Identifying People with Depression: The role of ‘Self Rated Health’

Depression is the leading cause of disability worldwide. However, it is under recognized and undertreated. Self-rated health is a one-item question that has been used for population health monitoring. It was aimed to examine the prospect of using ‘self-rated health’ (SRH) in identifying people with depression among adult community-based population in Bangladesh over a one-year period controlling for socio-demographic, chronic diseases and symptoms, physical disability, smoking, and life events. We examined data from 3455 participants aged 18 years and above who participated in the 2015 January and 2016 January Health and Socio-Economic Survey of Independent University, Bangladesh. Using multiple logistic regressions, depression at baseline was examined to predict self-rated health at one-year follow-up adjusting for socio-demographic variables, chronic diseases, risk behaviors, and life events. Respondents with depression at baseline had 35% higher odds of reporting poor SRH in the follow-up round compared to those with no depression (OR=1.35, 95% CI=1.03 1.78, P<0.03). SRH may be used by community health workers as a preliminary indicator to identify people who may have depression followed by further screening and management for depression. South East Asia Journal of Public Health Vol.8(1) 2018: 10-16

Barriers to access maternal health services among urban poor women in Bangladesh: A Case of Rajshahi City

Bangladesh has made tremendous achievements in the health sector over the last few decades, albeit worse in maternal health (MH) compared to other South Asian countries. The fact that women, particularly poor, have less access to maternal health care (MHC) services is one of the prime reasons. The main objective of this study was to explore what types of barriers poor mothers faced during the service use. A triangulation of method (interviews of service recipients through interview schedule and service providers through checklist, focus group discussion and observation) was used for the collection of primary data (sample 200) from two slum areas in Rajshahi City between March and April, 2013. The study found socio-cultural and organizational barriers to access to MHC services more acute than physical and financial barriers. As suggested, building awareness of bad consequences of early marriage on MH, ensuring a strong coordination among service providing organizations in dispensing free drugs and posting female doctors in study areas are urgently needed for further improvement of MH. South East Asia Journal of Public Health Vol.8(1) 2018: 22-31

Health effects of brick kiln operations: A study on largest brick kiln cluster in Bangladesh

Brick manufacturing industry is considered as one of the fastest-growing industrial sectors posing serious health hazards in most South East Asian countries like Bangladesh. A major portion of brick kilns in Bangladesh are located in and around the Dhaka, one of the world’s most densely populated cities, where the health effects of these brick kilns are obvious but yet not completely known. The study was thus performed based on a structured questionnaire survey to assess the health effects of brick kiln operations on kiln workers and local inhabitants at Baghiya of Konabari union in Gazipur near Dhaka of Bangladesh. A total of 100 randomly selected respondents (70 brick kiln workers and 30 local inhabitants) were surveyed. The results of the survey revealed that wood and coal are mostly used fuel for brick production in the study area. The respondents were suffering from skin disease (28%), headache (20%), eye irritation (10%), lung disease (8%), and respiratory diseases such as, asthma (20%), bronchitis (10%) and others (6%) problems, while skin diseases, asthma and other lung diseases were prevalent in workers, and eye irritation, headache and bronchitis were in inhabitants. Inhabitants (36%) who were living in surrounding areas of brick kilns for more than 20 years and workers (40%) who were residing for less than 5 years were suffering most from various diseases. Health education or awareness programs need to be organized since 77.1% and 63.3% of the workers and inhabitants, respectively, were never participated in any health education or awareness programs, and eco-friendly brick kilns should be installed maintaining the existing rules and regulations for minimizing the impacts of brick kiln operation induced air pollution in this respect. South East Asia Journal of Public Health Vol.8(1) 2018: 32-36

Use of rapid immunochromatographic test to detect dengue infection in community-based patients in Indonesia

Severe dengue virus (DENV) manifestations commonly occurred in secondary infections. Serology assay using rapid immunochromatographic test is one of diagnostic modalities used in community setting. The aim of this research was to evaluate the use of a serial rapid immunochromatographic test in establishing DENV infection in community pa-tients. This cross-sectional study was conducted in Clinical Microbiology Laboratory Department of Microbiology Faculty of Medicine Universitas Indonesia Jakarta using paired stored sera from community-based DENV patient col-lected in 2010. Samples with positive nonstructural protein 1 (NS1) result were subjected to hemagglutination inhibi-tion (HI) assay. Serial NS1, IgM, IgG, clinical features, and virus serotype result from previous study were taken as secondary data and compared with HI assay result as gold standard. For rapid immunochromatographic test vs HI analysis, both results were classified as ‘Primary Infection’ and ‘Secondary Infection’. A total of 25 samples fulfilled the inclusion criteria. The proportion of primary and secondary infection according to Bioline SD Dengue Duo was 44% and 56%, respectively. In the other side, 23 samples (92%) were classified as secondary infection by mean of HI assay; the rest was primary infection. The highest agreement rate between serial rapid immunochromatographic test and HI was 68%. The rapid test can detect IgM and IgG as early as on 3rd day of fever. The results of rapid immunochromatographic test were in accordance with HI if it was examined within 3-7 day of fever and therefore can replace HI for determining DENV infection whether primary or secondary. South East Asia Journal of Public Health Vol.8(1) 2018: 17-21

Should social accountability be considered as one of the key benchmarks for excellence in medical education?

not available South East Asia Journal of Public Health Vol.8(1) 2018: 1-2

Vegetarian practices, body composition and dietary intake among Hindus and Buddhists in Kuching, Sarawak, Malaysia

Though vegetarians own the privilege of a wide range of health benefits and of much lower risk of many diseases, they are also cut off many essential nutritional values. This study aimed to determine the vegetarian practices, body composition and dietary intake of vegetarians among Hindus and Buddhists in Kuching, Sarawak. Using questionnaire and anthropometric measurement, this cross-sectional study was carried out in Hindu and Buddhist temples in Kuching. Data was entered and analysed using SPSS version 22. A total of 114 respondents participated in the study, with mean age of 45.8 years (SD±16.01), females (57%), and majority Buddhists (81.6%). Majority of the respondents were on lacto-ovo vegetarian diet (71%) with more among the Hindus. More than half of the respondents were overweight and obese (64.1%). About 58% of the respondents were found to have abnormal waist circumference and 78.1% with over fat percentage. Buddhist respondents consumed more carbohydrates than Hindus. Hindu respondents consume more macro-nutrients such as protein and fat with a mean intake of 102.9 g (SD ±34.60) and 20.9 % of total energy intake respectively and more micro-nutrients. Vegetarian diet does not warranty healthy body as the quality and quantity of the food intake can influence the nutritional status of a person. Knowledge on choice of food should be imparted to improve their health status. South East Asia Journal of Public Health Vol.8(1) 2018: 3-9

Neonatal outcome of term deliveries in Sri Lanka

Major proportion (40-70%) of neonatal mortality is among ‘term neonates’. Even though, information on neonatal outcomes of term neonates is scarce. The high volume of term neonatal admissions to neonatal care units signify the importance of studying the neonatal outcomes among term neonates. The aim of this study is to describe the neonatal outcomes, of term neonates following term deliveries (37 completed weeks - 41 completed weeks and 6 days) at Teaching Hospital (TH) Kandy, Sri Lanka. A descriptive cross-sectional study was conducted to describe neonatal outcomes of term neonates before the initial hospital discharge point. A sample of 1,105 neonates, delivered at term were studied during the study period. Mean gestational age at delivery is 38.85 weeks and 41% of term neonates are delivered before completion of 39 weeks of Period of Amenorrhoea (POA). The mean birth weight of the term neo-nates is 2925.24 grams. Out of all term neonates, 15.84% (n=175) were admitted to Neonatal Care Unit (NCU) and 23.3% (n=257) had at least one diagnosed neonatal condition. The commonest neonatal condition was bacterial sepsis of newborn (n=138, 12.48%), followed by neonatal jaundice from other and unspecified causes (n=84, 7.6%), and respiratory distress of newborn (n=44, 3.94%). Median hospital stay of term neonates is 3 days. Majority of term neo-nates admitted to NCU are normal weight term neonates. Nearly one-fourth of term neonates had at least one diag-nosed neonatal condition. Prevention and control of infection from the time of birth to the time of discharge from the hospital should be given due attention to reducing bacterial sepsis among term neonates.South East Asia Journal of Public Health Vol.7(2) 2017: 34-39

Evaluation of antimicrobial resistance pattern of uropathogens in a tertiary care hospital in Dhaka city, Bangladesh

Urinary tract infection (UTI) is one of the most common bacterial infections seen in developing countries like Bangladesh. This study is, therefore, designed to determine the bacterial uropathogens and their antibiotic resistance pattern among patients with complaints of UTIs in Dhaka city. This study was carried out in the laboratory of the Department of Microbiology, Bangladesh Medical College, Dhaka, Bangladesh from January to June 2015. A total of 2541 urine samples were collected in sterile containers from suspected urinary tract infected cases. A specimen was considered positive for UTI if an organism was cultured at a concentration of ≥105CFU/ml or when an organism was cultured at a concentration of 104CFU/ml and >5 pus cells per high power field. Antimicrobial susceptibility testing of the isolated bacterial species was performed by disc diffusion method following the National Committee for Clinical laboratory Standards (NCCLS) guidelines. A total of 303 (11.92%) bacterial uropathogens were isolated from 2541 urine samples. Among the 303 isolates, majority of the isolates 197 (65.02%) were from females. Both the age groups up to 18 years and above 18 years the highest prevalence was found in females 34(11.22%) and 163 (53.79%) respectively. Most predominant organism was Escherichia coli 262(86.46%)followed by Pseudomonas 12(3.96%), Enterococci 12(3.96%), Klebsiella11(3.63%). Escherichiacoli showed very high resistance to amoxycillin 95.41%, cefradin 90.45%, nalidixic acid and Klebsiella to amoxycillin 90.90%, nitrofurantoin 90.90%. Again Pseudomonas was highly resistant to cefuroxime 100%, cefexime 100%and ceftriaxone 83.33%. Enterococci were found highly resistance to cefexime 91.66%, cloxacillin 83.33%, and erythromycin 83.33%.Due to wide scale resistance of the drugs used to treat UTI, choice of drugs in the treatment of UTI is quite narrow. In country like ours awareness for prevention of UTI should be encouraged among the community level as it affects all age groups.South East Asia Journal of Public Health Vol.7(2) 2017: 12-18

School-based educational intervention to improve children’s oral health-related behaviors in rural Bangladesh

Children in rural Bangladesh have limited access to oral health services. As a pilot project, a one-day one-time oral health educational intervention was conducted at a primary school in Tangail district in Bangladesh. This study assessed the effect of this educational intervention on the children’s oral behaviors using controlled pre- and post-intervention design. Fifty-two students at the intervention school and 37 students at a control school agreed to participate in this study. A baseline survey was conducted for children at both schools using a standardized semi-structured questionnaire. Children at the intervention school received face-to-face dental exercises and a group seminar. Six months after the intervention, a follow-up survey was conducted at both schools to compare changes in children’s oral behaviors at the two schools. The increase in the percentage of intervention-school participants who reported brushing their teeth two or more times per day between the baseline and follow-up surveys was 7.6 times greater than that in the control group (95% CI= 1.7–35.1; p<0.009). The increase in the percentage of intervention-school participants who reported brushing their teeth before bed between the two surveys was 7.3 times greater than that in the control group (95% CI=1.6–34.0; p<0.001). The findings suggest the importance of skill-based intervention, in collaboration with dentists, school teachers, parents, and community health educators. Future studies on the effectiveness of school-based educational interventions should consider longer-term sustainable behavioral changes in children’s oral health.South East Asia Journal of Public Health Vol.7(2) 2017: 27-33

Expectations of adolescents to receive reproductive health information and services from health service system: A qualitative study in Bangladesh

Adolescents, aged 10-19 years, constitute one fifth of Bangladesh's total population of 158 million. Similar to adolescents elsewhere, Bangladeshi adolescents also have special sexual and reproductive health (SRH) information and service needs; however, these needs are not adequately addressed by the existing health service system. The present study was conducted to identify adolescents’ expectations of and preferences for receiving SRH information and services. This qualitative study was conducted in six purposively selected areas of Bangladesh using 20 Key Informant Interviews (KII) during September-November 2012. Key informants aged between 15 to 19 years were leaders of youth organizations or class monitors in school. Informants were unmarried and married, males and females, and from rural and urban areas. This study identified that there is a strong need for SRH services for adolescents. Irrespective of their residence and gender, adolescents preferred health service providers to be qualified medical doctors, who are experienced, well-trained and polite. Availability of doctors, maintaining privacy and treatment through counseling were mentioned as their priorities. Both urban and rural adolescents recommended establishing adolescent friendly environment in every government and NGO health service facility. They also asked for gender specific service provider for female and male adolescents. Urban adolescents expressed the need for school health program with provision of school health clinics. On the other hand, rural adolescents recommended for community health workers to raise awareness on adolescent sexual and reproductive health (ASRH) issues with parents and families. The adolescents also expected to receive SRH information through mass media, school curriculum, and booklets on adolescent SRH, and peer educator. Addressing the expectations of adolescents will open a new skylight to policy makers to design highly accessible health services for adolescents in BangladeshSouth East Asia Journal of Public Health Vol.7(2) 2017: 19-26