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Selecting suitable Megacity Solid Waste Disposal (MSWD) sites is a challenging task in densely populated deltas of developing countries, exacerbated by limited public awareness about waste management. One of the major environmental concerns in Dhaka City, the world's densest megacity, is the presence of dumps close to surface water bodies resources. This study employed the Geographic Information System (GIS)-Analytic Hierarchy Process (AHP) framework to integrate geomorphological (slope and flow accumulation), geological (lithological and lineament), hydrogeological (depth to groundwater table and surface waterbody), socioeconomic (Land use land cover, distance to settlement, road, and airport), and climatological (wind direction) determinants, coupled by land-use and hydro-environmental analyses, to map optimal dumps (MSWDO) sites. The resulting preliminary (MSWDP) map revealed 15 potential landfill areas, covering approximately 5237 hectares (ha). Combining statistical analysis of restricted areas (settlements, water bodies, land use) with AHP-based ratings, the MSWDO map revealed two optimal locations (2285 ha). Additionally, the hydro-environmental analysis confirmed the unsuitability of northern sites due to shallow groundwater (< 5.43 m) and thin clay, leaving 11 options excluded. Sites 12 (Zone A, 2255 ha) and 15 (Zone B, 30 ha), with deeper groundwater tables and thicker clay layers, emerged as optimal choices for minimizing environmental risks and ensuring effective long-term waste disposal. This study successfully integrates remote sensing, geospatial data, and GIS-AHP modeling to facilitate the development of sustainable landfill strategies in similar South Asian delta megacities. Such an approach provides valuable insights for policymakers to implement cost-effective and sustainable waste management plans, potentially minimizing the environmental risks to achieve Sustainable Development Goals (SDGs) 6, 11, 13, and 15.
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Monitoreo del Ambiente , Sistemas de Información Geográfica , Eliminación de Residuos , Bangladesh , Eliminación de Residuos/métodos , Monitoreo del Ambiente/métodos , Instalaciones de Eliminación de Residuos , Tecnología de Sensores Remotos , Residuos Sólidos/análisis , Ciudades , Administración de Residuos/métodosRESUMEN
BACKGROUND: Severe acute malnutrition (SAM) can be diagnosed using weight-for-height Z-score (WHZ) and/or mid-upper arm circumference (MUAC). Although some favor using MUAC alone, valuing its presumed ability to identify children at greatest need for nutritional care, the functional severity and physiological responses to treatment in children with varying deficits in WHZ and MUAC remain inadequately characterized. OBJECTIVE: We aimed to compare clinical and biochemical responses to treatment in children with 1) both low MUAC and low WHZ, 2) low MUAC-only, and 3) low WHZ-only. METHODS: A multicenter, observational cohort study was conducted in children aged 6-59 mo with nonedematous, uncomplicated SAM in Bangladesh, Burkina Faso, and Liberia. Anthropometric measurements and critical indicators were collected 3 times during treatment; metrics included clinical status, nutritional status, viability, and serum leptin, a biomarker of mortality risk in SAM. RESULTS: Children with combined MUAC and WHZ deficits had greater increases in leptin levels during treatment than those with low MUAC alone, showing a 34.4% greater increase on the second visit (95% confidence interval [CI]: 7.6%, 43.6%; P = 0.02) and a 34.3% greater increase on the third visit (95% CI: 13.2%, 50.3%; P = 0.01). Similarly, weight gain velocity was higher by 1.56 g/kg/d in the combined deficit group (95% CI: 0.38, 2.75; P = 0.03) compared with children with low MUAC-only. Children with combined deficits had higher rates of iron deficiency and wasting while those with low WHZ alone and combined deficits had higher rates of tachypnea and pneumonia during treatment. CONCLUSIONS: Given the comparable treatment responses of children with low WHZ alone and those with low MUAC alone, and the greater vulnerability at admission and during treatment in those with combined deficits, our findings support retaining WHZ as an independent diagnostic and admission criterion of SAM, alongside MUAC. This trial was registered at www. CLINICALTRIALS: gov/study/NCT03400930 as NCT03400930.
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Desnutrición Aguda Severa , Humanos , Masculino , Femenino , Lactante , Desnutrición Aguda Severa/terapia , Preescolar , Bangladesh/epidemiología , Burkina Faso , Estudios de Cohortes , Estado Nutricional , Liberia , Leptina/sangre , Peso CorporalRESUMEN
This empirical study sought to determine the levels of satisfaction among engineering students enrolled at a multicultural international institution in Bangladesh with a reputation for excellence. An assortment of first- and fourth-year undergraduate students participated in the study by completing an online survey. The study focused on selected determinants namely; support services (SS), campus life (CL), economic factors (EF) and University corporate image (CI). The researchers used a survey research design (SRD) to illuminate students' opinions and views. A multiple regression analysis (MRA) was used to regress opinions of 326 respondents who participated in the study. The disproportional stratified random sampling was used to determine the samples. The study was guided by two hypotheses. The study analyzed predictors of student satisfaction with academic services by employing standard multiple regression analysis. The findings showed that the four determinants SS, CL, EF and CI were statistically significant to predict students' satisfaction levels [F(4,321) = 143.786, p < .001]. It was empirically discovered that Support Services had the highest impact to the model [ß = .496, p < .05] followed by university Corporate Image [ß = .365, p < .05]. The findings showed that Campus Life and Economic Factors were not statistically significant (p>.05) in the model of predictors implying that they do not influence students' satisfaction levels on their academic career at the university. The researchers recommend that in order to maintain students' satisfaction levels on their academic experiences, universities should consolidate on support services provided to the students as well as improving their corporate image and world view.
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Ingeniería , Satisfacción Personal , Estudiantes , Humanos , Bangladesh , Estudiantes/psicología , Universidades , Femenino , Masculino , Análisis de Regresión , Ingeniería/educación , Encuestas y Cuestionarios , Diversidad Cultural , Adulto Joven , AdultoRESUMEN
Background: Since August 2017, around 940 000 forcibly displaced Myanmar nationals (FDMN), mostly women and children, have fled persecution in Myanmar and arrived in the refugee camps across the border in Cox's Bazar, Bangladesh. This large-scale humanitarian crisis created an urgency for sexual and reproductive healthcare-related services among many of the sexually assaulted FDMN women and girls. Ipas, an international non-governmental organisation (NGO) that has been working on expanding access to safe menstrual regulation, post-abortion care, and family planning services in Bangladesh since 2011, initiated an emergency humanitarian response programme in the refugee camps in Cox's Bazar in 2017 for the victim FDMN women and girls who were in desperate need of care. To understand the implementation process and the scope of sustainability and scale-up of Ipas's programme in the current humanitarian settings, icddr,b, a Bangladesh-based international health research institution, conducted an evaluation study. Methods: Due to the emergency crisis situation, Ipas could not collect baseline data while initiating its humanitarian response programme in 2017. Only a post-evaluation was carried out by icddr,b from August to December 2022 based on a desk review, health facility observation and assessment, qualitative interviews, and a stakeholder consultation workshop. Results: In collaboration with relevant stakeholders from the Government of Bangladesh and local and international NGOs, Ipas performed structural renovation and logistical arrangements to ensure facility readiness within the camps. Until December 2022, it provided comprehensive training on menstrual regulation, post-abortion care, and family planning services to around 700 service providers from partner organisations and expanded its activities from 8 to 51 service delivery points in 23 camps. Overall, 42 213 FDMN women received menstrual regulation and post-abortion care, while 339 334 received family planning services from these facilities, with a growing trend over time. Conclusions: Despite the challenges and barriers inherent to a humanitarian setting, Ipas's programme activities have achieved significant progress in providing menstrual regulation, post-abortion care, family planning services, and trauma/survival-centred care to the FDMN women and girls. A flexible approach, stakeholder coordination and commitment, cohesive methods for health systems strengthening, and community engagement were instrumental to the success of Ipas's humanitarian response programme.
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Evaluación de Programas y Proyectos de Salud , Refugiados , Humanos , Mianmar , Bangladesh , Femenino , Servicios de Salud Reproductiva/organización & administración , Adulto , Salud Reproductiva , Sistemas de Socorro/organización & administración , Altruismo , Campos de Refugiados , Salud Sexual , AdolescenteRESUMEN
Thalassemia poses a major public health concern in Bangladesh with a high prevalence of carriers. However, there is a substantial knowledge gap regarding its epidemiology, clinical aspects, and treatment outcomes. Despite its high prevalence, there is a notable lack of awareness regarding thalassemia in the Bangladeshi population. The absence of precisely validated data impedes a comprehensive understanding of this disease.Premarital thalassemia screening is reportedly a successful strategy for countries such as Saudi Arabia and Iran and has also been proposed for Bangladesh. Mandatory screening coupled with genetic counseling is promising for reducing the prevalence of thalassemia by identifying carriers and providing relevant health education. However, sociocultural barriers, challenges, financial constraints, and health risks associated with prenatal diagnosis and abortion could hinder the success of such programs.Positive outcomes from other countries underscore the effectiveness of such programs in reducing thalassemia incidence. The early identification of carriers and genetic counseling can significantly reduce the burden of thalassemia. Additionally, the strain on the healthcare system would be eased, and the quality of life of thalassemia patients would be improved.In conclusion, based on evidence mandatory premarital screening with genetic counseling could be an effective measure to reduce the prevalence of thalassemia in Bangladesh. Leveraging positive attitudes, adopting successful international models, and addressing existing challenges are crucial for the successful implementation of programs that contribute to the overall health and well-being of the country's population.
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Exámenes Prenupciales , Talasemia , Humanos , Bangladesh/epidemiología , Talasemia/prevención & control , Talasemia/diagnóstico , Talasemia/epidemiología , Femenino , Asesoramiento Genético , PrevalenciaRESUMEN
INTRODUCTION: The WHO estimates a gap of about 30% between the incident (10.6 million) and notified (7.5 million) cases of tuberculosis (TB). Combined with the growing recognition in prevalence surveys of the high proportion of cases identified who are asymptomatic or paucisymptomatic, these data underscore how current symptom screening approaches and use of diagnostic tests with suboptimal performance on sputum miss large numbers of cases. Thus, the development of sputum-free biomarker-based tests for diagnosis is becoming necessary, which the WHO has already identified as a priority for new TB diagnostics.The objective of this study is to evaluate a combination of exhaled breath condensate (EBC) samples and mycobacterial lipoarabinomannan (LAM) as point-of-care (POC) assays to identify TB patients. METHODS AND ANALYSIS: This prospective diagnostic accuracy study is conducted at the TB Screening and Treatment Centre of International Center for Diarrhoeal Disease Research, Bangladesh, on a cohort of adults and adolescents >11 years of age. A total of 614 individuals with presumptive pulmonary TB based on TB signs, symptoms and radiography are being recruited from 28 August 2023. Spot sputum is collected for standard reference testing (L-J culture, GeneXpert MTB/Rif, acid-fast Bacilli microscopy) to fine-tune categorisation of TB disease status for each participant, defined as (1) definite TB (at least one positive standard reference test); (2) probable TB (not microbiologically confirmed but under TB treatment); (3) possible TB (no TB treatment but signs, symptoms and radiography suggestive of TB); (4) other respiratory disease (microbiologically not confirmed and no radiography presenting abnormalities compatible with TB); and (5) unknown (no microbiological evidence with normal/no TB abnormalities with radiography). Urine and EBC specimens will be subjected to LAM POC testing and biobanked for further investigation. Statistical analyses will include an assessment of diagnostic accuracy by constructing receiver operating curves and calculating sensitivity and specificity, as well as post-test probabilities. ETHICS AND DISSEMINATION: The study protocol was approved by the Research Review Committee as well as the Ethical Review Committee of icddr,b and recorded under a protocol reference number, PR-2301. Results will be submitted to open-access peer-reviewed journals, presented at academic meetings, and shared with national and international policymaking bodies.
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Pruebas Respiratorias , Lipopolisacáridos , Tuberculosis Pulmonar , Humanos , Lipopolisacáridos/análisis , Tuberculosis Pulmonar/diagnóstico , Pruebas Respiratorias/métodos , Estudios Prospectivos , Biomarcadores/análisis , Bangladesh , Adulto , Pruebas en el Punto de Atención , Sensibilidad y Especificidad , Sistemas de Atención de Punto , Masculino , Femenino , Adolescente , Mycobacterium tuberculosis/aislamiento & purificación , Esputo/microbiologíaRESUMEN
Background: Informally trained health care providers, such as village doctors in Bangladesh, are crucial in providing health care services to the rural poor in low- and middle-income countries. Despite being one of the primary vendors of antibiotics in rural Bangladesh, village doctors often have limited knowledge about appropriate antibiotic use, leading to varied and potentially inappropriate dispensing and treatment practices. In this study, we aimed to identify, map, and survey village doctors in the Sitakunda subdistrict of Bangladesh to understand their distribution, practice characteristics, clinical behaviours, access to technologies, and use of these technologies for clinical decision-making. Methods: Using a 'snowball' sampling method, we identified and mapped 411 village doctors, with 371 agreeing to complete a structured survey. Results: The median distance between a residential household and the closest village doctor practice was 0.37 km, and over half of the practices (51.2%) were within 100 m of the major highway. Village doctors were predominately male (98.7%), with a median age of 39. After completing village doctor training, 39.4% had completed an internship, with a median of 15 years of practice experience. Village doctors reported seeing a median of 84 patients per week, including a median of five paediatric diarrhoea cases per week. They stocked a range of antibiotics, with ciprofloxacin and metronidazole being the most prescribed for diarrhoea. Most had access to phones with an internet connection and used online resources for clinical decision-making and guidance. Conclusions: The findings provide insights into the characteristics and practices of village doctors and point to the potential for internet and phone-based interventions to improve patient care and reduce inappropriate antibiotic use in this health care provider group.
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Agentes Comunitarios de Salud , Pautas de la Práctica en Medicina , Humanos , Bangladesh , Masculino , Femenino , Adulto , Pautas de la Práctica en Medicina/estadística & datos numéricos , Persona de Mediana Edad , Autoinforme , Antibacterianos/uso terapéutico , Servicios de Salud Rural/estadística & datos numéricosRESUMEN
Metabolic syndrome (MetS) is a cluster of interconnected metabolic risk factors, including abdominal obesity, high blood pressure, and elevated fasting blood glucose levels, that result in an increased risk of heart disease and stroke. In this research, we aim to identify the risk factors that have an impact on MetS in the Bangladeshi population. Subsequently, we intend to construct predictive machine learning (ML) models and ultimately, assess the accuracy and reliability of these models. In this particular study, we utilized the ATP III criteria as the basis for evaluating various health parameters from a dataset comprising 8185 participants in Bangladesh. After employing multiple ML algorithms, we identified that 27.8% of the population exhibited a prevalence of MetS. The prevalence of MetS was higher among females, accounting for 58.3% of the cases, compared to males with a prevalence of 41.7%. Initially, we identified the crucial variables using Chi-Square and Random Forest techniques. Subsequently, the obtained optimal variables are employed to train various models including Decision Trees, Random Forests, Support Vector Machines, Extreme Gradient Boosting, K-nearest neighbors, and Logistic Regression. Particularly we employed the ATP III criteria, which utilizes the Waist-to-Height Ratio (WHtR) as an anthropometric index for diagnosing abdominal obesity. Our analysis indicated that Age, SBP, WHtR, FBG, WC, DBP, marital status, HC, TGs, and smoking emerged as the most significant factors when using Chi-Square and Random Forest analyses. However, further investigation is necessary to evaluate its precision as a classification tool and to improve the accuracy of all classifiers for MetS prediction.
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Aprendizaje Automático , Síndrome Metabólico , Humanos , Síndrome Metabólico/epidemiología , Síndrome Metabólico/diagnóstico , Bangladesh/epidemiología , Masculino , Femenino , Adulto , Persona de Mediana Edad , Factores de Riesgo , Prevalencia , Adulto Joven , Anciano , Adolescente , Obesidad Abdominal/epidemiología , Obesidad Abdominal/diagnósticoRESUMEN
The tannery industry produces one of the worst contaminants, and unsafe disposal in nearby waterbodies and landfills has become an imminent threat to public health, especially when the resulting multidrug-resistant bacteria and heavy metals enter community settings and animal food chains. In this study, we have collected 10 tannery wastewater (TWW) samples and 10 additional non-tannery wastewater (NTW) samples to compare the chemical oxygen demand (COD), pH, biological oxygen demand (BOD), dissolved oxygen (DO), total dissolved solids (TDS), chromium concentration, bacterial load, and antibiotic resistance profiles. While COD, pH, and chromium concentration data were previously published from our lab, this part of the study uncovers that TWW samples had a significantly higher bacterial load, compared to the non-tannery wastewater samples (5.89 × 104 and 9.38 × 103 cfu/mL, respectively), higher BOD and TDS values, and significantly lower DO values. The results showed that 53.4, 46.7, 40.0, and 40.0% of the TWW isolates were resistant to ceftriaxone, erythromycin, nalidixic acid, and azithromycin, respectively. On the other hand, 20.0, 30.0, 50.0, and 40.0% of the NTW isolates were resistant to the same antibiotics, respectively. These findings suggest that the TWW isolates were more resistant to antibiotics than the NTW isolates. Moreover, the TWW isolates exhibited higher multidrug resistance than the NTW isolates, 33.33, and 20.00%, respectively. Furthermore, spearman correlation analysis depicts that there is a negative correlation between BOD and bacterial load up to a certain level (r = - 0.7749, p = 0.0085). In addition, there is also a consistent negative correlation between COD and bacterial load (r = - 0.7112, p = 0.0252) and TDS and bacterial load (r = - 0.7621, p = 0.0104). These findings suggest that TWW could pose a significant risk to public health and the environment and highlight the importance of proper wastewater treatment in tannery industries.
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Farmacorresistencia Bacteriana Múltiple , Curtiembre , Aguas Residuales , Aguas Residuales/microbiología , Bangladesh , Bacterias/efectos de los fármacos , Bacterias/aislamiento & purificación , Residuos Industriales/análisis , Análisis de la Demanda Biológica de Oxígeno , Antibacterianos/farmacología , Pruebas de Sensibilidad MicrobianaRESUMEN
Xanthine oxidase (XO) is an enzyme that converts hypoxanthine into xanthine and xanthine into uric acid, which is then eliminated by the kidneys. Serum XO has been linked to diabetes, hypertension, liver dysfunction, and cardiovascular diseases. However, limited information exists on the relationship between serum XO activity and MetS. This study aimed to analyze the relationship between XO activity and metabolic syndrome (MetS) and its components in an adult population group in Bangladesh A total of 601 participants aged ≥18 years were included in the study. MetS was defined based on the criteria set by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III). Serum XO activity was measured using the enzyme-linked immunosorbent assay (ELISA), while other biochemical parameters were measured using colorimetric methods. The relationship between serum XO and MetS levels was determined through multivariate logistic regression analysis. Serum XO activity was found to be significantly higher in females (6.17 ± 3.77 U/L) as compared to males (4.00 ± 2.77 U/L) (p < 0.001). Furthermore, participants with MetS had significantly higher mean levels of serum XO (5.34 ± 3.39 U/L) than those without MetS (3.86 ± 2.90 U/L) (p < 0.001). The prevalence of MetS and its components, such as blood pressure and blood glucose increased across the XO quartiles (p < 0.001). Regression analysis indicated that XO activity was significantly and independently associated with the prevalence of MetS (at least p < 0.05 for all cases) and its components, including elevated blood pressure, high blood glucose, and low HDL-C (at least p < 0.05 for all cases). In conclusion, individuals with MetS had significantly higher XO levels than those without MetS. Serum XO activity showed an independent association with MetS and some of its components. Therefore, XO might serve as a useful marker of MetS. Prospective studies are needed to determine the underlying mechanisms linking XO and MetS.
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Síndrome Metabólico , Xantina Oxidasa , Humanos , Síndrome Metabólico/sangre , Síndrome Metabólico/epidemiología , Masculino , Femenino , Bangladesh/epidemiología , Adulto , Persona de Mediana Edad , Xantina Oxidasa/sangre , Xantina Oxidasa/metabolismoRESUMEN
Importance: The emergence of acute neurological symptoms in children necessitates immediate intervention. Although low- and middle-income countries (LMICs) bear the highest burden of neurological diseases, there is a scarcity of diagnostic and therapeutic resources. Therefore, current understanding of the etiology of neurological emergencies in LMICs relies mainly on clinical diagnoses and verbal autopsies. Objective: To characterize the association of premortem neurological symptoms and their management with postmortem-confirmed cause of death among children aged younger than 5 years in LMICs and to identify current gaps and improve strategies to enhance child survival. Design, Setting, and Participants: This cross-sectional study was conducted between December 3, 2016, and July 22, 2022, at the 7 participating sites in the Child Health and Mortality Prevention Surveillance (CHAMPS) network (Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa). Minimally invasive tissue sampling was performed at the CHAMPS sites with specimens from deceased children aged younger than 5 years. This study included deceased children who underwent a premortem neurological evaluation and had a postmortem-confirmed cause of death. Data analysis was performed between July 22, 2022, and January 15, 2023. Main Outcomes and Measures: Descriptive analysis was performed using neurological evaluations from premortem clinical records and from postmortem determination of cause of death (based on histopathology, microbiological testing, clinical records, and verbal autopsies). Results: Of the 2127 deaths of children codified during the study period, 1330 (62.5%) had neurological evaluations recorded and were included in this analysis. The 1330 children had a median age of 11 (IQR, 2-324) days; 745 (56.0%) were male and 727 (54.7%) presented with neurological symptoms during illness before death. The most common postmortem-confirmed neurological diagnoses related to death were hypoxic events (308 [23.2%]), meningoencephalitis (135 [10.2%]), and cerebral malaria (68 [5.1%]). There were 12 neonates with overlapping hypoxic events and meningoencephalitis, but there were no patients with overlapping meningoencephalitis and cerebral malaria. Neurological symptoms were similar among diagnoses, and no combination of symptoms was accurate in differentiating them without complementary tools. However, only 25 children (18.5%) with meningitis had a lumbar puncture performed before death. Nearly 90% of deaths (442 of 511 [86.5%]) with neurological diagnoses in the chain of events leading to death were considered preventable. Conclusions and Relevance: In this cross-sectional study of children aged younger than 5 years, neurological symptoms were frequent before death. However, clinical phenotypes were insufficient to differentiate the most common underlying neurological diagnoses. The low rate of lumbar punctures performed was especially worrying, suggesting a challenge in quality of care of children presenting with neurological symptoms. Improved diagnostic management of neurological emergencies is necessary to ultimately reduce mortality in this vulnerable population.
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Causas de Muerte , Países en Desarrollo , Humanos , Lactante , Preescolar , Masculino , Estudios Transversales , Femenino , Países en Desarrollo/estadística & datos numéricos , Enfermedades del Sistema Nervioso/mortalidad , Kenia/epidemiología , Recién Nacido , Sudáfrica/epidemiología , Bangladesh/epidemiología , Etiopía/epidemiología , Sierra Leona/epidemiología , Malí/epidemiología , Mozambique/epidemiología , Autopsia/estadística & datos numéricosRESUMEN
Identifying the primary source of heavy metals (HMs) pollution and the key pollutants is crucial for safeguarding eco-health and managing risks in industrial vicinity. For this purpose, this investigation was carried out to investigate the pollution area identification with soil static environmental capacity (QI), receptor model-oriented critical sources, and Monte Carlo simulation (MCS) based probabilistic environmental and human health hazards associated with HMs in agricultural soils of Narayanganj, Bangladesh. The average concentration of Cr, Ni, Cu, Cd, Pb, Co, Zn, and Mn were 98.67, 63.41, 37.39, 1.28, 23.93, 14.48, 125.08, and 467.45 mg/kg, respectively. The geoaccumulation index identified Cd as the dominant metal, indicating heavy to extreme contamination in soils. The QI revealed that over 99% of the areas were polluted for Ni and Cd with less uncertain regions whereas Cr showed a significant portion of areas with uncertain pollution status. The positive matrix factorization (PMF) model identified three major sources: agricultural (29%), vehicular emissions (25%), and industrial (46%). The probabilistic assessment of health hazards indicated that both carcinogenic and non-carcinogenic risks for adult male, adult female, and children were deemed unacceptable. Moreover, children faced a higher health hazard compared to adults. For adult male, adult female, and children, industrial operations contributed 48.4%, 42.7%, and 71.2% of the carcinogenic risks, respectively and these risks were associated with Ni and Cr as the main pollutants of concern. The study emphasizes valuable scientific insights for environmental managers to tackle soil pollution from HMs by effectively managing anthropogenic sources. It could aid in devising strategies for environmental remediation engineering and refining industry standards.
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Metales Pesados , Contaminantes del Suelo , Suelo , Metales Pesados/análisis , Contaminantes del Suelo/análisis , Suelo/química , Humanos , Monitoreo del Ambiente , Bangladesh , Medición de Riesgo , Contaminación Ambiental , Agricultura , Método de MontecarloRESUMEN
Jellyfish are known for experiencing periodic blooms in population, which occur when their density increases suddenly. The present study assessed the level of heavy metals and proximate composition in the jellyfish Lobonemoides robustus collected from Cox's Bazar coast of Bangladesh. This is the first study conducted in Bangladesh. Most of the studied metals were not possible to detect in L. robustus samples because concentrations were below the detection limit. Ca, Na, Se, and Mg were found to have safe levels in the L. robustus while the amount of Pb was recorded 0.39 ppm. The findings of Target Hazard Quotient, and Carcinogenic Risk indicate that the L. robustus is safe for human consumption (both for children and adults). Hence, it is suitable for consumption and can be exported. This study emphasizes the need for regular marine environment monitoring to ensure that the seafood harvested from these waters is safe for consumption.
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Monitoreo del Ambiente , Metales Pesados , Contaminantes Químicos del Agua , Animales , Metales Pesados/análisis , Medición de Riesgo , Contaminantes Químicos del Agua/análisis , Humanos , Bangladesh , Escifozoos , Alimentos Marinos/análisisRESUMEN
This study aimed to assess the concentrations of eight trace metals - Cr, As, Pb, Mn, Ni, Zn, Hg, and Co - in the intertidal zone of Cox's Bazar of Bangladesh, the world's longest continuous beach. Most metal concentrations were below sediment quality guidelines and other comparative studies. The mean metal concentrations (mg kg-1) were as follows: Mn (471.67) > Zn (256.35) > Cr (89.96) > Pb (39.66) > Ni (36.44) > As (18.79) > Co (11.08) > Hg (0.0036). Statistical analyses revealed that only samples collected from stations 5 and 7 presented any cause for concern. Risk assessment indices, i.e., Geo-accumulation Index (Igeo), Contamination Factor (CF), Pollution Load Index (PLI), Potential Ecological Risk Index (PERI), and Toxic Risk Index (TRI), all indicated a low to moderate risk of pollution for all sites, suggesting that the study area is currently free from any significant negative impacts resulting from human activities. The calculated Hazard Index (HI) was <1, indicating no significant non-carcinogenic impact on adults or children. The Total Carcinogenic Risk was also well below the threshold value.
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Monitoreo del Ambiente , Metales , Contaminantes Químicos del Agua , Bangladesh , Contaminantes Químicos del Agua/análisis , Medición de Riesgo , Metales/análisis , Sedimentos Geológicos/química , Playas , Metales Pesados/análisisRESUMEN
Unsafe patient care in hospitals, especially in low- and middle-income countries, is often caused by poor infection prevention and control (IPC) practices; insufficient support for water, sanitation, and hygiene (WASH); and inadequate waste management. We looked at the intersection of IPC, WASH, and the global initiative of improving health care quality, specifically around maternal and newborn care in Bangladesh health facilities. We identified 8 primary quality improvement and IPC/WASH policy and guideline documents in Bangladesh and analyzed their incorporation of 30 subconditions under 5 critical conditions: water; sanitation; hygiene; waste management/cleaning; and IPC supplies, guidelines, training, surveillance, and monitoring. To determine how Bangladesh health care workers implemented the policies, we interviewed 33 informants from 16 public and private facilities and the national level. Bangladesh's 8 primary guidance documents covered 55% of the 30 subconditions. Interviews showed that Bangladesh health facility staff generally rely on eight tools related to quality improvement (five); IPC (two); and supportive supervision (one) plus a robust supervision mechanism. The stakeholders identified a lack of human resources and environmental hygiene infrastructure and supplies as the main gaps in providing IPC/WASH services. We concluded that the Bangladesh government had produced substantial guidance on using quality improvement methods to improve health services. Our recommendations can help identify strategies to better integrate IPC/WASH in resources including standardizing guidelines and tools within one toolkit. Strategizing with stakeholders working on initiatives such as universal health coverage and patient safety to integrate IPC/WASH into quality improvement documents is a mutually reinforcing approach.
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Control de Infecciones , Mejoramiento de la Calidad , Bangladesh , Humanos , Control de Infecciones/métodos , Control de Infecciones/normas , Higiene/normas , Calidad de la Atención de Salud , Saneamiento/normas , Infección Hospitalaria/prevención & control , Instituciones de Salud/normas , Personal de Salud , FemeninoRESUMEN
This study examined the factors influencing green accounting and reporting practices (GARPs) in Bangladesh's pharmaceutical and textile industries. Hence, it draws upon disclosure theory to disclose relevant information in the context of environmental accounting and encourages them to boost their environmental performance. It utilized content analysis from 13 pharmaceuticals and 22 textiles data from Dhaka stock exchange (DSE) listed companies of Bangladesh and applied quantitative methods for comparative analysis. The findings showed that GARPs are influenced by firm characteristics and external factors rather than organizational performance, and eleven environmental indicators (separately) have a lower mean of less than 0.50 in both industries. Firms' general characteristics (FFGC) are noteworthy factors that exhibit a negative coefficient for both the pharmaceutical and textile sectors but hold a robust impact on the GARPs, with P = 0.007 and 0.003, respectively. The statistical significance of environmental factors (EFs) applies to the textile sector p = 0.000. Implementing GARPs in the pharmaceutical industry proved more effective than in the textile sector, offering valuable support to managers in expediting environmental practices in Bangladesh's textile industry.
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Industria Farmacéutica , Industria Textil , Bangladesh , Humanos , TextilesRESUMEN
BACKGROUND: As the Sustainable Development Goal 3.2.1 deadline (2030) approaches, rapidly reducing under-5 mortality (U5M) gains more prominence. However, initiatives or interventions that aided Bangladesh in achieving Millennium Development Goal 4 showed varied effectiveness in reducing certain cause-specific U5M. Therefore, this study aimed to examine the predictors of the key cause-specific mortalities. METHODS: This cross-sectional study was conducted using the Bangladesh Demographic and Health Survey 2011 and 2017-18 data. Cause-specific U5M was examined using multilevel multinomial mixed-effects analyses, and overall/all-cause U5M was examined using multilevel mixed-effects analyses. The respective estimates were compared. RESULTS: The cause-specific analysis revealed that pneumonia and prematurity-related U5M were significantly associated with antenatal care and postnatal care, respectively. However, analysis of overall/all-cause U5M did not reveal any significant association with health services. Twins or multiples had a greater risk of mortality from preterm-related conditions (adjusted Relative Risk Ratio (aRRR): 38.01, 95% CI: 19.08-75.7, p < .001), birth asphyxia (aRRR: 6.52, 95% CI: 2.51-16.91, p < .001), and possible serious infections (aRRR: 11.12, 95% CI: 4.52-27.36, p < .001) than singletons. Children born to mothers 18 years or younger also exhibited a greater risk of mortality from these three causes than children born to older mothers. This study also revealed an increase in the predicted risk of prematurity-related mortality in the 2017-18 survey among children born to mothers 18 years or younger, children born to mothers without any formal education, twins or multiples and children who did not receive postnatal care. CONCLUSIONS: This research provides valuable insights into accelerating U5M reduction; a higher risk of preterm-related death among twins underscores the importance of careful monitoring of mothers pregnant with twins or multiples through the continuum of care; elevated risk of death among children who did not receive postnatal care, or whose mothers did not receive antenatal care stresses the need to strengthen the coverage and quality of maternal and neonatal health care; furthermore, higher risks of preterm-related deaths among the children of mothers with low formal education or children born to mothers 18 years or younger highlight the importance of more comprehensive initiatives to promote maternal education and prevent adolescent pregnancy.
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Causas de Muerte , Mortalidad del Niño , Encuestas Epidemiológicas , Mortalidad Infantil , Humanos , Bangladesh/epidemiología , Estudios Transversales , Lactante , Femenino , Mortalidad Infantil/tendencias , Preescolar , Recién Nacido , Mortalidad del Niño/tendencias , Masculino , Adulto , Adolescente , Atención Prenatal , Adulto Joven , Embarazo , Atención Posnatal/estadística & datos numéricosRESUMEN
This study focuses on Bangladeshi university entrance test-taking students mental health problems and explores the geographical distribution of these problems using GIS technique. A cross-sectional survey was conducted among 1523 university entrance test-taking students. Data were collected on participants' socio-demographic characteristics, COVID-19-related factors, admission tests, depression, and anxiety. Chi-square tests and logistic regression were performed using SPSS software. GIS mapping was used to visualize the distribution of mental health problems across districts using ArcGIS. The study found that the prevalence rates of depression and anxiety among university entrance examinees were 53.8% and 33.2%, respectively. Males exhibited higher rates of depression and anxiety compared to females, while repeat test-taking students were more susceptible to these mental health issues compared to first-time test-takers. Factors such as urban residence, personal/familial COVID-19 infections, and COVID-19 deaths in close relationships were associated with increased mental health problems. District-based distribution showed no significant variation in depression, but anxiety varied significantly. Post-hoc GIS analysis revealed variations in the distribution of depression and anxiety among males, as well as variations in anxiety distribution based on student status across districts. This study emphasizes the high prevalence of depression and anxiety among university entrance examinees, emphasizing the importance of addressing mental health risks in this population. It also suggests the need for reforms in the university entrance test-taking system to reduce psychological problems and advocates for a more inclusive approach to student admissions to alleviate mental health burdens.
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Ansiedad , COVID-19 , Depresión , Sistemas de Información Geográfica , Estudiantes , Humanos , Masculino , Femenino , Bangladesh/epidemiología , Estudiantes/psicología , Depresión/epidemiología , Universidades , Ansiedad/epidemiología , COVID-19/epidemiología , COVID-19/psicología , Prevalencia , Estudios Transversales , Adulto Joven , Adolescente , Adulto , SARS-CoV-2/aislamiento & purificación , Salud Mental , Factores de RiesgoRESUMEN
In Bangladesh, groundwater, the principal source of drinking water, contains predominantly high levels of iron. Drinking groundwater is associated with good iron status in populations. Against this backdrop, iron supplementation is often associated with side effects, which reduces its intake compliance. However, the level of iron in groundwater is not consistent, and low levels exist in many areas of the country. In the present study, we examined the role of groundwater with a low concentration of iron in the prevention of anemia in Bangladeshi children. In 2018, a cross-sectional study was conducted in Bangladesh among children aged 2-5 years (n = 122) who drank groundwater containing a low level of iron (0-<2 mg/L). The combined intake of iron was calculated from the key sources-diet, groundwater, and the simulated intake of MNPs. The intakes of iron were compared against the standard reference intake. The children's hemoglobin levels were measured using a photometer. The combined intake of iron from diet, groundwater with low levels of iron, and the simulated consumption of low-iron MNP in children was 5.8 ± 2.0 and 6.9 ± 2.5 mg/day, comprising 193% and 169% of the Estimated Average Requirements in the 2-3-year-old and 4-5-year-old subgroups, respectively. The combined intake of bioavailable iron from dietary and low-iron groundwater was 0.42 ± 0.023 and 0.22 ± 0.019 mg/day in children exposed to groundwater concentrations of 0.8-<2.0 mg/L and 0.0-<0.8 mg/L, respectively (p < 0.001). The mean concentration of hemoglobin in the respective groups was 12.17 ± 0.94 g/dL and 11.91 ± 0.91 g/dL (p = 0.30). The combined intake of iron from diet and the low-iron groundwater was associated with maintenance of hemoglobin concentration at the non-anemic level in > 90% of the children. The findings highlight the protective influence of the low concentration of iron in the drinking groundwater against childhood anemia in Bangladesh.
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Agua Subterránea , Hierro , Población Rural , Humanos , Bangladesh/epidemiología , Agua Subterránea/química , Agua Subterránea/análisis , Estudios Transversales , Preescolar , Masculino , Femenino , Hierro/administración & dosificación , Hierro/sangre , Anemia Ferropénica/prevención & control , Anemia Ferropénica/epidemiología , Agua Potable/química , Agua Potable/análisis , Hemoglobinas/análisis , Suplementos Dietéticos , DietaRESUMEN
Offering fresh perspectives on the lived experience of ageing in extreme poverty, this article delves into unpacking the relationally driven processes of social, institutional, and self-othering that contribute to agency erosion in older adults. Positing that the context of extreme poverty in which a person ages is micropolitically shaped, where society, institutions, and ageing self interact in a complex way, it is argued that ageing in extreme poverty, inter alia, means ageing in subaltern conditions. A critical consequence of this process is the subjugation of older adults, leading to a life marked by the state of 'social death'. Additional research is needed to unpack such nuances to better understand ageing processes in extreme poor societies. This necessitates an approach informed by postcolonial perspectives that take into account the dynamics of othering and agency erosion. It concludes by asserting that to reverse extreme poverty among older adults as well as to reverse their subaltern conditions requires a political project that empowers the older adults in society, restores agency and strengthens their 'relational security'.