BackgroundLittle is known about the prevalence of depression in people with diabetes in Bangladesh. This study examined the prevalence and factors associated with depression in out-patients with Type 2 diabetes in Bangladesh.MethodsIn this cross-sectional study a random sample of 483 diabetes out-patients from three diabetes clinics in Bangladesh was invited to participate. Of them 417 patients took part. Depressive symptoms were measured using previously developed and culturally standardized Bengali and Sylheti versions of the World HealthOrganization-5 Well Being Index (WHO-5) and the Patient Health Questionairre-9 (PHQ-9) with predefined cut-off scores. Data was collected using two different modes; e.g. standard assisted collection and audio questionnaire methods. Associations between depression and patient characteristics were explored using regression analysis.ResultsThe prevalence of depressive symptoms was 34% (PHQ-9 score ≥ 5) and 36% (WHO-5 score < 52) with audio questionnaire delivery method. The prevalence rates were similar regardless of the type (PHQ-9 vs. WHO-5) and language (Sylheti vs. Bengali) of the questionnaires, and methods of delivery (standard assisted vs. audio methods). The significant predictors of depressive symptoms using either the PHQ-9 or WHO-5 questionnaires were; age, income, gender, treatment intensity, and co-morbid cardiovascular disease. Further, depression was strongly associated with poor glycaemic control and number of co-morbid conditions.ConclusionsThis study demonstrated that depression prevalence is common in out-patients with type 2 diabetes in Bangladesh. In a setting where recognition, screening and treatment levels remain low, health care providers need to focus their efforts on diagnosing, referring and effectively treating this important disease in order to improve service delivery.

BackgroundUnderstanding injection practices is crucial for evidence-based development of intervention initiatives. This study explored the extent of injection use and injection safety practices in primary care hospitals in Bangladesh.MethodsThe study employed both quantitative and qualitative research methods. The methods used were - a retrospective audit of prescriptions (n = 4320), focus group discussions (six with 43 participants), in-depth interviews (n = 38) with a range service providers, and systematic observation of the activities of injection providers (n = 120), waste handlers (n = 48) and hospital facilities (n = 24). Quantitative and qualitative data were assessed with statistical and thematic analysis, respectively, and then combined.ResultsAs many as 78% of our study sample (n = 4230) received an injection. The most commonly prescribed injections (n = 3354) including antibiotics (78.3%), IV fluids (38.6%), analgesics/pain killers (29.4%), vitamins (26.7%), and anti-histamines (18.5%). Further, 43.7% (n = 1145) of the prescribed antibiotics (n = 2626) were given to treat diarrhea and 42.3% (n = 600) of IV fluids (n = 1295) were used to manage general weakness conditions. Nearly one-third (29.8%; n = 36/120) of injection providers reported needle-stick injuries in the last 6 months with highest incidences in Rajshahi division followed by Dhaka division. Disposal of injection needles, syringes and other materials was not done properly in 83.5% (n = 20/24) of the facilities. Health providers' safety concerns were not addressed properly; only 23% (n = 28/120) of the health providers and 4.2% (n = 2/48) of the waste handlers were fully immunized against Hepatitis B virus. Moreover, 73% (n = 87/120) of the injection providers and 90% (n = 43/48) of the waste handlers were not trained in injection safety practices and infection prevention. Qualitative data further confirmed that both providers and patients preferred injections, believing that they provide quick relief. The doctors' perceived injection use as their prescribing norm that enabled them to prove their professional credibility and to remain popular in a competitive health care market. Additionally, persistent pressure from hospital administration to use up injections before their expiry dates also influenced doctors to prescribe injections regardless of actual indications.ConclusionsAs far as the patients and providers' safety is concerned, this study demonstrated a need for further research exploring the dynamics of injection use and safety in Bangladesh. In a context where a high level of injection use and unsafe practices were reported, immediate prevention initiatives need to be operated through continued intervention efforts and health providers' training in primary care hospitals in Bangladesh.

This paper examines the effect of net migration on prospective population growth in Dhaka City for the next several years. The paper deals with the urban challenges in Bangladesh focusing on rapid urban growth in the megacity of Dhaka. Here Population of Dhaka city has been predicted with the help of an ordinary differential equation model known as Malthusian Exponential population model which is parameterized by growth rate. In order to include the immigrant population, we make necessary modification of the model, which is again an exponential model where the growth rate () is the sum of the actual growth rate () and immigrant rate ().We use fourth order Runge-Kutta scheme for the numerical solution of the autonomous and non-autonomous case where we incorporate the growth rate as a function of time. We perform error estimation of the numerical solution which justifies the correctness of the implementation by using computer programming. The procedure used in this study is by comparing two projected population scenarios one with constant growth rate and the other is time dependent growth rate based on the latest data collected through surveys of population censuses and relevant studies.

Background: Leprosy and Tuberculosis (TB) patients have choices of receiving treatment between Non-government Organization (NGO) operated and public hospital. Objective: This study compared patients’ level of satisfaction between NGO and public hospitals treating Leprosy and TB. Methodology: The study was conducted in Khulna city during February-April, 2020. Using random sampling technique, questionnaire survey among patients and in-depth interviews among seven doctors and health service providers were conducted. Wilcoxon Signed Rank Test was employed to compare the difference in the level of satisfaction between NGOs and public hospitals. The sample patients’ opinion on NGO and public health services for Leprosy and TB were synthesized from the perspectives of doctors and health service providers. Results: A total number of 53 patients were recruited for this study. The findings of the study suggested that most of the Leprosy and TB patients belonged to the low-income group, which led to ignoring the symptoms and delayed disease detection. In contrast to the NGO led health facility where the level of patients’ satisfaction was high, public hospitals performed poorly for Leprosy and TB treatment. The stark difference between NGO operated and the public hospital was due to the specialized care by NGO hospitals, and due to the overwhelming number of non-communicable disease patients at the public hospitals. Access to funding, logistics and training, and a small number of patients, spurred better services by the NGO operated hospitals than their public counterparts. Conclusion: The study conclusively proved that NGO operated hospitals offered better health services than public ones for Leprosy and TB patients in Khulna. Bangladesh Journal of Infectious Diseases December 2021;8(2):71-74