BackgroundPublic health is at risk due to chemical contaminants in drinking water which may have immediate health consequences. Drinking water sources are susceptible to pollutants depending on geological conditions and agricultural, industrial, and other man-made activities. Ensuring the safety of drinking water is, therefore, a growing problem. To assess drinking water quality, we measured multiple chemical parameters in drinking water samples from across Bangladesh with the aim of improving public health interventions.MethodsIn this cross-sectional study conducted in 24 randomly selected upazilas, arsenic was measured in drinking water in the field using an arsenic testing kit and a sub-sample was validated in the laboratory. Water samples were collected to test water pH in the laboratory as well as a sub-sample of collected drinking water was tested for water pH using a portable pH meter. For laboratory testing of other chemical parameters, iron, manganese, and salinity, drinking water samples were collected from 12 out of 24 upazilas.ResultsDrinking water at sample sites was slightly alkaline (pH 7.4 ± 0.4) but within acceptable limits. Manganese concentrations varied from 0.1 to 5.5 mg/L with a median value of 0.2 mg/L. The median iron concentrations in water exceeded WHO standards (0.3 mg/L) at most of the sample sites and exceeded Bangladesh standards (1.0 mg/L) at a few sample sites. Salinity was relatively higher in coastal districts. After laboratory confirmation, arsenic concentrations were found higher in Shibchar (Madaripur) and Alfadanga (Faridpur) compared to other sample sites exceeding WHO standard (0.01 mg/L). Of the total sampling sites, 33 % had good-quality water for drinking based on the Water Quality Index (WQI). However, the majority of the households (67 %) used poor-quality drinking water.ConclusionsHigher values of iron, manganese, and arsenic reduced drinking water quality. Awareness raising on chemical contents in drinking water at household level is required to improve public health.

Supporting caregivers’ mental wellbeing and ability to provide psychosocial stimulation may promote early childhood development. This paper describes the systematic approach of developing an integrated stimulation intervention, identifying the feasibility and challenges faced throughout the period. We developed an integrated curriculum by culturally adapting three interventions (Reach Up, Thinking Healthy, and general nutrition advice) and piloted this curriculum (Mar–April 2017) in courtyard groups sessions and individual home visits with pregnant women (n = 11) and lactating mothers (of children <24 months) (n = 29). We conducted qualitative interviews with the participants (n = 8) and the community health workers who delivered the intervention (n = 2). Most participants reported willingness to attend the sessions if extended for 1 year, and recommended additional visual cues and interactive role-play activities to make the sessions more engaging. Participants and community health workers found it difficult to understand the concept of “unhealthy thoughts” in the curriculum. This component was then revised to include a simplified behavior-focused story. Community health workers reported difficulty balancing the required content of the integrated curriculum but were able to manage after the contents were reduced. The revised intervention is likely feasible to deliver to a group of pregnant and lactating mothers in a low-resource setting.

IntroductionIn low- and middle-income countries, children experience multiple risks for delayed development. We evaluated a multicomponent, group-based early child development intervention including behavioural recommendations on responsive stimulation, nutrition, water, sanitation, hygiene, mental health and lead exposure prevention.MethodsWe conducted a 9-month, parallel, multiarm, cluster-randomised controlled trial in 31 rural villages in Kishoreganj District, Bangladesh. Villages were randomly allocated to: group sessions (‘group’); alternating groups and home visits (‘combined’); or a passive control arm. Sessions were delivered fortnightly by trained community members. The primary outcome was child stimulation (Family Care Indicators); the secondary outcome was child development (Ages and Stages Questionnaire Inventory, ASQi). Other outcomes included dietary diversity, latrine status, use of a child potty, handwashing infrastructure, caregiver mental health and knowledge of lead. Analyses were intention to treat. Data collectors were independent from implementers.ResultsIn July–August 2017, 621 pregnant women and primary caregivers of children<15 months were enrolled (group n=160, combined n=160, control n=301). At endline, immediately following intervention completion (July–August 2018), 574 participants were assessed (group n=144, combined n=149, control n=281). Primary caregivers in both intervention arms participated in more play activities than control caregivers (age-adjusted means: group 4.22, 95% CI 3.97 to 4.47; combined 4.77, 4.60 to 4.96; control 3.24, 3.05 to 3.39), and provided a larger variety of play materials (age-adjusted means: group 3.63, 3.31 to 3.96; combined 3.81, 3.62 to 3.99; control 2.48, 2.34 to 2.59). Compared with the control arm, children in the group arm had higher total ASQi scores (adjusted mean difference in standardised scores: 0.39, 0.15 to 0.64), while in the combined arm scores were not significantly different from the control (0.25, –0.07 to 0.54).ConclusionOur findings suggest that group-based, multicomponent interventions can be effective at improving child development outcomes in rural Bangladesh, and that they have the potential to be delivered at scale.Trial registration numberThe trial is registered in ISRCTN (ISRCTN16001234).

Heavy metal toxicity is one of the most devastating abiotic stresses. Heavy metals cause serious damage to plant growth and productivity, which is a major problem for sustainable agriculture. It adversely affects plant molecular physiology and biochemistry by generating osmotic stress, ionic imbalance, oxidative stress, membrane disorganization, cellular toxicity, and metabolic homeostasis. To improve and stimulate plant tolerance to heavy metal stress, the application of biostimulants can be an effective approach without threatening the ecosystem. Melatonin (N-acetyl-5-methoxytryptamine), a biostimulator, plant growth regulator, and antioxidant, promotes plant tolerance to heavy metal stress by improving redox and nutrient homeostasis, osmotic balance, and primary and secondary metabolism. It is important to perceive the complete and detailed regulatory mechanisms of exogenous and endogenous melatonin-mediated heavy metal-toxicity mitigation in plants to identify potential research gaps that should be addressed in the future. This review provides a novel insight to understand the multifunctional role of melatonin in reducing heavy metal stress and the underlying molecular mechanisms.

The COVID-19 pandemic threatens child development throughout the world as nutrition, routine healthcare, and the ability to provide nurturing care for young children are disrupted (Yoshikawa et al., 2020). In many low-and middle-income countries (LMICs), COVID-19 lockdowns have resulted in difficulties accessing essential healthcare,