Socio-demographic characteristics and tobacco use among the adults in urban slums of Dhaka, Bangladesh

Background: Use of tobacco has become one of the major causes of premature deaths in most developing countries, including Bangladesh. The poorest and most disadvantaged populations, such as those living in slums, are considered to be extremely vulnerable to non-communicable diseases and their risk factors, especially tobacco use. The objective of this study was to assess the current status of tobacco consumption among slum dwellers and its association with socio-demographic factors. Methods: A cross-sectional study was conducted in three slums of Dhaka city. Information about tobacco use as well as socio-demographic characteristics was collected from adult slum dwellers via face to face interviews using WHO STEPS questionnaire. Result: Overall proportion of smoking, smokeless tobacco consumption and dual use of tobacco was 35% [95% CI: 31.6-39.8], 40.6% [95% CI: 36.5-45.2] and 12% [95% CI: 9.3-15.0] respectively. Elderly people (55-64 years) were more likely to smoke (OR: 2.34, 95% CI: 1.21-4.49) than younger people (aged 25-34 years). On the other hand, those who had no schooling history (OR: 2.95, 95% CI: 1.66-5.25) were more likely to consume smokeless tobacco than those who had higher education (secondary or above). At the same time, manual workers were more likely to indulge in dual use of tobacco (OR: 5.17, 95% CI: 2.82-9.48) as compared to non-manual workers. Conclusion: The urban slum population of Dhaka city has a high prevalence of tobacco use, which increases their likelihood of developing non-communicable diseases. Proper attention needs to be directed towards addressing the risk factors related to non-communicable diseases within this vulnerable population

Non-communicable disease (NCD) risk factors and diabetes among adults living in slum areas of Dhaka, Bangladesh

Backgroun

Impact of fortified biscuits on micronutrient deficiencies among primary school children in Bangladesh

Background Micronutrient deficiencies can compromise the development potential of school-aged children, and their later health and productivity as adults. School feeding and school-based fortification approaches have been utilized globally to redress nutritional deficiencies in this age group. Objective We explored the acceptability and micronutrient impact of a Bangladesh Government supported school-based micronutrient fortification program for children attending rural primary schools in 10 disadvantaged sub-districts. Methods We applied a mixed methods approach. The quantitative component assessed the impact of micronutrient fortification on 351 children aged 6-11 years using a cohort pre-post research design with a control group. The qualitative component explored the acceptability of the intervention using focus group discussions, body mapping and semi-structured interviews with teachers, school-going children and school authorities. Results Daily consumption of fortified biscuits by primary school children had a significant positive impact on mean levels of iron, folic acid, vitamin B12, retinol and vitamin D controlling for sex, baseline deficiency status, CRP, and H. pylori. Levels of anemia and vitamin D deficiency were also significantly reduced. Qualitative findings indicated the widespread acceptability of the daily biscuit. Teachers perceived students to be more attentive in class, less tired, and some attributed better school performance to biscuit consumption. Children reported similar improvements in concentration and energy levels. Conclusions This study is among the first in Bangladesh to comprehensively assess a school-based fortification program in terms of its acceptability and impact on micronutrient status of children aged 6-11 years of age. While results strongly support this modality of school feeding, research on the cognitive impacts of micronutrient fortified biscuits will help clarify the case for scaled-up investments in school- based feeding program in Bangladesh and other low and middle income countries

Association between socio-demographic characteristics and selected NCD risk factors (currently smoking, fruits and vegetables consumption, and physical activity) (Unadjusted odds ratios (UOR) and adjusted odds ratio (AOR) are estimated using regression model) (n = 507).

<p>Association between socio-demographic characteristics and selected NCD risk factors (currently smoking, fruits and vegetables consumption, and physical activity) (Unadjusted odds ratios (UOR) and adjusted odds ratio (AOR) are estimated using regression model) (n = 507).</p

NCD risk factors by selected socio-demographic characteristics (n = 507).

<p>NCD risk factors by selected socio-demographic characteristics (n = 507).</p

Association between socio-demographic characteristics and clustering of NCD risk factors using logistic regression model (n = 503).

<p>Association between socio-demographic characteristics and clustering of NCD risk factors using logistic regression model (n = 503).</p

Baseline characteristics of primary school children in intervention and control groups^*.

<p>Baseline characteristics of primary school children in intervention and control groups^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0174673#t003fn001" target="_blank">*</a>}.</p

Nutrient composition of fortified biscuits per 100 gm.

<p>Nutrient composition of fortified biscuits per 100 gm.</p

The prevalence and adjusted relative risk ratios of different micronutrient deficiencies at baseline and endline comparing primary school children in intervention and control groups^*.

<p>The prevalence and adjusted relative risk ratios of different micronutrient deficiencies at baseline and endline comparing primary school children in intervention and control groups^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0174673#t006fn001" target="_blank">*</a>}.</p

Micronutrient deficiency cut-offs for children.

<p>Micronutrient deficiency cut-offs for children.</p