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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can spread to the environment through several routes and persist for a more extended period. Therefore, we reviewed pertinent literature to understand the transmission dynamics of SARS-CoV-2 and genomic epidemiology of emerging variants of concern (VOCs) in the environment, their inactivation strategies, and the impact of COVID-19 on the ecosystem. The fallouts of the reviewed studies indicate that SARS-CoV-2 transmits through air and fomite, contaminated surfaces, biomedical wastes, and stool, which contaminates the environment through wastewater. As a result, multiple VOCs of SARS-CoV-2 were circulating in the environment. Genomic epidemiology revealed that the most prevalent VOC was Delta (B.1.617.2; 44.24%), followed by Omicron (B.1.1.529; 43.33%), in the environment. Phylogenetic analysis showed that environmental strains are clustered with a likeness of the human strains of the same or nearby countries, emphasizing the significance of continued environmental surveillance to track the emergence of the new variant. Thus, we should reduce viral dispersion in the environment through rapid and appropriate disinfection strategies. Moreover, the increased production and use of macro and microfiber plastic products should be brought under strict legislation with integrated waste management to control the unrelenting propagation of viral RNA. Finally, a comprehensive understanding of the environmental transmission pathways of SARS-CoV-2 is crucial for forecasting outbreak severity in the community, allowing us to prepare with the correct tools to control any impending pandemic. We recommend wastewater-based SARS-CoV-2 surveillance and air particulates to track the emerging VOCs of SARS-CoV-2 spread in the environment.

Anthropogenic land-use changes increase the frequency of interactions and habitat overlap between humans and macaques which play an important role in zoonotic disease transmission. This exploratory qualitative study aimed to examine connections between land-use change and macaque-human interactions and assess the chance of zoonotic disease transmission. We conducted ethnographic interviews and focus group discussions in Old Dhaka, Madaripur, and Chandpur, Bangladesh. Participants reported significant anthropogenic landscape transformations leading to increased human-macaque contact in the study areas. Participants also reported that all three sites underwent substantial landscape alteration from natural or agricultural land to a human-altered environment with roads, commercial, and residential buildings. Participants noted that the disappearance of forestland appeared to increase the macaque dependence on backyard fruit trees. Where rivers and ponds were filled to support local construction, macaques were also observed as becoming more dependent upon human water sources. These changed may help expanding the macaques' foraging areas, and they appear to be invading new areas where people are not culturally habituated to living with them. In response, many residents reported reacting aggressively toward the macaques, which they believed led to more bites and scratches. However, other respondents accepted the presence of macaques around their homes. Few participants considered macaques to be a source of disease transmission. This study revealed that local environmental changes, deforestation, urban expansion, construction, and water bodies' disappearance are linked to increasing human-macaque interactions. Understanding these interactions is critical to develop successful mitigation interventions at interfaces with a high risk for viral disease spillover.

The novel coronavirus disease of 2019 (COVID-19) pandemic has caused an exceptional drift of production, utilization, and disposal of personal protective equipment (PPE) and different microplastic objects for safety against the virus. Hence, we reviewed related literature on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detected from household, biomedical waste, and sewage to identify possible health risks and status of existing laws, regulations, and policies regarding waste disposal in South Asian (SA) countries. The SARS-CoV-2 RNA was detected in sewage and wastewater samples of Nepal, India, Pakistan, and Bangladesh. Besides, this review reiterates the enormous amounts of PPE and other single-use plastic wastes generated from healthcare facilities and households in the SA region with inappropriate disposal, landfilling, and/or incineration techniques wind-up polluting the environment. Consequently, the Delta variant (B.1.617.2) of SARS-CoV-2 has been detected in sewer treatment plant in India. Moreover, the overuse of non-biodegradable plastics during the pandemic is deteriorating plastic pollution condition and causes a substantial health risk to the terrestrial and aquatic ecosystems. We recommend making necessary adjustments, adopting measures and strategies, and enforcement of the existing biomedical waste management and sanitation-related policy in SA countries. We propose to adopt the knowledge gaps to improve COVID-19-associated waste management and legislation to prevent further environmental pollution. Besides, the citizens should follow proper disposal procedures of COVID-19 waste to control the environmental pollution.

Nipah virus (NiV) infection is a zoonotic disease with epidemic potential due to its human-to-human transmission. In Bangladesh, where NiV infection is frequent, NiV spillover from fruit bats to humans usually occurs in winter. This study aimed to describe the magnitude and scope of a NiV outbreak in February 2019, identify the source of infection, and contain the spread of disease. We interviewed the cases’ family members, conducted verbal autopsies, and collected samples for laboratory tests. Five family members reported died from, at the time, an unknown disease. All had fever, altered mental status, vomiting and diarrhea. Reverse transcription polymerase chain reaction confirmed NiV in one person. We suspected secondary transmission occurred when the family traveled with the primary case from their house to the hospital by ambulance. The trip took 8.5 hours and no one wore a face mask or gloves. The secondary attack rate among ambulance travelers was 67%. In this outbreak, NiV was transmitted human-to-human among riders in the ambulance. We recommend that everyone should use protective measures while traveling with suspected NiV infected patients to reduce the risk of transmission. Strengthening the existing Nipah virus surveillance system may generate earlier notification and response to contain further transmission.

Md Abul Kalam,1 Shahanaj Shano,2,3 Sharmin Afrose,4 Md Nasir Uddin,2 Nafis Rahman,5 Faruk Ahmed Jalal,6 Samira Akter,7 Ariful Islam,3,8 Md Mujibul Anam,7 Mohammad Mahmudul Hassan9 1Bangladesh Country Office, Helen Keller International, Dhaka, 1212, Bangladesh; 2Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, 1212, Bangladesh; 3EcoHealth Alliance, New York, NY, USA; 4World Food Programme, Dhaka, 1207, Bangladesh; 5Department of Public Health, American International University of Bangladesh, Dhaka, 1212, Bangladesh; 6Handicap International - Humanity & Inclusion, Dhaka, 1212, Bangladesh; 7Department of Anthropology, Jahangirnagar University, Savar, Dhaka, 1243, Bangladesh; 8Centre for Integrative Ecology, School of Life and Environmental Science, Deakin University, Geelong Campus, Warrnambool, VIC, 3216, Australia; 9Chattogram Veterinary and Animal Science University, Chattogram, 4225, BangladeshCorrespondence: Md Abul KalamHelen Keller International, Bangladesh Country Office, Dhaka, 1215, Bangladesh, Tel +8801912408148, Email a.kalam724@gmail.comIntroduction: The COVID-19 pandemic is thought to have led to increased “inappropriate” or “unjustified” seeking and consumption of antibiotics by individuals in the community. However, little reference has been made to antibiotic seeking and using behaviors from the perspectives of users in Bangladesh during this health crisis.Purpose: This study seeks to document how antibiotic medicines are sought and used during a complex health crisis, and, within different contexts, what are the nuanced reasons why patients may utilize these medicines sub-optimally.Methods: We used an exploratory, qualitative design. Forty semi-structured telephone interviews were conducted with people diagnosed with COVID-19 (n=20), who had symptoms suggestive of COVID-19 (n=20), and who had received care at home in two cities between May and June 2021 in Bangladesh. In this study, an inductive thematic analysis was performed.Results: The analysis highlighted the interlinked relationships of antibiotic seeking and consumption behaviors with the diversity of information disseminated during a health crisis. Antibiotic-seeking behaviors are related to previous experience of use, perceived severity of illness, perceived vulnerability, risk of infection, management of an “unknown” illness and anxiety, distrust of expert advice, and intrinsic agency on antimicrobial resistance (AMR). Suboptimal adherence, such as modifying treatment regimes and using medication prescribed for others, were found to be part of care strategies used when proven therapeutics were unavailable to treat COVID-19. Early cessation of therapy was found to be a rational practice to avoid side effects and unknown risks.Conclusion: Based on the results, we highly recommend the take up of a pandemic specific antimicrobial stewardship (AMS) program in the community. To deliver better outcomes of AMS, incorporating users’ perspectives could be a critical strategy. Therefore, a co-produced AMS intervention that is appropriate for a specific cultural context is an essential requirement to reduce the overuse of antibiotics during the COVID-19 pandemic and beyond.Keywords: COVID-19, antimicrobial resistance, consumption behavior, antimicrobial stewardships, community engagement, Bangladesh

Background While vaccines ensure individual protection against COVID-19 infection, delay in receipt or refusal of vaccines will have both individual and community impacts. The behavioral factors of vaccine hesitancy or refusal are a crucial dimension that need to be understood in order to design appropriate interventions. The aim of this study was to explore the behavioral determinants of COVID-19 vaccine acceptance and to provide recommendations to increase the acceptance and uptake of COVID-19 vaccines in Bangladesh. Methods We employed a Barrier Analysis (BA) approach to examine twelve potential behavioral determinants (drawn from the Health Belief Model [HBM] and Theory of Reasoned Action [TRA]) of intended vaccine acceptance. We conducted 45 interviews with those who intended to take the vaccine (Acceptors) and another 45 interviews with those who did not have that intention (Non-acceptors). We performed data analysis to find statistically significant differences and to identify which beliefs were most highly associated with acceptance and non-acceptance with COVID-19 vaccines. Results The behavioral determinants associated with COVID-19 vaccine acceptance in Dhaka included perceived social norms, perceived safety of COVID-19 vaccines and trust in them, perceived risk/susceptibility, perceived self-efficacy, perceived positive and negative consequences, perceived action efficacy, perceived severity of COVID-19, access, and perceived divine will. In line with the HBM, beliefs about the disease itself were highly predictive of vaccine acceptance, and some of the strongest statistically-significant (p Conclusion An effective behavior change strategy for COVID-19 vaccines uptake will need to address multiple beliefs and behavioral determinants, reducing barriers and leveraging enablers identified in this study. National plans for promoting COVID-19 vaccination should address the barriers, enablers, and behavioral determinants found in this study in order to maximize the impact on COVID-19 vaccination acceptance.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has swamped the global environment greatly in the current pandemic. Wastewater-based epidemiology (WBE) effectively forecasts the surge of COVID-19 cases in humans in a particular region. To understand the genomic characteristics/footprints and diversity of SARS-CoV-2 in the environment, we analyzed 807 SARS-CoV-2 sequences from 20 countries deposited in GISAID till 22 May 2021. The highest number of sequences (n = 638) were reported in Austria, followed by the Netherlands, China, and Bangladesh. Wastewater samples were highest (40.0%) to successfully yield the virus genome followed by a 24 h composite wastewater sample (32.6%) and sewage (18.5%). Phylogenetic analysis revealed that SARS-CoV-2 environmental strains are a close congener with the strains mostly circulating in the human population from the same region. Clade GRY (32.7%), G (29.2%), GR (25.3%), O (7.2%), GH (3.4%), GV (1.4%), S (0.5%), and L (0.4%) were found in environmental samples. Various lineages were identified in environmental samples; nevertheless, the highest percentages (49.4%) of the alpha variant (B.1.1.7) were detected in Austria, Liechtenstein, Slovenia, Czech Republic, Switzerland, Germany, and Italy. Other prevalent lineages were B.1 (18.2%), B.1.1 (9.2%), and B.1.160 (3.9%). Furthermore, a significant number of amino acid substitutions were found in environmental strains where the D614G was found in 83.8% of the sequences. However, the key mutations—N501Y (44.6%), S982A (44.4%), A570D (43.3%), T716I (40.4%), and P681H (40.1%) were also recorded in spike protein. The identification of the environmental belvedere of SARS-CoV-2 and its genetic signature is crucial to detect outbreaks, forecast pandemic harshness, and prepare with the appropriate tools to control any impending pandemic. We recommend genomic environmental surveillance to trace the emerging variants and diversity of SARS-CoV-2 viruses circulating in the community. Additionally, proper disposal and treatment of wastewater, sewage, and medical wastes are important to prevent environmental contamination.

The novel coronavirus disease of 2019 (COVID-19) pandemic has caused an exceptional drift of production, utilization, and disposal of personal protective equipment (PPE) and different microplastic objects for safety against the virus. Hence, we reviewed related literature on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detected from household, biomedical waste, and sewage to identify possible health risks and status of existing laws, regulations, and policies regarding waste disposal in South Asian (SA) countries. The SARS-CoV-2 RNA was detected in sewage and wastewater samples of Nepal, India, Pakistan, and Bangladesh. Besides, this review reiterates the enormous amounts of PPE and other single-use plastic wastes generated from healthcare facilities and households in the SA region with inappropriate disposal, landfilling, and/or incineration techniques wind-up polluting the environment. Consequently, the Delta variant (B.1.617.2) of SARS-CoV-2 has been detected in sewer treatment plant in India. Moreover, the overuse of non-biodegradable plastics during the pandemic is deteriorating plastic pollution condition and causes a substantial health risk to the terrestrial and aquatic ecosystems. We recommend making necessary adjustments, adopting measures and strategies, and enforcement of the existing biomedical waste management and sanitation-related policy in SA countries. We propose to adopt the knowledge gaps to improve COVID-19-associated waste management and legislation to prevent further environmental pollution. Besides, the citizens should follow proper disposal procedures of COVID-19 waste to control the environmental pollution.

Antimicrobial resistance (AMR) has become an emerging health issue globally, posing a threat to zoonotic pathogens and foodborne diseases. In Bangladesh, the poultry sector supplies the majority of the demand for animal-source protein. The irrational and excessive use of antimicrobials (AMU) has been observed in the poultry sector. The development of AMR is associated with many factors, including the knowledge and attitudes of poultry farmers. Therefore, AMR reduction requires intervention from all the stockholders, including the farmers who are considered as end users of antimicrobials. This current research conducted a cross-sectional study to assess the knowledge, attitudes, and practices (KAP) of poultry farmers on AMU and AMR in Bangladesh. We determined the KAP of poultry farmers (broiler and layer farmers) of some selected districts of the country using a tested and paper-based questionnaire. The results demonstrated that most of the respondents have insufficient KAP regarding AMU and AMR. The respondents used a variety of antimicrobials primarily in the treatment of various diseases in poultry. One-third of the farmers did not seek antimicrobials from registered vets. Instead, they depended on others or themselves. The factor score analysis further revealed that the farmers’ demographic and socioeconomic variables were significant factors influencing the KAP. An adjusted logistic regression analysis showed that older farmers with 9–12 years of farming experience and graduate-level education, engaging in medium-sized layer farming, were more likely to have correct KAP on AMU and AMR. Further, farmers from the Cox’s Bazar region showed correct knowledge, whereas farmers of the Chattogram region showed a correct attitude towards AMU and AMR. A Spearman’s rank-order correlation revealed a positive association between knowledge–attitudes and knowledge–practices. The findings of the current investigation provide baseline evidence about the KAP of poultry farmers from low-income resources and offer insights into designing interventions and policies for the use of AMU and AMR in Bangladesh.

Poultry production has boomed in Bangladesh in recent years. The poultry sector has contributed significantly to meet the increased demand for animal source proteins in the country. However, increased use of antimicrobials appeared to be a significant threat to food safety in the poultry sector. The poultry drug and feed sellers are at the frontline position involving selecting and delivering the antimicrobials to the poultry farmers. Studies assessing the poultry drug and feed sellers’ knowledge, attitudes, and practices (KAPs) are limited. The current study aimed to assess the community poultry drug and feed sellers’ KAPs of antimicrobial use (AMU) and antimicrobial resistance (AMR) in some selected areas of Bangladesh. We determined the respondents’ (drug and the feed sellers) KAPs of AMU and AMR using a tested and paper-based questionnaire. The study demonstrated that most respondents have insufficient knowledge, less positive attitudes, and inappropriate practices regarding AMU and AMR. The factor score analysis further showed that the type of respondents and their years of experience, level of education, and training on the drug were the significant factors impacting the current knowledge, attitudes, and practices of AMU and AMR. The adjusted logistic regression analysis revealed that the drug sellers who completed their education up to 12th grade and had training on the drug had adequate knowledge of AMU and AMR. The data also showed that the drug sellers belong to the age group 31–35 and 36–40 years and who completed 12th grade had good attitudes on the same. Likewise, the analysis further determined that drug sellers belonging to the age category 18–25 and 26–30 years, and interestingly, the respondents who completed education up to 12th grade, had better practices. Spearman’s rank-order correlation revealed a positive association between each pair of the KAPs scores for the respondents. The correlation was fair between knowledge–attitudes, knowledge–practices, and attitudes–practices. Based on the current study results, we recommend educational interventions and appropriate training for the poultry drug and feed sellers to raise awareness and to upgrade their current knowledge on the appropriate use of antimicrobials. This will ultimately lead to reducing the chances of developing AMR in the poultry sectors of the country.

BackgroundWhile vaccines ensure individual protection against COVID-19 infection, delay in receipt or refusal of vaccines will have both individual and community impacts. The behavioral factors of vaccine hesitancy or refusal are a crucial dimension that need understanding to implicate appropriate interventions. The aim of this study was to assess the behavioral determinants of COVID-19 vaccine acceptance and to provide recommendations to increase the uptake of COVID-19 vaccines in Bangladesh.MethodsWe employed a Barrier Analysis (BA) approach to examine twelve potential behavioral determinants (drawn from the Health Belief Model and Theory of Reasoned Action [TRA]) of intended vaccine acceptance. We conducted 45 interviews with those who intended to take the vaccine (Acceptors) and another 45 interviews with those who did not have that intention (Non-acceptors). We performed data analysis to find statistically significant differences and to identify which beliefs were most highly associated with acceptance and non-acceptance with COVID-19 vaccines.ResultsCOVID-19 vaccine Acceptors in Dhaka were different from Non-acceptors in terms of many of their beliefs and responses. The behavioral determinants associated with the behavior included perceived social norms, perceived safety of COVID-19 vaccines and trust in them, perceived risk/susceptibility, perceived self-efficacy, perceived positive and negative consequences, perceived action efficacy, perceived severity of COVID-19, access, and perceived divine will. In line with the Health Belief Model, beliefs about the disease itself were highly correlated with vaccine acceptance, although not the only determinant. Other responses of Acceptors provide clues such as providing vaccination through government health facilities, schools, and kiosks, and having vaccinators maintain proper COVID-19 health and safety protocols as to ways to make it easier to boost acceptance.ConclusionAn effective behavior change strategy for COVID-19 vaccines uptake will need to address multiple beliefs and behavioral determinants, reducing barriers and leveraging enablers identified in this study. The national plans on COVID-19 vaccination should adopt culturally and community label acceptable and appropriate evidence-based behavior change interventions strategies to promote high vaccination coverage and acceptance in all societal structures across the country.

Bats are known reservoirs of Nipah virus (NiV) and some filoviruses and also appear likely to harbor the evolutionary progenitors of severe acute respiratory syndrome coronavirus (SARS-CoV), severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), and Middle East respiratory syndrome coronavirus (MERS-CoV). While bats are considered a reservoir of deadly viruses, little is known about people&rsquo, s knowledge, attitudes, and perceptions of bat conservation and ecology. The current study aimed to assess community people&rsquo, s knowledge, attitudes, and perceptions of bat ecology, myths, and the role of bats in transmitting NiV in Bangladesh. Since 2001, NiV has been a continuous threat to public health with a mortality rate of approximately 70% in Bangladesh. Over the years, many public health interventions have been implemented to raise awareness about bats and the spreading of NiV among the community peoples of Nipah outbreak areas (NOAs) and Nipah non-outbreak areas (NNOAs). We hypothesized that people from both areas might have similar knowledge of bat ecology and myths about bats but different knowledge regarding their role in the spreading of NiV. Using a four-point Likert scale-based questionnaire, our analysis showed that most people lack adequate knowledge regarding the role of bats in maintaining the ecological balance and instead trust their beliefs in different myths about bats. Factor score analysis showed that respondents&rsquo, gender (p = 0.01), the outbreak status of the area (p = 0.03), and their occupation (p = 0.04) were significant factors influencing their knowledge of bat ecology and myths. A regression analysis showed that farmers had 0.34 times the odds of having correct or positive knowledge of bat ecology and myths than businesspersons (odds ratio (OR) = 0.34, 95% confidence interval (95% CI) = 0.15&ndash, 0.78, p = 0.01). Regarding the spreading of NiV via bats, people had a lower level of knowledge. In NOAs, age (p = 0.00), occupation (p = 0.00), and level of education (p = 0.00) were found to be factors contributing to the amount of knowledge regarding the transmission of NiV, whereas in NNOAs, the contributing factors were occupation (p = 0.00) and level of education (p = 0.01). Regression analysis revealed that respondents who were engaged in services (OR = 3.02, 95% CI = 1.07&ndash, 8.54, p = 0.04) and who had completed primary education (OR = 3.06, 95% CI = 1.02&ndash, 9.17, p &lt, 0.05) were likely to have correct knowledge regarding the spreading of NiV. Based on the study results, we recommend educational interventions for targeted groups in the community, highlighting the ecosystem services and conservation of bats so as to improve people&rsquo, s current knowledge and subsequent behavior regarding the role of bats in ecology and the spreading of NiV in Bangladesh.

South Asian (SA) countries have been fighting with the pandemic novel coronavirus disease 2019 (COVID-19) since January 2020. Earlier, the country-specific descriptive study has been done. Nevertheless, as transboundary infection, the border sharing, shared cultural and behaviour practice, effects on the temporal and spatial distribution of COVID-19 in SA is still unveiled. Therefore, this study has been revealed the spatial hotspot along with descriptive output on different parameters of COVID-19 infection. We extracted data from the WHO and the worldometer database from the onset of the outbreak up to 15 May 2020. Europe has the highest case fatality rate (CFR; 9.22%), whereas Oceania has the highest (91.15%) recovery rate from COVID-19. Among SA countries, India has the highest number of cases (85,790), followed by Pakistan (38,799) and Bangladesh (20,065). However, the number of tests conducted was minimum in this region in comparison with other areas. The highest CFR was recorded in India (3.21%) among SA countries, whereas Nepal and Bhutan had no death record due to COVID-19 so far. The recovery rate varies from 4.75% in the Maldives to 51.02% in Sri Lanka. In Bangladesh, community transmission has been recorded, and the highest number of cases were detected in Dhaka, followed by Narayanganj and Chattogram. Dhaka and its surrounding districts, Faridpur and Madaripur district of Bangladesh, is in the hotspot on the spatiotemporal tendency. But no cold spot was pointed out in Bangladesh. Three hotspots and three cold spots at different confidence levels were detected in India. Findings from this study suggested the “test, trace, and isolation” approach for earlier detection of infection to prevent further community transmission of COVID-19., Highlights • Scientific question: Whether temporal pattern and spatial hotspot might be crucial or not to dig out the key players for community transmission of the pandemic COVID-19 in South Asia? • Evidence before this study: Circulation of COVID-19 is evident among South Asian countries since February 2020. Earlier, country specific descriptive study has been reported. Besides, as transboundary infection the border sharing, common cultural and behaviour practice, effects on temporal and spatial distribution of SARS-COV-2 in South Asia is still unveiled. Therefore, this study has been revealed the hotspot along with descriptive output on different parameters of COVID-19 infection. • New findings: This study identified the probable hotspots of COVID-19 in India and Bangladesh. We identified the variation in trends of transmission in different SA countries from specified clusters to intense community transmission. • Significance of the study: Findings from this study suggested “test, trace and isolation” approach for earlier detection of infection to prevent further community transmission of COVID-19. Besides, we should establish a potential early-warning system that could be used under non-outbreak condition to identify potential pandemic like disease X that has occurred and could resurface in the future.

The COVID-19 pandemic has manifested more than a health crisis and has severely impacted on social, economic, and development crises in the world. The relationship of COVID-19 with countries&rsquo, economic and other demographic statuses is an important criterion with which to assess the impact of this current outbreak. Based on available data from the online platform, we tested the hypotheses of a country&rsquo, s economic status, population density, the median age of the population, and urbanization pattern influence on the test, attack, case fatality, and recovery rates of COVID-19. We performed correlation and multivariate multinomial regression analysis with relative risk ratio (RRR) to test the hypotheses. The correlation analysis showed that population density and test rate had a significantly negative association (r = &minus, 0.2384, p = 0.00). In contrast, the median age had a significant positive correlation with recovery rate (r = 0.4654, p = 0.00) and case fatality rate (r = 0.2847, p = 0.00). The urban population rate had a positive significant correlation with recovery rate (r = 0.1610, p = 0.04). Lower-middle-income countries had a negative significant correlation with case fatality rate (r= &minus, 0.3310, p = 0.04). The multivariate multinomial logistic regression analysis revealed that low-income countries are more likely to have an increased risk of case fatality rate (RRR = 0.986, 95% Confidence Interval, CI = 0.97&minus, 1.00, p &lt, 0.05) and recovery rate (RRR = 0.967, 95% CI = 0.95&ndash, 0.98, p = 0.00). The lower-income countries are more likely to have a higher risk in case of attack rate (RRR = 0.981, 95% CI = 0.97&ndash, 0.99, p = 0.00) and recovery rate (RRR = 0.971, 95% CI = 0.96&ndash, 0.98, p = 0.00). Similarly, upper middle-income countries are more likely to have higher risk in case of attack rate (RRR = 0.988, 95% CI = 0.98&ndash, 1.0, p = 0.01) and recovery rate (RRR = 0.978, 95% CI = 0.97&ndash, 0.99, p = 0.00). The low- and lower-middle-income countries should invest more in health care services and implement adequate COVID-19 preventive measures to reduce the risk burden. We recommend a participatory, whole-of-government and whole-of-society approach for responding to the socio-economic challenges of COVID-19 and ensuring more resilient and robust health systems to safeguard against preventable deaths and poverty by improving public health outcomes.

Aim : Antimicrobial residue in animal food products is an important index of food safety. Antimicrobial residues could result from chemotherapeutic or chemoprophylactic use of drugs in food animals. This occurrence of residue in animal food products has received enormous worldwide attention from some local, international, and public health agencies. A crosssectional study was conducted from July to December 2009 to detect the antibiotic residues in tissues and eggs of laying hens at Chittagong of Bangladesh. Materials and Methods : Microbial inhibition test (MIT) and thin layer chromatography (TLC) methods were used to detect antibacterial residues in poultry tissues (liver, kidney, breast, and thigh muscles) and eggs. The bacteria and pH of the MIT method were as follows: Bacillus subtilis on test agar medium with a pH of 7.2, Bacillus cereus with a pH of 6.0, and Escherichia coli at pH with an 8.0. Results : The overall prevalence of antibiotic residues detected by MIT was 64% in liver, 63% in kidney, 56% in breast muscle, 50% in thigh muscle, and 60% in eggs. There was significant variation in results between MIT and TLC (p