Bishwajit Ghose

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    Diabetes mellitus and high blood pressure in relation to BMI among adult non-pregnant women in Bangladesh.

     

     Abstract  

     

    To investigate the association between overweight and obesity (in terms of BMI) and diabetes, HBP and diabetes-HBP comorbidity among adult women non-pregnant in Bangladesh. Information about demographics, socioeconomic, blood pressure and blood glucose levels were collected for 2022 women ageing above 35 years were collected from Bangladesh Demographic and Health Survey (BDHS 2011). The primary outcome variables were diabetes and high blood pressure. Diabetes was defined as fasting plasma glucose value ≥7.0mmol/L and HBP as systolic blood pressure ≥140mmHg or diastolic blood pressure ≥90mmHg. Blood pressure and plasma glucose measurement were performed by standard clinical procedures. Data were analysed using cross-tabulation, chi-square tests and logistic regression methods. Mean age of the participants was 41.42 (SD=4.37). 38.7% of the women had BMI values ≥25. The prevalence of HBP, diabetes, and diabetes-HBP comorbidity was respectively 18% and 5.1%, and 2%. The adjusted odds of having diabetes, HBP and Diabetes-HBP comorbidity were respectively 2.14 (p=0.002; 95%CI=1.31-3.48), 2.3 (p=<0.0001; 95%CI=1.70-2.98), and 3.4 (p=0.004; 95%CI=1.47-7.81) times higher among overweight/obese women compared to those with normal weight. Overweight and obesity account for a major proportion of diabetes, HBP and the comorbidity of these two among non-pregnant women. There remains a considerable risk for future expansion of diabetes and HBP as the prevalence of overweight/obesity is rising constantly. Maintaining a healthy BMI needs to be regarded as among the most important diabetes and HBP preventive strategies among Bangladeshi women.

     



    Lifestyle Behaviors, Subjective Health, and Quality of Life Among Chinese Men Living With Type 2 Diabetes.

     

     Abstract  

     

    The aim of the present study was to investigate the association between self-reported health (SRH) and quality of life (QoL) with five lifestyle-related behaviors including tobacco smoking, drinking alcohol, physical activity status, consumption of fruits, and consumption of vegetables among men diagnosed with type 2 diabetes. Participants were 786 Chinese men older than 40 years and living in urban households. Cross-sectional data on self-rated health, associated sociodemographics, and health-related behaviors were collected from the Study on Global AGEing and Health (Wave 1) of World Health Organization. Results of multivariable regression reported significant association with adherence to healthy lifestyle behavior and SRH but not QoL. According to the results, percentage of men who reported being in good SRH was overwhelmingly high (95.9%) compared with good QoL (5%). Adherence to healthy behavior was strongly associated with SRH in both bivariate and multivariate analysis, adjusted odds ratio (95% confidence interval) of good SRH for nonsmokers: 1.276 [1.055, 2.773], nondrinkers:1.351 [1.066, 3.923], taking physical exercise: 1.267 [1.117, 3.109], consuming at least five servings of fruits: 1.238 [1.034, 6.552], and vegetables: 1.365 [1.032, 3.885]. The current findings suggest that abstention from tobacco and alcohol, optimum consumption of fruits and vegetables, regular physical exercise could have marked impact on the health status of diabetic men.

     



    Epidemiology of breast cancer: retrospective study in the Central African Republic.

     

    Abstract  

     

    Breast cancer is recognised as a major public health problem in developing countries; however, there is very limited evidence about its epidemiology in the Central African Republic. The aim of this study was to investigate the epidemiological and histopathological characteristics of breast cancer in Bangui. This is a retrospective study based on the data collected from pathological anatomy records from 2003 to 2015 in Bangui. A questionnaire was designed to collect information and data was analysed using descriptive and inferential statistical methods. The mean age was 45.83 (SD = 13.5) years. The age group of 45-54 years represented the majority of the study population (29.3%). Over 69.5% of the women were housewives with a moderate economic status (56.9%). Less than 14% of the study population had a level of academic degree and 85.6% lived in cities. The breast cancer prevalence was 15.27%. The age-standardized incidence and death by world population (ASW) were 11.19/100,000 and 9.97/100,000 respectively. 50-54 years were most affected. Left breast cancer is mainly common and the time between first symptoms and consultation is more than 48 months. Most (69%) of the samples analysed were lumpectomy. The most common morphology of breast cancer was invasive ductal carcinoma (64.9%). Scarff Bloom Richardson III was the main grade in both common pathological types, but their proportion showed no significant increase along with time (χ2 = 7.06, p = 0.54). Invasion of regional lymph node differed significantly among the pathological type of breast cancer (χ2 = 24.6, p = 0.02). Surgery and chemotherapy were appropriate treatment yet 84.5% of the cases died. The findings of this study showed that breast cancer is common and mostly affected women. Epidemiological trends are more or less common to those of developing countries with a predominance of invasive ductal carcinoma. However, most of the women studied live in an urban area and developed the disease in advanced stage. The establishment of an appropriate framework will effectively contribute to promoting the early detection and reducing the incidence of this disease in the population.

     



    Extent of Knowledge about HIV and Its Determinants among Men in Bangladesh.

     

     Abstract  

     

    Bangladesh is currently a low human immunodeficiency virus (HIV) prevalent country. However, the risk factors are widespread and the number of at-risk population is also rising, which warrants special policy attention. The risks of transmission were shown to be correlated with the level of HIV knowledge of individuals. In this study, we aimed to explore the level and influencing factors of HIV knowledge among adult men in Bangladesh. Data for the present study were collected from the sixth round of Bangladesh Demographic and Health Survey. Participants were 3305 men between 15 and 54 years of age regardless of HIV status. The primary outcome variable was the HIV knowledge score, which was calculated by responses to questions regarding general concepts and the mode of transmission of HIV. Association between the HIV knowledge score and the explanatory variables were analyzed by binary logistic regression methods. The mean HIV knowledge score was 7.2 (SD 1.3). Results indicate that being an urban resident [ p  < 0.001; odds ratios (OR) = 0.56, 95% confidence intervals (CI) = 0.48-0.64], having secondary/higher educational level ( p  < 0.001 OR = 0.56, 95%CI = 0.48-0.64), reading newspaper [ p  = 0.006; OR = 0.76, 95%CI = 0.62-0.92], and communication with community health workers (CHWs) ( p  = 0.05; OR = 0.77, 95%CI = 0.60-10.00) were significantly associated with a high (equal or above mean value) HIV knowledge level. The level of HIV knowledge among Bangladeshi men is low. Leveraging HIV awareness programs targeting adult men to prevent future expansion of the epidemic should be a high priority. Revitalization and restructuring of the education sector and strengthening CHW’s engagement to improve knowledge about HIV transmission among men could generate beneficial returns for HIV prevention programs.

     



    Factors Influencing Health Knowledge and Behaviors among the Elderly in Rural China.

     

     Abstract  

     

    Health knowledge and behaviors are the key elements that ensure high quality of health for the elderly. This study explored and determined the conditions and factors of health knowledge and behaviors that affect the elderly in rural China. A cross-sectional research approach and random stratified sampling method were used in 12 towns and 48 villages in the Chongqing Municipality, Henan, and Zhejiang Provinces in China from June to September 2013. The collected data included: (1) socio-demographic characteristics of 1593 elderly people; (2) accuracy rate on health knowledge of the elderly, which was analyzed and compared among the three sample areas by using Chi-square test; and (3) mean scores on the health behaviors of the elderly, which were analyzed and compared by using analysis of variance (ANOVA). The multiple-linear regression method was used to analyze the factors affecting the health knowledge and behaviors of the elderly. Significant differences were observed among the nine items in the health knowledge questionnaire ( p  = 0.000 < 0.001). The average accuracy rate of the nine items was 57.43%. Significant differences were observed among the eleven items on the health behaviors of the elderly in the sample rural areas ( p  = 0.000 < 0.001). Age, economic level, degree of education, distance from home to medical institutions and disposable personal income (DPI) can affect the scores of the health knowledge and behaviors of the elderly ( p  = 0.000 < 0.001). Lack of health knowledge and poor health behaviors are common among the elderly in the sample areas of rural China. This deficiency poses a serious threat on the promotion of health conditions and the improvement of the level of health quality among the elderly. Different types of access to sources of health knowledge should be used to increase health knowledge scores of the elderly. Various potential intervening measures should also be adopted to improve their health behaviors of elderly people.

     



    Trends and determinants of HIV/AIDS knowledge among women in Bangladesh.

     

     Abstract  

     

    Globally, women share an indiscriminate burden of the HIV epidemic and the associated socioeconomic consequences. Previous studies have demonstrated a positive correlation between levels of HIV knowledge with its prevalence. However, for Bangladesh such evidence is non-existent. In this study, we aimed to explore the extent of HIV knowledge in relation to the socio-demographic variables such as age, region, area of residence i.e., urban or rural, wealth index and education, and investigate the factors influencing the level of HIV knowledge among Bangladeshi women. We used data from the Bangladesh Demographic and Health Survey (BDHS) survey conducted in 2011. In total 12,512 women ageing between 15 and 49 ever hearing about HIV regardless of HIV status were selected for this study. HIV knowledge level was estimated by analyzing respondents’ answers to a set of 11 basic questions indicative of general awareness and mode of transmission. Descriptive statistics, cross-tabulation and multinominal logistic regression were performed for data analysis. Little over half the respondents had good knowledge regarding HIV transmission risks. The mean HIV knowledge score was -0.001 (SD 0.914). Average correct response rate about mode of transmission was higher than for general awareness. Educational level of women and sex of household head were found to be significantly associated with HIV knowledge in the high score group. Those with no education, primary education or secondary education were less likely to be in the high score group for HIV knowledge when compared with those with higher than secondary level of education. Similarly those with male as household head were less likely to be in the higher score group for HIV knowledge. Level of HIV knowledge among Bangladeshi women is quite low, and the limiting factors are rooted in various demographic and household characteristics. Education and sex of the household head have been found to be significantly correlated with the level of HIV knowledge and propound sound grounds for their incorporation in the future HIV prevention strategies. Education of women may also have wider ramifications allowing reduction in gender inequality, which in turn favors higher knowledge about HIV.

     



    Association of Living Arrangement Conditions and Socioeconomic Differentials with Anemia Status among Women in Rural Bangladesh.

     

     Abstract  

     

    In Bangladesh, iron deficiency is the most common cause of anemia and remains a significant public health concern. Being a high anemia prevalent country, numerous efforts have been made to confront the issue especially among women and children by both local and international actors. Though the situation has substantially improved in recent years, a staggering number of adult women are currently living with anemia. The etiology of anemia is a multifactorial problem and has been proposed to be associated with various household, societal, economic, cultural factors apart from dietary habits. However, evidence regarding the household arrangements and socioeconomic determinants of anemia is scarce, especially in the context of Bangladesh. To this end, we utilized the 2011 demographic and health survey data to explore the association between anemia status and selected demographic, socioeconomic, and household characteristics. Our result showed significant correlation of anemia with both sociodemographic and household characteristics. Among the sociodemographic variables the following were found to be significantly associated with anemia status: age (p = 0.014; OR = 1.195; 95% CI = 1.036-1.378) and microcredit membership (p = 0.014; OR = 1.19; 95% CI = 1.037-1.386). Regarding the household arrangements, women utilizing biomass fuel for cooking (p < 0.019; OR = 1.82; 95% CI = 0.981-2.460) were more likely to be anemic.

     



    Anemia Status in Relation to Body Mass Index Among Women of Childbearing Age in Bangladesh.

     

     Abstract  

     

    Undernutrition and micronutrient deficiency disorders together constitute a major public health concern in Bangladesh. Among many vitamin and mineral deficiency diseases, iron-deficiency anemia remains the most persistent and has been shown to contribute to high maternal and child morbidity and mortality in the country. In parallel with micronutrient malnutrition, the country is also experiencing a rising epidemic of overweight and obesity due to changing pattern in dietary behavior and body mass index status. Previous empirical studies have demonstrated a strong correlation between body weight and anemia status. However, results remain inconclusive and for Bangladesh such evidence is nonexistent. To this end, we conducted this study using Bangladesh Demographic and Health Survey 2011 data with an aim to explore the association between body mass index and anemia status among adult women in Bangladesh. According to the findings, age between 15 and 29 years ( P < .001, OR = 1.30, 95% CI = 1.12-1.49), experiencing first birth before reaching the age of 18 years ( P < .001, OR = 1.31, 95% CI = 1.15-1.50), lack of access to potable water ( P = .013, OR = 1.467, 95%CI = 1.085- 1.982), being underweight ( P < .001, 95% CI = 1.208-1.570) and normal weight ( P < .001, 95% CI = 1.819-2.516) were significantly associated with anemia status.

     



    Determinants of public malaria awareness during the national malaria elimination programme: a cross-sectional study in rural China.

     

     Abstract  

     

    Public malaria health promotion is an integral part of the national malaria elimination programme, which was launched by the Chinese government in 2010. However, the public awareness of malaria needs to improve. This study aims to explore the determinants of public awareness of malaria. A cross-sectional survey was conducted using stratified sampling method from June 2015 to March . Bivariate logistic regression was performed to explore the association between predictors and malaria awareness in the sample population. The homogeneity of the interaction between group assignment and the degree of knowledge related to malaria among the subgroups was calculated by Cochran-Mantel-Haenszel test. Community media (including bulletin boards of village clinics or township hospitals, newspapers, exercise books, shopping bags, aprons, disposable cups, leaflets and banner advertisements) was the most prominent determinant influencing public awareness of malaria. The probability of having high-degree of knowledge about malaria among participants who received malaria-related information from community media were 3.99 times greater than those who did not (odds ratio 3.99, 95 % confidence interval 3.04-5.25, p < 0.001). Moreover, socio-demographic predictors including age, distance to township hospital, endemic county type, history of suffering from malaria, electronic media, self-assessed household income level, educational attainment and the knowledge about malaria were clearly associated with public awareness of malaria. Community media played the most important role in public awareness of malaria. However, only a few participants have received malaria knowledge through this media. It suggests that community media was an effective publicity material, which should expand its coverage. Malaria health promotion campaign needs to be aligned with target populations, in particular, people who are under 45 years old and residents (especially in type-3 counties) in remote areas.

     



    Association between food insecurity and anemia among women of reproductive age.

     

     Abstract  

     

    Food insecurity and hidden hunger (micronutrient deficiency) affect about two billion people globally. Household food insecurity (HFI) has been shown to be associated with one or multiple micronutrient (MMN) deficiencies among women and children. Chronic food insecurity leads to various deficiency disorders, among which anemia stands out as the most prevalent one. As a high malnutrition prevalent country, Bangladesh has one of the highest rates of anemia among all Asian countries. In this study, we wanted to investigate for any association exists between HFI and anemia among women of reproductive age in Bangladesh. Information about demographics, socioeconomic and anemia status on 5,666 married women ageing between 13 and 40 years were collected from a nationally representative cross-sectional survey Bangladesh Demographic and Health Survey (BDHS 2011). Food security was measured by the Household Food Insecurity Access Scale (HFIAS). Capillary hemoglobin concentration (Hb) measured by HemoCue® was used as the biomarker of anemia. Data were analysed using cross-tabulation, chi-square tests and multiple logistic regression methods. Anemia prevalence was 41.7%. Logistic regression showed statistically significant association with anemia and type of residency (p = 0.459; OR = 0.953, 95%CI = 0.840-1.082), wealth status (Poorest: p < 0.001; OR = 1.369, 95%CI = 1.176-1.594; and average: p = 0.030; 95%CI = 1.017-1.398), educational attainment (p < 0.001; OR = 1.276, 95%CI = 1.132-1.439) and household food insecurity (p < 0.001; 95%CI = 1.348-1.830). Women who reported food insecurity were about 1.6 times more likely to suffer from anemia compared to their food secure counterparts. HFI is a significant predictor of anemia among women of reproductive age in Bangladesh. Programs targeting HFI could prove beneficial for anemia reduction strategies. Gender aspects of food and nutrition insecurity should be taken into consideration in designing national anemia prevention frameworks.