32 research outputs found

    Exploration of gaps and challenges in managing burn injury at district and sub-district government health care facilities in Bangladesh

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    Background: Burn injury is one of the leading cause of mortality and morbidity worldwide. In developing countries like Bangladesh, burn is one of the leading causes of illness, disabilities and deaths. More than 365,000 people are injured every year by electrical, thermal and other causes of burn injuries where 27,000 people needed hospital admission and over 5600 people died. Emergency management of burn at the facility level can reduce the severity of burn injuries and improve overall survival. The study has explored the health care providers’ views on gaps and challenges in management of burn injury at the facilities district and sub district health facilities in Bangladesh. Methodology: A qualitative study was conducted during the period in July 2015. In-depth interviews (n = 19) were performed with the doctors and nurses working in the three district government hospitals and seven sub-district (upazila) government health facilities. Thematic analysis was performed on different themes. Results: Health care providers mentioned that the people are coming to the facilities usually, hours after the incidence. Before visiting the facilities, the burn victims mostly seek treatment from the traditional healers or form village doctors (quack) or from the local pharmacy, over the counter. Family waited until they felt that the patient may not survive. It has identified that delaying in decision making and transferring the patient to the health facility are the key challenges identified by the doctors and nurses when they attended any burn patients in their facility. Moreover, use of different traditional infectious agent in burnt areas from their home make the burn surface more damage. While as, deficiency of adequate supplies, logistics and adequate trainings for the health workers in the facility create much more difficulties to treat a burn patient at primary or secondary health care centers. Conclusion: Burn patients are maltreated in the community before coming to the healthcare facility in most of the cases. The community has misperceptions on burn management which delay the proper management in the facility. Readiness of the facility on the other hand is a big challenge. In order to consistent in burn care in Bangladesh, its equally important to build knowledge and awareness among the community on burn prevention and their role. Like this, readiness of the facilities in time will build confidence in community, thus in turns, will save thousands of lives from burn injury in Bangladesh

    Socioeconomic inequality in child injury in Bangladesh – implication for developing countries

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    <p>Abstract</p> <p>Background</p> <p>Child injury is an emerging public health issue in both developed and developing countries. It is the main cause of deaths and disabilities of children after infancy. The aim of this study was to investigate the socioeconomic inequality in injury related morbidity and mortality among 1–4 years children.</p> <p>Materials and methods</p> <p>Data used for this study derived from Bangladesh Health and Injury Survey. A multistage cluster sampling technique was conducted for this survey. In this study quintiles of socioeconomic status were calculated on the basis of assets and wealth score by using principle component analysis. The numerical measures of inequality in mortality and morbidity were assessed by the concentration index.</p> <p>Results</p> <p>The poorest-richest quintile ratio of mortality due to injury was 6.0 whereas this ratio was 5.6 and 5.5 for the infectious diseases and non-communicable diseases. The values of mortality concentration indices for child mortality due to infection, non-communicable diseases and injury causes were -0.40, -0.32 and -0.26 respectively. Among the morbidity concentration indices, injury showed significantly greater inequality. All the concentration indices revealed that there were significant inequalities among the groups. The logistic regression analysis indicated that poor children were 2.8 times more likelihood to suffer from injury mortality than rich children, taking into account all the other factors.</p> <p>Conclusion</p> <p>Despite concentration indices used in this study, the analysis reflected the family's socioeconomic position in a Bangladesh context, showing a very strong statistical association with child mortality. Due to the existing socioeconomic situation in Bangladesh, the poor children were more vulnerable to injury occurrence.</p

    Exploring perceptions of common practices immediately following burn injuries in rural communities of Bangladesh

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    © 2018 The Author(s). Background: Burns can be the most devastating injuries in the world, they constitute a global public health problem and cause widespread public health concern. Every year in Bangladesh more than 365,000 people are injured by electrical, thermal and other causes of burn injuries. Among them 27,000 need hospital admission and over 5600 people die. Immediate treatment and medication has been found to be significant in the success of recovering from a burn. However, common practices used in the treatment of burn injuries in the community is not well documented in Bangladesh. This study was designed to explore the perception of local communities in Bangladesh the common practices used and health-seeking behaviors sought immediately after a burn injury has occurred. Methods: A qualitative study was conducted using Focus Group Discussions (FGD) as the data collection method. Six unions of three districts in rural Bangladesh were randomly selected and FGDs were conducted in these districts with six burn survivors and their relatives and neighbours. Data were analyzed manually, codes were identified and the grouped into themes. Results: The participants stated that burn injuries are common during the winter in Bangladesh. Inhabitants in the rural areas said that it was common practice, and correct, to apply the following to the injured area immediately after a burn: egg albumin, salty water, toothpaste, kerosene, coconut oil, cow dung or soil. Some also believed that applying water is harmful to a burn injury. Most participants did not know about any referral system for burn patients. They expressed their dissatisfaction about the lack of available health service facilities at the recommended health care centers at both the district level and above. Conclusions: In rural Bangladesh, the current first-aid practices for burn injuries are incorrect; there is a widely held belief that using water on burns is harmful

    Applying quality improvement methods to neglected conditions: Development of the South Asia Burn Registry (SABR)

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    Objective: South Asia has the highest mortality rate from burns in the world. Application of quality improvement methods to burn care can help identify health system gaps. Our overall aim is to introduce a sustainable hospital-based burn registry for resource-constrained settings to assess health outcomes of burn injury patients presenting to dedicated burn injury centers in South Asia.Results: The South Asia Burn Registry (SABR) is implemented through collaborative approach in selected burn centers in Bangladesh and Pakistan. Th registry collects data on burn injury events, the care provided, and the functional status of patients at discharge from burn centers. It covers the entire spectrum of care provision for burn injury patients from the actual event through their discharge from the healthcare system. SABR investigates locally relevant contextual factors associated with burn injury and health-system requirements for burn patients receiving emergency and inpatient care in resource-constrained settings. It also explores factors associated with burn injury and care provision. SABR will inform better prevention and management efforts in South Asia and help to address healthcare needs of burn injury patients

    Health-seeking behaviour of stroke patients in a rural area of Bangladesh

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    Background: Improper health-seeking behaviours (HSB) have been correlated with detrimental health outcomes, elevated rates of illness and mortality. The study aimed to investigate how stroke patients in a rural community of Bangladesh seek health care. Methods: A cross-sectional survey was conducted in the Raiganj sub-district of Sirajganj district from January to June 2016, using a validated screening tool to identify stroke patients at the household level. Neurologists confirmed the diagnosis after examining all suspected cases. Out of the 419 suspected cases identified during the screening process, 186 cases were officially reported after undergoing a confirmed diagnosis. Information on health-seeking behaviour was collected through face-to-face interviews with patients or their attendants. Results: After experiencing a stroke, approximately 35% of patients received treatment from unregistered care providers and over 40% received treatment outside of a hospital setting. Males were significantly more likely than females to receive treatment from registered physicians or hospitals (P<.05 and P<.01). A significantly higher proportion of educated individuals sought healthcare from registered physicians or hospitals (P<.05). Although better health-seeking behaviour was observed among higher-income groups, the findings were not statistically significant. Around 67% of patients were found to be hypertensive, with about one-third of them not taking any medication for their elevated blood pressure. Approximately 37% of patients had elevated blood glucose levels but only 22% were taking medication. Conclusion: A notable proportion of stroke patients in rural Bangladesh sought treatment from unqualified service providers. Health-seeking behaviour was associated with factors such as gender, education, and economic condition. Bangabandhu Sheikh Mujib Medical University Journal 2023;16(2): 75-8

    Response to an earthquake in Bangladesh : Experiences and Lesson Learnt

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    A powerful earthquake occurred in Nepal on 25th April 2015 where the highest measure of the tremor was 7.9 on the Richter scale with a minimum of 6.6. The death toll was around 3000 and thousands were injured in the devastation of the disaster. The earthquake and subsequent earth tremors were also felt in other South East Asian countries including Bangladesh, India and China. Bangladesh was jolted twice by tremors and, although the tremor was not as severe, it was reported to be between 4 and 5 on the Richter scale. Aftershocks over the next few days were also experienced and these ranged around 5 on the Richter scale. In Bangladesh, six lives were lost, and more than 200 people were injured and were taken to hospital. There were also many buildings that collapsed in the mega city Dhaka and its surrounding areas. This study describes the country’s response to the earthquake. This experience and the lessons learnt highlight the importance for national earthquake-proof building regulations and systems to lessen the damage and devastation of any future earthquake

    Rescue and Emergency Management of a Man-Made Disaster: Lesson Learnt from a Collapse Factory Building, Bangladesh

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    A tragic disaster occurred on April 24, 2013, in Bangladesh, when a nine storied building in a suburban area collapsed and killed 1115 people and injured many more. The study describes the process of rescue operation and emergency management services provided in the event. Data were collected using qualitative methods including in-depth interviews and a focus group discussion with the involved medical students, doctors, volunteers, and local people. Immediately after the disaster, rescue teams came to the place from Bangladesh Armed Forces, Bangladesh Navy, Bangladesh Air Force, and Dhaka Metropolitan and local Police and doctors, medical students, and nurses from nearby medical college hospitals and private hospitals and students from colleges and universities including local civil people. Doctors and medical students provided 24-hour services at the disaster place and in hospitals. Minor injured patients were treated at health camps and major injured patients were immediately carried to nearby hospital. Despite the limitations of a low resource setting, Bangladesh faced a tremendous challenge to manage the man-made disaster and experienced enormous support from different sectors of society to manage the disaster carefully and saved thousands of lives. This effort could help to develop a standard emergency management system applicable to Bangladesh and other counties with similar settings

    Snakebite Epidemiology in Bangladesh : A national community based health and injury survey

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    Insert Snakebite is a global public health issue, and in majority of cases it is undermined. Tropical and subtropical countries are most effected, Bangladesh being one of them. There is scarcity of countries’ epidemiological situation in relation to snakebite poisoning. This study has looked at the epidemiological status of snakebite poisoning from national representative survey findings. Methods: A nationwide cross-sectional survey was conducted in 12 randomly selected districts of Bangladesh in 2003. A total of 171,366 households were surveyed and information was collected from 819,429 populations by face to face interview. Multi-stage cluster sampling methods were used in this survey and covered urban, rural and slum populations. Results: Annually an estimated 15,372 (10.98/100,000) individuals were bitten by snakes and of them 1709 (1.22/100,000) died every year. Males were found to be most vulnerable with a risk of 1.51 times higher than female. Rural populations were also 10.54 times higher at risk than the populations living in the urban areas. Among the victims 94% were from the poor socio economic conditions. Around 43.9% of the incidences occurred during evening to midnight. Home was found the most common area for snake bite (33.6%), and the Leg was found to be the most common site for biting (63.1%). A total of 96.6% victims sought treatment, of them 61% sought immediate treatment from traditional healing methods. Conclusions: Present incidence of snakebite in Bangladesh has clearly shown that there is emerging public health needs for intervention that can reduce the mortality and burden of the disease in the country

    Determinants of childhood burns in rural Bangladesh: A nested case–control study

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    Background: Burn is one of the major causes of childhood illnesses in Bangladesh and is the third leading cause of illness of 1- to 4-year-old children. Rural children are more at risk compared to urban-dwelling children. Objective: The study was designed to identify the risk factors of childhood burn in rural Bangladesh. Methods: This nested case–control study was conducted in rural Bangladesh. The study population was children of less than 10 years old in three sub-districts of Bangladesh. Results: Children of families who did not have a household with a separate kitchen, a common occurrence in rural areas, were at significantly higher risk of burn (OR 1.65; 95% CI 1.22–2.24). A kitchen without a door was also found to create a more hazardous environment compared to a kitchen with a door. The traditional kerosene lamp (kupi bati) was found to be one of the major determinants of childhood burn in rural Bangladesh (OR 3.16; 95% CI 1.58–6.35). No use or restricted use of kupi bati significantly reduces the risk of childhood burn. Children of nuclear families were at significantly higher risk of burn compared to combined families. Conclusion: Cooking in an open place and use of the traditional kerosene lamp are the major determinants of childhood burn in rural Bangladesh. A combined family environment reduces the risk of childhood burn. Childhood burn can be reduced by prohibiting use of kupi bati and limiting children's access to the cooking area. Promoting combined family could be an initiative of childhood burn prevention progra

    IJBT1107003

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    Abstract: Electrical injury is a major cause of burn injury and significant cause of mortality, morbidity and disability. To explore the proportional incidence of thermal and electrical burn injuries in Bangladesh, a population-based cross sectional survey was conducted between January and December 2003. Nationally representative data was collected from 171,366 rural and urban households, comprising of a total population of 819,429.The study was designed to describe the proportional incidence of thermal, electrical and chemical cause of burn in Bangladesh. Electrical injury constituted about one third of the total burn injuries. Among the total 1,999 injuries about 31% were due to electrical injuries, about 26% were due to flame, about 25% were due to hot liquid, over 16% by hot object, about 2% by chemical and less than 1% were due to explosives. The incidence of death rate was 3.97 per 100,000 populations per year. Thermal burn was found as the major cause of death due to burn injures and constituted 58% of the total deaths due to burn. Electrical injuries caused 42% of the deaths. It was estimated that more than 5,600 people die due to burn and electrical injuries every year in Bangladesh considering the incidence rate of 3.97 per 100,000 populations per year in the 150 million population. Electrical injury including lightning constitute about one third of the burn related mortality, morbidity and disabilities. Rural people and children are the more vulnerable group. Electrical injury needs to be included as a special component in a burn prevention strategy, particularly in rural Bangladesh
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