3%, respectively. A significantly (p &lt; 0.05) higher odds of having depression (OR 15.6; 95% CI 3.1–78.1), poor oral health (OR 7.3; 95% CI 1.3–41.8), and no formal education (OR 6.5; 95% CI 1.3–32.1) was observed among the malnourished respondents. Though it was not statistically significant, among the malnourished, 31.3, 25.0 and 25.0% avoided highly oily food, beef/mutton, and sugary food, respectively. Conclusions More than two-thirds of the older population were malnourished or at risk of malnutrition, where the female respondents were more vulnerable. Depression, inadequate oral health, and lack of education were negatively associated with the nutritional status of the older population. </jats:sec

Mortality Cause in Goldsmith Workers of Bangladesh: Findings From Verbal Autopsy

Abstract Background: Information on the mortality causes of goldsmith workers in Bangladesh is very limited. This study was conducted to find out the causes of death in this group of population.Methods: The study subject was deceased goldsmith workers where face-to-face interviews were conducted with the family members who were present during the deceased's illness preceding death. A World Health Organization recommended questionnaire was adapted to conduct 20 deceased goldsmith workers' verbal autopsy. Causes of death were determined by reviewing the outcomes of the interviews by the expert physicians.Results: The mean age of the goldsmith workers at death was 59.2 ± 9.3 years. Among the deceased goldsmith workers, 70.0% were smokers, and 50.0% of them were alcohol consumers. Cardiovascular diseases (CVD) were the most common immediate and underlying cause of death (55.0% and 45.0%, respectively). Acute ischemic heart disease was the single most common (30.0%) immediate cause of death among the deceased goldsmith workers, whereas, for underlying causes of death, it was both acute and chronic ischemic heart diseases (35.0%).Conclusions: The life expectancy of goldsmith workers was much lower than the average life expectancy of Bangladesh, where CVD was the common cause of death. Smoking and alcohol consumption were prevalent among the majority of the deceased goldsmith workers. Awareness of healthy lifestyles should be prioritized for a successful CVD control program for this population. Trial registration: Not applicable.</jats:p

Seroprevalence of Chikungunya Virus Infection in an Urban Slum Population of Bangladesh: A Cross-Sectional Study

Background: Chikungunya virus is common in Bangladesh. Objective: The aim of the study was to estimate the post-outbreak seroprevalence of chikungunya virus infection in a Bangladeshi urban slum population. Methodology: From April to May 2018, a cross-sectional study was conducted in Bauniabadh, an underprivileged slum area in Mirpur Thana (subdistrict), Dhaka, Bangladesh. Randomly selected residents of this area were interviewed and screened for chikungunya IgM and IgG antibodies in sera using the immunochromatographic process. Results: Randomly selected 403 residents were recruited of which 200 cases were male and 203 cases were female. Chikungunya seroprevalence was 4.7% cases with males being more vulnerable than females (6.5% vs. 3.0% ). People over the age of 60 years were found to be infected at a higher rate (7.2%) than people between the ages of 18 and 59 years (5.5%) and those in the pediatric age group (1%). During the outbreak, 22% of patients with joint pain and 17% with fever were diagnosed as having chikungunya. Conclusion Urban slum people, especially the elderly, are affected by chikungunya outbreak in Bangladesh characterized by fever and joint pain. Journal of Current and Advance Medical Research, January 2022;9(1):3-8</jats:p

An assessment of Bangabandhu Sheikh Mujib Medical University for improving the research capacity

# Background Bangabandhu Sheikh Mujib Medical University (BSMMU) is a postgraduate medical university in Bangladesh, where health research is an institutional mission. To improve the institutional research culture that contributes to better research capabilities, an assessment of BSMMU’s research output, challenges faced while conducting research, feasible actions to overcome them, and indicators for evaluating the research capacity were identified. # Methods Published manuscripts from BSMMU for the year 2018, registered with PubMed and BanglaJOL, were reviewed to assess the status of research output. Key informant interviews and in-depth interviews were conducted with various members of the academic departments, central library, institutional review board and University journals, to identify research-related challenges, strategies to overcome, and indicators to evaluate the research capacity. # Results In 2018, the total number of scientific articles published was 364, among which 68.4% of the articles were published in local journals and 31.6% in international journals. Journals published by the University lacked indexation into international medical databases and had no impact factor. The majority of the interviewees mentioned about the lack of dedicated time for research, prioritized research agendas and need for research-related trainings to improve research performance as challenges. Establishing policies for research support, development of University’s research infrastructure and better mechanisms to disseminate research findings, were identified as key opportunities for improvement. For future evaluation of research capacity strengthening, individual levels indicators (publication outputs, research grants, awards, number of collaborations) were emphasized. # Conclusions Preference for publishing in the local journals was observed rather than in international peer-reviewed journals. The key challenges for undertaking research included the absence of dedicated time and trainings for skill development. Publication outputs, research grants, awards, number of collaborations were identified as notable indicators for evaluating improvements in research capacity at an individual level. Establishing policies and guidelines for research support, along with the development of appropriate research infrastructure in the University, will enable it to guide national policies and programs