Association between Global Monkeypox Cases and Meteorological Factors

The emergence of an outbreak of Monkeypox disease (MPXD) is caused by a contagious zoonotic Monkeypox virus (MPXV) that has spread globally. Yet, there is no study investigating the effect of climatic changes on MPXV transmission. Thus, studies on the changing epidemiology, evolving nature of the virus, and ecological niche are highly paramount. Determination of the role of potential meteorological drivers including temperature, precipitation, relative humidity, dew point, wind speed, and surface pressure is beneficial to understand the MPXD outbreak. This study examines the changes in MPXV cases over time while assessing the meteorological characteristics that could impact these disparities from the onset of the global outbreak. To conduct this data-based research, several well-accepted statistical techniques including Simple Exponential Smoothing (SES), Auto-Regressive Integrated Moving Average (ARIMA), Automatic forecasting time-series model (Prophet), and Autoregressive Integrated Moving Average with Explanatory Variables (ARIMAX) were applied to delineate the correlation of the meteorological factors on global daily Monkeypox cases. Data on MPXV cases including affected countries spanning from 6 May 2022, to 9 November 2022, from global databases and meteorological data were used to evaluate the developed models. According to the ARIMAX model, the results showed that temperature, relative humidity, and surface pressure have a positive impact [(51.56, 95% confidence interval (CI): -274.55 to 377.68), (17.32, 95% CI: -83.71 to 118.35) and (23.42, 95% CI: -9.90 to 56.75), respectively] on MPXV cases. In addition, dew/frost point, precipitation, and wind speed show a significant negative impact on MPXD cases. The Prophet model showed a significant correlation with rising MPXD cases, although the trend predicts peak values while the overall trend increases. This underscores the importance of immediate and appropriate preventive measures (timely preparedness and proactive control strategies) with utmost priority against MPXD including awareness-raising programs, the discovery, and formulation of effective vaccine candidate(s), prophylaxis and therapeutic regimes, and management strategies.Peer reviewe

The 2022 dengue outbreak in Bangladesh: hypotheses for the late resurgence of cases and fatalities

Bangladesh reported the highest number of annual deaths (n = 281) related to dengue virus infection in 2022 since the virus reappeared in the country in 2000. Earlier studies showed that >92% of the annual cases occurred between the months of August and September. The 2022 outbreak is characterized by late onset of dengue cases with unusually higher deaths in colder months, that is, October-December. Here we present possible hypotheses and explanations for this late resurgence of dengue cases. First, in 2022, the rainfall started late in the season. Compared to the monthly average rainfall for September and October between 2003 and 2021, there was 137 mm of additional monthly rainfall recorded in September and October 2022. Furthermore, the year 2022 was relatively warmer with a 0.71°C increased temperature than the mean annual temperature of the past 20 yr. Second, a new dengue virus serotype, DENV-4, had recently reintroduced/reappeared in 2022 and become the dominant serotype in the country for a large naïve population. Third, the post-pandemic return of normalcy after 2 yr of nonpharmaceutical social measures facilitates extra mosquito breeding habitats, especially in construction sites. Community engagement and regular monitoring and destruction of Aedes mosquitoes' habitats should be prioritized to control dengue virus outbreaks in Bangladesh

An Estimation of Five-decade Long Monkeypox Case Fatality Rate: Systematic Review and Meta-analysis

On July 23, 2022 the World Health Organization (WHO) has announced the Monkeypox disease (MPXD) as a worldwide public health issue. This study conducts a systematic review and meta-analysis to determine the overall case fatality rate (CFR) of MPXD worldwide during 1970–2022. The tenure-tracked MPXD outbreaks associated with CFR were calculated based on available published data from six different periods (i.e., 1970-79, 1980-89, 1990-99, 2000-09, 2010-19, and 2000-2022). A total of 229 peer-reviewed accessible articles were investigated, of which, 17 articles met the inclusion and exclusion criteria. Most of the studies on MPXD CFR were published in the Democratic Republic of the Congo (DRC) providing 47% of data for the current meta-analysis. The overall pooled CFR of MPXD was 4.14% (range: 0.62% – 9.51%) during 1970–2022. In this study, total of 379 death cases were found from published MPXV based research articles where the pooled estimate CFR was 1.87%. The pooled CFR was higher during the earlier outbreak of the MPXD such as 10.71% in 1970-1979. With the progress of time, the CFR from MPXD followed a decreasing trend and reached 5.38% in 1980-1999 and 4.45% in 2000-2022. Young male children aged73.0%. This is the first meta-analysis using 52 years of data which indicates that the CFR of MPXV is decreasing from previous years. The findings of this meta-analysis might be paramount for the policymakers to tackle MPXD and minimize the overall CFR of MPXD through strategic actions

A 30-day follow-up study on the prevalence of SARS-COV-2 genetic markers in wastewater from the residence of COVID-19 patient and comparison with clinical positivity

Wastewater based epidemiology (WBE) is an important tool to fight against COVID-19 as it provides insights into the health status of the targeted population from a small single house to a large municipality in a cost-effective, rapid, and non-invasive way. The implementation of wastewater based surveillance (WBS) could reduce the burden on the public health system, management of pandemics, help to make informed decisions, and protect public health. In this study, a house with COVID-19 patients was targeted for monitoring the prevalence of SARS-CoV-2 genetic markers in wastewa-ter samples (WS) with clinical specimens (CS) for a period of 30 days. RT-qPCR technique was employed to target non-structural (ORF1ab) and structural-nucleocapsid (N) protein genes of SARS-CoV-2, according to a validated experimental protocol. Physiological, environmental, and biological parameters were also measured following the American Public Health Association (APHA) standard protocols. SARS-CoV-2 viral shedding in wastewater peaked when the highest number of COVID-19 cases were clinically diagnosed. Throughout the study period, 7450 to 23,000 gene copies/1000 mL were detected, where we identified 47 % (57/120) positive samples from WS and 35 % (128/360) from CS. When the COVID-19 patient number was the lowest (2), the highest CT value (39.4; i.e., lowest copy number) was identified from WS. On the other hand, when the COVID-19 patients were the highest (6), the lowest CT value (25.2 i.e., highest copy numbers) was obtained from WS. An advance signal of increased SARS-CoV-2 viral load from the COVID-19 patient was found in WS earlier than in the CS. Using customized primer sets in a traditional PCR approach, we confirmed that all SARS-CoV-2 variants identified in both CS and WS were Delta variants (B.1.617.2). To our knowledge, this is the first follow-up study to determine a temporal relationship be-tween COVID-19 patients and their discharge of SARS-CoV-2 RNA genetic markers in wastewater from a single house including all family members for clinical sampling from a developing country (Bangladesh), where a proper sewage system is lacking. The salient findings of the study indicate that monitoring the genetic markers of the SARS-CoV-2 virus in wastewater could identify COVID-19 cases, which reduces the burden on the public health system during COVID-19 pandemics.Peer reviewe

Wastewater-based epidemiological surveillance to monitor the prevalence of SARS-CoV-2 in developing countries with onsite sanitation facilities

Wastewater-based epidemiology (WBE) has emerged as a valuable approach for forecasting disease outbreaks in developed countries with a centralized sewage infrastructure. On the other hand, due to the absence of well-defined and systematic sewage networks, WBE is challenging to implement in developing countries like Bangladesh where most people live in rural areas. Identification of appropriate locations for rural Hotspot Based Sampling (HBS) and urban Drain Based Sampling (DBS) are critical to enable WBE based monitoring system. We investigated the best sampling locations from both urban and rural areas in Bangladesh after evaluating the sanitation infrastructure for forecasting COVID-19 prevalence. A total of 168 wastewater samples were collected from 14 districts of Bangladesh during each of the two peak pandemic seasons. RT-qPCR commercial kits were used to target ORF1ab and N genes. The presence of SARS-CoV-2 genetic materials was found in 98% (165/168) and 95% (160/168) wastewater samples in the first and second round sampling, respectively. Although wastewater effluents from both the marketplace and isolation center drains were found with the highest amount of genetic materials according to the mixed model, quantifiable SARS-CoV-2 RNAs were also identified in the other four sampling sites. Hence, wastewater samples of the marketplace in rural areas and isolation centers in urban areas can be considered the appropriate sampling sites to detect contagion hotspots. This is the first complete study to detect SARS-CoV-2 genetic components in wastewater samples collected from rural and urban areas for monitoring the COVID-19 pandemic. The results based on the study revealed a correlation between viral copy numbers in wastewater samples and SARS-CoV-2 positive cases reported by the Directorate General of Health Services (DGHS) as part of the national surveillance program for COVID-19 prevention. The findings of this study will help in setting strategies and guidelines for the selection of appropriate sampling sites, which will facilitate in development of comprehensive wastewater-based epidemiological systems for surveillance of rural and urban areas of low-income countries with inadequate sewage infrastructure.This research was supported by Water Aid Bangladesh, North South University, Dhaka, COVID-19 Diagnostic Lab, Department of Microbiology, Noakhali Science and Technology University (NSTU), Noakhali, Bangladesh, the International Training Network of Bangladesh University of Engineering and Technology (ITN-BUET) - Centre for Water Supply and Waste Management, and KTH Royal Institute of Technology, Sweden. We acknowledge the sincere help and support of the staff and volunteers of NSTU-COVID-19 Diagnostic Lab, Noakhali Science and Technology University, Bangladesh during the different phases of the study. PB and MTI acknowledge the Life Science Technology Platform, Science for Life Laboratory for the seed funding to initiate the wastewater-based epidemiological studies for SARS-CoV-2 in Bangladesh. We would also like to acknowledge the two anonymous reviewers for their critical comments as well as their thoughtful insights, which has significantly improved the manuscript.Peer reviewe

The Prevalence of Active Commuting to School and the Factors Influencing Mode Choice: A Study of University Students in a Secondary City of Bangladesh

Physical activity among people of all ages has been decreasing at an alarming rate in recent years. Active commuting is recognized as a public health strategy to increase physical activity. The objectives of the study were to determine the habit of active commuting and the associated factors of commute mode choice among university students in the secondary city of Sylhet, Bangladesh. The study was cross-sectional in nature, and information from three hundred and forty-eight students was collected through an online survey using Google Forms. In addition to basic statistical tools, a multiple logistic regression model was applied to identify the factors that were associated with the commuting mode choice of the students. The results have shown that the prevalence of using an active commuting mode is not at a satisfactory level (43%). No remarkable difference in commuting behavior was found between males and females. The “distance between campus and students’ residences” and the “mode of commuting preferred by roommate or classmate” are the most significant factors influencing students’ commuting choices and related actions. In addition, respondents with lower socio-economic conditions have more of a tendency to use active modes of commuting. Weather, time constraints, road safety, and family residence in rural or urban areas all have an impact on choosing an active mode of transportation for attending classes, but none is overly significant. It is recommended to promote the health and financial benefits of active commuting. Necessary facilities should be constructed to increase the level of active commuting, such as additional residential halls near campus and developing a built environment on the campus for walking and cycling for both male and female students

Exploring two pandemics in academic arena: physical activity and sedentary behaviors profile of university students in Bangladesh

The overlay of the COVID-19 pandemic on the pandemic of physical inactivity has become a great concern. Both types of pandemics can decrease the health protection capacity and consequently increase complexity in human lives. This cross-sectional study intended to examine changes in physical activity and sedentary behaviors during the COVID-19 pandemic among university students in a second-tier city of Bangladesh. Two hundred and nine students responded to an online questionnaire administered via Google Survey. In addition to descriptive statistics, parametric and non-parametric tests for comparing means, medians and distributions were used to assess differences in activity traits before and during the COVID-19 pandemic. Results show that the occurrence of COVID-19 has significantly reduced the practice of walking and physical activities among the students. They are commonly motivated by introjected regulation. Father’s occupation and the type of family of a student have significant influences on the total physical activity in either situation. Bangladeshi university students have, particularly, been perceived as not generally used to vigorous physical activities. They are inactive compared to students from other countries. Thus, the public health policymakers and the corresponding authority should inspire the students to be more physically active by implementing different strategies such as increasing bicycling and walking facilities on the campu

Exploring two pandemics in academic arena: physical activity and sedentary behaviors profile of university students in Bangladesh

The overlay of the COVID-19 pandemic on the pandemic of physical inactivity has become a great concern. Both types of pandemics can decrease the health protection capacity and consequently increase complexity in human lives. This cross-sectional study intended to examine changes in physical activity and sedentary behaviors during the COVID-19 pandemic among university students in a second-tier city of Bangladesh. Two hundred and nine students responded to an online questionnaire administered via Google Survey. In addition to descriptive statistics, parametric and non-parametric tests for comparing means, medians and distributions were used to assess differences in activity traits before and during the COVID-19 pandemic. Results show that the occurrence of COVID-19 has significantly reduced the practice of walking and physical activities among the students. They are commonly motivated by introjected regulation. Father’s occupation and the type of family of a student have significant influences on the total physical activity in either situation. Bangladeshi university students have, particularly, been perceived as not generally used to vigorous physical activities. They are inactive compared to students from other countries. Thus, the public health policymakers and the corresponding authority should inspire the students to be more physically active by implementing different strategies such as increasing bicycling and walking facilities on the campus

Cesarean delivery and early childhood diseases in Bangladesh: An analysis of Demographic and Health Survey (BDHS) and Multiple Indicator Cluster Survey (MICS).

IntroductionThe rate of cesarean delivery (C-section) has been increasing worldwide, including Bangladesh, and it has a negative impact on the mother and child's health. Our aim was to examine the association between C-section and childhood diseases and to identify the key factors associated with childhood diseases.MethodsWe used four nationally representative data sets from multiple indicator cluster survey (MICS, 2012 and 2019) and Bangladesh Demographic and Health Survey (BDHS, 2011and 2014) and analyzed 25,270 mother-child pairs. We used the frequency of common childhood diseases (fever, short or rapid breaths, cough, blood in stools, and diarrhea) as our outcome variable and C-section as exposure variable. We included mother's age, place of residence, division, mother's education, wealth index, child age, child sex, and child size at birth as confounding variables. Negative binomial regression model was used to analyze the data.ResultsIn the BDHS data, the prevalence of C-section increased from 17.95% in 2011 to 23.33% in 2014. Also, in MICS, the prevalence almost doubled over an eight-year period (17.74% in 2012 to 35.41% in 2019). We did not observe any significant effect of C-section on childhood diseases in both surveys. Only in 2014 BDHS, we found that C-section increases the risk of childhood disease by 5% [Risk Ratio (RR): 1.05, 95% CI: 0.95, 1.17, p = 0.33]. However, the risk of childhood disease differed significantly in all survey years by division, child's age, and child's size at birth after adjusting for important confounding variables. For example, children living in Chittagong division had a higher risk [(2011 BDHS RR: 1.22, 95% CI: 1.08, 1.38) and (2019 MICS RR: 1.21, 95% CI: 1.08, 1.35)] of having disease compared to Dhaka division. Maternal age, education, and wealth status showed significant differences with the outcome in some survey years.ConclusionOur study shows that C-section in Bangladesh continued to increase over time, and we did not find significant association between C-section and early childhood diseases. High C-section rate has a greater impact on maternal and child health as well as the burden on the health care system. We recommend raising public awareness of the negative impact of unnecessary C-section in Bangladesh