Browsing by Author "Quayyum, Zahidul"

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Air quality and respiratory health: prevalence, knowledge, and practices in Dhaka’s informal settlements - a cross-sectional study
(BRAC University, 2025) Akter, Rabeya; Quayyum, Zahidul; Saha, Priom
Background: Several studies suggest that air pollution causes morbidity and mortality, this problem is particularly severe in developing countries. However, little is known about the prevalence of respiratory symptoms among adults in informal settlements with varying air pollution and their practice and knowledge status regarding air pollution and its impact on health. The objective of this study is to explore the prevalence of respiratory symptoms in two informal settlements in Dhaka and the knowledge and practice status of the adult residents. Methods: The study design was cross-sectional and was conducted in Shyampur and Dakshinkhan areas. These study sites were selected based on air quality data collected from a study conducted in BRAC JPGSPH in 2023. Shyampur was selected for having comparatively high air pollution, whereas Dakshinkhan was chosen for having comparatively low air pollution. A total of 316 adult residents were interviewed. This study used multiple sequential logistic regression models to examine the relationship between respiratory symptoms, sociodemographic, and environmental factors, and knowledge and practice status. Results: The proportion of people having respiratory symptoms in Shyampur and Dashinkhan areas were 60.26% and 55.41% respectively. Knowledge status varied in the two areas, while the practice status was almost equal in Shyampur and Dakshinkhan. Results of the sequential multiple logistic regression revealed that the participants in Dakshinkhan had lower odds of having respiratory symptoms (OR= 0.61; 95% CI: 0.36-1.01) compared to Shyampur area. The odds of suffering from respiratory symptoms were significantly associated with individuals who are aged 50 years and above ( OR= 2.31; 95% CI: 1.07-4.98); those who were aged 30-39 years old (OR= 2.05; 95% CI: 1.11-3.82); exposure to indoor smoking (OR= 1.53; 95% CI:0.93-2.50), higher income level ( OR=1.91; 95% CI:1.04-3.49), knowledge status (Good level) ( OR= 2.07; 95% CI: 1.06-4.05), knowledge status (moderate level) ( OR = 2.07, 95% CI: 1.06-4.05). In stratified logistic regression analysis age, income, and exposure to smoking indoors showed a significant association, while in Dakshinkhan resident’s knowledge status was significantly associated with respiratory symptoms. Conclusion: The impact on respiratory symptoms is higher in areas with comparatively high pollution than in areas with comparatively low pollution. Along with socio-demographic and environmental factors, housing conditions, and participant’s knowledge status emerged as significant variables in predicting respiratory symptoms in informal settlements.
Challenges and strategies in conducting sexual and reproductive health research among Rohingya refugees in Cox’s Bazar, Bangladesh
(BMC, 12/14/2020) Ahmed, Rushdia; Aktar, Bachera; Farnaz, Nadia; Ray, Pushpita; Awal, Abdul; Hassan, Raafat; Bin Shafique, Sharid; Hasan, Md Tanvir; Quayyum, Zahidul; Jafarovna, Mohira Babaeva; Kobeissi, Loulou Hassan; El Tahir, Khalid; Chawla, Balwinder Singh; Rashid, Sabina Faiz
Background: Rohingya diaspora or Forcibly Displaced Myanmar Nationals (FDMNs), took shelter in the refugee camps of Cox’s Bazar, Bangladesh due to armed conflict in the Rakhine state of Myanmar. In such humanitarian crises, delivering sexual and reproductive health (SRH) services is critical for better health outcomes of this most-at-risk population where more than half are adolescent girls and women. This is a reflective paper on challenges and related mitigation strategies to conduct SRH research among FDMNs. The research on which this paper is based employed a concurrent mixedmethod design combining a cross-sectional survey and qualitative interviews and group discussions with FDMNs to understand their SRH needs and demand-side barriers. Assessment of health facilities and qualitative interviews with healthcare providers and key stakeholders were carried out to assess facility readiness and supply-side barriers. Challenges and strategies: The researchers faced different challenges while conducting this study due to the unique characteristics of the FDMN population and the location of the refugee camps. The three key challenges researchers encountered include: sensitivity regarding SRH in the FDMNs, identifying appropriate sampling strategies, and community trust issues. The key approaches to overcome these challenges involved: actively engaging community members and gatekeepers in the data collection process to access respondents, identifying sensitive SRH issues through survey and exploring in-depth during qualitative interviews; and contextually modifying the sampling strategy. Conclusion: Contextual adaptation of research methods and involving community and local key stakeholders in data collection are the key lessons learnt from this study. Another important lesson was researchers’ identity and positionality as a member of the host country may create distrust and suspicion among the refugees. The multi-level complexities of humanitarian settings may introduce unforeseen challenges and interrupt research plans at different stages of research which require timely and contextual adaptations.
Cost-recovery strategies in the health and population programmes of Bangladesh: issues for the application of users fees
(International Centre for Diarrhoeal Disease Research, Bangladesh, 1999) Quayyum, Zahidul; Routh, Subrata; Rahman, M Anisur; Jahan, Monowar; Barkat-e-Khuda
The publication is funded by the United States Agency for International Development(USAID) under the Cooperative Agreement No. 388-A-00-97-00032-00 with the ICDDR,B: Centre for Health and Population Research. The centre is supported by the following countries, donor agencies and others whice share its concern for the health and population problems of developing countries: The aid agencies of the governments of Australia, Bangladesh, Belgium, Canada, European Union, Japan, the Netherlands, Norway, Saudi Arabia, Sweden, Switzerland, the United Kingdom and the United States of America; UN agencies:United Nations Development Programme(UNDP), UNICEF, and World Health Organization(WHO); International organizations: International Atomic Energy Agency (IAEA), International Centre for Research on Women,International Development Research Centre(IDRC), Population Council, Swiss Red Cross, and the World Bank; Foundations: Aga Khan Foundation, Child Health Foundation, Ford Foundation, George Mason Foundation, and Rockfeller Foundation; Medical research organization: International Life Sciences Institute (ILSI), National Institutes of Health (NIH), New England Medical Centre (NEMC), Northfield Laboratories, Protect and Gamble, Rhone Poulenc Rorer, and Thrasher Research Fund; Universities: Johns Hopkins University, Karolinska Institute, Loughborough University, London School of Hygiene and Tropical Medicine (LSHTM), University of Alabama at Birmingham, University of Goteborg, University of Pennsylvania, and University of Virginia; Others: American Express Bank, Helen Keller International, Lederle Praxis, NRECA International Ltd., The Rand Corporation, Save the Children Fund-USA, Social Development Centre of the Philippines, UCB Osmotics Ltd., and Wander A.G.
Demand for child curative care in two rural Thanas of Bangladesh : effects of income and women's employment
(International Centre for Diarrhoeal Diseases Research Bangladesh:Dhaka, 1998) Levin, Ann; Rahman, M. Anisur; Quayyum, Zahidul; Routh, Subrata; Barkat-e-Khuda
Demand for Child Curative Care in Two Rural Thanas of Bangladesh: Effects of Income and Women’s Employment
(1998) Levin, Ann; Rahman, M Anisur; Quayyum, Zahidul; Routh, Subrata; Khuda, Barkat-e-
Developing core economic parameter sets for asthma studies: A realist review and an analytical framework
(BMJ Journals, 10/20/2020) Roukas, Chris; Quayyum, Zahidul; Patel, Anita; Fitzsimmons, Deborah; Phillips, Ceri; Hounsome, Natalia
Objective: To develop a standardised set of economic parameters (core economic parameter set) for economic evaluations in asthma studies. Design A systematic literature review and an analytical framework. Outcome measures Economic parameters used to evaluate costs and cost-effectiveness of healthcare interventions for people with asthma. Data sources PubMed, the Cochrane Database of Systematic Reviews, the National Health Service Economic Evaluation Database, the Database of Abstracts of Reviews of Effects and the Health Technology Aaaessment Library starting from 1990. Review methods Research methods were based on the realist review methodology and included a number of nonsequential, iterative and overlapping components, such as developing an analytical framework for the realist review; systematic literature review of economic parameters; identifying and categorising economic parameters; producing preliminary list of core economic parameters. Results Database searches found 2531 publications of which 224 were included in the systematic review. We identified 65 economic parameters that were categorised into 11 groups to enable the realist synthesis. Parameters related to secondary care, primary care, medication use, emergency care and work productivity comprised 84% of all economic parameters. An analytical framework was used to investigate the rationale behind the choices of economic parameters in these studies. The main framework domains included type of intervention, research population, study design, study setting and a stakeholder’s perspective. Conclusion Past research thus suggests that in asthma study parameters depicting the use of secondary care, primary care, medication, emergency care and work productivity can be considered as core economic parameters, since they apply to different types of studies. Parameters including diagnostics, healthcare delivery, school activity, informal care, medical devices and health utility apply to a particular type of study (or research question), and thus can be recommended as supplemental parameters.
Economic evaluation of culprit lesion only PCI vs. immediate multivessel PCI in acute myocardial infarction complicated by cardiogenic shock: the CULPRIT‑SHOCK trial
(Springer Link, 10/7/2020) Robles‑Zurita, Jose Antonio; Briggs, Andrew; Rana, Dikshyanta; Quayyum, Zahidul; Oldroyd, Keith G.; Zeymer, Uwe; Desch, Stefen; de Waha‑Thiele, Suzanne; Thiele, Holger
Background The CULPRIT-SHOCK trial compared two treatment strategies for patients with acute myocardial infarction and multivessel coronary artery disease complicated by cardiogenic shock: (a) culprit vessel only percutaneous coronary intervention (CO-PCI), with additional staged revascularisation if indicated, and (b) immediate multivessel PCI (MV-PCI). Methods A German societal and national health service perspective was considered for three diferent analyses. The cost utility analysis (CUA) estimated costs and quality adjusted life years (QALYs) based on a pre-trial decision analytic model taking a lifelong time horizon. In addition, a within trial CUA estimated QALYs and costs for 1 year. Finally, the cost efectiveness analysis (CEA) used the composite primary outcome, mortality and renal failure at 30-day follow-up, and the within trial costs. Econometric and survival analysis on the trial data was used for the estimation of the model parameters. Subgroup analysis was performed following an economic protocol. Results The lifelong CUA showed an incremental cost efectiveness ratio (ICER), CO-PCI vs. MV-PCI, of €7010 per QALY and a probability of CO-PCI being the most cost-efective strategy>64% at a €30,000 threshold. The ICER for the within trial CUA was €14,600 and the incremental cost per case of death/renal failure avoided at 30-day follow-up was €9010. Cost-efectiveness improved with patient age and for those without diabetes. Conclusions The estimates of cost-efectiveness for CO-PCI vs. MV-PCI have been shown to change depending on the time horizon and type of economic evaluation performed. The results favoured a long-term horizon analysis for avoiding underestimation of QALY gains from the CO-PCI arm.
Establishing a systematic pricing mechanism for MCH-FP services of NGOs in Urban Bangladesh : a preliminary assessment
(International Centre for Diarrhoeal Diseases Research Bangladesh:Dhaka, 1997) Quayyum, Zahidul; Thwin, Aye Aye; Baqui, Abdullah Hel; Mazumder, Mahbub Alam; Begum, Anwara; Sobhani, Jahanara
Estimated societal costs of stroke in the UK based on a discrete event simulation
(Oxford Academic, 12/17/2019) Patel, Anita; Berdunov, Vladislav; Quayyum, Zahidul; King, Derek; Knapp, Martin; Wittenberg, Raphael
Background: there are around 100,000 new stroke cases and over a million people living with its consequences annually in the UK. This has large impacts on health and social care, unpaid carers and lost productivity. We aimed to estimate associated costs. Methods: we estimated 2014/2015 annual mean cost per person and aggregate UK cost of stroke for individuals aged ≥40 from a societal perspective. Health and social care costs in the first and subsequent years after stroke were estimated from discrete event simulation modelling, with probability of progression and length of receipt of different health and social care services obtained from routine registry and audit data. Unpaid care hours and lost productivity were obtained from trial data. UK unit costs were applied to estimate mean costs. Epidemiological estimates of stroke incidence and prevalence were then applied to estimate aggregate costs for the UK. Results: mean cost of new-onset stroke is £45,409 (95% CI 42,054-48,763) in the first year after stroke and £24,778 (20,234– 29,322) in subsequent years. Aggregate societal cost of stroke is £26 billion per year, including £8.6 billion for NHS and social care. The largest component of total cost was unpaid care (61%) and, given high survival, £20.6 billion related to ongoing care. Conclusion: the estimated aggregate cost of stroke substantially exceeds previous UK estimates. Since most of the cost is attributed to unpaid care, interventions aimed at rehabilitation and reducing new and recurrent stroke are likely to yield substantial benefits to carers and cost savings to society
Ethics and methods for collecting sensitive data: Examining sexual and reproductive health needs of and services for Rohingya refugees at Cox’s Bazar, Bangladesh
(The International Journal of Information, Diversity, & Inclusion, 7/13/2020) Aktar, Bachera; Ahmed, Rushdia; Hassan, Raafat; Farnaz, Nadia; Ray, Pushpita; Awal, Abdul; Bin Shafique, Sharid; Hasan, Md Tanvir; Quayyum, Zahidul; Rashid, Sabina Faiz
During humanitarian emergencies, such as the forced displacement of the Rohingya diaspora, women and adolescent girls become highly vulnerable to sexual and reproductive health (SRH) issues and abuse. Although sensitive in nature, community-driven information is essential for designing and delivering effective community-centric SRH services. This article provides an overview of the theoretical framework and methodologies used to investigate SRH needs, barriers, and challenges in service-delivery and utilization in the Rohingya refugee camps in Cox’s Bazar, Bangladesh. It also offers insights on important methodological and ethical factors to consider while conducting research in a similar context.A concurrent mixed-method study was undertaken in ten randomly selected Rohingya refugee camps between July and November2018. The design consisted of a cross-sectional household survey of 403 Rohingya adolescent girls and women, along with an assessment of 29 healthcare facilities. The team also completed in-depth interviews with nine adolescent girls, 10 women, nine formal andnine informal healthcare providers, key informant interviews with seven key stakeholders and seven influential community members. Lastly, three focus group discussions were undertaken with a group of 18 Rohingya men. Our theoretical framework drew from the socio-ecological models developed by Karl Blanchet and colleagues(2017) insofar as they considered a multiplicity of related contextual and cross-cutting factors.Building good rapport with community gatekeepers was key in accessing and sustaining the relationship with the various respondents. The data collected through such context-specific research approaches is critical in designing community-centric service-delivery mechanisms, and culturally and gender-sensitiveSRH interventions in humanitarian crises.
Health care expenditure willingness and ability to pay for ESP : implications for fees for services[abstract]
(2001) Khan, M. Mahmud; Quayyum, Zahidul; Ahmed, Shakil
Housing and health in Dhaka city’s urban informal settlements: developing the health socio-environmental housing index
(BRAC University, 2025) Huda, Fabi Sumaiya; Quayyum, Zahidul; Saha, Priom
Housing has been studied as an important social determinant of health for its influence in an individual’s physical and mental well-being. With the growing population in Dhaka city, many families are being forced to live in urban informal settlements in search of cheap and available housing. Characterized by inadequate basic services, informal settlements are a public health issue of concern as it increases the likelihood of individuals experiencing adverse health outcomes. A cross-sectional study was conducted across Dakshinkhan and Shyampur Informal settlements. With a systematic sampling approach 316 households were surveyed which resulted in health status information for 1219 individuals. Household information was collected for 16 dimensions of housing quality, and individual health information was collected for respiratory conditions, infectious diseases, and mental health disorders (only for female respondents above the age of 18, n=316). A composite index was created using principal component analysis and scores were normalized (0= inadequate housing, 1= adequate housing) to assess housing quality through the Healthy Socio-Environmental Housing Index (HSEH). Multiple logistic regressions were used to assess the association between the HSEH index and health. Findings suggest a significant association between housing and health status, with improving housing quality associated with better health outcomes. Multiple logistic regression resulted in significant relationship for (i)respiratory conditions (OR:0.16, CI: 0.07-0.37), (ii)infectious diseases (OR:0.18, CI: 0.05-0.55) and (iii)mental health disorders (OR: 0.28. CI: 0.07-1.10) with housing quality. Inadequacies in housing quality increase the likelihood for negative health outcomes, highlighting the importance of housing as a public health concern. For Dhaka city to equitably serve its residents, it needs to take immediate action to improve the standard of housing across the city through policy and interventions. The HSEH is useful in these policy discussions as an appropriate means of monitoring and evaluation, especially to recognize areas of priority by degree of inadequate quality across different informal settlements in the city.
Impact of National immunization days on polio-related knowledge and practice of urban women in Bangladesh
(International Centre for Diarrhoeal Diseases Research Bangladesh:Dhaka, 1996) Quaiyum, Md. Abdul; Tunon, Cristobal; Baqui, Abdullah Hel; Quayyum, Zahidul; Khatun, Jahanara
Loops and Building Blocks: A Knowledge co-Production Framework for Equitable Urban Health
(Springer Link, 3/18/2021) Audia, Camilla; Berkhout, Frans; Owusu, George; Quayyum, Zahidul; Agyei-Mensah, Samuel
This paper sets out a structured process for the co-production of knowledge between researchers and societal partners and illustrates its application in an urban health equity project in Accra, Ghana. The main insight of this approach is that research and knowledge co-production is always partial, both in the sense of being incomplete, as well as being circumscribed by the interests of participating researchers and societal partners. A second insight is that project-bound societal engagement takes place in a broader context of public and policy debate. The approach to co-production described here is formed of three recursive processes: codesigning, co-analysing, and co-creating knowledge. These ‘co-production loops’ are themselves iterative, each representing a stage of knowledge production. Each loop is operationalized through a series of research and engagement practices, which we call building blocks. Building blocks are activities and interactionbased methods aimed at bringing together a range of participants involved in joint knowledge production. In practice, recursive iterations within loops may be limited due of constraints on time, resources, or attention. We suggest that co-productio
Measuring the prevalence of depression and anxiety among the ever married women in informal settlements of Dhaka & assessing inter-tool consistency: a cross-sectional study
(BRAC University, 2025) Chaahat, Amatul Haque; Quayyum, Zahidul; Saha, Priom
Background: The burden of mental health disorders is rapidly escalating into a global crisis, particularly in low income countries like Bangladesh. Residents facing poor living conditions in informal settlements in Dhaka, face increased mental and physical health challenges, with women at a higher risk for disorders such as depression and anxiety. This study aims to evaluate the use of two specific tools in assessing the mental health disorders of ever-married women aged 18-64. The tools used to measure anxiety are GAD-7 and Beck Anxiety Inventory and depression are PHQ-9 and Beck Depression Inventory-II. Furthermore, this study examines the consistency of scores gathered from these instruments across different severity levels of each condition. Method: 316 residents from the informal settlements of Shyampur and Dakshinkhan areas of Dhaka City participated in our study. After excluding incomplete questionnaires, 292 were included in the final analysis. Our questionnaire was based on the Bengali version of four existing tools. We conducted descriptive and bivariate analyses to measure prevalence and performed chi-square tests to check score consistency across severity levels of depression and anxiety. Findings: In ever-married women aged 18-64 in informal settlements, anxiety prevalence is 55.82% on the GAD-7 scale and 59.25% on the BAI. Depression prevalence is 62.67% on the PHQ-9 and 50.00% on the BDI-II. The consistency of GAD-7 and BAI scores for minimal and severe levels of anxiety are 70.54% and 81.25%, respectively. For depression, minimal and severe case consistency is 85.32% and 100%. Conclusion: This study revealed higher anxiety and depression among participants, highlighting the need for increased budget allocations for mental health care. The government should also improve the availability and accessibility of services for women and draw attention to raising mental health awareness. Notably, the anxiety and depression rates from the two tools were similar, indicating they can be used interchangeably when specific conditions are not present.
Reducing drug costs through rationalization of diarrhoea and ARI case management in urban areas
(1998) Quayyum, Zahidul; Amin, Selina; Baqui, A.H.; Manaf, Samina
Situation analysis for delivering integrated comprehensive sexual and reproductive health services in humanitarian crisis condition for Rohingya refugees in Cox’s Bazar, Bangladesh: Protocol for a mixed-method study
(BMJ, 7/3/2019) Ahmed, Rushdia; Farnaz, Nadia; Aktar, Bachera; Hassan, Raafat; Shafique, Sharid Bin; Ray, Pushpita; Awal, Abdul; Rahman, Atiya; Urbaniak, Veronique; Kobeissi, Loulou Hassan; Rosie, Jeffries; Say, Lale; Hasan, Md Tanvir; Quayyum, Zahidul; Rashid, Sabina Faiz
Introduction Rohingya diaspora are one of the most vulnerable groups seeking refuge in camps of Cox’s Bazar, Bangladesh, arising an acute humanitarian crisis. More than half of the Rohingya refugees are women and adolescent girls requiring quality sexual and reproductive health (SRH) services. Minimum initial service package of SRH are being rendered in the refugee camps; however, WHO is aiming to provide integrated comprehensive SRH services to meet the unmet needs of this most vulnerable group. For sustainable and successful implementation of such comprehensive SRH service packages, a critical first step is to undertake a situation analysis and understand the current dimensions and capture the lessons learnt on their SRH-specific needs and implementation challenges. This situation analysis is pertinent in current humanitarian condition and will provide an overview of the needs, availability and delivery of SRH services for adolescent girls and women, barriers in accessing and providing those services in Rohingya refugee camps in Cox’s Bazar, Bangladesh, and similar humanitarian contexts. Methods and analysis A concurrent mixed-methods design will be used in this study. A community-based household survey coupled with facility assessments as well as qualitative in-depth interviews, key informant interviews and focus group discussions will be conducted with community people of Rohingya refugee camps and relevant stakeholders providing SRH services to Rohingya population in Cox’s Bazar, Bangladesh. Survey data will be analysed using univariate, bivariate and multivariable regression statistics. Descriptive analysis will be done for facility assessment and thematic analysis will be conducted with qualitative data. Ethics and dissemination Ethical approval from Institutional Review Board of BRAC James P Grant School of Public Health (2018-017-IR) has been obtained. Findings from this research will be disseminated through presentations in local, national and international conferences, workshops, peer-reviewed publications, policy briefs and interactive project report.
The demand for child curative care in rural Bangladesh : effect of income and women's employment
(1998-04) Levin, Ann; Rahman, Anisur; Quayyum, Zahidul; Routh, Subrata
The demand for child curative care in two rural thanas of Bangladesh: effect of income and women's employment
(2001) Levin, Ann; Rahman, M.A.; Quayyum, Zahidul; Routh, Subrata; Barkat-e-Khuda