National Institute of Preventive and Social Medicine

Dhaka, Bangladesh

National Institute of Preventive and Social Medicine

Dhaka, Bangladesh

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Alim Md.A.,Nagoya University | Alim Md.A.,Directorate General of Health Services | Sarker M.A.B.,Nagoya University | Selim S.,Directorate General of Health Services | And 3 more authors.
Environmental Health and Preventive Medicine | Year: 2014

Objectives: Burning of biomass fuel (cow-dung, crop residue, dried leaves, wood, etc.) in the kitchen releases smoke, which may impair the respiratory functions of women cooking there. This paper aimed to compare the respiratory symptoms between biomass fuel users and gas fuel users in Bangladesh. Methods: A cross-sectional survey was conducted through face-to-face interviews and chest examination of 224 adult women using biomass fuel in a rural village and 196 adult women using gas fuel in an urban area. Results: The prevalence of respiratory involvement (at least one among nine symptoms and two diseases) was significantly higher among biomass users than among gas users (29.9 vs. 11.2 %). After adjustment for potential confounders by a logistic model, the odds ratio (OR) of the biomass users for the respiratory involvement was significantly higher (OR = 3.23, 95 % confidence interval 1.30-8.01). The biomass fuel use elevated symptoms/diseases significantly; the adjusted OR was 3.04 for morning cough, 7.41 for nasal allergy, and 5.94 for chronic bronchitis. The mean peak expiratory flow rate of biomass users (253.83 l/min) was significantly lower than that of gas users (282.37 l/min). Conclusions: The study shows significant association between biomass fuel use and respiratory involvement among rural women in Bangladesh, although the potential confounding of urban/rural residency could not be ruled out in the analysis. The use of smoke-free stoves and adequate ventilation along with health education to the rural population to increase awareness about the health effects of indoor biomass fuel use might have roles to prevent these involvements. © 2013 The Japanese Society for Hygiene.


PubMed | James Cook University, National Institute of Preventive and Social Medicine and Directorate General of Health Services
Type: Journal Article | Journal: Transactions of the Royal Society of Tropical Medicine and Hygiene | Year: 2015

Bangladesh has a high burden of lymphatic filariasis (LF) disease. This survey estimated the current number of clinical cases in a historically endemic district after a decade of mass drug administration (MDA).A cluster survey was conducted in 30 villages of Nilphamari District. Ten households per village were randomly selected, and individuals with LF clinical conditions identified. Hydrocoele and lymphoedema (leg, arm, breast) cases were quantified and mapped, and differences by sex, age, severity of disease and episodes of acute dermatolymphangioadenitis attacks (ADLA) examined.From 1242 surveyed >10 years old 55 individuals (4.4%) with LF clinical conditions were identified. Males were mostly affected by hydrocoeles, and females by leg lymphoedema. Higher prevalence and more advanced stages of disease were found in older age groups.Overall low prevalence of severe clinical disease was found, which has positive implications for the elimination goal. Future planning of MMDP strategies will need to address the varying clinical conditions, severity of disease and impact of ADLAs affecting different sub-groups of the population. It will also be important to monitor for new cases, and examine the shift in age distribution of cases over time.


Karim M.R.,Health Services | Rahman A.,National Institute of Preventive and Social Medicine | Akhter S.,Army Medical Core
Bangladesh Medical Research Council Bulletin | Year: 2015

In Bangladesh, nearly 10.5 hundred thousand individuals may have autism. Recent figures released by the CDC (2012) show that autism spectrum disorders (ASDs) now affect 1 in 88 children. Cognitive impairment, limited adaptive skills, and severe social impairment as seen in Autism Spectrum Disorders (ASD) thought to be associated with poorer health related quality of life (HRQoL). The objective of the study was to measure HRQoL and cognitive functioning in a group of autism Spectrum Disorder (ASD) children and to relate HRQoL with their socio demographic characteristics and cognitive functioning from parents' perception. This cross sectional study was conducted among149 purposively selected parents who have institutionalized autistic children (2 to 18 years old) from January to June 2013. HRQoL was assessed by Pediatric Quality of Life Inventory 4.0 (Verni1998) and cognitive functioning was assessed with The PedsQL TM Cognitive Functioning Scale. Three fourth of the children were male (n=115, 77.2%) and the mean (SD) age of the children was 7.8(3.06) years. Symptoms of autism appeared at about their 2nd birthday 2.1 (.70) while the average (SD) age of diagnosis was around three years 2.9 (.98). The children were reported to go to school at an early age of 3(1.75) years. Out of 149 respondents, ten percent parents (n=14) had the history of consanguineous marriage. The sample data provides significant difference between the scores by the ability of verbal communication (p<.05), presence of autistic siblings (p<.05) and mother's occupation (p<.05). There found negative correlation between HRQoL and age of symptom appearance and cognitive functioning with age of diagnosis (r = - 0.18; p=.03). Cognitive functioning was strongly correlated with total PedsQL score and its domains (r = 0.73; p=.00). i.e. Higher cognitive function leads to good health related quality of life. Linear regression was performed to study the relationship between HRQoL and independent variables found significant in univariate analysis. The results of the regression indicated the predictors in the model explained 57 % of the variance (R2=.57, F=23.05, p<.001). It was found that fathers who were doctors and engineers by profession (t=2.34, p=.02), child's ability to communicate with words (t= 2.73, p=.007), age of symptom appearance (t= -2.71, p=.008), and cognitive functioning (t =12.28, p <0.001) significantly predicted HRQol of ASD children. Father's occupational status, child's ability to communicate by word, age of symptom appearance, and Cognitive functioning of ASD children were found related to their quality of life.


Flora M.S.,National Institute of Preventive and Social Medicine | Amin M.N.,Combined Military Hospital | Karim M.R.,National Institute of Preventive and Social Medicine | Afroz S.,Northern International Medical College | And 3 more authors.
Bangladesh Medical Research Council Bulletin | Year: 2013

Despite success in tuberculosis control, multi-drug resistant tuberculosis in Bangladesh is increasing and currently multi-drug-resistant tuberculosis rate is 3.6% in new cases and 19% in re-treatment cases. This study focused on determination of multi-drug-resistant tuberculosis which is warranted for effective prevention strategy. An unmatched case control study was conducted in 2010. Purposively recruited 136 culture-proved multi-drug-resistant- tuberculosis cases and 152 cured tuberculosis patients were interviewed. Associations between exposure and outcome variables were initially tested by X2-test, t-test. A result was considered significant at p value <0.05. Effects of exposure variables were also assessed after adjusting for other variables by binary logistic regression models. Crude and adjusted Odds Ratio with 95% Confidence Interval was computed. Younger age (p=0.008) and, periurban locality (p=0.002) were associated with multi-drug-resistant tuberculosis. History of contact (p<0.001) and tuberculosis in the past (p<0.001) were four and eight times, respectively, more likely to influence multi-drug-resistant tuberculosis. Regularity [Odds Ratio 0.05; 95% Confidence Interval (0.01 to 0.39)] and always observation of treatment [Odds Ratio 0.25; 95% Confidence Interval (0.10 to 0.61)], sputum conversion [Odds Ratio 0.02; 95% Confidence Interval (0.01 to 0.08)] negatively associated with multi-drug-resistant tuberculosis. Gender and socio-economic status did not show any influence. Treatment course and sputum conversion was the best predictors. Like other developing countries adequacy of treatment is the most important exposure variable. Strengthening of control activities might contribute in preventing development of resistance in tuberculosis patients.


PubMed | The National Center For Parasitology, James Cook University, Ministry of Health, University of Queensland and 6 more.
Type: Journal Article | Journal: Malaria journal | Year: 2016

Significant progress has been made in reducing the malaria burden in the Asia Pacific region, which is aggressively pursuing a 2030 regional elimination goal. Moving from malaria control to elimination requires National Malaria Control Programmes (NMCPs) to target interventions at populations at higher risk, who are often not reached by health services, highly mobile and difficult to test, treat, and track with routine measures, and if undiagnosed, can maintain parasite reservoirs and contribute to ongoing transmission.A qualitative, free-text questionnaire was developed and disseminated among 17 of the 18 partner countries of the Asia Pacific Malaria Elimination Network (APMEN).All 14 countries that responded to the survey identified key populations at higher risk of malaria in their respective countries. Thirteen countries engage in the dissemination of malaria-related Information, Education, and Communication (IEC) materials. Eight countries engage in diagnostic screening, including of mobile and migrant workers, military staff, and/or overseas workers. Ten countries reported distributing or recommending the use of long-lasting insecticide-treated nets (LLINs) among populations at higher risk with fewer countries engaging in other prevention measures such as indoor residual spraying (IRS) (two countries), spatial repellents (four countries), chemoprophylaxis (five countries), and mass drug administration (MDA) (three countries). Though not specifically tailored to populations at higher risk, 11 countries reported using mass blood surveys as a surveillance tool and ten countries map case data. Most NMCPs lack a monitoring and evaluation structure.Countries in the Asia Pacific have identified populations at higher risk and targeted interventions to these groups but there is limited information on the effectiveness of these interventions. Platforms like APMEN offer the opportunity for the sharing of protocols and lessons learned related to finding, targeting and successfully clearing malaria from populations at higher risk. The sharing of programme data across borders may further strengthen national and regional efforts to eliminate malaria. This exchange of real-life experience is invaluable to NMCPs when scarce scientific evidence on the topic exists to aid decision-making and can further support NMCPs to develop strategies that will deliver a malaria-free Asia Pacific by 2030.


Rahman R.,Shaheed Suhrawardy Medical College | Faiz M.A.,Sir Salimullah Medical College | Selim S.,Shaheed Suhrawardy Medical College | Rahman B.,University of New South Wales | And 7 more authors.
PLoS Neglected Tropical Diseases | Year: 2010

Background: Snake bite is a neglected public health problem in the world and one of the major causes of mortality and morbidity in many areas, particularly in the rural tropics. It also poses substantial economic burdens on the snake bite victims due to treatment related expenditure and loss of productivity. An accurate estimate of the risk of snake bite is largely unknown for most countries in the developing world, especially South-East Asia. Methodology/Principal Findings: We undertook a national epidemiological survey to determine the annual incidence density of snake bite among the rural Bangladeshi population. Information on frequency of snake bite and individuals' length of stay in selected households over the preceding twelve months was rigorously collected from the respondents through an interviewer administered questionnaire. Point estimates and confidence intervals of the incidence density of snake bite, weighted and adjusted for the multi-stage cluster sampling design, were obtained. Out of 18,857 study participants, over one year a total of 98 snake bites, including one death were reported in rural Bangladesh. The estimated incidence density of snake bite is 623.4 / 100,000 person years (95% C I 513.4-789.2 /100,000 person years). Biting occurs mostly when individuals are at work. The majority of the victims (71%) receive snake bites to their lower extremities. Eightysix percent of the victims received some form of management within two hours of snake bite, although only three percent of the victims went directly to either a medical doctor or a hospital. Conclusions/Significance: Incidence density of snake bite in rural Bangladesh is substantially higher than previously estimated. This is likely due to better ascertainment of the incidence through a population based survey. Poor access to health services increases snake bite related morbidity and mortality; therefore, effective public health actions are warranted. © 2010 Rahman et al.


Imam M.H.,National Institute of Preventive and Social Medicine | Karim M.R.,National Institute of Preventive and Social Medicine | Ferdous C.,Bangladesh Institute of Health Science | Akhter S.,Combined Military Hospital
Bangladesh Medical Research Council Bulletin | Year: 2011

Identifying the level of health related quality of life (HQoL) and their influencing factors in human immunodeficiency virus (HIV) positive people is of extreme importance in implementing an interventional program to support this group. This cross sectional study was an attempt to determine the level and factors associated with HQoL among the people living with HIV. A convenient sample of 82 HIV-infected people from three NGOs and one Infectious Disease Hospital (IDH), were interviewed using an interviewer administered, semi structured questionnaire developed by adopting the "WHOQOL-HIV BREF instrument". A majority of the respondents were with low Quality of Life (QoL) in all the domains of HQoL. The proportion of respondents with low QoL was highest in the domain of social relationship (64.6%) followed by psychological domain (59.8%), physical domain (58.5%), level of independence domain (56.1%), environmental domain (52.4%) and spirituality domain (52.4%) of HQoL. Bivariate analysis revealed that the overall perception of QoL was better in the respondents living in urban area, who were employed and asymptomatic of the centre for disease control (CDC) stage of HIV. The perception of overall health was higher in females, all respondents less than 35 years of age, asymptomatic of the CDC stage of disease and with a current CD 4 count greater than 200 cell/mm 3. These findings highlight the need for enhanced socio-psychosocial support and a better environment for improving the health related quality of life among people living with HIV.


Karim M.R.,National Institute of Preventive and Social Medicine | Flora M.S.,National Institute of Preventive and Social Medicine | Akhter S.,Combined Military Hospital
Bangladesh Medical Research Council Bulletin | Year: 2011

An operational research was done to explore the effect of targeted food supplementation by comparing the birthweight of the babies of two areas (intervention & nonintervention). This record-based study was carried out in Kapasia and Savar upazila of Dhaka division, relying on the primary organizational data of 565 mothers. In the National Nutrition Program (NNP) area only fifty percent moderate to severe malnourished [Chronic Energy Deficiency (CED) II & III] mothers were preferably targeted for onsite food support while 34 of them managed to complete the full course. The mean (±SD) BMI of the supplemented mothers were lower (16.21±0.77) kg/m2, than non-supplemented mothers in Kapasia (17.14±.82) kg/m2 and Savar 17.03±1.19) kg/m2 area. The mean (±SD) birth-weight for non NNP (Savar) category Mean (±SD) 2470±366.03 grams, for NNP (Kapasia) non-supplemented group 2720.18 (±368.63) grams and in Kapasia good supplemented group it was 2752.94 (±344.86) grams. Supplemented and non-supplemented mothers of NNP mothers were four times more likely to deliver normal birthweight babies [odds ratio with 95%CI 3.84 (2.01, 7.34)] and [odds ratio with 95%CI 3.90 (2.17, 7.01)] than mothers of control area when adjusted for sociodemographic variables. Birth weight status improved with better CED levels. Birth weight adjusted for CED status, had no significant association with food supplementation. In this study, the basic findings were food supplementation could not increase birth-weight significantly as other effects contributed to improve birthweight were removed. As fully supplemented CED III mothers gave birth almost same weighted babies in comparison to the babies of CED I mothers; the recovery from the probability of being less weighted than the current status might be considered as a potential effect of food supplementation.


Razzaque A.,International Center for Diarrhoeal Disease Research | Nahar L.,East West University of Bangladesh | Mustafa A.H.M.G.,International Center for Diarrhoeal Disease Research | Ahsan K.Z.,The World Bank | And 2 more authors.
Asia-Pacific Journal of Public Health | Year: 2011

The study examined noncommunicable diseases risk factors among adults 25 to 64 years old of the Matlab Health and Demographic Surveillance System using World Health Organization STEP-wise methodology. The prevalence of smoking was found to be very high for males (53.9%) and it increased initially with age, whereas smoking was almost nil for females (0.8%). About 30% each of males and females used smokeless tobacco and its consumption increased with age. Consumption of vegetable/fruit is very low in this population (90% below recommended level), whereas one third of males and two thirds of female have low levels of physical activities. The raised blood pressure was more prevalent among females than in males (21.0% vs 12.5%, respectively) and the same was true for being overweight (13.9% vs 10.3%, respectively). Raised blood pressure increased with age but overweight did not vary by age for males, whereas it increased initially for females. Smoking (males) and use of smokeless tobacco decreased with increase in education, but both blood pressure and overweight increased. © 2011 APJPH.


Karim F.,Marks Dental College | Begum J.,National Institute of Preventive and Social Medicine
Bangladesh Journal of Medical Science | Year: 2014

Background: Health education is a process of transmission of knowledge and skills necessary for improvement in quality of life. Objectives: The purpose of this quasi-experimental study was to evaluate the oral hygiene related knowledge among the population in a selected community before and after health education. Materials and Methods: A total of 106 respondents were taken purposively at South Pirerbag of Dhaka city. Baseline data were collected by pre-tested structured questionnaire. An educational intervention program was conducted by dividing the respondents into seven groups, 15 in each group; method was group discussion and lecture; poster, model of teeth and brush were the aids. Post intervention data were collected by the same questionnaire. Results: Among the respondents, 61.32% were male and 38.68% were female, mean age was 46.25 years, 35.85% had primary level education, monthly family income was Tk 5000-10000 in 66.98%. Before intervention 64.15% told that teeth should be cleaned twice daily, 62.26% told teeth should be cleaned by brush and paste and 2.83% told teeth should be cleaned after breakfast and night; whereas after intervention the result was 91.51%, 85.85% and 67.93% respectively. Before intervention 66.98% stated that tobacco is hazardous to health but 32.4% have no idea about the type of diseases that occur due to tobacco; whereas after intervention 89.62% told that tobacco is hazardous to health and most of them had idea about harmful effect of tobacco. Conclusion: Educational intervention program is effective to improve the knowledge of the respondents about oral hygiene. © 2014, Bangladesh Journal of Medical Science. All rights reserved.

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