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.

BackgroundAlthough Bangladesh has achieved tremendous success in health care over the last four decades, it still lagged behind in the areas of maternal and child malnutrition and primary health care (PHC). To increase access to PHC, the Bangladesh government established approximately 18,000 community clinics (CCs). The purpose of this study was to examine the associations of socioeconomic determinants of women aged 12–49 years with the CCs awareness and visitation.MethodsWe analyzed secondary data provided by Bangladesh Demographic and Health Survey-2011. A two-stage cluster sampling was used to collect the data. A total of 18,222 ever married women aged 12–49 years were identified from selected households and 17,842 were interviewed. The main outcome measures of our study were awareness and visitation of CCs. Bivariate logistic regression was used to calculate odds ratio (OR) and 95 % confidence interval (CI) to examine the associations between the awareness and visiting CCs with socioeconomic determinants.ResultsLow prevalence of awareness about CC (18 %) was observed among studied women and only 17 % of them visited CCs. Significant associations (P < 0.05) with CCs awareness and visitation were observed among aged 20–29 years (adjusted OR = 1.18; 95 % CI = 1.03–1.35 and adjusted OR = 1.49; 95 % CI = 1.05–2.11), primary education (adjusted OR = 1.20; 95 % CI = 1.08–1.34 and adjusted OR = 1.37; 95 % CI = 1.05–1.78), and poorest family (adjusted OR = 1.21; 95 % CI = 1.03–1.42 and adjusted OR = 2.36; 95 % CI = 1.56–3.55, respectively), after controlling potential confounders.ConclusionsAwareness and visitation of CCs were found to be positively associated with lower economic conditions, young age, and primary education. Awareness and access to CCs might be increased through community activities that involve health care workers. The government should also lower barriers to PHC access through CCs by providing adequate logistics, such as human resources and equipment.

Introduction: This study aimed to assess the knowledge and practice of health care workers (HCWs) towards universal precautions (UPs) and to look into any associations between knowledge and practice. Methodology: A cross-sectional study was undertaken between August and October 2012, involving 300 HCWs from four national public hospitals in Kabul, Afghanistan. A self-administered questionnaire assessing the knowledge and practice of UPs was used. Results: Among the 300 respondents, the mean knowledge score was 5.2 with a standard deviation (SD) of 1.5. On the practice score, the mean was 8.7 (SD = 2.2). A total of 90.6% and 70.8% of HCWs believed that UPs were necessary in contact with urine/feces and tears, respectively, although UPs are not necessary in these cases. On the other hand, 57.8% reported that they always recapped the needle after giving an injection, and 31.8% did not always change gloves in between patients. There were no associations between the knowledge and self-reported practice of UPs. Conclusions: The HCWs in Kabul had inadequate knowledge and poor practice of UPs. Training for HCWs is needed to encourage them to adhere to practice based on improved knowledge.

BackgroundSeveral studies in the past have reported inconclusive evidences on association of smoking and migraine. Nevertheless, no study so far reported association of smokeless tobacco with migraine. The objective of this study was to examine the association of smoked and smokeless tobacco use with migraine.MethodsA hospital-based case–control study was conducted at the neurology outpatient department of a tertiary care hospital in Dhaka, Bangladesh. We enrolled 138 migraine cases diagnosed during March-September 2010 in neurology outpatient department, and 276 gender and age matched healthy controls from among their attendants. Diagnosis of migraine was based on the International Headache Society criteria. Use of smokeless tobacco and smoking (cigarette/bidi/hukka) were determined by an interviewer administered questionnaire.ResultsAmong the cases, 52.9% were overall tobacco users; 24.6% were only smokers, 15.9% only smokeless tobacco users and 12.3% used both. The respective figures among controls were 14.5%, 7.2%, 6.9% and 0.4% (P <0.001 for all). The conditional logistic regression analysis found that migraine had higher odds of exposure to smoked tobacco use, smokeless tobacco use, and both compared to control after adjusting for confounding variables (alcohol drinking, insufficient sleep, mental stress, and number of family members); adjusted odds ratio (aOR) was 6.6 (95% confidence interval [CI] = 2.2-19.6, P = 0.001), 5.8 (95%CI = 1.9-17.4, P = 0.001), and 54.2 (95%CI = 4.3-684.4, P = 0.002), respectively. The aOR of cigarette/bidi/hukka smoking for different doses was 5.5 (95%CI = 1.2-24.8, P = 0.027) for 1–5 times per day, 6.3 (95%CI = 1.8-21.2, P = 0.003) for 6–10 times per day, and 6.7 (95%CI = 1.9-23.2, P = 0.003) for >10 times per day relative to non users.ConclusionsBoth smoked and smokeless tobaccos were found to be associated with migraine. There is a need to incorporate smokeless tobacco along with smoked tobacco into the anti-tobacco awareness programs to reduce the burden of migraine in Bangladesh.

BackgroundThe rabies incidence and number of dogs in Cambodia are much higher than in nearby countries. Knowledge and behaviors which are related to rabies and/or dogs are considered to be contributing factors for rabies infection control in the community; however, such information in rural Cambodia is limited. This cross-sectional study aimed to assess knowledge and experiences related to rabies as well as dog-related behaviors among people in Siem Reap Province, and to identify the specific factors associated with adequate knowledge.MethodsFour-stage sampling was employed to identify villages and households. In total, 360 respondents were interviewed using a structured questionnaire. Data were descriptively summarized and logistic regression was performed to estimate odds ratios of adequate knowledge related to rabies for respondents’ characteristics.ResultsOnly 9.7% of respondents had adequate knowledge of rabies. Of the respondents, 86.9 and 18.3% had experienced hearing of or seeing a suspected rabid dog and a suspected rabid human, respectively. More than two-thirds (70.6%) of households had at least one dog, and the ratio of dog to human populations was 1: 2.8. Only a few owners had vaccinated dogs, used a cage, or tied up their dog. Visiting a health center was the first choice of treatment for respondents when bitten by a dog. However, post-exposure prophylaxis (PEP) was not commonly expected as a treatment choice by respondents. Those with higher education were more likely to have adequate knowledge than those with no education (adjusted OR 12.34, 95% CI 2.64–57.99, p < 0.01). Farmers and non-poor families were also less likely to have adequate knowledge than those of other professions and poor families (adjusted OR 0.30, 95% CI 0.12–0.76, p = 0.01, and adjusted OR 0.13, 95% CI 0.04–0.47, p < 0.01, respectively).ConclusionsHigh dog population, inadequate knowledge of rabies, low recognition of human rabies, and poor dog management were found to be serious challenges for controlling rabies. Health education related to rabies should be introduced, targeting farmers in particular who easily encounter stray dogs but have little knowledge of rabies risk factors and signs. At the same time, PEP delivery and dog management should be improved.