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Acceptability and Compliance to a 10-Day Regimen of Zinc Treatment in Diarrhea in Rural Bangladesh

Food and Nutrition Sciences 2013年第4期4卷 357-364页

作者： Shahnawaz Ahmed dilruba Nasrin farzana Ferdous fahmida dil farzana Guddu Kaur Mohammod Jobayer Chisti Sumon Kumar Das Abu Syed Golam Faruque Centre for Vaccine Development (CVD) University of Maryland School of Medicine Baltimore USA International Centre for Diarrheal Disease Research Dhaka Bangladesh University of Sydney Sydney Australia

We hypothesised that the promotion of blister packs of zinc may be carried out by health personnel in health care facilities to the mothers of children suffering from diarrhea. We predicted that good acceptability and good compliance to zinc treatment in rural Bangladesh would be over 75% and at least 60%, respectively. Between January and December 2011, six hundred and thirty five children aged 6 - 59 months who presented with acute diarrhea received a 10-day zinc regimen. Determination of acceptability and compliance of a dispersible zinc tablet in children 6 - 59 months old was main point of the study. In-home follow-ups started within 2 - 3 weeks after the regimen began. Seventy seven percent of the mothers/caretakers perceived that the taste of the zinc tablets was the same or better than that of other medicines given to their children and expressed willingness to use zinc in the future (good acceptability). Sixty-two percent of the children completed full 10-day course of zinc treatment by taking one tablet a day that had been completely dissolved in a small amount of water (good compliance). There was 63% excess risk for poor compliance to zinc if father stays at home with the family [OR = 1.63 (95%CI;1.09, 2.46) p = 0.019]. Despite vomiting, 33% children continued to receive zinc tablet [OR = 0.67 (95%CI;(0.47, 0.97, 0.032)] after adjusting for co-variates. Both acceptability and compliance to dispersible zinc tablets in childhood diarrheal illnesses are still not at the expected level in rural Bangladesh.

关键词： Acceptability Compliance Diarrhea Young Children Zinc

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Prolonged acute diarrhea in adults: Decades of observation from epidemiological perspective in urban Bangladesh

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Open Journal of Gastroenterology 2013年第3期3卷 208-213页

作者： Sumon Kumar Das Mohammod Jobayer Chisti Shahnawaz Ahmed Mohammad Abdul Malek fahmida dil farzana farzana Ferdous Jonathan Latham Abu Syed Golam Faruque Centre for Nutrition and Food Security (CNFS) International Centre for Diarrhoeal Disease Research Bangladesh (icddrb) Dhaka Bangladesh London School of Hygiene and Tropical Medicine London UK

The study aimed to determine the epidemiological, clinical characteristics, and etiology of adults aged ≥20 years presented with prolonged acute diarrhea (≥7 days). A total of 18,210 adults aged ≥20 years were enrolled in the Diarrheal Disease Surveillance System of icddr,b between 1993-2012 and included into the analysis. Of these, 17,631 (97%) had duration of diarrhea ≤6 days, 418 (2%) diarrhea presented with a duration of 7 - 13 days and rest 161 (1%) had history of diarrhea ≥14 days. A higher proportion of adult individuals who had duration of diarrhea ≥14 days (70% vs. 56%;p male. At least 73% of all patients used oral rehydration solution;but proportion was lower among prolonged acute diarrhea groups. Use of antimicrobials was higher among those with duration 7 - 13 days (81%) and ≥14 days (81%). Diarrhea lasting ≥14 days, 47% were suffering from chronic energy deficiency and 30% had history of smoking. Individuals with diarrhea ≥7 days less frequently presented with vomiting, watery stool, frequency of stool >10 times/24 hours, drowsy or lethargy, fast breathing, some or severe dehydration, received intravenous saline for initial corrections of dehydration and stayed for longer duration in hospital (≥24 hours) but more often presented with abdominal pain. Stool microscopic examination showed less frequent presence of red blood cells (36% vs. 44%;p = 0.043) and fecal leucocytes (50% vs. 59%;p = 0.029) among individuals with diarrhea ≥14 days compared to those with ≤6 days. None was infected with Vibrio cholerae (≥14 days) (3% for 7 - 13 days);however, isolation rate of Aeromonas was higher among adults with duration for ≥14 days (11%). Only 15% with ≥14 days were positive for Shigella contrary to 19% (7 - 13 days) and 56% (≤6 days). Differences in sociodemographic, clinical presentation and etiology varied with duration of diarrhea among adults.

关键词： Adult Bangladesh Diarrhea Prolonged Acute Diarrhea

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Health and Nutritional Status of Young Foster Children Attending a Diarrhea Treatment Hospital in Bangladesh

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Food and Nutrition Sciences 2013年第8期4卷 785-790页

作者： Durdana Akhter Sumon Kumar Das Mohammod Jobayer Chisti Gazi Imran fahmida dil farzana Shahnawaz Ahmed farzana Ferdous Mohammad Abdul Malek Abu Syed Golam Faruque Centre for Nutrition and Food Security (CNFS) icddrb Dhaka Bangladesh Centre for Vaccine Sciences (CVS) International Centre for Diarrhoeal Disease Research Bangladesh (icddrb) Dhaka Bangladesh Dhaka Shishu (Children’s) Hospital Dhaka Bangladesh

There is scarcity of evidence-based information about socio-demographic as well as ailment factors associated with foster children in Bangladesh. Thus the aim of the present study was to determine the socio-economic, health and nutritional status of young foster children in urban Dhaka. A total of 208 (1%;n = 208/28,948) under-5 foster children were enrolled in the Diarrheal Disease Surveillance System of icddr,b between 1993-2012. Randomly selected under-5 children (n = 624) with a ratio of 1:3 were extracted and constituted as comparison group. Forty-three percent (n = 90) foster children were male. Lack of formal schooling of mother was higher among foster children compared to non-foster children (52% vs. 35%;p < 0.001). Higher proportion of foster children suffered from some or severe dehy-dration (60% vs. 47%;p = 0.001) and often received intravenous saline (12% vs. 5%;p = 0.002) in comparison to non-foster children. Significantly lower proportion of foster children had rotavirus diarrhea (26% vs. 43%;p < 0.001). In multivariate analysis, foster children were 2 times (95% CI: 1.31-4.32) more likely to be stunted and 194 times (95% CI: 82.25-457.76) more likely to be non-breastfed. Infants aged 6-11 months were 8 times (95% CI: 3.70-15.50) more likely to be foster compared to older children and probability of fostering was 7 times (95% CI: 3.96-13.33) higher among mothers with a median age of 25 years. The findings of our study clearly demonstrate the existing health and nutritional problems of foster children. Therefore, appropriate health and nutrition interventions are critical for foster children in Bangladesh.

关键词： Bangladesh Diarrhea Foster Children Malnutrition

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Socio-demographic, host and clinical characteristics of people with typhoidal and non-typhiodal<i>Salmonella</i>gastroenteritis in urban Bangladesh

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Journal of Biomedical Science and Engineering 2013年第8期6卷 834-842页

作者： Sumon Kumar Das Mohammod Jobayer Chisti Mohammad Abdul Malek Shahnawaz Ahmed fahmida dil farzana farzana Ferdous K. M. Shahunja Mohammed Abdus Salam Tahmeed Ahmed Abu Syed Golam Faruque Centre for Nutrition and Food Security (CNFS) International Centre for Diarrheal Disease Research Bangladesh (icddrb) Dhaka Bangladesh

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

关键词： Bangladesh Diarrhea Non-Typhiodal Salmonella Typhoidal Salmonella Urban

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Association of Television Watching Practices of Mothers on Overweight and Obesity of Their Under-5 Offspring in Urban Bangladesh

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Food and Nutrition Sciences 2014年第19期5卷 1811-1817页

作者： Jui Das Sumon Kumar Das Shahnawaz Ahmed Mohammod Jobayer Chisti Mohammad Habibur Rahman Sarker fahmida dil farzana farzana Ferdous Mohammad Abdul Malek Aminur Rahman Abu Syed Golam Faruque Abdullah Al Mamun International Centre for Diarrhoeal Disease Research Bangladesh (icddrb) Dhaka Bangladesh School of Population Health The University of Queensland Brisbane Australia Department of Clinical Trial and Clinical Epidemiology Graduate School of Comprehensive Human Sciences University of Tsukuba Tsukuba Japan

Childhood overweight and obesity, is an emerging public health concern in developing countries like Bangladesh. However, regular television watching by child’s mother and its impact on excess weight gain or overweight and obesity to their offspring is not reported elsewhere. The aim of the present analysis was to determine the socio-demographic characteristics among overweight and obese children based on those mothers who watch television regularly and compare this finding with malnourished and well-nourished under-5 children. A total of 20,800 under-5 children were enrolled during 1996 to 2012 in the Diarrheal Disease Surveillance System (DDSS) of Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). Mean weight-for-age z-score (–1.61 vs. –2.30;mean difference: ?0.69;p < 0.001), height-for-age z-score (–1.42 vs. –1.99;–0.57;<0.001), weight-for-height z-score (–1.59 vs. –1.07;–0.53;<0.001), BMI-for-age z-score (–1.09 vs. –1.61, –0.52;<0.001) differed significantly between the children whose mother did and did not watch television regularly. Under-5 children whose mother watched television regularly (2%) compared to those who did not (1%), had 2.28 [(95% CI-1.61 - 3.24) p < 0.001] times increased odds of being overweight and obese. Television watching of mothers is associated with childhood overweight and obesity and is one of the most public health concerns in Bangladesh. These changes may be in part of better socio-economic condition, changes in life style behaviour and dietary pattern.

关键词： Childhood Overweight and Obesity Mother’s Watching of Television Urban Bangladesh

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Screening of Acetic Acid Producing Microorganisms from Decomposed Fruits for Vinegar Production

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Advances in Microbiology 2015年第5期5卷 291-297页

作者： farzana Diba fahmida Alam Ali Azam Talukder Department of Microbiology Jahangirnagar University Dhaka Bangladesh Human Genome Centre School of Medical Sciences Universiti Sains Malaysia Kubang Kerian Malaysia

Acetic acid bacteria capable of growing at 30°C - 37°C were collected from various decomposed fruits available in Bangladeshi local markets in order to assess their suitability for vinegar production. Initially, 42 microorganisms were isolated from decomposed fruits like grapes, mangoes, pineapples, oranges, safeda etc. during summer when temperature reaches up to 37°C. Then their growths were checked in YPG medium containing various ethanol concentrations at different time point at 37°C. From the preliminary screening, 15 Gram negative bacterial isolates have produced halos or yellow zone around the colonies on YPG agar plate at 37°C which indicated acetic acid production capability by those bacteria. Furthermore, acetic acid production rates were determined by titration method and about 3 - 6.9 gm/100ml acetic acid were estimated by using 4% ethanol at 37°C by shaking culture for 3 days. Several biochemical analysis revealed that our collection contained huge amount of acetic acid producing bacteria and some of them could be potential candidates for vinegar production.

关键词： Decomposed Fruit High Temperature Fermentation Acetic Acid Vinegar

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