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The coronavirus disease 2019 (COVID-19) stances an incredible impact on the quality of life and denigrates the physical and mental health of the patients. This cross-sectional study aimed to assess the health-related quality of life (HRQOL) of COVID-19 patients. We conducted this study at the National Institute of Preventive and Social Medicine (NIPSOM) of Bangladesh for the period of June to November 2020. All the COVID-19 patients diagnosed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay in July 2020 formed the sampling frame. The study enrolled 1204 adult (aged >18 years) COVID-19 patients who completed a one-month duration of illness after being RT-PCR positive. The patients were interviewed with the CDC HRQOL-14 questionnaire to assess HRQOL. Data were collected by telephone interview on the 31st day of being diagnosed and by reviewing medical records using a semi-structured questionnaire and checklist. Around two-thirds (72.3%) of the COVID-19 patients were males and a half (50.2%) were urban residents. In 29.8% of patients, the general health condition was not good. The mean (±SD) duration of physical illness and mental illness was 9.83(±7.09) and 7.97(±8.12) days, respectively. Most of the patients (87.0%) required help with personal care, and 47.8% required assistance with routine needs. The mean duration of 'healthy days' and 'feeling very healthy' was significantly lower in patients with increasing age, symptoms, and comorbidity. The mean duration of 'usual activity limitation', 'health-related limited activity', 'feeling pain/worried', and 'not getting enough rest' were significantly higher among patients' having symptoms and comorbidity. 'Not so good' health condition was significantly higher in females (OR = 1.565, CI = 1.01–2.42) and those having a symptom (OR = 32.871, CI = 8.06–134.0) of COVID-19 and comorbidity (OR = 1.700, CI = 1.26–2.29). Mental distress was significantly higher among females (OR = 1.593, CI = 1.03–2.46) and those having a symptom (OR = 4.887, CI = 2.58–9.24). Special attention should be given to COVID-19 patients having symptoms and comorbidity to restore their general health, quality of life, and daily activities. [ABSTRACT FROM AUTHOR]

Not all cases of rheumatic fever (RF) end up as rheumatic heart disease (RHD). The fact raises the possibility of existence of a subgroup with characteristics that prevent RF patients from developing the RHD. The present study aimed at exploring the risk factors among patients with RHD. The study assessed the risk of RHD among people both with and without RF. In total, 103 consecutive RHD patients were recruited as cases who reported to the National Centre for Control of Rheumatic Fever and Heart Disease, Dhaka, Bangladesh. Of 309 controls, 103 were RF patients selected from the same centre, and the remaining 206 controls were selected from Shaheed Suhrawardy Medical College Hospital, who got admitted for other non-cardiac ailments. RHD was confirmed by auscultation and colour Doppler echocardiography. RF was diagnosed based on the modified Jones criteria. An unadjusted odds ratio was generated for each variable, with 95% confidence interval (CI), and only significant factors were considered candidate for multivariate analysis. Three separate binary logistic regression models were generated to assess the risk factors of RF, risk factors of RHD compared to non-rheumatic control patients, and risk factors of RHD compared to control with RF. RF and RHD shared almost a similar set of risk factors in the population. In general, age over 19 years was found to be protective of RF; however, age of the majority (62.1%) of the RHD cases was over 19 years. Women [odds ratio (OR) = 2.2, 95% CI 1.1-4.3], urban resident (OR = 3.1, 95% CI 1.2-8.4), dwellers in brick-built house (OR = 3.6, 95% CI 1.6-8.1), having > 2 siblings (OR = 3.1, 95% CI 1.5- 6.3), offspring of working mothers (OR = 7.6, 95% CI 2.0-24.2), illiterate mother (OR = 2.6, 95% CI 1.2-5.8), and those who did not brush after taking meals (OR = 2.5, 95% CI 1.0-6.3) were more likely to develop RF. However, more than 5 members in a family showed a reduced risk of RF. RHD shared almost a similar set of factors in general. More than three people sharing a room also showed an increased risk of RHD (OR = 1.9, 95% CI 1.0-3.4), in addition to the risk factors of RF. Multivariate model also assessed the factors that may perpetuate RHD among RF patients. Overcrowding (OR = 2.4, 95% CI 1.2-4.7) and illiteracy (OR = 2.4, 95% CI 1.1-5.2) posed the risk of RHD in the RF patients. The study did not find new factors that might pose an increased risk, rather looked for the documented risk factors and how these operate in the population of Bangladesh. [ABSTRACT FROM AUTHOR]

Background: Several large outbreaks of chikungunya have been reported in the Indian Ocean region in the last decade. In 2017, an outbreak occurred in Dhaka, Bangladesh, one of the largest and densest megacities in the world. Population mobility and fluctuations in population density are important drivers of epidemics. Measuring population mobility during outbreaks is challenging but is a particularly important goal in the context of rapidly growing and highly connected cities in low- and middle-income countries, which can act to amplify and spread local epidemics nationally and internationally. Methods: We first describe the epidemiology of the 2017 chikungunya outbreak in Dhaka and estimate incidence using a mechanistic model of chikungunya transmission parametrized with epidemiological data from a household survey. We combine the modeled dynamics of chikungunya in Dhaka, with mobility estimates derived from mobile phone data for over 4 million subscribers, to understand the role of population mobility on the spatial spread of chikungunya within and outside Dhaka during the 2017 outbreak. Results: We estimate a much higher incidence of chikungunya in Dhaka than suggested by official case counts. Vector abundance, local demographics, and population mobility were associated with spatial heterogeneities in incidence in Dhaka. The peak of the outbreak in Dhaka coincided with the annual Eid holidays, during which large numbers of people traveled from Dhaka to other parts of the country. We show that travel during Eid likely resulted in the spread of the infection to the rest of the country. Conclusions: Our results highlight the impact of large-scale population movements, for example during holidays, on the spread of infectious diseases. These dynamics are difficult to capture using traditional approaches, and we compare our results to a standard diffusion model, to highlight the value of real-time data from mobile phones for outbreak analysis, forecasting, and surveillance. Author summary: Chikungunya is an emerging mosquito-borne disease in many parts of the world, with a high morbidity burden. Fluctuations in human density and mobility are important drivers of epidemics, particularly in the context of large cities in low- and middle-income countries, which can act to amplify and spread local epidemics. Here, we first describe the epidemiology of chikungunya in Dhaka, Bangladesh, one of the largest megacities in the world, during an outbreak in 2017. Using data from a household survey, we estimate a much higher attack rate than suggested by official case counts. We then use estimates of population movement from mobile phone data for over 4 million subscribers, to understand the role of human mobility on the spatial spread of chikungunya. We show that regular population fluxes around Dhaka city played a significant role in determining disease risk, and that travel during the Eid holidays likely spread the infection to the rest of the country. Our results show the impact of large-scale population movements, particularly during holidays, on the spread of infectious diseases, and highlight the value of real-time data from mobile phones for outbreak analysis and forecasting. [ABSTRACT FROM AUTHOR]

Background: A single-dose regimen of inactivated whole-cell oral cholera vaccine (OCV) is attractive because it reduces logistical challenges for vaccination and could enable more people to be vaccinated. Previously, we reported the efficacy of a single dose of an OCV vaccine during the 6 months following dosing. Herein, we report the results of 2 years of follow-up.Methods: In this placebo-controlled, double-blind trial done in Dhaka, Bangladesh, individuals aged 1 year or older with no history of receipt of OCV were randomly assigned to receive a single dose of inactivated OCV or oral placebo. The primary endpoint was a confirmed episode of non-bloody diarrhoea for which the onset was at least 7 days after dosing and a faecal culture was positive for Vibrio cholerae O1 or O139. Passive surveillance for diarrhoea was done in 13 hospitals or major clinics located in or near the study area for 2 years after the last administered dose. We assessed the protective efficacy of the OCV against culture-confirmed cholera occurring 7-730 days after dosing with both crude and multivariable per-protocol analyses. This trial is registered at ClinicalTrials.gov, number NCT02027207.Findings: Between Jan 10, 2014, and Feb 4, 2014, 205 513 people were randomly assigned to receive either vaccine or placebo, of whom 204 700 (102 552 vaccine recipients and 102 148 placebo recipients) were included in the per-protocol analysis. 287 first episodes of cholera (109 among vaccine recipients and 178 among placebo recipients) were detected during the 2-year follow-up; 138 of these episodes (46 in vaccine recipients and 92 in placebo recipients) were associated with severe dehydration. The overall incidence rates of initial cholera episodes were 0·22 (95% CI 0·18 to 0·27) per 100 000 person-days in vaccine recipients versus 0·36 (0·31 to 0·42) per 100 000 person-days in placebo recipients (adjusted protective efficacy 39%, 95% CI 23 to 52). The overall incidence of severe cholera was 0·09 (0·07 to 0·12) per 100 000 person-days versus 0·19 (0·15 to 0·23; adjusted protective efficacy 50%, 29 to 65). Vaccine protective efficacy was 52% (8 to 75) against all cholera episodes and 71% (27 to 88) against severe cholera episodes in participants aged 5 years to younger than 15 years. For participants aged 15 years or older, vaccine protective efficacy was 59% (42 to 71) against all cholera episodes and 59% (35 to 74) against severe cholera. The protection in the older age groups was sustained throughout the 2-year follow-up. In participants younger than 5 years, the vaccine did not show protection against either all cholera episodes (protective efficacy -13%, -68 to 25) or severe cholera episodes (-44%, -220 to 35).Interpretation: A single dose of the inactivated whole-cell OCV offered protection to older children and adults that was sustained for at least 2 years. The absence of protection of young children might reflect a lesser degree of pre-existing natural immunity in this age group.Funding: Bill & Melinda Gates Foundation to the International Vaccine Institute. [ABSTRACT FROM AUTHOR]

Objective: To assess knowledge about risk factors and complication of coronary heart disease (CHD). Method: It was a cross-sectional type of study and research participants were one of the family members of the patient suffering from coronary heart disease. The sample population and unit of sample were households. A total of 147 participants were selected from Inpatient Department of the National Institute of Cardio-Vascular Disease, Sher-e-Bangla Nagar, Dhaka from January 2013 to July 2013 following purposive method of sampling on the basis of defined selection criteria. The research instrument was a pre-tested face-to-face interviewer questionnaire. Knowledge level of the respondents was assessed using Likert type of scale incorporate in the questionnaire. Results: Most of the research participants (95.2%, n=140) were educated and only 4.8% (n=07) found illiterate. In profession, 29.9% (n=44) of the respondents were housewife, 36.1% (n=53) service holder, 22.4% (n=24) businessmen and 11.6% (n=17) students. Their average monthly income was Tk. 9149±108 and their family income was Tk. 3448±7 in average. The mean age of the respondents was 33.1±6.8 years of which 76.9% (n=113) married and rest of them (23.1%, n=34) unmarried. Among the respondents, 50.3(n=74) were male and 49.7% (n=73) female respectively. The level of knowledge of the respondents about risk factors and complication of coronary heart disease on the basis of gender, education and occupation was assessed. Of them, 75.5% (n=111) had poor knowledge about risk factors and complication of coronary heart disease, 24.5% (n=36) satisfactory knowledge and none of them had good knowledge about it which was significantly associated with the level of education, occupational and monthly income status of the respondents. Conclusion: An individual can modify or avoid many risk factors to prevent CHD or minimize the complication of CHD except age and genetic factors. However, need based health education and behavioral change intervention programs among the risk populations (target populations) and to ensure easy access in public healthcare facilities may be the most important applicable ways to control and/or prevention of CHD in Bangladesh. [ABSTRACT FROM AUTHOR]

Highlights: [•] Largest feasibility study to reach high-risk endemic urban population with OCV. [•] 82% were reached with first dose and 87% of those received two doses. [•] Coverage in children was 81% and it was significantly higher in females than males. [•] Two doses cost per-person was US$3.93 and delivering cost of single dose was US$0.76. [•] Mass OCV delivery with existing national immunization system is feasible. [ABSTRACT FROM AUTHOR]