Browsing by Author "Rahman, Omar"

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A doubale blind randomizes study to evaluate intravenous "Dhaka solution" with and without 25 grams/liter of dextrose
(1985) Rahman, Omar; Bennish, M.; Alam, A.N.; Salam, A.
Age and gender variation in the impact of household structure on elderly mortality
(International Journal of Epidemiology, 1999) Rahman, Omar
Relationship to head of household and the presence of spouses and sons have powerful impacts on reducing mortality for elderly men and women in rural Bangladesh with the effects varying significantly by gender and age. Furthermore, individual rather than joint access to material resources is an important determinant of elderly mortality.
American families : policy issues
(Population Index, 1993) DaVanzo, J; Rahman, Omar; Wadhwa, K.T.
Increases in the number of children living in single-parent (usually female-headed) households and in the proportion of mother who work outside their homes have raised concern in the United States about the effects of these trends on the well-being of children and the possible need for policy intervention. This paper discusses the arguments for and against policies that affect families.
Availability, affordability, and consumption of fruits and vegetables in 18 countries across income levels: findings from the Prospective Urban Rural Epidemiology (PURE) study
(The Lancet, Global Health, 2016-10-01) Miller, Victoria; Khatib, Rasha; Yusuf ali, Afzal hussein; Rahman, Omar
Summary Background Several international guidelines recommend the consumption of two servings of fruits and three servings of vegetables per day, but their intake is thought to be low worldwide. We aimed to determine the extent to which such low intake is related to availability and affordability. Methods We assessed fruit and vegetable consumption using data from country-specific, validated semi-quantitative food frequency questionnaires in the Prospective Urban Rural Epidemiology (PURE) study, which enrolled participants from communities in 18 countries between Jan 1, 2003, and Dec 31, 2013. We documented household income data from participants in these communities; we also recorded the diversity and non-sale prices of fruits and vegetables from grocery stores and market places between Jan 1, 2009, and Dec 31, 2013. We determined the cost of fruits and vegetables relative to income per household member. Linear random effects models, adjusting for the clustering of households within communities, were used to assess mean fruit and vegetable intake by their relative cost. Findings Of 143 305 participants who reported plausible energy intake in the food frequency questionnaire, mean fruit and vegetable intake was 3·76 servings (95% CI 3·66–3·86) per day. Mean daily consumption was 2·14 servings (1·93–2·36) in low-income countries (LICs), 3·17 servings (2·99–3·35) in lower-middle-income countries (LMICs), 4·31 servings (4·09–4·53) in upper-middle-income countries (UMICs), and 5·42 servings (5·13–5·71) in high-income countries (HICs). In 130 402 participants who had household income data available, the cost of two servings of fruits and three servings of vegetables per day per individual accounted for 51·97% (95% CI 46·06–57·88) of household income in LICs, 18·10% (14·53–21·68) in LMICs, 15·87% (11·51–20·23) in UMICs, and 1·85% (−3·90 to 7·59) in HICs (ptrend=0·0001). In all regions, a higher percentage of income to meet the guidelines was required in rural areas than in urban areas (p<0·0001 for each pairwise comparison). Fruit and vegetable consumption among individuals decreased as the relative cost increased (ptrend=0·00040). Interpretation The consumption of fruit and vegetables is low worldwide, particularly in LICs, and this is associated with low affordability. Policies worldwide should enhance the availability and affordability of fruits and vegetables. Funding Population Health Research Institute, the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, AstraZeneca (Canada), Sanofi-Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, GlaxoSmithKline, Novartis, King Pharma, and national or local organisations in participating countries.
CYclone aftermath: research and directions for the future[book chapter]
(1992) Chowdhury, Mushtaque; Choudhury, Yusuf; Bhuiya, Abbas; Islam, Kamal; Hussain, Zakir; Rahman, Omar; Glass, Roger; Bennish, Michael
Effects of bidi smoking on all-cause mortality and cardiorespiratory outcomes in men from south Asia: an observational community-based substudy of the Prospective Urban Rural Epidemiology Study (PURE)
(The Lancet, Global Health, 2017-02-01) Duong, MyLinh; Rangarajan, Sumathy; Zhang, Xiaohe; Rahman, Omar; Yusuf, Rita
Summary Background Bidis are minimally regulated, inexpensive, hand-rolled tobacco products smoked in south Asia. We examined the effects of bidi smoking on baseline respiratory impairment, and prospectively collected data for all-cause mortality and cardiorespiratory events in men from this region. Methods This substudy of the international, community-based Prospective Urban Rural Epidemiology (PURE) study was done in seven centres in India, Pakistan, and Bangladesh. Men aged 35–70 years completed spirometry testing and standardised questionnaires at baseline and were followed up yearly. We used multilevel regression to compare cross-sectional baseline cardiorespiratory symptoms, spirometry measurements, and follow-up events (all-cause mortality, cardiovascular events, respiratory events) adjusted for socioeconomic status and baseline risk factors between non-smokers, light smokers of bidis or cigarettes (≤10 pack-years), heavy smokers of cigarettes only (>10 pack-years), and heavy smokers of bidis (>10 pack-years). Findings 14 919 men from 158 communities were included in this substudy (8438 non-smokers, 3321 light smokers, 959 heavy cigarette smokers, and 2201 heavy bidi smokers). Mean duration of follow-up was 5·6 years (range 1–13). The adjusted prevalence of self-reported chronic wheeze, cough or sputum, dyspnoea, and chest pain at baseline increased across the categories of non-smokers, light smokers, heavy cigarette smokers, and heavy bidi smokers (p<0·0001 for association). Adjusted cross-sectional age-related changes in forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity (FVC) ratio were larger for heavy bidi smokers than for the other smoking categories. Hazard ratios (relative to non-smokers) showed increasing hazards for all-cause mortality (light smokers 1·28 [95% CI 1·02–1·62], heavy cigarette smokers 1·59 [1·13–2·24], heavy bidi smokers 1·56 [1·22–1·98]), cardiovascular events (1·45 [1·13–1·84], 1·47 [1·05–2·06], 1·55 [1·17–2·06], respectively) and respiratory events (1·30 [0·91–1·85], 1·21 [0·70–2·07], 1·73 [1·23–2·45], respectively) across the smoking categories. Interpretation Bidi smoking is associated with severe baseline respiratory impairment, all-cause mortality, and cardiorespiratory outcomes. Stricter controls and regulation of bidis are needed to reduce the tobacco-related disease burden in south Asia. Funding Population Health Research Institute, Canadian Institutes of Health Research, and Heart and Stroke Foundation of Ontario. DOI: http://dx.doi.org/10.1016/S2214-109X(17)30004-9
Excess mortality for the unmarried in rural Bangladesh
(1993-06) Rahman, Omar
Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): a prospective cohort study
(The Lancet, In press, 2017-11-04) Miller, Victoria; Mente, Andrew; Dehghan, Mahshid; Rangarajan, Sumathy; Rahman, Omar; et al.
Summary Background The association between intake of fruits, vegetables, and legumes with cardiovascular disease and deaths has been investigated extensively in Europe, the USA, Japan, and China, but little or no data are available from the Middle East, South America, Africa, or south Asia. Methods We did a prospective cohort study (Prospective Urban Rural Epidemiology [PURE] in 135 335 individuals aged 35 to 70 years without cardiovascular disease from 613 communities in 18 low-income, middle-income, and high-income countries in seven geographical regions: North America and Europe, South America, the Middle East, south Asia, China, southeast Asia, and Africa. We documented their diet using country-specific food frequency questionnaires at baseline. Standardised questionnaires were used to collect information about demographic factors, socioeconomic status (education, income, and employment), lifestyle (smoking, physical activity, and alcohol intake), health history and medication use, and family history of cardiovascular disease. The follow-up period varied based on the date when recruitment began at each site or country. The main clinical outcomes were major cardiovascular disease (defined as death from cardiovascular causes and non-fatal myocardial infarction, stroke, and heart failure), fatal and non-fatal myocardial infarction, fatal and non-fatal strokes, cardiovascular mortality, non-cardiovascular mortality, and total mortality. Cox frailty models with random effects were used to assess associations between fruit, vegetable, and legume consumption with risk of cardiovascular disease events and mortality. Findings Participants were enrolled into the study between Jan 1, 2003, and March 31, 2013. For the current analysis, we included all unrefuted outcome events in the PURE study database through March 31, 2017. Overall, combined mean fruit, vegetable and legume intake was 3·91 (SD 2·77) servings per day. During a median 7·4 years (5·5–9·3) of follow-up, 4784 major cardiovascular disease events, 1649 cardiovascular deaths, and 5796 total deaths were documented. Higher total fruit, vegetable, and legume intake was inversely associated with major cardiovascular disease, myocardial infarction, cardiovascular mortality, non-cardiovascular mortality, and total mortality in the models adjusted for age, sex, and centre (random effect). The estimates were substantially attenuated in the multivariable adjusted models for major cardiovascular disease (hazard ratio [HR] 0·90, 95% CI 0·74–1·10, ptrend=0·1301), myocardial infarction (0·99, 0·74–1·31; ptrend=0·2033), stroke (0·92, 0·67–1·25; ptrend=0·7092), cardiovascular mortality (0·73, 0·53–1·02; ptrend=0·0568), non-cardiovascular mortality (0·84, 0·68–1·04; ptrend =0·0038), and total mortality (0·81, 0·68–0·96; ptrend<0·0001). The HR for total mortality was lowest for three to four servings per day (0·78, 95% CI 0·69–0·88) compared with the reference group, with no further apparent decrease in HR with higher consumption. When examined separately, fruit intake was associated with lower risk of cardiovascular, non-cardiovascular, and total mortality, while legume intake was inversely associated with non-cardiovascular death and total mortality (in fully adjusted models). For vegetables, raw vegetable intake was strongly associated with a lower risk of total mortality, whereas cooked vegetable intake showed a modest benefit against mortality. Interpretation Higher fruit, vegetable, and legume consumption was associated with a lower risk of non-cardiovascular, and total mortality. Benefits appear to be maximum for both non-cardiovascular mortality and total mortality at three to four servings per day (equivalent to 375–500 g/day). Funding Full funding sources listed at the end of the paper (see Acknowledgments).
Gender and Life-Cycle Differentials in the Patterns and Determinants of Adult Health
(The Journal of Human Resources, 1993) Strauss, J.; Gertler, P.; Rahman, Omar; Fox, K.
This study investigates the socioeconomic determinants of adult ill health in developing countries. Use as measures of health, self reported general health plus a variety of measures of problems in physical functioning. Strong residential effects exist, although the factors behind them remain to be investigated.
Hyperglycemia during childhood diarrhea
(1997-01) Ronan, Anne; Azad, Abul K.; Rahman, Omar; Phillips, Rodney E.; Bennish, Michael L.
Matlab health and socio-economic survey
(1995-02-07) Rahman, Omar; Menken, Jane; Gertler, Paul; Foster, Andrew; Khan, Nizam
Prevalence and mechanisms of hypoglycemia in association with diarrhea
(1983-11-25) Rahman, Omar; Bennish, M.; Alam, A.N.; Wahed; Phillips, R.; Warrell, D.
Self-Reported Health Among Older Bangladeshis: How Good a Health Indicator Is It?
(The Gerontologist, 2003) Rahman, Omar
Purpose: This study examines the value of selfreported health (SRH) as an indicator of underlying health status in a developing country setting. Design and Methods: Logistic regression methods with adjustments for multistage sampling are used to examine the factors associated with SRH in 2,921 men and women aged 50 and older in rural Bangladesh. Results: SRH incorporates multiple dimensions of health status (including physical disability assessed by measured physical performance; selfreported limitations in activities of daily living, or ADLs; self-reported chronic morbidity; and selfreported acute morbidity), severity, comorbidity, and trajectory in a similar fashion for both men and women and for different age groups. Older individuals are more likely to report poor SRH than their younger counterparts, and women report significantly worse SRH than their male peers at each age group. In both cases, this disadvantage can be fully accounted for by differences in measured physical performance, ADL limitations, and chronic and acute morbidity. Implications: Among older Bangladeshis, SRH is an easily recorded, multifaceted, nuanced indicator of underlying health status that is significantly associated with measured physical performance. Moreover, SRH appears to be independent of age- and gender-related norms.
Shared environments: a multilevel analysis of community context and child nutritional status in Bangladesh
(Public Health Nutrition, 2011-02) Corsi, Daniel J.; Chow, Clara K.; Lear, Scott A.; Rahman, Omar; Subramanian, S.V.; Teo, Koon
The goal of the study was to examine the influence of community environment on the nutritional status (weight-for-age and height-forage) of children (aged 0–59 months) in Bangladesh. In addition, we tested the association between specific characteristics of community environments and child nutritional status. The data are from the nationally representative 2004 Bangladesh Demographic and Health Survey. The findings showed that the community environment influences child nutrition in Bangladesh, and maternal- and child-level covariates may fail to capture the entire influence of communities.
The Impact of Kin on the Mortality of the Elderly in Rural Bangladesh
(Population Studies, 1999-07) Rahman, Omar
This study uses high quality longitudinal data on kin availability, proximity, and marital status from the Matlab surveillance area in rural Bangladesh to explore the impact of kin members on the survival of the elderly over a six year period. The results - from discrete time hazard models- suggest that the presence of a spouse, sons, and brothers substantially improves survivorship, but with differing effects by the sex of the elderly and the number of sons and brothers. This study offers little support of any of the following as mechanisms by which kin affect the survival of the elderly: changes in the economic status of the elderly as proxied by land holdings; improved access to instrumental support as proxied by the marital status of sons; decreases in social isolation as proxied by proximity of kin
Tobacco control environment: cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries
(British Medical Journal(BMJ), 2017-03-01) Yusuf, S.; Chow, C K; Rahman, Omar; et al.
Abstract Objectives This study examines in a cross-sectional study ‘the tobacco control environment’ including tobacco policy implementation and its association with quit ratio. Setting 545 communities from 17 high-income, upper-middle, low-middle and low-income countries (HIC, UMIC, LMIC, LIC) involved in the Environmental Profile of a Community's Health (EPOCH) study from 2009 to 2014. Participants Community audits and surveys of adults (35–70 years, n=12 953). Primary and secondary outcome measures Summary scores of tobacco policy implementation (cost and availability of cigarettes, tobacco advertising, antismoking signage), social unacceptability and knowledge were associated with quit ratios (former vs ever smokers) using multilevel logistic regression models. Results Average tobacco control policy score was greater in communities from HIC. Overall 56.1% (306/545) of communities had >2 outlets selling cigarettes and in 28.6% (154/539) there was access to cheap cigarettes (<5cents/cigarette) (3.2% (3/93) in HIC, 0% UMIC, 52.6% (90/171) LMIC and 40.4% (61/151) in LIC). Effective bans (no tobacco advertisements) were in 63.0% (341/541) of communities (81.7% HIC, 52.8% UMIC, 65.1% LMIC and 57.6% LIC). In 70.4% (379/538) of communities, >80% of participants disapproved youth smoking (95.7% HIC, 57.6% UMIC, 76.3% LMIC and 58.9% LIC). The average knowledge score was >80% in 48.4% of communities (94.6% HIC, 53.6% UMIC, 31.8% LMIC and 35.1% LIC). Summary scores of policy implementation, social unacceptability and knowledge were positively and significantly associated with quit ratio and the associations varied by gender, for example, communities in the highest quintile of the combined scores had 5.0 times the quit ratio in men (Odds ratio (OR) 5·0, 95% CI 3.4 to 7.4) and 4.1 times the quit ratio in women (OR 4.1, 95% CI 2.4 to 7.1). Conclusions This study suggests that more focus is needed on ensuring the tobacco control policy is actually implemented, particularly in LMICs. The gender-related differences in associations of policy, social unacceptability and knowledge suggest that different strategies to promoting quitting may need to be implemented in men compared to women.
Use of secondary prevention drugs for cardiovascular disease in the community in high-income, middle-income, and low-income countries (the PURE Study): a prospective epidemiological survey
(Lancet, 2011-08-28) Yusuf, Salim; Islam, Shofiqul; Chow, Clara K.; Rangarajan, Sumathy; Rahman, Omar; et al
The research was aimed to assess use of proven eff ective secondary preventive drugs (antiplatelet drugs, β blockers, angiotensin-converting-enzyme [ACE] inhibitors or angiotensin-receptor blockers [ARBs], and statins) in individuals with a history of coronary heart disease or stroke.