Center for Communicable Diseases

Dhaka, Bangladesh

Center for Communicable Diseases

Dhaka, Bangladesh

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Bhuiyan M.U.,Center for Communicable Diseases | Zaman S.,Northumbria University | Ahmed T.,Center for Nutrition and Food Security
BMC Pediatrics | Year: 2013

Background: Childhood obesity has become an emerging urban health problem in urban cities in Bangladesh, particularly in affluent families. Risk factors for obesity in this context have not been explored yet. The objective of this study was to identify the risk factors associated with overweight and obesity among school children and adolescents in Dhaka, Bangladesh.Methods: From October through November 2007, we conducted a case-control study among children aged 10-15 years in seven schools in Dhaka. We assessed body mass index (weight in kg/height in sq. meter) to identify the cases (overweight/obese) and controls (healthy/normal weight) following the Centers for Disease Control and Prevention age and sex specific growth chart. We used a structured questionnaire to collect demographic information and respondent's exposure to several risk factors such as daily physical activity at home and in school, hours spent on computer games and television watching, maternal education level and parents' weight and height.Results: We enrolled 198 children: 99 cases, 99 controls. Multiple logistic regression analysis revealed that having at least one overweight parent (OR = 2.8, p = 0.001) and engaging in sedentary activities for >4 hours a day (OR = 2.0, p = 0.02) were independent risk factors for childhood overweight and/or obesity while exercising ≥ 30 minutes a day at home was a protective factor (OR = 0.4, p = 0.02). There were no significant associations between childhood overweight and sex, maternal education or physical activity at school.Conclusion: Having overweight parents along with limited exercise and high levels of sedentary activities lead to obesity among school children in urban cities in Bangladesh. Public health programs are needed to increase awareness on risk factors for overweight and obesity among children and adolescents in order to reduce the future burden of obesity-associated chronic diseases. © 2013 Bhuiyan et al.; licensee BioMed Central Ltd.


Memish Z.A.,Ministry of Health | Memish Z.A.,Alfaisal University | Alsahly A.,Regional Health Directorate | Masri M.al.,Ministry of Health | And 6 more authors.
Influenza and other Respiratory Viruses | Year: 2015

Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging viral pathogen that primarily causes respiratory illness. We conducted a seroprevalence study of banked human serum samples collected in 2012 from Southern Saudi Arabia. Sera from 300 animal workers (17% with daily camel exposure) and 50 non-animal-exposed controls were examined for serological evidence of MERS-CoV infection by a pseudoparticle MERS-CoV spike protein neutralization assay. None of the sera reproducibly neutralized the MERS-CoV-pseudotyped lentiviral vector. These data suggest that serological evidence of zoonotic transmission of MERS-CoV was not common among animal workers in Southern Saudi Arabia during July 2012. © 2014 The Authors.


Luby S.P.,Center for Communicable Diseases | Luby S.P.,Centers for Disease Control and Prevention | Agboatwalla M.,Health Oriented Preventive Education | Hoekstra R.M.,Centers for Disease Control and Prevention
American Journal of Tropical Medicine and Hygiene | Year: 2011

Diarrhea burden is often estimated using cross-sectional surveys. We measured variability in diarrhea prevalence among children < 5 years of age living in squatter settlements in central Karachi, Pakistan. We pooled data from non-intervention control households from studies conducted from 2002 through 2006. The prevalence of diarrhea varied on average by 29% from one week to the next, by 37% from one month to the next, and during peak diarrhea season by 32% from one year to the next. During 24 months when the same nine neighborhoods were under surveillance, each month the prevalence of diarrhea varied by at least an order of magnitude from the lowest to the highest prevalence neighborhood, and each neighborhood recorded the highest diarrhea prevalence during at least one month. Cross-sectional surveys are unreliable measures of diarrhea prevalence. Copyright © 2011 by The American Society of Tropical Medicine and Hygiene.


Choudhury K.N.,National Center for Control of Rheumatic Fever and Heart Disease | Mainuddin A.K.,Center for Communicable Diseases | Wahiduzzaman M.,Bangladesh Institute of Health Science | Islam S.M.,Center for Control of Chronic Diseases
Vascular health and risk management | Year: 2014

BACKGROUND: Hypertension and dyslipidemia are major risk factors for cardiovascular disease, accounting for the highest morbidity and mortality among the Bangladeshi population. The objective of this study was to determine the association between serum lipid profiles in hypertensive patients with normotensive control subjects in Bangladesh.METHODS: A cross-sectional study was carried out among 234 participants including 159 hypertensive patients and 75 normotensive controls from January to December 2012 in the National Centre for Control of Rheumatic Fever and Heart Disease in Dhaka, Bangladesh. Data were collected on sociodemographic factors, anthropometric measurements, blood pressure, and lipid profile including total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), and high density lipoprotein (HDL).RESULTS: The mean (± standard deviation) systolic blood pressure and diastolic blood pressure of the participants were 137.94±9.58 and 94.42±8.81, respectively, which were higher in the hypertensive patients (P<0.001). The serum levels of TC, TG, and LDL were higher while HDL levels were lower in hypertensive subjects compared to normotensives, which was statistically significant (P<0.001). Age, waist circumference, and body mass index showed significant association with hypertensive patients (P<0.001) but not with normotensives. The logistic regression analysis showed that hypertensive patients had 1.1 times higher TC and TG, 1.2 times higher LDL, and 1.1 times lower HDL than normotensives, which was statistically significant (P<0.05).CONCLUSION: Hypertensive patients in Bangladesh have a close association with dyslipidemia and need measurement of blood pressure and lipid profile at regular intervals to prevent cardiovascular disease, stroke, and other comorbidities.


Rahaman M.H.,North South University | Islam T.,Center for Communicable Diseases | Colwell R.R.,University of Maryland University College | Alam M.,University of Maryland University College
Frontiers in Microbiology | Year: 2015

Vibrio cholerae, the etiological agent of cholera, has been a scourge for centuries. Cholera remains a serious health threat for developing countries and has been responsible for millions of deaths globally over the past 200 years. Identification of V. cholerae has been accomplished using a variety of methods, ranging from phenotypic strategies to DNA based molecular typing and currently whole genomic approaches. This array of methods has been adopted in epidemiological investigations, either singly or in the aggregate, and more recently for evolutionary analyses of V. cholerae. Because the new technologies have been developed at an ever increasing pace, this review of the range of fingerprinting strategies, their relative advantages and limitations, and cholera case studies was undertaken. The task was challenging, considering the vast amount of the information available. To assist the study, key references representative of several areas of research are provided with the intent to provide readers with a comprehensive view of recent advances in the molecular epidemiology of V. cholerae. Suggestions for ways to obviate many of the current limitations of typing techniques are also provided. In summary, a comparative report has been prepared that includes the range from traditional typing to whole genomic strategies. © 2015 Rahaman, Islam, Colwell and Alam.


Shah R.,Independent Consultant | Nahar Q.,Center for Population | Gurley E.S.,Center for Communicable Diseases
American Journal of Tropical Medicine and Hygiene | Year: 2016

We estimated the proportion of maternal deaths in Bangladesh associated with acute onset of jaundice. We used verbal autopsy data from a nationally representative maternal mortality survey to calculate the proportion of maternal deaths associated with jaundice and compared it to previously published estimates. Of all maternal deaths between 2008 and 2010, 23% were associated with jaundice, compared with 19% from 1998 to 2001. Approximately one of five maternal deaths was preceded by jaundice, unchanged in 10 years. Our findings highlight the need to better understand the etiology of these maternal deaths in Bangladesh. © 2016 by The American Society of Tropical Medicine and Hygiene.


Hasan B.,Uppsala University | Melhus A.,Uppsala University | Sandegren L.,Uppsala University | Alam M.,Center for Communicable Diseases | And 2 more authors.
Microbial Drug Resistance | Year: 2014

The presence and frequency of multiresistant bacteria in wild birds act as indicators of the environmental contamination of antibiotic resistance. To explore the rate of contamination mediated by Escherichia coli, 150 fecal samples from the brown-headed gull (Chroicocephalus brunnicephalus) and 8 water samples from the Bay of Bengal area were collected, cultured, and tested for antibiotic susceptibility. Special attention was paid to extended-spectrum beta-lactamase (ESBL)-producing isolates, which were further characterized genetically. Antibiotic resistance was found in 42.3% (36/85) of the E. coli isolates and multidrug resistance in 11.8%. Isolates from the area with a higher human activity were more resistant than those from an area with a lower level of activity. Most frequent was resistance to ampicillin (29.4%), followed by trimethoprim-sulfamethoxazole (24.7%) and quinolones (22.4%). Carriage of ESBL-producing E. coli was relatively high (17.3%) in the gulls, whereas no ESBL producers were found in the water. All ESBL-producing E. coli isolates, but one, carried blaCTX-M-15or blaCTX-M-15-like genes. A blaCTX-M-14-like enzyme was found as an exception. Gulls from two different colonies shared E. coli clones and harbored the clinically relevant sequence types ST10, ST48, and ST131. The high frequency of antibiotic resistance and ESBL production among E. coli isolates from gulls indicates that the environmental contamination of antibiotic resistance has already gone far on the coastlines of the Bay of Bengal. Considering the limited control over the antibiotic consumption and waste from human activities in Bangladesh, there is no easy solution in sight. © Copyright 2014, Mary Ann Liebert, Inc. 2014.


Boucher Y.,University of Alberta | Orata F.D.,University of Alberta | Alam M.,Center for Communicable Diseases
Frontiers in Microbiology | Year: 2015

Cholera is a diarrheal disease that has changed the history of mankind, devastating the world with seven pandemics from 1817 to the present day. Although there is little doubt in the causative agent of these pandemics being Vibrio cholerae of the O1 serogroup, where, when, and how this pathogen emerged is not well understood. V. cholerae is a ubiquitous coastal species that likely existed for tens of thousands of years. However, the evolution of a strain capable of causing a large-scale epidemic is likely more recent historically. Here, we propose that the unique human and physical geography of low-lying river deltas made it possible for an environmental bacterium to evolve into a deadly human pathogen. Such areas are often densely populated and salt intrusion in drinking water frequent. As V. cholerae is most abundant in brackish water, its favored environment, it is likely that coastal inhabitants would regularly ingest the bacterium and release it back in the environment. This creates a continuous selection pressure for V. cholerae to adapt to life in the human gut. © 2015 Boucher, Orata and Alam.


Gurley E.S.,Center for Communicable Diseases
American Journal of Epidemiology | Year: 2014

The timing of a child's first acute lower respiratory infection (ALRI) is important, because the younger a child is when he or she experiences ALRI, the greater the risk of death. Indoor exposure to particulate matter less than or equal to 2.5 m in diameter (PM2.5) has been associated with increased frequency of ALRI, but little is known about how it may affect the timing of a child's first ALRI. In this study, we aimed to estimate the association between a child's age at first ALRI and indoor exposure to PM2.5 in a low-income community in Dhaka, Bangladesh. We followed 257 children from birth through age 2 years to record their age at first ALRI. Between May 2009 and April 2010, we also measured indoor concentrations of PM2.5 in children's homes. We used generalized gamma distribution models to estimate the relative age at first ALRI associated with the mean number of hours in which PM2.5 concentrations exceeded 100 g/m3. Each hour in which PM2.5 levels exceeded 100 g/m3 was independently associated with a 12% decrease (95% confidence interval: 2, 21; P = 0.021) in age at first ALRI. Interventions to reduce indoor exposure to PM2.5 could increase the ages at which children experience their first ALRI in this urban community. © The Author 2014.


Bulbul T.,Center for Communicable Diseases | Hoque M.,Bangabandhu Sheikh Mujib Medical University
BMC Pediatrics | Year: 2014

Background: Obesity has been declared an epidemic in many high income countries. In low income countries, the coexistence of obesity and underweight makes the situation more grievous. The priority is to explore the overall pictures of body weight status in low income countries and countries that are in transitional phase. Through this country wide cross sectional study we would like to capture the current body weight status among the school aged children, both in urban and rural areas in Bangladesh. Methods: We conducted a countrywide cross sectional study, from June to September 2009. By random sampling, we selected 10,135 students from 6 to 15 years from both the urban and rural schools. We categorized the students into overweight, obese and underweight by using the values for age and sex at +1SD, +2SD and -2 SD of Z scores of BMI respectively. Results: We observed among 6 to 15 year olds from both the urban and rural areas 3.5% were obese, 9.5% were overweight and 17.6% were underweight. The proportion of obese and overweight students were greater among the students from urban schools (5.6%, 10.6%) compared to the students from rural schools (1.2%, 8.6%) (RD = 4.3, 95% CI = 3.6, 5.0; RD = 2.0, 95% CI = 0.1, 3.1). The proportion of underweight students were lower in the urban schools (16.1%) compared to the rural schools (19.2%) (RD = -3.1; 95% CI = -4.6, -1.6). Conclusions: The rate of obesity and overweight is alarming among school aged children in Bangladesh. Overweight and underweight are coexisting which needs special attention to minimize the dual burden. © 2014 Bulbul and Hoque; licensee BioMed Central Ltd.

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