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Background: Anemia is a major public health concern; however, research on anemia and its contributing variables is scarce. To address the gap, we investigated the prevalence and associated factors of anemia in school-aged adolescent girls in rural Bangladesh., Methods: We conducted a cross-sectional study in two secondary schools at Chandpur, Bangladesh, from January to April 2022. We randomly selected 422 adolescent girls based on prevalence rates from existing research to ensure reliable estimates and a robust study representation. We performed interviews with a semi-structured questionnaire after receiving ethical permission and written informed consent. In addition, physical examination and anthropometric measurements were done, followed by blood testing to identify anemia. Blood hemoglobin was measured using a spectrophotometric method, and quality control was ensured by validated results with control samples. Univariate with multiple logistic regression was employed for analysis to find the association between anemia and all other variables that were adjusted to control the potential effect of confounding variables., Results: The overall prevalence of anemia was 37.7% (mild- 33.8% and moderate- 3.9%). In the univariate analysis having a working mother (OR 3.84; 95% CI 1.31-11.26), undernutrition (OR 2.40; 95% CI 1.27-4.52), and irregular lunch consumption (OR 2.15; 95% CI 1.00-4.60) were associated with anemia. Conversely, being a user of a slab latrine (OR 0.61; 95% CI 0.40-0.93) and not weekly consumption of pure milk (OR 0.62; 95% CI 0.41-0.92) were negatively associated with anemia. In multivariate logistic regression analysis, associated factors for prevalent anemia were working mother [adjusted odds ratio (aOR) 7.65; 95% CI 1.97-29.50], slab latrine user (aOR 0.46; 95% CI 0.26-0.79), and irregular lunch consumption (aOR 2.92; 95% CI 1.21-7.03)., Conclusion: The prevalence of anemia among adolescent girls in rural Bangladesh remains high with undernutrition. Anemia is associated with working mothers, slab latrine users, and irregular lunch consumers within the studied population.' Thus, policymakers may promote school-based nutritional education and lunch programs with iron supplementation and improve sanitary facilities., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Rahman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Dried fish holds a significant place in the Bangladeshi diet particularly for people living in coastal regions. However, there is a growing concern regarding its adverse effects on human health, as it contains high levels of illegal preservatives, heavy metals, and other harmful substances. In this study, we aimed to explore the current knowledge, attitudes, and practices regarding health hazards due to unsafe dried fish consumption among people across the country. We conducted a cross-sectional study among consumers to assess their knowledge, attitudes, and practices about the health risks associated with consuming hazardous dried fish. We interviewed a total of 415 participants, of whom 52.8% were male; the majority were students (55.9%), aged between 18 and 30 years (63.9%), and living in urban areas (81.7%). Most of the participants (60.7%) had less accurate knowledge of the health hazards of unsafe dry fish, 92.8% had more positive attitudes to buying safe dry fish, and 26.8% used unsafe dry fish more frequently. Many respondents were unaware of the presence of harmful substances in dried fish, such as illegal pesticides (66.5%), microplastics (77.6%), and heavy metals (67.4%). A significant number of participants (13%) reported that they had a history of cancer in any of their family members. Many individuals (57.4%) were not familiar with the proper storage and preparation methods of dry fish. The majority of participants (81.4%) strongly prefer packed dried fish. Most of the respondents (67.7%) agreed to participate in awareness programs. Female consumers were more likely to have more accurate knowledge (AOR = 1.53; 95% CI = 1.03-2.29, p = 0.0.37) than males, and participants whose present residence were in rural were more likely to have accurate knowledge (AOR = 2.64; 95% CI = 1.30-5.36, p = 0.007) than those whose present residence were in urban or semi-urban areas. A targeted education campaign focused on improving awareness of the risks associated with eating unsafe dry fish is needed, particularly in coastal areas., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Rahat et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Bangladesh has made an intense effort to improve maternal healthcare facilities including facility delivery, but the number of home deliveries is still very high. Therefore, this study aims to find out district-wise prevalence and determine the individual and community-level predictors of home delivery among women in Bangladesh., Methods: Data were derived from the Multiple Indicator Cluster Survey (MICS) 2019, a nationwide cross-sectional survey in Bangladesh. A final sample of 9,166 (weighted) women who gave birth in the two years preceding the survey were included in this study. Considering the two-stage cluster sampling strategy adopted by MICS, we used multilevel (2-level) logistic regression analysis to find out the correlates of home delivery., Results: The overall weighted prevalence of home delivery was 46.41% (95% confidence interval [CI]: 45.39-47.43). The highest prevalence was observed in Bandarban district (84.58%), while the lowest was found in Meherpur district (6.95%). The intercept-only regression model demonstrates that the likelihood of women from various clusters having home delivery varied significantly (variance: 1.47, standard error [SE]: 0.117), indicating the applicability of multilevel regression modeling. The multilevel regression analysis showed that women with higher education, wealth status and ANC visit, and those aged >18 years at first marriage/union were associated with lower odds of delivering child at home compared to their counterparts. While women from age group of 35-49 years, whose last pregnancy was unintended were more likely to deliver child at home. In addition, those respondents belonging to a community that had higher wealth status, women's education level, and exposure to media showed lower odds of having delivery at home., Conclusions: The finding indicates that delivery at home is still high in Bangladesh. Targeted interventions to reduce home delivery are urgently needed in Bangladesh to tackle adversities during deliveries and save mothers from the consequences., Competing Interests: The authors have declared no competing interests exists., (Copyright: © 2024 Dey et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Postnatal care (PNC) is the care of a newborn and mother for up to six weeks from one hour of placenta birth. The postnatal period is one of the most hazardous stages for mothers and their baby's health. The PNC is influenced by several maternal, family, biological, and socio-economic factors and it is necessary to identify the most significant factors of PNC. Therefore, the authors focus on determining the significant determinants of postnatal care in Bangladesh., Methods and Materials: This study is based on a secondary dataset extracted from the Bangladesh Demographic and Health Survey (BDHS)-2017/18. Descriptive statistics, chi-square test, and multilevel logistic regression have been used to determine the contributing factors of PNC., Results: The rate of postnatal care was highest in Sylhet (73.7%) and lowest in Dhaka (57.1%). Female babies had 10.1% less odds of having postnatal care than male babies. Findings depict that the children with 1-3 siblings have 1. 82 times more odds (odds ratio (OR):1.82, 95% confidence interval (CI):0.03-3.21) of PNC than babies without any siblings. Children who suffered from fever recently had 1.25 times (OR = 1.25, 95% CI:1.09-1.45) more odds of taking PNC than their counterparts. Children of working mothers had 1.33 times (OR:1.33, 95% CI:1.14-1.56) more odds of having PNC than children of non-working mothers., Conclusion: The sex of a child, birth order number, place of residence, region, receiving Bacillus Calmette-Guérin (BCG) vaccine, number of antenatal care visits, having fever recently, number of household members, media exposure, and household facilities are significantly linked with PNC in Bangladesh. To ensure the good health of a child, it is necessary to focus on the targeted groups and put emphasis on the identified variables. The authors believe that the findings will be helpful to the policymakers of Bangladesh to lessen childhood morbidities which will be helpful in achieving the target of the Sustainable Development Goals (SDGs) for reducing preventable maternal and under-five deaths by 2030., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Sumon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The unprecedented global impact of the 2019 coronavirus disease (COVID-19) has necessitated a comprehensive understanding of its transmission dynamics and control measures. In this study, we present a detailed analysis of a COVID-19 vaccination model tailored to the context of Bangladesh, incorporating dual-dose vaccination strategies. By employing qualitative and bifurcation analysis techniques, we investigate the equilibrium points, effective reproduction number (R0), and critical thresholds that influence the prevalence and control of COVID-19 in the region. Our findings reveal insights into the effectiveness of vaccination programs and provide a framework for developing targeted control plans. Through a rigorous examination of model parameters and sensitivity analysis, we identify key factors driving COVID-19 transmission dynamics, emphasizing the significance of vaccination rates and other critical parameters. The validation of our model against real-world data underscores its utility in informing evidence-based decision-making for managing the COVID-19 pandemic in Bangladesh and beyond., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Kuddus et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Early marriage, defined as marriage under the age of 18, is widely recognized as a human rights violation with deleterious consequences on women's health and well-being. It persists as a significant global public health issue, predominantly being practiced in South Asian countries. In Countries like Bangladesh, this practice contributes to an increase in early pregnancies among women of reproductive age, further exacerbating adverse maternal and child health outcomes. While certain predictors of early marriage are recognized, additional investigation is warranted due to diverse socio-economic and demographic circumstances. This study, therefore, aimed to identify the prevalence and determinants of early marriage among women in Bangladesh., Methods: This study included a total weighted sample of 18,228 married women aged 18 to 49 years, extracted from the most recent nationally representative Bangladesh Demography and Health Survey (2017-18). We estimated the survey weighted pooled prevalence of early marriage among women and stratified by their different characteristics. We used multilevel mixed-effect binary logistic regression model and estimated the odds ratios (ORs) with their 95% confidence intervals (CIs) to identify the individual-, household-, and community-level factors associated with early marriage practice. All analyses were performed by Stata software version 18., Results: Overall, 74.27% [95% CI: 73.15, 75.35] women got married before reaching the age of 18 years. Early marriage was more prevalent in Rajshahi (82.69%), Rangpur (81.35%), and Khulna division (79.32%). Women with higher education (OR = 0.10, 95% CI: 0.08, 0.12), husband's higher education (OR = 0.57, 95% CI: 0.48, 0.67), and non-Muslim women (OR = 0.46, 95% CI: 0.40, 0.52) were associated with a lower likelihood of experiencing early marriage. Compared to those household heads aged ≤35 years, the likelihood of early marriage among women was lower for those household heads aged 36-55 years (OR = 0.84, 95% CI: 0.76, 0.93) and >55 years (OR = 0.78, 95% CI: 0.69-0.88). Women aged 18-24 years (OR = 1.24, 95% CI: 1.10, 1.40), husbands with agricultural occupation (OR = 1.22, 95% CI:1.06, 1.41), middle wealth index level (OR = 1.14, 95% CI: 1.02, 1.28), family size five or more (OR = 1.21, 95% CI: 1.11, 1.31), and rural residence (OR = 1.17, 95% CI: 1.04, 1.30) were more likely to experience early marriage., Conclusion: This study underscores the alarming prevalence of early marriage among women in Bangladesh, with three-fourths experiencing early marriage, particularly in specific regions. Notably, women education and older household heads were significantly associated with a reduced likelihood of early marriage. Our findings suggest that culturally sensitive interventions should focus on empowering older household heads, alongside initiatives to increase awareness among younger household heads, and enhance education, particularly in rural and impoverished households. These efforts could potentially alter socio-cultural practices and reduce early marriage in Bangladesh., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Rashid et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The widespread increase in multiple variants of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) since 2020 is causing significant health concerns worldwide. While whole-genome sequencing (WGS) has played a leading role in surveillance programs, many local laboratories lack the expertise and resources. Thus, we aimed to investigate the circulating SARS-CoV-2 variants and evaluate the performance of multiplexed real-time reverse transcription-PCR (RT-PCR) for screening and monitoring the emergence of new SARS-CoV-2 variants in Bangladesh., Methods: A total of 600 confirmed SARS-CoV-2-positive cases were enrolled either prospectively or retrospectively from two divisions of Bangladesh. The samples were screened by variant RT-PCR targeting five mutations of the spike gene (N501Y, P681R, L452R, E484K, E484Q). A subsample of the study population was also selected for third-generation sequencing (TGS) and the results were compared to the variant RT-PCR screening. An in-depth comparison was made between the two methods in terms of congruence and cost-benefit., Result: Seven variants were detected among samples, with similar distributions of the variants across both divisions. Variant RT-PCR for the targeted mutations lead to a 98.5% call rate; only nine samples failed to be determined. No association was found regarding the demographic features, clinical criteria, or routine RT-PCR Ct values across the variants. The clade diversity of the sequenced subpopulation (n = 99) exhibited similar distributions across the two study sites and other epidemiologic variables. Variant RT-PCR successfully distinguished variants of concern (VOCs) and variants of interest (VOIs); however, 8% discrepancy was observed for the closest lineages. Moreover, the variant RT-PCR represented an ideal balance of cost, time, and accuracy that outweigh their limitations., Conclusion: Based on the strong agreement of variant RT-PCR with TGS, such rapid, easily accessible approaches of rapid strain typing are essential in the context of pandemic responses to guide both treatment decisions and public health measures., Competing Interests: The authors declare no competing interest., (Copyright: © 2024 Kawser et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: In developing countries like Bangladesh, under-five children are mostly experiencing and suffering from common diseases like fever, cough, diarrhea, and acute respiratory infections (ARI). To mitigate these problems, it's crucial to spot prevalent areas and take proper action. This study investigates the spatial distribution and associated factors of prevalent childhood illnesses across Bangladesh., Methods and Findings: This research comprised 8,306 children's information from the Bangladesh Demographic and Health Survey (BDHS) 2017-18. We performed chi-square, t-tests, binary logistic regression and spatial analyses in this work. BDHS survey data and GPS data were aggregated to identify common childhood illnesses among under-five children. Moran's index first mapped childhood illnesses. Afterward, Getis-Ord Gi* discovered hot and cold spots for illnesses. However, Kriging interpolation predicted child illnesses in unsampled areas. Here, 33.2% (CI: 32.2-34.3), 36% (CI: 35-37.1), 4.7% (CI: 4.3-5.2), and 12.9% (CI: 12.2-13.6) of children under five had fever, cough, diarrhea, and ARI, respectively. In the fortnight before to the survey, 47.3% (CI: 46.2-48.3) of under-5 children were ill. Common childhood illnesses are associated with children's (age, underweight status, etc.), mothers' (age, education, etc.), and household factors (residency, wealth index, etc.). Underweight status is associated with fever, cough and at least one disease. The unsampled north-western and south-western areas of Bangladesh had a higher prevalence of fever, cough, ARI and at least one common disease. Cough was most common in the central-northern region; fever was most common in the lower southern region; and ARI was most common in Bangladesh's south-east. Childhood diseases were more prevalent in Bangladesh's central-northern and southern regions., Conclusions: Our research demonstrates the regional clustering of common childhood diseases in Bangladesh. Policymakers should focus on these higher-prevalence regions, and the necessary preventive measures should be taken immediately., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Islam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Menstrual disorders, influenced by dietary habits like high fat intake and low fruit and vegetable consumption, are a global public health issue. This study assessed the prevalence of dysmenorrhea, premenstrual syndrome (PMS), and irregular menstrual cycle (IMC) among female university students in Bangladesh, focusing on food cravings and low vitamin A intake as risk factors., Methods: In this comprehensive study, data from randomly selected female university students were collected using a structured questionnaire. The associations were analyzed through chi-square tests and multivariable logistic regression, reported as adjusted odds ratios (AOR)., Results: The most prevalent menstrual disorder was dysmenorrhea (68.3%) followed by PMS (33.8%), and IMC (24.3%). Food cravers for high-fat and sweet foods were likely to experience dysmenorrhea (AOR: 2.4, 95% CI: 1.5-3.9, P<0.001), suffer from PMS (AOR: 3.9, 95% CI: 2.3-6.6, P<0.001), and have IMC (AOR: 3.0, 95% CI: 1.6-5.3, P<0.001) vs. subjects who didn't. Subjects consuming vitamin A-rich plant foods had 40% (AOR: 0.6, 95% CI: 0.4-0.9, P < 0.01) and 60% (AOR: 0.4, 95% CI: 0.2-0.6, P<0.001) less likely suffering from dysmenorrhea and IMC vs. who didn't. Both underweight and overweight/obese subjects experienced more than 2-fold dysmenorrhea vs. normal-weight peers. The chance of IMC was nearly 3-fold among overweight/obese subjects. However, lower physical activity was associated with PMS and IMC whereas family history was associated with dysmenorrhea and PMS. Among the socio-demographic factors, maternal education, place of residence, and earlier menarche (≤12 years) were associated with dysmenorrhea while marital status was associated with IMC., Conclusion: This study indicates that increasing the intake of vitamin A-rich plant foods and reducing high-fat, sweet foods can lower the risk of dysmenorrhea and IMC. Additionally, it highlights the need for regular exercise to mitigate the increased risk of PMS and IMC., Competing Interests: The authors have declared that no competing interests exist., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

Metabolic syndrome (MetS) is a cluster of interconnected metabolic risk factors, including abdominal obesity, high blood pressure, and elevated fasting blood glucose levels, that result in an increased risk of heart disease and stroke. In this research, we aim to identify the risk factors that have an impact on MetS in the Bangladeshi population. Subsequently, we intend to construct predictive machine learning (ML) models and ultimately, assess the accuracy and reliability of these models. In this particular study, we utilized the ATP III criteria as the basis for evaluating various health parameters from a dataset comprising 8185 participants in Bangladesh. After employing multiple ML algorithms, we identified that 27.8% of the population exhibited a prevalence of MetS. The prevalence of MetS was higher among females, accounting for 58.3% of the cases, compared to males with a prevalence of 41.7%. Initially, we identified the crucial variables using Chi-Square and Random Forest techniques. Subsequently, the obtained optimal variables are employed to train various models including Decision Trees, Random Forests, Support Vector Machines, Extreme Gradient Boosting, K-nearest neighbors, and Logistic Regression. Particularly we employed the ATP III criteria, which utilizes the Waist-to-Height Ratio (WHtR) as an anthropometric index for diagnosing abdominal obesity. Our analysis indicated that Age, SBP, WHtR, FBG, WC, DBP, marital status, HC, TGs, and smoking emerged as the most significant factors when using Chi-Square and Random Forest analyses. However, further investigation is necessary to evaluate its precision as a classification tool and to improve the accuracy of all classifiers for MetS prediction., Competing Interests: There is no conflict of interest among the authors., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

Bangladesh continues to face the persistent issue of child malnutrition. This study aims to investigate the influence of parental characteristics on undernutrition among children under the age of five in both urban and rural areas of Bangladesh. This study utilizes data from the Bangladesh Demographic and Health Survey (BDHS) 2017-18, which includes 7806 children under the age of five and their parents. The effects of parental education and occupation on undernutrition (e.g., stunting, underweight, and wasting) are examined using the binary probit regression technique. Among rural children, 32.6% are stunted, 22.5% are underweight, and 8.1% are wasted. The corresponding figures for urban children are 25.3%, 18.9%, and 8.9%, respectively. In all forms of undernutrition, children living in rural areas face greater challenges than those living in urban areas. The prevalence of stunting and underweight is low among children, irrespective of their rural or urban background, when both parents have the same level of education. The prevalence is also low when fathers are employers or traders and mothers are homemakers, or when highly educated fathers are employers or traders and highly educated mothers are homemakers. In both rural and urban areas, the risk of stunting, underweight and all forms of malnutrition among children decreases as parents' education levels increase. Children whose fathers work in service or business activities are less likely to experience stunting, being underweight, or wasting compared to children whose fathers work in agriculture or other professions in both areas. In urban areas, children born to mothers with lower levels of education are more vulnerable to wasting than children whose mothers have at least secondary education. To reduce child undernutrition nationwide, it is recommended that both parents have at least a secondary school education and that the father has a stable and sufficient income., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Nahar, Zahangir. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Problematic smartphone use (PSU) and attention deficit hyperactivity disorder (ADHD) in children, adolescents, and young adults are of major concern to parents. However, the prevalence and associated factors related to these issues in Bangladeshi adolescents and young adults remain unclear to the best of our knowledge. The aim of this study is to assess PSU and ADHD in the context of adolescent and young adult age groups in Bangladesh., Methods: The present study collected data from diverse geographical locations in Bangladesh via face-to-face surveys using stratified random sampling methods. We considered age, sex, and geographic location stratification criteria. A total of 578 respondents participated in the survey initially. From this, we discarded 36 responses after screening because the information provided was insufficient or incomplete response. In the end, 542 replies were incorporated into the final analysis. PSU and ADHD depend on several factors, including the individual's demographic background., Results: The prevalence of PSU and ADHD symptoms in adolescents and young adults in Bangladesh is 61.44% and 37.45%, respectively based on our findings. The symptoms of PSU are correlated with age, education level, family type (nuclear/joint), sleeping pattern, physical exercise, and residence area. ADHD symptoms are correlated with age, education level, living with family, smoking habit, physical disability, sleeping pattern, physical exercise, residence area, and PSU. Also, we observed that ADHD and PSU symptoms are positively correlated with each other., Conclusion: A large proportion of young adults and adolescents reported PSU and ADHD symptoms. The present findings have practical implications in clinical psychology, psychotherapy, and related policy considerations. We propose to develop an inclusive interventional strategy and community-based programs to address PSU and ADHD-related issues., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Islam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Comorbidity of diabetes mellitus and tuberculosis (TB) is a major public health concern in low- and middle-income countries including Bangladesh. An integrated approach is required for adequate management of diabetes mellitus and TB. The objective of the present study was to investigate the availability and readiness of the TB care centers of Bangladesh toward diabetic patients' management., Methods: The present study was conducted based on existing data obtained from the Bangladesh Health Facility Survey (BHFS) 2017. Data collected from a total of 303 facilities providing TB services were retrieved. The outcome variables of the present study were availability and readiness of the TB health facilities for providing diabetes mellitus service. Readiness was measured for four domains: staff and guidelines, equipment, diagnostic facility and basic medicine. The independent variables were: facility level, management authority and location of the facility. Binary and multiple logistic regression models were constructed for both the outcome variables (availability and readiness) to find out their predictors., Results: Services for diabetes mellitus were available in 68% of the TB facilities while high readiness was present in 36% of the facilities. For domain-specific readiness index, readiness for the domains of staff and guidelines, equipment, diagnostic facility and basic medicine was reported in 46%, 96%, 38% and 25% facilities respectively. In the logistic regression model, availability of diabetes mellitus services was better in primary level (aOR 2.62, 95% CI 1.78-4.77) and secondary level (aOR 3.26, 95% CI 1.82-9.05) facilities than community facilities. Similarly, readiness of diabetes mellitus care was also better in these facilities (aOR 2.55, 95% CI 1.05-4.71 for primary and aOR 2.75, 95% CI 1.80-4.32 for secondary facilities). Besides, private TB facilities had better availability (aOR 2.84, 95% CI 1.75-5.89) and readiness (aOR 2.52, 95% CI 1.32-4.29) for diabetes mellitus care., Conclusion: Availability and readiness for providing diabetes mellitus services in TB care providing facilities in Bangladesh is inadequate., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Rafi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Construction workers are a population that is at risk for mental illnesses such as depression, anxiety, and even suicide due to the high stress and physical demands of their work. This study aimed to determine the prevalence and risk factors for depression, anxiety, and stress among Bangladeshi construction workers., Methods: From February 2022 to June 2022, community-based cross-sectional research was conducted among construction workers. Survey data was gathered using interviewer administered questionnaires with 502 participants from the construction sites. Data were collected based on the information related to socio-demographics, lifestyle, occupation, health hazards, and mental health (i.e., depression, anxiety, and stress). The results were interpreted using the chi-square test and logistic regression utilizing SPSS statistical software., Results: The study revealed the prevalence rates of depression, anxiety, and stress among construction workers to be 17.9%, 30.3%, and 12%, respectively. Key findings indicate that construction workers who maintained a healthy sleep duration were 64% less likely to be depressed compared to those with poor sleep (AOR = 0.36; 95% CI: 0.21-0.61, p<0.001). Workers who did not experience breathing issues upon starting construction work had a 45% lower likelihood of experiencing depression (AOR = 0.55; 95% CI: 0.32-0.97, p = 0.037) and an 82% lower likelihood of experiencing anxiety (AOR = 0.18; 95% CI: 0.11-0.30, p<0.001). Bricklayer construction workers were 72% less likely to experience stress (AOR = 0.28; 95% CI: 0.08-0.95, p = 0.041), and workers without breathing issues after starting construction work were 66% less likely to experience stress (AOR = 0.34; 95% CI: 0.17-0.66, p = 0.001)., Conclusions: The study found that depression, anxiety, and stress are prevalent among construction workers in Bangladesh, with breathing issues as a significant risk factor. Thus, there is a need for effective measures to reduce these problems and provide a safe working environment for construction workers to ensure their productivity and the country's overall growth., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Roy et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: In Bangladesh, the uptake of cervical cancer screening is low. Lack of knowledge and understanding of symptoms and risk factors contributes to low screening uptake. The purpose of this study was to explore the knowledge of cervical cancer risk factors and symptoms and to measure the association with socio-demographic characteristics among women and household decisionmakers living in hard-to-reach areas of Bangladesh., Methods: A cross-sectional survey was conducted in five districts in Bangladesh among women aged between 30 and 60 years, their husbands, and their mothers-in-law from April to September 2022. Data were collected using a modified version of the validated AWACAN questionnaire tool. The significance level was considered at p-value <0.05 and odds ratios with 95% confidence., Results: Nearly 50% of participating women in hard-to-reach areas of Bangladesh and their family decisionmakers had low levels of knowledge of the risk factors and symptoms of cervical cancer. Only 20% of respondents in our survey knew about HPV, the most important risk factor for developing cervical cancer. Most respondents were familiar with the terminology of cervical cancer as a disease; however, approximately 40% of respondents did not know that not adhering to cervical cancer screening could be seen as a risk factor. Women do not make decisions about participation in cervical cancer screening on their own. Knowledge of cervical cancer risk factors and symptoms among decisionmakers was significantly associated with higher education and higher household monthly expenditure., Conclusion: Women, their husbands, and mothers-in-law in hard-to-reach areas of Bangladesh had limited knowledge about cervical cancer risk factors and symptoms. Engaging these key decision-makers in targeted health education is vital to improve screening uptake. Conduction of future research to identify and address screening barriers is also essential for effective prevention efforts., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Nazrul et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Rapidly increasing antibiotic-resistant bacterial strains in Bangladesh's food and farm animals stem from the excessive and inappropriate use of antibiotics. To assess the prevalence of multi-drug resistant (MDR) Gram-negative bacteria in poultry chicks, we sought to isolate and identify strains carrying antimicrobial resistance genes. Isolation and identification involved biochemical tests, 16S rRNA sequencing, and PCR screening of species-specific genes. MDR patterns were evaluated using CLSI guidelines with seventeen antibiotics across twelve classes. Targeted gene sequences were amplified for the detection of Extended-spectrum β-Lactamase (ESBL), carbapenem, tetracycline, sulfonamide, and colistin resistance genes. Common isolates, such as Escherichia coli, Klebsiella pneumoniae, Proteus penneri, and Enterobacter hormaechei, exhibited average Multiple Antimicrobial Resistance (MAR) indices of 0.66, 0.76, 0.8, 0.84, and 0.81, 0.76, 0.84, 0.41 for broiler and layer chicken, respectively. Providencia stuartii and Salmonella enterica, exclusive to broiler samples, had MAR indices of 0.82 and 0.84, respectively. Additional isolates Morganella morganii, Aeromonas spp., and Wohlfahrtiimonas chitiniclastica were found in layers (Average MAR indices: 0.73, 0.71, and 0.91). Notably, M. morganii, E. hormaechei and W. chitiniclastica were identified for the first time in Bangladeshi poultry chicken, although their evolution is yet to be understood. In this study, Pan-drug resistance was observed in one P. stuartii (broiler) and one Aeromonas spp. (layer) with a MAR index 1, while all isolates exhibited MAR indices >0.2, indicating MDR. Antimicrobial resistance (AMR) gene screening identified blaTEM, blaSHV, tetA, and sul1 in a majority of the MDR strains. Interestingly, E. coli (lactose positive and negative) and E. hormaechei were exclusively found to possess the tetB gene. In addition, E. coli (lactose negative), Klebsiella pneumoniae, Enterobacter hormaechei, M. morganii, and P. stuartii were observed to carry the colistin-resistant mcr-1 gene, whereas sul2 was detected in E. coli (lactose positive and negative), E. hormaechei, P. stuartii, and P. penneri. These findings emphasize the health risk of our consumers of both broiler and layer chickens as they have turned into a potent reservoir of various AMR gene carrying MDR and Pan-drug resistant bacteria., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Munim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Participating in physical exercise is advantageous for maintaining optimum health, improving physical capacity, decreasing the likelihood of chronic diseases, and promoting overall wellbeing., Aim: This study aimed to find out the prevalence and factors that contribute to musculoskeletal injuries among individuals who participated in fitness activities at the gym., Methods: This cross-sectional study included 1123 gym members, both male and female, aged between 18 and 50 years, from selected fitness centers in Bangladesh. Musculoskeletal injuries were assessed using the Nordic musculoskeletal disorder questionnaire. Binary logistic regression identified the gym members' predictors of musculoskeletal injuries., Results: The highest prevalence of musculoskeletal injuries at the low back (36.6%) was seen among the eight body sites, followed by the shoulder (24.7%) and knee (17.1%). Males (aOR 2.589, CI 1.18 to 5.65) and those who go to the gym to lose weight (aOR 3.859, CI 0.91 to 16.33) and for physical fitness (aOR 1.895, CI 1.07 to 3.35) had a greater risk of musculoskeletal injury. Participants who carried out strength training exercises (aOR 4.10, CI 2.74 to 6.19) had a four-fold increased risk of musculoskeletal injuries than those who did not. Furthermore, higher adjusted odds of musculoskeletal injuries were found for the potential causes of injuries in incorrect holding (aOR 1.69, CI 1.10 to 2.60), overweight lifting (aOR 2.00, CI 1.30 to 3.08), lack of workout knowledge (aOR 3.56, CI 2.09 to 5.85), and insufficient information from the trainer (aOR 5.66, CI 1.84 to 17.39)., Conclusion: Musculoskeletal injuries are highly prevalent among gym-goers in Bangladesh. The back was the most often injured area, followed by the shoulder and knee. It is important to exhibit caution and take extra care while doing strength training activities in order to avoid injury. Prior to engaging in gym-based activities, it is essential to have a thorough understanding of proper exercise knowledge., Competing Interests: The authors have clarified that there are no competing interests., (Copyright: © 2024 Islam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Maternal hypertension may be an underrecognized but important risk factor for perinatal death in low resource settings. We investigated the association of maternal hypertension and perinatal mortality in rural Bangladesh. This nested, matched case-control study used data from a 2019 cross-sectional survey and demographic surveillance database in Baliakandi, Bangladesh. We randomly matched each pregnancy ending in perinatal death with five pregnancies in which the neonate survived beyond seven days based on maternal age, education, and wealth quintile. We estimated associations of antenatal care-seeking and self-reported hypertension with perinatal mortality using conditional logistic regression and used median and interquartile ranges to assess the mediation of antenatal care by timing or frequency. Among 191 cases and 934 matched controls, hypertension prevalence was 14.1% among cases and 7.7% among controls. Compared with no diagnosis, the probability of perinatal death was significantly higher among women with a pre-gestational hypertension diagnosis (OR 2.90, 95% CI 1.29, 6.57), but not among women with diagnosis during pregnancy (OR 1.68, 95% CI 0.98, 2.98). We found no association between the number of antenatal care contacts and perinatal death (p = 0.66). Among women with pre-gestational hypertension who experienced a perinatal death, 78% had their first antenatal contact in the sixth or seventh month of gestation. Hypertension was more common among rural women who experience a perinatal death. Greater effort to prevent hypertension prior to conception and provide early maternity care to women with hypertension could improve perinatal outcomes in rural Bangladesh., Competing Interests: The authors declare that they have no competing interests., (Copyright: © 2024 Bear et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Women in the fisher communities in coastal regions of Bangladesh are engaged in a wide range of fishery activities. However, there is limited evidence available on the occupational hazards and risks experienced by them., Method: The study was conducted among fishing colonies in Cox's Bazar and Chattogram districts in Bangladesh. This was a cross-sectional study blending qualitative and quantitative approaches. The qualitative component comprised five focus group discussions to understand the occupational context, hazards, and risks faced by the fisherwomen, informing the questionnaire design for the subsequent survey. The quantitative survey involved a sample of 207 women from fisher communities, gathering socio-demographic information, occupational hazards, risks, and health and safety practices., Findings: The study found a high occurrence of occupational hazards, health risks and limited availability of preventive measures among the women in fisher communities. Occupational hazards include physical safety hazards such as slippery surfaces and fish cutting instruments, and physical hazards like prolonged sun exposure and noise. Chemical hazards like pesticides and saltwater, ergonomic hazards such as prolonged uncomfortable posture and heavy lifting, and biological hazards including inadequate sanitation facilities were prevalent. The study also identified the potential occupational risks, and the outcomes resulting from the hazards, including injuries (87.44%), musculoskeletal conditions (69.08%), skin diseases/conditions (56.52%), eye complaints (33.82%), severe respiratory distress (24.15%) and high incidence of self-reported communicable diseases. Most women (78.26%) did not use personal protective equipment, and the majority (93.72%) lacked a workplace first aid kit., Conclusion: The study revealed a high prevalence of occupational hazards and health risks, including injuries and diseases, among Bangladeshi women in fisher communities with insufficient safety measures. Collaboration among government, NGOs, development partners, fisheries stakeholders, and the community is imperative for targeted training, innovative procedures, ergonomic solutions, provision of protective equipment, and advocacy to enhance the well-being of these women., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Halder et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Heart disease is a significant public health threat, and its burden is increasing worldwide. Recent evidence suggests that dietary pattern is a key modifiable factor for heart disease. Research regarding dietary patterns and heart disease in Bangladesh with their spatial variability is limited. In this study, the spatial variation and relationship between dietary patterns and heart disease among Bangladeshi people was investigated. The country-representative Household Income and Expenditure Survey 2016 dataset was used, and a total of 77,207 participants aged 30 years and over were included. A principal component analysis was conducted to derive the dietary patterns. Both statistical and spatial analyses were performed. The overall prevalence of heart disease was 3.6%, with a variation of 0.6% to 10.4% across districts of Bangladesh. Three major dietary patterns, named "festival pattern", "pickles and fast foods pattern", and "rice and vegetable pattern" were identified, accounting for 25.2% of the total dietary variance. Both the dietary pattern and heart disease rate varied across the region. A higher risk of heart disease was persistent in the western-south, southern, central, and eastern regions, as was greater adherence to the "festival pattern" and "pickles and fast foods pattern." After adjusting for confounders, participants with the highest adherence to the "rice and vegetable pattern" were associated with a lower likelihood of developing heart disease (AOR: 0.78, 95% CI: 0.64-0.95, p <0.05), while the highest adherence to the "pickles and fast foods pattern" was associated with a higher likelihood of developing heart disease (AOR: 1.50, 95% CI: 1.27-1.76, p <0.001). The spatial disparities in the prevalence of heart disease and dietary patterns underscore the significance of prioritizing intervention at the district level, especially in the western-south, southern, central, and eastern regions, to control the rising heart disease trends in Bangladesh., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Hassan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Anaemia is a major public health concern in developing countries, particularly among children, adolescents, and women of reproductive age. The study aimed to assess the anaemia status among adolescent girls, pregnant, and lactating women with their contributing factors in the southern rural regions of Bangladesh. This cross-sectional study was conducted among 400 adolescent girls, 375 pregnant, and 375 lactating women using a multistage cluster-random sampling technique. Anaemia was measured through haemoglobin concentration in blood capillaries collected with a Hemocue 301 machine. Multinomial logistic regression was used to determine the factors associated with anaemia. The average age of pregnant and lactating women was 24 years and 15.2 years for girls. Overall, the prevalence of anaemia was 50% among pregnant women, 46% among lactating women, and 38% among adolescent girls. The risk of anaemia among adolescent girls was higher among non-Muslim (aOR = 2.13, 95%CI:1.05-4.31), belonged to families having >5 members (aOR = 2.24, 95%CI:1.16-4.31) while exposure to media reduced their risk (aOR = 0.33, 95%CI:0.15-0.74). Pregnant women who consumed a diversified diet, washed their hands after toilet, and received ≥4 ANC visits had a lower likelihood of developing anaemia. Lactating women who were employed, consumed a diversified diet, washed their hands before preparing food, and after toilet, had been exposed to media, received ≥4 ANC visits, and consumed ≥90 IFA, had a lower risk of developing anaemia. However, anaemia was more likely to be associated with lactating women who were non-Muslim (aOR = 3.75; 95%CI:1.26-11.22). The high prevalence of anaemia emphasizes the need to reconsider the existing strategy for the prevention and control of micronutrient deficiencies in Bangladesh., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ara et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Spinal cord injury (SCI) is a consequence of significant disability and health issues globally, and long COVID represents the symptoms of neuro-musculoskeletal, cardiovascular and respiratory complications., Purpose: This study aimed to identify the symptom responses and disease burden of long COVID in individuals with spinal cord injury., Methods: This case-control study was conducted on patients with SCI residing at a specialised rehabilitation centre in Bangladesh. Forty patients with SCI with and without long COVID symptoms (LCS) were enrolled in this study at a 1:1 ratio according to WHO criteria., Result: Twelve LCS were observed in patients with SCI, including fatigue, musculoskeletal pain, memory loss, headache, respiratory problems, anxiety, depression, insomnia, problem in ADL problem in work, palpitation, and weakness. The predictors of developing long COVID include increasing age (p<0.002), increasing BMI (p<0.03), and longer duration of spinal cord injury (p<0.004). A significant difference (p<0.01) in overall years of healthy life lost due to disability (YLD) for non-long COVID cases was 2.04±0.596 compared to long COVID (LC) cases 1.22±2.09 was observed., Conclusion: Bangladeshi patients of SCI presented 12 long COVID symptoms and have a significant disease burden compared to non long COVID cases., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Kabir et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: This study aims to observe the associated risk factors of lower back pain and the factors that increase the pain severity. So, the main objective of this research is to identify the factors which may cause the lower back pain and the causal effect on the pain severity and respective treatment. This study also tries to determine the demographical characteristics of the low back pain patients and determine the inter relationship of psychological health, work stress and treatment effect with the pain disability index., Study Design: In this cross-sectional study, 200 patients with lower back pain were interviewed who were taking treatments from the physiotherapy department at the Center for the Rehabilitation of the Paralysed, Savar, Dhaka, Bangladesh., Methods: A quantitative research model has been performed to observe the relationship between different causes of low back pain effects on the patients. Different statistical analysis including structural equation modeling have been performed to observe their pain severity and treatment effect., Results: The study found 64% (128) of the total participants as male and 36% (72) as female among 200 patients of low back pain. The study also observed the highest portion of the patients belong to the age group 39 to 45 years (21.5%). On the basis of BMI, obese weight respondents were 26.5% (53), overweight respondents were 37% (74), normal weight respondents were 33% (66), and underweight respondents were only 3.5% (7). Here, sex, body mass index (BMI), living place and educational status have significant association with pain disability index (PDI). On the other hand, smoking tendency of patients has insignificant relationship (p>0.05) with pain disability index (PDI). The path coefficients of the structural equation model identified that all the null hypotheses of no significant relationship have been rejected for 5% level of significance. The hypothesis of psychological health is positively related to pain severity of a patient has an acceptable strength (β = 0.745, p<0.001) and a positive direction. Another hypothesis (Psychological health is positively related to the treatment of a patient) shows an acceptable strength (β = 0.401, p <0.001) and a positive direction. Work stress is also found to be positively related to pain severity of a patient with an acceptable strength (β = 0.544, p < 0.001) and a positive direction. The hypothesis (Work stress is positively related to the treatment of a patient) has an acceptable strength (β = 0.322, p< 0.05) and a positive direction. The hypothesis (pain severity is positively related to the treatment of patients) shows an acceptable strength (β = 0.801, p < 0.001) and a positive direction., Conclusion: The research found out the psychological health situation and work stress of patients are significantly related with pain severity with acceptable strength. Also, Pain severity is significantly associated with treatment scheme intensity., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Rahman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Aim: Malnutrition in pregnant women significantly affects both mother and child health. This research aims to identify the best machine learning (ML) techniques for predicting the nutritional status of pregnant women in Bangladesh and detect the most essential features based on the best-performed algorithm., Methods: This study used retrospective cross-sectional data from the Bangladeshi Demographic and Health Survey 2017-18. Different feature transformations and machine learning classifiers were applied to find the best transformation and classification model., Results: This investigation found that robust scaling outperformed all feature transformation methods. The result shows that the Random Forest algorithm with robust scaling outperforms all other machine learning algorithms with 74.75% accuracy, 57.91% kappa statistics, 73.36% precision, 73.08% recall, and 73.09% f1 score. In addition, the Random Forest algorithm had the highest precision (76.76%) and f1 score (71.71%) for predicting the underweight class, as well as an expected precision of 82.01% and f1 score of 83.78% for the overweight/obese class when compared to other algorithms with a robust scaling method. The respondent's age, wealth index, region, husband's education level, husband's age, and occupation were crucial features for predicting the nutritional status of pregnant women in Bangladesh., Conclusion: The proposed classifier could help predict the expected outcome and reduce the burden of malnutrition among pregnant women in Bangladesh., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Begum et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: This study aimed to identify the child-related factors associated with depressive symptoms among mothers of school-going children in Dhaka city of Bangladesh., Methods: The study followed a cross-sectional design and was conducted between June and December 2019 among mothers of school-going children from Dhaka City, Bangladesh. A multistage sampling technique was adopted, and a total of 324 mothers of school-going children studying in the same school for at least six months were selected. Depressive symptoms of mothers were measured using a 20-item Self-Rating Depression Scale weighted to 100 percent, with 25-49 categorized as no depression and ≥ 50 as having depression. A binary logistic regression model was executed to identify the child-related factors associated with depressive symptoms among mothers. All statistical analyses were performed using the statistical software, Stata (Version 14.0)., Results: More than half of the participants (54.3%) were aged 40 years or above and had up to HSC level education (52.5%). The majority of the participants were homemakers (67.0%), mothers of a girl child (53.1%), and had a family income of 50,000 BDT or more (52.8%). Adjusted analyses revealed that the mother's depressive symptoms were associated with their child's frequent complaints of headaches or stomach aches (aOR = 13.19, 95% CI 3.03-57.37), having an injury (aOR = 4.05, 95% CI 1.44-11.41), and unfriendly relationship with mothers (aOR = 21.46, 95% CI 5.04-91.28)., Conclusion: The present study highlighted several child-related factors that are associated with depressive symptoms among mothers that need to be considered while designing any intervention to address depressive symptoms among mothers of school-going children. It is also important to counsel mothers and fathers of the children about the importance of having a sound mother-child relationship while addressing depressive symptoms among mothers., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Sultana et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Limited research addressed links between nutritional status, dietary habits, and cognitive functions in young children. This study assessed the status of cognitive functions and their association with nutritional status and dietary habits of school age children of Bangladesh., Methods: This cross-sectional multi-centre study was conducted on 776 participants in 11 conveniently selected educational institutions. A printed questionnaire with three sections (Section 1: background information, section 2: PedsQL™ Cognitive Functioning Scale, and section 3: semi-quantitative food-frequency questionnaire) was utilized for the data collection purpose. Sections 1 and 3 were self-reported by parents, and trained volunteers completed section 2 in-person along with the anthropometric measurements. Statistical analyses were done in Stata (v.16). Mean with standard deviation and frequencies with percentages were used to summarize quantitative and qualitative variables, respectively. Pearson's chi-square test and Spearman's rank correlation coefficient were used to explore bivariate relationships., Results: The mean age of the participants was 12.02±1.88 years, and the majority (67%) were females. The prevalence of poor cognitive function was 46.52%, and among them, 66.02% were females. In terms of body mass index (BMI), 22.44% possessed normal weight, 17.51% were overweight, and 5.19% were obese. This study found a statistically significant relationship between BMI and cognitive functions. Furthermore, different dietary components (e.g., protein, carbohydrate, fat, fiber, iron, magnesium) showed a significant (p<0.05 for all) weak positive correlation with cognitive function., Conclusion: BMI and dietary habits were associated with the cognitive function of young children in Bangladesh. Although the cross-sectional design of the study precludes causal relationships from being determined, the study finding deserves further examination via longitudinal research., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Liza et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Heat waves significantly impact people's lives and livelihoods and are becoming very alarming and recognized as hot topics worldwide, including in Bangladesh. However, much less is understood regarding recent hotspots, the frequency of heat waves over time, and their underlying causes in Bangladesh. The objective of the study is to explore the current scenario and frequency of heat waves and their possible causes across Bangladesh. The Mann-Kendall and Sen's slope techniques were used to determine seasonal and annual temperature trend patterns of heat wave frequencies. Daily maximum temperature datasets collected from the Bangladesh Meteorological Department (BMD) during 1991-2021 are applied. The frequency of days with Tmax≥ 36°C as the threshold was used to compute different types of heat waves based on the BMD's operational definition. The results show that the mild heat wave (MHW) days followed the subsequent hotspot order: Rajshahi (103) > Chuadanga (79), Ishurdi (60), and Jessore (58), respectively. The frequency of days with Tmax≥36°C was persistence for many days in 2014, especially in the western part of Bangladesh compared to other parts. Similarly, the heat waves condition shown its deadliest event by increasing more days in 2021. The highest increasing trend was identified at the Patuakhali site, with a rate of 0.516 days/year, while the highest decreasing trend was noticed at the Chuadanga site, with a rate of -0.588 days/year. The frequency of days (Tmax≥36°C) is an increasing trend in the south-western part of Bangladesh. The synoptic condition in and around Bangladesh demonstrates that the entrance of heat waves in Bangladesh is due to the advection of higher temperatures from the south/southwest of the Bay of Bengal. The outcomes will guide the national appraisal of heatwave effects, shedding light on the primary causes of definite heatwave phenomena, which are crucial for developing practical adaptation tools., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Rahman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The primary objective of this study was to isolate bacteria from diabetic foot ulcers and subsequently assess their antibiotic resistance capabilities. Seventy-five patients diagnosed with diabetic foot ulcers were investigated. A number of these patients (97.33%) had type 2 diabetes, with a significant proportion of them having been diagnosed for 1-5 years (29.33%). Notably, a substantial number of these individuals were on insulin usage (78.66%). Among the patients under examination, 49.33% reported having no use of tobacco products, alcohol, or betel leaf. The ulcers analyzed in this study were classified into grades 1-5 according to the Wagner scale. Wagner grade 2 diabetic foot ulcers had the highest number of culture-positive patients, at 33.33%. Pus samples collected from patients were cultured on selective media, and bacterial identity was confirmed by biochemical tests and polymerase chain reaction. A total of 141 isolates were isolated. Among the isolates, 82.97% gram-negative bacteria and 17.02% gram-positive bacteria were detected. Klebsiella pneumoniae was the most common isolate. Proteus spp., Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus were also detected. Approximately 61.33% of the ulcers exhibited were polybacterial. In this study, it was observed that all bacterial isolates, except for Proteus spp., were primarily detected in patients classified under Wagner's grade 2. Moreover, antibiotic susceptibility was also tested on these 141 isolates. Among them, Escherichia coli showed the highest multidrug resistance, 81.81%. Most of the gram-negative bacteria were resistant to ampicillin. All of the gram-negative isolates exhibited high levels of susceptibility to piperacillin-tazobactam, and these levels were Klebsiella pneumoniae (97.56%), Pseudomonas aeruginosa (95.24%), Escherichia coli (81.82%), and Proteus spp. (80%). On the other hand, gram-positive Staphylococcus aureus mostly showed sensitivity towards vancomycin and norfloxacin (79.17%)., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Baral et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The study aimed to assess the level of potentially toxic elements (As, Cd, Pb, Zn, Cu, Cr, Mn, and Ni) and associated health implications through commonly consumed rice cultivars of Bangladesh available in Capital city, Dhaka. The range of As, Cd, Pb, Zn, Cu, Cr, Mn, and Ni in rice grains were 0.04-0.35, 0.01-0.15, 0.01-1.18, 10.74-34.35, 1.98-13.42, 0.18-1.43, 2.51-22.08, and 0.21-5.96 mg/kg fresh weight (FW), respectively. The principal component analysis (PCA) identified substantial anthropogenic activities to be responsible for these elements in rice grains. The estimated daily intake (EDI) of the elements was below the maximum tolerable daily intake (MTDI) level. The hazard index (HI) was above the threshold level, stating non-carcinogenic health hazards from consuming these rice cultivars. The mean target cancer risk (TCR) of As and Pb exceeded the USEPA acceptable level (10-6), revealing carcinogenic health risks from the rice grains., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Shaheen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Diarrhoea is a global health problem. More than a quarter of diarrhoeal deaths occur among children less than five years. Different literatures analyzed presentation and outcomes of less than five diarrhoeal children. The world has made remarkable progress in reducing child mortality. So, older children are growing in number. Our aim was to identify clinical differentials and variations of pathogens among younger (less than five) and older (five to nine years) diarrhoeal children., Method: Data were extracted from the diarrhoeal disease surveillance system (DDSS) of Dhaka Hospital (urban site) and Matlab Hospital (rural site) of the International Centre for Diarrhoeal Disease Research, Bangladesh for the period of January 2012 to December 2021. Out of 28,781 and 12,499 surveillance patients in Dhaka and Matlab Hospital, 614 (2.13%) and 278 (2.22%) children were five to nine-years of age, respectively. Among under five children, 2456 from Dhaka hospital and 1112 from Matlab hospital were selected randomly for analysis (four times of five to nine years age children, 1:4)., Results: Vomiting, abdominal pain, and dehydrating diarrhoea were significantly higher in older children in comparison to children of less than five years age (p-value <0.05) after adjusting study site, gender, antibiotic use before hospitalization, diarrhoeal duration < 24 hours, intake of oral rehydration fluid at home, parental education, WASH practice and history of cough. Vibrio. cholerae, Salmonella, and Shigella were the common fecal pathogen observed among older children compared to under five after adjusting for age, gender and study site., Conclusion: Although percentage of admitted diarrhoeal children with five to nine years is less than under five years children but they presented with critical illness with different diarrhoeal pathogens. These observations may help clinicians to formulate better case management strategies for children of five to nine years that may reduce morbidity., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Nuzhat et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Several safety measures like movement restrictions, closure of educational institutions, and social distancing measures continue over the world including Bangladesh during the COVID-19 pandemic. This study aimed to examine the patterns of eating behaviors, physical activity, and lifestyle modifications among adolescents during the COVID-19 pandemic residing in Bangladesh., Methods: A cross-sectional study was performed among 490 adolescents in Bangladesh from December 2020 to May 2021. The survey was carried out through a semi-structured web-based questionnaire that asked questions about socio-demographics (i.e., age, sex, marital status, education, residence), perceived health status and quality of life, anthropometrics (i.e., height, weight), dietary habits (i.e., frequency of eating, daily intake of certain foods, number of meals eaten daily), and physical activity (i.e., modified version of the International Physical Activity Questionnaire Short Form [IPAQ-SF]), as well as, pre- and during COVID-19 information on stress, and sleep., Results: During the pandemic, 43.7% participants reported weight gain; and 23.5% reported an increased number of meals per day during COVID-19. Additionally, the participants' eating habits diverged from the local balanced diet principles and were more akin to 'unhealthy' eating patterns. Though, during the COVID-19 pandemic, physical exercise slightly increased (>3 times/ week: 8.2% vs. 13.5%; p<0.001) compared to pre-COVID-19 period, the screen time for entertainment increased drastically (>5 hours/ week: 12.2% vs. 27.3%; p<0.001). Compared to the pre-pandemic, a sizeable proportion of individuals experienced more physical tiredness, emotional exhaustion, irritation, and stress (p<0.001) during the pandemic. During the pandemic, 47.5% of participants experienced different sleep difficulties., Conclusions: Although lockdowns and social distancing are important safety measures to protect people from COVID-19, findings reveal that they might cause a variety of lifestyle changes, physical inactivity, and psychological issues in Bangladeshi adolescents., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ferdous et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This study aimed to explore the prevalence and determinants of discrimination against or harassment among Bangladeshi women. The nationally representative cross-sectional data of the Multiple Indicator Cluster Survey 2019 were employed in the study. Women aged 15-49 were asked whether they felt discrimination or harassment due to seven potential reasons in the last twelve months before the survey. The outcome was a binary variable indicating whether a woman has experienced discrimination or harassment for any of the seven reasons. Responses were obtained from 64378 women and analysed through bivariate and multivariate procedures. The data had a hierarchical structure since women were nested within the clusters. A mixed-effects logistic regression model was used to analyse the data appropriately. A strong association between discrimination or harassment was seen with the functional difficulties of women. Notably, women with functional difficulties were 1.629 times more likely to experience discrimination or harassment than women without such difficulties. Other significant factors were the respondents' area, age, education, current marital status, wealth index quintile and ethnicity. The study concludes that education, marital status, functional difficulties and wealth index are the most important determinants of discrimination or harassment of women., Competing Interests: The authors declare that there is no competing interest., (Copyright: © 2024 Alam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Vaccination has been an indispensable step in controlling the coronavirus disease pandemic. In early 2021, Bangladesh launched a mass vaccination campaign to boost the COVID-19 vaccination rate when doses were available and immunized millions in the country. Although deemed a success, disparities became conspicuous in vaccination coverage across population of different socioeconomic background., Methods: The purpose of this cross-sectional study was to assess the vaccination coverage for three doses and detect disparities in uptake of the COVID-19 vaccine among rural population of hard-to-reach areas and urban individuals belonging to the high-risk group -defined in our study as individuals from elusive population such as floating population/street dwellers, transgender, addicts and disabled population. We conducted household survey (n = 12,298) and survey with high risk group of people (2,520). The collected primary data were analysed using descriptive statistical analysis., Results: Our findings show that coverage for the first dose of COVID-19 vaccination was high among respondents from both rural Hard-to-reach (HTR) (92.9%) and non-HTR (94.6%) areas. However, the coverage for subsequent doses was observed to reduce significantly, especially for third dose (52.2% and 56.4% for HTR and non-HTR, respectively)., Conclusion: Vaccination coverage among urbanites of high-risk group was found to be critically low. Vaccine hesitancy was also found to be high among individuals of this group. It is essential that the individuals of urban high-risk group be prioritized. Individuals from this group could be provided incentives (transport for disabled, monetary incentive to transgenders; food and medicine for drug user and floating people) and vaccination centers could be established with flexible schedule (morning/afternoon/evening sessions) so that they receive vaccine at their convenient time. Community engagement can be used for both high-risk group and rural population to enhance the COVID-19 vaccination coverage and lower disparities in uptake of the vaccine doses nationwide., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Jannat et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: To estimate the prevalence of Type 2 Diabetes (T2D) in urban and rural settings and identify the specific risk factors for each location., Method: We conducted this study using data from the 2017-18 Bangladesh Demographic and Health Survey (BDHS), sourced from the DHS website. The survey employed a stratified two-stage sampling method, which included 7,658 women and 7,048 men aged 18 and older who had their blood glucose levels measured. We utilized chi-square tests and ordinal logistic regression to analyze the association between various selected variables in both urban and rural settings and their relationship with diabetes and prediabetes., Results: The prevalence of T2D was 10.8% in urban areas and 7.4% in rural areas, while pre-diabetes affected 31.4% and 27% of the populations in these respective settings. The study found significant factors influencing diabetes in both urban and rural regions, particularly in the 55-64 age group (Urban: AOR = 1.88, 95% CI [1.46, 2.42]; Rural: AOR = 1.87, 95% CI [1.54, 2.27]). Highly educated individuals had lower odds of T2D, while wealthier and overweight participants had higher odds in both areas. In rural regions, T2D risk was higher among caffeinated drink consumers and those not engaged in occupation-related physical activity, while these factors did not show significant influence in urban areas. Furthermore, urban participants displayed a significant association between T2D and hypertension., Conclusion: Our study outlines a comprehensive strategy to combat the increasing prevalence of T2D in both urban and rural areas. It includes promoting healthier diets to control BMI level, encouraging regular physical activity, early detection through health check-ups, tailored awareness campaigns, improving healthcare access in rural regions, stress management in urban areas, community involvement, healthcare professional training, policy advocacy like sugary drink taxation, research, and monitoring interventions. These measures collectively address the T2D challenge while accommodating the distinct features of urban and rural settings., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Talukder et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Globally, undernutrition is the leading cause of mortality among under-five children. Bangladesh and India were in the top ten countries in the world for under-five mortality. The aim of the study was to investigate the nutritional status of Bengali under-five children., Methods: Data on 25938 under-five children were retrieved from the Bangladesh Demographic and Health Survey 2017-18 (BDHS) and the National Family Health Survey of India 2015-16 (NFHS-4). Stunting, wasting, underweight and thinness were considered to understand the nutritional status of under-five children. Binary logistic regression was used to identify associated factors of undernutrition among children., Results: Over one-quarter of Bengali under-five children were found to be suffering from the problem of stunting (31.9%) and underweight (28.1%), while other nutritional indicators raised serious concern and revealed inter-country disparities. In the cases of wasting, underweight and thinness, the mean z-scores and frequency differences between Bangladesh and India were significant. The nutritional status of Bengali under-five children appeared to have improved in Bangladesh compared to India. Child undernutrition had significant relations with maternal undernutrition in both countries. Girls in Bangladesh had slightly better nutritional status than boys. In Bangladesh, lack of formal education among mothers was a leading cause of child undernutrition. Stunting and underweight coexist with low household wealth index in both counties., Conclusions: The research revealed that various factors were associated with child undernutrition in Bengalis. It has been proposed that programmes promoting maternal education and nutrition, along with household wealth index be prioritised. The study recommends that the Governments of Bangladesh and India should increase the budget for health of children so as to reach the sustainable development goals., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Kundu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Purpose: Since the coronavirus (COVID-19) was announced as being a global pandemic on 11 March, governments from all parts of the world declared a quarantine period, during which people were prohibited from leaving their homes (except for essential activities) to contain the spread of the virus. Since then, the population has faced different levels of restrictions (i.e., mobility, social activities) that limited participation in normal daily routines. Consequently, these restrictions may have adversely changed physical activity, diet, sleep patterns, and screen time or work routine. So, the pandemic has had profound influence on the mental health of the entire societies. As the mental health status of Bangladeshi patients living in rural area that have recovered from COVID-19 has not been previously studied, this gap is addressed through the present investigation focusing on one rural Bangladeshi community., Methods: A convenience sampling method was employed to recruit participants for this cross-sectional study. Data was gathered by conducting face-to-face interviews with 243 recovered COVID-19 patients (as confirmed by a positive Reverse Transcription PCR test) attending a local primary health care facility center and instructed to consider how they felt in the preceding week., Results: By administering a validated Bengali version of the Depression, Anxiety, and Stress Scale (DASS-21) to measure participants' mental health status, we noted that 24% of the sample exhibited depressive symptoms. In addition, 30.9% and 21.8% of the participants experienced stress symptoms and reported anxiety, respectively. Sociodemographic factors such as female sex, lower educational level, living away from family, smaller living accommodations, and lower economic status significantly predicted mental health outcomes in multivariate logistic regressions., Conclusion: These results may help health care providers formulate proper mental health interventions and preventive measures to minimize the mental health problems among patients that have recovered from COVID-19., Competing Interests: he authors have declared that no competing interests exist., (Copyright: © 2024 Ibne Zaid et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: With half a female population, empowering women can be a key factor in our country's global advancement. Focusing on household decision-making and attitudes toward wife beating, our study addresses the dearth of research exploring how different socio-economic and demographic factors associated with women's empowerment evolve over the past decade in Bangladesh (from BDHS 2007 to BDHS 2017-18)., Methods: Data from four waves of Bangladesh Demographic and Health Survey (BDHS, 2007 to BDHS, 2017-18) were used in this study. We put forth two domains-household decision-making and attitudes toward domestic violence-to assess women's empowerment. Principal component analysis (PCA) was employed to create women's empowerment index. To assess the unadjusted association between the selected covariates and women's empowerment, Pearson Chi-square test and ANOVA F test have been used, while adjusted association has been analyzed through proportional odds model (POM)., Results: In BDHS 2017-18, women from urban areas experienced 'high' empowerment than women in rural areas (56.08% vs. 45.69%). A notable change has been observed in the distribution of women's empowerment index by education over the survey years. Findings also showed that in all the survey years, division, place of residence, education level, number of living children, media exposure, wealth index, working status, and relationship with household head have been found to have significant association with women's empowerment index. For instance, women who completed secondary education in 2007, 2011, 2014, and 2017-18, respectively have 14.4%, 31.8%, 24.6%, and 39.6% higher odds of having empowerment compared to those who were uneducated. Further, age at first marriage, spousal age gap, NGO membership etc. emerged as a contributing factor in specific survey years., Conclusion: Our study affirmed that, over a ten-year period, women were more likely to protest against physical violence and to participate in various decision-making regarding their personal and social life. Empowerment is notably higher among women in urban residents, those with secondary education, 1-2 children, media exposure, and employment. Policy recommendations should emphasize targeted measures to raise awareness and empower uneducated, unemployed, economically disadvantaged, and physically oppressed women., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Akter et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Socioeconomic inequality in antenatal care visits is a great concern in developing countries including Bangladesh; however, there is a scarcity of investigation to assess the factors of inequality and these changes over time. In this study, we investigated the trend of socioeconomic inequalities (2004-2017) in 1+ANC and 4+ANC visits, and extracted determinants contributions to the observed inequalities and urban-rural disparities in Bangladesh over the period from 2011 to 2017., Methods: The data from the Bangladesh Demographic and Health Surveys (BDHS) conducted in 2004, 2007, 2011 and 2017 were analyzed in this study. The analysis began with exploratory and bivariate analysis, followed by the application of logistic regression models. To measure the inequalities, the Erreygers concentration index was used, and regression-based decomposition analyses were utilized to unravel the determinant's contribution to the observed inequalities. The Blinder-Oaxaca type decomposition is also used to decompose the urban-rural disparity into the factors., Results: Our analysis results showed that the prevalence of 1+ANC and 4+ANC visits has increased across all the determinants, although the rate of 4+ANC visits remains notably low. The magnitudes of socioeconomic inequality in 4+ANC visits represented an irregular pattern at both the national and urban levels, whereas it increased gradually in rural Bangladesh. However, inequalities in 1+ANC visits declined substantially after 2011 across the national, rural and urban areas of Bangladesh. Decomposition analyses have suggested that wealth status, women's education, place of residence (only for 4+ANC visits), caesarean delivery, husband education, and watching television (TV) are the main determinants to attribute and changes in the level of inequality and urban-rural disparity between the years 2011 and 2017., Conclusions: According to the findings of our study, it is imperative for authorities to ensure antenatal care visits are more accessible for rural and underprivileged women. Additionally, should focus on delivering high-quality education, ensuring the completion of education, reducing income disparity as well as launching a program to enhance awareness about health facilities, and the impact of caesarean delivery., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Biswas et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Bangladesh's islands, because of their geographical location, frequently encounter crises like floods and river erosion, which pose significant threats to the residents' well-being and livelihoods. To delve into the effects of these disasters on livelihood and healthcare challenges, a mixed-method study was undertaken in a riverine-island near a major river of Bangladesh., Methodology: Between February 15th and February 28th, 2023, a cross-sectional study was conducted on an island in Bangladesh. The quantitative method involved conducting a survey of 442 households, with a total of 2921 participants. Additionally, 10 in-depth interviews and 10 key-informant interviews were conducted using semi-structured guidelines. Qualitative interviews were audio-recorded, transcribed verbatim, and analyzed using a thematic analysis. Triangulation was employed in this study through the integration of qualitative and quantitative analysis, resulting in the presentation of findings that offer an in-depth comprehension of the phenomenon being investigated., Results: River erosions and floods are common and recurring natural disasters that significantly impact the lives of the riverine island inhabitants. These disasters often disrupted their livelihoods, forced many residents to endure substandard living conditions or relocated during flood events. The island faced a low diagnostic prevalence of chronic diseases (e.g., 5.1% of adults were hypertension and 2.5% are diabetes) because of the absence of diagnostic facilities and a shortage of certified doctors. A significant number of chronic illness people in the community turned to alternative medicine sources (39.3%) such as homeopathy, Kabiraj, and Ayurvedic medicine, especially it gets increased during periods of natural disasters. Moreover, reproductive aged women revealed that 79.4% of them gave birth at home, with 6.0% of these home deliveries resulting in miscarriage or infant death. The destruction of crops, unstable job opportunities, an inadequate educational system, and a deficient healthcare delivery system exacerbated the hardships faced by the population affected by these disasters., Conclusion: The failure to seek treatment for chronic diseases and undiagnosed diseases is a significant health issue among the aging adults on the island. Island residents face the challenge of establishing effective prevention strategies for the well-being of older adults especially at the period of natural disasters. It is crucial for the government and non-governmental organizations (NGOs) to collaborate to prevent the negative effects of floods and river erosions. This should include efforts to enhance the quality of education, healthcare services, job opportunities, and financial assistance for rebuilding homes., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Hossain et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Functional difficulty in children is a crucial public health problem still undervalued in developing countries. This study explored the socio-demographic factors and anthropometry associated with children's functional difficulty in Bangladesh. Data for 2-4-year-old children, obtained from Multiple Indicator Cluster Survey 2019, were used in this study. The mixed-effects logistic regression model was used to analyse the data. Children whose mothers had functional difficulty were found to be 2.75 times more likely to have functional difficulty than children whose mothers had no functional difficulty (95% CI 1.63-4.63). Male children were more likely to experience functional difficulty than female children (OR = 1.48). Furthermore, stunting was found to be significantly associated with functional difficulty (OR = 1.50). The study also revealed that division and mother's education, specifically, children with mothers having higher secondary + education, had significant association with the outcome variable. The findings provided a vital overview of child disability in a developing country., Competing Interests: The authors declare that there is no competing interest., (Copyright: © 2024 Rahman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The COVID-19 pandemic has been a major health concern in Bangladesh until very recently. Although the Bangladesh government has employed various infection control strategies, more targeted Non-Pharmaceutical interventions (NPIs), including school closure, mask-wearing, hand washing, and social distancing have gained special attention. Despite significant long-term adverse effects of school closures, authorities have opted to keep schools closed to curb the spread of COVID-19 infection. However, there is limited knowledge about the impact of reopening schools alongside other NPI measures on the course of the epidemic. In this study, we implemented a mathematical modeling framework developed by the CoMo Consortium to explore the impact of NPIs on the dynamics of the COVID-19 outbreak and deaths for Bangladesh. For robustness, the results of prediction models are then validated through model calibration with incidence and mortality data and using external sources. Hypothetical projections are made under alternative NPIs where we compare the impact of current NPIs with school closures versus enhanced NPIs with school openings. Results suggest that enhanced NPIs with schools opened may have lower COVID-19 related prevalence and deaths. This finding indicates that enhanced NPIs and school openings may mitigate the long-term negative impacts of COVID-19 in low- and middle-income countries. Potential shortcomings and ways to improve the research are also discussed., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Shimul et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Although under-five mortality has declined appreciably in Bangladesh over the last few decades, neonatal mortality still remains high. The objective of the study is to assess the level and determinants of preterm birth and the contribution of preterm birth to neonatal mortality., Methods: Data for this study came from selected slums in and around Dhaka city, where; since 2015, icddr,b has been maintaining the Health and Demographic Surveillance System (HDSS). The HDSS data were collected by female Field Workers by visiting each household every three months; however, during the visit, data on the Last Menstrual Period (LMP) were also collected by asking each eligible woman to ascertain the date of conception. Gestational age was estimated in complete weeks by subtracting LMP from the date of the pregnancy outcome. In this study, 6,989 livebirths were recorded by HDSS during 2016-2018, and these births were followed for neonatal survival; both bivariate and multivariate analyses were performed., Results: Out of total births, 21.7% were born preterm (before 37 weeks of gestation), and sub-categories were: 2.19% for very preterm (28 to 31 weeks), 3.81% for moderate preterm (32 to 33 weeks), and 15.71% for late preterm (34 to 36 weeks). The study revealed that preterm babies contributed to 39.6% of neonatal deaths; however, the probability of death was very high on the 1st day of birth (0.124 for very preterm, 0.048 for moderate preterm, 0.024 for late preterm, and 0.013 for term birth), and continued until the 3rd day. In the regression analysis, compared to the term neonates, the odds of neonatal mortality were 8.66 (CI: 5.63, 13.32, p<0.01), 4.13 (CI: 2.69, 6.34, p<0.01) and 1.48 (CI: 1.05, 2.08, p<0.05) respectively for very, moderate, and late preterm birth categories. The population attributable fraction for neonatal mortality was 23%, and sub-categories were 14% for very preterm, 10% for moderate preterm, and 6% for late preterm., Conclusions: Although urban slums are in proximity to many health facilities, a substantial proportion of preterm births contribute to neonatal deaths. So, pregnant women should be targeted, to ensure timely care during pregnancy, delivery, and post-partum periods to improve the survival of new-borns in general and preterm birth in particular., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Razzaque et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

In developing nations, catastrophic health expenditures have become an all-too-common occurrence, threatening to push households into impoverishment and poverty. By analyzing the Household Income and Expenditure Survey 2016, which features a sample of 46,080 households, this study provides a comprehensive district-by-district analysis of the variation in household catastrophic health expenditures and related factors. The study utilizes a multilevel logistic regression model, which considers both fixed and random effects to identify factors associated with catastrophic health expenditure. The findings of the study indicate that districts located in the eastern and southern regions are at a significantly higher risk of experiencing catastrophic health expenditures. A potential explanation for this trend may be attributed to the high prevalence of chronic diseases in these districts, as well as their economic conditions. The presence of chronic diseases (AOR 5.45 with 95% CI: 5.14, 5.77), presence of old age person (AOR 1.50 with 95% CI: 1.39, 1.61), place of residence (AOR 1.40 with 95% CI: 1.14, 1.73) are found to be highly associated factors. Additionally, the study reveals that the thresholds used to define catastrophic health expenditures exhibit substantial variation across different regions, and differ remarkably from the threshold established by the WHO. On average, the thresholds are 23.12% of nonfood expenditure and 12.14% of total expenditure. In light of these findings, this study offers important insights for policymakers and stakeholders working towards achieving universal health coverage and sustainable development goals in Bangladesh., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Alam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: The vaccination against coronavirus disease 2019 (COVID-19) has been identified as a promising strategy to reduce the severity of the pandemic. Despite the safe and effective COVID-19 vaccines, bringing socioeconomically disadvantaged people under vaccination coverage has been challenging for developing countries like Bangladesh. Therefore, this study explored the determinants of vaccine acceptance among urban slum residents of Bangladesh using the Health Belief Model (HBM) and Theory of Planned Behavior (TPB)., Methods: A face-to-face survey of 400 urban slum dwellers in two large cities in Bangladesh was conducted between July 5 to August 5, 2021. The questionnaire included vaccine acceptance, socio-demographics, health-related characteristics, trust in health authorities, reasons for vaccine hesitancy, and dimensions of HBM and TPB frameworks. Hierarchical logistic regression was performed to evaluate the association between these characteristics and vaccination acceptance., Results: Around 82% (n = 327) of respondents were willing to accept the COVID-19 vaccine. In a fully adjusted model, respondents with secondary level education had higher intention (OR = 46.93, 95%CI = 1.21-1807.90, p < 0. 05) to accept COVID-19 vaccine. Respondents with bad (OR = 0.11, 95%CI = 0.01-0.35, p<0.05) or very bad (OR = 0.01, 95%CI = 0.01-0.35, p<0.05) health conditions were less interested in the COVID-19 vaccination. In regard to HBM dimensions, greater perceived susceptibility (OR = 1.75, 95% CI = 1.12-2.75, p < 0.05), and perceived benefits (OR = 3.28, 95% CI = 1.17-6.00, p < 0.001) were associated with a greater willingness to get vaccinated. In regard to TPB, higher self-efficacy in preventing illness without the vaccine increased the desire to get vaccinated (OR = 1.55, 95% CI = 1.02-2.37, p < 0.05). Fear of unknown side effects, religious beliefs, contraindications to vaccination, and insufficient information on the vaccine were the main reasons for vaccine hesitancy., Conclusions: These findings offer valuable insights for policymakers in Bangladesh to design targeted interventions that address vaccine hesitancy and increase vaccination acceptability among socially disadvantaged individuals in urban areas. Strategies should focus on providing accurate and accessible information about the vaccine, communicating its positive impact effectively, engaging with religious leaders to address misconceptions, and tailoring vaccination campaigns to meet the unique needs of different demographic groups., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Patwary et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This study aims to investigate socioeconomic disparities in nutritional status among ever-married women in Bangladesh and to break down urban-rural differences in the underlying causes of undernutrition. We utilized data from the Bangladesh Demographic and Health Survey 2017-18, a sample size of 18328 ever-married women, including 5170 from urban residences, and 13159 from rural residences. To explore socioeconomic inequality, we employed a concentration indexing measure, while a multiple binary logistic regression model was carried out to identify the determinants associated with the outcome variable. A Blinder-Oaxaca decomposition analysis was performed to decompose the urban-rural gap in women's nutritional status using associated factors. The prevalence of undernutrition among ever-married women in Bangladesh was 12 percent. Notably, this percentage varied by region, with urban residents accounting for 8.6% and rural residents accounting for 13.3%. Our findings confirmed that undernutrition was more prevalent among women with lower wealth indexes in Bangladesh, as indicated by the concentration index (CIX = -0.26). The multivariable analysis investigating the determinants of undernutrition status among ever-married women, with a focus on residence revealed significant associations with respondent age, education, marital status, mass media access, wealth status, and division. According to the Blinder-Oaxaca decomposition and its extension, the prevalence was significantly higher in rural residences of Bangladesh than in urban residences, and the endowment effect explained 86 percent of the total urban-rural difference in undernutrition prevalence. The results of this study indicate that the factors that influence women's nutritional status in rural areas play a significant role in the gap, and the majority of the gap is caused by education and economic position. In order to effectively promote maternal health policies in Bangladesh, intervention techniques should be created that are aimed at the population, that is, the poorest and least educated., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Hossain et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: As with many countries around the world, the incidence of diabetes in Bangladesh is increasing significantly. Whilst there is controversy in the field regarding the health impact of artificial sweeteners in Western communities, the link between sweetener consumption and awareness in Bangladesh has not been established., Methods: In the present study, 260 diabetic patients completed a questionnaire survey to investigate the use and awareness of sweeteners and how this links to demographics and potential co-morbidities., Results: Findings show that daily artificial sweetener consumption is significantly associated with hypertension but not other co-morbidities such as kidney disease or obesity. We further demonstrate that there is limited checking of artificial sweeteners in food or drink products by participants. the rurality of diabetic participants was found to significantly correlates with lower awareness of any health impact of artificial sweeteners., Conclusions: The findings from this study demonstrate that there is a need to increase the awareness of artificial sweetener use in diabetic patients in Bangladesh. Combined with a more robust understanding of the health impact of artificial sweeteners, these findings suggest that there is potential to improve outcomes for diabetic patients by improving this awareness., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Shil et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Since August 2020; the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) in collaboration with UNICEF has been operating a COVID-19 field hospital at the Teknaf sub-district of Cox's Bazar in Bangladesh. This paper is focused on estimating the effects of a history of tobacco smoking and pre-existing co-morbidities on the severity of COVID-19 infection among adult patients admitted into the aforesaid hospital. We conducted a retrospective data analysis of COVID-19 adult patients hospitalized from August 27, 2020 to April 20, 2022. Based on inclusion criteria; a total of 788 admitted patients were included in the analysis. We conducted a Chi-squared test and Fisher's exact test for the categorical variables to see their associations. Multinomial logistic regression models were performed to explore the risk factors for the severity of COVID-19 infection. Among 788 patients, 18.4%, 18.8%, 13%, 7.1%, 3.4%, and 1.9% have had a history of smoking, hypertension, diabetes, chronic obstructive pulmonary disease (COPD), cardiovascular diseases (CVD), and asthma respectively. Overall, the mean age of the patients was 40.3 ± 16.4 years and 51% were female. In multivariate analysis, history of smoking and co-morbidities were identified as the risk factors for the severity of COVID-19 infection; the history of smoking was found linked with an increase in the risk of developing critical, severe, and moderate level of COVID-19 infection- notably 3.17 times (RRR = 3.17; 95% CI: 1.3-7.68), 2.98 times (RRR = 2.98; 95% CI: 1.87-4.76) and 1.96 times (RRR = 1.96; 95% CI: 1.25-3.08) respectively more than the patients who never smoked. It was evident that patients with at least one of the selected co-morbidities such as hypertension, diabetes, COPD, CVD, and asthma exhibited a significantly higher likelihood of experiencing severe illness of COVID-19 compared to patients without any co-morbidity. History of tobacco smoking and pre-existing co-morbidities were significantly associated with an increased severity of COVID-19 infection., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Islam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Globally, ocular morbidity and disability among children are major public health concerns. This study was designed to explore the health-seeking behaviours of parents in Bangladesh whose children have ocular problems. A cross-sectional mixed method was followed for this study. The method was designed to measure the eye health care-seeking practices of caregivers/parents with children with ocular morbidity in three unions (the lowest administrative geographical area comprising 30,000-50,000 population) of the Raiganj Upazila under the Sirajganj District of Bangladesh. The study period was from January to April 2017. Face-to-face interviews using a semi-structured quantitative questionnaire with the caregivers and KI were conducted among the health service providers during the study period. This was the first community-based study conducted in Bangladesh to find out caregivers' health-seeking behaviour with identified ocular morbidity. Among 198 confirmed cases of childhood ocular problems, only 87 (43.9%) parents sought health care for their children's ocular morbidities. Better health-seeking behavior was found among the wealthier families. Proportions were 55.3% and 36% among wealthy and low-income families, respectively. Affluent families sought care from qualified service providers. Educated household heads chose qualified service providers for their children at a higher rate than illiterate household heads. Lack of knowledge, lack of awareness and financial constraints are significant barriers to seeking proper health care. More than half of the caregivers did not seek any eye care services for their children. Socio-demographic factors, and financial constraints play an essential role in the health-seeking behaviour of the parents., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Hussain et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The undergraduate admission test is one of the most stressful assessments in a student's life, as it is required for admission to any of Bangladesh's public universities or medical colleges. Those taking the admissions test are under a lot of pressure to perform well. This study aimed to determine the prevalence of clinical depression among Bangladeshi admission candidates and the factors that contribute to it., Methodology: Patient Health Questionnaire (PHQ-9) and other socio-demographic information were collected from 5263 students from all over Bangladesh. Apart from descriptive statistics and chi-square tests, an ordinal logistic regression model was also applied to determine the factors associated with depression., Results: The study revealed that among the undergraduate admission applicants, 74% of individuals were affected by depression, while 26% experienced moderate depression, 26% experienced moderately severe depression, and 22% experienced severe depression. The level of depression among females was 1.8 times higher than the male admission candidates. Our analyses found that gender (p <0.001), exercise (p <0.001), pre-marital relationships (p <0.001), daily study time less than 3 hours (p <0.001), practice of religion (p <0.001), victim of blackmail (p <0.001), family unrest (p <0.001), major illness (p <0.001), COVID-19 infection (p <0.001), GPA in higher secondary (p <0.001), mental problem (p <0.001), all categories of the variable confidence level for exam preparation (p <0.001) had a significant impact on increasing depression., Conclusion: The research found a severe rate of depression among Bangladeshi undergraduate admission candidates. Interactive mental health care programs must include family and teachers to tackle the problem. To alleviate mental stress and depression, students should learn to nurture their mental health., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Siddik et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: The present study aims to measure the prevalence of non-disabled frailty and its associated factors among Bangladeshi older adults., Methods: This cross-sectional study was conducted during September and October 2021 among 1,045 Bangladeshi older adults (≥60 years). Telephone interviews, using a semi-structured questionnaire, were undertaken to collect data on participants' characteristics and level of frailty. The non-disabled frailty was measured using the 'Frail Non-Disabled (FiND)' questionnaire. A multinomial logistic regression model assessed the factors associated with frailty among the participants., Results: Around a quarter of the participants (24.8%) were frail. The multinomial regression analysis showed that older participants aged ≥80 years (RRR = 3.23, 95% CI: 1.41-7.37) were more likely to be frail compared to participants aged 60-69 years. Likewise, the participants living in a large family with ≥4 members (RRR = 1.39, 95% CI: 1.01-1.92) were more likely to be frail compared to those living in smaller families. Also, participants having memory or concentration problems (RRR = 1.56, 95% CI: 1.12-2.17) were more likely to be frail compared to those who were not suffering from these problems. Moreover, participants whose family members were non-responsive to their day-to-day assistance (RRR = 1.47, 95% CI: 1.06-2.03) were more likely to be frail compared to those whose family members were responsive. Furthermore, participants who were feeling lonely (RRR = 1.45, 95% CI: 1.07-1.98) were more likely to be frail than their counterparts who were not feeling lonely., Conclusions: The findings of the present study suggest developing tailored interventions to address the burden of frailty among the older populations in Bangladesh. In particular, providing long-term care and health promotion activities can be of value in preventing frailty and reducing adverse health outcomes among this vulnerable population group., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Mistry et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)