The prevalence of sexually transmitted infections (STIs) and reproductive tract infections (RTIs) among hotel-based sex workers (HBSWs) in Dhaka, Bangladesh, was studied. A total of 400 HBSWs were enrolled in the study during April to July 2002. Endocervical swabs, high vaginal swabs, and blood samples from 400 HBSWs were examined for Neisseria gonorrhoeae (by culture), Chlamydia trachomatis (by PCR), Trichomonas vaginalis (by microscopy), antibody to Treponema pallidum (by both rapid plasma reagin and Treponema pallidum hemagglutination tests), and antibody to herpes simplex virus type 2 (HSV-2) (by enzyme-linked immunosorbent assay). Sociodemographic information as well as gynecological and obstetric information was collected. Among the HBSWs, 228 women (57%) were symptomatic and 172 (43%) were asymptomatic, 35.8% were positive for N. gonorrhoeae, 43.5% were positive for C. trachomatis, and 4.3% were positive for T. vaginalis. A total of 8.5% had syphilis, 34.5% were positive for HSV-2, and 86.8% were positive for at least one RTI or STI. There was no significant difference between the prevalences of STIs among the symptomatic and asymptomatic HBSWs. These data suggested a high prevalence of STIs, particularly gonorrhea and chlamydia, among HBSWs in Dhaka.As in other developing countries, sexually transmitted infections (STIs) and reproductive tract infections (RTIs) represent a major public health problem in Bangladesh (1). Control of ulcerative (syphilis, chancroid, and herpes simplex virus type 2 [HSV-2] infection) and nonulcerative (gonorrhea, chlamydia, and trichomoniasis) STIs and of RTIs (bacterial vaginosis and candidiasis) is important not only for preventing complications related to infection but also for preventing heterosexual transmission of human immunodeficiency virus (HIV). In a number of recent studies, it has been shown that bacterial and parasitic agents of STIs and RTIs, increase the release of virion particles in the semen and ulcers in the genital region and thus increase the risk of both acquisition and transmission of HIV in patients with STIs (15, 2, 4). Consistent with this observation, Grosskurth et al. have demonstrated that control of STIs through syndromic management in the general population in a rural area of Tanzania was able to reduce the serological incidence of HIV by 42% (8).Female sex workers (FSWs) are particularly at risk for STIs and HIV (5). They often are infected by their clients and subsequently transmit the infection to other partners. It has earlier been demonstrated that in most parts of Asia and Africa, 60 to 70% of the STIs relate to clients of FSWs and sexual networks (14).The number of FSWs in Bangladesh is unknown, but estimates range from 50,000 to 100,000. FSWs work in brothels, streets, hotels, and residences (7). However, in recent years there has been remarkable change in the nature of the sex industry, possibly due to (i) eviction of brothels from major cities, (ii) increased demand for sex workers in nonstigmatized locations, (iii) demand for flexible...

Bangladesh is a low HIV prevalence country with several well-documented at-risk groups, the most prominent of which is brothel-based sex workers. Using two waves of HIV behavioral surveillance data for a national sample of all operating registered brothels supplemented by historical and observational accounts, this article presents a case study of the changing conditions in the brothels. Between the two waves of surveillance, several brothels were forcibly closed; the number of sex workers dropped; the average number of clients per woman rose; and overall safety, both in terms of violence and protected sex, did not improve. Only treatment-seeking behavior for sexually transmitted diseases was positively changed. Continued surveillance of the possible negative impact of HIV prevention programs is under way. Protective policies are needed to facilitate improved HIV prevention and safety of sex workers, a key to controlling the HIV epidemic.

Arsenic groundwater contamination in Bangladesh warrants immediate remediation. This randomised controlled intervention trial was conducted to determine the effectiveness of two possible interventions: dug wells and three-pitcher filters. A total of 640 individuals participated with 218 randomised to the dug well group, 216 to the three-pitcher group and 206 to a control group. Data were collected at baseline and at 1, 6 and 12 months after the intervention. Self reported compliance with dug wells remained below 20% during the entire 12 months of the study. The compliance with the three-pitcher filters decreased after 6 months and became similar to the compliance of the dug well group after 12 months. A substantial decrease in urinary arsenic metabolites occurred only among those who were compliant with dug wells and three-pitcher filter systems after 1 month of intervention as opposed to control participants. However, a persistent reduction in urinary arsenic concentrations was observed only among the dug well users after 12 months of intervention. Our results show that a functional dug well could be offered as a long-term alternative to tube wells, but use of this option is likely to be low, unless appropriate behavioural change measures are taken. Our study also demonstrates that arsenic removal technologies such as three-pitcher filters are an effective option as a short-term measure. The three-pitcher filters that are not adequately maintained are not an effective option for a year. These arsenic removal technologies may be even harmful in the long term if the resultant water quality is not properly monitored.

Introduction: COVID-19 is a major threat to human beings. Clinical characterization, rapid identification of cases and isolation are vital for containments of rapidly spreading disease. The objectives of the study were to evaluate the clinico pathologic profile of Covid 19 positive Bangladeshi patients and also to see their clinical outcome within defined period. Methods: This cohort study on 201 Bangladeshi cases was done in Combined Military Hospital, a tertiary level hospital in Dhaka, Bangladesh from April 2020 to May 2020. Total 201 COVID-19 cases were enrolled after getting the result positive for RT-PCR. After collection, data were analysed to show the characteristics of Covid 19 and their outcome after treatment. Results: Among 201 cases, 180 (90%) were male and 21 (10%) were female. The most prevalent affected age groups were 71 (35.5%) patients in 26-35 years age, 54 (27%) in 16- 25 years, 49 (24.5%) in 35-45 years. Mean age is 32.2±2. Among the total cases, 146 (73%) have positive history of contact, 37 (18.5%) have no history of any contact, 8 (4%) denied any contact with COVID-19 patients. Regarding clinical presentations, 67 (33.5%) patients presented with only one symptoms, 125 (62.5%) had multiple symptoms and 9 (4.5%) cases were asymptomatic. 154 (77%) patients presented with fever. Other presentations were cough 71 (35.5%), headache 27 (13.5%), myalgia 25 (12.5%), sore throat 25 (12.5%), malaise 15 (7.5%), respiratory distress 11 (5.5%). Respiratory system was the dominant domain of clinical presentation. Leukopenia was presented by 12 patients and 12 had lymphopenia. 18 patients had mild thrombocytopenia. Pulse oxymetry showed oxygen saturation below 88% in 12 cases. After oxygen therapy 7 cases were improved and 5 cases were shifted to Corona ICU as their saturation fell below 70. These 5 patients are categorised as severe disease, rest 196 patients were mild in nature. Conclusion: COVID 19 affects male more than female. Common symptoms are fever, cough, headache, myalgia, sore throat, malaise, respiratory distress. Respiratory system is the dominant domain of clinical presentation. ICU support was needed in 2.5 % cases and death rate was 1% which was associated with comorbidity of CKD. J Bangladesh Coll Phys Surg 2020; 38(0): 37-42

Using village-based rice processing plants in rural Bangladesh, this study considered how parboiling rice could be altered to reduce the content of the carcinogen inorganic arsenic. Parboiling is normally conducted with rough rice (i.e., where the husk is intact) that is soaked overnight at ambient temperatures, and then either steamed or boiled for ∼10 min, followed by drying. Across 13 geographically dispersed facilities it was found that a simple alteration parboiling wholegrain, instead of rough rice, decreased the inorganic arsenic content by 25% (P = 0.002) in the final polished grain. Also, parboiling wholegrain had little impact on milling quality of the final polished rice. The wholegrain parboiling approach caused statistically significant median enrichment of calcium, by 213%; and a reduction in potassium, by 40%; with all other nutrient elements tested being unaffected. Milled parboiled rough rice had an enriched inorganic arsenic compared to nonparboiled milled rice, but parboiling of wholegrain rice did not enrich inorganic arsenic in the final milled product. Polished rice produced from the parboiling of both rough and wholegrain rice significantly reduced cadmium compared to nonparboiled polished rice, by 25%. This study also identified that trimethylarsine oxide and tretramethylarsonium are widely elevated in the husk and bran of rice and, therefore, gives new insights into the biogeochemical cycling of arsenic in paddy ecosystems.

Bangladesh is a low HIV prevalence country, with buprenorphine injectors having the highest prevalence of HIV at 2.5% as of 1999. Using National HIV Behavioral Surveillance data, the impact of a needle exchange program (NEP) on sharing behavior among injecting drug users in two cities was measured. Results showed positive changes that varied with the different settings. Those who reported utilizing the NEP were compared with those who did not. Differences in Dhaka were significant for the average proportion of needles shared but not for the proportion of men who ever shared in the last week. In Rajshahi, where professional injectors were the norm, the impact of an NEP was greater and affected both the proportion of needles shared as well as the proportion of men never sharing. Behavioral surveillance methods have the potential to measure intervention impact through comparative analysis in certain settings.

Background Socio-demographics and comorbidities are involved in determining the severity and fatality in patients with COVID-19 suggested by studies in various countries, but study in Bangladesh is insufficient. Aims We designed the study to evaluate the association of sociodemographic and comorbidities with the prognosis of adverse health outcomes in patients with COVID-19 in Bangladesh. Methods A multivariate retrospective cohort study was conducted on data from 966 RT-PCR positive patients from eight divisions during December 13, 2020, to February 13, 2021. Variables included sociodemographic, comorbidities, symptoms, Charlson comorbidity index (CCI) and access to health facilities. Major outcome was fatality. Secondary outcomes included hospitalization, duration of hospital stay, requirement of mechanical ventilation and severity. Results Male (65.8%, 636 of 966) was predominant and mean age was 39.8 ± 12.6 years. Fever (79%), dry cough (55%), and loss of test/smell (51%) were frequent and 74% patients had >3 symptoms. Fatality was recorded in 10.5% patients. Comorbidities were found in 44% patients. Hypertension (21.5%) diabetes (14.6%), and cardiovascular diseases (11.3%) were most prevalent. Age >60 years (OR: 4.83, 95% CI: 2.45–6.49), and CCI >3 (OR: 5.48, 95% CI: 3.95–7.24) were predictors of hospitalizations. CCI >4 (aOR: 3.41, 95% CI: 2.57–6.09) was predictor of severity. Age >60 years (aOR: 3.77, 95% CI: 1.07–6.34), >3 symptoms (aOR: 2.14, 95% CI: 0.97–4.91) and CCI >3 vs. CCI <3 (aOR: 5.23, 95% CI: 3.77–8.09) were independently associated with fatality. Conclusions Increased age, >3 symptoms, increasing comorbidities, higher CCI were associated with increased hospitalization, severity and fatality in patients with COVID-19.

Melioidosis is an under-recognized fatal disease in humans, caused by the Gram-negative bacterium Burkholderia pseudomallei. Globally, more than 35,000 human melioidosis cases have been reported since 1911. Soil acts as the natural reservoir of B. pseudomallei. Humans may become infected by this pathogen through direct contact with contaminated soil and/or water. Melioidosis commonly occurs in patients with diabetes mellitus, who increase the occurrence of melioidosis in a population. We carried out a systematic review and meta-analysis to investigate to what extent diabetes mellitus affects the patient in getting melioidosis. We selected 39 articles for meta-analysis. This extensive review also provided the latest updates on the global distribution, clinical manifestation, preexisting underlying diseases, and risk factors of melioidosis. Diabetes mellitus was identified as the predominant predisposing factor for melioidosis in humans. The overall proportion of melioidosis cases having diabetes was 45.68% (95% CI: 44.8–46.57, p < 0.001). Patients with diabetes mellitus were three times more likely to develop melioidosis than patients with no diabetes (RR 3.40, 95% CI: 2.92–3.87, p < 0.001). The other potential risk factors included old age, exposure to soil and water, preexisting underlying diseases (chronic kidney disease, lung disease, heart disease, and thalassemia), and agricultural activities. Evidence-based clinical practice guidelines for melioidosis in patients with diabetes mellitus may be developed and shared with healthcare professionals of melioidosis endemic countries to reduce morbidity.