Exploring healthcare-seeking behavior of most vulnerable groups amid the COVID-19 pandemic in the humanitarian context in Cox’s Bazar, Bangladesh: Findings from an exploratory qualitative study

The COVID-19 pandemic has raised new concerns about healthcare service availability, accessibility, and affordability in complex humanitarian settings where heterogeneous populations reside, such as Rohingya refugees in Bangladesh. This study was conducted in ten Rohingya camps and four wards of the adjacent host communities in Cox’s Bazar to understand the factors influencing healthcare-seeking behavior of the most vulnerable groups (MVGs) during COVID-19 pandemic. Data were extracted from 48 in-depth interviews (24 in each community) conducted from November 2020 to March 2021 with pregnant and lactating mothers, adolescent boys and girls, persons with disabilities, elderly people, and single female-household heads. This study adopted Andersen’s behavioral model of healthcare-seeking for data analysis. Findings suggest that the healthcare-seeking behavior of the participants amid COVID-19 pandemic in the humanitarian context of Cox’s Bazar was influenced by several factors ranging from socioeconomic and demographic, existing gender, cultural and social norms, health beliefs, and various institutional factors. Lack of household-level support, reduced number of healthcare providers at health facilities, and movement restrictions at community level hampered the ability of many participants to seek healthcare services in both Rohingya and host communities. Most of the female participants from both communities required permission and money from their male family members to visit healthcare facilities resulting in less access to healthcare. In both communities, the fear of contracting COVID-19 from healthcare facilities disproportionately affected pregnant mothers, elderly people, and persons with disabilities accessing health services. Additionally, the economic uncertainty had a significant impact on the host communities’ ability to pay for healthcare costs. These findings have the potential to influence policies and programs that can improve pandemic preparedness and health system resilience in humanitarian contexts

Enhancement of Solar PV Hosting Capacity in a Remote Industrial Microgrid: A Methodical Techno-Economic Approach

To meet the zero-carbon electricity generation target as part of the sustainable development goals (SDG7), remote industrial microgrids worldwide are considering the uptake of more and more renewable energy resources, especially solar PV systems. Estimating the grid PV hosting capacity plays an essential role in designing and planning such microgrids. PV hosting capacity assessment determines the maximum PV capacity suitable for the grid and the appropriate electrical location for PV placement. This research reveals that conventional static criteria to assess the PV hosting capacity fail to ensure the grid’s operational robustness. It hence demands a reduction in the theoretical hosting capacity estimation to ensure grid compatible post-fault voltage and frequency recovery. Energy storage technologies, particularly fast-responsive batteries, can potentially prevent such undesirable scenarios; nevertheless, careful integration is required to ensure an affordable cost of energy. This study proposes a novel methodical techno-economic approach for an off-grid remote industrial microgrid to enhance the PV hosting capacity by integrating battery energy storage considering grid disturbance and recovery scenarios. The method has been validated in an industrial microgrid with a 2.6 MW peak demand in a ready-made garment (RMG) factory having a distinctive demand pattern and unique constraints in remote Bangladesh. According to the analysis, integrating 2.5 MW of PV capacity and a 1.2 MVA battery bank to offset existing diesel and grid consumption would result in an energy cost of BDT 14.60 per kWh (USD 0.1719 per kWh). For high PV penetration scenarios, the application of this method offers higher system robustness, and the financial analysis indicates that the industries would not only benefit from positive environmental impact but also make an economic profit

Knowledge, attitudes and practices of healthcare professionals toward the novel coronavirus during the early stage of COVID-19 in a lower-and-middle income country, Bangladesh

Healthcare workers (HCWs) are at an increased risk of COVID-19 infection because of their direct exposure to suspected and confirmed coronavirus patients in healthcare facilities. This condition is even more acute in low-and lower-middle-income countries (LMICs). Given the poor healthcare settings of Bangladesh, it is challenging to halt the spread of infection without proper knowledge, attitudes, and good behavioral practices (KAPs). Therefore, this study conducted a cross-sectional study from May 5 to 31, 2020, with 203 healthcare professionals to determine the knowledge, attitudes, and practices (KAP) toward COVID-19. Participants were doctors, nurses, dentists, and allied health professionals. A self-administered questionnaire including several KAP-related items aligned with the World Health Organization (WHO) guidelines was distributed over various online platforms to collect data. Bivariate and multivariable logistic regression analyses were conducted to determine the factors influencing KAP levels. The majority of participants were male (52.22%). The prevalence of high knowledge levels, positive attitudes, and good practices were 51.23, 45.81, and 49.75%, respectively. Social media was the most common source for seeking coronavirus information. Workers at private institutions were less likely (OR = 0.56, 95% CI = 0.30–0.95, p < 0.05) to be knowledgeable than workers at public institutions. Doctors had more positive attitudes than other healthcare professionals. Older participants showed high rates of good behavioral practices (OR = 1.05, 95% CI = 1.06–1.32, p < 0.05) than younger ones. Workers at private institutions had a better practice level toward COVID-19 (OR = 2.11, 95% CI = 1.17–3.83) than those at public institutions. These results point to the necessity for proper training programs for medical professionals that help them gain confidence to deliver the correct treatment to their patients and the need to implement preventative steps during pandemics

Evaluation of potential bacterial protease inhibitor properties of selected hydroxyquinoline derivatives : An in silico docking and molecular dynamics simulation approach

Antimicrobial drug resistance (AMR) is a severe global threat to public health. The increasing emergence of drug-resistant bacteria requires the discovery of novel antibacterial agents. Quinoline derivatives have previously been reported to exhibit antimalarial, antiviral, antitumor, antiulcer, antioxidant and, most interestingly, antibacterial properties. In this study, we evaluated the binding affinity of three newly designed hydroxyquinolines derived from sulfanilamide (1), 4-amino benzoic acid (2) and sulfanilic acid (3) towards five bacterial protein targets (PDB ID: 1JIJ, 3VOB, 1ZI0, 6F86, 4CJN). The three derivatives were designed considering the amino acid residues identified at the active site of each protein involved in the binding of each co-crystallized ligand and drug-likeness properties. The ligands displayed binding energy values with the target proteins ranging from −2.17 to −8.45 kcal/mol. Compounds (1) and (3) showed the best binding scores towards 1ZI0/3VOB and 1JIJ/4CJN, respectively, which may serve as new antibiotic scaffolds. Our in silico results suggest that sulfanilamide (1) or sulfanilic acid (3) hydroxyquinoline derivatives have the potential to be developed as bacterial inhibitors, particularly MRSA inhibitors. But before that, it must go through the proper preclinical and clinical trials for further scientific validation. Further experimental studies are warranted to explore the antibacterial potential of these compounds through preclinical and clinical studies. Communicated by Ramaswamy H. Sarma

Livelihood challenges of single female household heads in the Rohingya and host communities in Cox’s Bazar, Bangladesh during the COVID-19 pandemic

Background: Following the mass influx of Rohingya refugees into Cox’s Bazaar, Bangladesh in 2017, makeshift settlement camps in Ukhiya and Teknaf have been overburdened, leading to livelihood challenges for both Rohingya and host communities. The humanitarian crisis has had adverse effects on vulnerable populations, which include older people, persons with disabilities, adolescents, and single female household heads. Using a subset of a larger dataset on households with most vulnerable groups in both communities, we analysed the effect of the pandemic and lockdown on the livelihood of single female household (HH) heads. Methods: A cross-sectional household roster survey was designed to collect data from households with most vulnerable groups (MVGs) of host and Rohingya communities from December 2020 to March 2021; 11 host community villages and 10 Rohingya camps purposively selected as per the affiliated intervention of the project. The paper analysed quantitative and qualitative data from the sub-group of single female household heads without any income/low income. Participants were surveyed for their socio-demographic characteristics, COVID-19 experiences and knowledge, food security situation, social experiences and mental health using PHQ-2 test for depression. Results: We surveyed 432 single female HH heads. Support during the pandemic was reported to be low, with less than 50% of HHs reporting relief meeting their needs; only 36% and 15% of these HHs received rations in camps and host communities respectively. Loan facilities were mostly unavailable and there were reported insufficiencies in food consumption. Over 50% of respondents tested positive on the PHQ-2, a scale used to screen for depression. Further analyses indicates that having a chronic health issue (OR 2.2, 95% CI 1.33–3.66) was positively associated with the PHQ-2 score for Rohingya single females. For host single females, having an ill member in the HH (OR 1.46, 95% CI 1.02–2.08) and the inability to save before the pandemic (OR 1.57 95% CI 1.11–2.23) increased the odds of screening positive for depression. Conclusion: Our study findings revealed insufficiencies with economic opportunities and food security for single female-headed households, as well as a high rate of positive screening for depression amongst this population. These findings call for a more in-depth understanding of the needs of this group

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic