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Permanent URI for this collectionhttps://hdl.handle.net/10361/7186

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Diagnosed hematological malignancies in Bangladesh - a retrospective analysis of over 5000 cases from 10 specialized hospitals
(© 2014 BioMed Central Ltd., 2014) Sorowar Hossain, Mohammad; Iqbal, Mohd S; Ahmed Khan, Mohiuddin; Golam Rabbani, Mohammad; Khatun, Hazera; Munira, Sirajam; Miah, M Morshed Zaman; Kabir, Amin Lutful; Islam, Naima; Farhana Dipta, Tashmim; Rahman, Farzana; Mottalib, Abdul; Afrose, Salma; Ara, Tasneem; Biswas, Akhil Ranjan; Rahman, Mizanur; Abedin, AKM Mustafa; Rahman, Mahbubur; Yunus, ABM; Niessen, Louis W; Sultana, Tanvira Afroze; BRAC James P Grant School of Public Health
Background: The global burden from cancer is rising, especially as low-income countries like Bangladesh observe rapid aging. So far, there are no comprehensive descriptions reporting diagnosed cancer group that include hematological malignancies in Bangladesh.Methods: This was a multi-center hospital-based retrospective descriptive study of over 5000 confirmed hematological cancer cases in between January 2008 to December 2012. Morphological typing was carried out using the " French American British" classification system.Results: A total of 5013 patients aged between 2 to 90 years had been diagnosed with malignant hematological disorders. A 69.2% were males (n = 3468) and 30.8% females (n = 1545), with a male to female ratio of 2.2:1. The overall median age at diagnosis was 42 years. Acute myeloid leukemia was most frequent (28.3%) with a median age of 35 years, followed by chronic myeloid leukemia with 18.2% (median age 40 years), non-Hodgkin lymphoma (16.9%; median age 48 years), acute lymphoblastic leukemia (14.1%; median age 27 years), multiple myeloma (10.5%; median age 55 years), myelodysplastic syndromes (4.5%; median age 57 years) and Hodgkin's lymphoma (3.9%; median age 36 years). The least common was chronic lymphocytic leukemia (3.7%; median age 60 years). Below the age of 20 years, acute lymphoblastic leukemia was predominant (37.3%), followed by acute myeloid leukemia (34%). Chronic lymphocytic leukemia and multiple myeloma had mostly occurred among older patients, aged 50-over.Conclusions: For the first time, our study presents the pattern and distribution of diagnosed hematological cancers in Bangladesh. It shows differences in population distributions as compared to other settings with possibly a lower presence of non-Hodgkin lymphoma. There might be under-reporting of affected women. Further studies are necessary on the epidemiology, genetics and potential environmental risk factors within this rapidly aging country.
Breast cancer in South Asia: a Bangladeshi perspective
(© 2014 Elsevier Ltd., 2014) Hossain, Mohammad Sorowar; Ferdous, Shameema; E. Karim-Kos, Henrike; BRAC James P Grant School of Public Health
South Asian countries are facing a hidden breast cancer epidemic. A significant proportion of the breast cancer cases occur in premenopausal women. Knowledge of the various aspects of breast cancer in different geographical regions is limited in South Asia. In this article, we review the Bangladeshi perspective of the epidemiology, risk factors, pathology, diagnosis and treatment of breast cancer. As in other developing countries, because of the lack of breast cancer awareness in Bangladeshi population and inadequate access to health care, most patients are diagnosed at an advanced stage of the disease. Early detection has a crucial impact on overall treatment outcomes. To battle against breast cancer in resource-limited countries like Bangladesh, it is not feasible to set up a parallel health service system solely dedicated to cancer. Therefore, a cost-effective public health strategy is needed which could reach a large number of women in the country. Considering all these issues, we propose an innovative female-based primary healthcare approach focused on awareness, screening and early detection of breast cancer in Bangladesh. This preventive strategy could be a model for other resource-limited developing countries.
Evaluation of three immunological tests for the diagnosis of pulmonary tuberculosis in a rural endemic area of Bangladesh
(© 2014 Elsevier Ltd, 2014-06) Islam, Mohammad Tariqul; Rabbi, Fazle; Ferdous, Shameema; Parvin, Ummey Shahnaz; Hossain, Akram; Hossain, Mohammad Sorowar; Department of Mathematics and Natural Sciences
Objective: Bangladesh is a high tuberculosis burden country. It is always challenging to diagnose active pulmonary tuberculosis (PTB) cases in rural areas where the setting up of conventional microscopic and cultural diagnostic tools is difficult. The objective of the present study is to find a feasible, reliable and easily accessible alternative diagnostic approach for PTB in the rural areas of Bangladesh. Methods: A total of 86 sputum samples were collected from clinically suspected PTB patients of Anantapur village, an underdeveloped remote area of Netrokona district, Bangladesh. Sputum samples were screened by Ziehl-Neelsen (Z-N) and fluorescence staining methods and were categorized as smear-positive active PTB cases (n= 50) and smear-negative controls (n= 36); then the performance of three popular immunological tests were evaluated, including ICT, ELISA and Mantoux tests (MT). Results: The sensitivity of ICT, ELISA, and MT (10. mm induration size) was 68%, 84% and 96%, respectively, and the specificity of these tests was 94.4%, 80.6% and 52.8%, respectively. When the cut-off size of induration in MT was changed from 10 to ≥15. mm, the sensitivity and specificity of MT became 92% and 83.3%, respectively. It was also found that the interpretation of MT was not significantly affected by BCG vaccination when ≥15. mm induration was taken as a cut-off value. Conclusion: Considering the resource-constraints of rural and remote areas, the Mantoux test could be an alternative tool for the diagnosis of active PTB.

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