Background: This empirical study investigated the extent of malnutrition and factors associated with malnutrition amid children aged 0-59 months in Bangladesh using Bangladesh Demographic Health Survey data, 2014. Methods: To examine the extent of malnutrition among the children under five in Bangladesh, we used Height-forage, weight-for-height and weight-for-age. The association between the selected factors and nutritional status were assessed and logistic regression models were fitted for the three indicators. Results: 36.2% children are stunted, 15% are wasted and 33% are underweight. Prevalence of stunting or underweight is lowest amongst children aged 0-6 months and highest at the age of 18 to 23 months (stunted 48% and underweight 37%). Wasting is highest in 0-6months. Odd of being stunted is 30% to 50% higher in Sylhet division as compared to other divisions. Other key covariates for stunting are urban area (OR = 1.226, p-value = 0.004), no or primary education of father (OR = 1.318, p-value < 0.001), no or primary education of mother (OR = 1.22, p-value = 0.002), underweight mothers (OR = 1.76, p-value <0.001) and wealth index poorest (OR = 2.892, p-value < 0.001). Important covariates for wasting are mother's occupation as physical labor (OR = 1.208, p-value = 0.018), underweight mothers (OR = 2.145, p-value <0.001) and wealth index poorest (OR = 2.892, p-value < 0.001). For underweight main covariates are: no or primary education of father (OR = 1.182, p-value = 0.011), no or primary education of mother (OR = 1.214, p-value = 0.002), mothers in physical labor (OR = 1.289, p-value < 0.001), underweight mothers (OR = 2.625, p-value < 0.001) and wealth index poorest (OR = 2. 315, p-value < 0.001). Conclusions: In addition to the ongoing programs to improve child health, government may wish to design targeted nutrition intervention strategies to make sure that health information and health education are easily accessible for parents. The most vulnerable groups including the children from poorest socio-economic group or children in the urban area require special attention. Mothers should also be given focus while designing intervention programs.
Maternal health services have a potentially critical role in the improvement of reproductive health. The use of health services is related to the availability, quality and cost of the services, as well as to social structure, health beliefs and the personal characteristics of the users. The present paper examined the factors that influence the use of maternal health services for some selected pregnancy-related complications (e.g. prolonged labour, excessive bleeding, high fever/discharge and convulsions) in Bangladesh by using data from the Bangladesh Demographic Health Survey, 1999-2000. It was found that younger mothers were significantly less likely to seek professional healthcare at the time of birth. The odds for rural women seeking healthcare services from a doctor, nurse and/or midwife were half those of urban women. The strong influence of the mothers' education and parity on the utilisation of healthcare services is consistent with findings from other studies. The possession of assets emerged as an important predictor of seeking care from health professionals at the time of birth. Another factor, i.e. a husband's concern about pregnancy complications, showed a significant and positive impact on the utilisation of healthcare services, which is very important for rural women when they are dependent on their spouses. It was observed that the respondents living in urban areas, who had higher levels of education and lower parity, and more assets (used as a proxy for income), visited trained healthcare providers more often and were more likely to use healthcare facilities provided by trained personnel at the time of delivery. This is a reflection of the fact that, irrespective of their needs, only people from higher economic or educational groups can afford to seek healthcare from trained personnel in Bangladesh. In other words, predisposing and enabling factors appear to have a strong association with women's healthcare utilisation during pregnancy.
Background: To develop an effective countermeasure and determine our susceptibilities to the outbreak of COVID-19 is challenging for a densely populated developing country like Bangladesh and a systematic review of the disease on a continuous basis is necessary.Methods: Publicly available and globally acclaimed datasets (4 March 2020–30 September 2020) from IEDCR, Bangladesh, JHU, and ECDC database are used for this study. Visual exploratory data analysis is used and we fitted a polynomial model for the number of deaths. A comparison of Bangladesh scenario over different time points as well as with global perspectives is made.Results: In Bangladesh, the number of active cases had decreased, after reaching a peak, with a constant pattern of death rate at from July to the end of September, 2020. Seventy-one percent of the cases and 77% of the deceased were males. People aged between 21 and 40 years were most vulnerable to the coronavirus and most of the fatalities (51.49%) were in the 60+ population. A strong positive correlation (0.93) between the number of tests and confirmed cases and a constant incidence rate (around 21%) from June 1 to August 31, 2020 was observed. The case fatality ratio was between 1 and 2. The number of cases and the number of deaths in Bangladesh were much lower compared to other countries.Conclusions: This study will help to understand the patterns of spread and transition in Bangladesh, possible measures, effectiveness of the preparedness, implementation gaps, and their consequences to gather vital information and prevent future pandemics.
Background Neonatal cholestasis (NC) is a major cause of morbidity and mortality in young infants. This study examines the etiology of NC and its outcome during 2 years of follow-up at a tertiary referral center in Bangladesh. Results Out of 80 cholestatic infants, 60% had intrahepatic cholestasis with a mean age of onset of 12.4±2.8 days and a mean age of admission of 82.4±29.0 days. The remaining 40% were extrahepatic with a mean age of onset of 6.7±2.3 days and a mean age of admission of 94.6±50.4 days. Biliary atresia (BA), idiopathic neonatal hepatitis (INH), and TORCH (Toxoplasma, rubella, cytomegalovirus, and herpes simplex) infection except rubella were the most common causes. After receiving treatment, 46.2% of the cases improved, 23.8% deteriorated with morbidity, and 30% died. The majority of the children with INH, TORCH, choledochal cyst, hypothyroidism, galactosemia, and urinary tract infection (UTI) with sepsis were improved. Significant mortality was found in BA (56.6%), intrahepatic bile duct paucity (PIBD) (100%), and progressive familial intrahepatic cholestasis (PFIC) (100%) whereas the rest of BA (43.4%) live with persistent morbidity. Significant clinical improvement was observed in 37 (46.2%) cases of cholestasis evidenced by decreasing jaundice, change of color of urine from dark to normal color, change of stool color from pale to yellow, and gradual decrease in liver size from hepatomegaly state. In addition, decreasing median total bilirubin, direct bilirubin, alanine transaminase, gamma-glutamyl transferase, and alkaline phosphatase showed biochemical improvement at 2 years follow-up. The age of admission, etiology, and presence of ascites are the predictors of outcomes. Conclusion BA was the most common cause of extrahepatic while INH and TORCH infection were the most common cause of intrahepatic cholestasis. Majority of children with intrahepatic cholestasis improved but deteriorated with BA and genetic causes. Prompt referral and early diagnosis as well as the etiology of NC were the main determinants of the favorable outcome.
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