The study shows significant association between biomass fuel use and respiratory involvement among rural women in Bangladesh, although the potential confounding of urban/rural residency could not be ruled out in the analysis. The use of smoke-free stoves and adequate ventilation along with health education to the rural population to increase awareness about the health effects of indoor biomass fuel use might have roles to prevent these involvements.

Despite success in tuberculosis control, multi-drug resistant tuberculosis in Bangladesh is increasing and currently multi-drug-resistant tuberculosis rate is 3.6% in new cases and 19% in re-treatment cases. This study focused on determination of multi-drug-resistant tuberculosis which is warranted for effective prevention strategy. An unmatched case control study was conducted in 2010. Purposively recruited 136 culture-proved multi-drug-resistant- tuberculosis cases and 152 cured tuberculosis patients were interviewed. Associations between exposure and outcome variables were initially tested by chi2-test, t-test. A result was considered significant at p value < 0.05. Effects of exposure variables were also assessed after adjusting for other variables by binary logistic regression models. Crude and adjusted Odds Ratio with 95% Confidence Interval was computed. Younger age (p = 0.008) and, peri-urban locality (p = 0.002) were associated with multi-drug-resistant tuberculosis. History of contact (p < 0.001) and tuberculosis in the past (p < 0.001) were four and eight times, respectively, more likely to influence multi-drug-resistant tuberculosis. Regularity [Odds Ratio 0.05; 95% Confidence Interval (0.01 to 0.39)] and always observation of treatment [Odds Ratio 0.25; 95% Confidence Interval (0.10 to 0.61)], sputum conversion [Odds Ratio 0.02; 95% Confidence Interval (0.01 to 0.08)] negatively associated with multi-drug-resistant tuberculosis. Gender and socio-economic status did not show any influence. Treatment course and sputum conversion was the best predictors. Like other developing countries adequacy of treatment is the most important exposure variable. Strengthening of control activities might contribute in preventing development of resistance in tuberculosis patients.

Introduction Chronic Respiratory Diseases (CRDs) are some of the most prevailing non-communicable diseases (NCDs) worldwide and cause three times higher morbidity and mortality in low- and middle-income countries (LMIC) than in developed nations. In Bangladesh, there is a dearth of data about the quality of CRD management in health facilities. This study aims to describe CRD service availability and readiness at all tiers of health facilities using the World Health Organization’s (WHO) Service Availability and Readiness Assessment (SARA) tool. Methods A cross-sectional study was conducted from December 2017 to June 2018 in a total of 262 health facilities in Bangladesh using the WHO SARA Standard Tool. Surveys were conducted with facility management personnel by trained data collectors using REDCap software. Descriptive statistics for the availability of CRD services were calculated. Composite scores for facility readiness (Readiness Index ‘RI’) were created which included four domains: staff and guideline, basic equipment, diagnostic capacity, and essential medicines. RI was calculated for each domain as the mean score of items expressed as a percentage. Indices were compared to a cutoff of70% which means that a facility index above 70% is considered ‘ready’ to manage CRDs at that level. Data analysis was conducted using SPSS Vr 21.0. Results It was found, tertiary hospitals were the only hospitals that surpassed the readiness index cutoff of 70%, indicating that they had adequate capacity and were ready to manage CRDs (RI 78.3%). The mean readiness scores for the other hospital tiers in descending order were District Hospitals (DH): 40.6%, Upazila Health Complexes (UHC): 33.3% and Private NGOs: 39.5%). Conclusion Only tertiary care hospitals, constituting 3.1% of sampled health facilities, were found ready to manage CRD. Inadequate and unequal supplies of medicine as well as a lack of trained staff, guidelines on the diagnosis and treatment of CRDs, equipment, and diagnostic facilities contributed to low readiness index scores in all other tiers of health facilities.

Age, education, father's occupation, crowding, kitchen location and intimate contact with a TB case were significantly associated with smear-positive childhood TB.

Background WHO estimated 20% of adolescents (10–19 years) have mental health problems. We examined the prevalence and associated risk predictors of overweight/obesity and perceived stress using eating behaviors and physical activity among school-and-college-going urban adolescents in Bangladesh. Methods A cross-sectional study with a multistage sampling technique was employed to select 4609 adolescent students, aged 13–19 years, from all eight Bangladesh divisions during January–June 2019. Data were collected using a self-administered questionnaire containing Turconi Physical Activity Questionnaire (PAQ), Adolescent Stress Questionnaire (ASQ), Dutch Eating Behavior Questionnaire (DEBQ), and Anthropometric measurements. Logistic regression and different association measures assessed relationships among adolescent characteristics. Results The major 61.5% of adolescents were in moderate-to-extremely-severe levels of stress, 28.2% were overweight/obese, only 2.7% had a very active lifestyle, and 30.5% had a sedentary lifestyle. Perceived stress was positively and significantly correlated with eating behaviors and body mass index, whereas physical activity was significantly associated with the prevalence of overweight/obesity and high stress. The prevalence of overweight/obesity (53.8%) and high stress (52.5%) was higher in males. Adolescents’ obesity was 2.212 times more likely who had a sedentary lifestyle (95% CI 1.377–3.552), 1.13 times more likely for those who had experienced stress due to school/leisure conflict (95% CI 1.051–1.222), and 1.634 times more likely for those who were tempted by restrained eating behavior (95% CI 1.495–1.786). Conclusion Stress on secondary school-and-college-going students needs to be recognized, and strategies need to be developed to improve adolescents’ mental health.

Childhood tuberculosis is one of the major causes of childhood mortality and morbidity though much neglected within our National Tuberculosis Control Program. This case control study was carried out to identify the risk factors for tuberculosis among children. Cases (n=95) and controls (n=94) were selected from Directly Observed Treatment Short Course (DOTS) centers of four upazillas of Dhaka and Gazipur districts. Cases were childhood tuberculosis patient, who were test positive by sputum microscopy from January to May, 2011 and controls were children who visited DOTS laboratory suspecting tuberculosis infection but were sputum negative. Both cases and controls were selected from the sputum examination registers and were traced at home for exposure data. The study showed more girls were infected than boys. Several socio demographic and environmental factors were found to be associated with the development of childhood tuberculosis. Logistic regression model was constructed to find out the important predictors which revealed age, education of the respondents, indoor environment and contact pattern were significantly associated with childhood tuberculosis. Children more than 14 years of age had 6.25 times higher risk of developing childhood tuberculosis; (Odds ratio=6.25; 95% CI for OR=2.00 to 19.55), Children completed primary education had 3.12 times lower risk of developing childhood tuberculosis, (Odds ratio=.32; 95% CI for OR=.10 to 1.00). Those who resided in better in-house environment had 4.35 times lower risk of developing childhood tuberculosis (Odds ratio=.23; 95% CI for OR=.06 to .95) and children came in contact with source tuberculosis cases who were their relatives or neighbors were 5.26 times lower risk of developing childhood tuberculosis than being in contact with family members with TB (Odds ratio=.19; 95% CI for OR=.07 to .49). Contact Screening should be incorporated in National TB program for early detection and effective treatment of tuberculosis. Improvement of indoor environment and ventilation status of the bedroom might reduce the risk of developing childhood tuberculosis.

No abstract

Household food security is an emerging public health issue and the rural elderly people are one of the most vulnerable groups for the household food security. This cross-sectional study was conducted in Barobaria union of Gofargaon upazila of Mymensingh district to assess the nutritional status of rural elderly (?60 years) in relation to the household food security. A total of 118 purposively selected elderly were interviewed and measured for height and weight following a standard protocol. The mean (SD) age of the respondents was 68.6 (7.3) years and gender participation was equally represented. Majority (68.6%) of the respondents was illiterate and 92% were Muslims. Mean family size and monthly family income was estimated to be 5.5 and Taka 6106, respectively and 70% of the rural elderly were found to be dependent on their family members as they were not involved in income generation and most of the respondents were the members of joint family. Only about 29% of the total elderly were at the highest quarter of food security. Illiteracy, members of single family and larger family were found to be significantly associated with lower level of household food security (p < 0.05). Although age, sex, personal income and occupational category had no significant association, the total family income was significantly associated with household food security. Among the respondents 56% were underweight including 13% with severe chronic energy deficiency. Only 5.9% were overweight. Illiterates were three times more likely to be underweight than literates (OR 2.95 with 95% CI 1.32, 6.59). Smoking, lower family income, poor housing, single family, irregularity in treatment were significantly associated with underweight. A significant difference was found between mean body mass index of different household food security level (F =3.22, p < 0.05). There was gradual increase of mean body mass index with the improved status of food security level. Policy makers, therefore, need to consider programs that empower people to solve the problem of food insecurity and to improve the nutritional status of rural elderly people. DOI: http://dx.doi.org/10.3329/bmj.v40i3.18649 Bangladesh Medical Journal 2011 Vol.40(3):8-11