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Lightning is one of the most widespread and deadly hazards in Bangladesh. Bangladesh has among the highest death rates of any country. The main objective of this study is to analyze the people's perception to investigate the potential misconceptions and myths on lightning. This paper addresses present safety knowledge and awareness among people, the spatial variation of lightning strikes from 1998 to 2013 and spatial variation of lightning deaths from 2011 to 2015 in Bangladesh. People's perception on lightning has been analyzed using field surveys, and the spatial variation of lightning strikes and deaths has been analyzed using geographic information system. The results of this paper revealed that there are some misconceptions, myths, and misunderstanding among the different demographic groups of people in Bangladesh. Analysis of annual spatial variation of lightning flash density suggests that the northern and northeastern parts of Bangladesh have the highest lightning flash rate density. Pre-monsoon season experiences the highest rate of flash density among all seasons. Analysis of spatial variation of lightning deaths suggests that Chapai Nawabganj District of Bangladesh is in the top of the lightning death rates per million people per district over years 2011–2015. It was found that the main reasons behind this large number of deaths are lack of lightning safety knowledge and awareness, lack of shelters, and lack of lightning safety precaution training. To improve this situation and minimize the loss of lives and property, a comprehensive plan and policy should be developed. [ABSTRACT FROM AUTHOR]

Background and Aims: Given the significance of addressing neonatal mortality in pursuing the 2030 Sustainable Development Goal on child health, research focus on this area is crucial. Despite the persistent high rates of neonatal mortality rate (NMR) in Bangladesh, there remains a notable lack of robust evidence addressing inequalities in NMR in the country. Therefore, this study aims to fill the knowledge gap by comprehensively investigating inequalities in NMR in Bangladesh. Methods: The Bangladesh Demographic and Health Survey (BDHS) data from 2000 to 2017 were analyzed. The equity stratifiers used to measure the inequalities were wealth status, mother's education, place of residence, and subnational region. Difference (D) and population attributable fraction (PAF) were absolute measures, whereas population attributable risk (PAR) and ratio (R) were relative measures of inequality. Statistical significance was considered by estimating 95% confidence intervals (CIs) for each estimate. Results: A declining trend in NMR was found in Bangladesh, from 50.2 in 2000 to 31.9 deaths per 1000 live births in 2017. This study detected significant wealth‐driven (PAF: −20.6, 95% CI: −24.9, −16.3; PAR: −6.6, 95% CI: −7.9, −5.2), education‐related (PAF: −11.6, 95% CI: −13.4, −9.7; PAR: −3.7, 95% CI: −4.3, −3.1), and regional (PAF: −20.6, 95% CI: −27.0, −14.3; PAR: −6.6, 95% CI: −8.6, −4.6) disparities in NMR in all survey points. We also found a significant urban–rural inequality from 2000 to 2014, except in 2017. Both absolute and relative inequalities in NMR were observed; however, these inequalities decreased over time. Conclusion: Significant variations in NMR across subgroups in Bangladesh highlight the need for comprehensive, and targeted interventions. Empowering women through improved access to economic resources and education may help address disparities in NMR in Bangladesh. Future research and policies should focus on developing strategies to address these disparities and promote equitable health outcomes for all newborns. [ABSTRACT FROM AUTHOR]

This paper proposes a heat-wave definition for Bangladesh that could be used to trigger preparedness measures in a heat early warning system (HEWS) and explores the climate mechanisms associated with heat waves. A HEWS requires a definition of heat waves that is both related to human health outcomes and forecastable. No such definition has been developed for Bangladesh. Using a generalized additive regression model, a heat-wave definition is proposed that requires elevated minimum and maximum daily temperatures over the 95th percentile for 3 consecutive days, confirming the importance of nighttime conditions for health impacts. By this definition, death rates increase by about 20% during heat waves; this result can be used as an argument for public-health interventions to prevent heat-related deaths. Furthermore, predictability of these heat waves exists from weather to seasonal time scales, offering opportunities for a range of preparedness measures. Heat waves are associated with an absence of normal premonsoonal rainfall brought about by anomalously strong low-level westerly winds and weak southerlies, detectable up to approximately 10 days in advance. This circulation pattern occurs over a background of drier-than-normal conditions, with below-average soil moisture and precipitation throughout the heat-wave season from April to June. Low soil moisture increases the odds of heat-wave occurrence for 10-30 days, indicating that subseasonal forecasts of heat-wave risk may be possible by monitoring soil-moisture conditions. [ABSTRACT FROM AUTHOR]

The dengue virus is the most dangerous one that mosquitoes may spread to people. Despite attempts by the government, dengue outbreaks are becoming increasingly common in Bangladesh. Interventions in public health rely heavily on KAP (knowledge, attitude, and practice) studies. The primary goal of this research is to forecast the occurrence of dengue disease in the city of Dhaka using methods from machine learning and time series analysis and then to compare the models in order to find the one with the lowest MAPE. From January 2016 through July 2021, monthly data were retrieved for this study from WHO and the Directorate General of Health and Services (DGHS). According to the findings of this research, neural networks outperform time series analysis when it comes to making predictions. The best-fitted neural network (NN) model was found in model 04 with 05 hidden layers which produced the minimum error model with the value of error 0.003032557, and the values of RMSE and MAPE are 7.588889e − 06 and 1.15273, respectively, for the prediction of the dengue fever in Dhaka city. In contrast, the original dengue data in the time series analysis is not stationary. Take the difference and run the unit root test by the augmented Dickey–Fuller (ADF) test to make it stationary. The dengue data series is stationary at the first-order difference, as evidenced by the ACF and PACF, which show no noticeable spike in the first-order difference. The ARIMA (6, 1, 1) model with the lowest AIC = −251.8, RMSE = 0.0310797, and MAPE = 15.2892 is the best choice model for predicting the dengue death rate. Therefore, from these two models, the NN model gives better prediction performance with the lowest value of MAPE. So, the neural network gives better prediction performance than time series analysis. The NN model forecasted 12-month death rates of dengue fever that suggest the death rate in dengue fever falling month by month. This study is more innovative than any other research because this research approach is different from any other research approach. The model selection criteria are based on the most effective performance metrics MAPE, indicating the lowest error and better prediction performance. Therefore, from this research, the author suggests machine learning gives better prediction performance than time series analysis for any other prediction performance. [ABSTRACT FROM AUTHOR]

Background Everyday 2591 elderly people die due to injury worldwide. The complications and consequences of injury is different and worse than that of other age-groups. Yet little is known about the injury scenario of elderly population of Bangladesh. This paper aim to describe the epidemiology of geriatric injury of Bangladesh which will help policy-makers to undertake interventions for this vulnerable-group. Methods Bangladesh Health and Injury Survey 2016, a nationwide cross-sectional survey was carried out among 299,216 residents to identify the injury-related mortality and morbidity. Injury data among the population aged 60-years and above was extracted and analyzed for this study. Results Injury was found to cause 3.9% of the total deaths among elderly population of Bangladesh. Mortality and morbidity rate due to injury was found 157 (95%CI 112- 216) per 100,000 elderly populations and 129 (95%CI 124-133) per 1000 elderly population respectively. Fatality rate was 182.6 among urban population and 147 among rural population. Fall was identified as the leading cause of injury deaths and morbidity. It caused 47.2% of all fatality followed by Transport-injury (19.4%) and Suicide (13.9%). Among all fatally injured, 72.2% victims received treatment from health-service providers and among these 58.3% (n = 21) went to registered doctors. Conclusions Fall is the leading cause of injury related mortality and morbidity among elderly of Bangladesh. A significant amount of deaths also occurred due to RTI and suicide. Further in-depth research and interventions are needed to minimize the preventable burden of fatality and morbidity among this vulnerable-group. Key messages Elderly, Injury, Epidemiology, Bangladesh [ABSTRACT FROM AUTHOR]

Nipah virus (NiV) is an emerging zoonotic paramyxovirus to which is attributed numerous high mortality outbreaks in South and South-East Asia; Bangladesh's Nipah belt accounts for the vast majority of human outbreaks, reporting regular viral emergency events. The natural reservoir of NiV is the Pteropus bat species, which covers a wide geographical distribution extending over Asia, Oceania, and Africa. Occasionally, human outbreaks have required the presence of an intermediate amplification mammal host between bat and humans. However, in Bangladesh, the viral transmission occurs directly from bat to human mainly by ingestion of contaminated fresh date palm sap. Human infection manifests as a rapidly progressive encephalitis accounting for extremely high mortality rates. Despite that, no therapeutic agents or vaccines have been approved for human use. An updated review of the main NiV infection determinants and current potential therapeutic and preventive strategies is exposed. [ABSTRACT FROM AUTHOR]

This paper reports on an analysis of neonatal mortality from communicable and non-communicable diseases in Bangladesh. The competing-risks model employed incorporated both observed and unobserved heterogeneity and allowed the two heterogeneity terms to be correlated. The data used came from the Health and Demographic Surveillance System, Matlab. The results confirm the conclusions of previous studies about the levels, trends, and causes of neonatal death in the Matlab area: the education of the mother helps protect her children from death from both communicable and non-communicable diseases; the children of a father in a low-status occupation are particularly vulnerable to death from communicable diseases; and children born to mothers aged less than 20 face a particularly high risk of dying from a non-communicable disease. The risks of dying from a communicable disease and from a non-communicable disease were both found to fall significantly as the distance to the nearest health centre decreased. [ABSTRACT FROM PUBLISHER]

Background and Aims: Bangladesh did not have enough evidence on the current estimates and trend in inequities in the under‐five mortality rate (U5MR). There is also a shortage of evidence on trends and inequalities in healthcare‐seeking for pneumonia among under‐five children (U5C) in Bangladesh. Hence, this study investigated the inequalities in U5MR and health care seeking for pneumonia in U5C through socioeconomic and geographic disparities in Bangladesh between 2007 and 2017. Methods: Data from 2007, 2011, 2014, and 2017 Bangladesh Demographic and Health surveys were analyzed using the Health Equity Assessment Toolkit (HEAT) software by World Health Organization (WHO). The data on U5MR and healthcare‐seeking for pneumonia were first disaggregated into five equity dimensions: wealth status, education, child sex, place of residence, and administrative divisions. Second, using summary metrics such as difference (D), population attributable risk (PAR), ratio (R), and population attributable fraction (PAF), inequalities were assessed. Results: The U5MR declined from 73.9 deaths per 1000 live births in 2007 to 48.6 deaths in 2017, while the prevalence of healthcare‐seeking for pneumonia in U5C fluctuated over time (34.6% in 2007, 35.4% in 2011, 42.0% in 2014, and 39.8% in 2017). Profound socioeconomic and geographic disparities in U5MR and the prevalence of healthcare‐seeking for pneumonia in U5C favored the wealthy, educated, and urban residents. At the same time, the Sylhet division showed the worst situation for U5MR. There were also sex‐related disparities in U5MR (PAR = −4.5, 95% confidence interval: −5.3 to −3.7) with higher risk among male children than females. Conclusion: These results indicate that improving disadvantaged women, such as the poor, uneducated, and rural inhabitants, who exhibit disproportionate disparities in U5MR and healthcare‐seeking behavior is important. To reduce childhood mortality, it is essential to improve healthcare‐seeking for pneumonia among U5C. Facilitating women for better education and economic encompasses would help reducing disparity. [ABSTRACT FROM AUTHOR]

Background: Despite significant reduction of childhood mortality in Bangladesh, large spatial variations persist. Identification of lower level spatial units with higher concentrations of deaths can be useful for strengthening services in these areas. This paper reports findings from a spatial analysis of deaths in Chakaria, a rural subdistrict, where a Health and Demographic Surveillance System has been in place since 1999. Chakaria is an INDEPTH member site. Methods: An analysis was done of 339 deaths among nearly 24,500 children under the age of five during 2005- 2008. One ward, the lowest level of administrative units, was the unit of spatial analysis. Data from 24 wards were analyzed. The Discrete Poisson Probability Model was used to identify the clustering of deaths. Results: Deaths were concentrated within 12 wards located in the low-lying deltaic flood plains of the Chakaria HDSS area. The risk of death in the low-lying areas was statistically significantly higher, 1.5 times, than the non-low-lying areas (p<0.02). Conclusion: Spatial analysis can be a useful tool for identifying high-risk mortality areas. An understanding of the risk factors prevalent in the low-lying areas can help design effective interventions to reduce mortality in these areas. [ABSTRACT FROM AUTHOR]

Background: Biosecurity‐based interventions are important health strategies for the control of infectious disease and improve productivity in broiler. There are various reasons why broilers die at the early stages of production; however, biosecurity measures are crucial in reducing the risk of disease prevalence and can therefore affect the overall deaths in a flock for a specific period (crude mortality rate [CMR]). Objectives: This study was designed to determine the current biosecurity situation on small‐scale broiler farms in Bangladesh and its relationship to the CMR during the early stages of production. Methods: A cross‐sectional observational study was conducted on small‐scale broiler farms (N = 57) located in peri‐urban areas of Chattogram and Pabna districts of Bangladesh. Descriptive and predictive statistical analyses were performed to estimate the frequency of categorical variables and their effect on CMR. Results: The findings indicated that around 80% of small‐scale broiler farms lacked adequate biosecurity measures. Both on day 1 (p = 0.012) and on days 2–14 (p = 0.003), flocks with inadequate biosecurity had considerably higher median CMRs. Farms that were near the neighbourhood used wood shavings as bedding, offered tube well/shallow well or supply line water, maintained a brief empty period (≤5 days) before introducing new flocks and began using antibiotics on day 1 all had significantly higher CMR at both days 1 and 2–14. Conclusions: The findings point to the necessity of implementing stringent biosecurity measures in broiler production in locations where there is a shortage, which can lower the burden of arbitrary antibiotic usage and will lower total production costs due to crude mortality and management‐related issues. [ABSTRACT FROM AUTHOR]

Purpose: This paper is focused to reflect the changes in burn mortality and events leading to fatal burn injuries.Methods: Two national community-based cross sectional health and injury surveys were done in Bangladesh during 2003 and 2016. Similar methodology had been followed in both the surveys. Multistage cluster sampling method considering probability-proportional-to-size strategy was used in both the surveys to obtain the desired sample. A pretested semi-structured questionnaire was deployed to identify causes of mortality and morbidity among the population. Verbal autopsy method was used to ascertain the cause of death.Results: An estimated 5000 deaths occurred during 2002 due to burn, whereas, around 9000 deaths were caused by burn in 2015 reflected by the death rates 3.5 and 5.7 per 100,000 population in respective years. This study found an increase in death rates in all age groups from 2002 to 2015. Electrocution caused the highest burn deaths in this country, especially among males and in rural areas. The death toll by this particular mechanism has increased by more than two folds within a decade. The place of occurrence of fatal burn injuries has also shifted from home to the outside of the home especially in the agricultural fields.Conclusion: Burn death is an emerging cause of injury deaths in Bangladesh. Further researches are required to explore the epidemiology of electrocution deaths in Bangladesh and design effective interventions. [ABSTRACT FROM AUTHOR]

Bangladesh is renowned in disaster risk reduction (DRR) for active involvement of community people and local disaster management institutions in DRR activities. Our study aimed to describe the disaster risk management (DRM) institutions and assess their functioning in six coastal unions across the three coastal zones of Bangladesh. Both qualitative and quantitative research approaches were used. The study focused on two key local institutions—the Union Disaster Management Committees (UDMCs) and the Cyclone Preparedness Program (CPP)—functioning at the union level in DRM. Such institutions have both horizontal and vertical collaborations with other institutions. However, we argue that the UDMCs' external dependencies in their functioning indicate their limited financial and administrative autonomy, which is a barrier to successfully institutionalizing disaster management. The results show that the CPP is the most successful program, markedly increasing the trust of the people in warning dissemination and evacuation efforts in the event of a cyclone. Although the adoption of decentralized risk management systems has resulted in significant progress in increased rate of evacuation and reduced death rate and damage, lack of funding and equipment, limited coordination between institutions, lack of skilled and knowledgeable workforce, and inappropriate power structures may reduce the effectiveness of DRR activities prior to, during, and following disasters. [ABSTRACT FROM AUTHOR]

Aim To examine the incidence of cardiovascular disease (CVD), of death, and the comparative effects of 12 common modifiable risk factors for both outcomes in South Asia. Methods and results Prospective study of 33 583 individuals 35–70 years of age from India, Bangladesh, or Pakistan. Mean follow-up period was 11 years. Age and sex adjusted incidence of a CVD event and mortality rates were calculated for the overall cohort, by urban or rural location, by sex, and by country. For each outcome, mutually adjusted population attributable fractions (PAFs) were calculated in 32 611 individuals without prior CVD to compare risks associated with four metabolic risk factors (hypertension, diabetes, abdominal obesity, high non-HDL cholesterol), four behavioural risk factors (tobacco use, alcohol use, diet quality, physical activity), education, household air pollution, strength, and depression. Hazard ratios were calculated using Cox regression models, and average PAFs were calculated for each risk factor or groups of risk factors. Cardiovascular disease was the most common cause of death (35.5%) in South Asia. Rural areas had a higher incidence of CVD (5.41 vs. 4.73 per 1000 person-years) and a higher mortality rate (10.27 vs. 6.56 per 1000 person-years) compared with urban areas. Males had a higher incidence of CVD (6.42 vs. 3.91 per 1000 person-years) and a higher mortality rate (10.66 vs. 6.85 per 1000 person-years) compared with females. Between countries, CVD incidence was highest in Bangladesh, while the mortality rate was highest in Pakistan. The modifiable risk factors studied contributed to approximately 64% of the PAF for CVD and 69% of the PAF for death. Largest PAFs for CVD were attributable to hypertension (13.1%), high non-HDL cholesterol (11.1%), diabetes (8.9%), low education (7.7%), abdominal obesity (6.9%), and household air pollution (6.1%). Largest PAFs for death were attributable to low education (18.9%), low strength (14.6%), poor diet (6.4%), diabetes (5.8%), tobacco use (5.8%), and hypertension (5.5%). Conclusion In South Asia, both CVD and deaths are highest in rural areas and among men. Reducing CVD and premature mortality in the region will require investment in policies that target a broad range of health determinants. [ABSTRACT FROM AUTHOR]

A detailed analysis of survey data collected in 1961-1962 for a sample of 4200 families in central East Pakistan produced consistent and reasonable estimates of birth and death rates for the preceding decade. Extremely high levels of infant and child mortality declined noticeably in the period 1952-1961. Age-specific birth rates to married women also decreased in the decade for women over the age of 19, while a small increase was recorded for married women aged 15 to 19. During the 1950s total marital fertility declined about one-fifth. Birth rates remained high in 1960 according to these estimates, but there is reason to anticipate further reductions in birth rates, particularly among older women. To improve under- standing of the determinants of fertility and to aid in the formulation of policy to cope with population trends, statistical analysis must increasingly consider information on families over time. Retrospective household survey data may provide the empirical base for this line of inquiry. [ABSTRACT FROM AUTHOR]

Nipah virus infection is a renewable threatening stage III zoonotic disease caused high mortality rates and significant public health risks in the past two decades. Several outbreaks of the Nipah virus occurred in Malaysia, Bangladesh, India and other Asian countries, which differed in the characteristics as each outbreak results from a novel strain of the virus. The continuous change of the viral hosts, as it jumps from bats to the animal/human and vice versa, but the virus in need to adapt to the new environment and favor mutations accuracy. The recent outbreaks of the virus caused much concern worldwide due to its ease of transmission and high mortality rates. During the rapid spread and replication of Nipah virus, more mutations are likely to develop, enhancing its epidemiological patterns and increasing its pathogenicity, raising the risk for a new pandemic. This review presents the chronological development of Nipah virus outbreaks and the main differences from the originally discovered Nipah virus and the more recent strains and discussed the potential of this virus to become a new pandemic. [ABSTRACT FROM AUTHOR]

Background: Almost all countries without complete vital registration systems have data on deaths collected by hospitals. However, these data have not been widely used to estimate cause of death (COD) patterns in populations because only a non-representative fraction of people in these countries die in health facilities. Methods that can exploit hospital mortality statistics to reliably estimate community COD patterns are required to strengthen the evidence base for disease and injury control programs. We propose a method that weights hospital-certified causes by the probability of death to estimate population cause-specific mortality fractions (CSMFs).Methods: We used an established verbal autopsy instrument (VAI) to collect data from hospital catchment areas in Chandpur and Comilla Districts, Bangladesh, and Bohol province, the Philippines, between 2011 and 2014, along with demographic covariates for each death. Hospital medical certificates of cause of death (death certificates) were collected and mapped to the corresponding cause categories of the VAI. Tariff 2.0 was used to assign a COD for community deaths. Logistic regression models were created for broad causes in each country to calculate the probability of in-hospital death, given a set of covariate values. The reweighted CSMFs for deaths in the hospital catchment population, represented by each hospital death, were calculated from the corresponding regression models.Results: We collected data on 4228 adult deaths in the Philippines and 3725 deaths in Bangladesh. Short time to hospital and education were consistently associated with in-hospital death in the Philippines and absence of a disability was consistently associated with in-hospital death in Bangladesh. Non-communicable diseases (excluding stroke) and stroke were the leading causes of death in both the Philippines (33.9%, 19.1%) and Bangladesh (46.1%, 21.1%) according to the reweighted method. The reweighted method generally estimated CSMFs that fell between those derived from hospitals and those diagnosed by Tariff 2.0.Conclusions: Statistical methods can be used to derive estimates of cause-specific probability of death in-hospital for Bangladesh and the Philippines to generate population CSMFs. In regions where hospital death certification is of reasonable quality and routine verbal autopsy is not applied, these estimates could be applied to generate cost-effective and robust CSMFs for the population. [ABSTRACT FROM AUTHOR]

Background: Little is known about long-term changes linking chronic diseases and poverty in low-income countries such as Bangladesh. This study examines how chronic disease mortality rates change across socioeconomic groups over time in Bangladesh, and whether such mortality is associated with households falling into poverty.Methods: Age-sex standardized chronic diseases mortality rates were estimated across socioeconomic groups in 1982, 1996 and 2005, using data from the health and demographic surveillance system in Matlab, Bangladesh. Changes in households falling below a poverty threshold after a chronic disease death were estimated between 1982-96 and 1996-2005.Results: Age-sex standardized chronic disease mortality rates rose from 646 per 100 000 population in 1982 to 670 in 2005. Mortality rates were higher in wealthier compared with poorer households in 1982 [Concentration Index = 0.037; 95% confidence interval (CI): 0.002, 0.072], but switched direction in 1996 (Concentration Index = -0.007; 95% CI: -0.023, 0.009), with an even higher concentration in the poor by 2005 (Concentration Index = -0.047; 95% CI: -0.061, -0.033). Between 1982-96 and 1996-2005, the highest chronic disease mortality rates were found among those households that fell below the poverty line. Households that had a chronic disease death in 1982 were 1.33 (95% CI: 1.03, 1.70) times more likely to fall below the poverty line in 1996 compared with households that did not.Conclusions: Chronic disease mortality is a growing proportion of the disease burden in Bangladesh, with poorer households being more affected over time periods, leading to future household poverty. [ABSTRACT FROM AUTHOR]

Introduction: In 2005, Bangladesh, India, and Nepal joined forces to eliminate Visceral Leishmaniasis (or kala-azar) from the region by 2015. In Bangladesh the elimination target is set at less than one new case per 10,000 population per year at upazila (sub-district) level. As the deadline approaches, we review the status of the elimination initiative in this country. Methods: We collected all available disease surveillance data at the Disease Control Unit of the Directorate General of Health Services, Government of Bangladesh from 1994 to 2013. Additionally, we retrieved data from the Civil Surgeon Office from the Mymensingh district, one of the most heavily affected areas in Bangladesh. Results: Between 1994 and 2013, 109,266 kala-azar cases causing 329 deaths were reported from 37 endemic districts in Bangladesh. Only 16 districts reported cases every year. The Mymensingh district was the most affected with 53,582 (49.04%) cases. Between 2008 and 2013 only 16 upazilas showed incidence rates above the elimination target in which they ranged from 1.06 to 18.25 per 10,000 people per year. Discussion: While clear progress has been made towards eliminating VL, 16 upazilas in Bangladesh had not yet reached the target in 2013, based on official notification data that probably suffered from under-reporting bias. The elimination initiative urgently needs to establish methods to ascertain and monitor the elimination target. [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]

Background: Snake bite is a neglected public health problem in the world and one of the major causes of mortality and morbidity in many areas, particularly in the rural tropics. It also poses substantial economic burdens on the snake bite victims due to treatment related expenditure and loss of productivity. An accurate estimate of the risk of snake bite is largely unknown for most countries in the developing world, especially South-East Asia. Methodology/Principal Findings: We undertook a national epidemiological survey to determine the annual incidence density of snake bite among the rural Bangladeshi population. Information on frequency of snake bite and individuals' length of stay in selected households over the preceding twelve months was rigorously collected from the respondents through an interviewer administered questionnaire. Point estimates and confidence intervals of the incidence density of snake bite, weighted and adjusted for the multi-stage cluster sampling design, were obtained. Out of 18,857 study participants, over one year a total of 98 snake bites, including one death were reported in rural Bangladesh. The estimated incidence density of snake bite is 623.4 / 100,000 person years (95% C I 513.4–789.2 /100,000 person years). Biting occurs mostly when individuals are at work. The majority of the victims (71%) receive snake bites to their lower extremities. Eighty-six percent of the victims received some form of management within two hours of snake bite, although only three percent of the victims went directly to either a medical doctor or a hospital. Conclusions/Significance: Incidence density of snake bite in rural Bangladesh is substantially higher than previously estimated. This is likely due to better ascertainment of the incidence through a population based survey. Poor access to health services increases snake bite related morbidity and mortality; therefore, effective public health actions are warranted. Author Summary: Snake bite is one of the major causes of morbidity and mortality in many rural tropical areas. As a neglected public health problem, estimate of the risk is largely unknown. However, the associated personal and economic impact of snake bite is substantial across developing countries. This national survey investigated the risk and consequences of snake bite among the rural Bangladeshi population. We surveyed 18857 individuals from 24 out of 64 districts in Bangladesh where 98 snake bites including one death were reported. The estimated incidence density of snake bite is 623.4/ 100,000 person years (95% CI: 513.4–789.2/100,000 person years). Biting occurs mostly when individuals are at work. The majority of the victims (71%) received snake bites to their lower extremities. Eighty-six percent of the victims received some form of management within two hours of snake bite, although only three percent of them went directly to either a medical doctor or a hospital. The observed rate of snake bite in rural Bangladesh is substantially higher than anticipated. This coupled with poor access to health services led to an increase in related morbidity and mortality. An improvement in public health actions is therefore warranted. [ABSTRACT FROM AUTHOR]

In Matlab thana, a rural area of Bangladesh, there is a substantial deficit of males of reproductive age owing to urban migration of males who leave their families behind. These men nevertheless return to visit their families frequently. Thirty percent of the births in this area occur to families with migrant fathers: neonatal mortality rates in these families are nearly double those of families with non-migrant fathers. This high risk, in turn, interacts with educational attainment and maternal nutrition. Only those migrant families where mothers have no education or low body weight experience high neonatal mortality rates. Psychological stress during pregnancy, probably caused by fear and anxiety related to the husband's absence may in part be responsible for such differential risk of mortality during the neonatal period. [ABSTRACT FROM PUBLISHER]

This article reports on women admitted to Dhaka Medical College Hospital for incomplete, illegally induced abortion. Women with low complication rates more often had abortions induced by medical practitioners. These women were younger, of lower parity and better educated than women having abortions initiated by other practitioners. Poorly educated women from slum areas almost always had an abortion induced by a non-medical practitioner through the insertion of a solid object. These women experienced high complication rates and often required hysterectomies. This group also had high mortality rates. The drain on hospital resources needed to treat these abortion patients was great. [ABSTRACT FROM PUBLISHER]

This author discusses the effects of flood disasters in developing countries. The author believes that the poorest suffer most in calamities, wherein the death rate is three to four times higher than in developed countries. One of the poorest developing countries is Bangladesh, which has the highest rates of flooding in the world. Studies have attributed psychological disorders of children from the extreme stress they acquired due to the disasters. The studies also suggest that people may recover from a disaster but the mental distress may still continue.