BRAC Research and Evaluation Division

Dhaka, Bangladesh

BRAC Research and Evaluation Division

Dhaka, Bangladesh
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Haque U.,International Center for Diarrhoeal Disease Research Bangladesh | Haque U.,Nagasaki University | Hashizume M.,Nagasaki University | Sunahara T.,Nagasaki University | And 4 more authors.
Malaria Journal | Year: 2010

Background. Malaria is endemic in 13 eastern districts where the overall infection prevalence is 3.97%. In 2006, Bangladesh received US$ 36.9 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) to support the national malaria control programme of Bangladesh. Objectives. The objective of this study was to i) clarify factors associated with treatment seeking behaviours of malaria ii) distribution of LLIN, and iii) re-treatment of ITN in remote area of a CHT district of Bangladesh two years after implementation of national control programme. Methods. All households of Rajasthali sub-district of Rangamati district (households about 5,322, population about 24,097), all BRAC health workers (n = 15), health facilities and drug vendors' locations were mapped. Distances from households to health facilities, BRAC health workers and drug vendors were calculated. Logistic regression analysis was performed to assess the associations between the choice of the treatment and the distance to various treatment sources, education, occupation and ethnicity. SaTScan was used to detect clustering of treatment-seeking approaches. Findings. LLIN distribution and the re-treatment of ITN exceeded target goals. The most common treatment facility for malaria-associated fever was malaria control programme led by BRAC and government (66.6%) followed by the drug vendor (48.8%). Conclusion. Closeness to health facilities run by the malaria control programme and drug vendors were significantly associated with the choice of treatment. A high proportion of people preferred drug vendors without having a proper diagnosis. Drug vendors are highly patronized and thus there is a need to improve their services for public health good. Otherwise it may cause incomplete treatment, misuse of anti-malarial drugs that will contribute to the risk of drug resistance and jeopardize the present malaria control efforts in Bangladesh. © 2010 Haque et al; licensee BioMed Central Ltd.


PubMed | BRAC Research and Evaluation Division, Médecins Sans Frontières, Ministry of Health, The Union and 3 more.
Type: Journal Article | Journal: Public health action | Year: 2015

BRAC, a non-governmental organisation, implemented a modified smoking cessation programme for tuberculosis (TB) patients based on International Union Against Tuberculosis and Lung Disease (The Union) guidelines in 17 peri-urban centres of Dhaka, Bangladesh.To determine whether a modified version of The Unions smoking cessation intervention was effective in promoting cessation among TB patients and determinants associated with quitting smoking.Cohort study of routinely collected data.A total of 3134 TB patients were registered from May 2011 to April 2012. Of these, 615 (20%) were current smokers, with a mean age of 38 years (13.8). On treatment completion, 562 patients were analysed, with 53 (9%) lost to follow-up or dead, while 82% of smokers had quit. Patients with extra-pulmonary TB were less likely to quit than those with pulmonary TB. Patients with high-intensity dependence were less likely to quit than those with low-intensity dependence.This study suggests that a simplified smoking cessation intervention can be effective in promoting smoking cessation among TB patients in Bangladesh. This is encouraging for other low-resource settings; the Bangladesh National Tuberculosis Control Programme should consider nationwide scaling up and integration of this smoking cessation plan.


PubMed | BRAC Research and Evaluation Division and BRAC Center
Type: | Journal: Journal of health, population, and nutrition | Year: 2016

Public health is at risk due to chemical contaminants in drinking water which may have immediate health consequences. Drinking water sources are susceptible to pollutants depending on geological conditions and agricultural, industrial, and other man-made activities. Ensuring the safety of drinking water is, therefore, a growing problem. To assess drinking water quality, we measured multiple chemical parameters in drinking water samples from across Bangladesh with the aim of improving public health interventions.In this cross-sectional study conducted in 24 randomly selected upazilas, arsenic was measured in drinking water in the field using an arsenic testing kit and a sub-sample was validated in the laboratory. Water samples were collected to test water pH in the laboratory as well as a sub-sample of collected drinking water was tested for water pH using a portable pH meter. For laboratory testing of other chemical parameters, iron, manganese, and salinity, drinking water samples were collected from 12 out of 24 upazilas.Drinking water at sample sites was slightly alkaline (pH 7.40.4) but within acceptable limits. Manganese concentrations varied from 0.1 to 5.5 mg/L with a median value of 0.2 mg/L. The median iron concentrations in water exceeded WHO standards (0.3 mg/L) at most of the sample sites and exceeded Bangladesh standards (1.0 mg/L) at a few sample sites. Salinity was relatively higher in coastal districts. After laboratory confirmation, arsenic concentrations were found higher in Shibchar (Madaripur) and Alfadanga (Faridpur) compared to other sample sites exceeding WHO standard (0.01 mg/L). Of the total sampling sites, 33 % had good-quality water for drinking based on the Water Quality Index (WQI). However, the majority of the households (67 %) used poor-quality drinking water.Higher values of iron, manganese, and arsenic reduced drinking water quality. Awareness raising on chemical contents in drinking water at household level is required to improve public health.


Yunus F.M.,BRAC Research and Evaluation Division | Rahman M.J.,Sanitation and Hygiene Research Group | Alam M.Z.,University of Texas at Arlington | Hore S.K.,B Chronic Disease Epidemiology and Genetics Research Group | And 2 more authors.
BMC Public Health | Year: 2014

Background: Chronic exposure to arsenic is associated with neoplastic, cardiovascular, endocrine, neuro-developmental disorders and can have an adverse effect on women's reproductive health outcomes. This study examined the relationship between arsenic skin lesions (a hallmark sign of chronic arsenic poisoning) and age of natural menopause (final menopausal period) in populations with high levels of arsenic exposure in Bangladesh. Methods. We compared menopausal age in two groups of women - with and without arsenic skin lesions; and presence of arsenic skin lesions was used as an indicator for chronic arsenic exposure. In a cross-sectional study, a total of 210 participants were randomly identified from two ongoing studies - participants with arsenic skin lesions were identified from an ongoing clinical trial and participants with no arsenic skin lesions were identified from an ongoing cohort study. Mean age of menopause between these two groups were calculated and compared. Multivariable linear regression was used to estimate the relationship between the status of the arsenic skin lesions and age of natural menopause in women. Results: Women with arsenic skin lesions were 1.5 years younger (p <0.001) at the time of menopause compared to those without arsenic skin lesions. After adjusting with contraceptive use, body mass index, urinary arsenic level and family history of premature menopause, the difference between the groups' age at menopause was 2.1 years earlier (p <0.001) for respondents with arsenic skin lesions. Conclusions: The study showed a statistically significant association between chronic exposure to arsenic and age at menopause. Heavily exposed women experienced menopause two years earlier than those with lower or no exposure. © 2014 Yunus et al.; licensee BioMed Central Ltd.


Islam Q.S.,BRAC Research and Evaluation Division | Ahmed S.M.,BRAC Research and Evaluation Division | Ahmed S.M.,Brac University | Islam M.A.,BRAC Health Nutrition and Population Programme | And 3 more authors.
International Health | Year: 2014

Background: BRAC (formerly Bangladesh Rural Advancement Committee), in collaboration with the National Tuberculosis Control Programme, provides one full-day training on TB to make informal allopathic providers knowledgeable for managing TB in rural Bangladesh. This study explored the knowledge and practices of the providers receiving the above training in the control and prevention of TB. Methods: The study was conducted in 30 subdistricts, with 30 trained and 30 untrained providers randomly selected from each subdistrict. Approximately 3% (49/1800) did not provide complete information. Pre-tested structured and semi-structured questionnaires were used. Results: TB was commonly perceived as a disease of only males (66.1%, 1157/1751). Only one-quarter knew about the bacterial cause of TB. Very few providers (2.1%, 36) had adequate knowledge regarding prevention of TB. They also lacked knowledge about TB treatment duration (71.6%, 1253), the meaning of DOTS (directly observed treatment, short course) (26.0%, 455) and multidrug resistance (20.6%, 360). Antibiotics (79.7%, 1396) and cough syrup (75.0%, 1313) were commonly prescribed by providers despite symptoms suggestive of TB. However, 70.2% (613) and 74.5% (650) of trained providers' knowledge and practice scores were equal to or more than the mean scores (≥6.97 and ≥6.6, respectively), whereas they were only 49.5% (435) and 64.2% (563), respectively, among untrained providers (p<0.0001). Conclusions: Misperception, lack of knowledge and irrational use of antibiotics are challenges that need to be addressed for controlling and preventing TB efficiently. © The Author 2014.


Ghosh S.C.,BRAC Research Division Evaluation | Karim F.,BRAC Research and Evaluation Division
The Future of Water, Sanitation and Hygiene in Low-Income Countries: Innovation, Adaptation and Engagement in a Changing World - Proceedings of the 35th WEDC International Conference | Year: 2011

NGOs are playing a significant role to ameliorate the sanitation situation in Bangladesh. Multi-stage 30 cluster sampling was adopted to collect quantitative data and 4,200 households were visited from 10 purposively selected sub-districts with and without NGO-led WASH programme. In every sub-district a focus group discussion was conducted to collect relevant information supplementing the findings from quantitative study. The overall sanitation coverage in areas with NGO intervention was significantly (p 0.00]) higher than the areas without any such intervention. Logistic regression analyses showed that the existence of NGO-led programme, the level of education, poverty, land ownership and access to media had significant (p 0.00]) influence on sanitation practice. Financial crisis was reported to be the predominant reason for households not having their own sanitary latrine, where NGO assistance was sought for. People acknowledged the role of NGOs in raising awareness, increasing sanitary latrine use and reported NGO assistance necessary for 100 percent sanitation.


PubMed | BRAC Research and Evaluation Division
Type: | Journal: BMC public health | Year: 2014

Chronic exposure to arsenic is associated with neoplastic, cardiovascular, endocrine, neuro-developmental disorders and can have an adverse effect on womens reproductive health outcomes. This study examined the relationship between arsenic skin lesions (a hallmark sign of chronic arsenic poisoning) and age of natural menopause (final menopausal period) in populations with high levels of arsenic exposure in Bangladesh.We compared menopausal age in two groups of women--with and without arsenic skin lesions; and presence of arsenic skin lesions was used as an indicator for chronic arsenic exposure. In a cross-sectional study, a total of 210 participants were randomly identified from two ongoing studies--participants with arsenic skin lesions were identified from an ongoing clinical trial and participants with no arsenic skin lesions were identified from an ongoing cohort study. Mean age of menopause between these two groups were calculated and compared. Multivariable linear regression was used to estimate the relationship between the status of the arsenic skin lesions and age of natural menopause in women.Women with arsenic skin lesions were 1.5 years younger (p <0.001) at the time of menopause compared to those without arsenic skin lesions. After adjusting with contraceptive use, body mass index, urinary arsenic level and family history of premature menopause, the difference between the groups age at menopause was 2.1 years earlier (p <0.001) for respondents with arsenic skin lesions.The study showed a statistically significant association between chronic exposure to arsenic and age at menopause. Heavily exposed women experienced menopause two years earlier than those with lower or no exposure.


PubMed | BRAC Research and Evaluation Division, University of New South Wales and BRAC Health Nutrition and Population Programme
Type: Journal Article | Journal: Public health action | Year: 2015

All sputum microscopy laboratories under the BRAC Tuberculosis Programme in Dhaka City.To study the nutritional status of tuberculosis (TB) patients attending microscopy laboratories during convalescence following DOTS.The study included 1068 TB patients registered for treatment at 10 laboratories from May 2010 to December 2011, and 910 healthy neighbourhood controls. Weight (in kg), height (in cm) and mid-upper arm circumference (MUAC; in cm) were measured before, at 2 months and immediately after completion of treatment. Body mass index (BMI) < 18.5 kg/m(2) and MUAC < 22.0 cm were taken as cut-offs for defining malnourishment.Two thirds of the patients (67%) had a low BMI (<18.5 kg/m(2)) before treatment, compared to only 23% among the healthy controls. At the end of treatment, 50% of the patients still had a low BMI, including 12% who had severe malnourishment (BMI 16 kg/m(2)). MUAC < 22.0 cm was higher among patients before (42%), at 2 months (39%) and immediately after completion of treatment (34%) compared to the control group (9%).Malnutrition is a serious problem among TB patients in peri-urban areas of Dhaka City. Under the circumstances, additional nutritional supplements, combined with education on nutrition, are expected to contribute to rapid and sustained recovery during DOTS-based treatment.


PubMed | BRAC Research and Evaluation Division and University of Newcastle
Type: Journal Article | Journal: International journal of environmental research and public health | Year: 2016

Arsenic contamination in drinking water has a detrimental impact on human health which profoundly impairs the quality of life. Despite recognition of the adverse health implications of arsenic toxicity, there have been few studies to date to suggest measures that could be taken to overcome arsenic contamination. After the statement in 2000 WHO Bulletin that Bangladesh has been experiencing the largest mass poisoning of population in history, we researched existing literature to assess the magnitude of groundwater arsenic contamination in Bangladesh. The literature reviewed related research that had been initiated and/or completed since the implementation of the Millennium Development Goals (MDGs) under four domains: (1) extent of arsenic contamination; (2) health consequences; (3) mitigation and technologies and (4) future directions. To this means, a review matrix was established for analysis of previous literature based on these four core domains. Our findings revealed that several high-quality research articles were produced at the beginning of the MDG period, but efforts have dwindled in recent years. Furthermore, there were only a few studies conducted that focused on developing suitable solutions for managing arsenic contamination. Although the government of Bangladesh has made its populations access to safe drinking water a priority agenda item, there are still pockets of the population that continue to suffer from arsenic toxicity due to contaminated water supplies.


PubMed | BRAC Research and Evaluation Division, Brac University, National TB Control Programme and BRAC Health Nutrition and Population Programme
Type: Journal Article | Journal: International health | Year: 2014

BRAC (formerly Bangladesh Rural Advancement Committee), in collaboration with the National Tuberculosis Control Programme, provides one full-day training on TB to make informal allopathic providers knowledgeable for managing TB in rural Bangladesh. This study explored the knowledge and practices of the providers receiving the above training in the control and prevention of TB.The study was conducted in 30 subdistricts, with 30 trained and 30 untrained providers randomly selected from each subdistrict. Approximately 3% (49/1800) did not provide complete information. Pre-tested structured and semi-structured questionnaires were used.TB was commonly perceived as a disease of only males (66.1%, 1157/1751). Only one-quarter knew about the bacterial cause of TB. Very few providers (2.1%, 36) had adequate knowledge regarding prevention of TB. They also lacked knowledge about TB treatment duration (71.6%, 1253), the meaning of DOTS (directly observed treatment, short course) (26.0%, 455) and multidrug resistance (20.6%, 360). Antibiotics (79.7%, 1396) and cough syrup (75.0%, 1313) were commonly prescribed by providers despite symptoms suggestive of TB. However, 70.2% (613) and 74.5% (650) of trained providers knowledge and practice scores were equal to or more than the mean scores (6.97 and 6.6, respectively), whereas they were only 49.5% (435) and 64.2% (563), respectively, among untrained providers (p<0.0001).Misperception, lack of knowledge and irrational use of antibiotics are challenges that need to be addressed for controlling and preventing TB efficiently.

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