Background Considering the high risk of maternal morbidity and mortality, increased risks of unintended pregnancy, and the unmet need for contraceptives prevalent among the Rohingya refugees, this study aims to explore the knowledge, attitude, and practice (KAP) of family planning (FP) and associated factors among Rohingya women living in refugee camps in Bangladesh. Methods Four hundred Rohingya women were interviewed. Data were collected using a structured and pretested questionnaire, which included study participants’ socio-demographic characteristics, access to FP services, knowledge, attitude, and practice of FP. Linear regression analysis was performed to identify the influencing factors of FP-KAP. Results Of the 400 Rohingya refugee women, 60% were unaware that there was no physical harm brought by using a permanent method of birth control. Half of the women lack proper knowledge regarding whether a girl was eligible for marriage before the age of 18. More than two-thirds of the women thought family planning methods should not be used without the husband’s permission. Moreover, 40% were ashamed and afraid to discuss family planning matters with their husbands. Of the study participants, 58% had the opinion that a couple should continue bearing children until a son is born. Linear regression analyses found that study participants’ who have a profession, have less children, whose primary source of FP knowledge was through a physician/nurse, have had FP interventions in the camp, and talk with a health care provider on FP were found to have better FP-KAP. Conclusion The study showed that Rohingya refugee women are a marginalized population in terms of family planning and their comprehensive FP-KAP capability was low. Contraceptives among the Rohingyas were unpopular, mainly due to a lack of educational qualifications and family planning awareness. In addition, family planning initiatives among Rohingya refugees were limited by a conservative culture and religious beliefs. Therefore, strengthening FP interventions and increasing the accessibility to essential health services and education are indispensable to improving improve maternal health among Rohingya refugees.

There is limited long-term data on the effect of ART on clinical outcomes in HIV/HBV patients in China. The objective of this study was to understand the ART treatment effect and the factors associated with the loss to follow-up or death of HIV/HBV co-infected patients in the city of Beijing, China. Methods: This study examined clinical indicators for HIV mono-infected or HIV/HBV co-infected patients from Jan. 2010 to Sep. 2018. Included patients were followed for a mean duration of 34.5 months after ART. Covariance analysis for repeated measures was used to analyze the changes of clinical indicators; multivariate logistic regression and Cox model were used to analyze the influencing factors of the abnormal incidence of clinical indicators and the lost to follow-up or death in HIV patients. Results: A total of 841 HIV/HBV co-infected patients and 2000 HIV patients were analyzed. Adherence was estimated to be 93% in all patients. At baseline, ALT, AST, OIs and APRI≥0.5 in HIV/HBV patients were higher, while the CD4 and CD4/CD8 ratio were lower. After ART treatment, the rate of APRI≥0.5 (4.4%) were still higher in HIV/HBV patients and HBV co-infection affect the prevalence of APRI≥0.5 (OR=2.745, 95% CI 1.041-7.243). The variables related to LTFU or death in HIV patients were initial CD4 (HR=0.784, 95% CI 0.652-0.943), APRI≥0.5 (HR=4.647, 95% CI 1.331-16.227), OIs (HR=4.910, 95% CI 2.352-10.247) and age (HR=1.336, 95% CI 1.004-1.778). HBV coinfection was not associated with increased LTFU or overall mortality in HIV patients (p>0.05). Conclusion: With good ART treatment and adherence rate, the clinical indicators were improved significantly in HIV/HBV co-infected patients. However, the incidence of hepatic fibrosis was higher in these patients.

Background In Bangladesh, particularly in rural areas, it is not common for teenage girls to openly discuss sexual and reproductive health (SRH) issues including menarche with their mothers because of cultural taboos and traditional beliefs. In light of this, we aim to explore mother-daughter interpersonal communication in regards to menarche and influencing determinants in Chattogram, Bangladesh. Methods A cross-sectional questionnaire survey was conducted among younger adolescent girls (N = 870) attending grade 7 and grade 8 aged 12–14 years in six high schools. In addition, mothers were also interviewed to obtain more in-depth insights into the issue. Results Among adolescents, 81.6% communicated with their mothers followed by sisters, relatives and friends after experiencing menarche, while 59.9% reported that it was mothers who first commenced interaction with them. More than half (51.7%) stated that they felt shy during interaction with their mothers after menarche. Many mothers transmitted different myths and misconceptions with regards to menstruation, with this more prevalent in rural areas compared to urban settings. Being urban respondents, use of Facebook by mothers, mothers as the prime source of SRH knowledge, and prior knowledge of menarche were reported as the significant predictors (p < 0.05) for the extent of communication between adolescents and mothers. Conclusion The type of communication regarding menarche displayed an unhealthy interactional process and behavioral pattern. Therefore, providing more detailed and comprehensive SRH education in the school curriculum, developing and distributing behavioral change communication materials among mothers and adolescents are urgently required.

Background: This study aimed to predict the disease burden of esophageal cancer (EC) over the period 2013-2030 in China. Methods : A dynamic cohort Markov model was developed to simulate the EC prevalence, disability-adjusted life years (DALY), and the medical direct expenditure based on gender. JoinPoint Regression Program was used to calculate the average annual percentage change (AAPC) of EC prevalence and DALY rates, while the regression model was applied to analyze the changing trend of economic burden over time. Results: The predicted DALY rates per 100 000 people increased in both-sex (219.17 - 252.39) and males (302.89 – 384.31), while it decreased in females (131.21- 115.91). The years of life lost (YLL) accounted for the majority of DALYs. The AAPC were 0.8%(95% CI, 0.8%-0.9%), 1.4%(95% CI, 1.3%- 1.5%), and -0.7%(95% CI, -0.8%- -0.7%) in both-sex, males and females, respectively. The medical direct expenditure in both-sex, males, and females was predicted to increase by 165.35%, 194.04%, and 94.20%, respectively. Conclusions: EC still caused a severe burden on society. YLL was responsible for the majority of the DALYs, which highly suggesting the implementation of accurate prevention like screening and early diagnosis and treatment programs.