Road safety is a global concern; particularly, in developing countries due to the significantly high collision occurrences and subsequent deaths. This study presents a spatial and temporal analysis ...of collision frequency and injury severity of crashes in Dhaka, Bangladesh. The focus is to understand the spatio-temporal trend of collisions involving pedestrians, public transit and unconventional modes, which are the key collision factors in Dhaka. This research utilizes the police-reported collision record for Dhaka for the years 2011-2015. In temporal analysis, temporal trends (monthly, daily and hourly) of injury severity of different vehicle occupants (pedestrians, public transit and unconventional modes) have been explored using descriptive analytics. Daily distribution suggests that a higher share of severe injuries involving pedestrians (16.6%) and unconventional modes (20.5%) occur on Fridays and Thursdays, respectively. The hourly distribution suggests that pedestrians are more vulnerable from 11:00am to 12:00pm on weekends. Unconventional mode users are vulnerable from 7:00am to 8:00am on weekdays. Spatial analysis is performed adopting a Kernel density estimation (KDE) technique. The results suggest that the major activity locations of Dhaka such as central business district (CBD), airport and ferry terminals are collision prone areas. Interestingly, the density of public transit collisions is skewed around the major transit hubs of the city.
In Bangladesh, seasonal influenza imposes considerable disease and economic burden, especially for those at high-risk of severe disease. The most successful approach for influenza prevention is the ...administration of a vaccine. Many poor and middle-income nations, including Bangladesh, do not have a national strategy or program in place for seasonal influenza vaccines, despite the World Health Organization's (WHO) advice to prioritize high-risk populations. Additionally, there is a scarcity of substantial data on the cost-effectiveness of seasonal influenza vaccination in these countries. The aim of our study is to determine acceptability, health beliefs, barriers, and intention of receiving influenza vaccine among high-risk populations, assess the cost-effectiveness of implementing a facility-based seasonal influenza vaccination programme, and investigate the required capacity for a potential seasonal influenza vaccination programme.
We will undertake this study following STROBE guidelines. We will conduct the study in inpatient and outpatient departments of three selected tertiary-level hospitals leveraging the ongoing hospital-based influenza surveillance (HBIS) platform. The study population will include the WHO-defined four high-risk groups excluding healthcare workers: children six months to eight years, pregnant women, elderly ≥ 60 years, and adults with chronic diseases. We will collect quantitative data on participants' acceptability, health beliefs, barriers, and vaccination intentions using the health belief model (HBM) from patients meeting the criteria for high-risk populations attending two public tertiary-level hospitals. In one of the two public tertiary-level hospitals, we will arrange an influenza vaccination campaign before the influenza season, where the vaccine will be offered free of cost to high-risk patients, and in the second hospital, vaccination will not be offered. Both the vaccinated and unvaccinated participants will then be followed-up once a month for one year to record any influenza-like illness, hospitalization, and death. Additional data for objective two will be collected from patients with symptoms of influenza-like illness (ILI) and severe acute respiratory infection (SARI) at one public and one private hospital to determine both direct and indirect costs associated with influenza illness. We will estimate the required number of influenza vaccines, safe injections, and total storage volume utilizing secondary data. We will use a deterministic Markov decision-analytic model to estimate the cost-effectiveness of facility-based influenza vaccination in Bangladesh.
The results of this study will enable the National Immunization Technical Advisory Group and the Ministry of Health & Family Welfare of Bangladesh to decide what steps to take to develop and implement an influenza vaccination strategy targeting high-risk populations.
The Clinicaltrials.gov registration number is NCT05996549. The registration for the protocol version 2.0 took place in August 2023, with the initial participant being enrolled in March 2022.
Irrational and inappropriate use of antibiotics in commercial chicken production can contribute to the development of antimicrobial resistance. We aimed to assess antibiotic usage in commercial ...chicken production in Bangladesh, and identify factors associated with this practice. We conducted a large-scale cross-sectional study to collect information on antibiotic usage in commercial chickens from January to May 2021. Structured interviews were conducted with 288 broiler, 288 layer and 192 Sonali (locally-produced cross-bred) farmers in 20 sub-districts across Bangladesh. The frequency of antibiotic usage, the types of antibiotics and purpose of usage were estimated for each production type. Adjusted odds ratios (aOR) were calculated to measure the association between antibiotic usage and factors related to the characteristics of the farms and farmers using multivariable logistic regression models. The proportion of farms, irrespective of their production type, reporting usage of antibiotics in the 24 hours preceding the interview was 41% (n = 314, 95% CI: 37–44%). Forty-five percent (n = 344, 41–48%) reported antibiotic usage in the last 72 hours, 86% (n = 658, 83–88%) in the last 14 days, and almost all farms, 98% (n = 753, 97–99%), had used antibiotics since the start of their production cycle. Use of antibiotics in the 24 hours preceding an interview was more frequently reported in broiler (OR 1.91, 95% CI: 1.36–2.69) and Sonali (OR 1.94, 95% CI: 1.33–2.33) than layer farms. Oxytetracycline (23–31%, depending on production type), doxycycline (18–25%), ciprofloxacin (16–26%) and amoxicillin (16–44%) were the most frequently used antibiotics. Antibiotics were reported to be used for both treatment and prophylactic purposes on most farms (57–67%). Usage of antibiotics in the 24h preceding an interview was significantly associated with the occurrence of any illnesses in chickens (aOR broiler: 41.22 95% CI:13.63–124.62, layer: aOR 36.459.52–139.43, Sonali: aOR 28.474.97–162.97). Antibiotic usage was mainly advised by veterinary practitioners (45–71%, depending on production type), followed by feed dealers (21–40%) and farmers (7–13%). Improvement of chicken health through good farming practices along with changes in key stakeholders (feed dealers and practitioners) attitudes towards antibiotic recommendations to farmers, may help to reduce the levels of antibiotic usage and thus contribute to mitigate antimicrobial resistance.
The highly active bio-polysaccharide based compound namely chitin and chitosan have been extracted from shrimp shell which usually expelled out extensively from food processing industries and ...considered as waste materials. However, by conducting demineralization, de-proteinization and deacetylation on it which could be a new route of production of valuable meso-porous chitosan that possesses a noteworthy well-organized honeycomb like surface microstructure which undoubtedly capable to form sustainable bio-composites. Whereas the honeycomb like microstructures showed a well-defined pore canals (Pc) and pore canal tubes (Pct) onto their surface. The samples were characterized via ATR-FTIR spectroscopy, High resolution SEM, AFM, EDX, XRD and 13C solid-state Cross-Polarization Magic Angle Spinning (CPMAS) NMR. The molecular weight(M‾v) of isolated chitin and chitosan were determined by viscosity and the values were 1.06 × 106(DPv = 5228), 1.8 × 104(DPv = 116) respectively besides degree of deacetylation (DDA) were measured by ATR-FTIR spectroscopy, CPMAS NMR, pH-metric titration and the values were 24&21 for chitin and 84&82 for chitosan. The results suggest that the shrimp shell waste is an attractive source of well-organized honeycomb like meso-porous chitin and chitosan with regular surface microstructures which might have a significant/potential application into the sustainable bio-composite formulation due to various industrial and biomedical sector indeed.
•A new route of production of mesoporous chitosan has successfully been developed•The produced CS possesses an outstanding honeycomb microstructure with Pc & Pct•Honeycomb structure conformed by SEM & AFM significant to produce strong composite•DDA value of CS was 84 confirmed by ATR-FTIR,13C CPMAS NMR, pH-metric titration•Molecular weight (M‾v) of CS was 1.8×104(DPv=116) determined by average viscosity
Early diagnosis of breast cancer is the best approach towards its control that may result in alleviating related mortality and morbidity. This study aimed to evaluate knowledge about breast cancer ...and both practices and perceived barriers to breast self-examination among female university students in Bangladesh. A cross-sectional study was carried out with 400 female students of Jahangirnagar University, Bangladesh. Participants were sampled from female dormitories at the university from January to April 2020. Proportionate stratified random sampling was conducted to calculate the study sample from each dormitory. A validated semi-structured self-reported questionnaire was employed to collect data from participants during the survey periods. The questionnaire consisted of demographic variables, items about knowledge about breast cancer, breast self-examination practices and its barriers. We applied descriptive and inferential statistics and data were analyzed using the Statistical Package for the Social Sciences (SPSS). Participants were aged between 18-26 years and comprised university students of first year (20%), second year (24%), third year (22%), fourth year (21%) and Master's (14%). 18% of them reported positive family history (mother, aunt, sister/cousin, grandmother) of breast cancer. The overall mean score of total knowledge items was 15 (SD = 3) out of 43, with an overall correct rate of 34%. The mean score of total knowledge items was significantly higher (p<0.001) among Master's students and students with family members who have had breast cancer. Only one in five students (21%) ever practiced breast self-examination. The mean score of practice of breast self-examination was significantly higher (p<0.001) among participants who reported having family member of breast cancer. Total knowledge score about breast cancer and practice of breast self-examination were significantly correlated with each other (r = 0.54; p<0.001). About 33% participants reported 'lack of knowledge' as the main barrier to practicing breast self-examination followed by 'I do not have the symptoms' (22%), and 'shyness/ uncomfortable feelings' (17%). The study revealed low levels of knowledge about breast cancer and low breast self-examination practices. Our findings highlight the need to develop, implement and promote socially, culturally and demographically appropriate educational interventions programs aimed at breast cancer and breast self-examination awareness and practice in Bangladesh.
► The emission of hazardous volatiles was investigated from back diffusion gases of automobiles. ► Pollutant emission patterns vary greatly between the different driving conditions. ► Back diffusion ...can be a significant source of in-vehicle pollution to passengers.
As back diffusion gases from automobiles are significant sources of in-vehicular pollution, we investigated eight automobiles, five for back diffusion (driving) measurements and three for reference conditions (non-driving). To characterize the back diffusion emission conditions, seven volatile organic compounds (VOC) and four carbonyl compounds (CCs) were measured along with dilution-to-threshold (D/T) ratio. The data obtained from back diffusion measurements were examined after having been divided into three subcategories: (i) driving and non-driving, (ii) with and without automobile upgrading (sealing the inner line), and (iii) differences in CO emission levels. Among the VOCs, the concentrations of toluene (T) was found to be the highest (range: 13.6–155ppb), while benzene (0.19–1.47ppb) was hardly distinguishable from its ambient levels. Other VOCs (xylene, trimethylbenzene, and styrene) were generally below <1ppb. Unlike VOCs, the concentrations (ppb) of CCs were seen at fairly enhanced levels: 30.1−95 (formaldehyde), 34.6−87.2 (acetaldehyde), 4.56−34.7 (propionaldehyde), and 3.45−68.8 (butyraldehyde). The results of our study suggest that the back diffusion phenomenon, if occurring, can deteriorate in-vehicle air, especially with the most imminent health hazards from a compound such as formaldehyde in view of its exceedance pattern over common guidelines.
Single nucleotide polymorphisms (SNPs) may influence arsenic methylation efficiency, affecting arsenic metabolism. Whether gene-environment interactions affect arsenic metabolism during pregnancy ...remains unclear, which may have implications for pregnancy outcomes.
We aimed to investigate main effects as well as potential SNP-arsenic interactions on arsenic methylation efficiency in pregnant women.
We recruited 1613 pregnant women in Bangladesh, and collected two urine samples from each participant, one at 4–16 weeks, and the second at 21–37 weeks of pregnancy. We determined the proportions of each arsenic metabolite inorganic As (iAs)%, monomethylarsonic acid (MMA)%, and dimethylarsinic acid (DMA)% from the total urinary arsenic level of each sample. A panel of 63 candidate SNPs was selected for genotyping based on their reported associations with arsenic metabolism (including in As3MT, N6AMT1, and GSTO2 genes). We used linear regression models to assess the association between each SNP and DMA% with an additive allelic assumption, as well as SNP-arsenic interaction on DMA%. These analyses were performed separately for two urine collection time-points to capture differences in susceptibility to arsenic toxicity.
Intron variants for As3MT were associated with DMA%. rs9527 (β = −2.98%, PFDR = 0.008) and rs1046778 (β = 1.64%, PFDR = 0.008) were associated with this measure in the early gestational period; rs3740393 (β = 2.54%, PFDR = 0.002) and rs1046778 (β = 1.97%, PFDR = 0.003) in the mid-to-late gestational period. Further, As3MT, GSTO2, and N6AMT1 polymorphisms showed different effect sizes on DMA% conditional on arsenic exposure levels. However, SNP-arsenic interactions were not statistically significant after adjusting for false discovery rate (FDR). rs1048546 in N6AMT1 had the highest significance level in the SNP-arsenic interaction test during mid-to-late gestation (β = −1.8% vs. 1.4%, PGxE_FDR = 0.075). Finally, As3MT and As3MT/CNNM2 haplotypes were associated with DMA% at both time points.
We found that not all genetic associations reported in arsenic methylation efficiency replicate in pregnant women. Arsenic exposure level has a limited effect in modifying the association between genetic variation and arsenic methylation efficiency.
•As3MT polymorphisms affect arsenic methylation efficiency throughout pregnancy.•The SNP-arsenic interaction effect on DMA% is not significant after adjusting for FDR.•N6AMT1 SNPs may interact with arsenic level affecting DMA% in the mid-to-late gestational period.
Vehicular automation is changing the conventional way of driving – e.g., the role of a driver is changing into an observer or a passenger due to the higher levels of automation. However, the success ...of this vehicle automation potentially leading to fully autonomous vehicles largely depends on the interest and comfort of consumers. Adoption of such disruptive technologies might have a retrospective aspect related to individuals’ experiences, such as exposure to technologies over their life course. This study adopts a life history-oriented approach to investigate individuals' preferences towards different levels of vehicle autonomy. The effects of historical experiences in different life domains such as technology usage in daily life and availability of vehicle technology, and the evolution of demographics such as historically living in an owned dwelling are explored. Data comes from a retrospective survey conducted in the Okanagan region of Canada. A random parameter rank-ordered logit model is developed to accommodate the relative ranked preferences of the alternatives and to capture unobserved heterogeneity. The model results suggest that individuals with historical exposure to vehicle technology have a higher likelihood of adopting higher levels of vehicle automation, whereas individuals having advanced technology only in the current vehicle reveal a lower interest towards higher vehicle autonomy. Individuals without a driver’s license show a higher interest in full automation, whereas they are less interested in no automation. The model confirms the existence of heterogeneity. For instance, pro-urban individuals prefer no automation, whereas pro-suburban individuals are inclined towards full automation. Both variables show significant heterogeneity with a large standard deviation. The findings of this study demonstrate the need to accommodate the effects of historical experiences while analyzing the preferences towards different levels of automation. Such inclusion of life history-oriented attributes within the travel demand forecasting models is expected to improve the demand and usage prediction accuracy of different levels of vehicle automation.
With limited infection control practices in overcrowded Bangladeshi hospitals, surfaces may play an important role in the transmission of respiratory pathogens in hospital wards and pose a serious ...risk of infection for patients, health care workers, caregivers and visitors. In this study, we aimed to identify if surfaces near hospitalized patients with respiratory infections were contaminated with respiratory pathogens and to identify which surfaces were most commonly contaminated. Between September-November 2013, we collected respiratory (nasopharyngeal and oropharyngeal) swabs from patients hospitalized with respiratory illness in adult medicine and paediatric medicine wards at two public tertiary care hospitals in Bangladesh. We collected surface swabs from up to five surfaces near each case-patient including: the wall, bed rail, bed sheet, clinical file, and multipurpose towel used for care giving purposes. We tested swabs using real-time multiplex PCR for 19 viral and 12 bacterial pathogens. Case-patients with at least one pathogen detected had corresponding surface swabs tested for those same pathogens. Of 104 patients tested, 79 had a laboratory-confirmed respiratory pathogen. Of the 287 swabs collected from surfaces near these patients, 133 (46%) had evidence of contamination with at least one pathogen. The most commonly contaminated surfaces were the bed sheet and the towel. Sixty-two percent of patients with a laboratory-confirmed respiratory pathgen (49/79) had detectable viral or bacterial nucleic acid on at least one surface. Klebsiella pneumoniae was the most frequently detected pathogen on both respiratory swabs (32%, 33/104) and on surfaces near patients positive for this organism (97%, 32/33). Surfaces near patients hospitalized with respiratory infections were frequently contaminated by pathogens, with Klebsiella pneumoniae being most common, highlighting the potential for transmission of respiratory pathogens via surfaces. Efforts to introduce routine cleaning in wards may be a feasible strategy to improve infection control, given that severe space constraints prohibit cohorting patients with respiratory illness.
Dengue fever, the most prevalent mosquito-borne viral infection, is a recurrent public health threat in Bangladesh. Despite the government's efforts, dengue outbreaks are on the upswing, and people's ...knowledge, belief, and preventive practices regarding the disease at the rural community level are unclear.
The objective of this study was to assess the level of knowledge, belief and preventive practices regarding dengue and associated factors among community people from rural Bangladesh.
A cross-sectional survey was conducted involving 401 people using a convenient sampling technique from three unions of Savar from August to September 2021. Participants' responses were collected through face-to-face interviews using a pre-tested structured questionnaire that included information related to socio-demographics, dengue-related knowledge, preventive practices, and the health belief model (HBM) constructs. Multiple linear regression analysis was performed to determine the factors associated with the knowledge and preventive practices of dengue.
Overall, participants (mean age = 33.47 ± 12.96 years; age range = 18-75 years) correctly answered 66.15% of the knowledge questions regarding dengue. Higher education, travel to dengue-risk regions, and self-efficacy under the HBM construct were all shown to be strongly associated with dengue knowledge. Regarding HBM constructs, about 80% of the participants perceived dengue as dangerous, but less than half (41.4%) believed themselves susceptible to dengue. Considering perceived barriers, 73.07% of the participants believed their residential area was not suitable for Aedes mosquito breeding. Nearly all (93.52%) believed they always kept their surrounding area clean as part of self-efficacy. Moreover, on average participants engaged in 53.69% of all dengue preventive practices. Being older, female, having a higher education, being a service holder, having a good quality of house structure, and perceived susceptibility as well as self-efficacy under the HBM construct were all factors in participants' dengue prevention activities. Participants' dengue preventative practices were shown to be significantly influenced by their knowledge.
The findings of this study found a moderate level of knowledge regarding dengue among the participants. Regarding dengue prevention, although participants scored highly in several indicators, the overall preventive practices were not satisfactory. This suggests that there is a pressing need for expanded education outreach aimed at increasing public awareness of dengue and encourage preventive practices within rural communities in Bangladesh.
PDF
