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Depression and health-related quality of life of patients with type 2 diabetes attending tertiary level hospitals in Dhaka, Bangladesh
(BioMed Central Ltd, 2023-12-01) Namdeo, Manish K.; Verma, Sarita; Das Gupta, Rajat; Islam, Rubana; Nazneen, Shaila; Rawal, Lal B.; BRAC James P Grant School of Public Health
Introduction: Type 2 diabetes mellitus (T2DM) and depression are closely linked. People with T2DM are at increased risk of developing depression and vice versa. T2DM and depression comorbid conditions adversely affect Health-Related Quality of Life (HRQOL) and management of T2DM. In this study, we assessed depression and HRQOL among patients with T2DM in Dhaka, Bangladesh. Methods: A cross-sectional study was conducted in two tertiary-level hospitals in Dhaka, Bangladesh. Data were collected from 318 patients with T2DM. A set of standard tools, PHQ-9 (for assessing depression) and EuroQol-5D-5L (for assessing the HRQOL), were used. Statistical analyses, including Chi-square and Fisher's exact tests, Wilcoxon (Mann–Whitney), and Spearman's correlation coefficient tests, were performed using SPSS (v.20). Results: The majority of the patients (58%) were females, with a mean age (standard deviation) of 52 ± 10 years, and 74% of patients lived in urban areas. The prevalence of depression was 62% (PHQ-9 score ≥ 5). Over three-quarters (76%) reported problems in the anxiety/ depression dimension of EQ-5D, followed by pain/discomfort (74%), mobility (40%), self-care (36%), and usual activities (33%). The depression and T2DM comorbid condition were associated with all the five dimensions of EQ-5D (χ2 statistics with df = 1 was 52.33, 51.13, 52.67, 21.61, 7.92 for mobility, self-care, usual activities, pain/discomfort, and anxiety/ depression dimensions respectively, p- < 0.01). The mean EQ-5D index (0.53 vs. 0.75) and the mean EQ-5D VAS (65 vs. 76) both showed lower values in T2DM patients with depression compared to T2DM patients without depression (Wilcoxon test, p- < 0.001). Conclusions: We conclude that the majority of the patients with T2DM had comorbid conditions, and the HRQOL was negatively affected by comorbid depression in T2DM patients. This suggests the importance of timely screening, diagnosis, treatment, and follow-up of comorbid depression in T2DM patients to improve overall health and QOL. © 2023, Wuhan University Global Health Institute.
Barriers and facilitators for treatment-seeking among women with genital fistula: a facility-based qualitative study in Bangladesh
(BioMed Central Ltd, 2025-12-01) Kon, Kanako; Imoto, Atsuko; Rashid Sabina Faiz; Masuda Ken; BRAC James P Grant School of Public Health
Background: Women living with genital fistula often endure prolonged suffering and face multiple barriers to accessing treatment. Bangladesh’s government has enhanced referral mechanisms, enabling case detection in communities and facilitating surgical interventions at medical college hospitals through nationwide initiatives. However, research on barriers and facilitators for fistula treatment in Bangladesh remains limited. Detailed insights into treatment-seeking paths with time sequences are scarce. This study aimed to explore facilitators and barriers to completing fistula treatment with the description of treatment-seeking paths. This study is important to assist with future policy and program strategies for fistula treatment. Methods: A facility-based qualitative study was conducted at Dhaka Medical College Hospital, Dhaka, Bangladesh. Data were collected from February to May 2024 through 18 in-depth interviews (IDIs) with in-patients, five IDIs with families, and 11 key informant interviews with health service providers. Participants’ treatment-seeking paths were described chronologically and identified patterns of treatment-seeking paths. Thematic analysis, guided by the Partners for Applied Social Sciences model for health-seeking behavior and access to care, was used to analyze case histories. Results: The average duration of treatment-seeking by the women was 39 months, with a maximum of 22 years. Women with fistula often sought care at multiple facilities (up to eight), suspended treatment, and encountered systemic obstacles that delayed treatment. Key barriers included scarce information on illness and treatment in the community, less decision-making power, failure of medical communication, and systemic failures in cost, treatment, and referral systems. Facilitators that motivated women to complete treatment included informal peer support through shared treatment experiences and emotional, physical, and financial support. Conclusions: Analysis of treatment-seeking paths revealed the absence of standardized treatment routes for women with fistula. To ensure effective care, raising societal awareness about fistula, improving treatment and referral systems, enhancing medical communication, and providing peer and emotional support are strongly recommended. © The Author(s) 2025.
Correction to: Water, sanitation and hygiene (WASH) practices and deworming improve nutritional status and anemia of unmarried adolescent girls in rural Bangladesh (Journal of Health, Population and Nutrition, (2023), 42, 1, (127), 10.1186/s41043-023-00453-8)
(BioMed Central Ltd, 2024-12-01) Jolly, Saira Parveen; Chowdhury, Tridib Roy; Sarker, Tanbi Tanaya; Afsana, Kaosar; BRAC James P Grant School of Public Health
Following publication of the original article [1], the authors identified errors in Tables 2 and 3. The symbol ± appeared twice in Table 2 between mean and (95%.) where it shouldn’t have been indicated. The sub-header Mean ± SD was missing from the Table 3 sub-header. The incorrect Table 2: Dietary diversity and nutrients intake and of the adolescent girls by study areas Variables p-value Comparison n = 809 Average number of food groups intake during last 24 hrs, Mean ± SD** 3.91 ± 1.25 3.97 ± 1.24 0.889 Dietary diversity score during last 24 hrs, n (%) * 1 ‒3 food groups (low) 37.85(307) 38.44(311) 0.431 4 ‒6 food groups (average) 59.93(486) 58.54(472) 7 ‒10 food groups (high) 2.22(18) 3.21(26) Vitamin A rich dark green leafy vegetable, n (%) * 20.5 (166) 30.3 (245) 0.000 Organ meat, n (%) * 1.5 (12) 1.2 (10) 0.672 Fish, meat, poultry, n (%) * 73.7 (598) 74.8 (605) 0.630 Energy, in kcal/day, Mean(95% CI)** 1344.29(1357.64-1418.94) 1403.61(1375.78-1431.43) 0.468 Protein, in g/day, Mean(95% CI)** 45.61(44.37–46.85) 46.36(45.26–47.46) 0.375 Fat, in g/day, Mean (95% CI) ** 14.28(13.78–14.78) 14.28(13.77–14.29) 0.998 Carbohydrate, in g/day, Mean (95% CI) ** 260.37(254.64-266.11) 264.34(258.83-269.84) 0.328 Calcium, in mg/day, Mean (95% CI) ** 635.38(550.01-720.75) 745.07(667.48–822.30) 0.062 Iron, in g/day, Mean (95% CI) ** 7.78(7.5–8.07) 8.65(8.22–9.07) 0.001 Zinc, in mg/day, Mean (95% CI) ** 8.85(8.31–8.78) 8.68(8.44–9.07) 0.445 Vitamin A, in µg/day, Mean± (95% CI) ** 167.95(151.88-184.02) 233.01(207.14-258.19) 0.000 Thiamin, in mg/day, Mean (95% CI) ** 1.19(1.16–1.22) 1.18(1.15–1.21) 0.801 Riboflavin, in mg/day, Mean (95% CI) ** 0.64(0.61–0.67) 0.67(0.62–0.71) 0.365 Vitamin C, in mg/day, Mean± (95% CI) ** 65.00(61.06–68.93) 71.09(67.04–75.14) 0.034 Intake of iron supplement during last one month, %(n)* 5.2 (42) 4.4(36) 0.493 Frequency of taking iron supplement, %(n)* Daily 23.8(10) 38.9(14) 0.322 7 days 33.3(14) 30.6(11) < 7 days 42.9(18) 30.6(11) *Chi-square test **Student t-test Hrs = Hours The correct Table 2: Dietary diversity and nutrients intake and of the adolescent girls by study areas Variables p-value Comparison n = 809 Average number of food groups intake during last 24 hrs, Mean ± SD** 3.91 ± 1.25 3.97 ± 1.24 0.889 Dietary diversity score during last 24 hrs, n (%) * 1 ‒3 food groups (low) 37.85(307) 38.44(311) 0.431 4 ‒6 food groups (average) 59.93(486) 58.54(472) 7 ‒10 food groups (high) 2.22(18) 3.21(26) Vitamin A rich dark green leafy vegetable, n (%) * 20.5 (166) 30.3 (245) 0.000 Organ meat, n (%) * 1.5 (12) 1.2 (10) 0.672 Fish, meat, poultry, n (%) * 73.7 (598) 74.8 (605) 0.630 Energy, in kcal/day, Mean(95% CI)** 1344.29(1357.64-1418.94) 1403.61(1375.78-1431.43) 0.468 Protein, in g/day, Mean(95% CI)** 45.61(44.37–46.85) 46.36(45.26–47.46) 0.375 Fat, in g/day, Mean (95% CI) ** 14.28(13.78–14.78) 14.28(13.77–14.29) 0.998 Carbohydrate, in g/day, Mean (95% CI) ** 260.37(254.64-266.11) 264.34(258.83-269.84) 0.328 Calcium, in mg/day, Mean (95% CI) ** 635.38(550.01-720.75) 745.07(667.48–822.30) 0.062 Iron, in g/day, Mean (95% CI) ** 7.78(7.5–8.07) 8.65(8.22–9.07) 0.001 Zinc, in mg/day, Mean (95% CI) ** 8.85(8.31–8.78) 8.68(8.44–9.07) 0.445 Vitamin A, in µg/day, Mean (95% CI) ** 167.95(151.88-184.02) 233.01(207.14-258.19) 0.000 Thiamin, in mg/day, Mean (95% CI) ** 1.19(1.16–1.22) 1.18(1.15–1.21) 0.801 Riboflavin, in mg/day, Mean (95% CI) ** 0.64(0.61–0.67) 0.67(0.62–0.71) 0.365 Vitamin C, in mg/day, Mean (95% CI) ** 65.00(61.06–68.93) 71.09(67.04–75.14) 0.034 Intake of iron supplement during last one month, %(n)* 5.2 (42) 4.4(36) 0.493 Frequency of taking iron supplement, %(n)* Daily 23.8(10) 38.9(14) 0.322 7 days 33.3(14) 30.6(11) < 7 days 42.9(18) 30.6(11) *Chi-square test **Student t-test Hrs = Hours The incorrect Table 3: Nutritional status of the adolescent girls by study area Variables Study area p-value Intervention n = 811 Comparison n = 809 Weight in kg 38.36 ± 8.29 38.50 ± 8.85 0.742 Height in cm 146.57 ± 8.26 146.56 ± 8.46 0.985 a MAC in mm 213.56 ± 28.49 213.42 ± 29.72 0.923 b BMI in kg/m2 17.70 ± 2.76 17.74 ± 2.98 0.793 c HAZ- score -1.27 ± 1.07 1.24 ± 1.05 0.516 d BMIZ 0.71 ± 1.07 0.72 ± 1.11 0.982 Hb in g/dl 12.4 ± 1.3 12.3 ± 1.3 0.529 **Student t test aMid arm circumferences b BMI = Body Mass Index cHeight-for-age Z score dBMI-for-age Z score The correct Table 3: Average nutritional status of adolescent girls by study area Variables Study area p-value Intervention n = 811 Comparison n = 809 Mean ± SD Mean ± SD Weight in kg 38.36 ± 8.29 38.50 ± 8.85 0.742 Height in cm 146.57 ± 8.26 146.56 ± 8.46 0.985 a MAC in mm 213.56 ± 28.49 213.42 ± 29.72 0.923 b BMI in kg/m2 17.70 ± 2.76 17.74 ± 2.98 0.793 c HAZ- score -1.27 ± 1.07 1.24 ± 1.05 0.516 d BMIZ 0.71 ± 1.07 0.72 ± 1.11 0.982 Hb in g/dl 12.4 ± 1.3 12.3 ± 1.3 0.529 **Student t test aMid arm circumferences b BMI = Body Mass Index cHeight-for-age Z score dBMI-for-age Z score The correct Tables 2 and 3 have been indicated in this correction article and the original article [1] has been corrected. © The Author(s) 2024.
SensaNet: a lightweight DL model for tuberculosis detection in histopathological images
(Institute of Electrical and Electronics Engineers Inc., 2025-01-01) Mahtab M.A.; Tasnim, Sanjida; Choudhury M.S.; Wasi S.; Bhuiyan S.T.; Alam S.B.; Rahman R.; School of Data & Sciences, BRAC University
Tuberculosis remains a global health problem, particularly in resource-limited settings in which early and accurate diagnosis is paramount. This research presents SensaNet, an efficient yet light-weight binary tuberculosis (TB) classification for histopathological image patches. SensaNet is evaluated against a well-curated set of 27,987 Kinyoun-stained image patches that were scanned from digitized slides of sputum smears, with wellbalanced bacilli-positive and negative distributions. SensaNet combines current architectural innovations such as Squeeze-and-Excitation (SE) blocks, Swish activation, and single-head self-attention to amplify feature representation in channel and spatial domains with lower memory cost. Experimental results confirm that SensaNet achieves an accuracy of 98.54%, precision of 98.19%, and recall of 98.95%, outperforming several baseline architectures on sensitivity with the compact size of 12.2 MB and only above 1 million parameters. Comparative analysis proves SensaNet's suitability for TB diagnosis, offering a good trade-off between diagnostic performance and computational expense. These results weigh in favor of the model's potential deployment for real-time point-of-care diagnostics, particularly for low-resource environments.
Determinants of health seeking behavior for chronic non-communicable diseases and related out-of-pocket expenditure: Results from a cross-sectional survey in northern Bangladesh
(BioMed Central Ltd., 2019-12-23) Rasul, Fatema Binte; Kalmus, Olivier; Sarker, Malabika; Adib, Hossain Ishrath; Hossain, Md Shahadath; Hasan, Md Zabir; Brenner, Stephan; Nazneen, Shaila; Islam, Muhammed Nazmul; De Allegri, Manuela; BRAC James P Grant School of Public Health
Background: In spite of high prevalence rates, little is known about health seeking and related expenditure for chronic non-communicable diseases in low-income countries. We assessed relevant patterns of health seeking and related out-of-pocket expenditure in Bangladesh. Methods: We used data from a household survey of 2500 households conducted in 2013 in Rangpur district. We employed multinomial logistic regression to assess factors associated with health seeking choices (no care or self-care, semi-qualified professional care, and qualified professional care). We used descriptive statistics (5% trimmed mean and range, median) to assess related patterns of out-of-pocket expenditure (including only direct costs). Results: Eight hundred sixty-six (12.5%) out of 6958 individuals reported at least one chronic non-communicable disease. Of these 866 individuals, 139 (16%) sought no care or self-care, 364 (42%) sought semi-qualified care, and 363 (42%) sought qualified care. Multivariate analysis confirmed that the following factors increased the likelihood of seeking qualified care: A higher education, a major chronic non-communicable disease, a higher socio-economic status, a lower proportion of chronic household patients, and a shorter distance between a household and a sub-district public referral health facility. Seven hundred fifty-four (87 %) individuals reported out-of-pocket expenditure, with drugs absorbing the largest portion (85%) of total expenditure. On average, qualified care seekers encountered the highest out-of-pocket expenditure, followed by those who sought semi-qualified care and no care, or self-care. Conclusion: Our study reveals insufficiencies in health provision for chronic conditions, with more than half of all affected people still not seeking qualified care, and the majority still encountering considerable out-of-pocket expenditure. This calls for urgent measures to secure better access to care and financial protection. © 2019 The Author(s).