Journal of Health, Population, and Nutrition

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https://imsear.searo.who.int/handle/123456789/8

ISSN: 1606-0997 (Print)

Frequency: Quarterly

Language: English

Published by ICDDR,B: Centre for Health and Population Research

Peer-reviewed open access journal indexed in Index Medicus

Web site: https://www.banglajol.info/index.php/JHPN/

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Now showing 1 - 20 of 940

16S rRNA Gene-targeted TTGE in Determining Diversity of Gut Microbiota during Acute Diarrhoea and Convalescence.
(2012-09) Monira, Shirajum; Shabnam, Syeda Antara; Alam, Nur Haque; Endtz, Hubert Ph; Cravioto, Alejandro; Alam, Munirul
The human gut microbiota play a vital role in health and nutrition but are greatly modified during severe diarrhoea due to purging and pathogenic colonization. To understand the extent of loss during and after diarrhoea, faecal samples collected from children (n=21) suffering from acute diarrhoea and from their healthy siblings (n=9) were analyzed by 16S rRNA gene-targeted universal primer polymerase chain reaction (PCR), followed by temporal temperature gradient gel electrophoresis (TTGE). The gut microbiota decreased significantly as indicated by the number of TTGE bands at day 0 of acute diarrhoea [patients vs healthy siblings: 11±0.9 vs 21.8±1.1 (mean±standard error), p<0.01]. The number of bands showed a steady increase from day 1 to day 7; however, it remained significantly less than that in healthy siblings (15±0.9, p<0.01). These results suggest that appropriate therapeutic and post-diarrhoeal nutritional intervention might be beneficial for the early microbial restoration and recovery.
The 2008 Cholera Epidemic in Zimbabwe: Experience of the icddr,b Team in the Field.
(2011-10) Ahmed, Sirajuddin; Bardhan, Pradip Kumar; Iqbal, Anwarul; Mazumder, Ramendra Nath; Khan, Azharul Islam; Islam, Md Sirajul; Siddique, Abul Kasem; Cravioto, Alejandro
During August 2008–June 2009, an estimated 95,531 suspected cases of cholera and 4,282 deaths due to cholera were reported during the 2008 cholera outbreak in Zimbabwe. Despite the efforts by local and international organizations supported by the Zimbabwean Ministry of Health and Child Welfare in the establishment of cholera treatment centres throughout the country, the case-fatality rate (CFR) was much higher than expected. Over two-thirds of the deaths occurred in areas without access to treatment facilities, with the highest CFRs (>5%) reported from Masvingo, Manicaland, Mashonaland West, Mashonaland East, Midland, and Matabeleland North provinces. Some factors attributing to this high CFR included inappropriate cholera case management with inadequate use of oral rehydration therapy, inappropriate use of antibiotics, and a shortage of experienced healthcare professionals. The breakdown of both potable water and sanitation systems and the widespread contamination of available drinking-water sources were also considered responsible for the rapid and widespread distribution of the epidemic throughout the country. Training of healthcare professionals on appropriate cholera case management and implementation of recommended strategies to reduce the environmental contamination of drinking-water sources could have contributed to the progressive reduction in number of cases and deaths as observed at the end of February 2009.
The 2010 Outbreak of Cholera among Workers of a Jute Mill in Kolkata, West Bengal, India.
(2011-02) Mridha, Prakash; Biswas, Asit K; Ramakrishnan, R; Murhekar, Manoj V
On 10 March 2010, an outbreak of diarrhoeal disease was reported among workers of a jute mill in Kolkata, West Bengal, India. The cluster was investigated to identify the agent(s) and the source of infection and make recommendations. A suspected case of cholera was defined as having >3 loose watery stools in a 24-hour period and searched for case-patients in the workers’ colony. The outbreak was described by time, place, and person, and a case-control study was conducted to identify the source of infection. Rectal swabs were collected from the hospitalized case-patients, and the local water-supply system was assessed. In total, 197 case-patients were identified among 5,910 residents of the workers’ colony (attack rate 3.33%). Fifteen of 24 stool samples were positive for Vibrio cholerae O1. The outbreak started on 7 March, peaked on 11 March, and ended on 16 March 2010. Compared to 120 controls, 60 cases did not differ in terms of age and socioeconomic status. Drinking-water from the reservoir within the mill premises was associated with an increased risk of illness [odds ratio: 26.7, 95% confidence interval (CI) 11.4-62.6) and accounted for most cases (population attributable risk percentage=82%, 95% CI 70.8-92.9). An outbreak of cholera occurred among workers of the jute mill due to contamination of the drinking-water reservoir. It occurred within a few days of re-opening of the mill after the workers’ strike. Health authorities need to enforce disinfection of drinking-water and regularly test its bacteriological quality, particularly before re-opening of the mill after the strike.
Abdominal Tuberculosis in a Child Presenting with Radiological Evidence of Pneumatosis Intestinalis and Portal Venous Gas.
(2010-12) Alp, Handan; Orbak, Zerrin; Sepetcigil, Oguzhan; Kantarci, Mecit; Kartal, Ibrahim
Pneumatosis intestinalis, in association with portal venous gas, is a rare finding in children and young adults. In radiological studies, it is characterized by gas-filled cysts within the bowel-wall. It is often a sign of the serious significant underlying illness and is associated with a poor prognosis. A case of pneumatosis intestinalis and portal venous gas associated with abdominal tuberculosis in a child is presented here. Despite responding well to anti-tubercular treatment, he died suddenly at home, two months after discharge. It is recommended that cases with pneumatosis intestinalis should be carefully observed, although symptoms appear to be improving.
Abortion Clients of a Public-sector Clinic and a Non-governmental Organization Clinic in Nepal.
(2013-09) Thapa, Shyam; Neupane, Shailes
This paper investigates similarities and differences between abortion clients of a public-sector clinic and a non-governmental organization (NGO) clinic in Nepal. In 2010, a survey of 1,172 women was conducted in two highly-attended abortion clinics in Kathmandu—one public-sector clinic and another operated by an NGO. Data on the sociodemographic characteristics of clients, their fertility preferences, and use of contraceptives were analyzed. Similarities and differences between the two groups of clients were examined by either chi-square or t-test. The clients of the two clinics were similar with respect to age (27.3±5.7 years), education (26.5% had no education), and number of living children (1.88±1.08). They differed with regard to contraceptive practice, the circumstances resulting in unintended pregnancy, and future fertility preferences. Just over 50% clients of the public and 35% clients of the NGO clinic reported use of contraceptives surrounding the time of unintended pregnancy. The groups also differed in the contraceptive methods used and in reasons for not using any method. The NGO clinic contributed principally to expanding the availability of and access to abortion services.
Acceptability and accessibility of a Shigellosis vaccine in Nha Trang city of Viet Nam.
(2004-06-12) Kaljee, Linda M; Genberg, Becky L; von Seidlein, Lorenz; Canh, Do Gia; Thoa, Le Thi Kim; Thiem, Vu Dinh; Tho, Le Huu; Minh, Truong Tan; Trach, Dang Duc
The acceptability and accessibility of a hypothetical Shigella vaccination campaign was explored. A household survey was conducted with 539 randomly-selected residents of six communes in Nha Trang city of Viet Nam. Four categories of acceptability, such as refusers, low acceptors, acceptors, and high acceptors, were established, Refusers were significantly more likely to be elderly women and were less likely to know the purpose of vaccinations. Low acceptors tended to be male, elderly, and live in urban areas. Low acceptors perceived the disease as less serious and themselves as less vulnerable than acceptors and high acceptors. In terms of accessing vaccination, the commune health centre workers and commune leaders were the preferred sources of information and commune health centres the preferred location for vaccination. Direct verbal information from healthcare providers and audio-visual media were preferred to written information. The respondents expressed a desire for knowledge about the side-effects and efficacy of the vaccine. These findings are significant for targeting specific messages about shigellosis and vaccination to different populations and maximizing informed participation in public-health campaigns.
Acceptability and use of clean home delivery kits in Nepal: a qualitative study.
(2003-12-25) Beun, Monique H; Wood, Siri K
This research was carried out in rural Nepal to explore how different categories of birth attendants at home deliveries accepted and used clean home delivery kit (CHDK) and its contents, including hand-washing practices, during delivery and preparations for birth. In-depth interviews were conducted to collect information from 51 women-both users and non-users of the kit. The respondents were interviewed within one month of their most recent delivery. Results of the interviews showed that the attendants who used the kit perceived it as hygienic and convenient, affordable, and culturally acceptable. The razor blade and thread were the most useful items, and the purpose of the plastic coin was understood. Despite its perceived usefulness, awareness and use of the kit were low, and common reasons for non-use included not knowing about the kit or difficulty in procuring a kit locally. In addition, the kit had limited influence on general hygiene practices. The authors explore the importance of evaluating promotional efforts re-targeted to individuals who hold decision-making power regarding the use of the kit. They recommend that kit promoters emphasize hand-washing and single use of the kit.
Acceptability of and adherence to dispersible zinc tablet in the treatment of acute childhood diarrhoea.
(2005-09-03) Nasrin, Dilruba; Larson, Charles P; Sultana, Samina; Khan, Toslim U
Zinc treatment is now recommended by the World Health Organization as part of the routine management of acute childhood diarrhoea. A dispersible zinc tablet formulation was developed taking into account the taste, cost, and feasibility to distribute and store. Only limited information is available on the acceptability of and adherence to dispersible zinc tablet. No study has formally assessed whether the formulation is acceptable to children and if caretakers can adhere to the instructions regarding preparation, dosage, and duration of treatment. This community-based study aimed at determining the acceptability of and adherence to a dispersible zinc tablet formulation in a cohort of children (n=320) aged less than five years. Caretakers of children with acute childhood diarrhoea were prescribed zinc tablet treatment and followed up after 2-3 weeks. The formulation was acceptable to children; 90.1% of 303 caretakers perceived that the tablets were equally or even more acceptable to their children compared to other medicines. Ninety-eight percent of the children received the standard dose of one tablet per day, and 55.8% completed the full 10-day course of zinc treatment. Adherence rates did not vary by age or gender of the child. These findings indicate that the tablet formulation is acceptable, but further efforts are required to enhance adherence.
Acceptability of massage with skin barrier-enhancing emollients in young neonates in Bangladesh.
(2007-06-08) Ahmed, A S M Nawshad Uddin; Saha, Samir K; Chowdhury, M A K Azad; Law, Paul A; Black, Robert E; Santosham, Mathuram; Darmstadt, Gary L
Oil massage of newborns has been practised for generations in the Indian sub-continent; however, oils may vary from potentially beneficial, e.g. sunflower seed oil, to potentially toxic, e.g. mustard oil. The study was carried out to gain insights into oil-massage practices and acceptability of skin barrier-enhancing emollients in young, preterm Bangladeshi neonates. Preterm infants of <33 weeks gestational age were randomized to high-linoleate sunflower seed oil, Aquaphor Original Emollient Ointment, or the comparison group (usual care). A survey was administered at admission to assess routine skin-care practices prior to admission and at discharge to assess acceptability of emollient therapy during hospitalization. Oil massage was given to 83 (21%) of 405 babies before hospital admission, 86% (71/83) of whom were delivered at home. Application of oil, most commonly mustard oil (88%, 73/83), was started within one hour of birth in 51 cases (61%) and was applied all over the body (89%, 74/83) one to six (mean 2.2) times before admission. Of infants who received emollient therapy in the hospital, 42% (n=32) of mothers reported that the emollient applied in the hospital was better than that available at home, and only 29% would use the same oil (i.e. mustard oil) in the future as used previously at home. No problems resulted from use of emollient in the hospital. Topical therapy with sunflower seed oil or Aquaphor was perceived by many families to be superior to mustard oil. If caregivers and health professionals can be motivated to use inexpensive, available emollients, such as sunflower seed oil that are beneficial, emollient therapy could have substantial public-health benefit.
Access and Barriers to Immunization in West Bengal, India: Quality Matters.
(2013-12) Barman, Debjani; Dutta, Arijita
While many studies attempted to evaluate performance of immunization programmes in developing countries by full coverage, there is a growing awareness about the limitations of such evaluation, irrespective of the overall quality of performance. Availability of human resources, equipment, supporting drugs, and training of personnel are considered to be crucial indicators of the quality of immunization programme. Also, maintenance of time schedule has been considered crucial in the context of the quality of immunization. In addition to overall coverage of vaccination, the coverage of immunization given at right time (month-specific) is to be considered with utmost importance. In this paper, District Level Household and Facility Survey-3 (DLHS-3) 2007-2008 data have been used in exploring the quality of immunization in terms of month-specific vaccine coverage and barriers to access in West Bengal, India. In West Bengal, the month-specific coverage stands badly below 20% but the simple non-month-specific coverage is as high as 75%. Among the demand-side factors, birthplace of the child and religion of the household heads came out as significant predictors while, from the supply-side, availability of male health workers and equipment at the subcentres, were the important determinants for month-specific vaccine coverage. Hence, there should be a vigorous attempt to make more focused planning, keeping in mind the nature of the barriers, for improvement of the month-specific coverage in West Bengal.
Access to drinking-water and arsenicosis in Bangladesh.
(2006-09-21) Caldwell, Bruce K; Smith, Wayne T; Lokuge, Kamalini; Ranmuthugala, Geetha; Dear, Keith; Milton, Abul H; Sim, Malcolm R; Ng, Jack C; Mitra, S N
The discovery of arsenic contamination in groundwater has challenged efforts to provide safe drinking-water to households in rural Bangladesh. Two nationally-representative surveys in 2000 and 2002 investigated water-usage patterns, water-testing, knowledge of arsenic poisoning, and behavioural responses to arsenic contamination. Knowledge of arsenicosis rose between the two surveys among women from 42% to 64% but awareness of consequences of arsenic remained limited; only 13% knew that it could lead to death. Behavioural responses to arsenic have been limited, probably in part because of the lack of concern but also because households are uncertain of how best to respond and have a strong preference for tubewell water even when wells are known to be contaminated. Further work conducted by the survey team highlighted the difficulties in providing alternative sources of water, with many households switching back to their original sources of water.
Achieving the Millennium Development Goal for Under-five Mortality in Bangladesh: Current Status and Lessons for Issues and Challenges for Further Improvements.
(2011-04) Sayem, Amir Mohammad; Nury, Abu Taher Md Sanaullah; Hossain, Md. Delwar
The study assessed the achievements in, critically reviewed the relevant issues of, and put forward recommendations for achieving the target of the Millennium Development Goal relating to mortality of children aged less than five years (under-five mortality) in Bangladesh within 2015. To materialize the study objectives, a thorough literature review was done. Mortality of under-five children and infants decreased respectively to 65 from 151 and to 52 from 94 per 1,000 livebirths during 1990-2006. The immunization coverage increased from 54% to 81.9% during the same period. The projection shows that Bangladesh will achieve targeted reduction in under-five mortality and infant mortality within the time limit, except immunization coverage. Neonatal mortality contributed to the majority of childhood deaths. Contribution of neonatal mortality to child mortality was the highest. There were remarkable differences in child mortality by sex, division, and residence. To progress further for achieving the target of MDG relating to child mortality, some issues, such as lower use of maternal healthcare services, hazardous environmental effects on childhood illness, high malnutrition among children, shorter duration of exclusive breastfeeding practices, various child injuries leading to death, low healthcare-use of children, probable future threat of financial shortage, and strategies lacking area-wise focus on child mortality, need to be considered. Without these, the achievement of MDG relating to child mortality may not be possible within 2015.
Achieving the millennium development goals for health and nutrition in Bangladesh: key issues and interventions--an introduction.
(2008-09-04) Sack, David A
Achieving the millennium development goals in Bangladesh.
(2008-09-04) Sack, David A
Acquisition of bed-nets, sleeping-habits, and control of malaria in the Gambia: sociocultural dimension.
(2005-12-08) Okoko, Brown Jacob
Action monitoring for equity and gender in health.
(2008-09-04) Bhuiya, Abbas; Hanifi, S M A; Mahmood, Shehrin Shaila
Equity and gender, despite being universal concerns for all health programmes in Bangladesh, are often missing in many of the health agenda. The health programmes fail to address these important dimensions unless these are specifically included in the planning stage of a programme and are continually monitored for progress. This paper presents the situation of equity in health in Bangladesh, innovations in monitoring equity in the use of health services in general and by the poor in particular, and impact of targeted non-health interventions on health outcomes of the poor. It was argued that an equitable use of health services might also result in enhanced overall coverage of the services. The findings show that government services at the upazila level are used by the poor proportionately more than they are in the community, while at the private facilities, the situation is reverse. Commonly-used monitoring tools, at times, are not very useful for the programme managers to know how well they are doing in reaching the poor. Use of benefit-incidence ratio may provide a quick feedback to the health facility managers about their extent of serving the poor. Similarly, Lot Quality Assurance Sampling can be an easy-to-use tool for monitoring coverage at the community level requiring a very small sample size. Although health problems are biomedical phenomena, their solutions may include actions beyond the biomedical framework. Studies have shown that non-health interventions targeted towards the poor improve the use of health services and reduce mortality among children in poor households. The study on equity and health deals with various interlocking issues, and the examples and views presented in this paper intend to introduce their importance in designing and managing health and development programmes.
Active management of third stage of labour saves facility costs in Guatemala and Zambia.
(2006-12-27) Fullerton, Judith T; Frick, Kevin D; Fogarty, Linda A; Fishel, Joy D; Vivio, Donna M
This study calculated the net benefit of using active management of the third stage of labour (AMTSL) rather than expectant management of the third stage of labour (EMTSL) for mothers in Guatemala and Zambia. Probabilities of events were derived from opinions of experts, publicly available data, and published literature. Costs of clinical events were calculated based on national price lists, observation of resources used in AMTSL and EMTSL, and expert estimates of resources used in managing postpartum haemorrhage and its complications, including transfusion. A decision tree was used for modelling expected costs associated with AMTSL or EMTSL. The base case analysis suggested a positive net benefit from AMTSL, with a net cost-saving of US $18,000 in Guatemala (with 100 lives saved) and US $145,000 in Zambia (with 467 lives saved) for 100,000 births. Facilities have strong economic incentives to adopt AMTSL if uterotonics are available.
Acute otitis media during the first two years of life in a rural community in Bangladesh: a prospective cohort study.
(2007-12-12) Roy, Eliza; Hasan, Kh Zahid; Haque, Fazlul; Siddique, A K M; Sack, Richard Bradley
The study investigated the burden of acute otitis media (AOM) during the first two years of life in a cohort of 252 newborns in rural Bangladesh using data collected on occurrences of AOM. Trained community health workers (CHWs) conducted household surveillance and picked up cases of AOM using the study algorithm. The incidence rate was 0.9 episodes per child-year observed. Forty-six percent (n=115) of the 252 subjects developed AOM: 36% (n=91) during the first year of life and 10% (n=24) during the second year of life (p<0.001). The age-specific incidence rates of AOM varied; peaks occurred in the 6-12-month age-group and the lowest in the first three months of life. In total, 20% (n=49) of the study subjects had single, 26% (n=66) recurrent, and 54% (n=137) no episode of AOM. Perforation with discharge developed in 85% (n=322) of 375 episodes. The duration of discharge from the ears was < or =6 weeks in 95% of the episodes, but in 5% of the episodes, discharge from the ears continued for >6 weeks. The incidence of AOM was higher in the monsoon season compared to the summer season (p<0.003). The study documented AOM as an important cause of morbidity among rural children up to two years of age in Bangladesh and should be addressed with strategies to overcome the burden of disease.
Addressing Social Exclusion: Analyses from South Asia and Southern Africa.
(2009-08) Johnston, Heidi Bart
Adherence to antimalarial drug therapy among vivax malaria patients in northern Thailand.
(2009-02-03) Khantikul, Nardlada; Butraporn, Piyarat; Kim, Han S; Leemingsawat, Somjai; Tempongko, M A Sandra B; Suwonkerd, Wannapa
Vivax malaria is a significant cause of morbidity due to malaria in northern Thailand, accounting for approximately 50% of all malaria cases. The objective of this study was to determine the behavioural factors associated with adherence to the standard 14-day course of chloroquine and primaquine, prescribed from malaria clinics, among patients with vivax malaria. A retrospective study was conducted among 206 patients living in Muang and Mae Sa Riang districts of Mae Hon Son province in northern Thailand. Data on adherence and potential behavioural factors relating to adherence were collected using a structured interviewer-administered questionnaire and supplemented with qualitative data from focus-group interviews. The results indicated that 76.21% of the 206 patients with vivax malaria did not complete the medication course. The adherence of the patients was associated with knowledge scores of malaria (adjusted odds ratio [AOR]=2.2, 95% confidence interval [CI] 1.1-4.5) and accessing drug prescription scores (AOR=5.6, 95% CI 2.13-15.3). Therefore, further effort is needed to educate patients with vivax malaria on knowledge of malaria and its treatment with simple health messages and encourage them to adhere to their treatment.

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