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Article ; Online: Prevalence of multimorbidity among Bangladeshi adult population: a nationwide cross-sectional study.

Khan, Nusrat / Rahman, Mahfuzar / Mitra, Dipak / Afsana, Kaosar

2019 Volume 9, Issue 11, Page(s) e030886

Abstract: Objective: This study aimed to report prevalence and evaluate the association between multimorbidity and associated risk factors in the adult population of Bangladesh.: Design: A cross-sectional study was conducted using a multistage clustered random ...

Abstract	Objective: This study aimed to report prevalence and evaluate the association between multimorbidity and associated risk factors in the adult population of Bangladesh. Design: A cross-sectional study was conducted using a multistage clustered random sampling strategy. Setting: The study was conducted among the general population of 58 districts in Bangladesh. Participants: A total of 12 338 male and female individuals aged ≥35 were included for analysis in this study. Identified through a household listing conducted prior to the study, from 15 297 individuals meeting the inclusion criteria, 12 338 participants were included based on availability during data collection, consent and health condition. Outcome measures: Multimorbidity in terms of hypertension, diabetes, cancer, cardiovascular diseases, stroke and chronic obstructive pulmonary disease. Results: Approximately 8.4% (95% CI 7.0 to 9.7) of individuals suffer from multimorbidity, of which hypertension accounted for (30.1%) followed by diabetes (10.6%). The mean age of the population was 58.6 (SD ±9.2) years. The prevalence of multimorbidity was lower among men (7.7%) compared with women (8.9%). The likelihood of having multimorbidity among obese individuals were more than double than people with normal body mass index (BMI). Physical activity protected individuals from developing multimorbidity: however, the physical activity adjusted OR was 0.5 (95% CI 0.2 to 1.2). After adjusting for all covariates, higher age, higher educational status, economic status, and higher BMI were found to be significantly associated with the odds of developing multimorbidity, with an overall adjusted OR of 0.02 (95% CI 0.01 to 0.02). Conclusion: This study reported a high prevalence of multimorbidity in Bangladesh, although it explored the burden and identified risk factors considering only six chronic diseases. Further detailed exploration through longitudinal studies considering a wider range of diseases is needed to document the actual burden, develop effective preventive measures and clinical guidelines to improve the quality of life of the population.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Bangladesh/epidemiology ; Cost of Illness ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Multimorbidity ; Prevalence ; Risk Factors
Language	English
Publishing date	2019-11-28
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2019-030886
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Deadly wells: taking action to protect future generations.

Rahman, Mahfuzar

Journal of health, population, and nutrition

2006 Volume 24, Issue 3, Page(s) 259–261

MeSH term(s)	Arsenic Poisoning/epidemiology ; Arsenic Poisoning/prevention & control ; Developing Countries ; Drinking ; Fresh Water/analysis ; Humans ; Public Health ; Risk Factors ; Water Purification/methods
Language	English
Publishing date	2006-09
Publishing country	Bangladesh
Document type	Editorial
ZDB-ID	2025045-9
ISSN	2072-1315 ; 1606-0997
ISSN (online)	2072-1315
ISSN	1606-0997
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Article: International research on arsenic contamination and health.

Rahman, Mahfuzar

Journal of health, population, and nutrition

2006 Volume 24, Issue 2, Page(s) 123–128

MeSH term(s)	Arsenic Poisoning/complications ; Arsenic Poisoning/epidemiology ; Environmental Monitoring ; Environmental Pollutants/adverse effects ; Environmental Pollution/adverse effects ; Epidemiological Monitoring ; Global Health ; Health Status ; Humans ; Population Surveillance ; Research/organization & administration ; Skin Diseases/chemically induced ; Skin Neoplasms/chemically induced ; Vascular Diseases/chemically induced
Chemical Substances	Environmental Pollutants
Language	English
Publishing date	2006-06
Publishing country	Bangladesh
Document type	Editorial ; Review
ZDB-ID	2025045-9
ISSN	2072-1315 ; 1606-0997
ISSN (online)	2072-1315
ISSN	1606-0997
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Article ; Online: Prevention of social exclusion and role of antenatal care by BRAC community health workers in improving safe motherhood and neonatal care in urban slums of Bangladesh.

Saira Parveen Jolly / Tridib Roy Chowdhury / Mahfuzar Rahman / Ariful Alam / Kaosar Afsana

PLoS ONE, Vol 15, Iss 7, p e

2020 Volume 0235340

Abstract: The transformation of the BRAC MANOSHI programme from humanitarian to a social enterprise model, has made it increasingly urgent to enumerate the minimum number of door-to-door antenatal care (ANC) visits by community health workers (CHWs), for the ... ...

Abstract	The transformation of the BRAC MANOSHI programme from humanitarian to a social enterprise model, has made it increasingly urgent to enumerate the minimum number of door-to-door antenatal care (ANC) visits by community health workers (CHWs), for the purpose of effectively improving facility delivery. Thus prevent social exclusion of poor slum communities in Bangladesh with regard to safe motherhood and essential newborn care (ENC). This cross-sectional study was conducted, during March-July, 2015 in slums of Chittagong, Dhaka and Sylhet city corporations of Bangladesh. A census was conducted among 25,700 households covering 10 branch offices of MANOSHI to identify women with a delivery outcome in the preceding three years of the survey. A total of 1100 respondents were interviewed randomly through a structured questionnaire. These women were stratified into three categories-1, 2 & 3, consisting of 497, 205 and 398 women respectively. Women in category-1 did not receive any ANC checkup from the BRAC CHWs, while women in category-2 and category-3 received one to three and ≥four ANC checkups from BRAC CHWs respectively. Data was analysed using STATA Version 13 (Chicago Inc.). Findings revealed that women, who received ≥four ANC checkups from BRAC CHWs, are 25% more likely to avail facility delivery [adjusted Prevalence Ratio (aPR) 1.25; 95% confidence interval (CI) (1.01-1.54)] compared to the women who did not receive any ANC from BRAC CHWs. Women in category-2 [aPR3.64; 95% CI (1.76-7.54)] and in category-3 [aPR5.92; 95% CI (3.04-11.53)] respectively had four and six folds higher tendency to receive postnatal care (PNC) within 48 hours after delivery. Furthermore, facility delivery improved PNC assisted by medically trained providers (MTPs) within 48 hours after delivery and ENC in both categories 2 & 3. The evidence shows that at least four ANC visits of BRAC CHWs can increase institutional delivery, and which can further facilitate PNC and ENC visits. At present, the BRAC MANOSHI programme needs to ...
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Demographic, Socio-economic and Lifestyle Determinants of Under- and Over-nutrition among Bangladeshi Adult Population: Results from a Large Cross-Sectional Study.

Mitra, Dipak K / Mistry, Sabuj Kanti / Afsana, Kaosar / Rahman, Mahfuzar

Journal of epidemiology and global health

2019 Volume 8, Issue 3-4, Page(s) 134–142

Abstract: Bangladesh is currently going through a nutritional transition with rapid increase in overnutrition while undernutrition is still remaining prevalent. Nevertheless, population-based data on demographic, socio-economic and lifestyle factors associated ... ...

Abstract	Bangladesh is currently going through a nutritional transition with rapid increase in overnutrition while undernutrition is still remaining prevalent. Nevertheless, population-based data on demographic, socio-economic and lifestyle factors associated with underweight and overweight among adult population is scarce. Employing a nationwide cross-sectional survey, we collected anthropometric, demographic, socio-economic, lifestyle and dietary information from 12,180 adults aged ≥35 years. Body Mass Index (BMI) was calculated using standard formula and categorized into underweight (<18.50), normal weight (18.50-22.99), and overweight (≥23.00). Multivariable multinomial logistic regression was performed to identify factors associated with underweight and overweight. Overall, prevalence of underweight and overweight was 18.1% (95% CI: 17.5-18.8) and 33.7% (95% CI: 32.9-34.6), respectively. All the demographic, socio-economic, dietary and lifestyle factors showed significant association with nutritional status in bivariate analysis. In adjusted analysis, factors showing significant positive association with underweight included female gender (ARRR-1.38, 95% CI: 1.11-1.71), older age [compared to 35-39 years age group, ARRR (95% CI) for ≥ 70 years is 2.32 (1.89-2.86), for 60-69 years is 1.62 (1.36-1.93), for 50-59 years 1.34 (1.13-1.58) and for 40-49 years 1.05 (0.87-1.15)] and smoking habit (ARRR-1.32, 95% CI: 1.14-1.52) while factors showing significant inverse association with underweight included higher household wealth [compared to lowest wealth quintile, ARRR (95% CI) for highest quintile is 0.68 (0.55-0.84), for second highest quintile 0.77 (0.65-0.91), for middle quintile 0.81 (0.69-0.94) and for second lowest quintile 0.89 (0.77-1.03)], urban residence (ARRR-0.66, 95% CI: 0.66-0.90), and more frequent meat/fish and fruits consumption (ARRR-0.76, 95% CI: 0.65-0.90). On the other hand, factors significantly associated with increased risk of overweight included female gender (ARRR-1.35, 95% CI: 1.12-1.63), higher household wealth [compared to lowest wealth quintile, ARRR (95% CI) for highest quintile is 2.27 (1.93-2.68), for second highest quintile 1.67 (1.44-1.94), for middle quintile 1.26 (1.10-1.46) and for second lowest quintile 1.07 (0.93-1.24), excess food availability [compared to food shortage, ARRR (95% CI) for excess food in the household is 1.29 (1.12-1.47) and for no shortage/no excess is 1.23 (1.09-1.38) and more frequent fruits consumption [compared to no fruits, ARRR (95% CI) for 5-7 days per week consumption is 1.61 (1.41-1.83) and for 3-4 days per week is 1.28 (1.16-1.41) and factors significantly associated with decreased risk of overweight included older age [compared to 35-39 years age group, ARRR (95% CI) for ≥ 70 years is 0.77 (0.64-0.93), for 60-69 years is 0.82 (0.71-0.94), for 50-59 years 0.91 (0.80-1.04) and for 40-49 years 1.01 (0.89-1.15)] and smoking (ARRR-0.76, 95% CI: 0.68-0.86). Both underweight and overweight are prevalent in Bangladeshi adult population. Several demographic, socio-economic, dietary and lifestyle factors are associated with underweight and overweight in Bangladesh. Population level impact of these factors should be examined to design suitable public health and nutrition interventions to address this dual challenge.
MeSH term(s)	Adult ; Bangladesh/epidemiology ; Body Mass Index ; Cross-Sectional Studies ; Ethnic Groups ; Female ; Humans ; Life Style ; Male ; Middle Aged ; Nutritional Status ; Overweight/diagnosis ; Overweight/epidemiology ; Prevalence ; Risk Factors ; Socioeconomic Factors ; Thinness/diagnosis ; Thinness/epidemiology
Language	English
Publishing date	2019-03-13
Publishing country	France
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2645324-1
ISSN	2210-6014 ; 2210-6006
ISSN (online)	2210-6014
ISSN	2210-6006
DOI	10.2991/j.jegh.2018.03.002
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Article ; Online: Prevention of social exclusion and role of antenatal care by BRAC community health workers in improving safe motherhood and neonatal care in urban slums of Bangladesh.

Jolly, Saira Parveen / Chowdhury, Tridib Roy / Rahman, Mahfuzar / Alam, Ariful / Afsana, Kaosar

PloS one

2020 Volume 15, Issue 7, Page(s) e0235340

Abstract	The transformation of the BRAC MANOSHI programme from humanitarian to a social enterprise model, has made it increasingly urgent to enumerate the minimum number of door-to-door antenatal care (ANC) visits by community health workers (CHWs), for the purpose of effectively improving facility delivery. Thus prevent social exclusion of poor slum communities in Bangladesh with regard to safe motherhood and essential newborn care (ENC). This cross-sectional study was conducted, during March-July, 2015 in slums of Chittagong, Dhaka and Sylhet city corporations of Bangladesh. A census was conducted among 25,700 households covering 10 branch offices of MANOSHI to identify women with a delivery outcome in the preceding three years of the survey. A total of 1100 respondents were interviewed randomly through a structured questionnaire. These women were stratified into three categories-1, 2 & 3, consisting of 497, 205 and 398 women respectively. Women in category-1 did not receive any ANC checkup from the BRAC CHWs, while women in category-2 and category-3 received one to three and ≥four ANC checkups from BRAC CHWs respectively. Data was analysed using STATA Version 13 (Chicago Inc.). Findings revealed that women, who received ≥four ANC checkups from BRAC CHWs, are 25% more likely to avail facility delivery [adjusted Prevalence Ratio (aPR) 1.25; 95% confidence interval (CI) (1.01-1.54)] compared to the women who did not receive any ANC from BRAC CHWs. Women in category-2 [aPR3.64; 95% CI (1.76-7.54)] and in category-3 [aPR5.92; 95% CI (3.04-11.53)] respectively had four and six folds higher tendency to receive postnatal care (PNC) within 48 hours after delivery. Furthermore, facility delivery improved PNC assisted by medically trained providers (MTPs) within 48 hours after delivery and ENC in both categories 2 & 3. The evidence shows that at least four ANC visits of BRAC CHWs can increase institutional delivery, and which can further facilitate PNC and ENC visits. At present, the BRAC MANOSHI programme needs to implement feasible strategies to include pregnant women in the slums in receiving at least four ANC checkups by BRAC CHWs for ensuring safe motherhood and newborn care.
MeSH term(s)	Adult ; Bangladesh/epidemiology ; Community Health Workers ; Cross-Sectional Studies ; Female ; Health Services Accessibility ; Humans ; Infant, Newborn ; Maternal Health Services/trends ; Middle Aged ; Poverty Areas ; Pregnancy ; Pregnant Women ; Prenatal Care/trends ; Surveys and Questionnaires ; Urban Population
Language	English
Publishing date	2020-07-08
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0235340
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Demographic, Socio-economic and Lifestyle Determinants of Under- and Over-nutrition among Bangladeshi Adult Population

Dipak K. Mitra / Sabuj Kanti Mistry / Kaosar Afsana / Mahfuzar Rahman

Journal of Epidemiology and Global Health, Vol 8, Iss

Results from a Large Cross-Sectional Study

2018 Volume 3

Abstract	Bangladesh is currently going through a nutritional transition with rapid increase in overnutrition while undernutrition is still remaining prevalent. Nevertheless, population-based data on demographic, socio-economic and lifestyle factors associated with underweight and overweight among adult population is scarce. Employing a nationwide cross-sectional survey, we collected anthropometric, demographic, socio-economic, lifestyle and dietary information from 12,180 adults aged ≥35 years. Body Mass Index (BMI) was calculated using standard formula and categorized into underweight (<18.50), normal weight (18.50– 22.99), and overweight (≥23.00). Multivariable multinomial logistic regression was performed to identify factors associated with underweight and overweight. Overall, prevalence of underweight and overweight was 18.1% (95% CI: 17.5–18.8) and 33.7% (95% CI: 32.9–34.6), respectively. All the demographic, socio-economic, dietary and lifestyle factors showed significant association with nutritional status in bivariate analysis. In adjusted analysis, factors showing significant positive association with underweight included female gender (ARRR-1.38, 95% CI: 1.11–1.71), older age [compared to 35–39 years age group, ARRR (95% CI) for ≥ 70 years is 2.32 (1.89–2.86), for 60–69 years is 1.62 (1.36–1.93), for 50–59 years 1.34 (1.13–1.58) and for 40–49 years 1.05 (0.87–1.15)] and smoking habit (ARRR-1.32, 95% CI: 1.14–1.52) while factors showing significant inverse association with underweight included higher household wealth [compared to lowest wealth quintile, ARRR (95% CI) for highest quintile is 0.68 (0.55–0.84), for second highest quintile 0.77 (0.65–0.91), for middle quintile 0.81 (0.69–0.94) and for second lowest quintile 0.89 (0.77–1.03)], urban residence (ARRR-0.66, 95% CI: 0.66–0.90), and more frequent meat/fish and fruits consumption (ARRR-0.76, 95% CI: 0.65–0.90). On the other hand, factors significantly associated with increased risk of overweight included female gender (ARRR-1.35, 95% CI: 1.12–1.63), ...
Keywords	Underweight ; overweight ; nutritional transition ; factors ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2018-12-01T00:00:00Z
Publisher	Springer
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Arsenic and hypertension in Bangladesh

Mahfuzar Rahman

Bulletin of the World Health Organization, Vol 80, Iss 2, Pp 173-

2002 Volume 173

Keywords	Public aspects of medicine ; RA1-1270 ; Medicine ; R
Language	English
Publishing date	2002-01-01T00:00:00Z
Publisher	World Health Organization
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Prevalence and Risk Factors of Cardiovascular Diseases among Bangladeshi Adults: Findings from a Cross-sectional Study.

Khanam, Fouzia / Hossain, Md Belal / Mistry, Sabuj Kanti / Afsana, Kaosar / Rahman, Mahfuzar

Journal of epidemiology and global health

2019 Volume 9, Issue 3, Page(s) 176–184

Abstract: Ever rising prevalence of Cardiovascular Diseases (CVD) is a major challenge for the health sector in Bangladesh. This study aimed to explore the prevalence of CVD and sociodemographic and lifestyle factors associated with it in Bangladesh. The data were ...

Abstract	Ever rising prevalence of Cardiovascular Diseases (CVD) is a major challenge for the health sector in Bangladesh. This study aimed to explore the prevalence of CVD and sociodemographic and lifestyle factors associated with it in Bangladesh. The data were collected through a cross-sectional survey following a two-stage cluster random sampling procedure. The present analysis was performed among 12,338 respondents aged ≥35 years, selected from rural areas and urban slums. Information was gathered using a structured questionnaire, whereas measurements were taken using standardized procedures. Logistic regression with exchangeable correlation structure among clusters was executed to explore the association. About 30% of participants had hypertension, 5% diabetes, 20% obesity; 77% were either smokers or consumed smokeless tobacco, and 28% were physically inactive. The prevalence of CVD was 4.5% (stroke: 1.8% and heart diseases: 3.2%). After adjusting for potential confounders, hypertension, diabetes, body mass index, extra salt intake, daily sleep, tiredness, age, gender, occupation, administrative division, and wealth quintile were found to be significantly associated with CVD. The study highlighted that the prevalence of CVD is high in Bangladesh, and its associated risk factors such as hypertension and diabetes are on the rise, especially in the older population, women, and high-income groups. Therefore, immediate public health intervention is warranted to address the issue.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Bangladesh/epidemiology ; Cardiovascular Diseases/epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Life Style ; Logistic Models ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Socioeconomic Factors
Language	English
Publishing date	2019-12-01
Publishing country	France
Document type	Journal Article
ZDB-ID	2645324-1
ISSN	2210-6014 ; 2210-6006
ISSN (online)	2210-6014
ISSN	2210-6006
DOI	10.2991/jegh.k.190531.001
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Article ; Online: Arsenic and hypertension in Bangladesh

Mahfuzar Rahman

Bulletin of the World Health Organization, Vol 80, Iss 2, Pp 173-

2002 Volume 173

Keywords	Public aspects of medicine ; RA1-1270 ; Medicine ; R ; DOAJ:Public Health ; DOAJ:Health Sciences
Language	English
Publishing date	2002-01-01T00:00:00Z
Publisher	World Health Organization
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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