Browsing by Author "Sarker, Malabika"

Now showing 1 - 20 of 121

A qualitative research on knowledge, attitude, and practice of hand washing among BRAC volunteers and their experience on message dissemination in Cox’s Bazar, Bangladesh
(Brac University, 2023) Rajan, N Ganesh; Sarker, Malabika; Barua, Mrittika
Introduction: Covid-19 Volunteers played a vital role in absorbing the shock on the healthcare system to some extent during the pandemic by task shifting. They played a multifaceted role where healthcare students assisted in medical activities, and non-medical volunteers helped with surveillance, quarantine, providing psychological support, and preventive measure campaigns. On contrary, disseminating healthcare knowledge by a non-medical person to the community in this infodemic scenario is challenging. The practice of handwashing is considered to be one of the best ways to prevent covid-19 infection. The current study focused on knowledge, attitude, and practice of handwashing among BRAC volunteer and their experience in message dissemination and implementation of handwashing stations. Method: This study was conducted in the Sadar and Ramu Upazila of cox’s Bazar of Bangladesh. We used an exploratory qualitative study to conduct this research and purposive sampling was done to select the volunteer. 8 in-depth interview was conducted using semi-structured in-depth interview guidelines. Findings: we found that volunteers were from different educational backgrounds and ages but they have good knowledge about covid-19 and handwashing. Induction training post-recruitment helped to attain this uniform knowledge among them. All-volunteer believed that covid-19 can be controlled by embracing proper covid-19 preventive measures, and handwashing. Various factors like financial allowance, security, power play, misconceptions, power play, inadequate logistical supply, and the design of the handwashing station acted as barriers and the BRAC brand, support from the local government and religious leader, and response from the community were the facilitator’s factors for message dissemination. Conclusion: From this study, we can say that volunteers have the proper knowledge to disseminate correct information to the community. During emergency periods volunteers can be trained to perform appropriate tasks. So as to absorb the shocks in the health system. In addition, involving key community stockholders in planning can make the message context-specific and easy to implement. Lately providing a human-centric designed handwashing station can promote hand washing in the community.
A qualitative study to explore the attitudes of women and obstetricians towards caesarean delivery in rural Bangladesh
(BMC, 9/12/2018) Begum, Tahmina; Ellis, Cathryn; Sarker, Malabika; Rostoker, Jean-Francois; Rahman, Aminur; Anwar, Iqbal; Reichenbach, Laura
Background: Caesarean section is a lifesaving surgical intervention for women and their newborns, though overutilization is a public health concern. The caesarean rate in Bangladesh is approximately 23% overall, and in private facilities it is over 70%. It is essential to know both the supply side (obstetricians) and demand side (parturient women) views on caesarean birth in order to formulate specific interventions to address the escalating rate of caesareans. Methods: This qualitative study took place in Matlab, a rural sub-district in Bangladesh. We interviewed women attending their 3rd antenatal visit, those with recent caesareans, and obstetricians from both public and private health facilities. In total there were twenty in-depth interviews and four focus group discussions. Study participants were asked about their preferences on birthing mode and knowledge of the caesarean section process. Thematic data analysis was done following a deductive approach. Results: Women from this rural community had a strong preference for normal vaginal birth. However, they were willing to accept the attending health care provider’s decision for caesarean birth. Antenatal care sessions did not provide information on the medical indications for caesarean section. Furthermore, some women had the misconception that episiotomy itself is a ‘small caesarean.’ Primary health care providers and clinic agents (brokers) had a strong influence on women’s decision to choose a health facility for giving birth. However, obstetricians, having a preference for caesarean section, were receiving more patients from these brokers which may be an important reason for the high rate of clinically non-indicated caesareans at private hospitals in Bangladesh. Improper labour monitoring and inadequate staffing at health facilities were additional influences on the preference for caesarean section. However, critical knowledge gaps were also observed among study obstetricians, particularly with regards to the indications for and timing of elective caesarean sections. Conclusion: There is a need to educate women about the advantages and disadvantages of different birthing modes to ensure their active participation in the decision making process. Strong policy regulations are needed to ensure legitimate decision making by obstetricians regarding mode of birthing.
Achieving universal health coverage through community empowerment: a proposition for Bangladesh
(© 2014 Medknow Publications, 2014) Joarder, Taufique; Sarker, Malabika
Achieving universal health coverage through community empowerment: a proposition for Bangladesh
(© 2014 Medknow Publications, 2014) Joarder, Taufique; Sarker, Malabika
Achieving universal health coverage through community empowerment: a proposition for Bangladesh
(© 2014 Medknow Publications, 2014) Joarder, Taufique; Sarker, Malabika
An assessment of knowledge and uptake of COVID-19 vaccine among the school going students at Cox Bazar in Bangladesh
(Brac University, 2023) Das, Nikkon Ranjan; Chowdhury, Mohiuddin Ahsanul Kabir; Sarker, Malabika
Adequate knowledge about COVID-19 vaccination among school students is necessary after the re-opening of schools to ensure that the students stay protected from COVID-19. BRAC has implemented interventions in the selected schools of Cox’s Bazar to increase knowledge and awareness about COVID-19. The purpose of this research was to evaluate the knowledge of school students about COVID-19 vaccination and the uptake rate of the vaccines among students who have received BRAC intervention at Cox’s Bazar. The sample size calculated for this study was 1546. The study used the descriptive statistics and logistic regression to assess the knowledge and uptake rate of vaccines and the associated factors with vaccine uptake among the students. The study found that 94% of the surveyed students knew about the COVID-19 vaccine, and 92% of them knew accurately about the vaccine doses. Moreover, 91% of the surveyed students have knowledge about the vaccine registration process. In the case of vaccine uptake, 97% of the surveyed students have taken a minimum of one dose of COVID-19 vaccine, and both male and female students have nearly equal uptake percentages. The logistic regression showed that the student’s age, the education of mother, the upazila (sub-district), the student's knowledge about vaccination, and the student’s knowledge about the vaccination process are significant factors associated with vaccine uptake. The knowledge about vaccines among students and the vaccine uptake rate were satisfactory. The results of this study demonstrated that the BRAC intervention to create awareness among students in schools has been successful in terms of COVID-19 vaccination.
Assessing knowledge and practices for covid-19prevention among students from class 8th & 9th standard in selected schools and equivalent grades level of madrasas in cox bazar districts, Bangladesh
(Brac University, 2023) Chand, Deepika Joyec; Sarker, Malabika; Chowdharyz, Mohiuddin Ahsanul Kabir
Background: Knowledge and practices are crucial cognitive components in public health, especially in health promotion and prevention (Ferdous et al., 2020).this paper examines knowledge and practice among students of 8th and 9th grade in schools and madrasas of Cox’s bazar district as this will help in developing effective intervention to increase knowledge and practice among students. Method: quantitative approach and cross-sectional design used to collect data among all student in grade 8 & 9 in schools and madrasas. Results: it was found that students have inadequate knowledge score about covid prevention whereas adequate practice score is observed to prevent covid-19. The level of knowledge varied by sociodemographic characteristics. Females [AOR .605,95% CI: (0.484 -0.755) < 0.01] and individuals studying in 9th grade [1.307(1.024 - 1.668) p<0.05 demonstrated inadequate levels of knowledge. Whereas the students living in Pekua were having odds .630 times performing more practice about COVID-19 prevention [OR .630, 95% CI: (0.396 - 1.004)] than students living in Sadar. the study predicts that the odds of a female student being carrying out practice about COVID-19 prevention are 1.014 times [OR 1.014 95% CI: (0.687 - 1.498) than those of a male student. Conclusion: Our findings suggest the need for effective and tailored health education programs aimed at improving COVID-19knowledge among students and to implementation and maintenance of safe practices.
Association between height and hypertension in the adult Nepalese population: Findings from a nationally representative survey
(Wiley, 11/7/2019) Gupta, Rajat Das; Haider, Shams Shabab; Hashan, Mohammad Rashidul; Rahman, Muhammad Aziz; Sarker, Malabika
Background and aims The burden of hypertension is increasing in Nepal. Different studies have evaluated the relationship between height and blood pressure in different regions, with mixed results. The relationship between height and hypertension has not yet been explored in the Nepalese context. Given this knowledge gap, this study aims to determine the relationship between height and hypertension among Nepalese adults (aged ≥18 years). Methods This study utilized the dataset from the Nepal Demographic and Health Survey (NDHS) 2016. Hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or a diastolic blood pressure ≥ 90 mmHg. Height, measured in centimeters (cm), was analyzed as a continuous variable. Based on previous evidence, the following covariates were considered: age, sex, presence of overweight or obesity, educational status, household wealth status, and place, province, and ecological zone of residence. Multilevel multivariable logistic regression was done to evaluate the association between height and hypertension. Both crude odds ratio (COR) and adjusted odds ratio (AOR) are reported, along with a 95% confidence interval (CI). Sample weight of NDHS was adjusted during analysis. Results Among 13 393 weighted individuals over the age of 18 years, the prevalence of hypertension in Nepal was found to be 21.1% (95% CI, 19.9%‐22.4%). In the final multivariable model, after adjusting for relevant covariates, it was found that height was inversely associated with hypertension. For a Nepalese adult, the odds of hypertension decreased by 10% with each 10‐cm increase in height (AOR 0.9; 95% CI 0.8‐0.9; P = 0.003). Conclusion Awareness should be raised among people with low stature for prevention of hypertension. Longitudinal studies are recommended to include genetic and social/environmental determinants of stature in the analyses.
Association between the frequency of television watching and overweight and obesity among women of reproductive age in Nepal: Analysis of data from the Nepal Demographic and Health Survey 2016
(PLOS ONE, 2/10/2020) Gupta, Rajat Das; Haider, Shams Shabab; Hashan, Mohammad Rashidul; Hasan, Mehedi; Sutradhar, Ipsita; Sajal, Ibrahim Hossain; Joshi, Hemraj; Haider, Mohammad Rifat; Sarker, Malabika
Background The prevalence of overweight and obesity, particularly among women, is increasing in Nepal. Previous studies in the South Asia have found television watching to be a risk factor for overweight and obesity among women of reproductive age. However, this association had not been studied in the context of Nepal. This study aims to identify the association between frequency of television watching and overweight and obesity among Nepalese women of reproductive age. Methods This cross-sectional study utilized the Nepal Demographic and Health Survey 2016 (NDHS 2016) data. A total weighted sample of 6,031 women were included in the final analyses. The women were 15–49 years of age and were either not pregnant or had not delivered a child within the two months prior to the survey. Body mass index (BMI) was the primary outcome of this study, which was categorized using an Asia-specific cutoff value. Normal and/ or underweight was defined as a BMI <23.0 kg/m2 , overweight was defined as a BMI between 23.0 kg/m2 and <27.5 kg/m2 , and obesity was defined as a BMI �27.5 kg/m2 . Frequency of watching television was the main independent variable of this study, which was divided into the following three categories: not watching television at all, watching television PLOS ONE | https://doi.org/10.1371/journal.pone.0228862 February 10, 2020 1 / 13 a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 OPEN ACCESS Citation: Das Gupta R, Haider SS, Hashan MR, Hasan M, Sutradhar I, Sajal IH, et al. (2020) Association between the frequency of television watching and overweight and obesity among women of reproductive age in Nepal: Analysis of data from the Nepal Demographic and Health Survey 2016. PLoS ONE 15(2): e0228862. https:// doi.org/10.1371/journal.pone.0228862 Editor: Cindy Gray, University of Glasgow, UNITED KINGDOM Received: July 20, 2019 Accepted: January 25, 2020 Published: February 10, 2020 Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: https://doi.org/10.1371/journal.pone.0228862 Copyright: © 2020 Das Gupta et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: The dataset of NDHS 2016 is available at the Demographic and Health less than once a week, and watching television at least once a week. Multilevel ordered logistic regression was conducted to find the factors associated with overweight and obesity. A p-value <0.05 was considered significant in the final model. Results Around 35% of the participants were overweight or obese (overweight: 23.7% and obese: 11.6%). A majority of the study participants was aged between 15 and 24 years (36.5%), and resided in an urban area (63.2%), Province No. 3 (22.3%), and the Terai ecological region (49.5%). Around one-third (34.0%) of the participants received no formal education while an almost similar proportion (35.5%) completed secondary education. Approximately half of the study participants (50.6%) reported watching television at least once a week, whereas more than a quarter (28.7%) of them did not watch television at all. Women who watched television at least once a day had a higher prevalence of overweight and obesity than the other groups (p-value <0.0001). Women who watched television at least once a week were 1.3 times more likely to be overweight or obese in comparison to women who never watched television (Adjusted Odds Ratio (AOR): 1.3, 95% CI: 1.0–1.7; p-value <0.05). In the urban areas, women who watched television at least once a week were 40% more likely to be overweight or obese than those who did not watch television at all (AOR: 1.4, 95% CI: 1.1–1.7; p-value <0.01). No significant association between overweight and obesity and the frequency of viewing television was observed in the rural area. Conclusions Watching television at least once a week is associated with overweight and obesity in women of reproductive age living in the urban areas of Nepal. Public health promotion programs should raise awareness among women regarding harmful health consequences of sedentary lifestyle due to television watching.
Association of frequency of television watching with overweight and obesity among women of reproductive age in India: Evidence from a nationally representative study
(PLOS ONE, 8/29/2019) Gupta, Rajat Das; Haider, Shams Shabab; Sutradhar, Ipsita; Hashan, Mohammad Rashidul; Sajal, Ibrahim Hossain; Hasan, Mehedi; Haider, Mohammad Rifat; Sarker, Malabika
Background For women of reproductive age, overweight and obesity are an established risk factor for several medical complications. To address the increasing rate of obesity in India through public health awareness programs, the association between common behaviors and overweight and obesity needs to be investigated. This study aims to determine whether there is any association between the frequency of television watching and overweight and obesity among women of reproductive age (15–49 years) in India. Methods This is a cross-sectional study that utilized data from the National Family Health Survey (NFHS-4), which utilized a nationally representative sample from all 29 states and 7 union territories of India. The survey itself followed a two-staged stratified random sampling technique. The primary outcome of interest was overweight (23.0 kg/m2 to <27.5 kg/m2) and obesity (≥27.5 kg/m2), measured by using the Asian body mass index cut-off. The major explanatory variable was the frequency of television watching, measured in days per week. Sample weight of NFHS-4 was adjusted during the analysis. Multilevel ordered logistic regression was conducted to identify the factors associated with overweight and obesity. To show the strength of association, both the unadjusted Crude Odds Ratio (COR) and the Adjusted Odds Ratio (AOR) were reported with a 95% confidence interval (CI). A p-value<0.05 was considered statistically significant. Results The analysis included weighted data from 644,006 Indian women of reproductive age (15–49 years). Among the respondents, 33.5% were overweight or obese (BMI ≥23.0 kg/m2). The prevalence of overweight and obesity increased with age (p-value <0.0001) and almost half of the women aged 35–49 years were either overweight or obese (48.6%). The prevalence was significantly higher among those living in an urban area compared to a rural area (urban 46.5% vs. rural 26.5%; p-value <0.001). The prevalence of overweight and obesity increased with the frequency of watching television and was the highest among the individuals who reported watching television almost every day (p-value <0.0001). Women watching television almost every day had 24% (AOR: 1.24, 95% CI: 1.21–1.26; p-value <0.001) increased odds of being overweight and obese compared to their counterparts who never watched television. Conclusions This study found that the likelihood of being overweight and obese significantly increased with the frequency of watching television; likely due to physical inactivity during leisure time. Further studies should examine the physical activity and food habits of this target group. Public health promotion programs in India should raise awareness regarding the harmful effects of the sedentary lifestyle associated with watching television.
Autism Spectrum disorders (ASD) in South Asia: a systematic review
(© 2017 BioMed Central Ltd., 8/1/2017) Hossain, Mohammad Didar; Ahmed, Helal Uddin; Jalal Uddin, M. M.; Chowdhury, Waziul Alam; Iqbal, Mohammad Shamim; Kabir, Razin Iqbal; Chowdhury, Imran Ahmed; Aftab, Afzal; Datta, Pran Gopal; Rabbani, Golam; Hossain, Saima Wazed; Sarker, Malabika
Background: Autism spectrum disorders (ASD) are a group of complex neurodevelopmental disorders. The prevalence of ASD in many South Asian countries is still unknown. The aim of this study was to systematically review available epidemiological studies of ASD in this region to identify gaps in our current knowledge. Methods: We searched, collected and evaluated articles published between January 1962 and July 2016 which reported the prevalence of ASD in eight South Asian countries. The search was conducted in line with the PRISMA guidelines. Results: We identified six articles from Bangladesh, India, and Sri Lanka which met our predefined inclusion criteria. The reported prevalence of ASD in South Asia ranged from 0.09% in India to 1.07% in Sri Lanka that indicates up to one in 93 children have ASD in this region. Alarmingly high prevalence (3%) was reported in Dhaka city. Study sample sizes ranged from 374 in Sri Lanka to 18,480 in India. The age range varied between 1 and 30 years. No studies were found which reported the prevalence of ASD in Pakistan, Nepal, Bhutan, Maldives and Afghanistan. This review identifies methodological differences in case definition, screening instruments and diagnostic criteria among reported three countries which make it very difficult to compare the studies. Conclusions: Our study is an attempt at understanding the scale of the problem and scarcity of information regarding ASD in the South Asia. This study will contribute to the evidence base needed to design further research and make policy decisions on addressing this issue in this region. Knowing the prevalence of ASD in South Asia is vital to ensure the effective allocation of resources and services.
Autism Spectrum disorders (ASD) in South Asia: a systematic review
(© 2017 BioMed Central Ltd., 8/1/2017) Hossain, Mohammad Didar; Ahmed, Helal Uddin; Jalal Uddin, M. M.; Chowdhury, Waziul Alam; Iqbal, Mohammad Shamim; Kabir, Razin Iqbal; Chowdhury, Imran Ahmed; Aftab, Afzal; Datta, Pran Gopal; Rabbani, Golam; Hossain, Saima Wazed; Sarker, Malabika
Background: Autism spectrum disorders (ASD) are a group of complex neurodevelopmental disorders. The prevalence of ASD in many South Asian countries is still unknown. The aim of this study was to systematically review available epidemiological studies of ASD in this region to identify gaps in our current knowledge. Methods: We searched, collected and evaluated articles published between January 1962 and July 2016 which reported the prevalence of ASD in eight South Asian countries. The search was conducted in line with the PRISMA guidelines. Results: We identified six articles from Bangladesh, India, and Sri Lanka which met our predefined inclusion criteria. The reported prevalence of ASD in South Asia ranged from 0.09% in India to 1.07% in Sri Lanka that indicates up to one in 93 children have ASD in this region. Alarmingly high prevalence (3%) was reported in Dhaka city. Study sample sizes ranged from 374 in Sri Lanka to 18,480 in India. The age range varied between 1 and 30 years. No studies were found which reported the prevalence of ASD in Pakistan, Nepal, Bhutan, Maldives and Afghanistan. This review identifies methodological differences in case definition, screening instruments and diagnostic criteria among reported three countries which make it very difficult to compare the studies. Conclusions: Our study is an attempt at understanding the scale of the problem and scarcity of information regarding ASD in the South Asia. This study will contribute to the evidence base needed to design further research and make policy decisions on addressing this issue in this region. Knowing the prevalence of ASD in South Asia is vital to ensure the effective allocation of resources and services.
Autism Spectrum disorders (ASD) in South Asia: a systematic review
(© 2017 BioMed Central Ltd., 8/1/2017) Hossain, Mohammad Didar; Ahmed, Helal Uddin; Jalal Uddin, M. M.; Chowdhury, Waziul Alam; Iqbal, Mohammad Shamim; Kabir, Razin Iqbal; Chowdhury, Imran Ahmed; Aftab, Afzal; Datta, Pran Gopal; Rabbani, Golam; Hossain, Saima Wazed; Sarker, Malabika
Background: Autism spectrum disorders (ASD) are a group of complex neurodevelopmental disorders. The prevalence of ASD in many South Asian countries is still unknown. The aim of this study was to systematically review available epidemiological studies of ASD in this region to identify gaps in our current knowledge. Methods: We searched, collected and evaluated articles published between January 1962 and July 2016 which reported the prevalence of ASD in eight South Asian countries. The search was conducted in line with the PRISMA guidelines. Results: We identified six articles from Bangladesh, India, and Sri Lanka which met our predefined inclusion criteria. The reported prevalence of ASD in South Asia ranged from 0.09% in India to 1.07% in Sri Lanka that indicates up to one in 93 children have ASD in this region. Alarmingly high prevalence (3%) was reported in Dhaka city. Study sample sizes ranged from 374 in Sri Lanka to 18,480 in India. The age range varied between 1 and 30 years. No studies were found which reported the prevalence of ASD in Pakistan, Nepal, Bhutan, Maldives and Afghanistan. This review identifies methodological differences in case definition, screening instruments and diagnostic criteria among reported three countries which make it very difficult to compare the studies. Conclusions: Our study is an attempt at understanding the scale of the problem and scarcity of information regarding ASD in the South Asia. This study will contribute to the evidence base needed to design further research and make policy decisions on addressing this issue in this region. Knowing the prevalence of ASD in South Asia is vital to ensure the effective allocation of resources and services.
Barriers and facilitators to knowledge translation activities within academic institutions in low- And middle-income countries
(Oxford Academic, 3/1/2021) Kalbarczyk, Anna; Rodriguez, Daniela C; Mahendradhata, Yodi; Sarker, Malabika; Seme, Assefa; Majumdar, Piyusha; Akinyemi, Oluwaseun O; Kayembe, Patrick; Alonge, Olakunle O
The barriers and facilitators of conducting knowledge translation (KT) activities are well-established but less is known about the institutional forces that drive these barriers, particularly in low-resource settings. Understanding organizational readiness has been used to assess and address such barriers but the employment of readiness assessments has largely been done in high-income countries. We conducted a qualitative study to describe the institutional needs and barriers in KT specific to academic institutions in low- and middle-income countries. We conducted a review of the grey and published literature to identify country health priorities and established barriers and facilitators for KT. Key-informant interviews (KII) were conducted to elicit perceptions of institutional readiness to conduct KT, including experiences with KT, and views on motivation and capacity building. Participants included representatives from academic institutions and Ministries of Health in six countries (Bangladesh, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria). We conducted 18 KIIs, 11 with members of academic institutions and 7 with policymakers. KIIs were analysed using a deductive and inductive coding approach. Our findings support many well-documented barriers including lack of time, skills and institutional support to conduct KT. Three additional institutional drivers emerged around soft skills and the complexity of the policy process, alignment of incentives and institutional missions, and the role of networks. Participants reflected on often-lacking soft-skills needed by researchers to engage policy makers. Continuous engagement was viewed as a challenge given competing demands for time (both researchers and policy makers) and lack of institutional incentives to conduct KT. Strong networks, both within the institution and between institutions, were described as important for conducting KT but difficult to establish and maintain. Attention to the cross-cutting themes representing barriers and facilitators for both individuals and institutions can inform the development of capacity building strategies that meet readiness needs.
Carrying out embedded implementation research in humanitarian settings: A qualitative study in Cox's Bazar, Bangladesh
(PLOS ONE, 7/16/2020) Shahabuddin, A. S. M.; Sharkey, Alyssa B.; Jackson, Debra; Rutter, Paul; Hasman, Andreas; Sarker, Malabika
Background: Embedded implementation research (IR) promotes evidence-informed policy and practices by involving decision-makers and program implementers in research activities that focus on understanding and solving existing implementation challenges. Although embedded IR has been conducted in multiple settings by different organizations, there are limited experiences of embedded IR in humanitarian settings. This study highlights some of the key challenges of conducting embedded IR in a humanitarian setting based on our experience with the Rohingya refugee population in Cox's Bazar, Bangladesh. Methods and findings: We collected qualitative data in between January and July 2019. First, we visited Rohingya refugee camps and interviewed representatives from different humanitarian organizations. Second, we conducted interviews with researchers from BRAC University who were engaged with data collection and analysis in a broader embedded IR study on maternal, newborn, child, and adolescent health (MNCAH) program implementation challenges. Data were analyzed using a thematic analysis approach. Two researchers developed and agreed on codes and relevant themes based on the objectives of this study. The findings of this study highlight several challenges encountered while conducting embedded IR in the Rohingya emergency setting in Cox's Bazar, which may have implications for other humanitarian settings. The overall context of the camps was complex, with more than 100 organizations devoted to providing health services for approximately 1 million refugees. Despite the presence of the Bangladesh government, United Nations agencies and other international organizations played key roles in making programmatic and policy decisions for the Rohingya. Because health service delivery modalities and policies and related implementation challenges for MNCAH programs for the refugees changed rapidly, the embedded IR approach used was flexible and able to adapt to changes identified, with research questions and methods modified accordingly. Access to the camps, reaching Rohingya respondents, overcoming language barriers in order to get quality information, and the limited availability of local research collaborators were additional challenges. Working with researchers or research institutes that are familiar with the context and have experience in conducting implementation and health systems research can help with collection of quality data, identifying key stakeholders and bringing them on board to ensure the execution of the project, and ensuring utilization of the research findings. Study limitations include possible constraints in generalizing our conclusions to other humanitarian settings. Implementation research conducted in additional humanitarian settings can contribute to the evidence on this topic. Conclusions: Findings indicate that embedded IR can be done effectively in humanitarian settings if the challenges are anticipated, and appropriate strategies and in-country partners put in place to address or mitigate them, before commencing the funding or starting of the project. Understanding the context and analyzing the role of relevant stakeholders prior to conducting the research, considering a simple descriptive method appropriate to answering real-time IR questions, and working with local researchers or research institutes with specific skill sets and prior experience conducting research in humanization contexts may reduce costs and time spent, and ensure collection of quality data relevant for policy and practice.
Climate change, migration and health systems resilience: Need for interdisciplinary research
(F1000 Research, 4/1/2019) Ridde, Valéry; Benmarhnia, Tarik; Bonnet, Emmanuel; Bottger, Carol; Cloos, Patrick; Dagenais, Christian; De Allegri, Manuela; Nebot, Ariadna; Queuille, Ludovic; Sarker, Malabika
Climate change is one of today's major challenges, and among the causes of population movement and international migration. Climate migrants impact health systems and how their ability to respond and adapt to their needs and patterns. To date, the resilience of health systems in the context of climate change has barely been explored. The purpose of this article is to show the importance of studying the relationship between climate change, migration, and the resilience of health systems from an interdisciplinary perspective. Resilience is an old concept, notably in the field of psychology, and is increasingly applied to the study of health systems. Yet, no research has analysed the resilience of health systems in the context of climate change. While universal health coverage is a major international goal, little research to date focused on the existing links between climate, migration, health systems and resilience. We propose an interdisciplinary approach relying on the concept of health system resilience to study adaptive and transformative strategies to articulate climate change, migration and health systems. Keywords
Clinical evaluation of dengue and identification of risk factors for severe disease: protocol for a multicentre study in 8 countries
(© 2016 BMC Infectious Diseases, 2/18/2016) Jaenisch, Thomas; Hoai Tam, Dong Thi; Thanh Kieu, Nguyen Tan; Ngoc, Tran Van; Tran Nam, Nguyen; Kinh, Nguyen Van; Yacoub, Sophie; Chanpheaktra, Ngoun; Kumar, Varun; Chai See, Lucy Lum; Sathar, Jameela; Sandoval, Ernesto Pleités; Marón Alfaro, Gabriela Maria; Laksono, Ida Safitri; Mahendradhata, Yodi; Sarker, Malabika; Ahmed, Firoz; Caprara, Andrea; Benevides, Bruno Souza; Marques, Ernesto T. A.; Magalhaes, Tereza; Brasil, Patricia; Netto, Marco; Tami, Adriana; Bethencourt, Sarah E.; Guzman, Maria; Simmons, Cameron; Quyen, Nguyen Thanh Ha; Merson, Laura; Dung, Nguyen Thi Phuong; Beck, Dorothea; Wirths, Marius; Wolbers, Marcel; Lam, Phung Khanh; Rosenberger, Kerstin; Wills, Bridget
Background The burden of dengue continues to increase globally, with an estimated 100 million clinically apparent infections occurring each year. Although most dengue infections are asymptomatic, patients can present with a wide spectrum of clinical symptoms ranging from mild febrile illness through to severe manifestations of bleeding, organ impairment, and hypovolaemic shock due to a systemic vascular leak syndrome. Clinical diagnosis of dengue and identification of which patients are likely to develop severe disease remain challenging. This study aims to improve diagnosis and clinical management through approaches designed a) to differentiate between dengue and other common febrile illness within 72 h of fever onset, and b) among patients with dengue to identify markers that are predictive of the likelihood of evolving to a more severe disease course. Method/Design This is a prospective multi-centre observational study aiming to enrol 7–8000 participants aged ≥ 5 years presenting with a febrile illness consistent with dengue to outpatient health facilities in 8 countries across Asia and Latin America. Patients presenting within 72 h of fever onset who do not exhibit signs of severe disease are eligible for the study. A broad range of clinical and laboratory parameters are assessed daily for up to 6 days during the acute illness, and also at a follow up visit 1 week later. Discussion Data from this large cohort of patients, enrolled early with undifferentiated fever, will be used to develop a practical diagnostic algorithm and a robust clinical case definition for dengue. Additionally, among patients with confirmed dengue we aim to identify simple clinical and laboratory parameters associated with progression to a more severe disease course. We will also investigate early virological and serological correlates of severe disease, and examine genetic associations in this large heterogeneous cohort. In addition the results will be used to assess the new World Health Organization classification scheme for dengue in practice, and to update the guidelines for “Integrated Management of Childhood Illness” used in dengue-endemic countries.
Clinical evaluation of dengue and identification of risk factors for severe disease: protocol for a multicentre study in 8 countries
(© 2016 BMC Infectious Diseases, 2/18/2016) Jaenisch, Thomas; Hoai Tam, Dong Thi; Thanh Kieu, Nguyen Tan; Ngoc, Tran Van; Tran Nam, Nguyen; Kinh, Nguyen Van; Yacoub, Sophie; Chanpheaktra, Ngoun; Kumar, Varun; Chai See, Lucy Lum; Sathar, Jameela; Sandoval, Ernesto Pleités; Marón Alfaro, Gabriela Maria; Laksono, Ida Safitri; Mahendradhata, Yodi; Sarker, Malabika; Ahmed, Firoz; Caprara, Andrea; Benevides, Bruno Souza; Marques, Ernesto T. A.; Magalhaes, Tereza; Brasil, Patricia; Netto, Marco; Tami, Adriana; Bethencourt, Sarah E.; Guzman, Maria; Simmons, Cameron; Quyen, Nguyen Thanh Ha; Merson, Laura; Dung, Nguyen Thi Phuong; Beck, Dorothea; Wirths, Marius; Wolbers, Marcel; Lam, Phung Khanh; Rosenberger, Kerstin; Wills, Bridget
Background The burden of dengue continues to increase globally, with an estimated 100 million clinically apparent infections occurring each year. Although most dengue infections are asymptomatic, patients can present with a wide spectrum of clinical symptoms ranging from mild febrile illness through to severe manifestations of bleeding, organ impairment, and hypovolaemic shock due to a systemic vascular leak syndrome. Clinical diagnosis of dengue and identification of which patients are likely to develop severe disease remain challenging. This study aims to improve diagnosis and clinical management through approaches designed a) to differentiate between dengue and other common febrile illness within 72 h of fever onset, and b) among patients with dengue to identify markers that are predictive of the likelihood of evolving to a more severe disease course. Method/Design This is a prospective multi-centre observational study aiming to enrol 7–8000 participants aged ≥ 5 years presenting with a febrile illness consistent with dengue to outpatient health facilities in 8 countries across Asia and Latin America. Patients presenting within 72 h of fever onset who do not exhibit signs of severe disease are eligible for the study. A broad range of clinical and laboratory parameters are assessed daily for up to 6 days during the acute illness, and also at a follow up visit 1 week later. Discussion Data from this large cohort of patients, enrolled early with undifferentiated fever, will be used to develop a practical diagnostic algorithm and a robust clinical case definition for dengue. Additionally, among patients with confirmed dengue we aim to identify simple clinical and laboratory parameters associated with progression to a more severe disease course. We will also investigate early virological and serological correlates of severe disease, and examine genetic associations in this large heterogeneous cohort. In addition the results will be used to assess the new World Health Organization classification scheme for dengue in practice, and to update the guidelines for “Integrated Management of Childhood Illness” used in dengue-endemic countries.
Comparing knowledge and practice of Covid-19 vaccination between general school (Grade 6 to 9) and madrasa-going students (Grade 6 to 9 equivalent) at Cox’s Bazar, Bangladesh
(Brac University, 2023) Neeher, Nishantika; Chowdhury, Mohiuddin Ahsanul Kabir; Sarker, Malabika
Background Schools and madrasas are regarded as high-risk locations for COVID-19 epidemics due to the crowded campus atmosphere, high movement, and constrained space. Therefore, vaccination is believed to be an essential tactic that can significantly reduce the occurrence and spread of this deadly infectious disease. However, there may be variations between a madrasa and a school regarding students’ desire to receive the COVID-19 vaccination. Therefore, a study comparing knowledge and practice of COVID-19 vaccination between general school and madrasa-going students is essential to improve vaccine coverage and prevent a future outbreak. Methods A cross-sectional quantitative survey was conducted on students from six schools and six madrasas in Bangladesh. A semi-structured and self-reported questionnaire containing informed consent, four sections containing the socio-demographics section, the impact of COVID section, knowledge about COVID vaccine section, and uptake of COVID vaccine was used. Multiple logistic regression was performed to determine the variables affecting the uptake of COVID-19 vaccinations. Results A total of 2361 respondents were included in the final analysis, out of whom 1550 (65.65%) were school students and 811 (34.35%) were from the madrasa. The average age of students was 13.74±1.41 (SD), and more than half were females (64.00%). Both students from school and madrasa had adequate knowledge about the COVID-19 vaccine, and the proportion of madrasa students with correct answers was higher than that of school students. The common source of knowledge for school students was school; for madrasa students, it was mass media. There was more than 95% vaccine uptake for both institutions, and the primary reason for taking the vaccine was the perception that the vaccine was safe. Socio-demographic factors like age, family size, and location had a significant association with vaccine uptake. Conclusions The findings reflect that there is no significant difference in uptake of the COVID vaccine between schools and madrasa. The proportion of madrasa students was higher than school students when asked about knowledge.
Cost-effectiveness of modified algorithm used in syndromic management of vaginal discharge in semi-high risk population in Dhaka (abstract)
(2000) Ali, Disha; Khan, M. Mahmud; Sarker, Malabika