Risk factors associated with overweight and obesity among urban school children and adolescents in Bangladesh: a case–control study

Background Childhood obesity has become an emerging urban health problem in urban cities in Bangladesh, particularly in affluent families. Risk factors for obesity in this context have not been explored yet. The objective of this study was to identify the risk factors associated with overweight and obesity among school children and adolescents in Dhaka, Bangladesh. Methods From October through November 2007, we conducted a case–control study among children aged 10–15 years in seven schools in Dhaka. We assessed body mass index (weight in kg/height in sq. meter) to identify the cases (overweight/obese) and controls (healthy/normal weight) following the Centers for Disease Control and Prevention age and sex specific growth chart. We used a structured questionnaire to collect demographic information and respondent’s exposure to several risk factors such as daily physical activity at home and in school, hours spent on computer games and television watching, maternal education level and parents’ weight and height. Results We enrolled 198 children: 99 cases, 99 controls. Multiple logistic regression analysis revealed that having at least one overweight parent (OR = 2.8, p = 0.001) and engaging in sedentary activities for >4 hours a day (OR = 2.0, p = 0.02) were independent risk factors for childhood overweight and/or obesity while exercising ≥ 30 minutes a day at home was a protective factor (OR = 0.4, p = 0.02). There were no significant associations between childhood overweight and sex, maternal education or physical activity at school. Conclusion Having overweight parents along with limited exercise and high levels of sedentary activities lead to obesity among school children in urban cities in Bangladesh. Public health programs are needed to increase awareness on risk factors for overweight and obesity among children and adolescents in order to reduce the future burden of obesity-associated chronic diseases.</p

Food Adulteration and Consumer Awareness in Dhaka City, 1995-2011

We conducted this study to investigate the magnitude of food adulteration during 1995\u20132011 and consumer awareness in Dhaka city. We reviewed results of food sample testing by Public Health Food Laboratory of Dhaka City Corporation, Bangladesh Standards and Testing Institution, Consumers Association of Bangladesh publications, reports from lay press, including those on mobile magistrate court operations. We conducted a cross-sectional survey among 96 residents of Dhaka city, using a structured questionnaire in 2006. The overall proportion of food samples adulterated decreased during 2001-2005, and 40-54% of daily-consumed food was adulterated during 1995-2011. More than 35 food items were commonly adulterated. Consumers considered expiry date and quality or freshness as the best criteria while buying packaged and open food items respectively; only 11 (12%) respondents considered approval of regulatory authority for buying packaged food items. More than half of the food consumed in Dhaka city is adulterated, which warrants actions by the Government, the industry, and the consumers

Childhood Mortality Due to Drowning in Rural Matlab of Bangladesh: Magnitude of the Problem and Proposed Solutions

Drowning is an important cause of mortality among children in rural Bangladesh. Children aged 1–4 year(s) are at a high risk of death from drowning. Although deaths of children due to drowning in Bangladesh are acknowledged as an important cause of death, little effort has been made to address the issue of preventing deaths from this cause. This study has attempted to describe the problem and suggests possible prevention strategies, which may contribute to reducing childhood mortality from drowning. Data presented in this study were collected from Matlab where ICDDR, B has been maintaining a demographic surveillance since 1966. During the study period from 1985 to 2000, 989 deaths from drowning were reported, of which 796 (80.5%) were children in the age-group of 1–4 year(s), 48 (4.8%) were in the age-group of less than one year, and 145 (14.7%) in the age-group of 5–19 years. During 1985–2000, death rate per 1,000 children due to all causes among children of 1–4-year age-group decreased appreciably from 20.7% to 5.2%, while drowning-related deaths did not. Forty-five percent (n=359) of drowning-related deaths occurred in ponds, 16.8% (n=134) in ditches, 8.1% (n=64) in canals, and 4.4% (n=35) in rivers. The sites of more than 25% of drowning-associated deaths were not recorded. Analysis of seasonal variation revealed that most deaths due to drowning occurred during April-October, i.e. mostly during the monsoon months. It was also observed that the majority (67%) of mothers of victims had no formal education. Deaths due to drowning were mostly associated with children aged 1–4 year(s) and were 20% more common among boys than among girls (odds ratio=1.2, 95% confidence interval 1.04–1.38, p<0.012). The paper recommends some interventions to reduce the number of deaths due to drowning in rural Bangladesh, which include: (a) increasing awareness among mothers and close family members about the risk of drowning, (b) door-fencing, and (c) filling of unused ditches and water holes around households

Prevalence of exclusive breastfeeding and associated factors among mothers in rural Bangladesh: a cross-sectional study

This article was published in International Breastfeeding Journal [© 2014 BioMed Central Ltd.] and the definite version is available at: https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/1746-4358-9-7Background: Exclusive breastfeeding (EBF) means that the infant receives only breast milk for the first six months of life after birth. In Bangladesh, the prevalence of EBF remained largely unchanged for nearly two decades and was 43% in 2007. However, in 2011, a prevalence of 64% was reported, an increase by 21 percentage points. The reasons for this large change remain speculative at this point. Thus to investigate the issue further, this study was conducted. The objective was to assess the prevalence of EBF and associated factors among mothers having children aged 0-6 months in rural Bangladesh. Methods: A cross-sectional study was conducted in Mirzapur Upazilla (sub district) among 121 mothers of infants aged 0-6 months. Eligible mothers were identified and randomly selected using the demographic surveillance system's computerized database that is updated weekly. A semi-structured questionnaire was used for interviews that inquired information on socio-demographic characteristics, obstetric, health service, breastfeeding related factors (initiation of breastfeeding, prelacteal feeding and colostrum feeding) and economic factors. EBF prevalence was calculated using 24 hour recall method. In multivariate analysis, a logistic regression model was developed using stepwise modeling to analyze the factors associated with EBF. Results: The prevalence of EBF in the last 24 hours preceding the survey was 36%. Bivariate and multivariate analysis revealed no significant association between EBF and its possible predictors at 0.05 level of alpha. However, there was some evidence of an association between EBF and having a caesarean delivery (OR = 0.47, 95% CI: 0.21, 1.06). In multivariate analysis, type of delivery: caesarean (AOR = 0.45, 95% CI: 0.19, 1.03) and wealth quintile: richer (AOR = 2.40, 95% CI: 0.94, 6.16) also showed some evidence of an association with EBF. Conclusion: The prevalence of EBF in Mirzapur (36%) is lower than the national figure (64%). Prelacteal feeding was not uncommon. These findings suggest that there is a need for breastfeeding support provided by health services. Hence, promotion of EBF during the first six months of life needs to be addressed and future breastfeeding promotion programmes should give special attention to those women who are not practicing EBF.Publishe

Infectious Diseases and Vaccine Sciences: Strategic Directions

Despite substantial progress, infectious diseases remain important causes of ill-health and premature deaths in Bangladesh. Bangladesh has experienced a >90% reduction in the incidence of deaths due to childhood diarrhoea over the last 25 years. Further reductions can be achieved through the introduction of effective vaccines against rotavirus and improvements in home hygiene, quality of drinking-water, and clinical case management, including appropriate use of oral rehydration solution and zinc. Pneumonia is now the leading cause of childhood deaths in Bangladesh, and the pneumonia-specific child mortality is largely unchanged over the last 25 years. Reductions in mortality due to pneumonia can be achieved through the introduction of protein conjugate vaccines against Haemophilus influenza type b and Streptococcus pneumoniae, improvements in case management, including efforts to prevent delays in providing appropriate treatment, and the wider use of zinc. Tuberculosis is responsible for an estimated 70,000 deaths each year in Bangladesh. Although services for directly-observed therapy have expanded markedly, improved case finding and involvement of private practitioners will be important to reduce the burden of disease

Nutritional Status, Dietary Intake, and Relevant Knowledge of Adolescent Girls in Rural Bangladesh

This study estimated the levels and differentials in nutritional status and dietary intake and relevant knowledge of adolescent girls in rural Bangladesh using data from the Baseline Survey 2004 of the National Nutrition Programme. A stratified two-stage random cluster-sampling was used for selecting 4,993 unmarried adolescent girls aged 13-18 years in 708 rural clusters. Female interviewers visited girls at home to record their education, occupation, dietary knowledge, seven-day food-frequency, intake of iron and folic acid, morbidity, weight, and height. They inquired mothers about age of their daughters and possessions of durable assets to divide households into asset quintiles. Results revealed that 26% of the girls were thin, with body mass index (BMI)-for-age &lt;15th percentile), 0.3% obese (BMI-for-age &gt;95th percentile), and 32% stunted (height-for-age 642SD). Risks of being thin and stunted were higher if girls had general morbidity in the last fortnight and foul-smelling vaginal discharge than their peers. Consumptions of non-staple good-quality food items in the last week were less frequent and correlated well positively with the household asset quintile. Girls of the highest asset quintile ate fish/meat 2.1 (55%) days more and egg/milk two (91%) days more than the girls in the lowest asset quintile. The overall dietary knowledge was low. More than half could not name the main food sources of energy and protein, and 36% were not aware of the importance of taking extra nutrients during adolescence for growth spurt. The use of iron supplement was 21% in nutrition-intervention areas compared to 8% in non-intervention areas. Factors associated with the increased use of iron supplements were related to awareness of the girls about extra nutrients and their access to mass media and education. Community-based adolescent-friendly health and nutrition education and services and economic development may improve the overall health and nutritional knowledge and status of adolescents

Mother’s dietary diversity and association with stunting among children <2 years old in a low socio‐economic environment: A case–control study in an urban care setting in Dhaka, Bangladesh

Mothers are often responsible for preparing nutritious foods in their households. However, the quality of mother’s diets is often neglected, which may affect both mother’s and child’s nutrition. Because no single food contains all necessary nutrients, diversity in dietary sources is needed to ensure a quality diet. We aimed to study the association between mother’s dietary diversity and stunting in children <2 years attending Dhaka Hospital of icddr,b, a diarrhoeal disease hospital in Dhaka, Bangladesh. A case–control study (n = 296) was conducted from November 2016 to February 2017. Data were collected from mothers of stunted children <2 years (length‐for‐age z score [LAZ] < −2) as “cases” and nonstunted (LAZ ≥ −1) children <2 years as “controls.” Mothers were asked to recall consumption of 10 defined food groups 24 hr prior to the interview as per Guidelines for Minimum Dietary Diversity for Women. Among the mothers of cases, 58% consumed <5 food groups during the last 24 hr, compared with 45% in control mothers (P = 0.03). Children whose mothers consumed <5 food groups were 1.7 times more likely to be stunted than children whose mothers consumed ≥5 food groups (P = 0.04). Intake of food groups such as pulses, dairy, eggs, and vitamin A rich fruit was higher in control mothers. Proportion of mother’s illiteracy, short stature, monthly family income <BDT 11,480, absence of bank account, and poor sanitation was also found to be higher in stunted group. Further study particularly intervention or longitudinal study to see the causality of mother’s dietary diversity with child stunting is recommended.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/148421/1/mcn12665.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/148421/2/mcn12665_am.pd