Prevalence of Hepatitis C Virus Infection in Multi-transfused Thalassaemia Patients in Bangladesh

Background: Thalassaemia is one of the most common hereditary diseases worldwide including Bangladesh. Multitransfused thalassaemia patients may acquire hepatitis C virus infection in spite of currently practicing screening schedule. It is postulated that there are some pitfalls in the currently practicing screening system behind the transmission of HCV in transfusion-dependent thalassaemia patients. Objectives: To find out the prevalence of hepatitis C virus infection in transfusiondependent thalassaemia patients and thereby to see the efficacy of currently practicing screening schedule for hepatitis C virus. Materials and Methods: This cross-sectional study was conducted from 1st December, 2015 to 30th November, 2016 at Dhaka Shishu (Children) Hospital Thalassemia Center (DSHTC). Three hundred and twenty patients of multitransfused β-thalassaemia major and Hb E β-thalassaemia aged 3−18 years were enrolled. History was taken and physical examination was done. Blood specimens were collected and sent to the standard laboratory for detection of antibody against hepatits C virus. Results: Among the subjects, 174 (54.3%) were male and 146 (45.7%) were female. Out of total 320 patients, 75 (23%) were β-thalassaemia major and 245 (77%) were Hb E β-thalassaemia. Among the 320 thalassaemia cases, 47 were found positive for anti-HCV with an overall prevalence of 14.7%. Conclusion: Despite screening of blood donors by Rapid Device (Strip) Method, HCV infection remains an important cause of viral hepatitis infection among multitransfused thalassaemia children

Outcome of Childhood Acute Lymphoblastic Leukaemia after Induction Therapy --- Three-Year Experience in a Tertiary Care Hospital in Bangladesh

Background: The incidence of different malignancies is increasing among the world populations. Acute lymphoblastic leukaemia (ALL) is the most common of all the paediatric malignancies. Response to induction therapy is one of the most important predictors of long term outcome of ALL. Objective: To see the immediate outcome of paediatric ALL patients following induction therapy. Materials and Methods: This retrospective study was conducted from January 2013 to December 2015. Total 221 paediatric ALL patients were included in this study. Diagnosis was based on history, examination, blast cells count on peripheral blood film and bone marrow study, CSF study and immunophenotyping of peripheral blood/bone marrow aspirate in patients who were financially capable. Among them, parents of 40 (18%) patients did not agree to start chemotherapy. According to Modified UK ALL 2003 protocol (Regimen A & B) 181 patients were given induction therapy (vincristine, prednisolone, L-asparaginase, and daunomycin) in high risk patients. Among them 14 patients discontinued, 10 patients died during chemotherapy and rest 157 patients completed induction phase. Bone marrow study was repeated after completion of induction therapy and remission pattern was seen. Results: Out of 157 chemotherapy completed patients, 137 (87%) went into complete remission (<5% blast cells in bone marrow), 14 (9%) into partial remission (5--25% blast cells in bone marrow) and 6 (4%) was not in remission (>25% blast cells in the bone marrow). Ten (5.5%) patients died due to bleeding, febrile neutropenia and sepsis during the course of induction therapy. Conclusion: ALL in children is curable with effective chemotherapy. Poverty, ignorance and misconception regarding outcome are responsible for refusal and discontinuation of chemotherapy in third world countries like Bangladesh. Mortality and treatment cost can be reduced with the improvement of the facilities for isolation, barrier nursing and supportive treatment, and by creating awareness

Infrastructure alone cannot ensure resilience to weather events in drinking water supplies

Climate resilient water supplies are those that provide access to drinking water that is sustained through seasons and through extreme events, and where good water quality is also sustained. While surface and groundwater quality are widely understood to vary with rainfall, there is a gap in the evidence on the impact of weather and extremes in rainfall and temperature on drinking water quality, and the role of changes in water system management. A three-country (Bangladesh, Nepal and Tanzania) observational field study tracked 2353 households clustered around 685 water sources across seven different geographies over 14 months. Water quality (E. coli) data was modelled using GEE to account for clustering effects and repeated measures at households. All types of infrastructure were vulnerable to changes in weather, with differences varying between geographies; protected boreholes provided the greatest protection at the point of collection (PoC). Water quality at the point of use (PoU) was vulnerable to changes in weather, through changes in PoC water quality as well as changes in management behaviours, such as safe storage, treatment and cleaning. This is the first study to demonstrate the impact of rainfall and temperature extremes on water quality at the PoC, and the role that weather has on PoU water quality via management behaviours. Climate resilience for water supplies needs to consider the infrastructure as well as the management decisions that are taking place at a community and household level

An epidemiological overview of malaria in Bangladesh

Summary: Bangladesh is one of the four major malaria-endemic countries in South-East Asia having approximately 34% of its population at risk of malaria. This paper aims at providing an overview of the malaria situation in this country. Relevant information was retrieved from published articles and reports in PubMed and Google Scholar.Malaria in Bangladesh is concentrated in 13 districts with a prevalence ranging between 3.1% and 36%, and is mostly caused by Plasmodium falciparum. Geographical conditions pose a potential risk for Plasmodium knowlesi malaria. Resistance to a number of drugs previously recommended for treatment has been reported. Low socio-economic status, poor schooling and close proximity to water bodies and forest areas comprise important risk factors.Despite the significant steps in Long Lasting Insecticide Net (LLIN)/Insecticide Treated Net (ITN) coverage in Bangladesh, there are still many challenges including the extension of malaria support to the remote areas of Bangladesh, where malaria prevalence is higher, and further improvements in the field of referral system and treatmen