The willingness to receive sexually transmitted infection services from public healthcare facilities among key populations at risk for human immunodeficiency virus infection in Bangladesh: A qualitative study.

BACKGROUND:In Bangladesh, community-based and peer-led prevention interventions for human immunodeficiency virus infection are provided to key populations (KPs) by drop-in centers (DICs), which are primarily supported by external donors. This intervention approach was adopted because public healthcare facilities were reportedly insensitive to the needs and culture of KPs, particularly with regard to the provision of sexually transmitted infection (STI) services. Nonetheless, in the absence of external funding, STI services need to be integrated into public healthcare systems. METHODS:A qualitative study was conducted in 2017 to understand the willingness of KPs to uptake the STI services of public healthcare facilities. Data were collected based on 34 in-depth interviews, 11 focus group discussions, and 9 key informant interviews. The social-ecological theoretical framework was used to analyze the data thematically and contextually. RESULTS:Most participants were either resistant or reluctant to uptake STI services from public healthcare facilities because of their previous firsthand experiences (e.g., disrespectful and judgmental attitudes and behaviors), perceived discrimination, anticipatory fear, and a lack of privacy. Very few participants who had visited these facilities to receive STI services were motivated to revisit them. Nevertheless, they emphasized their comfort in DICs over public healthcare facilities. Thus, it appears that KPs can be situated along a care-seeking continuum (i.e., resistance to complete willingness). Unless policymakers understand the context and reasons that underlie their movement along this continuum, it would be difficult to encourage KPs to access STI services from public healthcare facilities. CONCLUSION:KPs' willingness to uptake the STI services of public healthcare facilities depends not only on individual and community experiences but also on the nexus between socio-structural factors and health inequalities. Community mobilization and training about the needs and culture of KPs for healthcare professionals are essential. Therefore, addressal of a wide range of structural factors is required to motivate KPs into seeking STI services from public healthcare facilities

Community based peer-led TB screening intervention: an innovative approach to increase TB knowledge, presumptive case identification, and referral among sexual minority people in urban Bangladesh

Abstract Introduction One of the contributors to tuberculosis (TB) burden among vulnerable populations, such as sexual minority people, is the delay in case finding and notification. Given their socially excluded, hard-to-reach nature, community-led approaches need to be introduced to facilitate their screening of TB symptoms and their subsequent referral to TB healthcare providers. This article aimed to explore the existing challenges surrounding TB screening and referral, and the implementation facilitators and barriers of the proposed community-based TB screening model for sexual minority people in Dhaka, Bangladesh. Methods This study followed the quasi-experimental design using mixed methods (i.e., qualitative and quantitative) approach. The study participants who were also a part of the community-led TB screening model included sexual minority people enrolled in HIV prevention interventions. In addition to quantitative inquiry, in-depth interviews were conducted on sexual minority people, focus group discussions were also conducted on them and HIV prevention service providers, and key-informant interviews were conducted on service providers, programmatic experts and TB researchers. Data were analyzed using content, contextual and thematic approaches. Results The ‘Six Steps in Quality Intervention Development’ framework was used to guide the development of the community-based TB screening model. In Step 1 (identifying the problem), findings revealed low rates of TB screening among sexual minority people enrolled in the HIV prevention intervention. In Step 2 (identifying contextual factors for change), various individual, and programmatic factors were identified, which included low knowledge, low-risk perception, prioritization of HIV services over TB, and stigma and discrimination towards these populations. In Step 3 (deciding change mechanism), community-based screening approaches were applied, thus leading to Step 4 (delivery of change mechanism) which designed a community-based approach leveraging the peer educators of the HIV intervention. Step 5 (testing intervention) identified some barriers and ways forward for refining the intervention, such as home-based screening and use of social media. Step 6 (collecting evidence of effectiveness) revealed that the main strength was its ability to engage peer educators. Conclusion This study indicates that a community-based peer-led TB screening approach could enhance TB screening, presumptive TB case finding and referral among these populations. Therefore, this study recommends that this approach should be incorporated to complement the existing TB program

Dietary Habits of Students in Bangladesh Agricultural University and their Association with Overweight and Obesity

Purpose: The dietary habits of young adults have been affected; thus, overweight and obesity are increasingly being observed among the young. The purpose of this study is to assess the prevalence of overweight and obesity on a sample of students from the Bangladesh Agricultural University (BAU) and to examine their eating habits. Background: In the past year BAU has been experiencing a nutritional transition in food decisions from the everyday diet to the alimentation pattern. As a consequence, the dietary habits of young adults have been affected with progressive overweight and obesity .The purpose of this study is to assess the prevalence on a sample of MS stidents from BAU and to look at their uptake habits. Methods: A cross-sectional survey of 146 students were chosen randomly from the BAU throughout the JJ/2018 semester. With a 7 Days twenty four Hour Food frequency questionnaire where their Height, weight, dietary habits, Body mass index (BMI) were recorded. Statistical analyses were performed exploitation the Statistical Package for Social Sciences computer code (version 22.0) to determine overweight and obesity among students and to categorize uptake habits of food. Results: This study showed that the majority of the students (80.4%) were of normal weight (80.8% male students compared to 80% female students). The prevalence of overweight and obesity was 9.1% and 2.3% respectively .In contrast, 15.0% female students were underweight as compared to 3.8% males. Eating habits of the students showed that the majority (61.4%) reported taking meals regularly. There was a colored vegetable and fruits were intake scarcity among students. A total of 30.5% reported daily intake of colored vegetables with gender differences (P=.003) (31.5% females vs. 29.2% males). These prevalence rates were greater in girls than boys. There were no clear associations observed between dietary habits and measures of overweight and obesity. Conclusion: The overall low prevalence of overweight and obesity in the studied sample, indicate that university students would possibly benefit from nutrition and health promotion program to improve student’s eating habits.  There is a Significant differences observed among food type and frequency of consumption

Prevalence of HIV, risk behaviours and vulnerabilities of female sex partners of the HIV positive people who inject drugs (PWID) in Dhaka city, Bangladesh.

BackgroundThe HIV epidemic in Bangladesh is largely being driven by people who inject drugs (PWID) and mainly concentrated in Dhaka city. Intregrated biological and behavioural survey (IBBS) data of 2016 showed that a considerable percentage of the HIV positive PWID had unsafe sex with their female sex partners. Prevalence of HIV, risk behaviorus and vulnerabilities among the female sex partners of the PWID still remain unexplored.MethodsTo measure HIV prevalence, risk behaviours (drugs/injection/sexual) and vulnerabilities (treatment of and knowledge of sexually transmitted infections (STIs) and HIV/uptake of the routine HIV testing and HIV prevention services/physical and sexual violence), a quantitative survey was conducted among 227 female sex partners of the HIV positive PWID in Dhaka city in 2019 by adopting a take-all sampling technique.ResultsThe median age of participants was 34.0 years. Prevalence of HIV was 16.7% (95% CI: 12.4-22.2). Only 6.8% to 18.7% of the participants used condoms consistently with different male sex partners; only 6.8%cto 18.7% during last year. Seventy five percent (95% CI: 69.2-80.8) had no knowledge on STI symptoms. Self-reported symptoms of STIs were reported by 26% (95% CI: 20.7-32.1) and half sought treatment during last year. Nineteen percent (95% CI: 14.7-25.1) had comprehensive knowledge of HIV. As part of the routine HIV prevention services by the PWID drop-in-centres (DICs), 42.7% (95% CI: 36.4-49.3) of the participants were tested for HIV and knew their result within the last year. One-third never received HIV prevention services. During the last one year preceding the survey, 46% (95% CI: 39.3-52.6) reported been beaten and 20.2% (95% CI: 15.3-26.1) been raped.ConclusionIt is urgently necessary to consider the high-risk behaviours and vulnerabilities in designing or to strengthen targeted interventions for female sex partners of the HIV positive PWID in Dhaka city to ensure equality in accessing and utilization of services

Are we ready for a sustainable approach? A qualitative study of the readiness of the public health system to provide STI services to the key populations at risk of HIV in Bangladesh

Abstract Introduction In Bangladesh, sexually transmitted infection (STI) services are available for all populations in public health facilities. However, STI services for key populations (KPs) at risk of HIV need specifically designed approaches that are predominantly administered to KPs through donor-supported service centers operated by non-government organizations (NGOs) and community-based organisations (CBOs). However, the steady decline in donor funding warrants a sustainable transition of STI services for the KPs into public health facilities. This article aimed to explore the service availability and readiness of public health facilities to provide STI services for the KPs. Methods This qualitative study explored the service availability and readiness of public health facilities in three districts of Bangladesh by adapting the Service Availability and Readiness Assessment tool. We conducted 34 in-depth interviews,11 focus group discussions with KPs, and 29 key-informant interviews with healthcare providers, researchers, programme implementers and policy planners, in addition to series of direct observations at the public healthcare facilities. Data were analysed through thematic analysis, and categorised in relation to the WHO building blocks. Results This study revealed that the public health system was generally not ready to serve the KPs’ needs in terms of providing them with quality STI services. The ‘service delivery’ component, which is the most crucial facet of the public health system, was not ready to provide STI services to KPs. Findings also indicated that health workforce availability was limited in the primary and secondary healthcare layers but adequate in the tertiary layer, but needed to be oriented on providing culturally sensitised treatment. Counseling, an essential component of STI services, was neither ready nor available. However, health information systems and a few other components were partially ready, although this warrants systematic approaches to address these challenges. Conclusion The findings show that public health facilities are yet to be fully ready to render STI services to KPs, especially in terms of service delivery and human and health resources. Therefore, it is not only integral to mobilize communities towards the uptake of public health services, but health systems need to be prepared to cater to their needs

The PGPR mechanisms of salt stress adaptation and plant growth promotion

Worldwide crop productivity hampers severely due to the adverse effects of salinity. Global warming causes a rapid escalation of the salt-affected area, and new agricultural land is affected through saltwater intrusion. The ever-growing human population impulses to utilize the saline area for crop cultivation to ensure food security. Salinity resistance crops could be a promising substitute but with minor success because inappropriate tactics on saline soil management resulted in unsatisfactory yield. Salt-tolerant plant growth-promoting rhizobacteria (ST-PGPR) is considered an alternate way towards enhancing crop growth in saline ecosystems. It is reported that PGPR is enabled to produce exopolysaccharides which lead to biofilm formation and generate osmoprotectants and antioxidant enzymes that can significantly contribute to stimulating plant growth in the saline ecosystem. In addition, several plant growth-promoting characteristics of PGPR such as the acquisition of essential nutrients and upsurge hormone production could enhance plant growth simultaneously. In this review, we will explore the survival mechanisms of ST-PGPR and their influence on plant growth promotion in saline ecosystems

Additional file 2 of Are we ready for a sustainable approach? A qualitative study of the readiness of the public health system to provide STI services to the key populations at risk of HIV in Bangladesh

Additional file 2. Consolidated criteria for reporting qualitative research (COREQ) – consists of the characteristics of the qualitative methods section for this manuscript

Additional file 1 of Are we ready for a sustainable approach? A qualitative study of the readiness of the public health system to provide STI services to the key populations at risk of HIV in Bangladesh

Additional file 1. English interview guidelines- consists of various semi-structured questionnaires for different groups of informants such as health service providers of DICs and public healthcare facilities, government officials, and CBO leaders. The guidelines also contain a guideline for consultation workshops and an observation checklist for the public healthcare facilities