A comprehensive analysis of selected medicines collected from private drug outlets of Dhaka city, Bangladesh in a simple random survey.
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ABSTRACT:
SUBMITTER: Rahman MS
PROVIDER: S-EPMC8741935 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Dengue, the most important mosquito-borne viral disease of humans is a recurring global health problem. In Bangladesh, dengue outbreaks are on the increase despite the efforts of government and it is not clear what the understanding of the general Dhaka population towards dengue fever is. Knowledge, attitude and practice (KAP) studies are essential guides in public health interventions. Hence, using KAP, this study aims to assess patient-perspectives with regards to factors associated with dengue, as well as investigate the associated factors between the two corporations in Dhaka. A Hospital-based cross-sectional study of 242 fever patients from two city-corporations in Dhaka (Dhaka North City Corporations, DNCC (n = 91, 37.6%) and Dhaka South City Corporation, DSCC (n = 151, 62.4%) was conducted using pre-tested KAP items. Wilcoxon's Rank Sum was used to determine the KAP by DNCC, DSCC and both corporations and multivariate Poisson regression analyses. The two corporations were analysed separately due to the differences in income distribution, concentration of slums, hospitals and clinics. The study found that more than half of the study population were knowledgeable about dengue (mean percentage scores was 52%), possess an appropriate and acceptable attitude towards the disease (69.2%), and about two thirds of the respondents (71.4%) engaged in practices towards its prevention. After adjusting for the potential cofounders, the factors associated with KAP about dengue fever varied between DNCC and DSCC; with duration of residency and use of mosquito nets were associated with knowledge in the north while income class and age were associated with knowledge and attitude in the south. In the pooled analysis (combining both corporations), knowledge of dengue was associated with good practice towards dengue fever among the respondents. The duration of residence in Dhaka (10+ years), not using mosquito nets and length of time spent in the hospital (7+ days) due to dengue, and decreased knowledge (Adjusted coefficient (β) = -0.01, 95%CI: -0.02, -0.01) were associated with attitude towards dengue in DNCC. On the other hand, middle-high income class, age (40+ years) and increased knowledge were associated with practice towards dengue in DSCC (β = 0.02, 95%CI: 0.01, 0.03). Efforts to increase knowledge about dengue fever through education by the administrations of both corporations would benefit from targeting these high-risk groups for a more sustainable outcome.
| S-EPMC8009423 | biostudies-literature
Project description:Although the issue of substandard and falsified medicines is quite well known, most research has focused on medicines used to treat communicable diseases, and relatively little research has been carried out on the quality of medicines for noncommunicable diseases (NCDs). This study was designed to assess the quality of seven widely used medicines for NCDs in Cambodia during 2011-2013. Medicines were collected from private community drug outlets in Phnom Penh (urban area), by stratified random sampling and in Battambang, Kandal, Kampong Speu, and Takeo (rural areas) by convenience sampling. Samples were subsequently analyzed by visual inspection, authenticity investigation, and pharmacopoeial analysis by high-performance liquid chromatography. Various discrepancies were observed in visual inspection of packages and medicines. Of 372 tablet/capsule samples from 64 manufacturers in 16 countries, the manufacturers confirmed 107 (28.8%) as authentic; the authenticity of other samples could not be verified. Three hundred sixty-four (97.8%) samples were registered in Cambodia. Among all samples, 23.4% (95% CI 19.2-28.0) were noncompliant in one or more of the quality tests: 12.9% (95% CI 9.7-16.7) contained an amount of active pharmaceutical ingredient outside the permitted range, including some showing extreme deviations, 14% (95% CI 10.6-17.9) failed because of content variation, and 10.8% (95% CI 7.8-14.4) failed to meet pharmacopoeial reference ranges in dissolution tests. Pharmaceutical quality appeared to be unrelated to storage conditions. Although no sample was obviously falsified, there is a high prevalence of substandard medicines for NCDs in Cambodia, indicating the need for focused regulatory action, including collaborative initiatives with manufacturers.
| S-EPMC6838583 | biostudies-literature
Project description:IntroductionFor a medicine to qualify as safe and effective and to be of good quality, it should be properly labelled, stored, and transported. If a medicine is not handled properly, it ends up being unfit. Improper disposal of unfit medicines contributes to the appearance of their metabolites in the environment.MethodsA descriptive cross-sectional study was designed to capture quantitative data. The study was conducted in Mwanza region, Tanzania. The study population comprised nongovernmental hospitals and private medicines outlets in the region. The sample size was 111 facilities. This study was conducted between October 2013 and May 2014. The questionnaire was used to assess experience and challenges of dealing with unfit medicines. A review of waste management records was done to capture data of past disposal for unfit medicines. The coded data were analyzed using Statistical Package for Social Sciences (Version 20.0) computer analysis software. Comparison of proportions between groups was performed using Pearson's chi square.ResultsThe majority of facilities (41.4%) used methods such as the pouring of unfit medicines into the sink and into the dustbin. About 60.4% of facilities were found with unfit medicines at the time of survey. Majority of unfit medicines found were antibiotics (64.1%). Almost 10% of health facilities maintained a register book for recording unfit medicines.ConclusionThere was improper disposal of unfit medicines in health facilities studied, whereby commonly reported methods of disposal were pouring into the sink and putting into the street dustbin. In private medicines outlets, there was poor storage management practice as some of the unfit medicines were left unpacked into boxes or separated from the usable medicines and not properly labelled.
| S-EPMC6421723 | biostudies-literature
Project description:Pneumonia has been the leading cause of morbidity and mortality among children under 5 for more than 3 decades, particularly in low-income countries like Bangladesh. The World Health Organization (WHO) developed a pneumonia case management strategy which included the use of antibiotics for both primary and hospital-based care. This study aims to describe antibiotic usage for treating pneumonia in children in a private pediatric teaching hospital in Dhaka, Bangladesh.We conducted this cross-sectional study among children <5 years old who were admitted to a private pediatric hospital in Dhaka with a diagnosis of pneumonia in November 2012.We enrolled 80 children during the study period. Among them, 28 (35.4%) were underweight, 14 (17.7%) were moderately underweight, and 13 (16.5%) were severely under-weight. On the basis of WHO classification (2005), 43 children (54%) had severe pneumonia and 37 (46%) had very severe pneumonia, as diagnosed by the research physician. Among the prescribed antibiotics in the hospital, parenteral ceftriaxone was the most common 40 (50%), followed by cefotaxime plus amikacin 14 (17.5%), cefuroxime 7 (8.8%), ceftazidime plus amikacin 6 (7.5%), ceftriaxone plus amikacin 3 (3.8%), meropenem 2 (2.5%), cefepime 2 (2.5%), and cefotaxime 2 (2.5%).Despite the WHO pneumonia treatment strategy, the inappropriate use of higher-generation cephalosporin and carbapenem was high in the study hospital. The results underscore the noncompliance with the WHO guidelines of antibiotic use and the importance of enforcing regulatory policy of the rational use of antibiotics for treating hospitalized children with pneumonia. Following these guidelines may help prevent increased antimicrobial resistance.
| S-EPMC5548281 | biostudies-other
Project description:This study was designed to investigate the presence of potential human pathogenic bacteria, bacterial load, and their incidence in ready-to-eat leafy greens viz., coriander, lettuce, and mint leaves sold at diverse marketplaces in Dhaka City. Multiple identification methods including cultural, morphological, biochemical, and molecular analysis were employed in the Plant Pathology Laboratory of Sher-e-Bangla Agricultural University to identify the human pathogenic bacteria. In molecular analysis, the DNA samples were put through PCR using bacterial primer 27F: AGAGTTTGATCMTGGCTGAG and universal primer 1942R: CGGTTACCTTGTTACGACTT. Initially, nine different bacterial genera viz. Bacillus, Escherichia, Pseudomonas, Neisseria, Klebsiella, Enterobacter, Shigella, Vibrio, and Staphylococcus were detected, and their incidence was 93%, 67%, 44%, 30%, 26%, 26%, 11%, 7%, and 7% respectively. A total of twelve bacteria have been identified from these genera out of which 7 bacteria viz. Bacillus cereus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter aerogenes, Staphylococcus aureus, and Shigella spp., were reported as human pathogenic bacteria in several pieces of literature. The highest colony-forming units per gram were shown in mint (4.27 ± 2.35 × 109) followed by lettuce (2.87 ± 0.76 × 109) and coriander (2.43 ± 1.32 × 109). Considering marketplaces, the highest colony-forming units per gram were observed in the samples of street markets (5.0 ± 1.72 × 109) and the lowest was in supermarkets (1.87 ± 0.46 × 109) followed by local markets (2.7 ± 0.91 × 109). All the leafy green samples crossed the acceptable level of bacterial load (106 CFU/g). The findings of the study highlight the urgency for improved food safety protocols in their production and distribution in Dhaka city.
| S-EPMC10867497 | biostudies-literature
Project description:OBJECTIVES:In recent years, Bangladesh has made remarkable advances in health outcomes; however, the benefits of these gains are unequally shared among citizens and population groups. Dalits (jaat sweepers), a marginalised traditional working community, have relatively poor access to healthcare services. This study sought to explore the sociopolitical and cultural factors associated with health inequalities among Dalits in an urban setting. DESIGN:An exploratory qualitative study design was adopted. Fourteen in-depth interviews, five focus group discussions and seven key informant interviews were conducted. The acquired data were analysed using an iterative approach which incorporated deductive and inductive methods in identifying codes and themes. SETTINGS:This study was conducted in two sweeper communities in Dhaka city. PARTICIPANTS:Participants were Dalit men and women (in-depth interviews, mean age±SD 30±10; and focus group discussions), and the community leaders and non-governmental organisation workers (key informant interviews). RESULTS:The health status of members of these Dalit groups is determined by an array of social, economic and political factors. Dalits (untouchables) are typically considered to fall outside the caste-based social structure and existing vulnerabilities are embedded and reinforced by this identity. Dalits' experience of precarious access to healthcare or poor healthcare is an important manifestation of these inequalities and has implications for the economic and social life of Dalit populations living together in geographically constrained spaces. CONCLUSIONS:The provision of clinical healthcare services alone is insufficient to mitigate the negative effects of discriminations and to improve the health status of Dalits. A better understanding of the precise influences of sociocultural determinants of health inequalities is needed, together with the identification of the strategies and programmes needed to address these determinants with the aim of developing more inclusive health service delivery systems.
| S-EPMC6303619 | biostudies-literature
Project description:BackgroundData are scarce regarding the prevalence of diabetes mellitus (DM) among tuberculosis (TB) patients in Bangladesh. This study was undertaken to estimate the number needed to screen (NNS) to identify a case of DM among those with TB symptoms and those with confirmed TB disease, and to identify factors predicting treatment outcomes of TB patients with and without DM.MethodsPersons attending public-private model screening centres in urban Dhaka for the evaluation of TB were offered free blood glucose testing in addition to computer-aided chest X-ray and sputum Xpert MTB/RIF.ResultsAmong 7647 people evaluated for both TB and DM, the NNS was 35 (95% confidence interval (CI) 31-40) to diagnose one new case of DM; among those diagnosed with TB, the NNS was 21 (95% CI 17-29). Among those with diagnosed TB, patients with DM were more likely to have cavitation on chest X-ray compared to those without DM (31% vs 22%). Treatment failure (odds ratio (OR) 18.9, 95% CI 5.43-65.9) and death (OR 2.08, 95% CI 1.11-3.90) were more common among TB patients with DM than among TB patients without DM. DM was the most important predictor of a poor treatment outcome in the classification analysis for TB patients aged 39 years and above.ConclusionsA considerable burden of DM was found among patients accessing TB diagnostics through a public-private model in urban Bangladesh, and DM was associated with advanced TB disease and a high rate of poor treatment outcome.
| S-EPMC9006482 | biostudies-literature
Project description:ObjectiveThis study explored the illness experiences and healthcare-seeking behaviour of a cross-section of street dwellers of Dhaka City for designing a customised intervention.DesignA qualitative exploratory study of a sample of street dwellers of Dhaka City.SettingSamples were taken from three purposively selected spots of Dhaka City with a high concentration of the target population.ParticipantsFifteen in-depth interviews and six informal group discussions with 40 street dwellers (≥18 years), and key informant interviews with service providers (n=6) and policymakers (n=3) were conducted during January-June 2019 to elicit necessary data.Primary outcome measuresQualitative narrative of illness experiences of the sampled street dwellers, relevant healthcare-seeking behaviour and experiences of interactions with health systems.ResultsWe focused on three main themes, namely, reported illnesses, relevant healthcare-seeking behaviour and health system experiences of the street dwellers. Findings reveal that most of the street dwellers suffered from fever and respiratory illnesses in the last 6 months; however, a majority did not visit formal facilities. They preferred visiting retail drug shops for advice and treatment or waited for self-recovery. Formal facilities were visited only when treatment from drug shops failed to cure them or they suffered serious illnesses or traumatic injury. The reproductive-age women did not seek pregnancy care and most deliveries took place in the street dwellings. Lack of awareness, financial constraints and fear of visiting formal facilities were some of the reasons mentioned. Those who visited formal facilities faced barriers like the cost of medicines and diagnostic tests, long waiting time and opportunity cost.ConclusionsThe street dwellers lacked access to formal health systems for needed services as the latter lags far behind to outreach this extremely vulnerable population. What they need is explicit targeting with a customised package of services based on their illness profile, at a time and place convenient to them with minimum or no cost implications.
| S-EPMC7542956 | biostudies-literature
Project description:This study was carried out to characterize the biogeochemical and physicochemical properties of landfill leachate from Matuail Sanitary landfill site, Dhaka, Bangladesh. In addition, the study also aimed to identify the photodegradation of landfill leachate under natural sunlight. The leachate pH was slightly alkaline (7.87-8.07) with a minimum level of dissolved oxygen, and low BOD5/COD ratio that are indicators of the matured methanogenic phase. Ca, Fe, Br, Rb, Cu was present in a considerable amount. A trace amount of Sr, Co, As, Pb, Cr was found in the leachate sample. Fourier Transform - infrared (FTIR) spectra of all three samples had five major peak regions notably at 3440-3450 cm-1 (O-H groups of water), 1638 cm-1 (C=O Amide I, carboxylates C=C, aromatic ring modes, or alkenes), 1385-1390 cm-1 (deformation of the C-H bond in CH2 and CH3, or the asymmetric stretching of COO¯), 1115 cm-1 (stretching of the C-O bond in phenol ethers and phenols) and 605 cm-1 (S-O bends of sulfates). In addition to the appearance of new peak, peak shifting on the 2nd-day and 5th-day phototreatment are in compliance with the 34% TOC reduction. From analyzing three-dimensional excitation/emission (3D-EEM) spectra of the raw sample pyrene-like or humic-like peak A (Ex 255/Em 465), soil fulvic-like peak Mp (Ex 315/Em 450), and humic-like peak C (Ex 370/Em 455) was found indicating more humified characteristics of the mature landfill site. From 1-hour to 6-hours phototreatment, all three substances slightly lost fluorescence intensity. From the 2nd day to the 5th day of photo-treatment, two unknown photo-product was identified within Ex 210/Em 457 and Ex 205/Em 408 at peak A region. Fluorescence intensity lost was 65% for peak A and 44% for peak C. Soil fulvic-like peak Mp was absent on the 5th day of photo-treatment.
| S-EPMC8429108 | biostudies-literature
Project description:The acute effect of temperature on asthma morbidity in Bangladesh is not well understood. As climate varies extensively in different parts of the world, the relation between temperature and asthma might also differ. We investigated the association between temperature and asthma-related hospital visits in the tropical city of Dhaka. We analyzed information from a total of 5989 asthma patients who received ambulatory care in the form of nebulized medication at the National Asthma Center in Mohakhali, Dhaka from February to November 2013. A time-stratified case-crossover study was conducted to estimate the effect of daily temperature, with consideration of delayed effects and possible confounders such as relative humidity and political strikes. An inverse association was observed between temperature and the number of hospital visits. The effect was delayed for approximately a week. A degree centigrade decrease in mean temperature (averaged across lags 0-6) was associated with an increase of approximately 4.5% (95% CI 1.5, 7.5) in all asthma visits. The association was evident in adult males but marginal in elderly males. A positive association (lag 0) was observed among adult females, whereas no association was observed among children. Strikes significantly modified the effect among the elderly. Findings suggest temperature declines affect asthma outcomes in a warm climate, and this effect can be delayed and vary by sex and age group.
| S-EPMC7908622 | biostudies-literature