Conectar
by Md. Masud Reza, Hasibul Hasan Shanto, Samira Dishti Irfan, A. K. M. Masud Rana, Mohammad Niaz Morshed Khan, Golam Sarwar, Mohammad Sha Al Imran, Mahbubur Rahman, Md. Safiullah Sarker, Muntasir Alam, Md. Abu Hena Chowdhury, Mustafizur Rahman, Sharful Islam Khan
BackgroundUnintended pregnancy among female sex workers (FSW) is a pressing reproductive health concern attributable to risky sexual behaviors, healthcare inequities and poor negotiation powers with male sex partners. However, evidence is scarce on the prevalence and determinants of unintended pregnancies among FSW, which is crucial for enhancing reproductive healthcare. This analysis aims to measure the prevalence of lifetime unintended pregnancies and their associated factors.
MethodsA cross-sectional study was conducted on 327 FSW in Jashore (a border belt district of Bangladesh) from September 2022 to March 2023. Participants were recruited through take-all sampling. Data were collected on the lifetime history of unintended pregnancies and other relevant variables through face-to-face interviews. Chi-square statistic was used to compare the characteristics of FSW reporting unintended pregnancies. To assess the net association of factors associated with unintended pregnancy, multiple logistic regression was applied.
ResultThe lifetime prevalence of unintended pregnancies was reported at 75.8% (95%CI: 71.0–80.1). Among those who reported unintended pregnancies, 37.1% (95%CI: 30.8–43.8) had no education, 39.9% (95%CI: 32.8–47.5) were 25–34 years old, 49.6% (95%CI: 39.3–59.9) were currently married and 62.9% (95%CI: 49.7–74.4) earned ≤10,000 BDT per month compared to those who did not report lifetime unintended pregnancies. The likelihood of unintended pregnancies was significantly higher among those who reported having sex with non-transactional male sex partners (AOR: 2.4, 95%CI: 1.1–5.3, p = 0.036) than those who never had sex with any non-transactional male sex partner. The likelihood was also higher among those who reported rape in their lifetime (AOR: 2.0, 95%CI: 1.0–3.8, p = 0.037) and who self-reported mental health problems (AOR: 2.1, 95%CI: 1.0–4.2, p = 0.045) within the past year, compared to their counterparts.
ConclusionThis study highlights the considerable prevalence and associated determinants of unintended pregnancies among FSW in Jashore. These determinants need to be considered to strengthen reproductive healthcare interventions and policies for FSW. Reproductive health of FSW cannot be improved unless these factors are addressed in the ongoing interventions.
To assess the sex-specific status of dietary diversity (DD) and its associated factors among older men and women (aged ≥60 years) in Bangladesh.
A nationally representative cross-sectional survey was conducted in 2018–2019 on food security, nutrition and health of older adults of both sexes.
Data were collected from 82 clusters (rural 57, non-slum urban 15 and slum 10) from all eight administrative divisions of Bangladesh.
A total of 4817 participants aged ≥60 years (2482 men and 2335 women) were enrolled.
A list-based (24-item) recall method was employed, and the items were later aggregated into 10 food groups. The outcome variable was the prevalence of inadequate DD, defined as consumption of less than 5 food groups out of 10.
Men and women had mean DD scores of 4.33±1.6 and 4.13±1.7, respectively. Women had a higher prevalence of inadequate DD than men (61.2% vs 56.3%, p=0.028). Among the food groups, women consumed significantly less fish and eggs than men (fish: 50.96% vs 57.76%, p=0.002; eggs: 17.13% vs 22.10%, p=0.004). Poor education, rural dwellings, living in homes with fewer individuals and living in food-insecure households were associated with inadequate DD in both sexes. Furthermore, among men, older age and not being currently married, and among women, lower age and living in households with middle wealth status were associated with inadequate DD.
The study found that older women consume relatively less diverse diets than men, and several sociodemographic factors influence inadequate DD among older adults of both sexes in Bangladesh. These factors should be considered while developing policies and programmes to promote equitable access to a diversified diet and improve geriatric health and nutritional outcomes.
by Farhan R. Chowdhury, M. Ismail Hossain, Tangerul A. Jepu, Nusrat U. A. Saleh, Fatema T. Zohora, Tasmim A. Saleh, Mrinmoy Sarker, Al Numan, Zainab Yousuf, M. Aftab Uddin, Muktadir S. Hossain
Pneumococcal diseases caused by the human pathogenic bacterium Streptococcus pneumoniae are a major public health concern worldwide. In this study, we examined the pathogenicity of a clinical isolate of S. pneumoniae in the silk moth, Bombyx mori, larvae infection model. The whole genome sequencing of a clinical isolate of S. pneumoniae, Spn1 identified the presence of genes responsible for its virulence and antibiotic resistance. Spn1 infection of Bombyx larvae resulted in death within 24 h concomitant with an increase of phenoloxidase activity in the hemolymph. The bacterial load increased in the hemolymph within 9 h post-infection (p.i.) Ampicillin, ceftriaxone, tetracycline, imipenem, and erythromycin showed therapeutic effect in infected larvae, although the bacterial strain was resistant to erythromycin in vitro. The Bombyx homologs of mammalian TLR2 and TLR4, known as BmToll2 and BmToll9 (BmToll9−1 and BmToll9−2 isoforms), were upregulated in both the fat body and trachea. The antimicrobial peptide (AMP) genes, BmdefensinA and BmdefensinB, known to be regulated by the Toll signaling pathway, were significantly upregulated in both fat body and trachea after S. pneumoniae infection through hemolymph. Our data indicate that the Bombyx larvae can be a suitable infection model to study the pathogenicity of S. pneumoniae.Bangladesh is highly prone to recurrent flooding that disrupts all four pillars of food security. This study aimed to explore the effect of household food insecurity on the underweight status of women in flood-affected areas of Bangladesh, which remains underexplored.
This is a cross-sectional analysis.
This study was conducted in eight sub-districts (upazilas) across eight districts in Bangladesh that experience severe to moderate river flooding, flash floods and substantial tidal surges.
A total of 532 women participated in the study. The inclusion criteria for participation were as follows: (1) being at least 18 years of age, (2) residing in the household for at least 1 year and (3) having experienced limited food access in the 4 weeks before data collection due to flood-related constraints.
Household food insecurity was measured using the U.S. Agency for International Development Household Food Insecurity Access Scale questionnaire. An underweight status was evaluated through anthropometric measurements of women. Adjusted prevalence ratios (aPRs) were estimated using robust log-linear models.
Moderate food insecurity was the most common (58.3%) among the participants. The prevalence of underweight was the highest (52.1%) in the severely food-insecure group and decreased significantly with improved food security. Severe household food insecurity was strongly associated with a higher prevalence of underweight individuals (aPR = 4.12; 95% CI, 1.60 to 10.60). An underweight status was also prevalent in women from moderately food-insecure households (aPR = 1.75; 95% CI, 0.68 to 4.55).
This study reveals a significant association between household food insecurity and underweight status, highlighting the major challenges faced by women living in flood-prone areas of Bangladesh. These findings emphasise the urgent need to address household food insecurity to improve nutritional outcomes for women in vulnerable communities.
The rising burden of non-communicable diseases (NCDs), including mental health disorders (MHDs) such as anxiety and depression, poses a significant public health challenge globally. Evidence suggests that both diabetes and hypertension, the two most prevalent NCDs, are linked to a higher prevalence of MHDs. However, there is a lack of evidence on prevalence of generalised anxiety disorder (GAD) and depression among adults living with both diabetes and hypertension in Bangladesh. We aimed to assess the prevalence of GAD and depression and explore the associated factors among adults living with diabetes and hypertension comorbidity in rural Bangladesh.
We implemented a cross-sectional study.
The study was conducted in Chirirbandar, a sub-district of Dinajpur, Bangladesh.
We interviewed a total of 387 adults living with diabetes and hypertension comorbidity.
We had two primary outcome measures: GAD and depression. Individuals scoring ≥10 on the General Anxiety Disorder-7 scale were considered as having GAD and individuals scoring ≥10 on the Patient Health Questionnaire-9 scale were considered as having depression. The outcome variables were dichotomised based on these scores.
The prevalence of GAD was 7.24% (95% CI 5.04 to 10.29). Education level (grades 5–9) (adjusted OR (AOR): 3.40, 95% CI 1.26 to 9.19) and household wealth status (highest wealth tertile) (AOR: 0.12, 95% CI 0.02 to 0.62) were associated with GAD. The prevalence of depression was 17.83% (95% CI 14.32 to 21.98). Socioeconomic factors associated with depression included unemployment (AOR: 3.26, 95% CI 1.05 to 10.10) and household wealth status (highest wealth tertile) (AOR: 0.45, 95% CI 0.21 to 0.98). Higher odds of depression were also observed among participants with controlled hypertension (AOR: 3.88, 95% CI 1.81 to 8.35). Other factors, such as tobacco use, dietary diversity and physical activity, were not associated with GAD or depression.
A high prevalence of GAD and depression was observed among adults living with diabetes and hypertension comorbidity. The findings from the study emphasise the need for integration of mental health services into the existing non-communicable disease care. The identified factors associated with GAD or depression should be considered to develop targeted interventions for people with hypertension and diabetes comorbidity in Bangladesh.
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