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Islam M.S.,Center for Communicable Diseases | Luby S.P.,Center for Communicable Diseases | Luby S.P.,Centers for Disease Control and Prevention | Sultana R.,Center for Communicable Diseases | And 7 more authors.
American Journal of Infection Control | Year: 2014

Background Family caregivers are integral to patient care in Bangladeshi public hospitals. This study explored family caregivers' activities and their perceptions and practices related to disease transmission and prevention in public hospitals. Methods Trained qualitative researchers conducted a total of 48 hours of observation in 3 public tertiary care hospitals and 12 in-depth interviews with family caregivers. Results Family caregivers provided care 24 hours a day, including bedside nursing, cleaning care, and psychologic support. During observations, family members provided 2,065 episodes of care giving, 75% (1,544) of which involved close contact with patients. We observed family caregivers washing their hands with soap on only 4 occasions. The majority of respondents said diseases are transmitted through physical contact with surfaces and objects that have been contaminated with patient secretions and excretions, and avoiding contact with these contaminated objects would help prevent disease. Conclusion Family caregivers are at risk for hospital-acquired infection from their repeated exposure to infectious agents combined with their inadequate hand hygiene and knowledge about disease transmission. Future research should explore potential strategies to improve family caregivers' knowledge about disease transmission and reduce family caregiver exposures, which may be accomplished by improving care provided by health care workers. Copyright © 2014 Published by Elsevier Inc.

Minamoto K.,Kumamoto University | Mascie-Taylor C.G.N.,University of Cambridge | Karim E.,Health and Life science Partnership | Moji K.,Humanity | Rahman M.,Institute of Epidemiology Disease Control and Research
Public Health | Year: 2012

Objective: To investigate the long-term impact of health education in intestinal helminth infection control in rural Bangladesh. Study design: Longitudinal study to compare knowledge, awareness and practice for intestinal helminths between four communities: two receiving health education and two not receiving health education. Methods: Parents of 1497 children aged between 2 and 8 years [781 (52.2%) received health education] were investigated by interview at baseline, endline (18 months) and follow-up (5 years). Results: Health education had a significant effect on the installment of tubewells and latrines, but only had a temporary effect on health knowledge. Conclusion: This long-term follow-up study showed the lack of sustainability of knowledge and awareness in the long-term after health education interventions. © 2012 The Royal Society for Public Health.

Sultana Y.,Center for Infectious Diseases | Sultana Y.,University of Sydney | Gilbert G.L.,Center for Infectious Diseases | Gilbert G.L.,University of Sydney | And 3 more authors.
Parasitology | Year: 2012

Human strongyloidiasis is a neglected tropical disease with global distribution and this infection is caused by the parasitic nematode Strongyloides stercoralis. The aim of this study was to determine the prevalence of strongyloidiasis in Dhaka, Bangladesh. Sera from 1004 residents from a slum (group A) and 299 from city dwellers (group B) were tested for total IgG and IgG subclasses to Strongyloides antigen. There was a significant difference (PÅ <Å 0Å·001) in IgG seroprevalence between group A (22%) and group B (5%). Reactive IgG subclasses (IgG1 and IgG4) were also higher in group A (PÅ <Å 0Å·05). The seroprevalence of strongyloidiasis in group A increased with age but was unrelated to sex. The presence of reactive IgG to Strongyloides antigen had no correlation with either socio-economic or personal hygiene factors. However, a history of diarrhoea in a family member, in the past 6 months, but not in the respondents was associated with detection of antibodies to S. stercoralis (PÅ <Å 0Å·01). None of the sera from either group had an HTLV-I reaction. This study demonstrates that strongyloidiasis is prevalent in Dhaka, especially among slum dwellers, but concurrent infection with HTLV-I was not found. Future epidemiological studies should identify individual risk factors and other communities at risk so that appropriate interventions can be planned. © Cambridge University Press 2012.

Sultana Y.,Center for Infectious Diseases and Microbiology Laboratory Services | Sultana Y.,University of Sydney | Gilbert G.L.,Center for Infectious Diseases and Microbiology Laboratory Services | Gilbert G.L.,University of Sydney | And 3 more authors.
Transactions of the Royal Society of Tropical Medicine and Hygiene | Year: 2012

Residents of a slum community of Dhaka city, Bangladesh were tested by serological and faecal examination for evidence of Strongyloides stercoralis infection. In stool specimens from a total of 147 participants Strongyloides larvae were found in 34 (23.1%) by Harada-Mori culture, 15 (10.2%) by agar plate culture (APC) and one (0.7%) by microscopy. Strongyloides IgG, IgG1 and IgG4 antibodies were found in 90 (61.2%), 46 (31.3%) and 53 (36.1%) of participants, respectively. A positive correlation was observed between total IgG levels and the presence of isotypes IgG1 and IgG4 (p<0.001). Six sera (4.0%) reacted to the recombinant filaria antigen Bm 14, three of which were Strongyloides IgG positive. This indicates either there is cross reactivity or some participants are co-infected with lymphatic filariasis. No correlations were found between positive serology and Strongyloides infection in stool, socio- demographic factors or domestic hygienic practices. However, positive stool cultures showed significant associations with irregular nail trimming, walking bare-foot and irregular hand washing after defecation (p<0.05). Other enteric parasites were detected in stools of some participants but their presence showed no correlation with S. stercoralis infection or socio demographic factors. This study confirms that squatters in this slum community in Dhaka have a high prevalence of S. stercoralis infection identified both by serological and coprological methods. © 2012 Royal Society of Tropical Medicine and Hygiene.

Bhuiyan M.U.,Center for Communicable Diseases | Luby S.P.,Center for Communicable Diseases | Luby S.P.,Centers for Disease Control and Prevention | Zaman R.U.,Center for Communicable Diseases | And 11 more authors.
American Journal of Tropical Medicine and Hygiene | Year: 2014

During April 2007-April 2010, surveillance physicians in adult and pediatric medicine wards of three tertiary public hospitals in Bangladesh identified patients who developed hospital-acquired diarrhea. We calculated incidence of hospital-acquired diarrhea. To identify risk factors, we compared these patients to randomly selected patients from the same wards who were admitted > 72 hours without having diarrhea. The incidence of hospital-acquired diarrhea was 4.8 cases per 1,000 patient-days. Children < 1 year of age were more likely to develop hospital-acquired diarrhea than older children. The risk of developing hospital-acquired diarrhea increased for each additional day of hospitalization beyond 72 hours, whereas exposure to antibiotics within 72 hours of admission decreased the risk. There were three deaths among case-patients; all were infants. Patients, particularly young children, are at risk for hospital-acquired diarrhea and associated deaths in Bangladeshi hospitals. Further research to identify the responsible organisms and transmission routes could inform prevention strategies. Copyright © 2014 by The American Society of Tropical Medicine and Hygiene.

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