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Objective: This paper reflected on the prevalence of hypertension and diabetes in Bangladesh, which is spreading rapidly in low-income countries. The rationale of constructing more health centers for addressing NCDs was assessed in this paper by determining the relationship between prevalence of NCDs, particularly hypertension and diabetes, and distance to health facilities. Methods: From BDHS (Bangladesh Health and Demographic Survey) 2011 data set, 7544 samples were analyzed to demonstrate association between Non-communicable diseases (NCD) and distance from respondents’ home to health facilities like hospitals, community clinics, pharmacies or doctors’ chambers, and community facilities like market, post office or cinema hall. Bivariate analysis was conducted between accessibility to health facilities and prevalence of the diseases. The causal relationship between the spatial effects and the prevalence of the diseases were analyzed by applying Generalized Linear Mixed Model (GLMM) was fitted. Results: Fitting linear mixed effect models, we found that hypertension and diabetes react differently with various spatial effects. Distance from home to hospital had significant effect (P < 0.001) on hypertension showing people living further from the facilities or town centers seemed to be less hypertensive, whereas diabetes showed no such affiliation. Conclusion: Higher prevalence of diabetes (40.9%) over hypertension (26.5%) in people aging 35 or higher, have appeared to have caused the difference, which concluded that each non-communicable disease should be dealt to its own merit for policy making instead considering as a group of diseases. [ABSTRACT FROM AUTHOR]

(1) Background: The maltreatment of child labourers is a major public health concern. There is a dearth of research in Bangladesh on the intentional maltreatment of child labourers. This study explored the risk factors for the maltreatment of child labourers in rural Bangladesh based on the knowledge and understanding of experts; (2) Methods: Seventeen interviews were conducted with experts who were sampled using a purposeful approach. A thematic analysis was performed to analyse data using NVivo; (3) Results: Child labourers were exposed to maltreatment due to their demographic, their young age, dropping out of school, health complications, and excessive dependency on employers. Socio-cultural adversities such as corporal punishment practices, social stratification, and family disorganization pose risks of experiencing maltreatment. Economic poverty is also a factor. Child labourers were found to be victimized if they worked in violence prone sectors. Significantly, the unregulated market structure and the lack of monitoring has also led to the exploitation of children in the workplace. Gaps in public policies were also identified as risk factor for the maltreatment of child labourers; (4) Conclusion: There is a need for adequate evidence-based research on the determinants of the maltreatment of child labourers to formulate adequate policy. [ABSTRACT FROM AUTHOR]

Background: Poor nutrition during childhood impedes physical and mental development of children, which propagate the vicious cycle of intergenerational under nutrition. This paper is aimed at understanding the determinants of stunting among children aged 0 to 59 months in Bangladesh.Methods: The study used Bangladesh Demographic and Health Survey 2011 data and a multistage stratified cluster-sampling design. Anthropometric data (for height and weight) were collected and analysis was limited to 7647 children. Multiple binary logistic regression analysis was performed to assess the association of stunting with potential socioeconomic and demographic factors.Results: The prevalence of stunting has been found to be about 41% among children aged less than 60 months and higher in rural setting than in urban areas (43% vs 36%). Adjusted model revealed that several factors were influencing stunting. The children living in moderately food-insecure households had higher odds of becoming stunted (odds ratio [OR] = 1.27, 95% confidence interval [CI]: 1.05-1.54, P = .01) compared to the children living in food-secure households. The derived ORs of stunting for children delivered at institutions facilitated particularly by public (OR = 0.80, 95% CI: 0.67-0.96; P = .02) or private (OR = 0.81, 95% CI: 0.67-0.97; P = .02) sectors were less than for children delivered at home. Similarly, wealth index, exposure of mother to the mass media, age of child, size of child at birth, and parents' education were significantly associated with stunting.Conclusions: Moreover, the demographic characteristics and other indicators appeared to have significant influence in the prevalence of stunting. Public health programs are needed to avert the risk factors of stunting among children in Bangladesh. [ABSTRACT FROM AUTHOR]

Being a deltaic country and for its geographic location, Bangladesh faces devastating damages every year. In a new global index, Bangladesh has been ranked 7th among the countries most affected by extreme weather events in 20 years since 1998. The ability of a community to recover from a disaster is very much associated with strong social connections. For this research, both secondary and primary data sources have been considered. Socio‐demographic characteristics have been identified from a community‐based general questionnaire and BBS. Also, a newly developed integrated method has been used to measure the social capital of the community. Several statistical methods were used to analyse the data, such as factor analysis (PCA), ROC curve analysis and several GIS techniques, throughout the research. Results show that significant socio‐demographic variables help to develop a specific type of social capital. Consequently, social capital indirectly works as a key for recovering from any disaster impact and could build resilience to hazards. [ABSTRACT FROM AUTHOR]

Background: The deprived physical environments present in slums are well-known to have adverse health effects on their residents. However, little is known about the health effects of the social environments in slums. Moreover, neighbourhood quantitative spatial analyses of the mental health status of slum residents are still rare. The aim of this paper is to study self-rated mental health data in several slums of Dhaka, Bangladesh, by accounting for neighbourhood social and physical associations using spatial statistics. We hypothesised that mental health would show a significant spatial pattern in different population groups, and that the spatial patterns would relate to spatially-correlated health-determining factors (HDF)., Methods: We applied a spatial epidemiological approach, including non-spatial ANOVA/ANCOVA, as well as global and local univariate and bivariate Moran's I statistics. The WHO-5 Well-being Index was used as a measure of self-rated mental health., Results: We found that poor mental health (WHO-5 scores < 13) among the adult population (age ≥15) was prevalent in all slum settlements. We detected spatially autocorrelated WHO-5 scores (i.e., spatial clusters of poor and good mental health among different population groups). Further, we detected spatial associations between mental health and housing quality, sanitation, income generation, environmental health knowledge, education, age, gender, flood non-affectedness, and selected properties of the natural environment., Conclusions: Spatial patterns of mental health were detected and could be partly explained by spatially correlated HDF. We thereby showed that the socio-physical neighbourhood was significantly associated with health status, i.e., mental health at one location was spatially dependent on the mental health and HDF prevalent at neighbouring locations. Furthermore, the spatial patterns point to severe health disparities both within and between the slums. In addition to examining health outcomes, the methodology used here is also applicable to residuals of regression models, such as helping to avoid violating the assumption of data independence that underlies many statistical approaches. We assume that similar spatial structures can be found in other studies focussing on neighbourhood effects on health, and therefore argue for a more widespread incorporation of spatial statistics in epidemiological studies.

The article presents information on the abstracts of several articles that appeared in the March 1981 issue of the journal "Population and Development Review." The paper "Recent Demographic Change in Western Europe: An Assessment," by Jean Bourgeois-Pichat, considers recent and prospective trends in population change in Western Europe against the background of the historical demographic transition. With respect to population growth and fertility, the present simultaneity and uniformity of trends and reversals across Western Europe contrasts sharply with the historical diversity in the timing and pace of demographic transition. The study "Sex Bias in the Family Allocation of Food and Health Care in Rural Bangladesh," study examines the behavioral antecedents to the higher female than male mortality from shortly after birth through the childbearing ages in a rural area of Bangladesh. A framework is presented in which the intermediate variables through which sex-biased attitudes and practices might operate to affect health, nutrition and mortality are postulated.

The role of family planning programmes and declining fertility in improving infant and child survival has been the subject of considerable debate. In this paper, we analyse data from Matlab, Bangladesh, to assess the net effect of falling total fertility on the mortality rates of young children. Areal time-series models are estimated to determine the role of fertility decline after having controlled for the effects of other health service interventions. The results show that fertility reductions have little effect on neonatal and posteneonatal mortality, possibly a small effect on toddler (second-year) mortality, and a significant and relatively large impact on the mortality of children aged between two and four years. Possible explanations for these findings and their implications are discussed. [ABSTRACT FROM AUTHOR]

Background: The cause-specific under-five mortality of Bangladesh has been studied by fitting cumulative incidence function (CIF) based Fine and Gray competing risk regression model (1999). For the purpose of analysis, Bangladesh Demographic and Health Survey (BDHS), 2011 data set was used. Methods: Three types of mode of mortality for the under-five children are considered. These are disease, non-disease and other causes. Product-Limit survival probabilities for the under-five child mortality with log-rank test were used to select a set of covariates for the regression model. The covariates found to have significant association in bivariate analysis were only considered in the regression analysis. Results: Potential determinants of under-five child mortality due to disease is size of child at birth, while gender of child, NGO (non-government organization) membership of mother, mother's education level, and size of child at birth are due to non-disease and age of mother at birth, NGO membership of mother, and mother's education level are for the mortality due to other causes. Conclusion: Female participation in the education programs needs to be increased because of the improvement of child health and government should arrange family and social awareness programs as well as health related programs for women so that they are aware of their child health. [ABSTRACT FROM AUTHOR]

The black pomfret (Parastromateus niger) is one of the high-income-generating carangid fish species and the only known member of its genus. This study aims to identify existing gaps in stock status and population demography of this species and provide viable management recommendations to enhance the sustainability of this fishery. Therefore, three methodological approaches have been used in this study; TropFishR to present the current exploitation status, the length-based spawning potential ratio (LB-SPR) to quantify stock spawning biomass, and Froese's sustainability indicators (LBI) to establish a basic standard for sustainable management of the fishery. In the length-weight relationship of black pomfret, an allometric growth pattern (b = 2.19) was found. The VBGF life history parameters for black pomfret were L∞ = 55.25 cm, K = 0.54 year−1, and based on LCCC analysis, the total mortality (Z = 1.61 year−1), natural mortality (M = 0.69 year−1) and fishing mortality (F = 0.91 year−1) are calculated. The result reveals that this fishery is currently suffering from overexploitation and the stock's spawning biomass (SPR = 13%) is below the limit reference point because most of the catch (82%) was found to be under the maturity level. Based on the results, this study recommended strictly maintaining the mesh size of the net to ensure not to catch immature fish with a length smaller than 30.63 cm, recommended the length to catch be between 29 and 35 cm, and reducing fishing pressure by one-third to ensure the sustainability of the black pomfret fishery. [ABSTRACT FROM AUTHOR]

This paper evaluates a study fielded in Bangladesh in 1975 to test the hypothesis that ubiquitous availability of pills and condoms in a rural, traditional, noncontracepting population would increase contraceptive use and reduce fertility. Treatment and comparison areas were designated in Matlab, an area with accurate and complete demographic data. Use prevalence peaked at 18 percent in the first three months of the project and declined thereafter. Project activities continued until 1977. Results show that between-treatment fertility differentials were 10 percent in the first year of program impact, but that effects dissipated with time.

This paper evaluates the demographic impact of the Family Planning-Health Services Project in Matlab Thana of rural Bangladesh. The project was begun by the International Centre for Diarrhoeal Disease Research, Bangladesh in October 1977. Contraceptive services--including pills, condoms, IUDs, sterilization, and injectables--are supplemented by oral rehydration, tetanus toxoid, and other services. About 33 percent of eligible couples are using contraception. Impact is evaluated by direct measurement of birth rates in the treatment and comparison areas. An overall fertility decline of about 25 percent is observed, concentrated among older women. The impact is two-to-three times that of an earlier project that included fewer methods and used lesser trained workers. The study shows that intensive family planning efforts can affect fertility in the absence of socioeconomic changes.

Introduction: The paper aims to explore the magnitude and distribution of unintentional injuries among Bangladeshi children (<18 years).Methodology: A cross sectional survey was conducted during 2003 (January to December) in 12 randomly selected districts and Dhaka Metropolitan City of Bangladesh. Nationally representative data were collected from 171 366 households comprising of 351 651 children of under 18 years. Information includes the number of deaths and illness at the household in the preceding year. Verbal autopsy and verbal diagnosis form was used to determine the cause of mortality and morbidity respectively.Results: There were 351651 children in the study, of which 5577 had one or more injuries in the past one year. Drowning and falls was the leading cause of injury mortality and morbidity in children over 1 year of age respectively. Incidence of unintentional injuries was significantly higher among boys (95% CI = -2157.8) than girls (95% CI = 968.7 - 1085.8) while rural children were the most vulnerable group. Home and its premises was the most common place for the injury incidence.Conclusion: The result of the study could be an insight to the policy makers to develop realistic and effective strategies to address the issue. [ABSTRACT FROM AUTHOR]

The article discusses the applicability of the thesis by economist J.C. Caldwell, that large families bring more benefits to their members than do small families, into an empirically operational form and test it against households survey data collected in Bangladesh early in 1977. There is a statistically significant inverse correlation between adjusted consumption of rice per head and family size. The fact that larger families do less well by conventional measures of welfare, particularly food consumption per head, requires an explanation. However, there is no evidence of decreasing returns to scale in production and land holdings per head are not related to household size. So, the cause of the apparent inverse statistical relationship between adjusted food consumption and family size is not likely to be found in the technology of household production. Another explanation is that the distribution of food becomes more unequal as household size increases. The increasing pressure of population and land shortage may be increasing the costs and reducing the benefits of large families.

Background: Preterm birth (gestational age (GA) <37 weeks) is the leading cause of child mortality worldwide. However, GA is rarely assessed in population-based surveys, the major data source in low/middle-income countries. We examined the performance of new questions to measure GA in household surveys, a subset of which had linked early pregnancy ultrasound GA data. Methods: The EN-INDEPTH population-based survey of 69,176 women was undertaken (2017-2018) in five Health and Demographic Surveillance System sites in Bangladesh, Ethiopia, Ghana, Guinea-Bissau and Uganda. We included questions regarding GA in months (GAm) for all women and GA in weeks (GAw) for a subset; we also asked if the baby was 'born before expected' to estimate preterm birth rates. Survey data were linked to surveillance data in two sites, and to ultrasound pregnancy dating at <24 weeks in one site. We assessed completeness and quality of reported GA. We examined the validity of estimated preterm birth rates by sensitivity and specificity, over/under-reporting of GAw in survey compared to ultrasound by multinomial logistic regression, and explored perceptions about GA and barriers and enablers to its reporting using focus group discussions (n = 29). Results: GAm questions were almost universally answered, but heaping on 9 months resulted in underestimation of preterm birth rates. Preference for reporting GAw in even numbers was evident, resulting in heaping at 36 weeks; hence, over-estimating preterm birth rates, except in Matlab where the peak was at 38 weeks. Questions regarding 'born before expected' were answered but gave implausibly low preterm birth rates in most sites. Applying ultrasound as the gold standard in Matlab site, sensitivity of survey-GAw for detecting preterm birth (GAw <37) was 60% and specificity was 93%. Focus group findings suggest that women perceive GA to be important, but usually counted in months. Antenatal care attendance, women's education and health cards may improve reporting. Conclusions: This is the first published study assessing GA reporting in surveys, compared with the gold standard of ultrasound. Reporting GAw within 5 years' recall is feasible with high completeness, but accuracy is affected by heaping. Compared to ultrasound-GAw, results are reasonably specific, but sensitivity needs to be improved. We propose revised questions based on the study findings for further testing and validation in settings where pregnancy ultrasound data and/or last menstrual period dates/GA recorded in pregnancy are available. Specific training of interviewers is recommended. [ABSTRACT FROM AUTHOR]

Background: The burden of maternal undernutrition and low birth weight (LBW) incurs enormous economic costs due to their adverse consequences. Women's empowerment is believed to be one of the key factors for attaining maternal and child health and nutritional goals. Our objective was to investigate the association of women's empowerment with maternal undernutrition and LBW.Methods: We used nationally representative data from the Bangladesh Demographic Health Survey for 2011 and 2014. We analysed 27357 women and 9234 mother-child pairs. A women's empowerment index (WEI) was constructed using principal component analysis with five groups of indicators: a) education, b) access to socio-familial decision making, c) economic contribution and access to economic decision making, d) attitudes towards domestic violence and e) mobility. We estimated odds ratios as the measure of association between the WEI and the outcome measures using generalized estimating equations to account for the cluster level correlation.Results: The overall prevalence of maternal undernutrition was 20% and LBW was 18%. The WEI was significantly associated with both maternal undernutrition and LBW with a dose-response relationship. The adjusted odds of having a LBW baby was 32% [AOR (95% CI): 0.68 (0.57, 0.82)] lower in the highest quartile of the WEI relative to the lowest quartile. Household wealth significantly modified the effect of the WEI on maternal nutrition; in the highest wealth quintile, the odds of maternal undernutrition was 54% [AOR (95% CI): 0.46 (0.33, 0.64)] lower while in the lowest wealth quintile the odds of undernutrition was only 18% [AOR (95% CI): 0.82 (0.67, 1.00)] lower comparing the highest WEI quartile with the lowest WEI quartile. However, the absolute differences in prevalence of undernutrition between the highest and lowest WEI quartiles were similar across wealth quintiles (6-8%).Conclusions: This study used a comprehensive measure of women's empowerment and provides strong evidence that low levels of women's empowerment are associated with maternal undernutrition as well as with delivering LBW babies in Bangladesh. Therefore, policies to increase empowerment of women would contribute to improved public health. [ABSTRACT FROM AUTHOR]

Background: Disability among older adults is a public health concern. To date there are no in-depth and comprehensive analyses on older adults' disabilities in Bangladesh. This study investigated gender differences in the prevalence of disability and the socio-demographic factors associated with disability among older adults in Bangladesh.Methods: This research used a sample of 4176 elderly males and females aged 60 years and over from a nationally representative data set- Bangladesh's 2010 Household Income and Expenditure Survey. The study used both household level and individual level data and applied a wealth index, which was constructed based on household assets using principal component analysis. The Washington Group's short set of questions on disability were used to measure disability. Chi-square tests and ordinal logistic regression models were fit.Results: Forty-two percent of older had some form of functional disability, including 5% of elderly with severe/extreme functional disability. Seven percent of older adults had a self-care disability, including 3% of elderly with a severe/extreme form of self-care disability. Elderly females suffered from all the studied disabilities, including functional and self-care disabilities in higher percentages, and had higher odds ratios of having both functional disability and self-care disability compared to elderly males. The study also identified some significant factors affecting functional disability and self-care disability, namely age, having a chronic condition, wealth status and place of residence, including divisional differences.Conclusions: Programs aimed at reducing functional disability among seniors, particularly elderly females, should be granted the highest priority in Bangladesh. [ABSTRACT FROM AUTHOR]

Aim: To describe the oral health status and investigate factors affecting dental caries experience among children with cerebral palsy (CP) in rural Bangladesh.Method: A cross-sectional study was conducted among children with CP who are part of the Bangladesh Cerebral Palsy Register (BCPR) study. Caries experience was measured by identifying decayed, missing, and filled teeth for deciduous and permanent teeth (dmft/DMFT). Clinical periodontal index, body mass index, oral hygiene behaviour, masticatory ability, and dietary habits were recorded. CP motor types and severity of functional mobility (Gross Motor Function Classification System [GMFCS]) were assessed.Results: Of 90 children with CP (mean age 9y 7mo, range 2-17y, 37.8% female and 62.2% male), 35% of 2 to 6 year olds, and 70% of 7 to 11 year olds (p=0.014) experienced caries (dmft+DMFT>0). The mean values (standard deviation [SD]) of dmft and DMFT were 2.46 (3.75) and 0.72 (1.79) respectively. After adjusting for age and sex, binary logistic regression analysis showed a significant relationship with dental caries for children who had quadriplegia (odds ratio [OR] 5.56, p=0.035), tooth cleaning less than one time/day (OR 0.08, p=0.016), using toothpowder or charcoal for cleaning (OR 7.63, p=0.015), and snacking between meals more than one time/day (OR 6.93, p=0.012).Interpretation: Early oral health preventive care is required for children with CP because dental caries is highly prevalent in these children. [ABSTRACT FROM AUTHOR]

Introduction: Chronic non-communicable diseases (NCDs) are a major public health challenge, and undermine social and economic development in much of the developing world, including Bangladesh. Epidemiologic evidence on the socioeconomic status (SES)-related pattern of NCDs remains limited in Bangladesh. This study assessed the relationship between three chronic NCDs and SES among the Bangladeshi population, paying particular attention to the differences between urban and rural areas. Materials and Method: Data from the 2011 Bangladesh Demographic and Health Survey were used for this study. Using a concentration index (CI), we measured relative inequality across pre-diabetes, diabetes, pre-hypertension, hypertension, and BMI (underweight, normal weight, and overweight/obese) in urban and rural areas in Bangladesh. A CI and its associated curve can be used to identify whether socioeconomic inequality exists for a given health variable. In addition, we estimated the health achievement index, integrating mean coverage and the distribution of coverage by rural and urban populations. Results: Socioeconomic inequalities were observed across diseases and risk factors. Using CI, significant inequalities observed for pre-hypertension (CI = 0.09, p = 0.001), hypertension (CI = 0.10, p = 0.001), pre-diabetes (CI = -0.01, p = 0.005), diabetes (CI = 0.19, p<0.001), and overweight/obesity (CI = 0.45, p<0.001). In contrast to the high prevalence of the chronic health conditions among the urban richest, a significant difference in CI was observed for pre-hypertension (CI = -0.20, p = 0.001), hypertension (CI = -0.20, p = 0.005), pre-diabetes (CI = -0.15, p = 0.005), diabetes (CI = -0.26, p = 0.004) and overweight/obesity (CI = 0.25, p = 0.004) were observed more among the low wealth quintiles of rural population. In the same vein, the poorest rural households had more co-morbidities compared to the richest rural households (p = 0.003), and prevalence of co-morbidities was much higher for the richest urban households compared to the poorest urban households. On the other hand in rural the “disachievement” of health indicators is more noticeable than the urban ones. Conclusion: The findings indicate the high burden of selected NCDs among the low wealth quintile populations in rural areas and wealthy populations in urban areas. Particular attentions may be necessary to address the problem of NCDs among these groups. [ABSTRACT FROM AUTHOR]

Background: Unwanted birth is an important public health concern due to its negative association with adverse outcomes of mothers and children as well as socioeconomic development of a country. Although a number of studies have been investigated the determinants of unwanted births through logistic regression analysis, an extensive assessment using path model is lacking. In the current study, we applied path analysis to know the important covariates for unwanted births in Bangladesh. Methods: The study used data extracted from Bangladesh Demographic and Health Survey (BDHS) 2011. It considered sub-sample consisted of 7,972 women who had given most recent births five years preceding the date of interview or who were currently pregnant at survey time. Correlation analysis was used to find out the significant association with unwanted births. This study provided the factors affecting unwanted births in Bangladesh. The path model was used to determine the direct, indirect and total effects of socio-demographic factors on unwanted births. Results: The result exhibited that more than one-tenth of the recent births were unwanted in Bangladesh. The differentials of unwanted births were women’s age, education, age at marriage, religion, socioeconomic status, exposure of mass-media and use of family planning. In correlation analysis, it showed that unwanted births were positively correlated with women age and place of residence and these relationships were significant. On the contrary, unwanted births were inversely significantly correlated with education and social status. The total effects of endogenous variables such as women age, place of residence and use of family planning methods had favorable effect on unwanted births. Conclusion: Policymakers and program planners need to design programs and services carefully to reduce unwanted births in Bangladesh, especially, service should focus on helping those groups of women who were identified in the analysis as being at increased risks of unwanted births- older women, illiterate, low socioeconomic status, early age at marriage and rural poor susceptible women. [ABSTRACT FROM AUTHOR]

Background: Globally, women share an indiscriminate burden of the HIV epidemic and the associated socioeconomic consequences. Previous studies have demonstrated a positive correlation between levels of HIV knowledge with its prevalence. However, for Bangladesh such evidence is non-existent. In this study, we aimed to explore the extent of HIV knowledge in relation to the socio-demographic variables such as age, region, area of residence i.e., urban or rural, wealth index and education, and investigate the factors influencing the level of HIV knowledge among Bangladeshi women.Methods: We used data from the Bangladesh Demographic and Health Survey (BDHS) survey conducted in 2011. In total 12,512 women ageing between 15 and 49 ever hearing about HIV regardless of HIV status were selected for this study. HIV knowledge level was estimated by analyzing respondents' answers to a set of 11 basic questions indicative of general awareness and mode of transmission. Descriptive statistics, cross-tabulation and multinominal logistic regression were performed for data analysis.Results: Little over half the respondents had good knowledge regarding HIV transmission risks. The mean HIV knowledge score was -0.001 (SD 0.914). Average correct response rate about mode of transmission was higher than for general awareness. Educational level of women and sex of household head were found to be significantly associated with HIV knowledge in the high score group. Those with no education, primary education or secondary education were less likely to be in the high score group for HIV knowledge when compared with those with higher than secondary level of education. Similarly those with male as household head were less likely to be in the higher score group for HIV knowledge.Conclusions: Level of HIV knowledge among Bangladeshi women is quite low, and the limiting factors are rooted in various demographic and household characteristics. Education and sex of the household head have been found to be significantly correlated with the level of HIV knowledge and propound sound grounds for their incorporation in the future HIV prevention strategies. Education of women may also have wider ramifications allowing reduction in gender inequality, which in turn favors higher knowledge about HIV. [ABSTRACT FROM AUTHOR]

Background: Better data on cause of, and factors contributing to, neonatal deaths are needed to improve interventions aimed at reducing neonatal mortality in low- and middle-income countries. Methods: Community surveillance to identify all neonatal deaths across four districts in Bangladesh. Verbal autopsy for every fifth case and InterVA-4 used to assign likely cause of death. Findings: 6748 neonatal deaths identified, giving a neonatal mortality rate of 24.4 per 1000 live births. Of these, 51.3% occurred in the community and 48.7% at or on the way to a health facility. Almost half (46.1%) occurred within 24 hours of birth with 83.6% of all deaths occurring in the first seven days of life. Birth asphyxia was the leading cause of death (43%), followed by infections (29.3%), and prematurity (22.2%). In 68.3% of cases, care had been provided at a health facility before death occurred. Care-seeking was significantly higher among mothers who were educated (RR 1.18, 95% CI: 1.04–1.35) or who delivered at a health facility (RR 1.48, 95% CI 1.37–1.60) and lower among mothers who had 2–4 previous births (RR 0.89, 95% CI 0.82–0.96), for baby girls (RR 0.87, 95% CI 0.80–0.93), and for low birth weight babies (RR 0.89, 95% CI 0.82–0.96). Interpretation: Most parents of neonates who died had accessed and received care from a qualified healthcare provider. To further reduce neonatal mortality, it is important that the quality of care provided, particularly skilled birth attendance, emergency obstetric care, and neonatal care during the first month of life is improved, such that it is timely, safe, and effective. [ABSTRACT FROM AUTHOR]

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Objective: To investigate the association between maternal pregnancy intention and professional antenatal and delivery care utilization. Methods: Our data were derived from the 2011 nationally representative Bangladesh Demographic Health Survey. We included antenatal and delivery care utilization data of the most recent live births for women for the previous three years (n = 4672). We used multilevel logistic regression models to assess the relationship between pregnancy intention and use of professional antenatal and delivery care, with adjustment for potential confounding variables. Results: Approximately 13% and 16% of children were reported by their mothers as unwanted and mistimed at the time of conception, respectively. Among the women, 55% received at least one professional antenatal care service; 21% received four or more professional antenatal services, while 32% were attended by professionals during deliveries. Mothers of children whose pregnancies had been unwanted had a greater risk for not seeking professional antenatal and professional delivery care than those whose pregnancies had been wanted [1≥ ANC from professionals: AOR: 0.66; 95% CI:0.51–0.93; 4≥ ANC from professionals: AOR:0.56; 95% CI:0.37–0.84; and delivery care from professionals: AOR: 0.70; 95% CI:0.50–0.97]. Women who were married after age 18, had secondary or higher level of education, and were from the wealthiest households were more likely to utilize antenatal and delivery care. Conclusion: Unwanted pregnancy is significantly associated with lower utilization of professional antenatal and delivery care services in Bangladesh. Reducing unwanted births and promoting access to professional antenatal and delivery care are crucial for achieving the Sustainable Development Goals (SDGs) 3 in Bangladesh. [ABSTRACT FROM AUTHOR]

Background: Research findings on the predictors of smoking cessation behavior identified in Western countries may not be generalizable to smokers in the Southeast Asian countries (i.e., Bangladesh). This study examined the factors associated with smoking cessation behavior (quit attempts and smoking cessation) among a representative sample of Bangladeshi adults. Methods: Data from Wave 1 (2009) and Wave 2 (2010) of the International Tobacco Control (ITC) Survey in Bangladesh, a face-to-face survey of adult smokers, were analysed. Households were sampled using a stratified multistage design and interviewed using a structured questionnaire. Respondents included in the study are 1,861 adult daily smokers (cigarette only or dual use of cigarette and bidi) in the Wave 1 survey who completed the Wave 2 follow up. Results: Of the smokers (N = 1,861), 98 % were male, 18 % illiterate, 78 % married and 42 % were aged 40 or above; 89 % were cigarette smokers and 11 % were dual users (cigarette & bidi). Overall, 21.8 % of the baseline smokers made quit attempts (that is, making at least one quit attempt that lasted for at least 24 hours) during the 11- to 12-month interval between Waves 1 and 2 with only 4.1 % quitting successfully (that is, smokers who had stopped smoking for at least 6 months at the time of the Wave 2 survey). Significant predictors of attempts to quit included: residing areas outside Dhaka (OR = 3.41), being aged 40 or older (OR = 1.53), having a monthly income of above BDT10,000 (US$126) versus below BDT 5,000 (US$63) (OR = 1.57), intending to quit sometime in the future (OR = 1.73). Respondents not working indoors/outside the home were less likely to have made a quit attempt than those with no workplace restrictions on smoking (OR = 0.62). Predictors of successful smoking cessation included: being aged 40 or older (OR = 3.11), perceiving self-rated health as good or excellent (OR = 2.40), and an increased level of self-efficacy (OR = 1.75). Smokers who made a quit attempt not so recently (6 months ago or earlier) were less likely to quit than those who made a more recent (in last 6 months) quit attempt (OR = 0.23). Conclusion: Among Bangladeshi smokers, different factors were associated with quit attempt or successful cessation. Population based smoking cessation programs should take these factors into consideration in the design of smoking cessation interventions. At the same time, measures are necessary to encourage more smokers to make quit attempts. [ABSTRACT FROM AUTHOR]

Anthrax, foot and mouth disease (FMD), haemorrhagic septicaemia (HS), peste des petits ruminants (PPR) and rabies are considered to be endemic in Bangladesh. This retrospective study was conducted to understand the geographic and seasonal distribution of these major infectious diseases in livestock based on data collected through passive surveillance from 1 January 2010 to 31 December 2012. Data analysis for this period revealed 5,937 cases of anthrax, 300,333 of FMD, 13,436 of HS, 247,783 of PPR and 14,085 cases of dog bite/rabies. While diseases were reported in almost every district of the country, the highest frequency of occurrence corresponded to the susceptible livestock population in the respective districts. There was no significant difference in the disease occurrences between districts bordering India/Myanmar and non-border districts (p>0.05). Significantly higher (p<0.01) numbers of anthrax (84.5%), FMD (88.3%), HS (84.9%) and dog bite/rabies (64.3%) cases were reported in cattle than any other species. PPR cases were reported mostly (94.8%) in goats with only isolated cases (5.2%) in sheep. The diseases occur throughout the year with peak numbers reported during June through September and lowest during December through April, with significant differences (p<0.01) between the months. The annual usages of vaccines for anthrax, FMD, HS and PPR were only 7.31%, 0.61%, 0.84% and 11.59% of the susceptible livestock population, respectively. Prophylactic vaccination against rabies was 21.16% of cases. There were significant differences (p<0.01) in the administration of anthrax, FMD and HS vaccines between border and non-border districts, but not PPR or rabies vaccines. We recommend that surveillance and reporting of these diseases need to be improved throughout the country. Furthermore, all suspected clinical cases should be confirmed by laboratory examination. The findings of this study can be used in the formulation of more effective disease management and control strategies, including appropriate vaccination policies in Bangladesh. [ABSTRACT FROM AUTHOR]

Objective: To investigate inequality in disability in Bangladesh. Methods: The study used both household level and individual level data from a large nationally representative data set, Bangladesh’s Household Income and Expenditure Survey - 2010. Principal component analysis was used to construct a wealth index based on household assets from household level data. Then, using data from 49,809 individuals aged 5 years and over, chi-square tests and logistic regression were performed to test the association between wealth level and disability. Findings: Women and older people are significantly more likely to report having disabilities than men and younger people. For middle and rich families, respectively, there is a 14 percent lower likelihood of reporting disabilities than for poor families. Changes in the probability of having disabilities are linear with increasing wealth. In addition, the study identifies some significant factors affecting disability, namely, age, sex, education, marital status, and place of residence including divisional differences. Conclusion: In Bangladesh, worse health among the poor argues for policies prioritizing this group while at the same time giving special attention to women and the elderly. [ABSTRACT FROM AUTHOR]

In the absence of reliable systems for registering rare types of vital events large surveys are required to measure changes in their rates. However some events such as maternal deaths are widely known about in the community. This study examined the utility of asking respondents about events in their neighbourhood as an efficient method for measuring relative rates of rare health events such as maternal and infant deaths. A survey was conducted in the health and demographic surveillance system (HDSS) in Matlab, Bangladesh, which includes two areas with different health care regimes. Adult women were asked about any maternal deaths; multiple births; infant deaths, live births and some other events they knew of in a small specified area around their home. Agreement between HDSS records and survey responses was moderate or better (kappa≥0.44) for all the events and greatest for maternal deaths (kappa = 0.77) with 84% being reported. Most events were more likely to be reported if they were recent (p<0.05). Infant mortality rate in one area was 0.56 times that in the other which was well reflected by the ratio of survey results (0.53). Simulations were used to study the ability of the method to detect differences in maternal mortality ratio. These suggested that a sample size around 5000 would give 80% power to detect a 50% decrease from a baseline of 183 which compared well with an estimated sample size around 10 times larger using the direct sisterhood method. The findings suggest that the Neighbourhood Method has potential for monitoring relative differences between areas or changes over time in the rates of rare demographic events, requiring considerably smaller sample sizes than traditional methods. This raises the possibility for interventions to demonstrate real effects on outcomes such as maternal deaths where previously this was only feasible by indirect methods. [ABSTRACT FROM AUTHOR]

ObjectiveThe goal of the present study was to examine the influence of community environment on the nutritional status (weight-for-age and height-for-age) of children (aged 0–59 months) in Bangladesh. In addition, we tested the association between specific characteristics of community environments and child nutritional status.DesignCross-sectional survey.SettingThe data are from the nationally representative 2004 Bangladesh Demographic and Health Survey.SubjectsRespondents were ever-married women (aged 15–49 years) and their children (n 5731), residing in 361 communities. Child nutritional outcomes are physical measurements of weight-for-age and height-for-age in sd units. We considered the following attributes of community environments potentially related to child nutrition: (i) community water and sanitation infrastructure; (ii) availability of community health and education services; (iii) community employment and social participation; and (iv) education level of the community.ResultsMultilevel regression analysis showed that the spatial distribution of maternal and child covariates did not entirely explain the between-community variation in child nutritional status. The education level of the community emerged as the strongest community-level predictor of child height-for-age (highest v. lowest tertile, β = 0·18 (se 0·07)) and weight-for-age (highest v. lowest tertile, β = 0·21 (se 0·06)). In the height-for-age model, community employment and social participation also emerged as being statistically significant (highest v. lowest tertile, β = 0·13 (se = 0·06)).ConclusionsThe community environment influences child nutrition in Bangladesh, and maternal- and child-level covariates may fail to capture the entire influence of communities. Interventions to reduce child undernutrition in developing countries should take into consideration the wider community context. [ABSTRACT FROM PUBLISHER]

Background: Previous studies have reported associations between prenatal arsenic exposure and increased risk of infant mortality. An increase in infectious diseases has been proposed as the underlying cause of these associations, but there is no epidemiologic research to support the hypothesis. Objective: We evaluated the association between arsenic exposure in pregnancy and morbidity during infancy. Methods: This prospective population-based cohort study included 1,552 live-born infants of women enrolled during 2002-2004 in Matlab, Bangladesh. Arsenic exposure was assessed by the concentrations of metabolites of inorganic arsenic in maternal urine samples collected at gestational weeks 8 and 30. Information on symptoms of lower respiratory tract infection (LRTI) and diarrhea in infants was collected by 7-day recalls at monthly home visits. Results: In total, 115,850 person-days of observation were contributed by the infants during a 12-month follow-up period. The estimated risk of LRTI and severe LRTI increased by 69% [adjusted relative risk (RR) = 1.69; 95% confidence interval (CI), 1.36-2.09)] and 54% (RR = 1.54; 95% CI, 1.21-1.97), respectively, for infants of mothers with urinary arsenic concentrations in the highest quintile (average of arsenic concentrations measured in early and late gestation, 262-977 μg/L) relative to those with exposure in the lowest quintile (< 39 μg/L). The corresponding figure for diarrhea was 20% (RR = 1.20; 95% CI, 1.01-1.43). Conclusions: Arsenic exposure during pregnancy was associated with increased morbidity in infectious diseases during infancy. Taken together with the previous evidence of adverse effects on health, the findings strongly emphasize the need to reduce arsenic exposure via drinking water. [ABSTRACT FROM AUTHOR]

Infant and child mortality rates are significantly lower in the Maternal and Child Health-Family Planning (MCH-FP) area of Matlab, Bangladesh, than in a comparison area. The two areas are similar in terms of socioeconomic characteristics, but the MCH-FP area provides better maternal and child health and family planning services, resulting in different reproductive patterns, including lower fertility rates and longer intervals between pregnancies. We use data from the Matlab Demographic Surveillance System for nearly 126,000 singleton live births that occurred between 1982 and 2002 to investigate the extent to which the different reproductive patterns in the MCH-FP area explain why infant and child mortality rates are lower there. Differences in reproductive patterns account for a small portion (up to 20 percent) of the variation in these rates between the MCH-FP and comparison areas, suggesting that the majority of the difference is due to the quality of MCH services. [ABSTRACT FROM AUTHOR]

This study uses high quality longitudinal data on kin availability, proximity, and marital status from the Matlab surveillance area in rural Bangladesh to explore the impact of kin members on the survival of the elderly over a six year period. The results -- from discrete time hazard models- suggest that the presence of a spouse, sons, and brothers substantially improves survivorship, but with differing effects by the sex of the elderly and the number of sons and brothers. This study offers little support of any of the following as mechanisms by which kin affect the survival of the elderly: changes in the economic status of the elderly as proxied by land holdings; improved access to instrumental support as proxied by the marital status of sons; decreases in social isolation as proxied by proximity of kin. [ABSTRACT FROM AUTHOR]

A method of partitioning the fertility impact of infant and child death into two components - a physiological and a behavioural effect - is proposed by use of the Cox hazard model with three dummy variables that indicate the time of child death and the status of breastfeeding with reference to the return of menstruation postpartum. An application of the method to the 1991 Bangladesh Contraceptive Prevalence Survey data suggests that the effect from the physiological mechanism outweighed the effect from the behaviourial mechanism (the former effect raising the hazard of an additional birth by nearly 90 per cent). It appears that the effect of a child death declined over time and an early cessation of breastfeeding was not the sole cause for invoking the physiological mechanism. The risk of childbirth rose sharply among the educated if their children died, although the main effect of education itself was to reduce the risk. [ABSTRACT FROM AUTHOR]

Background: Although the recent decline in child mortality in Bangladesh is remarkable, death from causes other than infectious diseases and malnutrition remains an important component of child mortality. Death from drowning of children can be expected to be a problem in Bangladesh given the geographical features of the country.Objective: The objectives of this study are to determine the trend, pattern, and correlates of drowning deaths.Methods: Data are presented on deaths of children (1-4 years) due to drowning derived from a longitudinal, population-based surveillance system in operation in a rural area of Bangladesh in 1983-1995. Moreover, a case-control study was carried out to identify the risk factors associated with drowning.Results: Deaths due to drowning ranged from about 10% to 25% of child deaths during 1983-1995. The absolute risk of dying from drowning remained almost the same over the study period but the proportion of drownings to all causes of death has increased. Drowning is especially prevalent in the second year of life. Age of the mother and parity have a significant impact on drowning. The risk of dying from drowning increases with the age of mother and much more sharply with the number of living children in the family. Two socioeconomic variables did not have an influence on the risk of drowning.Conclusions: A substantial proportion of child deaths could be averted if parents and other close relatives paid more attention to the safety of children. The Child Health Programme of the Ministry of Health and Family Welfare of Bangladesh should develop health education programmes for villagers alerting them to the dangers of drowning and measures to prevent it. [ABSTRACT FROM AUTHOR]

This study examines the impact of contraceptive service availability on contraceptive use in Korea, Mexico, and Bangladesh. Using World Fertility Survey Data on once-married females and their communities of residence, the multivariate analysis finds that the community level of contraceptive availability directly affects the likelihood of current use, net of the effects of community development, education, parity, and marital duration. The results are supportive of the recent policy emphasis on maximizing the geographic availability of contraceptive services. [ABSTRACT FROM AUTHOR]

The article focuses on the sensitivity of estimated fertility levels and trends to alternative interpretations of responses in fertility surveys. It uses data from the 1975 Bangladesh Fertility Survey. It presents some simple mathematical models to evaluate the consequences of an erroneous interpretation. The author also presents some guidelines for a correct interpretation. It refers to a package program of the Central Office of the World Fertility Survey which edits and imputes different types of dates in World Fertility Survey questionnaires. It is found that in Bangladesh, the imputation had no serious impact upon, fertility levels.

It is informed that prior to the demographic transition in the now industrialized world, short-term fluctuations in births and deaths due to disasters-- famine, epidemic, war-- were common events. This article presents the findings of an investigation into the impact of one recent crisis, the 1971 Bangladesh Civil War, on births and deaths in a population of approximately 120,000 in rural Bangladesh. Data for the analysis come from a longitudinal vital registration system maintained by the Cholera Research Laboratory in Matlab Bazar thana, Bangladesh. Baseline trends of vital events for the years 1966-67 to 1970-71 are presented. Short-term fluctuations in births and deaths during the disturbances of 1971-72 and in the two subsequent years are analysed, and selected fertility and mortality rates are computed to document the differential impact of the conflict on the population. March 1971, marked the beginning of the Bangladesh Civil War. In the early part of that month, the urban workers in Bangladesh went on strike, many returning to their village homes. On March 25, 1971, armed conflict between the Pakistan army and Bengali civilians erupted. Over the next nine months, a conventional army attempted to subdue a rebellious civilian population. The conflict was not static. Initially the army held strategic positions in urban and transport centres and made periodic expeditions into the countryside. By June-July, however, a guerilla insurgency had developed and armed clashes in the countryside became common.

It is informed that enough is known about the population of the newly emerged state of Bangladesh to establish its importance in the field of demography. Warm and moist, Bangladesh is crisis-crossed by rivers and their tributaries, which often change course and cause the destruction of human habitations that flourish near their banks. The climate and action of the rivers have destroyed most of the historical remains of Bangladesh. The shifting rivers of the deltaic region also inhibited the growth of cities, and Bangladesh still remains predominantly rural. Censuses and vital registration in Bangladesh extend over a full century, but vital registration remained severely defective, and at least one census, the census of 1941, resulted in a gross overcount because of political maneuvering. Regular population censuses were taken in Bangladesh from 1872 until the partition of the sub-continent in 1947, as a part of the undivided Indian province of Bengal. Bangladesh and Assam were divided into separate provinces in 1905, but as a result of powerful political agitation were reunited shortly after.