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Chapman L.A.C.,University of Warwick | Dyson L.,University of Warwick | Courtenay O.,University of Warwick | Chowdhury R.,Country Programme Manager Bangladesh | And 4 more authors.
Parasites and Vectors | Year: 2015

Background: Visceral leishmaniasis has been targeted for elimination as a public health problem (less than 1 case per 10,000 people per year) in the Indian sub-continent by 2017. However, there is still a high degree of uncertainty about the natural history of the disease, in particular about the duration of asymptomatic infection and the proportion of asymptomatically infected individuals that develop clinical visceral leishmaniasis. Quantifying these aspects of the disease is key for guiding efforts to eliminate visceral leishmaniasis and maintaining elimination once it is reached. Methods: Data from a detailed epidemiological study in Bangladesh in 2002-2004 was analysed to estimate key epidemiological parameters. The role of diagnostics in determining the probability and rate of progression to clinical disease was estimated by fitting Cox proportional hazards models. A multi-state Markov model of the natural history of visceral leishmaniasis was fitted to the data to estimate the asymptomatic infection period and the proportion of asymptomatic individuals going on to develop clinical symptoms. Results: At the time of the study, individuals were taking several months to be diagnosed with visceral leishmaniasis, leading to many opportunities for ongoing transmission. The probability of progression to clinical disease was strongly associated with initial seropositivity and even more strongly with seroconversion, with most clinical symptoms developing within a year. The estimated average durations of asymptomatic infection and symptomatic infection for our model of the natural history are 147 days (95 % CI 130-166) and 140 days (95 % CI 123-160), respectively, and are significantly longer than previously reported estimates. We estimate from the data that 14.7 % (95 % CI 12.6-20.0 %) of asymptomatic individuals develop clinical symptoms - a greater proportion than previously estimated. Conclusions: Extended periods of asymptomatic infection could be important for visceral leishmaniasis transmission, but this depends critically on the relative infectivity of asymptomatic and symptomatic individuals to sandflies. These estimates could be informed by similar analysis of other datasets. Our results highlight the importance of reducing times from onset of symptoms to diagnosis and treatment to reduce opportunities for transmission. © 2015 Chapman et al. Source


Rahman Md.M.,University Malaysia Sarawak | Ahmad Sk.A.,National Institute of Preventive and Social Medicine NIPSOM | Karim Md.J.,Malaria Control Program | Chia H.A.,University Malaysia Sarawak
Journal of Community Health | Year: 2011

Despite established country's tobacco control law, cigarette smoking by the young people and the magnitude of nicotine dependence among the students is alarming in Bangladesh. This study was aimed to determine the prevalence of smoking and factors influencing it among the secondary school students. A two-stage cluster sampling was used for selection of schools with probability proportional to enrollment size followed by stratified random sampling of government and private schools. The 70-item questionnaire included 'core GYTS' (Global Youth Tobacco Survey) and other additional questions were used to collect relevant information. Analysis showed that the prevalence of smoking was 12.3% among boys and 4.5% among girls, respectively. The mean age at initiation of smoking was 10.8 years with standard deviation of 2.7 years. Logistic regression analysis revealed that boys are 2.282 times likely to smoked than girls and it was 1.786 times higher among the students aged 16 years and above than their younger counterparts. Smoking by teachers appeared to be the strong predictor for students smoking behaviour (OR 2.206, 95% CI: 1.576, 3.088) followed by peer influence (OR 1.988, 95% CI: 1.178, 3.356). Effective smoking prevention program should to be taken to reduce smoking behaviour. The school curricula had less impact in preventing smoking except teacher's smoking behaviour. © Springer Science+Business Media, LLC 2011. Source


Hossain K.J.,National Institute of Preventive and Social Medicine NIPSOM
Mymensingh medical journal : MMJ | Year: 2012

The aim of this study was to investigate mental illnesses among the substance abuse dependent populations. A total of 1076 substance abusers were recruited from the Outpatient Department of the Central Drug Addiction Treatment Center, Tejgaon, Dhaka from July 2008 to June 2009. They sought detoxification therapy voluntarily at this centre. The research participants were selected consecutively following the defined selection criteria. Research instruments were interviewer-administered questionnaire and standard mental state examination scales. Of the 1076 substance abusers, 82.6% had been using heroin currently and rest of them used phensedyl followed by injection drugs and cannabis with a period ranged 2-30 years. Results showed that 91.3% of the substance abusers had been suffering from insomnia and 75.0% had altered food habit. About 49.0% showed disturbed behaviors and 45.2% had been suffering from sexual dysfunctions. Around 32.0% of the substance abusers had been suffering from nonspecific generalized anxieties and 72.7% were found in abnormal mood/affects. A striking finding was that 7.3% of the substance abusers had been suffering from perceptual and/or thought disturbances. In conclusion, 7.3%-92.5% of the substance abusers had been suffering from mental illnesses. Insomnias, decreased intake of food and taste preference, irritable mood/affects, loss of interest in sex and non-specific anxieties were highly prevalent among them. Medical management and altering lifestyle are still the only applicable way to control this human catastrophe. Source


Karim M.R.,National Institute of Preventive and Social Medicine NIPSOM
One Century of the Discovery of Arsenicosis in Latin America (1914-2014): As 2014 - Proceedings of the 5th International Congress on Arsenic in the Environment | Year: 2014

A study was conducted on 600 children of arsenic exposed ([As] >50 μg L-1 of tube well water) and non-exposed (<50 μg L-1 of tube well water) areas to find out any difference in the nutritional status. Nutritional status was assessed by z-scores of weight for age, height for age and weight for height and also using 5th and 85th percentiles of the Body Mass Index for age. BMI of the children was found to be strongly associated with the arsenic level of the well water used by the families (p < 0.01). Thinness was found more among the children of exposed area (49%) than that of non-exposed one (38%). Comparatively children with normal BMI was found to be more in non-exposed area than in exposed area and the difference was found to be significant. The study suggests that arsenic exposure had negative impact on the nutritional status of children. © 2014 Taylor & Francis Group. Source


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

Background: This quasi experimental study was carried out to assess the effect of health education on oral hygiene among the smokeless tobacco users during April to June 2012. The aim was to compare the knowledge and practice about oral hygiene before and after health education. Materials and Methods: A total of 106 respondents were taken purposively in Dhaka city, Bangladesh. Baseline data were collected by pre tested structured questionnaire. An educational intervention program was conducted by dividing the respondents into seven groups; method was group discussion and lecture; poster, model of teeth and brush were the aids. Post intervention data were collected by the same structured questionnaire. Analysis was done by SPSS 14. Among the respondents 61.32% were male and 38.68% were female, mean age 46.25 years, majority had school level education, mean monthly family income was taka 7250.94. Results: In this study before educational intervention 64.15% respondents told that teeth should be cleaned twice daily, 62.26% told teeth should be cleaned by brush and paste; whereas after intervention the result was 91.51% and 85.85% respectively. Before intervention 66.98% stated that tobacco is hazardous to health; whereas after intervention 89.62% told tobacco is hazardous to health. Before intervention only 15.28% cleaned their teeth twice daily and 31.13% cleaned teeth by brush and paste; whereas after intervention it increased 41.38% and 46.23% respectively. Before intervention 72.64% told that people should visit dentist when dental problems occur; whereas after intervention it increased to 95.28%. Conclusion: From the above findings it may be concluded that educational intervention program is effective to improve the knowledge and practice of the respondents about oral hygiene. © 2014 Japan Health Sciences University & Japan International Cultural Exchange Foundation. Source

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