ORCID Profile
0000-0002-3029-6303
Current Organisations
UNSW Sydney
,
Biomedical Research Foundation
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Publisher: Informa UK Limited
Date: 03-12-2019
Publisher: Springer Science and Business Media LLC
Date: 30-09-2021
DOI: 10.1038/S41598-021-98585-6
Abstract: Residential area greenness may influence diabetes, but limited studies have explored this relationship in developing countries. This study assessed the association between residential area greenness and diabetes among urban adults in Bangladesh. The mediation effect of the body mass index (BMI) was also assessed. A total of 2367 adults aged ≥ 35 years were extracted from a nationally representative survey. Diabetes was characterised as fasting plasma glucose level be ≥ 7.0 mmol/L or taking prescribed medications to reduce blood sugar level. Residential area greenness was estimated by enhanced vegetation index. Binary logistic regression models were employed to estimate the association between residential area greenness and diabetes adjusting for sociodemographic factors. Mediation analysis was performed to assess whether BMI mediated the association between greenness and diabetes. Greater area greenness was associated with lower odds of diabetes (adjusted odds ratio 0.805, 95% confidence interval 0.693–0.935, p = 0.0052). BMI significantly mediated 36.4% of the estimated association between greenness and diabetes. Presence of areas of greenness adjacent to living area tends to be associated with lower diabetes prevalence. Findings emphasised the importance of preserving the local environment to tackle the growing diabetes prevalence in Bangladesh.
Publisher: Springer Science and Business Media LLC
Date: 03-2016
Publisher: Informa UK Limited
Date: 30-06-2022
DOI: 10.1080/09603123.2020.1777947
Abstract: Coastal morphology makes Bangladesh vulnerable to environmental hazards and climate change. Therefore, environmental characteristics may shape population health, including child health. The prevalence of stunting among under-five aged (U5) children is high in Bangladesh. However, there is a lack of research on environmental predictors of stunting. This study aimed to assess the association between community-level environmental characteristics and stunting using pooled data from the three latest Bangladesh demographic and health surveys (BDHS). According to the multilevel model, rainfall, distance to protected areas, and vegetation index showed a nonlinear association with stunting. The temperature was inversely, and distance to water bodies was positively related to stunting. Overall, results evidence the environmental characteristics are predictive of stunting, and these characteristics should be taken into account during intervention design to minimise the negative effects of environmental change on child health. Further research is also necessary to comprehend the causal pathways between environmental characteristics and stunting in Bangladesh.
Publisher: Elsevier BV
Date: 10-2022
DOI: 10.1016/J.MIDW.2022.103425
Abstract: Despite a significant decline over time, maternal mortality remains high in Bangladesh. Institutional delivery during childbirth is crucial to reducing maternal mortality, but uptake of institutional delivery services (IDS) remains suboptimal in Bangladesh. Though women's education plays a crucial role in the use of IDS, the educational status of the household head and area-level literacy rate also appear to act as predictors of IDS uptake. This study aims to assess the effect of the educational status of women and household heads as well as district-level adult literacy rates on the use of IDS during childbirth among women in Bangladesh. This study analyzed nationally representative cross-sectional survey data from the 2019 Bangladesh Multiple Indicator Cluster Survey. Bangladesh. 9,207 currently married women aged 15-49 years who had at least one live birth in the two years preceding the survey were included in the study. The outcome measure was women's use of IDS during their last childbirth. A multilevel logistic regression model was used to explore the association between education status of women and household heads, and district (i.e., area unit) adult literacy rates and uptake of IDS among women in Bangladesh by controlling for other sociodemographic covariates and clustering. About 53% of women used IDS during childbirth. Adjusting for other factors and clustering, women with higher educational status, those living in households with higher-educated heads, and those in districts with greater adult literacy rates are more likely to use IDS, after controlling for key sociodemographic variables including wealth. Uptake of IDS in Bangladesh remains low, with education playing an important independent role in determining rates. The findings of the study provide empirical evidence for policymakers to design multi-modal educational programs targeted not only at literate women but also at household head (especially male) and communities where literacy (and equally importantly health literacy) may be variable or absent.
Publisher: Emerald Publishing Limited
Date: 17-01-2023
Publisher: Cambridge University Press (CUP)
Date: 13-02-2019
DOI: 10.1017/S1368980018003907
Abstract: The availability of iodized salt in households remains low in Bangladesh, which calls for improving the salt iodization quality and its coverage. The present study assessed the socio-economic disparity in Bangladesh to characterize the availability of iodized salt at household level. Associations between different socio-economic factors and availability of iodized salt at household level were explored using Bayesian mixed-effects logistic models after adjusting the district- and cluster-level random effects. Bangladesh Multiple Indicator Cluster Survey (MICS), 2012–13. Households (s le size, n 50981). Results showed that 73·15 % of household salt s les were iodized to some extent although iodization level varied. According to the regression model, houses with young (adjusted odds ratio of posterior mean (OR) = 1·31 95 % credible interval (CI) 1·09, 1·64) and educated (OR = 3·66 95 % CI 3·25, 4·23) household heads had significantly higher likelihood of availability of iodized salt. In addition, iodized salt was less likely be found in poor and rural households, as urban households were 2·88 times (95 % CI 2·41, 3·34) more likely have iodized salt. Moreover, the regional locations of the households were an important component that contributed to the local iodized salt coverage. As per the district-wise distribution, the north-west part of Bangladesh and Cox’s Bazar in the far south seemed to lack household-level iodized salt. Our findings suggest that iodized salt intervention should be promoted considering the area variations, which could potentially help policy makers to design interventions in the context of Bangladesh.
Publisher: Elsevier BV
Date: 05-2020
Publisher: Springer Science and Business Media LLC
Date: 06-03-2018
Publisher: MDPI AG
Date: 27-10-2021
Abstract: Understanding environmental predictors of women’s use of closest breast screening venue versus other site(s) may assist optimal venue placement. This study assessed relationships between residential-area sociodemographic measures, venue location features, and women’s use of closest versus other venues. Data of 320,672 Greater Sydney screening attendees were spatially joined to residential state suburbs (SSCs) (n = 799). SSC-level sociodemographic measures included proportions of: women speaking English at home university-educated full-time employed and dwellings with motor-vehicles. A geographic information system identified each woman’s closest venue to home, and venue co-location with bus-stop, train-station, hospital, general practitioner, and shop(s). Multilevel logistic models estimated associations between environmental measures and closest venue attendance. Attendance at closest venue was 59.4%. Closest venue attendance was positively associated with SSC-level women speaking English but inversely associated with SSC-level women university-educated, full-time employed, and dwellings with motor-vehicles. Mobile venue co-location with general practitioner and shop was positively, but co-location with bus-stop and hospital was inversely associated with attendance. Attendance was positively associated with fixed venue co-location with train-station and hospital but inversely associated with venue co-location with bus-stop, general practitioner, and shop. Program planners should consider these features when optimising service locations to enhance utilisation. Some counterintuitive results necessitate additional investigation.
Publisher: Elsevier BV
Date: 09-2019
Publisher: Informa UK Limited
Date: 03-04-2022
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.YPMED.2021.106774
Abstract: Breast cancer screening (BCS) participation rates are often suboptimal and vary geographically. Environmental features may influence BCS participation, but few studies have assessed this relationship. This study assessed the associations between BCS participation, residential area sociodemographic characteristics, distance to BCS venue, and venue location attributes. Data for 384,433 women residing in Greater Sydney, Australia, invited to BCS during 2011-2014 were spatially joined to their state suburb (SSC) (n = 800). SSC sociodemographic measures included women's median age, proportion women speaking English at home, full-time employed, and university educated and proportion dwellings with motor-vehicles. Road network distance was calculated to each BCS venue. BCS venues were coded as co-located with bus-stop, train-station, hospital, general practitioner (GP), and shop. Hot spots were calculated to quantify spatial clustering of BCS participation. Multilevel logistic models were used to estimate the associations between environmental predictors and BCS participation, accounting for SSC-level clustering. BCS participation was 53.9% and spatially clustered. BCS was positively associated with SSC-level median age for women, proportions women speaking English and university educated, and dwellings with motor-vehicles. Distance to venue was inversely associated with BCS. Venue co-location with GP was positively associated and co-location with bus-stop, train-station, and shop, hospital were negatively associated with BCS. Residential sociodemographic features, geographic access, and venue location attributes are associated with BCS participation. These findings implicate the relevance of social and built environmental factors to programmatic aims to raise BCS participation. Additional research on venue location features is required to understand where best to site BCS venues.
Publisher: Elsevier BV
Date: 12-2020
Publisher: Springer Science and Business Media LLC
Date: 11-01-2022
DOI: 10.1007/S11356-021-18460-9
Abstract: Faecal contamination (by Escherichia coli [E. coli]) of household drinking water can have adverse effects on child health, particularly increasing the episodes of childhood diarrhea however, the evidence is scanty in Bangladesh. This study utilised data from the most recent nationally representative 2019 Multiple Indicator Cluster Survey to investigate the relationship between E. coli concentration in household drinking water and diarrheal episodes among children aged under-5 years in Bangladesh. Childhood diarrhea was identified by asking the children's mothers or caregivers if they had a diarrheal episode in the 2 weeks preceding the survey. E. coli colonies were counted as colony-forming units (CFUs) per 100 ml of water and classified into three risk groups (low: 10 CFU/100 ml). The design-adjusted logistic regression was used to estimate the association between drinking water E. coli risk groups and childhood diarrhea, adjusting for potential confounders. We observed a significant association between household drinking water E. coli contamination and diarrheal episodes among under-5 children. Compared to the children from households with a low risk of E. coli contamination in drinking water, children from households with a moderate risk of E. coli contamination were 1.68 times more likely to have diarrhea, which was 2.28 times among children from households with a high risk of E. coli contamination. Findings of the study have significant policy implications and urge to ensure safe water supplies, improve water management practices and modify hygiene behaviours to reduce episodes of childhood diarrhea.
Publisher: Informa UK Limited
Date: 02-06-2021
Publisher: BMJ
Date: 04-2021
DOI: 10.1136/BMJOPEN-2020-043853
Abstract: Participation in breast cancer screening (BCS) varies at the small-area level, which may reflect environmental influences. This study assessed small-area variation in BCS invitation response rates (IRRs) and associations between small-area BCS IRR, sociodemographic factors, BCS venue distance and venue location features in Greater Sydney, Australia. BCS IRR data for 2011–2012 were compiled for 9528 Australian Bureau of Statistics Statistical Area Level 1 (SA1) units (n=227 474 women). A geographial information system was used to extract SA1-level sociodemographic features (proportions of women speaking English at home, full-time employed and university educated, and proportion of dwellings with motor vehicles), SA1-level distance to closest venue(s) (expressed as quartiles), and closest venue(s) colocated with bus stops, train station, hospital, general practitioner and shops. Associations between area-level features, BCS venue distance, venue location features and IRR were estimated using ordinary least square-type spatial lag models including area education as a covariate. BCS IRR varied across SA1s (mean=59.8%, range: 0%–100%), with notable spatial autocorrelation (Moran’s I=0.803). BCS IRR was positively associated with greater SA1-level proportion of women speaking English at home (β=2.283, 95% CI 2.024 to 2.543), women’s education (in the model including speaking English at home β=0.454, 95% CI 0.211 to 0.697), dwellings with motor vehicles (β=1.836, 95% CI 1.594 to 2.078), greater distance to venue (eg, most distant quartile compared with closest: β=6.249, 95% CI 5.489 to 7.008), and BCS venue colocated with shops (β=0.762, 95% CI 0.273 to 1.251). Greater SA1-level women employment (β=−0.613, 95% CI −0.898 to −0.328) and venue colocated with train station (β=−1.889, 95% CI −2.376 to −1.402) or hospital (β=−0.677, 95% CI −1.164 to −0.189) were inversely related to BCS IRR. Small-area variation in BCS IRR exists for Greater Sydney and is strongly related to sociodemographic factors that, together with BCS venue location features, could inform targeted attempts to improve IRR.
Publisher: Springer Science and Business Media LLC
Date: 25-03-2021
Publisher: Informa UK Limited
Date: 26-03-2020
Publisher: Elsevier BV
Date: 12-2020
Publisher: Elsevier BV
Date: 03-2023
Publisher: Informa UK Limited
Date: 07-2020
Publisher: Wiley
Date: 23-12-2022
DOI: 10.1002/OSP4.648
Abstract: Despite advancements in the use of body mass index (BMI) to categorize obesity severity in pediatrics, its utility in guiding in idual clinical decision making remains limited. The Edmonton Obesity Staging System for Pediatrics (EOSS‐P) provides a way to categorize the medical and functional impacts of obesity according to the severity of impairment. The aim of this study was to describe the severity of obesity among a s le of multicultural Australian children using both BMI and EOSS‐P tools. This cross‐sectional study included children aged 2–17 years receiving obesity treatment through the Growing Health Kids (GHK) multi‐disciplinary weight management service in Australia between January to December 2021. BMI severity was determined using the 95th percentile for BMI on age and gender standardized Centre for Disease Control and Prevention (CDC) growth charts. The EOSS‐P staging system was applied across the four health domains (metabolic, mechanical, mental health and social milieu) using clinical information. Complete data was obtained for 338 children (age 10.0 ± 3.66 years), of whom 69.5% were affected by severe obesity. An EOSS‐P stage 3 (most severe) was assigned to 49.7% of children, the remaining 48.5% were assigned stage 2 and 1.5% were assigned stage 1 (least severe). BMI predicted health risk as defined by EOSS‐P overall score. BMI class did not predict poor mental health. Used in combination, BMI and EOSS‐P provide improved risk stratification of pediatric obesity. This additional tool can help focus resources and develop comprehensive multidisciplinary treatment plans.
Publisher: Public Library of Science (PLoS)
Date: 24-07-2017
Publisher: SAGE Publications
Date: 30-07-2017
Abstract: Poor nutrition during childhood impedes physical and mental development of children, which propagate the vicious cycle of intergenerational under nutrition. This paper is aimed at understanding the determinants of stunting among children aged 0 to 59 months in Bangladesh. The study used Bangladesh Demographic and Health Survey 2011 data and a multistage stratified cluster-s ling design. Anthropometric data (for height and weight) were collected and analysis was limited to 7647 children. Multiple binary logistic regression analysis was performed to assess the association of stunting with potential socioeconomic and demographic factors. The prevalence of stunting has been found to be about 41% among children aged less than 60 months and higher in rural setting than in urban areas (43% vs 36%). Adjusted model revealed that several factors were influencing stunting. The children living in moderately food-insecure households had higher odds of becoming stunted (odds ratio [OR] = 1.27, 95% confidence interval [CI]: 1.05-1.54, P = .01) compared to the children living in food-secure households. The derived ORs of stunting for children delivered at institutions facilitated particularly by public (OR = 0.80, 95% CI: 0.67-0.96 P = .02) or private (OR = 0.81, 95% CI: 0.67-0.97 P = .02) sectors were less than for children delivered at home. Similarly, wealth index, exposure of mother to the mass media, age of child, size of child at birth, and parents’ education were significantly associated with stunting. Moreover, the demographic characteristics and other indicators appeared to have significant influence in the prevalence of stunting. Public health programs are needed to avert the risk factors of stunting among children in Bangladesh.
Publisher: Springer Science and Business Media LLC
Date: 07-09-2017
Publisher: Springer Science and Business Media LLC
Date: 28-09-2017
Publisher: Oxford University Press (OUP)
Date: 16-09-2019
Abstract: Livestock is an integrated part of agriculture, yet the relationship between household livestock ownership and child nutrition is a significant knowledge gap. The present study aimed to assess the association between household livestock ownership and childhood stunting and to explore the geospatial variations at district level in Bangladesh. A complete data of 19 295 children aged below 5 years were extracted from the latest Bangladesh Multiple Indicator Cluster Survey 2012–13. The tropical livestock unit (TLU) score calculated as a weighted value for each livestock and categorized as low, medium, and high using tertile. A hierarchical Bayesian spatial logistic model was used to assess the association between TLU and childhood stunting. Children from the household with high TLU were 10% less likely to be stunted (adjusted posterior odds ratio: 0.90, 95% credible interval: 0.84–0.97) after controlling for demographic, socioeconomic, morbidity, place of residence and spatial effects. There was also a substantial spatial variation in childhood stunting across districts in Bangladesh with the highest burden in the Northern and North-Eastern regions. The positive effect of household livestock ownership on reducing child stunting suggests that, in addition to nutritional intervention in Bangladesh, efforts to strengthen livestock production would be beneficial for improving child nutrition status. However, a small effect size may be owing to the lack of dietary ersity, livestock health and productivity data as well as the complexity of the relationship, requiring further study. Furthermore, a significant regional disparity in stunting highlighted the importance of spatial targeting during the design of interventions and implementation.
Publisher: Informa UK Limited
Date: 2020
Publisher: Frontiers Media SA
Date: 03-07-2020
Publisher: Informa UK Limited
Date: 29-01-2020
DOI: 10.1080/09603123.2019.1570488
Abstract: This study seeks to identify the spatial risk pattern of households (HHs) exposed to arsenic contamination in Bangladesh by adjusting potential socio-economic, demographic factors. Data from Bangladesh Multiple Indicator Cluster Survey 2012-13 are used where hierarchical Bayesian spatial ordered logit model is implemented. The analysis shows that 25% of HH water s les were arsenic contaminated, although the majority (95%) of HHs used improved water sources. Arsenic contamination risk in the HH water was significantly associated with water source type and location, place of residence and districts. The model-based spatial prediction reveals that the north-east and south-west parts of Bangladesh have a high risk of contamination. To ensure the quality of HH water, our findings suggest that chemical test should be promoted considering the spatial risk of arsenic contaminations variations among HHs of Bangladesh. Furthermore, the study findings can effectively contribute in the planning of future interventions and programs.
Publisher: American Academy of Pediatrics (AAP)
Date: 14-04-2023
Abstract: To analyze Australian national data to examine the impact of the coronavirus disease 2019 (COVID-19) pandemic on mental health-related hospital presentations among children and adolescents during the pandemic period with restrictions, and the period after the restrictions eased. We analyzed the monthly mental health-related inpatient admissions and emergency department (ED) attendances data from 6 large pediatric hospitals across Australia, using the Bayesian structural time series models. The COVID-19 restriction period was from March 2020 to December 2021 and the COVID-19 restriction-eased period from January to June 2022. A total of 130 801 mental health-related hospital admissions (54 907) and ED attendances (75 894) were analyzed. During the COVID-19 restriction period, there was a significant increase in inpatient admissions related to deliberate self-harm behaviors (82%, 95% credible interval [CrI], 7%–160%) and ED attendances related to overall mental health disorders (15%, 95% CrI, 1.1%–30%) and eating disorders (76%, 95% CrI, 36%–115%). The increase was higher among females and those living in the least socioeconomically disadvantaged areas, suggesting a widening gap between mental health-related presentations by sex and socioeconomic status. After the restrictions eased, there were slight declines in mental health-related hospital presentations however, the numbers remained higher than the pre–COVID-19 levels. The increase in mental health-related hospital presentations during the COVID-19 period calls for additional support for pediatric mental health care, particularly for eating disorders and deliberate self-harm among female adolescents. It is important to monitor pediatric mental health service use as we enter “COVID-19 normal” period.
Publisher: Informa UK Limited
Date: 29-03-2020
DOI: 10.1080/09603123.2019.1593328
Abstract: The Escherichia coli (
Publisher: Springer Science and Business Media LLC
Date: 14-06-2022
DOI: 10.1007/S44199-022-00044-2
Abstract: Number of children ever born to women of reproductive age forms a core component of fertility and is vital to the population dynamics in any country. Using Bangladesh Multiple Indicator Cluster Survey 2019 data, we fitted a novel weighted Bayesian Poisson regression model to identify multi-level in idual, household, regional and societal factors of the number of children ever born among married women of reproductive age in Bangladesh. We explored the robustness of our results using multiple prior distributions, and presented the Metropolis algorithm for posterior realizations. The method is compared with regular Bayesian Poisson regression model using a Weighted Bayesian Information Criterion. Factors identified emphasize the need to revisit and strengthen the existing fertility-reduction programs and policies in Bangladesh.
Publisher: Cambridge University Press (CUP)
Date: 29-12-2022
DOI: 10.1017/S0007114521005134
Abstract: Young adulthood is a crucial period for major physiological transitions. Environmental changes associated with these transitions can influence health behaviour and health (e.g. poor diet, high body weight and elevated blood pressure (EBP)). Excess body weight can lead to EBP however, little is known about this relationship among young adults in developing countries. Focusing on Bangladesh, this study assessed the association between BMI and blood pressure (BP) metrics (systolic BP (SBP), diastolic BP (DBP) and BP class (optimal, normal/high normal and elevated)). Sex-specific analyses of these relationships were performed to assess any difference across sexes. Furthermore, associations of overweight/obesity with BP metrics were investigated. Young adults aged 18–24 years ( n 2181) were included from nationally representative cross-sectional Bangladesh Demographic and Health Survey 2017–2018. Multivariable linear and multinomial logistic regression models examined the relationships between BMI, overweight/obesity and BP metrics. Findings reveal that higher BMI was associated with higher SBP (0·83 95 % CI 0·67, 0·99), DBP (0·66 95 % CI 0·54, 0·74) and higher odds of having EBP (adjusted OR 1·24 95 % CI 1·17, 1·31). These relationships were stronger among males than females. Moreover, overweight/obese in iduals had higher SBP, DBP and higher odds of having EBP than in iduals with normal BMI. Strategies to reduce body weight and to improve healthy lifestyle, and awareness and monitoring of BP may help to address these serious health problems, particularly at an early age.
Publisher: Elsevier BV
Date: 09-2019
Publisher: Springer Science and Business Media LLC
Date: 11-01-2016
Publisher: Informa UK Limited
Date: 14-04-2021
Publisher: Springer Science and Business Media LLC
Date: 05-09-2016
Publisher: Wiley
Date: 30-12-2022
DOI: 10.1111/PSYG.12925
Abstract: Globally, the COVID‐19 pandemic seriously affected both physical and mental health conditions. This study aims to assess changes in the prevalence of depression among older adults during the COVID‐19 pandemic in Bangladesh and explore the correlates of depression in pooled data. This study followed a repeated cross‐sectional design and was conducted through telephone interviews on two successive occasions during the COVID‐19 pandemic (October 2020 and September 2021) among 2077 (1032 in 2020‐survey and 1045 in 2021‐survey) older Bangladeshi adults aged 60 years and above. Depression was measured using the 15‐item Geriatric Depression Scale (GDS‐15). The binary logistic regression model was used to identify the factors associated with depression in pooled data. A significant increase in the prevalence of depression was noted in the 2021 survey compared to the 2020 survey (47.2% versus 40.3% adjusted odds ratio (aOR): 1.40, 95% confidence interval (CI): 1.11–1.75). Depression was significantly higher among participants without a partner (aOR 1.92, 95% CI 1.45–2.53), with a monthly family income of BDT (aOR: 2.65, 95% CI 1.82–3.86) or 5000–10 000 BDT (aOR: 1.30, 95% CI 1.03–1.65), living alone (aOR 2.24, 95% CI 1.40–3.61), feeling isolated (aOR 3.15, 95% CI 2.49–3.98), with poor memory/concentration (aOR 2.02, 95% CI 1.58–2.57), with non‐communicable chronic conditions (aOR 1.34, 95% CI 1.06–1.69), overwhelmed by COVID‐19 (aOR 1.54, 95% CI 1.18–2.00), having difficulty earning (aOR 1.49, 95% CI 1.15–1.92) or obtaining food (aOR 1.56, 95% CI 1.17–2.09) during COVID‐19 pandemic, communicating less frequently (aOR 1.35, 95% CI 1.07–1.70) and needing extra care (aOR 2.28, 95% CI 1.75–2.96) during the pandemic. Policymakers and public health practitioners should provide immediate mental health support initiatives for this vulnerable population during the COVID‐19 pandemic and beyond. Policymakers should also invest in creating safe places to practise mindful eating, exercise, or other refuelling activities as a means of preventing and managing depression.
Publisher: Informa UK Limited
Date: 18-12-2020
Publisher: Wiley
Date: 10-2021
DOI: 10.1002/HSR2.391
Abstract: The coexistence of undernutrition and overnutrition creates a double burden of malnutrition (DBM) among women in Bangladesh. This study aimed to assess heterogeneous effects of sociodemographic factors on women's nutritional status using quantile regression (QR) models and to investigate the differences between the results of unconditional QR (UQR) and conditional QR (CQR) models. A s le of 17 285 nonpregnant women aged 15 to 49 years was extracted from the latest Bangladesh Demographic and Health Survey, 2017‐2018. Women's nutritional status was determined using body mass index (BMI). The UQR and CQR were used to estimate the heterogeneous effects of sociodemographic factors on women's BMI. Results show that the estimated effects of sociodemographic factors varied across the BMI distribution. For the same quantile, the effects differed between UQR and CQR. For instance, education was significantly positively associated with BMI. In UQR, secondary educated women achieved an increase of 0.996 and 1.720 in BMI at 10th and 90th quantiles, respectively, compared to noneducated women, whereas conditional effects were 1.336 and 1.492 at 10th and 90th quantiles, respectively, in CQR. These results also indicate secondary education appeared to have a lesser (or higher) impact in the lower (or upper) tail of BMI distribution, and unconditional and conditional effects for the same quantile varied notably. Other factors such as women's age, occupation, household wealth, number of children ever born and household size, religion, and place of residence were significantly associated with BMI and showed heterogeneous effects. Overall, there is a need to focus on heterogeneous effects of factors on women's nutritional status. Patterns of unconditional heterogeneous effects would be more informative than conditional heterogeneous effects while studying factors' effects. These findings may aid in developing strategies targeting high‐risk groups to combat the double burden of malnutrition.
Publisher: IOP Publishing
Date: 26-07-2023
Abstract: Child undernutrition is still a major public health concern in Bangladesh in spite of significant decline in the last few years. Climate change may impact the prevalence of undernutrition and its geographical variability through food security and recurring outbreaks of disease, as well as impede efforts to reduce the undernutrition burden. This study aims to evaluate rainfall and temperature associated with childhood malnutrition in Bangladesh. A spatial mixed effect logistic regression model was used to estimate the association between undernutrition (measured by the composite index of anthropometric failure) and residential area-level rainfall and temperatures, controlling for covariates and spatial effects of residential locations using national data from the 2017 to 2018 Bangladesh Demographic and Health Survey. Our findings indicate that an increase in rainfall was associated with increased odds of undernutrition [adjusted odds ratio (AOR) 1.15, 95% confidence interval (CI) 1.07–1.24], whereas an increase in temperature was associated with decreased odds of undernutrition (AOR 0.86, 95% CI 0.80–0.93). We also found statistically significant structured and unstructured spatial variations in undernutrition, indicating locational effects. Investing in infrastructure and education could be potential strategies for mitigating the negative effects of climate change. High-risk regions in terms of climatic change and malnutrition could be given priority for intervention implementation.
Publisher: Public Library of Science (PLoS)
Date: 06-02-2019
Publisher: Elsevier BV
Date: 08-2022
Publisher: BMJ
Date: 07-2021
DOI: 10.1136/BMJOPEN-2021-050493
Abstract: Overweight and obesity (OWOB) is a modifiable risk factor for both hypertension and diabetes. However, the association between OWOB and diabetes among Bangladeshi adults and how hypertension may mediate this relationship are not well explored. This study aimed to examine (1) whether OWOB is independently associated with diabetes among Bangladeshi adults, (2) whether this association is mediated by hypertension, and (3) the effect modification by wealth status and place of residence in the relationships. We used data of 9305 adults aged ≥18 years from the most recent nationally representative cross-sectional study of Bangladesh Demographic and Health Survey 2017–2018. Design-based logistic regression was used to assess the association between OWOB and diabetes, and counterfactual framework-based weighting approach was used to evaluate the mediation effect of hypertension in the OWOB–diabetes relationship. We used stratified analyses for the effect modifications. The prevalence of OWOB, diabetes and hypertension was 48.5%, 11.7% and 30.3%, respectively. We observed a significant association between OWOB and diabetes and a mediating role of hypertension in the OWOB–diabetes association. The odds of diabetes was 51% higher among adults with OWOB than those without OWOB (adjusted OR: 1.51, 95% CI 1.29 to 1.77). We observed that 18.64% (95% CI 9.84% to 34.07%) of the total effect of OWOB on the higher odds of diabetes was mediated through hypertension, and the mediation effect was higher among adults from non-poor households and from both rural and urban areas. Adult OWOB status is independently associated with diabetes in Bangladesh, and hypertension mediates this association. Therefore, prevention policies should target adults with both OWOB and hypertension, particularly those from non-poor households and from both rural and urban areas, to reduce the growing burden of diabetes and its associated risk.
Location: Bangladesh
Location: No location found
No related grants have been discovered for Jahidur Rahman Khan.