BackgroundBreastfeeding offers incredible health benefits to both child and mother. It is suggested by World Health Organization that an able mother should practice and maintain exclusive breastfeeding for first six months of her infant’s life. The objective of this study was to determine the prevalence and factors associated with exclusive breastfeeding for first six months of an infant’s life in Bangladesh.MethodsData was extracted from Bangladesh Demographic and Health Survey (BDHS-2014). BDHS-2014 collected data from 17,863 Bangladeshi married women in reproductive age from the entire country using two stages stratified cluster sampling. We included only mothers having at least one child currently aged not less than 6 months. Mothers who did not have child to breastfeed, some incomplete information and missing samples were excluded from the data set and consequently 3541 mothers were considered in the present study. Chi-square test, binary logistic regression models were used in this study.ResultsThe prevalence of exclusive breastfeeding (EBF) for first six months of an infant’s life in Bangladesh was 35.90%. Binary multivariable logistic regression model demonstrated that relatively less educated mothers were more likely to exclusively breastfeed their children than higher educated mothers.(AOR = 2.28, 95% CI: 1.05–4.93; p < 0.05). Housewife mothers were more likely to be EBF than their counterparts (AOR = 1.20, 95% CI: 1.02–1.42; p < 0.05). Higher rate of EBF was especially found among mothers who were living in Sylhet division, within 35–49 years old, and had access to mass media, had more than 4 children, had delivered at home and non-caesarean delivery, took breastfeeding counseling, antenatal and postnatal cares.ConclusionsStepwise regression model exhibited that most of the important predictors were modifiable factors for exclusive breastfeeding. Authorities should provide basic education on EBF to educated mothers, and organize more general campaign on EBF.

BackgroundEarly childbearing influences women’s health. This study aims to examine the effects of socio-demographic factors on nutritional status of early childbearing mothers in Bangladesh based on Body Mass Index (BMI) as the indicator.MethodsData was extracted from Bangladesh Demographic and Health Survey (BDHS)-2011. The survey was performed on 17,842 married women aged 15–49. We focused on early childbearing mothers (age ≤ 24, and who had delivered their first child ≤ 20). Mothers who were underweight (BMI ≤ 18.5 kg/m2) would be further classified into various grades of chronic energy deficiency (CED): mild (17.0 ≤ BMI < 18.5 kg/m2), moderate (16.0 ≤ BMI <17.0 kg/m2), and severe (BMI < 16.0 kg/m2). Multiple logistic regression model was used to examine the effect of socio-demographic factors on nutritional status.ResultsMean age of the mothers was 20.49 ± 2.37 years (ranged 15–24 years). The prevalence of underweight among early childbearing mothers was 32.1 % (urban 25 % and rural 35.1 %). Most of the underweight mothers had mild (62.2 %) CED, while the remaining had either moderate (25.9 %) or severe (11.9 %) CED. Multiple logistic regression analysis demonstrated that young mothers from rural areas, poor families, and those who were illiterate or with low level of education, working, and married to unemployed husband were at higher risk for being underweight. Young mothers who had non-caesarean delivered, delivered at home, or married at early age and had more than two children were also at higher risk for being underweight.ConclusionsThe prevalence of underweight among early childbearing mothers in Bangladesh is very high (32.1 %), associated with the still common practice of teenage marriage. Education level, wealth index, occupation, place of residence, age at first marriage and parity were important predictors for their nutritional status. The government and non-government organizations should take initiatives to reduce the prevalence of underweight mothers in Bangladesh.

Background Infections result from invasions of an organism into body tissues leading to diseases and complications that might eventually lead to death. Inappropriate use of antimicrobials has led to development of antimicrobial resistance (AMR) which has been associated with increased mortality, morbidity and health costs. Antimicrobial stewardship (AMS) programs are designed to ensure appropriate selections of an effective antimicrobial drugs and optimizing antibiotic use to minimize antibiotic resistance by implementing certain policies, strategies and guidelines. The aim of this study was to investigate practitioners’ perceptions regarding AMS implementation and to identify challenges and facilitators of these programs execution. Methods Cross-sectional study among health care providers in Eastern province of Saudi Arabia Hospitals. The data was collected using a survey including questions about demographic data and information about clinicians’ (physicians, pharmacists and nurses) previous experience with AMS and prescribing of antibiotics, the level of knowledge and attitudes regarding AMS programs’ implementation. Results More than 50% of clinicians (N = 184) reported lack of awareness of AMS programs and their components, whereas 71.2% do not have previous AMS experience. The majority of clinicians (72.3%) noticed increasing number of AMR infections over the past 5 years and (69.6%) were involved in care of patients with an antibiotic-resistant infection. Around 77.2% of respondents reported that formulary management can be helpful for AMS practice and majority of respondents (79.9%) reported that the availability of pathogens and antimicrobial susceptibility testing can be helpful for AMS. Major barriers to AMS implementation identified were lack of internal policy/guidelines and specialized AMS information resources. Lack of administrative awareness about AMS programs; lack of personnel, time limitation, limited training opportunities, lack of confidence, financial issue or limited funding and lack of specialized AMS information resources were also reported 65.8%, 62.5%, 60.9%, 73.9%, 50%, 54.3 and 74.5%, respectively. Conclusion Our study identified comprehensive education and training needs for health care providers about AMS programs. Furthermore, it appears that internal policy and guidelines need revision to ensure that the health care providers work consistently with AMS. Future research must focus on the benefit of implementing AMS as many hospitals are not implementing AMS as revealed by the clinicians. We recommend policy makers and concerned health authorities to consider the study findings into account to optimize AMS implementation.

Objective: The study aimed to evaluate the association between disease knowledge and medication adherence in patients with type 2 diabetes mellitus. Methods:A cross-sectional study was conducted for three months, in patients with type 2 diabetes who visited three community pharmacies located in Khobar, Saudi Arabia. Patients' disease knowledge and their adherence to medications were documented using Arabic versions of the Michigan Diabetes Knowledge Test and the General Medication Adherence Scale respectively. Data were analyzed through SPSS version 23. Chi-square test was used to report association of demographics with adherence. Spearman's rank correlation was employed to report the relationship among Hb A1c values, disease knowledge and adherence. Logistic regression model was utilized to report the determinants of medication adherence and their corresponding adjusted odds ratio. Study was approved by concerned ethical committee (IRB-UGS-2019-05-001).Results: A total of 318 patients consented to participate in the study. Mean Hb A1c value was 8.1%. A third of patients (N = 105, 33%) had high adherence and half of patients (N = 162, 50.9%) had disease knowledge between 51% -75%. A significantly weak-tomoderate and positive correlation (r = 0.221, p < 0.01) between medication adherence and disease knowledge was reported. Patients with >50% correct answers in the diabetes knowledge test questionnaire were more likely to be adherent to their medications (AOR 4.46, p < 0.01).Conclusion: Disease knowledge in most patients was average and half of patients had high-to-good adherence. Patients with better knowledge were 4 to 5 times more likely to have high adherence. This highlights the importance of patient education and awareness regarding medication adherence in managing diabetes.

Objective: Patient satisfaction is an indicator for quality of healthcare service and is sometimes linked to patients' willingness to pay. Willingness to pay is an economic method for estimating patient's inclination for a service in monetary terms. This study assessed satisfaction of patients from pharmacist counseling service and estimated their willing to pay for the same. Methods: A month-long survey was conducted in community and hospital pharmacies located in Khobar, Dammam, and Qatif cities of Saudi Arabia, using Arabic version of Patient Satisfaction Feedback (PSF) questionnaire that measured satisfaction with counseling as well as willingness-to-pay. Convenient sampling method was used, and sample size was calculated based on power analysis. Data was analyzed through SPSS version 23. Chi-square (c 2) test and logistic regression analyses were conducted to report associations between variables and, determinants of satisfaction as well as willingness to pay respectively. The study was approved by concerned ethical committee (IRB-2019-05-020). Results: Patients (n = 531) with previous counseling experience were more likely to be satisfied [adjusted odds ratio (AOR) 5.2, p < 0.05]. Patients were more willing to pay if, they had an income above SAR 10,000 i.e., USD 2666.5 (AOR 1.78, p < 0.05), were satisfied with counseling time duration (AOR 4.5) and, were able to get counseling without difficulty (AOR 2.1, p < 0.05). Patients were more likely to be satisfied and were willing to pay if, they received required knowledge/information completely (AOR 2.5, 3.7, and p < 0.05) and found pharmacist helpful (AOR 1, 4.5, and p < 0.05). Most patients (43.9%) were satisfied with pharmacist counseling and average satisfaction rating was 7.87 ± 1.99/10.

Eating disorder is highly prevalent among university students worldwide. However, in Malaysia, studies on eating disorder is scanty and were mostly conducted among medical students. A stratified cluster sampling was used to recruit participants in a university based in Kuala Lumpur. This cross-sectional study was conducted among 1017/1132 students (response rate: 89.8%). The questionnaires administered was a combination of the Eating Attitude Test-26 and items related to perceived body weight, body mass index, trying to weight loss, tobacco use, posttraumatic stress disorder, and depression. Descriptive analyses were performed to provide background information of at-risk students by gender. Multiple logistic regressions were used to identify associated factors of eating disorder. The results showed that 13.9% of the university students were at risk of eating disorder. Students who were trying to lose weight and had posttraumatic stress disorder predicted eating disorder. Hence, eating disorder among university students merits attention and requires implementations of public health policies.

BackgroundRisk factors of acute malnutrition in Bangladesh are well documented. However, due to regional variations in prevalence of acute malnutrition, it is important to explore the risk factors specific to the region, for designing and implementing public health interventions.MethodsA mixed-method matched case-control study was conducted in the Kurigram district of Bangladesh. Community perspectives on causes of acute malnutrition were collected from 75 purposively selected caregivers through interviews, focus group discussions and informal group discussions. The data was analysed manually by coding and sub-coding according to different themes. Caregivers of 52 malnourished and 95 well-nourished children matched in age group and sex with the malnourished children, were interviewed using a structured questionnaire. The conditional logistic regression analysis was performed to identify the risk factors of acute malnutrition.ResultsCaregivers perceived inappropriate feeding practice as a major cause of acute malnutrition whereas birth order (first child OR 0.3, 95% CI 0.09, 0.96), number of family members (OR 1.30, 95% CI 1.02, 1.65), illness in the last 2 weeks (OR 3.08, 95% CI 1.13, 8.42) and access to hygienic latrine (OR 0.25, 95% CI 0.07, 0.82) were also associated with acute malnutrition among children under five in Kurigram.ConclusionsCommunity awareness on infant feeding practices and family planning, management of childhood illness and access to hygienic latrine facilities should be prioritised to prevent acute malnutrition in the northern districts.

Objective The study aimed to document the quality of work life (QWL) among healthcare staff of intensive care unit (ICU) and emergency unit during COVID-19 outbreak using WHOQoL-BREF. Methods A multicenter cross-sectional study was conducted for two months (May – June 2020) among healthcare staff working in intensive care units (ICUs) and emergency units of the hospitals under National Guard Health Authority (NGHA) across five cities of Saudi Arabia. The study used the WHOQoL-BREF instrument to document the QWL through an electronic institutional survey. The data was analyzed through IBM SPSS version 23. The study was approved by an ethics committee. Results A total of 290 healthcare professionals responded to the survey. The mean overall quality of life score was 3.37 ± 0.97, general health = 3.66 ± 0.88, domains, i.e., physical = 11.67 ± 2.16, psychological = 13.08 ± 2.14, social = 13.22 ± 3.31 and environment = 12.38 ± 2.59. Respondents aged > 40 years, male gender, married status, being a physician and, having a work experience > 15 years and no extra working hours, had higher mean scores for several domains of Quality of life (QoL), overall QoL and general health (p < 0.05). Conclusion The QWL among healthcare staff during COVID-19 pandemic was low. Demographic factors were mainly the determinants for a higher QWL while extra working hours was determinant of lower QWL. Despite the pandemic, no COVID-19 related variable affected the work life of healthcare staff.