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Background: Bangladesh is one of the most anemia prone countries in South Asia. Children of age under five years and women of reproductive age are particularly vulnerable in this region. Although several studies have investigated the risk factors of anemia, only few have explored its association with malnutrition, despite its high prevalence in the same group. The objective of this paper is to investigate the association of malnutrition with anemia by conducting separate analyses for under-five children and women of reproductive age using data from the nationally representative 2011 Bangladesh Demographic and Health Survey. Methods: Two binary outcome variables are considered separately: presence of anemia in children under five years of age (Hb<11.0 g/dl) and presence of anemia in women of childbearing age (Hb<12.0 g/dl). The exposures of interest corresponding to these two outcomes are stunting (low height-for-age) and low BMI (<18.5 kg/m2), respectively. Preliminary analysis involves estimating the association between exposure and outcome while controlling for a single confounder by computing adjusted odds ratios (adjOR) using the Cochran-Mantel-Haenszel approach in stratified analysis. Later, associations between the exposures and outcomes are estimated separately for under-five children and women of reproductive age by fitting multivariable regression models that adjust simultaneously for several confounders. Results: The prevalence of anemia is found to be higher among both the stunted children and women with low BMI compared to their healthy counterparts (Children: 56% vs 48%; women: 50% vs 43%). Furthermore, stunted children and women with low BMI have significantly increased odds of developing anemia, as reflected by the adjusted ORs of 1.76 (95% CI:1.10–2.83) and 1.81 (95% CI: 1.11–3.48), respectively. The association of stunting with anemia in children was modified by their age and socio-economic condition, where risk of being anemic decreases with increasing age but with a lower rate for stunted children from richest family. In addition, stunted children of anemic mothers are at greater risk of being anemic compared to non-stunted children of anemic or non-anemic mothers. Again the association between BMI and anemia in women is modified by the level of education, with risk of anemia being lowest among women with low BMI and higher education. Conclusion: Evidence–based policies targeting the vulnerable groups are required to combat anemia and nutritional deficiencies simultaneously under the same program. [ABSTRACT FROM AUTHOR]

Objective: To conduct a secondary data analysis detailing the associations between sociodemographic and behavioral factors and nutrition-related chronic disease. Methods: These analyses utilized 2014 data from the Indonesian Family Life Survey, a home-based survey that collected socioeconomic, dietary intake, physical activity, and biological data among adults. We explored four outcomes in relation to sociodemographic and behavioral determinants: 1) hypertension, 2) elevated high-sensitivity c-reactive protein (hs-CRP), and 3) central obesity, as these are critical metabolic determinants in the progression to cardiovascular disease, and 4) type 2 diabetes. Hypertension was defined as systolic blood pressure ≥140 mm or diastolic blood pressure ≥ 90mm or current use of antihypertensive medication. Elevated hs-CRP was defined as hs-CRP >3 mg/dL. Central obesity was defined as waist circumference ≥ 90 cm if male and waist circumference ≥ 80 cm if female, which are specific to South Asia. Type 2 diabetes was defined as glycated hemoglobin ≥ 6.5%. We employed separate gender-stratified multivariate logistic regression models to test the associations between sociodemographic and behavioral determinants and each nutrition-related chronic disease outcome. All analyses employed sampling weights, which account for the survey design. Results: In 2014, about 30% of adults were hypertensive and one-fifth had elevated hs-CRP. Approximately 70% of women had central obesity and 11.6% of women and 8.9% of men had diabetes. Older-age was consistently associated with nutrition-related chronic disease and being overweight was associated with hypertension, elevated hs-CRP, and type 2 diabetes. Regularly consuming instant noodles (women) and soda (men) were associated with elevated hs-CRP and soda consumption was associated with central obesity among men. Conclusions: Large segments of the adult population in Indonesia now have or are at risk for non-communicable disease. Our analyses provide preliminary empirical evidence that interventions that target healthful food intake (e.g. reduce the intake of ultra-processed foods) should be considered and that the reduction of overweight is critical for preventing chronic diseases in Indonesia. [ABSTRACT FROM AUTHOR]

South Asia continues to carry the greatest share and number of wasted children worldwide. Understanding the determinants of wasting is important as policymakers renew efforts to tackle this persistent public health and development problem. Using data from national surveys in Bangladesh, India, the Maldives, Nepal, Pakistan and Afghanistan, this analysis explores factors associated with wasting among children aged 0 to 59 months (n = 252,797). We conducted multivariate mixed logistic regression and backwards stepwise methods to identify parsimonious models for each country separately (all p values <0.05). Younger children (0 to 5 months), and those whose mothers had a low body mass index (<18.5 kg/m2) had greater odds of being wasted in all countries. Later birth order, being male, maternal illiteracy, short maternal stature, lack of improved water source, and household poverty were also associated with wasting in various countries, but not systematically in all. Seasonality was also not consistently associated with wasting in the final models. These findings suggest that pre-conception (adolescence), pregnancy and early postpartum, represent windows of opportunity for tackling child wasting, not only stunting. Our analysis suggests that the underlying determinants of wasting and stunting in South Asia are similar, but not universal across geographies. Cost-effective interventions to prevent both stunting and wasting, and to treat severe wasting, need to be scaled up urgently. Separating these two manifestations of child undernutrition in conceptual and programmatic terms may unnecessarily impair progress to reach the Sustainable Development Goals targets aimed at addressing both child stunting and wasting. [ABSTRACT FROM AUTHOR]

New biotic stresses have emerged around the globe over the last decades threatening food safety and security. In 2016, scientists confirmed the presence of the devastating wheat-blast disease in Bangladesh, South Asia–its first occurrence outside South America. Severely blast-affected wheat fields had their grain yield wiped out. This poses a severe threat to food security in a densely-populated region with millions of poor inhabitants where wheat is a major staple crop and per capita wheat consumption has been increasing. As an ex ante impact assessment, this study examined potential wheat-blast scenarios in Bangladesh, India, and Pakistan. Based on the agro-climatic conditions in the epicenter, where the disease was first identified in Bangladesh in 2016, this study identified the correspondingly vulnerable areas in India, Pakistan and Bangladesh amounting to 7 million ha. Assuming a conservative scenario of 5–10% for blast-induced wheat production loss, this study estimated the annual potential wheat loss across the sampled countries to be 0.89–1.77 million tons, equivalent to USD 132–264 million. Such losses further threaten an already-precarious national food security, putting pressure on wheat imports and wheat prices. The study is a call for action to tackle the real wheat-blast threat in South Asia. [ABSTRACT FROM AUTHOR]

Globally, road traffic injuries accounted for about 1.36 million deaths in 2015 and are projected to become the fourth leading cause of disability-adjusted life years (DALYs) lost by 2030. One-fifth of these deaths occurred in South Asia where road traffic injuries are projected to increase by 144% by 2020. Despite this rapidly increasing disease burden there is limited evidence on the economic burden of road traffic injuries on households in South Asia. We applied a novel coarsened exact matching method to assess the household economic burden of road traffic injuries using nationally representative World Health Survey data from five South Asian countries- Bangladesh, India, Nepal, Pakistan and Sri Lanka collected during 2002–2003. We examined the impact of road traffic injuries on household out-of-pocket (OOP) health spending, household non-medical consumption expenditure and the employment status of the traffic injury-affected respondent. We exactly matched a household (after ‘coarsening’) where a respondent reported being involved in a road traffic injury to households where the respondent did not report a road traffic injury on each of multiple observed household characteristics. Our analysis found that road traffic injury-affected households had significantly higher levels of OOP health spending per member (I$0.75, p<0.01), higher OOP spending on drugs per member (I$0.30, p = 0.03), and higher OOP hospital spending per member (I$0.29, p<0.01) in the four weeks preceding the survey. Indicators of “catastrophic spending” were also significantly higher in road traffic injury-affected households: 6.45% (p<0.01) for a threshold of OOP health spending to total household spending ratio of 20%, and 7.40% (p<0.01) for a threshold of OOP health spending to household ‘capacity to pay’ ratio of 40%. However, no statistically significant effects were observed for household non-medical consumption expenditure, and employment status of the road traffic injury-affected individual. Our analysis points to the need for financial risk protection against the road traffic injury-related OOP health expenditure and a focus on prevention. [ABSTRACT FROM AUTHOR]