As one of the least developed countries of South Asia, Bangladesh continues experiencing a surge in the number of patients with dengue hemorrhagic fever (DHF), while struggling with the ongoing COVID-19 pandemic. The number of infected patients and deaths due to COVID-19 had risen rapidly since the beginning of July 2021 and broken all the previous records. The total number of dengue cases was also the highest in July. Now, the country is facing an unprecedented challenge of tackling a co-epidemic. Impoverished health infrastructure, ineffective intervention schemes against the disease and lack of awareness has made the country vulnerable to a risk of co-epidemic. Therefore, government and local authorities should take immediate actions, including capacity-building programs for both COVID-19 and dengue, while community engagement campaigns focusing on the destruction of breeding sources of Aedes mosquitoes can play a key role in reducing the effect of dengue at an early stage.
Diverse risk factors intercede the outcomes of COVID-19. We conducted this retrospective cohort study to identify the risk factors associated with morbidity and mortality outcomes with a cohort of 1016 COVID-19 patients diagnosed in May 2020. Data were collected by telephone-interview and reviewing records using a questionnaire and checklist. Morbidity (64.4% Vs. 6.0%) and mortality (2.3% Vs. 2.5%) outcomes varied between the 14th and 28th day. Morbidity risk factors included chronic obstructive pulmonary disease (COPD) (RR=1.19, RR=2.68) both on the 14th and 18th day while elderly (AOR=2.56) and smokeless tobacco (SLT) (AOR=2.17) on the 28th day. Mortality risk factors included elderly (AOR=10.14), COPD (RR=5.93), and SLT (AOR=2.25) on the 14th day, and elderly (AOR=24.37) and COPD (RR=2.72) on the 28th day. The morbidity risk was higher with chronic kidney disease (CKD) (RR=3.33) and chronic liver disease (CLD) (RR=3.99) on the 28th day. The mortality risk was higher with coronary heart disease (RR=4.54) and CLD (RR=9.66) on the 14th while with diabetes mellitus (RR=3.08, RR=2.08), hypertension (RR=3.14, RR=2.30), CKD (RR=8.97, RR=2.71), and malignant diseases (RR=10.29) on both 14th and 28th day. We must espouse program interventions considering the morbidity and mortality risk factors to condense the aggressive outcomes of COVID-19.
Out-of-pocket (OOP) expenses for hospitalized patients with chronic liver disease (CLD) poses an economic challenge on affected household in the form of catastrophic health expenditure (CHE), distress financing and impoverishment. OOP Expenses data for hospitalized CLD patients from Bangladesh is scarce. This study aimed to estimate the OOP expenses and resulting CHE, distress financing and impoverishment among hospitalized patients with CLD. This cross-sectional study was conducted among conveniently selected 107 diagnosed CLD patients admitted at Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka Medical College Hospital (DMCH) aged 18 years and above. Data were collected from the respondents using a semi-structured questionnaire through face to face interview during discharge from hospital. Out of pocket expenditure for chronic liver disease in selected hospitals was Bangladeshi Taka (BDT) 19,262. Direct medical, direct non-medical and indirect cost was BDT 16,240; 2,165 and 1,510, respectively. Investigation cost and medicine cost contributed to 48.48% and 31.81% of the total OOP expenses, respectively. At 10% threshold level, 29% of the respondents were affected by CHE. 64.5% of the respondents were facing distress financing due to OOP expenses. Among the respondents, 1.9% slipped below the international poverty line of $1.90 (BDT 161.10, in 2019).There was statistically significant (p < 0.05) difference among the mean OOP expenses for different etiological types of chronic liver disease. The study concluded that it requires establishing a more accessible and affordable decentralized health care system for CLD treatment along with the implementation of financial risk protection.
Shifting responsibilities of patient care from one nurse to another is an integral part of nursing practice. There is abundant evidence that inaccurate information in hospital is the primary cause of adverse events and gaps in patient care. A cross-sectional study was conducted in 250 Bedded General Hospital, Jashore from 1st January to 31st December 2017 with the aim to assess the state of nurses shifting duty management. Total 114 nurses were selected conveniently from this hospital and interviewed with a pre-tested semi-structured questionnaire and an observational checklist was used to observe the actual scenario. Data were analyzed by using Statistical Package for Social Science version (SPSS) 24.P-value less than 0.05 were set as statistically significant. Overall shifting duty management of the hospital were categorized into good, average and poor. Among the Nurses overall shifting duty management of the hospital were found as 48.2% (55) average, 34.3% (39) poor and 17.5% (20) good. There was a significant relationship between occurrence of interruption and duration of shifting duty (p < 0.05). Proper staffing and dedicated time management for critical patient‟s information sharing is needed to reduce gaps in patient care and enhance patient safety thereby. Thus it is essential to establish a standard protocol to ensure proper management of shifting duties of nurses and every hospital should follow this. Asian J. Med. Biol. Res. September 2020, 6(3): 530-535
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