Comparative resistance and yield performance of summer mungbean mutants and varieties as affected by MYMV

An experiment was conducted in the research field of the Department of Plant Pathology, Patuakhali Science and Technology University during February to April 2013 to select Mungbean Yellow Mosaic Virus (MYMV) resistant mutant/variety under natural epiphytotic condition. The screening was made on the six mungbean genotypes including three advanced mutant lines, MBM-07, MBM-21, MBM-88 and three varieties Bina mung-5, Bina mung-6, Bina mung-8 as check, to evaluate their reaction to MYMV at flowering and pod maturity stages. It was observed that at the flowering stage of MBM-21, MBM-88, and Bina mung-6 were found resistant with percent disease incidence recorded from 0.5, 1.0, and 0.5 percent respectively. At the maturity stage, no genotype were found to be immune and the disease incidence varied from the lowest 0.5 % in MBM-21 to highest 26 % in MBM-7. The mutant MBM-21 and variety Bina mung-6 were found moderately resistant with disease incidence ranging from 1 to 10 %. Among the less MYMV infected mungbean mutants, MBM-21 gave the highest yield (1569 kg ha-1) and the lowest yield was in MBM-07 (1183kg ha-1). The mutants MBM-21 completed by the short duration of 61.67 days as compared to check Bina mung-6 (67.33 days). Out of six summer screened mungbean mutants and varieties, MBM-21 exhibited highest resistance in both flowering and pod maturity stage. Therefore, MBM-21 might be selected as a resistant variety against MYMV after further trail in different Agro-Ecological Zones (AEZ) of Bangladesh

Long-term Impact of Changing Childhood Malnutrition on Rotavirus Diarrhoea: Two Decades of Adjusted Association with Climate and Socio-Demographic Factors from Urban Bangladesh

Background There is strong association between childhood rotavirus, diarrhoea, climate factors and malnutrition. Conversely, a significant nutritional transition (reduced under-nutrition) with a concurrent increasing trend of rotavirus infection in last decade was also observed among under 5 children, especially in developing countries including Bangladesh. Considering the pathophysiology of rotavirus, there might be an interaction of this nutrition transition which plays a pivotal role in increasing rotavirus infection in addition to climate and other man-made factors in urban areas such as Dhaka, Bangladesh. Methods Relevant monthly data from 1993–2012 were extracted from the archive of the Diarrhoeal Disease Surveillance System of icddr, b and linked with data collected from the Dhaka station of the Bangladesh Meteorological Department (mean temperature, rainfall, sea level pressure and humidity). Seasonal autoregressive integrated moving average time series models were deployed to determine the association between the monthly proportion of rotavirus infection and underweight, stunting and wasting adjusting for climate, socio-demographic and sanitation factors. Finding The proportion of rotavirus cases among all causes diarrhoea increased from 20% in 1993 to 43% in 2012 (Chi squared for trend p = 0.010). In contrast, underweight, stunting and wasting decreased from 59%-29% (p \u3c 0.001); 53%-21% (p \u3c 0.001) and 32%-22% (p \u3c 0.001) respectively over the same period. Mean ambient temperature increased from 25.76°C-26.62°C (p = 0.07); mean rainfall, sea level pressure and mean humidity decreased from 234.92–111.75 mm (p = 0.5), 1008.30–1006.61 mm of hg (p = 0.02) and 76.63%-70.26% (p \u3c 0.001), respectively. In the adjusted model, a decrease in monthly proportion of underweight [coef.: -0.189 (95% CI:-0.376, -0.003)] and wasting [-0.265 (-0.455, -0.075)] were significantly and inversely associated with rotavirus infection. However, an inverse but insignificant association was observed for stunting [-0.070 (-0.249, 0.109)]. Interpretation The reduction of acute childhood malnutrition is significantly associated with increasing rotavirus diarrhoea among under-5 children. Thus mass vaccination in addition to interventions directed at man-made modifiable predictors for prevention and control is warranted

Health Education Through a Campaign and mHealth to Enhance Knowledge and Quality of Life Among Patients With Chronic Kidney Disease in Bangladesh: Protocol for a Randomized Controlled Trial

BACKGROUND: Despite the growing burden of chronic kidney disease (CKD), disease knowledge and understanding are still lacking, especially in Bangladesh. OBJECTIVE: The aim of this study was to evaluate the outcome of a health education intervention in order to enhance knowledge, health-related quality of life (QOL), and motivation regarding healthy lifestyles among rural and periurban adults suffering from CKD. METHODS: A parallel-group (1:1) randomized controlled trial is ongoing in the Mirzapur subdistrict, Bangladesh, where two groups of patients with CKD are being compared. Patients aged 18 years and over with CKD (stages 1-3) were enrolled in November 2020. Patients were randomly allocated into either the intervention group (n=63) or the control group (n=63). The control group received usual treatment, while the intervention group received health education through a CKD campaign facilitated by a nephrologist and via mHealth (ie, periodic mobile phone calls) from community health workers. Both groups were followed up for a period of 6 months. The primary endpoint is patients' increased knowledge measured using the Chronic Kidney Disease Knowledge Questionnaire. The secondary endpoints are improved QOL measured using the standardized EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire as well as improvements in the levels of blood pressure, BMI, serum creatinine, fasting blood sugar, hemoglobin, cholesterol, high-density lipoprotein cholesterol, triglyceride, serum uric acid, blood urea nitrogen, and albumin to creatinine ratio. RESULTS: Enrollment of participants began in November 2020; the intervention and follow-up were completed in May 2021. We enrolled 126 patients in the study. Patients' mean ages were 57.97 (SD 15.03) years in the control group and 57.32 (SD 14.37) years in the intervention group. There were 45 out of 63 (71%) females in the control group and 38 out of 63 (60%) females in the intervention group. In addition, there were 38 out of 63 (60%) literate patients in the control group and 33 out of 63 (52%) literate patients in the intervention group. CONCLUSIONS: It is expected that a combined approach, incorporating both a CKD campaign and mHealth, for health education may be an effective tool for increasing knowledge and improving QOL among patients with CKD. TRIAL REGISTRATION: ClinicalTrials.gov NCT04094831; https://clinicaltrials.gov/ct2/show/NCT04094831. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/30191

Toxoplasma gondii Infection Is Associated with Low Birth Weight: Findings from an Observational Study among Rural Bangladeshi Women

Gestational Toxoplasma gondii (T. gondii) infection may cause substantial adverse effects on developing fetuses, newborns and also mothers. This study aims to estimate the seroprevalence of T. gondii among rural Bangladeshi pregnant women and determine the risk of a low birth weight (LBW). We followed a longitudinal design where 208 pregnant women were followed until the birth of their infants. Levels of IgG and IgM of T. gondii were assessed using chemiluminescent immunoassay. Modified Poisson regression was used to estimate crude and adjusted associations and multiple regression analysis was performed to understand the confounding and modifying effects of the variables. Thirty-nine (19%) children were born with LBW, among whom 15 (39%) mothers were positive for T. gondii IgG during pregnancy. After adjusting for several confounders and modifiers, pregnant women with T. gondii IgG or IgM seropositivity were significantly associated with LBW of infants (aRR: 2.00, 95% CI: 1.17-3.42). The strength of this association increased after adjusting for maternal education (aRR: 4.88, 95% CI: 1.74-13.69). The final model had an AROC of 0.84 with a sensitivity of 36% and specificity of 97%. Although causality is yet to be established, the study observed an association between T. gondii infection during pregnancy among rural Bangladeshi women and LBW of newborns

Perceptions about Telemedicine among Populations with Chronic Diseases amid COVID-19: Data from a Cross-Sectional Survey

Chronic diseases, including non-communicable diseases (NCDs), have arisen as a severe threat to health and socio-economic growth. Telemedicine can provide both the highest level of patient satisfaction and the lowest risk of infection during a pandemic. The factors associated with its usage and patient adherence are not visible in Bangladesh's resource-constrained settings. Therefore, this study aimed to identify perceptions about telemedicine among populations with chronic diseases amid the COVID-19 pandemic. A closed-ended self-reported questionnaire was created, and the questionnaire was written, reviewed, and finalized by a public health investigator, a psychiatrist, and an epidemiologist. The data for this study were collected from individuals using simple random sampling and snowball sampling techniques. Ethics approval was granted, and written/verbal consent was taken before interviews. Most of the participants showed a positive attitude towards telemedicine. People aged 35-54 years old and a higher level of education were less frequently associated with willingness to receive telemedicine services for current chronic disease (WRTCCD) than their counterparts. People living in urban areas and lower-income participants were more strongly associated with WRTCCD. Additionally, people who did not lose their earnings due to the pandemic were less strongly associated with WRTCCD. However, the main strength of this research is that it is a broad exploration of patient interest in several general forms of telehealth. In Bangladesh, there are many opportunities for telemedicine to be integrated into the existing healthcare system, if appropriate training and education are provided for healthcare professionals

Feasibility and acceptability of telepathology system among the rural communities of Bangladesh: A pilot study

Context: Telepathology is a promising tool for remote communities to receive pathology services where professional diagnosis services are inadequate. Aims: We aimed to clarify how effective telepathology was when compared with conventional pathology service among rural communities of Bangladesh. Methods and Materials: We conducted a cross-sectional study in suburban and rural areas of Bangladesh between June and August 2020. We enrolled 117 participants who received both telepathology services from Thakurgaon Eye Hospital and conventional pathology service experience. The participant's satisfaction with the accessibility and perceptions were statistically compared. In addition, we summarized descriptive statistics using the frequencies and percentages of participants' responses. Statistical Analysis Used: Wilcoxon's Signed-rank test using SPSS statistic software version 25.00. Results: Among the study participants, service cost, travel cost, travel time, waiting time, and travel distance were significantly higher for conventional pathology than telepathology (P < 0.001). The majority of participants (94%) were satisfied with the telepathology experience; however, one out of 117 participants was dissatisfied with this service when their travel distance was far away (≥50 km). Among the participants, 91.5% thought that telepathology service was effective for their treatment, and 98.3% wanted to continue this service in their community. On an average, participants saved 58% (95% CI, 53.4–61.5) of cost using telepathology rather than conventional pathology service. Conclusions: Remote under-resourced communities received professional pathology services with less time-consuming and significantly lower costs using the telepathology approach. Where pathology services are absent/insufficient, telepathology is efficacious for primary diagnosis, screening, and referral through professional pathologists for the satisfactory treatment of unreached communities

Beyond the regulatory radar: knowledge and practices of rural medical practitioners in Bangladesh

Abstract Background Informal and unregulated rural medical practitioners (RMPs) provide healthcare services to about two-thirds of people in Bangladesh, although their service is assumed to be substandard by qualified providers. As the RMPs are embedded in the local community and provide low-cost services, their practice pattern demands investigation to identify the shortfalls and design effective strategies to ameliorate the service. Methods We conducted a cross-sectional study in 2015–16 using a convenient sample from all 64 districts of Bangladesh. Personnel practising modern medicine, without any recognized training, or with recognized training but practising outside their defined roles, and without any regulatory oversight were invited to take part in the study. Appropriateness of the diagnosis and the rationality of antibiotic and other drug use were measured as per the Integrated Management of Childhood Illness guideline. Results We invited 1004 RMPs, of whom 877 consented. Among them, 656 (74.8%) RMPs owned a drugstore, 706 (78.2%) had formal education below higher secondary level, and 844 (96.2%) had informal training outside regulatory oversight during or after induction into the profession. The most common diseases encountered by them were common cold, pneumonia, and diarrhoea. 583 (66.5%) RMPs did not dispense any antibiotic for common cold symptoms. 59 (6.7%) and 64 (7.3%) of them could identify all main symptoms of pneumonia and diarrhoea, respectively. In pneumonia, 28 (3.2%) RMPs dispensed amoxicillin as first-line treatment, 819 (93.4%) dispensed different antibiotics including ceftriaxone, 721 (82.2%) dispensed salbutamol, and 278 (31.7%) dispensed steroid. In diarrhoea, 824 (94.0%) RMPs dispensed antibiotic, 937 (95.4%) dispensed ORS, 709 (80.8%) dispensed antiprotozoal, and 15 (1.7%) refrained from dispensing antibiotic and antiprotozoal together. Conclusions Inappropriate diagnoses, irrational use of antibiotics and other drugs, and polypharmacy were observed in the practising pattern of RMPs. The government and other stakeholders should acknowledge them as crucial partners in the healthcare sector and consider ways to incorporate them into curative and preventive care

Factors Associated With Pneumonia Among Overweight and Obese Under-Five Children in an Urban Hospital of a Developing Country

To our knowledge, there are no data on the role of overweight and obesity in childhood pneumonia. We sought to determine that impact of overweight and obesity in such children. In this retrospective chart analysis, we enrolled hospitalized children aged 6 to 59 months in the Dhaka Hospital of the icddr,b, Bangladesh (International Centre for Diarrhoeal Disease Research, Bangladesh), from January 2010 to June 2014. Children with pneumonia having overweight and obesity (body mass index score [BMIZ] >2.00) constituted cases (n = 25), and those who had pneumonia without overweight and obesity (BMIZ -2.00 to 2.00) constituted controls (n = 75). Controls were 3-fold of the cases and were randomly selected. Demographic, clinical, and laboratory data of the cases and the controls were compared. The cases more often had diarrhea and dehydration (36% vs 12%, = .013), hypoxemia (SpO < 90% in room air; 28% vs 7%, = .009) on admission, and required to change antibiotics (32% vs 11%, = .023) during hospitalization compared to the controls. However, in logistic regression analysis the cases were independently associated with diarrhea ( < .001) and hypoxemia ( = .024) on admission. Our data suggest that overweight and obesity in children with pneumonia is prone to be associated with hypoxemia on admission, which may guide clinicians in promptly managing pneumonia in order to evade its ramification in such children. However, future research with larger samples is imperative to consolidate or refute our observation

Bacterial Isolates from Tracheal Aspirates and their Anti-microbial Susceptibility in Mechanically-Ventilated Children with Pneumonia Admitted to an Urban Critical Care Ward

Background and Aims: Data on Bacterial isolates from tracheal aspirates in children with severe pneumonia requiring intubation and mechanical ventilation especially in developing countries are very limited. We examined the microbial spectrum of bacteria isolated from tracheal aspirate of those children. The antibiotic susceptibility profiles of those bacteria were also examined. Methods: We evaluated the data of all mechanically ventilated children aged 0-59 months admitted to Intensive Care Unit (ICU) of Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) between August 2009 and July 2013 having their tracheal aspirate culture done. Data were extracted from electronic medical records of the Dhaka Hospital. Results: Among 836 admitted pneumonia children in the ICU, we identified 35 children who fulfilled the inclusion criteria. Among them 34 (97%) had positive bacterial growths: Klebseilla species in 14 (40%), Escherichia coli in 11 (31%), Acinetobacter in 8 (23%) and Streptococcus species in 8 (23%). Additionally, Enterococcus, Staphylococcus aureus, Pseudominas and Proteus species were identified in 6 (17%), 4 (11%), and 2 (6%) of the children respectively. The susceptibility of the gram-negatives, except Klebseilla, to ampicillin, cotrimoxazole, gentamycin, ciprofloxacin, azithromycin, and ceftriaxone ranged from 0- 54%, while that for ceftazidime and amikacin ranged from 12-80%. The sensitivity of Klebseilla to these antibiotics ranged from 0-100%. Conclusions: Our data suggests that gram-negative bacteria, Klebseilla followed by Escherichia coli, and Acenetobacter are the predominant bacteria associated with severe pneumonia in ventilated children. The increased number of infections caused by Gram-negative bacteria is being accompanied by rising rates of multi-drug resistance which underscores the importance of aggressive antimicrobial therapy in the management of such children

Changing characteristics of rotavirus diarrhea in children younger than five years in urban Bangladesh

Background: Childhood rotavirus diarrhea is still one of the major public health challenges. The present study aimed to determine changing characteristics of rotavirus diarrhea in under-5 children at two periods of time. Methods: We enrolled 5,357 under-5 children with rotavirus positive in two different time periods; i) 1993-1997 (n = 2,493), and ii) 2008-2012 (n = 2,864) considering beginning and ending of two decades. These children were enrolled in the urban Dhaka Hospital of icddr,b. Results: Overall, proportion of rotavirus was about 25% in 1993-97, which was 42% in 2008-12 (68% rise; p5 [38% vs. 35%; aOR-1.32 (95% CI-1.10-1.58)] required more intravenous fluid [9% vs. 3%; aOR-4.93 (95% CI-3.19-7.63)], had higher co-infection with Shigella [3% vs. 1%; aOR-3.36 (95% CI-1.61-7.03)], Vibrio cholerae [4% vs. 1%; aOR-3.70 (95% CI-2.12-6.46)]; and ETEC [13% vs. 7%; aOR-2.21 (95% CI-1.65-2.97)]; however, significantly lower proportion of them used sanitary toilets [54% vs. 78%; aOR-0.66 (95% CI-0.54-0.80)], boiled drinking water [16% vs. 38%; aOR-0.60 (95% CI-0.48-0.74)], used antimicrobial at home [63% vs. 82%; aOR-0.56 (95% CI-0.46-0.69)] and had some or severe dehydration [18% vs. 34%; aOR-0.15 (95% CI-0.12-0.20)] in 1st observation period compared to that of 2 nd. Conclusion: Proportion of episodes of under-5 rotavirus diarrhea increased over the period. Concomitant changes in host, socio-demographic and clinical characteristics, and co-infections were also observed. Thus, vaccination campaign which is prevailing in private sector should also be introduced in public sector