ObjectivesTo support the Bangladesh National Kala-azar Elimination Programme (NKEP), we investigated the feasibility of using trained village volunteers for detecting post-kala-azar dermal leishmaniasis (PKDL) cases, using polymerase chain reaction (PCR) for confirmation of diagnosis and treatment compliance by PKDL patients in Kanthal union of Trishal sub-district, Mymensingh, Bangladesh.MethodsIn this cross-sectional study, Field Research Assistants (FRAs) conducted census in the study area, and the research team trained village volunteers on how to look for PKDL suspects. The trained village volunteers (TVVs) visited each household in the study area for PKDL suspects and referred the suspected PKDL cases to the study clinic. The suspected cases underwent physical examinations by a qualified doctor and rK39 strip testing by the FRAs and, if positive, slit skin examination (SSE), culture, and PCR of skin specimens and peripheral buffy coat were done. Those with evidence of Leishmania donovani (LD) were referred for treatment. All the cases were followed for one year.ResultsThe total population of the study area was 29,226 from 6,566 households. The TVVs referred 52 PKDL suspects. Probable PKDL was diagnosed in 18 of the 52 PKDL suspect cases, and PKDL was confirmed in 9 of the 18 probable PKDL cases. The prevalence of probable PKDL was 6.2 per 10,000 people in the study area. Thirteen PKDL suspects self-reported from outside the study area, and probable and confirmed PKDL was diagnosed in 10 of the 13 suspects and in 5 of 10 probable PKDL cases respectively. All probable PKDL cases had hypopigmented macules. The median time for PKDL development was 36 months (IQR, 24–48). Evidence of the LD parasite was documented by SSE and PCR in 3.6% and 64.3% of the cases, respectively. PCR positivity was associated with gender and severity of disease. Those who were untreated had an increased risk (odds ratio = 3.33, 95%CI 1.29–8.59) of having persistent skin lesions compared to those who were treated. Patients' treatment-seeking behavior and treatment compliance were poor.ConclusionImproved detection of PKDL cases by TVVs is feasible and useful. The NKEP should promote PCR for the diagnosis of PKDL and should find ways for improving treatment compliance by patients.

This retrospective study was conducted on 145 postmortem cases of hanging victims at government medical college morgue over a period of two years. The objective of this study was to find out the pattern of hanging cases as a proper method of suicide and to evaluate the present situation of hanging in this capital city. Out of 145 cases, 41% were male and 51% were married. One hundred and one victims hanged themselves at night, while 44 at day time. In 72 victims, stomachs were found empty. Most (97%) of the bodies were recovered from inside the living rooms. Ninety seven percent had complete suspension. One hundred and forty two (98%) cases had ligature mark in neck. Thirty nine cases had fracture of hyoid bones, 27 cases had fracture of thyroid cartilages. Most of the victims (45%) were from the age group 20-30 years. Dopatta (orna) was the commonest (35%) ligature material. Quarrel among husband and wife was the commonest (31%) cause of suicidal hanging. Hanging was observed as a frequently used method of suicide in Bangladesh.

ObjectiveTo estimate the prevalence and identify correlates of smokeless tobacco consumption among married rural women with a history of at least one pregnancy in Madaripur, Bangladesh.Materials and MethodsWe conducted a cross-sectional survey using an interviewer administered, pre-tested, semi-structured questionnaire. All women living in the study area, aged 18 years and above with at least one pregnancy in their lifetime, who were on the electoral roll and agreed to participate were included in the study. Information on socio-demographic characteristics and smokeless tobacco consumption was collected. Smokeless tobacco consumption was categorized as ‘Current’, ‘Ever but not current’ and ‘Never’. Associations between smokeless tobacco consumption and the explanatory variables were estimated using simple and multiple binary logistic regression.Results8074 women participated (response rate 99.9%). The prevalence of ‘Current consumption’, ‘Ever consumption but not current’, and ‘Never consumption’ was 25%, 44% and 31%, respectively. The mean age at first use was 31.5 years. 87% of current consumers reported using either Shadapata or Hakimpuree Jarda. Current consumption was associated with age, level of education, religion, occupation, being an income earner, marital status, and age at first use of smokeless tobacco. After adjustment for demographic variables, current consumption was associated with being over 25 years of age, a lower level of education, being an income earner, being Muslim, and being divorced, separated or widowed.ConclusionThe prevalence of smokeless tobacco consumption is high among rural women in Bangladesh and the age of onset is considerably older than that for smoking. Smokeless tobacco consumption is likely to be producing a considerable burden of non-communicable disease in Bangladesh. Smokeless tobacco control strategies should be implemented.

Objective: To determine the prevalence of anaemia in children of 6 to 59 months old in Narayanganj, Bangladesh to help policy makers to formulate health and nutrition policies in national level. Methods: In 2009, a representative sample of 767 young children (age ranging from 6 to 59 months) had their haemoglobin concentration measured. The sampling process was in three stages: at first, 5 Upazila hospitals, 1 District hospital and a 200 bedded specialized hospital were randomly selected to represent the whole district and its 5 geographic urban and rural areas. Next, using census lists, 15 census sectors were randomly chosen. Finally, 767 children of 6-59 months were selected. Blood was collected by vein puncture and haemoglobin concentration was measured with a haemoglobin meter. Data were analysed to determine prevalence of anaemia. Results: The prevalence of anemia among the children of 5-59 months old was 40.9% for the district as a whole. Prevalence in the municipal region of Narayanganj was 40.9%. The rural areas had the highest prevalence of 66.9%. Prevalence was almost two times higher in children of 6-23 months in comparison to children of 24-59 months i.e. 61.8% and 31.0% respectively. The mean haemoglobin concentrations in the younger and older age groups were 10.4(±1.5) g/ dl and 11.4(±1.4) g/dl respectively. There is no difference found between the sexes. Conclusion: This is the first assessment of anaemia prevalence among young children in Narayangaj, Bangladesh. As there is very high prevalence of anaemia among the children studied in Fatulla upazila, especially those in the age group 6-23 months, public health interventions are needed here most. Key words: Anaemia; iron deficiency anaemia; haemoglobin; child heath; Bangladesh. DOI: 10.3329/jdmc.v19i2.7084J Dhaka Med Coll. 2010; 19(2) : 126-130

Purpose-Changes in climate may have both beneficial and harmful effects on crop yields. However, the effects will be more in countries whose economy depends on agriculture. This study aims to measure the economic impacts of climate change on crop farming in Bangladesh. Design/methodology/approach-A Ricardian model was used to estimate the relationship between net crop income and climate variables. Historical climate data and farm household level data from all climatic zones of Bangladesh were collected for this purpose. A regression model was then developed of net crop

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Women’s empowerment has a great influence on health, nutrition, education, and the overall well-being of societies as well as of the children and households. This study investigates the effect of women’s empowerment on poverty reduction and focuses on household deprivation, in terms of education, health, and standard of living. Primary data was collected from 914 married women from rural areas of Bangladesh using a well-structured questionnaire and a random sampling technique. Descriptive statistics, logistic regression, and ordinary least squares models were used in this study. The results indicate that increased women’s access to education, asset ownership, decision-making power on children’s health and education, and access to medical facilities, have caused a significant decline in income poverty and multidimensional poverty. However, gender violence, taking resources against women’s will, and preventing women from working outside, have caused a considerable decline in per capita income and an increase in income poverty and multidimensional poverty. Overall, it is found that women’s empowerment has a great impact on the reduction of income poverty and multidimensional poverty in society. The findings of the study can assist and guide policymakers to initiate appropriate strategies for women’s empowerment to reducing poverty in Bangladesh while making progress towards other social and developmental goals.

Context: In Bangladesh, typhoid fever is a round the year problem which sometimes take epidemic proportions. The reason behind such occurrences are unsafe water supply, defective sewage system and unhygienic food handling practice. This study was designed to find out the prevalence of typhoid fever and related factors like sanitation facilities and food practice among the children of low income group people living in Kamrangir char and its adjacent areas in the semi urban Dhaka. Methodology: Data were collected from June 2009 to May 2010, from a sample of 96 patients with fever of more than seven days duration, who presented in the paediatric outpatient department of Dhaka Medical College Hospital, Dhaka. Detailed history, comprehensive physical examination and other relevant informations of the patients were recorded by following standard procedures. A raised anti O level with titre of >1:160 as well as other blood parameters were considered significant of having typhoid fever. Results: This study shows that 84(87.50%) patients had typhoid fever based on clinical examination and serological test results (widal test). It was observed that prevalence of enteric fever was high among the patients of school going age group (66.67%), habituated with unsafe drinking water (58.33%) and junk foods (72.92%). Statistical analysis showed that SSC level education in the parents who remain outside during the major part of the day for their livelihood had significant positive relationship with prevalence of typhoid fever. It was concluded that prevalence of typhoid fever was high among the children of school going age, who consume unsafe drinking water and food from outside source. Keywords: Typhoid fever; semi urban area; children. DOI: http://dx.doi.org/10.3329/jdmc.v20i1.8570 J Dhaka Med Coll. 2011; 20(1) :37-43