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Background: Suicide is a public health problem that gets little attention in Bangladesh especially in prevention aspects. Recent studies revealed that a significant portion of risk factors is closely related to family events. However, potential prevention strategies considering the family structure and involving family dynamics of Bangladesh have not been discussed. Objectives: We aim to highlight areas of family vulnerability and resilience when the threat of suicide is present, as well as the potential roles of family in suicide prevention in Bangladesh. Methods: We conducted a thorough narrative and focused literature search and synthesized evidence based on available articles discussing suicidality and family dynamics in Bangladesh. Results: Risk factors for suicide prevailing in the family have been organized, and several strategies for coping with family risk factors, including marital discord and family conflict have been proposed for testing empirically. Conclusions: The family has an important role to play in suicide prevention in Bangladesh. However, potential prevention strategies and their effectiveness have been untapped in the country. Studies are warranted to test the effectiveness of the proposed strategies. [ABSTRACT FROM AUTHOR]

Background: Increased suicide literacy and reduced stigma toward suicide facilitate the care‐seeking for suicidal behavior. However, no attempt has been identified to determine these two vital aspects in Bangladesh. Objectives: We aimed to validate the literacy of suicide scale and stigma of suicide scale into Bangla along with the determination of the level of suicide literacy and stigma toward suicide. Methods: We conducted this study between April and June 2021. Data were collected from medical school and university students by Google form. We used a questionnaire consisting of four segments (i.e., sociodemographic questionnaire, a questionnaire for suicidal behavior, Bangla literacy of suicide scale [LOSS‐B], and Bangla stigma of suicide scale [SOSS‐B]) for data collection. We tested the psychometric properties of the scales in a sample of 529 students and examined factors associated with suicide stigma and literacy. Results: The mean age of the students was 22.61 ± 1.68 (range 18–27) years, 274 (51.8%) were males, 476 (89.9%) were graduate students, and 490 (92.6%) were unmarried. The mean score of LOSS was 4.27 ± 1.99 ranging from 0 to 10. Factor analysis revealed acceptable psychometric properties of SOSS‐B. The literacy was significantly higher in females, students of medicine, having a family history of suicidal attempts, and a history of student nonfatal attempts, while stigma was significantly lower among the females and a history of past attempts. Conclusions: This study revealed the level of literacy and stigma and culturally tested the psychometric properties of the LOSS‐B and SOSS‐B among university students in Bangladesh. This is the first attempt to determine the level of suicide literacy and stigma in Bangladesh. We tested the psychometric properties of the literacy and stigma of suicide scales in Bangla. The literacy was significantly higher in females, students of medicine, having a family history of suicidal attempts, and a history of student non‐fatal attempts. [ABSTRACT FROM AUTHOR]

Background: Our knowledge of suicide in low‐income countries is limited. Understanding the importance of factors that contribute to suicide risk will allow for the appropriate allocation of limited resources. In order to prioritize suicide prevention activities in Bangladesh, we estimate the fractions of suicides attributable to key risk factors. Methods: Using data from matched cases (100) and controls (100) as part of a psychological autopsy study in Dhaka, we estimate the population attributable fraction for key clinical (psychiatric disorders and physical disability), and social (life events, psychical and/or sexual abuse, unemployment, and social isolation) risk factors for suicide in Bangladesh. Results: Assuming a causal relationship, life events were responsible for the largest proportion of suicide deaths (85.9%; confidence interval [CI], 79.6–90.2), followed by mental disorder (49.5%; CI, 45.3–53.4). The population attributable fraction for the risk factors was 42.9% (CI, 40.6–45) for depression, 11% (CI, 8.9–13) for sexual abuse, and 34.9% (CI, 10.1–52.9) for social isolation. Conclusions: The study determined the population attributable fraction of risk factors for suicide in Bangladesh. Prevention strategies should be prioritized on the management of the aftermaths of adverse life events, treatment of psychiatric disorders, sexual abuse, and social isolation in the country. This is the first study determining the population attributable fraction of risk factors for suicide in Bangladesh. Adverse life events were responsible for the largest proportion of suicide, followed by mental disorders. Prevention strategies should focus on the management of key social and clinical risk factors. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) pandemic has had a severe impact on population health. The genetic determinants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in southern Bangladesh are not well understood. Methods: This study aimed to determine the genomic variation in SARS-CoV-2 genomes that have evolved over 2 years of the pandemic in southern Bangladesh and their association with disease outcomes and virulence of this virus. We investigated demographic variables, disease outcomes of COVID-19 patients and genomic features of SARS-CoV-2. Results: We observed that the disease severity was significantly higher in adults (85.3%) than in children (14.7%), because the expression of angiotensinconverting enzyme-2 (ACE-2) diminishes with ageing that causes differences in innate and adaptive immunity. The clade GK (n = 66) was remarkable between June 2021 and January 2022. Because of the mutation burden, another clade, GRA started a newly separated clustering in December 2021. The burden was significantly higher in GRA (1.5-fold) highlighted in mild symptoms of COVID-19 patients than in other clades (GH, GK, and GR). Mutations were accumulated mainly in S (22.15 mutations per segment) and ORF1ab segments. Missense (67.5%) and synonymous (18.31%) mutations were highly noticed in adult patients with mild cases rather than severe cases, especially in ORF1ab segments. Moreover, we observed many unique mutations in S protein in mild cases compared to severe, and homology modeling revealed that those might cause more folding in the protein's alpha helix and beta sheets. Conclusion: Our study identifies some risk factors such as age comorbidities (diabetes, hypertension, and renal disease) that are associated with severe COVID-19, providing valuable insight regarding prioritizing vaccination for high-risk individuals and allocating health care and resources. The findings of this work outlined the knowledge and mutational basis of SARS-CoV-2 for the next treatment steps. Further studies are needed to confirm the effects of structural and functional proteins of SARS-CoV-2 in detail for monitoring the emergence of new variants in future. [ABSTRACT FROM AUTHOR]

Key Clinical Message: The incidence of nontuberculous mycobacterial (NTM) infections after operations is increasing in Bangladesh but data regarding clinical presentation, diagnosis, treatment, and prognosis after treatment are lacking. In this case series, three patients having persistent serous discharge from incision wound after operation were studied. Discharge from wounds were collected, wet film microscopy was performed for pus cells and fungus, Gram stain, Ziehl‐Neelsen (ZN) stain, culture in routine culture media and Lowenstein‐Jensen (LJ) media, Xene‐Xpert for mycobacterium tuberculosis (MTB), polymerase chain reaction (PCR) for NTM were done. NTM‐positive patients were treated initially for 6 weeks with four drugs regimen (clarithromycin 500 mg 12 hourly, ciprofloxacin 500 mg 12 hourly, linezolid 400 mg 12 hourly, and amikacin 500 mg 12 hourly), followed by 5 months with three drugs regimen (clarithromycin 500 mg 12 hourly, ciprofloxacin 500 mg 12 hourly, and linezolid 400 mg 12 hourly) as a maintenance dose. Cessation of discharge occurred within 3–4 weeks after starting treatment, and the wounds were healed. [ABSTRACT FROM AUTHOR]

Exclusive breastfeeding (EBF) provides significant health benefits to children. However, mothers may find it difficult to continue EBF for 6 months. The present analysis aimed to examine the influence of the Suchana intervention—a large‐scale programme implemented with the aim of improving the health and nutritional status of mothers and children from poor households in the Sylhet region of Bangladesh—on EBF and stunting among children under 6 months. Baseline and endline data were obtained from the Suchana evaluation. EBF was defined as an infant (<6 months) only receiving breast milk in the previous 24 h. Childhood stunting was defined as a length‐for‐age z‐score of less than −2 among children of the same age. Multiple logistic regression analysis was used to assess the associations of the Suchana intervention with EBF and stunting. EBF prevalence improved from 64% at baseline to 85% at the endline in the intervention area, with the intervention group having 2.25 times higher odds of EBF compared to the control group. Stunting prevalence reduced from 28% at baseline to 24% at the endline in the intervention group, but after controlling for covariates, the association between stunting and the intervention was not significant. However, the interaction analysis showed significantly lower stunting prevalence among EBF children in both intervention and control areas. The Suchana intervention had a positive impact on the EBF practice of rural children in a vulnerable region of Bangladesh, and EBF was identified as a significant factor associated with stunting. The findings suggest that the continuation of the EBF intervention has the potential to have an impact on reducing stunting in the region, highlighting the importance of promoting EBF to improve child health and development. Key messages: Suchana intervention in rural Bangladesh promoted exclusive breastfeeding (EBF) among mothers in the intervention group.EBF was found to be a significant factor associated with stunting in the study population.Better integration of determinants of stunting are needed to achieve a statistically significant reduction in stunting. [ABSTRACT FROM AUTHOR]

Background: We explored whether hospital‐based surveillance is useful in detecting severe acute respiratory infection (SARI) clusters and how often these events result in outbreak investigation and community mitigation. Methods: During May 2009–December 2020, physicians at 14 sentinel hospitals prospectively identified SARI clusters (i.e., ≥2 SARI cases who developed symptoms ≤10 days of each other and lived <30 min walk or <3 km from each other). Oropharyngeal and nasopharyngeal swabs were tested for influenza and other respiratory viruses by real‐time reverse transcriptase‐polymerase chain reaction (rRT‐PCR). We describe the demographic of persons within clusters, laboratory results, and outbreak investigations. Results: Field staff identified 464 clusters comprising 1427 SARI cases (range 0–13 clusters per month). Sixty percent of clusters had three, 23% had two, and 17% had ≥4 cases. Their median age was 2 years (inter‐quartile range [IQR] 0.4–25) and 63% were male. Laboratory results were available for the 464 clusters with a median of 9 days (IQR = 6–13 days) after cluster identification. Less than one in five clusters had cases that tested positive for the same virus: respiratory syncytial virus (RSV) in 58 (13%), influenza viruses in 24 (5%), human metapneumovirus (HMPV) in five (1%), human parainfluenza virus (HPIV) in three (0.6%), adenovirus in two (0.4%). While 102/464 (22%) had poultry exposure, none tested positive for influenza A (H5N1) or A (H7N9). None of the 464 clusters led to field deployments for outbreak response. Conclusions: For 11 years, none of the hundreds of identified clusters led to an emergency response. The value of this event‐based surveillance might be improved by seeking larger clusters, with stronger epidemiologic ties or decedents. [ABSTRACT FROM AUTHOR]

The genus Syzygium comprises 1200–1800 species that belong to the family of Myrtaceae. Moreover, plants that are belonged to this genus are being used in the traditional system of medicine in Asian countries, especially in China, India, and Bangladesh. The aim of this review is to describe the scientific works and to provide organized information on the available traditional uses, phytochemical constituents, and pharmacological activities of mostly available species of the genus Syzygium in Bangladesh. The information related to genus Syzygium was analytically composed from the scientific databases, including PubMed, Google Scholar, Science Direct, Web of Science, Wiley Online Library, Springer, Research Gate link, published books, and conference proceedings. Bioactive compounds such as flavanone derivatives, ellagic acid derivatives and other polyphenolics, and terpenoids are reported from several species of the genus Syzygium. However, many members of the species of the genus Syzygium need further comprehensive studies regarding phytochemical constituents and mechanism‐based pharmacological activities. [ABSTRACT FROM AUTHOR]

Objective: Iron in groundwater provides a good source of absorbable iron for humans and can contribute to optimal iron and haemoglobin (Hb) status among populations. We aimed to examine the relationship between the iron content of groundwater and anaemia status among 12‐ to 23‐month‐old children in a rural area of Bangladesh. Method: A cross‐sectional study was conducted in 80 randomly selected unions (the lowest administrative unit) in Sylhet and Moulvibazar districts of Bangladesh. A total of 800 children aged 12–23 months were selected via a systematic random sampling method. The child's age, sex, stunting status, consumption of iron‐rich or iron‐fortified food, maternal age and maternal body mass index (BMI) and the type of terrain were subjected to multiple logistic regression analysis to observe the independent relationships between groundwater iron content and anaemia in children. Results: In total, 50.4% of children were anaemic. The odds of children being anaemic were 1.51‐fold higher [OR: 1.51 (95% CI: 1.09, 2.09)] among households consuming water with an iron content <2 mg/L than in households consuming water with an iron content ≥2 mg/L. Childhood stunting, child's sex, child's age and the type of terrain were also significantly associated with anaemia among children. Conclusion: Groundwater with a high iron concentration was significantly associated with a decreased risk of childhood anaemia. This study provides evidence of the importance of groundwater iron to protect impoverished young children from anaemia. [ABSTRACT FROM AUTHOR]

Adequate maternal healthcare practices are crucial to both maternal and infant nutrition outcomes. The Sylhet region of Bangladesh is vulnerable and performs poorly, as maternal and child health indicators are falling behind compared to other areas. Suchana, a large‐scale intervention programme aims to improve the health and nutritional status of mothers and children in this region. The objective of the present analysis is to assess the changes in indicators related to maternal healthcare practices among Suchana beneficiaries. We obtained data from the Suchana baseline and endline evaluation survey. Descriptive statistics were employed to summarize data. The following maternal healthcare practices were considered: if a Suchana beneficiary mother received antenatal care (ANC) from skilled service providers, took day time resting during pregnancy, consumed additional diet during pregnancy, took at least 100 iron‐folic acid (IFA) tablets during pregnancy and took a vitamin A capsule after delivery. Logistic regression analysis was performed to assess the impact of the Suchana intervention on maternal healthcare practices. The prevalence of the outcome variables at endline in the intervention area were as follows: 40% of mothers received at least four ANC from skilled service providers, 50% practiced daytime resting during pregnancy, 51% consumed additional diet during pregnancy, 41% took at least 100 iron‐folic acid tablets during pregnancy, 39% received postnatal care and 30% took a vitamin A capsule after delivery. The Suchana intervention significantly, positively improved indicators related to maternal healthcare practices; these findings support future larger‐scale programmes to improve maternal healthcare practices among vulnerable people in rural Bangladesh. [ABSTRACT FROM AUTHOR]

Background: Bovine genital campylobacteriosis (BGC) is a venereal disease caused by Campylobacter fetus that has a negative impact on animal reproduction. The bull is considered to be a symptomless carrier that spreads the disease agent to breeding cows, causing infertility and sporadic abortion. Aim: The study aims to estimate the prevalence, identify risk factors of Campylobacter fetus (C. fetus) infection and antimicrobial resistance pattern of the C. fetus isolates. Method: A cross‐sectional survey was conducted in Mymensingh district of Bangladesh. Bull smegma samples (single sample from each bull) were collected from 300 bulls from four farms and tested via culture, biochemical identification and finally 16S rRNA and cdtA gene‐based molecular assays (PCR) for herd and animal‐level prevalence estimation. Herd‐ and animal‐level data on risk factors were collected from the farmers using a pretested questionnaire and analysed by univariable and multivariable logistic regression models with a p value of <0.05 was taken statistically significant for both analyses. Results: Among the surveyed farms, 75% (95% CI: 19.4%–99.4%) were confirmed to have bulls infected with Campylobacter fetus at herd level. However, animal‐level occurrence of C. fetus was estimated to be 8.7% (26/300) (95% CI: 5.7%–12.4%). Natural service increases the odds of campylobacteriosis 38.18 times (95% CI: 13.89–104.94) in comparison to artificial insemination for C. fetus infection in bulls. Significantly, half of the isolates (50%, n = 13) were identified to be multidrug resistant (MDR) for three to five antimicrobial agents. Conclusion: This study highlights the need to develop official guidelines for C. fetus control and prevention in Bangladesh including mandatory artificial insemination in reproductive cows and heifers, routine screening of breeding bulls for C. fetus free status. [ABSTRACT FROM AUTHOR]

Objective To understand the health-seeking behaviour of adolescent women in Bangladesh with respect to the use of maternal health services. Methods Literature review of seven electronic databases: PubMed, ISI Web of Knowledge, Psyc INFO, Embase, CINAHL, POPLINE and Global Health. Studies published in English between 1990 and 2013 which describe Bangladeshi adolescent women's healthcare-seeking behaviour during pregnancy, delivery and post-partum were included. Results Twelve studies were included in this review. 11 used quantitative methods and one used a mixed-methods approach. All studies included married adolescent women only. Women with lower educational levels are less likely to seek skilled maternal health services than those with higher levels of education. Use of maternal health services is also less common among rural married adolescent women than women in urban areas. Being part of the richest bands of wealth, having had previous experiences of childbirth and higher women's autonomy positively influence the use of skilled maternal health services among married adolescent women in Bangladesh. Antenatal care is a key predictor of the use of skilled birth attendants for delivery and post-natal care. Conclusion Maternal health-related programmes should be designed targeting rural and uneducated married adolescent women in Bangladesh. More qualitative investigations are required to broaden our understanding on maternal health-seeking behaviour of both married and unmarried adolescent women. [ABSTRACT FROM AUTHOR]

This research investigates the interannual variability of monsoon onset and withdrawal in Bangladesh, both of which are major climate features shaping multiple societal activities. There is considerable research on the monsoon timing in South Asia, but with much less focus on Bangladesh. We applied a local monsoon onset and withdrawal definition to observations and the latest‐generation high‐resolution gridded precipitation data from the Climate Hazards Center for the period 1981 through 2018. We analyzed the interannual variability in monsoon timing in Bangladesh and its teleconnection with the sea surface temperature anomalies (SSTA) over the Pacific Ocean (El Niño Southern Oscillation, ENSO) and the Indian Ocean (IO). The monsoon starts with early significant rains in northeast Bangladesh and propagates westward, and a similar pattern is observed for withdrawal, which tends to be more homogeneous in time and space. A high spatial and temporal variability in monsoon onset and withdrawal is observed in Bangladesh, with a within‐country average range of around 1 month despite it being a country of relatively small size. The association between monsoon onset and withdrawal and ENSO and IO is addressed at the country and regional level by analyzing composites for different ENSO and IO phases and associated atmospheric circulation and moisture transport. A similar association between monsoon onset and ENSO and IO phases was found, with generally earlier (later) onset dates during the negative (positive) phase of ENSO and IO. Monsoon withdrawal shows a clearer association with ENSO, with earlier (later) dates during the positive (negative) phase. Monsoon withdrawal is earlier during the negative IO phase. SSTA‐induced anomalies in circulation and moisture transport contribute to anomalies in monsoon timing. Results suggest both ENSO and IOD can be potentially used as sources of predictability of monsoon onset and withdrawal over specific regions of Bangladesh. [ABSTRACT FROM AUTHOR]

Lysergic acid diethylamide (LSD) is a potent hallucinogenic drug affecting the mood and perception of an individual. Although LSD‐induced self‐inflicted cut‐throat wounds and self‐harm injuries are extremely rarely reported behaviors, some reports are coming out in recent days that may complicate the depiction of scenarios in forensic psychiatry settings. [ABSTRACT FROM AUTHOR]

Malnutrition among women is a long‐standing public health concern that has significant adverse consequences on the survival and healthy development of children. Maternal mid‐upper arm circumference (MUAC) could potentially represent a simpler alternative to traditional nutritional indicators. This study aimed to investigate the factors associated with low maternal MUAC (as an indicator of being underweight) and address the research question of whether maternal MUAC is significantly associated with children's nutritional status among poor and very poor households in rural Bangladesh. Data on 5,069 households were extracted from the Suchana programme baseline survey, which was carried out in 80 randomly selected unions (the lowest administrative unit of Bangladesh) in Sylhet and Moulvibazar districts between November 2016 and February 2017. The outcome variables were three child nutritional status indicators: wasting, stunting and underweight. Mothers were classified as underweight if their MUAC was less than 23 cm. Separate multiple logistic regression analyses were used to determine the factors potentially associated with maternal underweight status and explore whether maternal underweight status is significantly associated with children's nutritional status. The prevalence of maternal underweight status was 46.7%, and the prevalence of wasting, stunting and underweight among children under two were 10.5%, 44.4% and 31.9%, respectively. After controlling for various socio‐economic and demographic characteristics, maternal MUAC was significantly associated with children's nutritional status in rural Bangladesh. [ABSTRACT FROM AUTHOR]

Mesoscale convective systems (MCSs) are important precipitation‐bearing phenomena in the Tropics. Hence, it is important to elucidate the temporal variation of MCSs. This study investigated the interannual variation of MCSs in Bangladesh and surrounding area during June–September using 3‐hr TRMM3B42 precipitation data. After objective detection of propagating MCSs (PMCSs), their statistical features were analyzed. It was found that the annual number of PMCSs decreased significantly during 1998–2015. The most remarkable decrease was in southward PMCSs generated over land, consistent with the observed decrease in precipitation. Recent weakening of the low‐level southwesterly and stabilization of the atmosphere probably contributed to the decrease of PMCSs. Because southward PMCSs generated over land were present on about 40% of days with heavy rain, PMCSs clearly have a crucial role in precipitation variability. The findings of this study suggest that investigation of MCSs is essential for understanding precipitation response to climate change in South Asia. Interannual variations of mesoscale convective systems (MCSs) over South Asia were analyzed over 18 years (1998–2015). Significant decrease in number of MCSs was detected in association with weakening of low‐level southwesterly during summer monsoon. The MCSs largely contribute to precipitation, and therefore, it is suggested that MCSs influence the uncertainty in future precipitation change. [ABSTRACT FROM AUTHOR]

In response to unusual crow die‐offs from avian influenza A(H5N1) virus infection during January‐February 2017 in Dhaka, Bangladesh, a One Health team assessed potential infection risks in live bird markets (LBMs). Evidence of aerosolized avian influenza A viruses was detected in LBMs and in the respiratory tracts of market workers, indicating exposure and potential for infection. This study highlighted the importance of surveillance platforms with a coordinated One Health strategy to investigate and mitigate zoonotic risk. [ABSTRACT FROM AUTHOR]

Introduction: Epidemiological research on the prevalence of asthma and helminthic infections in various countries has led to the hypothesis that helminthic infections protect against asthma by suppressing the host's immune response. This study was conducted to elucidate whether decreased Ascaris infection following a national deworming program was associated with increased recurrent wheezing among rural Bangladeshi children and to test their anti‐inflammatory immunity. Methods: This nested case‐control study was conducted from December 2015 to October 2016 in the rural service area of the International Centre for Diarrhoeal Disease Research, Bangladesh. Of the 1800 5–year old children randomly selected for the study, informed consent was obtained from the guardians of 1658 children. Data were collected using a semistructured questionnaire adopted from the International Study of Asthma and Allergies in Childhood and blood samples for the analysis of regulatory T (Treg) cell immune responses and the balance between Th1 and Th2 immunity in Ascaris infections. Results: A total of 145 children were found to have wheezing, yielding a prevalence rate of 8.7%, which was significantly lower than the rate found in 2001 (16.2%, P < .001); Ascaris infection also decreased from 2001 to 2016. The 127 wheezing children who agreed to participate further were compared to 114 randomly selected never‐wheezing children. Wheezing had a significant positive association with antibiotic use, history of pneumonia, parents' history of asthma, and Ascaris infection; children with Ascaris infection were twice as likely to have wheezing (adjusted odds ratio = 2.31, P = .053). Flow cytometry found no significant differences in the rates of Th1, Th2, and CD4 +CD25 +CD127low cells by the wheezing group. Conclusions: Ascaris infection had a positive rather than a negative association with wheezing and the rates of wheezing and Ascaris infections both decreased from 2001 to 2016. These findings undermines the hypothesis that such infections provide protection against asthma. [ABSTRACT FROM AUTHOR]