Occupational Health Hazards among Workers in Garment Factories in Bangladesh: A Cross-Sectional Study

Introduction: Garment workers constitute a lion share of the total labour force in Bangladesh, which bring most of the country’s foreign currency. The competitiveness of the garment industry in the world market is seriously affected by the ill health of the workers, since ill health decreases the labour productivity to a great extent. The competitiveness of the garment industry in the world market is seriously affected by the ill health of the workers, since ill health decreases the labour productivity to a great extent.Objective: To find out the occupational health hazards among the workers, working in different garment factories in Bangladesh.Materials and Methods: This descriptive study was conducted from January 2013 to June 2013. Total sample was 145 and purposive sampling technique was followed for data collection, which was done by face to face interview by an interviewer. The data was collected on a structured questionnaire. Data was analyzed by computer by SPSS version 17.0. Results: Out of 145 respondents, majority (40%) were found in the age group of 16-20 years where mean age was 23.30 years with S.D. of ±6.92 years. Among all the respondents, 89% were female. 45.52% were educated institutionally. 52.4% respondents were machine operator, but maximum (75%) were unskilled and 72% had length of job between 2-7 years. 91% respondents normally worked for 8-9 hours. 85.5% did 2-3 hours overtime. In the last one year 64.8% had no accident but minor cut, burn or injury was faced by 28.3%. Most of the (44%) respondents did not complain about physical environmental pollution but 33.8% complained of noise pollution. Majority (84.8%) told that doctor & nurse were constantly present in their factory and they were satisfied with their health facilities. Maximum (51%) respondents suffered from headache or shoulder pain. Majority did not mention any permanent illness. In this study the prevalence of occupational health hazards was 88.28%. A significant relationship was found between noise pollution and headache (P value 0.014). Conclusion: More emphasis should be given to the workers to improve their health condition and working environment, so that they can increase their efficiency which can ultimately increase the production and add GDP to the country. Government should provide more fund for research purposes in order to improve the condition of the working population and their working environment. Keywords: Occupational Accidents, Bangladesh

Feeding Practices among Infants in a Rural Community in Bangladesh: A Cross-Sectional Study

Background: Proper feeding practices during infancy are necessary for the growth and development of infants and to prevent malnutrition. This study was conducted to describe the feeding practice among infants in a rural area in Bangladesh. Methods: A cross-sectional study was conducted between February and June 2013. Data was collected through face-to-face interviews of 212 mothers using a pretested questionnaire. Results: Exclusive breast feeding and complementary feeding rates were 40.6% and 97.3%, respectively. One third of the mothers practiced prelactal feeding, and honey was the most common item. Maternal illness (72.7%) was the most common reason for not giving breast milk. Infant formula was used as an alternative food in majority of the cases (72.7%). Conclusion: Percentage of exclusive breast feeding was not satisfactory. Encouragement of female education is recommended to improve feeding practices and infant car

Prevalence of Contraceptive Use among Married Women of Reproductive Age Group in a Rural Area of Bangladesh: A Cross-Sectional Study

Introduction: Population explosion is one of the important issues in all around the world and more specifically in a developing country like Bangladesh. Contraceptives are devices, techniques and methods used to prevent fertilization thereby population explosion.The present study is an attempt to assess the prevalence of contraceptive use among married women of reproductive age in a selected rural area in Bangladesh.Objectives: To assess the prevalence of contraceptive use among married women of reproductive age group (15-49 years) in a rural area of Bangladesh.Materials and Methods: This descriptive type of cross sectional study was conducted from February 2012 to June 2012 in Mulaid village of Gazipur district, Bangladesh. Purposive sampling technique was followed. Data were collected in a structured questionnaire through face to face interview. Study population was all married women of reproductive age group. Sample size was 420. Results: Among 420 respondents, 62.3% were using contraceptive methods at the time of study and rest, 37.7% were not using due to some reasons, such as pregnancy, breast feeding etc. A mostly used contraceptive method among current users (69%) was oral contraceptive pill. Conclusion: This study revealed the awareness about contraceptive used among the married women. More health education on reproductive health through school health clinic, family planning services and mass media can improve the health and family planning situation of our country. Government should provide more fund for research purposes in order to raise the awareness and control population explosion. Keywords: Contraceptive Methods, Reproduction, Bangladesh

Acute Oxalate Nephropathy Due to Bilimbi Poisoning: A Case Report

Background: The concentrated juice made from Averrhoa bilimbi is rich in oxalic acid. It can cause acute oxalate nephropathy by blocking the tubules with calcium oxalate crystals. Case: An elderly woman was admitted to the hospital with a history of swelling of the legs, facial puffiness, and abdominal distention. Her biochemical study revealed features of acute renal failure. She gave history of taking half liter of bilimbi juice. Renal biopsy confirmed it was a case of acute oxalic nephropathy, which made it the second case of acute oxalic nephropathy due to ingestion of bilimbi juice ever reported from Bangladesh.Conclusion: It is not safe to consume high oxalate-containing fruits in large quantities

Eye diseases: the neglected health condition among urban slum population of Dhaka, Bangladesh

Introduction: Globally, eye diseases are considered as one of the major contributors of nonfatal disabling conditions. In Bangladesh, 1.5% of adults are blind and 21.6% have low vision. Therefore, this paper aimed to identify the community-based prevalence and associated risk factors of eye diseases among slum dwellers of Dhaka city. Methods: The study was carried out in two phases. In the first phase, a survey was conducted using multistage cluster sampling among 1320 households of three purposively selected slums in Dhaka city. From each household, one family member (≥ 18 years old) was randomly interviewed by trained data collectors using a structured questionnaire. After that, each of the participants was requested to take part in the second phase of the study. Following the request, 432 participants out of 1320 participants came into the tertiary care hospitals where they were clinically assessed by ophthalmologist for presence of eye diseases. A number of descriptive and inferential statistics were performed using Stata 13. Result: The majority of total 432 study participants were female (68.6%), married (82.6%) and Muslim (98.8%). Among them almost all (92.8%) were clinically diagnosed with eye disease. The most prevalent eye diseases were refractive error (63.2%), conjunctivitis (17.1%), visual impairment (16.4%) and cataract (7.2%). Refractive error was found significantly associated with older age, female gender and income generating work. Cataract was found negatively associated with the level of education, however, opposite relationship was found between cataract and visual impairment. Conclusion: Our study provides epidemiologic data on the prevalence of eye diseases among adult population in low-income urban community of Dhaka city. The high prevalence of refractive error, allergic conjunctivitis, visual impairment, and cataract among this group of people suggests the importance of increasing access to eye care services

Attitude towards diabetes and social and family support among type 2 diabetes patients attending a tertiary-care hospital in Bangladesh: a cross-sectional study

Background: Bangladesh has been suffering from an epidemiological transition from infectious and maternal diseases to non-communicable lifestyle-related diseases like diabetes, cardiovascular diseases, cancers etc. The burden of diabetes has been increasing rapidly due to high incidence as well as poor glycemic control leading to various macro and micro-vascular complications. In this study, we aim to assess the attitude towards diabetes and social and family support among the Bangladeshi type 2 diabetic mellitus (T2DM) patients. Methods: This was a cross-sectional study among 144 patients with T2DM at the medicine outpatient department of Dhaka Medical College Hospital (DMCH) in Dhaka, Bangladesh between 1 July and 31 July 2014. Data collection was done by interviewing patients using structured questionnaire. Understanding diabetes, education/advice received, attitude towards diabetes, family and friend support were measured by validated scales adapted from diabetes care profile. Results: This study includes a total of 144 patients (101 males and 43 females) with type 2 diabetes aged between 20 and 84 years. 87 % of the patients had inadequate blood glucose control (fasting blood sugar >7.2 mmol/L or >130 mg/dl). Statistically significant differences were observed in the mean scores of various attitude scales (i.e. positive, negative, care ability and self-care adherence scale) among patients with adequate and inadequate blood glucose control (p < 0.05). Statistically significant positive correlations were found between these three categories of social and family support. Self-satisfaction with diabetic care was significantly associated with adequate blood glucose control (p = 0.05). Conclusions: Positive attitude towards diabetes management and support from friends and family were associated with adequate diabetes management. Appropriate public health interventions should be designed to educate and motivate the family members to offer greater support to the diabetes patients

Prevalence of multiple non-communicable diseases risk factors among adolescents in 140 countries:A population-based study

BACKGROUND: Modifiable non-communicable disease (NCD) risk factors are becoming increasingly common among adolescents, with clustering of these risk factors in individuals of particular concern. The aim of this study was to assess global status of clustering of common modifiable NCD risk factors among adolescents. METHODS: We used latest available data from nationally representative survey for 140 countries, namely the Global School-based Student Health Survey, the Health Behaviour in School-Aged Children and the longitudinal study of Australian Children. Weighted mean estimates of prevalence with corresponding 95% confidence intervals of nine NCD risk factors - physical inactivity, sedentary behaviour, insufficient fruits and vegetable consumption, carbonated soft drink consumption, fast food consumption, tobacco use, alcohol consumption and overweight/obesity - were calculated by country, region and sex. FINDINGS: Over 487,565 adolescents, aged 11–17 years, were included in this study. According to trend analysis, prevalence of four or more NCD risk factors increased gradually over time. Prevalence of four or more NCD risk factors was 14.8% in 2003–2007 and increased to 44% in 2013–2017, an approximately three-fold increase (44.0%). Similar trends were also observed for three and two risk factors. Large variation between countries in the prevalence of adolescents with four or more risk factors was found in all regions. The country level range was higher in the South-East Asia Region (minimum Sri Lanka = 8%, maximum Myanmar = 84%) than Western Pacific Region (minimum China = 3%, maximum Niue = 72%), European Region (minimum Sweden = 13.9%, maximum Ireland = 66.0%), African Region (minimum Senegal = 0.8%, maximum Uganda = 82.1%) and Eastern Mediterranean Region (minimum Libya = 0.2%, maximum Lebanon = 80.2%). Insufficient vegetable consumption, insufficient fruit consumption and physically inactivity were three of the four most prevalent risk factors in all regions. INTERPRETATION: Our results suggest a high prevalence of four or more NCD risk factors in adolescents globally, although variation was found between countries. Results from our study indicate that efforts to reduce adolescent NCD risk factors and the associated health burden need to be improved. These findings can assist policy makers to target the rollout of country- specific interventions. FUNDING: None

Global, regional, and national burden of chronic kidney disease, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI

Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: Human resources for health (HRH) include a range of occupations that aim to promote or improve human health. The UN Sustainable Development Goals (SDGs) and the WHO Health Workforce 2030 strategy have drawn attention to the importance of HRH for achieving policy priorities such as universal health coverage (UHC). Although previous research has found substantial global disparities in HRH, the absence of comparable cross-national estimates of existing workforces has hindered efforts to quantify workforce requirements to meet health system goals. We aimed to use comparable and standardised data sources to estimate HRH densities globally, and to examine the relationship between a subset of HRH cadres and UHC effective coverage performance. Methods: Through the International Labour Organization and Global Health Data Exchange databases, we identified 1404 country-years of data from labour force surveys and 69 country-years of census data, with detailed microdata on health-related employment. From the WHO National Health Workforce Accounts, we identified 2950 country-years of data. We mapped data from all occupational coding systems to the International Standard Classification of Occupations 1988 (ISCO-88), allowing for standardised estimation of densities for 16 categories of health workers across the full time series. Using data from 1990 to 2019 for 196 of 204 countries and territories, covering seven Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) super-regions and 21 regions, we applied spatiotemporal Gaussian process regression (ST-GPR) to model HRH densities from 1990 to 2019 for all countries and territories. We used stochastic frontier meta-regression to model the relationship between the UHC effective coverage index and densities for the four categories of health workers enumerated in SDG indicator 3.c.1 pertaining to HRH: physicians, nurses and midwives, dentistry personnel, and pharmaceutical personnel. We identified minimum workforce density thresholds required to meet a specified target of 80 out of 100 on the UHC effective coverage index, and quantified national shortages with respect to those minimum thresholds. Findings: We estimated that, in 2019, the world had 104·0 million (95% uncertainty interval 83·5–128·0) health workers, including 12·8 million (9·7–16·6) physicians, 29·8 million (23·3–37·7) nurses and midwives, 4·6 million (3·6–6·0) dentistry personnel, and 5·2 million (4·0–6·7) pharmaceutical personnel. We calculated a global physician density of 16·7 (12·6–21·6) per 10 000 population, and a nurse and midwife density of 38·6 (30·1–48·8) per 10 000 population. We found the GBD super-regions of sub-Saharan Africa, south Asia, and north Africa and the Middle East had the lowest HRH densities. To reach 80 out of 100 on the UHC effective coverage index, we estimated that, per 10 000 population, at least 20·7 physicians, 70·6 nurses and midwives, 8·2 dentistry personnel, and 9·4 pharmaceutical personnel would be needed. In total, the 2019 national health workforces fell short of these minimum thresholds by 6·4 million physicians, 30·6 million nurses and midwives, 3·3 million dentistry personnel, and 2·9 million pharmaceutical personnel. Interpretation: Considerable expansion of the world's health workforce is needed to achieve high levels of UHC effective coverage. The largest shortages are in low-income settings, highlighting the need for increased financing and coordination to train, employ, and retain human resources in the health sector. Actual HRH shortages might be larger than estimated because minimum thresholds for each cadre of health workers are benchmarked on health systems that most efficiently translate human resources into UHC attainment

Mapping disparities in education across low- and middle-income countries

Analyses of the proportions of individuals who have completed key levels of schooling across all low- and middle-income countries from 2000 to 2017 reveal inequalities across countries as well as within populations. Educational attainment is an important social determinant of maternal, newborn, and child health(1-3). As a tool for promoting gender equity, it has gained increasing traction in popular media, international aid strategies, and global agenda-setting(4-6). The global health agenda is increasingly focused on evidence of precision public health, which illustrates the subnational distribution of disease and illness(7,8); however, an agenda focused on future equity must integrate comparable evidence on the distribution of social determinants of health(9-11). Here we expand on the available precision SDG evidence by estimating the subnational distribution of educational attainment, including the proportions of individuals who have completed key levels of schooling, across all low- and middle-income countries from 2000 to 2017. Previous analyses have focused on geographical disparities in average attainment across Africa or for specific countries, but-to our knowledge-no analysis has examined the subnational proportions of individuals who completed specific levels of education across all low- and middle-income countries(12-14). By geolocating subnational data for more than 184 million person-years across 528 data sources, we precisely identify inequalities across geography as well as within populations.Peer reviewe