There is inadequate information on the etiology of diarrhea in severely malnourished (SM) young children. Thus, the study aimed to determine the etiology of diarrhea among severely malnourished (z score ?3.00 SD) chil...There is inadequate information on the etiology of diarrhea in severely malnourished (SM) young children. Thus, the study aimed to determine the etiology of diarrhea among severely malnourished (z score ?3.00 SD) children in rural and urban Bangladesh. From the database (2000-2011) of Diarrheal Disease Surveillance Systems (DDSS) at rural Matlab and urban Dhaka hospitals of icddr,b, 2234 and 3109 under-5 children were found severely malnourished (underweight, stunted or wasted) respectively. Two comparison groups [moderately malnourished (MM) and well-nourished (WN)] were randomly selected in a ratio of 1:1:1. Children with all categories of SM were more likely to be infected with Vibrio cholerae (rural—11%;urban—15%), Shigella (16%;9%), Salmonella (1%;2%) and Campylobacter (3%;4%);and less likely to have rotavirus (25%;20%) compared to only one SM category. Isolation rate of Vibrio cholerae was significantly higher among SM both in rural and urban children (7%;13%) than those of MM (5%;10%) and WN (2%;8%) and lower for rotavirus (30%;31%), (34%;43%), (35%;47%) respectively (p 0.01). However, for Shigella it was only higher among rural SM children (11%) [MM (9%), and WN (8%) (p 0.01)]. The isolation rate of Salmonella in SM (2%) was similar to that in MM (2%;p = 0.72) but significantly higher than that in WN (1%;p 0.01) among urban children. Isolation rates of bacterial enteric pathogens were higher but rotavirus was lower in SM children in both rural and urban area with geographical heterogeneity.展开更多
There is a scarcity of information examining the prevalence of overweight and obesity in the general population of Bangladesh. Thus, the present study aimed to estimate the changing trends and socio-demographic charac...There is a scarcity of information examining the prevalence of overweight and obesity in the general population of Bangladesh. Thus, the present study aimed to estimate the changing trends and socio-demographic characteristics of overweight and obese individuals among an urban population inDhaka,Bangladesh. The present study included data from 49,532 patients enrolled in the Diarrheal Disease Surveillance System (DDSS) at theDhakaHospitalfrom 1993-2011. Overweight and obese was categorized among under-5 children (n = 508), 5 19 years (n = 96), and >19 years (n = 1330). Data was compared with normal weight and malnourished individuals of respective age strata. The proportion of overweight and obese increased from 0.64% 5.15% among children 0.001), 0.80% 6.70% among 5 19 years (p 0.001), and 3.66% 16.94% (p 0.001) among >19 years. Among those under-5, males [OR = 1.31 (95%CI 1.08, 1.57)] those with higher socio-economic status [1.99 (1.02, 3.82)], higher monthly mean family income [3.76 (2.41, 5.86)], non-slum residence [2.01 (0.74, 5.51)], high maternal literacy rate [3.66 (2.31, 5.79)], and using sanitary toilet [1.47 (1.07, 2.01)] were at higher risk of being overweight and obese compared to well-nourished and malnourished children. Among individuals 5 19 years, those with higher socioeconomic status and use of sanitary toilet were at higher risk of being overweight and obese. Among those >19 years, additionally males were less likely to be overweight and obese [0.59 (0.49, 0.68)]. Over the last two decades the prevalence of overweight and obesity in Dhaka city has increased at least five folds and it was much higher among those with better socioeconomic status.展开更多
Typhoidal (Salmonella enterica serover Typhi and Para-typhi A and B) (TS) and non-typhiodal Salmonella (NTS) gastroenteritis are less reported in Bangladesh. There is also a lack of report on socio-demographic and cli...Typhoidal (Salmonella enterica serover Typhi and Para-typhi A and B) (TS) and non-typhiodal Salmonella (NTS) gastroenteritis are less reported in Bangladesh. There is also a lack of report on socio-demographic and clinical characteristics of Bangladeshi people with typhoid fever and those with non-typhoidal Salmonella (NTS) gastroenteritis. Thus, the present study aimed to compare the socio-demographic, host and clinical characteristics, and seasonal variations between TS and NTS infections among patients attending at a large diarrheal disease hospital in urban Bangladesh. Information were extracted from the database of icddr,b in two different age stratums (0-14 years, and 15 years and above) as 54 with TS and 199 with NTS;and 65 with TS and 239 with NTS respectively after excluding all other pathogens. Randomly selected individuals with diarrhea but without any pathogen in stool constituted the control group (n = 253 and n = 304 respectively). Among 0-14 years, fever [aOR-4.35 (95% CI-1.45-13.06)] and drink unboiled water [aOR-0.22 (95% CI-0.06-0.83)] significantly differed between TS and NTS. Significant associations were observed with lower socio-economic context [aOR-10.02 (95% CI-3.79-26.45)], unbolied drinking water [aOR-2.16 (95% CI-1.05-4.43)], fever [aOR-4.54 (95% CI-1.71-12.03)], pneumonia [aOR-21.57 (95% CI-1.90-245.01)], wasting [aOR-2.60 (95% CI-1.21-5.57)], presence of RBC [aOR-0.09 (95% CI-0.02-0.33], leucocytes [aOR-3.97 (95% CI-1.76-8.99)] and macrophage [aOR-10.71 (95% CI-2.80-41.06)] in stool and alkaline pH [aOR-2.07 (95% CI-1.08-3.97)] when compared with control group. Among ≥15 years, TS was more frequently isolated from individuals with poor socio-economic background [aOR-2.09 (95% CI-1.0-4.33)] and use non-tap drinking water [aOR-0.29 (95% CI-0.13-0.66] compared to their NTS counterparts. Reported lack of formal schooling [aOR-0.65 (95% CI-0.44-0.96)], fever [aOR-2.10 (95% CI-1.03-4.31)], hospital stay (>24 hours) [aOR-1.66 (95% CI-1.05-2.62)], use of intravenous saline [aOR-0.50 (95% CI-0.34-0.76)] and RBC [aOR-2.34 (95% CI-1.23-4.45)] were associated with TS and NTS compared to control group. Socio-demographic, host and clinical characteristics between TS and NTS gastroenteritis were identical;however, findings significantly differed when compared with individuals presented with diarrhea but without any common enteric pathogen in stool.展开更多
文摘There is inadequate information on the etiology of diarrhea in severely malnourished (SM) young children. Thus, the study aimed to determine the etiology of diarrhea among severely malnourished (z score ?3.00 SD) children in rural and urban Bangladesh. From the database (2000-2011) of Diarrheal Disease Surveillance Systems (DDSS) at rural Matlab and urban Dhaka hospitals of icddr,b, 2234 and 3109 under-5 children were found severely malnourished (underweight, stunted or wasted) respectively. Two comparison groups [moderately malnourished (MM) and well-nourished (WN)] were randomly selected in a ratio of 1:1:1. Children with all categories of SM were more likely to be infected with Vibrio cholerae (rural—11%;urban—15%), Shigella (16%;9%), Salmonella (1%;2%) and Campylobacter (3%;4%);and less likely to have rotavirus (25%;20%) compared to only one SM category. Isolation rate of Vibrio cholerae was significantly higher among SM both in rural and urban children (7%;13%) than those of MM (5%;10%) and WN (2%;8%) and lower for rotavirus (30%;31%), (34%;43%), (35%;47%) respectively (p 0.01). However, for Shigella it was only higher among rural SM children (11%) [MM (9%), and WN (8%) (p 0.01)]. The isolation rate of Salmonella in SM (2%) was similar to that in MM (2%;p = 0.72) but significantly higher than that in WN (1%;p 0.01) among urban children. Isolation rates of bacterial enteric pathogens were higher but rotavirus was lower in SM children in both rural and urban area with geographical heterogeneity.
文摘There is a scarcity of information examining the prevalence of overweight and obesity in the general population of Bangladesh. Thus, the present study aimed to estimate the changing trends and socio-demographic characteristics of overweight and obese individuals among an urban population inDhaka,Bangladesh. The present study included data from 49,532 patients enrolled in the Diarrheal Disease Surveillance System (DDSS) at theDhakaHospitalfrom 1993-2011. Overweight and obese was categorized among under-5 children (n = 508), 5 19 years (n = 96), and >19 years (n = 1330). Data was compared with normal weight and malnourished individuals of respective age strata. The proportion of overweight and obese increased from 0.64% 5.15% among children 0.001), 0.80% 6.70% among 5 19 years (p 0.001), and 3.66% 16.94% (p 0.001) among >19 years. Among those under-5, males [OR = 1.31 (95%CI 1.08, 1.57)] those with higher socio-economic status [1.99 (1.02, 3.82)], higher monthly mean family income [3.76 (2.41, 5.86)], non-slum residence [2.01 (0.74, 5.51)], high maternal literacy rate [3.66 (2.31, 5.79)], and using sanitary toilet [1.47 (1.07, 2.01)] were at higher risk of being overweight and obese compared to well-nourished and malnourished children. Among individuals 5 19 years, those with higher socioeconomic status and use of sanitary toilet were at higher risk of being overweight and obese. Among those >19 years, additionally males were less likely to be overweight and obese [0.59 (0.49, 0.68)]. Over the last two decades the prevalence of overweight and obesity in Dhaka city has increased at least five folds and it was much higher among those with better socioeconomic status.
文摘Typhoidal (Salmonella enterica serover Typhi and Para-typhi A and B) (TS) and non-typhiodal Salmonella (NTS) gastroenteritis are less reported in Bangladesh. There is also a lack of report on socio-demographic and clinical characteristics of Bangladeshi people with typhoid fever and those with non-typhoidal Salmonella (NTS) gastroenteritis. Thus, the present study aimed to compare the socio-demographic, host and clinical characteristics, and seasonal variations between TS and NTS infections among patients attending at a large diarrheal disease hospital in urban Bangladesh. Information were extracted from the database of icddr,b in two different age stratums (0-14 years, and 15 years and above) as 54 with TS and 199 with NTS;and 65 with TS and 239 with NTS respectively after excluding all other pathogens. Randomly selected individuals with diarrhea but without any pathogen in stool constituted the control group (n = 253 and n = 304 respectively). Among 0-14 years, fever [aOR-4.35 (95% CI-1.45-13.06)] and drink unboiled water [aOR-0.22 (95% CI-0.06-0.83)] significantly differed between TS and NTS. Significant associations were observed with lower socio-economic context [aOR-10.02 (95% CI-3.79-26.45)], unbolied drinking water [aOR-2.16 (95% CI-1.05-4.43)], fever [aOR-4.54 (95% CI-1.71-12.03)], pneumonia [aOR-21.57 (95% CI-1.90-245.01)], wasting [aOR-2.60 (95% CI-1.21-5.57)], presence of RBC [aOR-0.09 (95% CI-0.02-0.33], leucocytes [aOR-3.97 (95% CI-1.76-8.99)] and macrophage [aOR-10.71 (95% CI-2.80-41.06)] in stool and alkaline pH [aOR-2.07 (95% CI-1.08-3.97)] when compared with control group. Among ≥15 years, TS was more frequently isolated from individuals with poor socio-economic background [aOR-2.09 (95% CI-1.0-4.33)] and use non-tap drinking water [aOR-0.29 (95% CI-0.13-0.66] compared to their NTS counterparts. Reported lack of formal schooling [aOR-0.65 (95% CI-0.44-0.96)], fever [aOR-2.10 (95% CI-1.03-4.31)], hospital stay (>24 hours) [aOR-1.66 (95% CI-1.05-2.62)], use of intravenous saline [aOR-0.50 (95% CI-0.34-0.76)] and RBC [aOR-2.34 (95% CI-1.23-4.45)] were associated with TS and NTS compared to control group. Socio-demographic, host and clinical characteristics between TS and NTS gastroenteritis were identical;however, findings significantly differed when compared with individuals presented with diarrhea but without any common enteric pathogen in stool.
