Uncertainty and sensitivity analysis of the basic reproduction number of diphtheria: a case study of a Rohingya refugee camp in Bangladesh, November-December 2017.
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SUBMITTER: Matsuyama R
PROVIDER: S-EPMC5885970 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Older adults residing in refugee settlements with unhealthy living environments, inadequate access to health care services, and limited psychosocial support are vulnerable to experience mental health problems jeopardizing their mental well-being. The present study aims to explore the mental well-being status and its socio-economic determinants among the older adults living in the Rohingya refugee camp in Bangladesh. This cross-sectional study was conducted among adults aged ≥ 60 residing in five sub-camps within the Rohingya refugee camp of Cox's Bazar, Bangladesh. Data were collected through face-to-face interviews conducted between November and December 2021. The 14-item Warwick-Edinburgh Mental Well-being Scale was used to assess mental well-being. A cumulated score was derived using the scale ranging from 14 to 70, with higher scores indicating greater levels of mental well-being. A generalized linear regression model was used to examine the socio-economic factors associated with the mental well-being of older adults. A total of 864 older adults participated in the study having a mean mental well-being score of 45.4. Regression analysis revealed that the difference in the logs of mental well-being score was expected to be significantly lower among participants aged 70-79 years (β: - 1.661; 95% CI: - 2.750 to - 0.572; p = 0.003), aged ≥ 80 years (β: - 3.198; 95% CI: - 5.114 to - 1.282; p = 0.001), and those with any non-communicable chronic conditions (β: - 2.903; 95% CI: - 3.833 to - 1.974; p < 0.001) when compared to their counterparts. Conversely, the difference in the logs of mental well-being score was expected to be significantly higher among individuals with formal schooling (β: 3.370, 95% CI: 1.855 to 4.886, p < 0.001) and those having additional income besides aid (β: 1.629; 95% CI: 0.642 to 2.615; p = 0.001), compared to their respective counterparts. Our findings highlight the need to provide psychosocial assistance to older individuals, particularly those who live in large families, suffer from chronic diseases, and live in socio-economic deprivation.
| S-EPMC11297237 | biostudies-literature
Project description:Background and objectiveIncreasing numbers of Rohingya refugees have been found to be infected with HIV since they arrived in Bangladesh after being ousted from Myanmar in 2017. This study aimed to examine the knowledge about HIV transmission among Rohingya refugee women and to identify factors that are associated with that knowledge.DesignA cross-sectional survey was conducted using a structured questionnaire that was based on the standard questionnaire of the Demographic and Health Survey programme.SettingRohingya settlements in the Kutupalong refugee camp at Ukhiya, Cox's Bazar, Bangladesh.ParticipantsInterviews were conducted with 508 women who had married or given birth in the 2 years before the survey was done.Outcome measureThe participants were asked to answer a set of questions to assess their knowledge about HIV transmission.ResultsAround 70% of the women could not accurately answer four of the eight questions, and there were substantial misconceptions about the modes of HIV transmission. Knowledge regarding HIV transmission among participants increases in conjunction with the age at which they were first married. Women who were involved in work outside their households or those whose husbands were employed were more likely than others to demonstrate relatively good knowledge of transmission. Women who had received some formal education were 2.37 times likely to show relatively good knowledge of HIV transmission than those who had not received any education. Availability of healthcare facilities in the blocks where women resided is also associated with better knowledge. However, knowledge of HIV transmission among Rohingya women was significantly lower than among women in Bangladesh and Myanmar.ConclusionMost Rohingya women have inadequate knowledge of HIV transmission. Targeted interventions are needed to provide HIV education and to assist with prevention and behavioural changes.
| S-EPMC8488728 | biostudies-literature
Project description:BackgroundRohingya people are often called the most persecuted minority in the world. Currently, almost 800,000 Rohingya refugees live in temporary shelters in Cox's Bazar, Bangladesh. More than one-quarter of them are women and girls of reproductive age who are at increased risk of unplanned pregnancies, unsafe abortions and related complications. However, the use of contraception remains inadequate, and particularly use of condoms and male participation is scarce. This study examines the barriers to condom use as a contraceptive method among married Rohingya couples.MethodsWe conducted in-depth qualitative interviews of married Rohingya men and women and thematically analysed the data.FindingsDepo Provera injections and pills are the dominant forms of contraception. Men's participation in family planning and contraceptive use is rare, and so is the use of condoms. Participants identified several barriers to condom use, including contraception being the responsibility of the women, socio-cultural issues, the stigma attached to condoms, unfamiliarity with condoms, the limitations of condoms, and issues of security in conjugal life. Health workers do not promote condoms in the same way as other contraceptive methods.InterpretationCondom use and men's participation in contraception use are rare in Rohingya camps. The involvement of family planning workers who are males may help to promote the use of condoms and increase the method-mix options of contraceptives.FundingLa Trobe University, Melbourne, Australia.
| S-EPMC10305886 | biostudies-literature
Project description:BackgroundFollowing an influx of an estimated 742,000 Rohingya refugees in Bangladesh, Médecins sans Frontières (MSF) established an active indicator-based Community Based Surveillance (CBS) in 13 sub-camps in Cox's Bazar in August 2017. Its objective was to detect epidemic prone diseases early for rapid response. We describe the surveillance, alert and response in place from epidemiological week 20 (12 May 2019) until 44 (2 November 2019).MethodsSuspected cases were identified through passive health facility surveillance and active indicator-based CBS. CBS-teams conducted active case finding for suspected cases of acute watery diarrhea (AWD), acute jaundice syndrome (AJS), acute flaccid paralysis (AFP), dengue, diphtheria, measles and meningitis. We evaluate the following surveillance system attributes: usefulness, Positive Predictive Value (PPV), timeliness, simplicity, flexibility, acceptability, representativeness and stability.ResultsBetween epidemiological weeks 20 and 44, an average of 97,340 households were included in the CBS per surveillance cycle. Household coverage reached over 85%. Twenty-one RDT positive cholera cases and two clusters of AWD were identified by the CBS and health facility surveillance that triggered the response mechanism within 12 hours. The PPV of the CBS varied per disease between 41.7%-100%. The CBS required 354 full-time staff in 10 different roles. The CBS was sufficiently flexible to integrate dengue surveillance. The CBS was representative of the population in the catchment area due to its exhaustive character and high household coverage. All households consented to CBS participation, showing acceptability.DiscussionThe CBS allowed for timely response but was resource intensive. Disease trends identified by the health facility surveillance and suspected diseases trends identified by CBS were similar, which might indicate limited additional value of the CBS in a dense and stable setting such as Cox's Bazar. Instead, a passive community-event-based surveillance mechanism combined with health facility-based surveillance could be more appropriate.
| S-EPMC7757896 | biostudies-literature
Project description:BACKGROUND/OBJECTIVES:This study examined the best practices with regard to infant and young child feeding in emergency (IYCF-E) program. This was done by observing a breastfeeding support scenario through wet nursing in Rohingya refugee camps in Cox's Bazar, Bangladesh. METHODS:Information on demographics, IYCF-E knowledge, wet nursing support, type of constraints faced, and possible ways to overcome such constraints was collected through face-to-face interviews with 24 conveniently selected wet nurses. Linear regression was used to analyze the associations. RESULTS:Mean age of wet nurses was 21.6 years; 16.67% had adequate knowledge about IYCF-E; and 29.17% had prior knowledge about wet nursing. Mean age of supported infants was 1.29 months, and 58.33% had a familial relationship with the wet nurses. Duration of breastfeeding support was significantly associated with the wet nurse's age, age of the wet nurses' youngest children, familial relationship with infants, knowledge about IYCF-E, and follow-ups from community nutrition workers (Ps <0.05). The status of facing problems (58.33%) was negatively correlated with duration of wet nursing, although this association was not statistically significant. The most extensively reported problems were as follows: misunderstandings with the infant's family (85.71%), family workload and time limitations (21.43%), household distance (42.86%), and family members' poor compliance (21.43%). Counseling from community nutrition workers (64.29%) and mediation by community leaders (57.14%) played key roles in mitigating such problems. Self-satisfaction (37.50%), counseling (62.50%), and religious inspiration (58.33%) were key motivators behind dedicated breastfeeding support. CONCLUSION:Wet nursing in the Rohingya refugee camps in Cox's Bazaar, Bangladesh, was associated with several factors involving both supply and demand. The present findings may help design better IYCF-E programs in similar context.
| S-EPMC6774527 | biostudies-literature
Project description:BackgroundPalliative care is an essential component of health responses in humanitarian settings, yet it remains largely unavailable in these settings, due to limited availability of palliative care training for healthcare professionals. Online training programs which connect experts to clinicians in the field have been proposed as an innovative strategy to build palliative care capacity humanitarian settings.ObjectiveTo describe the implementation and evaluate the impact of delivering palliative care education using an established virtual learning model (Project ECHO) for healthcare clinicians working in the Rohingya refugee response in Bangladesh. Program acceptability and the impacts on learners' self-reported knowledge, comfort, and practice changes were evaluated.MethodsUsing the Project ECHO model, an education program consisting of 7 core sessions and monthly mentoring sessions was developed. Each session included a didactic lecture, case presentation and interactive discussion. Surveys of participants were conducted before and after the program to assess knowledge, confidence, and attitudes about palliative care as well as learning experiences from the program.ResultsThis virtual palliative care training program engaged 250 clinicians, including nurses (35%), medical assistants (28%) and physicians (20%). Most participants rated the program as a valuable learning experience (96%) that they would recommend to their colleagues (98%). Participants reported improvements in their knowledge and comfort related to palliative care after participation in the program, and had improved attitudes towards palliative care with demonstrated statistical significance (p < 0.05).ConclusionsVirtual training is a feasible model to support healthcare providers in a humanitarian health response. Project ECHO can help to address the urgent need for palliative care in humanitarian responses by supporting healthcare workers to provide essential palliative care to the growing number of individuals with serious health-related suffering in humanitarian settings.
| S-EPMC9403457 | biostudies-literature
Project description:Background Infection Prevention and Control (IPC) is critical in controlling the COVID-19 pandemic and is one of the pillars of the WHO COVID-19 Strategic Preparedness and Response Plan 2020. We conducted an Intra-Action Review (IAR) of IPC response efforts to the COVID-19 pandemic in Cox's Bazar, Bangladesh, to identify best practices, challenges, and recommendations for improvement of the current and future responses. Methods We conducted two meetings with 54 participants purposively selected from different organizations and agencies involved in the frontline implementation of IPC in Cox's Bazar district, Bangladesh. We used the IPC trigger questions from the WHO country COVID-19 IAR: trigger question database to guide the discussions. Meeting notes and transcripts were then analyzed manually using content analysis, and results were presented in text and quotes. Results Best practices included: assessments, a response plan, a working group, trainings, early case identification and isolation, hand hygiene in Health Facilities (HFs), monitoring and feedback, general masking in HFs, supportive supervision, design, infrastructure and environmental controls in Severe Acute Respiratory Infection Isolation and Treatment Centers (SARI ITCs) and HFs and waste management. Challenges included: frequent breakdown of incinerators, limited PPE supply, inconsistent adherence to IPC, lack of availability of uniforms for health workers, in particular cultural and gender appropriate uniforms and Personal Protective Equipment (PPE). Recommendations from the IAR were: (1) to promote the institutionalization of IPC, programs in HFs (2) establishment of IPC monitoring mechanisms in all HCFs, (3) strengthening IPC education and training in health care facilities, and (4) strengthen public health and social measures in communities. Conclusion Establishing IPC programmes that include monitoring and continuous training are critical in promoting consistent and adaptive IPC practices. Response to a pandemic crisis combined with concurrent emergencies, such as protracted displacement of populations with many diverse actors, can only be successful with highly coordinated planning, leadership, resource mobilization, and close supervision. Supplementary Information The online version contains supplementary material available at 10.1186/s12939-023-01926-2.
| S-EPMC10241551 | biostudies-literature
Project description:Background:The Rohingyas are an ethnic minority group from Myanmar who have experienced severe forms of violence such as murder, rape, humanitarian defilement and forcible expellation from their motherland. Exposure to trauma has a long-lasting impact on psychological well-being and Health-related Quality of Life (HRQoL). Objective:The purpose of this study was to examine the prevalence of depression and association with HRQoL for Rohingya displaced persons. Methodology:This was a prospective, cross-sectional study in two refugee camps in Southern Bangladesh, with a structured and language validated questionnaire. Results:The study indicates the prevalence of depression was 70% (n=150 respondents), with 8.7% reporting "severe depression" in PHQ-9. WHOQOL-BREF scores were inversely associated with symptoms on the depression scale with a strong and significant correlation (r= 0.652; p<0.01) in total and physical health; psychological (r= 0.757, p<0.01), social relationship (r= 0.479, p<0.01), environment (r= 0.443, p<0.01), increasing age (r= 0.272, p<0.01), severity of depression (r= 0.489, p<0.01). Furthermore, there was a statistically significant correlation with overall quality of life with same variables subsequently (r =0.600, 0.309, 0.482, 0.170, 0.103, 0.272, 0.339; p<0.01), also correlation was observed between married individuals and severity of depression in PHQ (r= 0.346), physical state (r= 0.353), psychological state (r= 0.358), and with social relationship (r= 0.435), with statistical significance (p= <0.01). Conclusion:There are higher incidence rates of moderate to severe depression than the population norms and low health-related quality of life than published population norms for Rohingya displaced persons living in refugee camps. Depression rates were inversely associated with HRQoL for Rohingya displaced persons living in refugee camps. Future research may consider the prevention of related medical issues for long term program implementation.
| S-EPMC7254817 | biostudies-literature
Project description:In the wake of the Rohingya population's mass migration from Myanmar, one of the world's largest refugee settlements was constructed in Cox's Bazar, Bangladesh to accommodate nearly 900,000 new refugees. Refugee populations are particularly vulnerable to infectious disease outbreaks due to many population and environmental factors. A large measles outbreak, with over 1700 cases, occurred among the Rohingya population between September and November 2017. Here, we estimate key epidemiological parameters and use a dynamic mathematical model of measles transmission to evaluate the effectiveness of the reactive vaccination campaigns in the refugee camps. We also estimate the potential for subsequent outbreaks under different vaccination coverage scenarios. Our modeling results highlight the success of the vaccination campaigns in rapidly curbing transmission and emphasize the public health importance of maintaining high levels of vaccination in this population, where high birth rates and historically low vaccination coverage rates create suitable conditions for future measles outbreaks.
| S-EPMC7343595 | biostudies-literature
Project description:BackgroundThe COVID-19 pandemic has acutely affected Rohingya refugees living in camps in Cox's Bazar, Bangladesh. Reported increases in sexual and gender-based violence (SGBV) were attributed in part to pandemic-related public health measures. In addition, the Government of Bangladesh's restrictions to prevent the spread of COVID-19 have impacted the provision of comprehensive care for survivors of sexual violence. This study sought to understand how the COVID-19 pandemic affected SGBV and the provision of services for Rohingya survivors in Bangladesh.MethodsInterviews were conducted with 13 professionals who provided or managed health care or related services for Rohingya refugees after the onset of the COVID-19 pandemic in March 2020.ResultsAt the outset of the COVID-19 pandemic, organizations observed an increase in the incidences of SGBV. However, health care workers noted that the overall number of survivors formally reporting or accessing services decreased. The pandemic produced multiple challenges that affected health workers' ability to provide essential care and services to Rohingya survivors, including access to the camps, initial designation of SGBV-related services as non-essential, communications and telehealth, difficulty maintaining confidentiality, and donor pressure. Some emerging best practices were also reported, including engaging Rohingya volunteers to continue services and adapting programming modalities and content to the COVID-19 context.ConclusionsComprehensive SGBV services being deemed non-essential by the Government of Bangladesh was a key barrier to providing services to Rohingya survivors. Government restrictions adversely affected the ability of service providers to ensure that comprehensive SGBV care and services were available and accessible. The Government of Bangladesh has not been alone in struggling to balance the needs of displaced populations with the necessary precautions to prevent the spread of COVID-19 and its response can provide lessons to others overseeing the provision of services during epidemics and pandemics in other humanitarian settings. The designation of comprehensive services for survivors of SGBV as essential is vital and should be done early in establishing disease prevention and mitigation strategies.
| S-EPMC9166216 | biostudies-literature