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The coronavirus disease 2019 (COVID-19) pandemic has triggered a worldwide unprecedented public health crisis. Initially, COVID-19 was considered a disease of the respiratory system, as fever and at least one respiratory symptom was used to identify a suspected COVID-19 case. But there are now numerous reports of COVID-19 patients presenting with myriads of extrapulmonary symptoms, however, a substantial number of patients are asymptomatic. Additionally, there are significant clinical and epidemiological variations of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection across different geographical locations. The updated research, thus, challenges the existing surveillance system that is mainly based on fever and respiratory symptoms. As countries are coming out of lockdown to save economic fallout, a revised surveillance strategy is required to effectively identify and isolate the infected patients. Besides, since developing countries are becoming the new epicenters of pandemic and there are limited resources for RT-PCR based tests, documenting the clinical spectrum can play a vital role in the syndromic clinical diagnosis of COVID-19. A plethora of atypical symptoms also aids in guiding better treatment and remains as a source for further research. It is, therefore, crucial to understand the common and uncommon clinical manifestations of SARS-COV-2 infection and its variability across different geographic regions.

With the continued spread of COVID-19 across the world, rapid diagnostic tools, readily available respurposable drugs, and prompt containment measures to control the SARS-CoV-2 infection are of paramount importance. Examples of recent advances in diagnostic tests are CRISPR technology, IgG assay, spike protein detection, and use of artificial intelligence. The gold standard reverse transcription polymerase chain (RT-PCR) has also been upgraded with point-of-care rapid tests. Supportive treatment, mechanical ventilation, and extracorporeal membrane oxygenation (ECMO) remain the primary choice, while therapeutic options include antivirals, antiparasitics, anti-inflammatories, interferon, convalescent plasma, monoclonal antibody, hyperimmunoglobulin, RNAi, and mesenchymal stem cell therapy. Different types of vaccines such as RNA, DNA, and lentiviral, inactivated, and viral vector are in clinical trials. Moreover, rapidly deployable and easy-to-transport innovative vaccine delivery systems are also in development. As countries have started easing down on the lockdown measures, the chance for a second wave of infection demands strict and rational control policies to keep fatalities minimized. An improved understanding of the advances in diagnostic tools, treatments, vaccines, and control measures for COVID-19 can provide references for further research and aid better containment strategies.

BackgroundAccidental poisoning is a leading cause of unintentional injuries among children in low-income and middle-income countries (LMICs). The overall aspect of this unintentional poisoning is poorly understood in Bangladesh. The objectives of this study were (1) to explore the socio-demographic factors and circumstantial context of accidental poisoning and (2) the prevalence of the type of substances causing it.MethodsA descriptive case series study was conducted from April 2019 to February 2020 at a tertiary level hospital of the capital city Dhaka in Bangladesh. Children under 10 years of age admitted to the hospital with accidental poisoning were enrolled in this study. Parents of hospitalised children were interviewed face-to-face using a structured questionnaire. Descriptive statistics were used for data analysis.ResultsA total of 223 children were recruited in this study. Children between 2 and 5 years (60%), men (61%) and children with agility (65.5%) were among the prevalent victims. The majority of cases occurred (65%) in a nuclear family setting. Most mothers (85%) of these children were non-working and most incidents took place in parents’ homes (~82%). Nearly 70% of the poisoning incidents took place in the presence of parents and over half of these occurred in the bedroom. Kerosene was the prevalent cause (33%) of accidental poisoning while insecticide/pesticide ranked second (26.5%) followed by medicines (17%) and household chemicals (12). In one-third (31.4%) of the cases, poisoning chemicals were stored in soft drink bottles while two-thirds (67.3%) of the cases were kept in containers other than original ones. Although over 80 parents somewhat knew that chemicals could be harmful to the children if ingested, most of them did not take the safety measures.ConclusionIn this present study we found that preschool-aged children were more victims of accidental poisoning mostly by ingesting kerosene and a majority of the incidents took place in the bedroom while parents were present at home. Our study findings would serve as a baseline for designing future intervention studies and policies.

IntroductionAccidental poisoning is a leading cause of unintentional injuries among children in developing countries. The overall aspect of this unintentional poisoning is poorly understood in Bangladesh. The objectives of this study were 1) to explore the socio-demographic factors and circumstantial context of accidental poisoning and 2) the prevalence of the type of substances causing it.MethodsA prospective cross-sectional study was conducted between April 2019 and February 2020 at a tertiary level hospital of the capital city Dhaka in Bangladesh. Children under 10 years of age admitted to the hospital with accidental poisoning were enrolled in this study. Parents of hospitalized children were interviewed face-to-face using a structured questionnaire. Descriptive statistics were used for data analysis. ResultsA total of 223 children were recruited in this study. Children between 2 to 5 years (60%), male (61%), and children with agile or aggressive behaviour (65.5%) were among the prevalent victims. Most cases (65%) occurred in a nuclear family setting. Most mothers (85%) of these children were non-working, and most incidents took place in parents’ homes (~82%). Nearly 70% of the poisoning incidents took place in parents' presence, and over half of these occurred in the bedroom. Kerosene was the prevalent cause (33%) of accidental poisoning while insecticide/pesticide ranked second (26.5%) followed by medicines (17%) and household chemicals (12). In one-third (31.4%) cases, poisoning chemicals were stored in soft-drinks bottles, while two-thirds (67.3%) were kept in containers other than original ones. Although over 80% of parents knew that chemicals could be harmful to the children if they were ingested, most of them did not take safety measures. ConclusionIn this present study, we found that preschool-aged children were more victims of accidental poisoning, primarily by ingesting kerosene. A majority of the incidents occurred in the bedroom while parents were present at home. Our study findings would serve as a baseline for designing future intervention studies and policies.

The availability of voluntary nonremunerated blood donors (VNRBD) is a major concern in low- and middle-income countries including Bangladesh. There is a substantial paucity of safe blood supply against the expected demand. This study aims to explore the status of knowledge, attitude, and practice regarding blood donation of students and teachers of residential religious academic (RRA) institutions at the community level in Bangladesh. Religious institutions were selected through simple random sampling and the cross-sectional survey was conducted among 512 participants at Jamalpur district in Bangladesh. Descriptive statistics and stepwise binary logistic regression were performed with statistical significance defined as p < 0.05. Exploratory factor analysis (EFA) was used with Principal Component Analysis (PCA) as an extraction method to evaluate a linear KAP relationship regarding blood donation. The results showed that over 90% of the participants were students, non-smokers, and aged 18 to 30 year. The majority (92%) did not ever donate blood to anyone, yet over 42% wanted to be regular donors. More than 80% considered blood donation as a moral responsibility and an Islamic act. The common reasons for not donating blood were lack of knowledge (40%), lack of opportunity (20%), thinking it was harmful to health (21%), being scared of needles (16%), and no financial benefit (5.5%). Interestingly, more than 67% did not know their blood group and about 61 % of the respondents said they did not hear or could not remember about any blood donation program. The participants had poor knowledge of general eligibility criteria but an overall positive attitude towards blood donation. In PCA, two principal components with eigenvalues greater than 1 were retained explaining 77.42% of the total variance. The first component was influenced by knowledge and practice compared to the second component which was largely influenced by attitude. Teachers were more likely to donate blood (AOR: 1.94, 95% CI: 1.03-3.81) and possess good practice behaviour (AOR: 4.79, 95% CI: 2.23-11.92). This research highlights that a large portion of the potential healthy donors is being overlooked although they could be a valuable resource to alleviate the ongoing blood donation crisis. Funding Information: None to declare. Declaration of Interests: None to declare. Ethics Approval Statement: The study protocol was reviewed and approved by the institutional review board of Biomedical Research Foundation, Bangladesh (Ref. no: BRF/ERB/2018/004). Informed written consent was obtained from all the participants, and confidentiality was maintained during and after the data collection.

South Asian countries have been struggling to control the COVID-19 pandemic despite imposing months of lockdown and other public health measures. This review aims to describe the epidemiological features and shortcomings in public health preparedness to tackle COVID-19 as well as derive lessons from these events in the context of Bangladesh. We have shown that an increase in human mobility was evident throughout the lockdown period. Over 20,000 frontline health workers were affected, and more than 2100 unofficial deaths possibly linked with COVID-19 diagnosis were reported. Males were disproportionately affected in terms of infection (71%) and death (77%) than females. Over 50% of infected cases were reported among young adults (20-40-year age group). After seven months into the pandemic, a downward trend in laboratory test positive percentage was seen, although the number of new deaths per day remained largely unchanged. We believe our findings, observations and recommendations will remain as a valuable resource to facilitate better public health practice and policy for managing current and future infectious disease like COVID-19 in resource-poor developing countries., COVID-19, Pandemic, Bangladesh, Dhaka, Epidemiology, SARS-CoV2.

BackgroundSouth Asian countries including Bangladesh have been struggling to control the COVID-19 pandemic despite imposing months of lockdown and other public health measures (as of June 30, 2020). In-depth epidemiological information from these countries is lacking. From the perspective of Bangladesh, this study aims to understand the epidemiological features and gaps in public health preparedness.MethodThis study used publicly available data (8 March-30 June 2020) from the respective health departments of Bangladesh and Johns Hopkins University Coronavirus Resource Centre. Descriptive statistics was used to report the incidence, case fatality rates (CFR), and trend analysis. Spatial distribution maps were created using ArcGIS Desktop. Infection dynamics were analyzed via SIR models.FindingsIn 66 days of nationwide lockdown and other public health efforts, a total of 47,153 cases and 650 deaths were reported. However, the incidence was increased by around 50% within a week after relaxing the lockdown. Males were disproportionately affected in terms of infections (71%) and deaths (77%) than females. The CFR for males was higher than females (1.38% vs 1.01%). Over 50% of infected cases were reported among young adults (20-40-year age group). Geospatial analysis between 7 June 2020 and 20 June 2020 showed that the incidences increased 4 to 10-fold in 12 administrative districts while it decreased in the epicenter. As compared to the EU and USA, trends of the cumulative incidence were slower in South Asia with lower mortality.ConclusionOur findings on gaps in public health preparedness and epidemiological characteristics would contribute to facilitating better public health decisions for managing current and future pandemics like COVID-19 in the settings of developing countries.

Background: Considering the lack of definitive drug or vaccine, the non-pharmaceutical interventions need to be implemented to control the current coronavirus disease (COVID-19) outbreak, notably in countries with limited resources like Bangladesh. So, the study targeted the university students of Bangladesh as the representatives of the millennials to determine their level of awareness regarding COVID-19. Methods: A cross-sectional study was designed to determine the knowledge, attitude and practices with a co-produced perception section regarding COVID-19 among university students in Bangladesh. The survey was conducted from 16 to 23rd March, 2020. Descriptive and inferential analyses were performed with statistical significance defined as p < 0.05. Result: Among 1393 students participated in the study, about one-third of them had a positive attitude towards COVID-19 issues, although only 6.9% had good knowledge. While the majority of the participants followed sneezing/ coughing etiquette, frequent hand washing/sanitizing, limited body contact and public transport, etc., both good knowledge and positive attitude were significantly associated with respondents’ good practices. But despite the satisfactory hand hygiene behaviors, awareness is required about the type of sanitizers and the importance of washing hands for 20seconds. Promoting health educative activities through Facebook might be considered to improve the knowledge level, especially to raise awareness about rare symptoms and asymptomatic transmission. However, bazaars might be the potential point of the outbreak that needs to be controlled. Conclusion: The study supports the concerning lack of knowledge among the students along with suggesting the issues to be addressed for successful containment of COVID-19.

Objective: Antibiotic abuse has contributed to the development of antimicrobial resistance (AMR) and has become a global concern. With a poorly regulated health system and a general lack of data, Bangladesh remains under high risk of AMR spread. To minimize the existing gap in the literature, this study was conducted to assess the knowledge, attitude, and behavior regarding antibiotic use and misuse among university students. Methods: A cross-sectional study design was used to survey 1400 students using a self-administered questionnaire from the University of Dhaka, Bangladesh. Descriptive and inferential analyses were performed with statistical significance defined as p < 0.05. Results: More than half of the respondents had poor knowledge and neutral attitude towards antibiotics. The students from bioscience were found to have better knowledge and attitude than arts and business. Respondents with good knowledge were more likely to show a positive attitude, p