The widespread and indiscriminate use of antimicrobials in food animals is a key contributor to antimicrobial resistance and antimicrobial residue, which have become a growing public and animal health concern in developing countries such as Bangladesh. This study was aimed to assess the knowledge, attitude, and practices (KAP) of large-animal farmers towards antimicrobial use (AMU), antimicrobial resistance (AMR), and antimicrobial residue (AR) with their correlation. A cross-sectional survey was conducted with a structured and pretested questionnaire in the Mymensingh division of Bangladesh. A total of 212 large-animal farmers (dairy, beef fattening, buffalo, sheep, and goat farmers) were surveyed. Results showed that most of the farmers are male (85.8%) and belong to the 18–30 age group (37.3%). About 20.3% had no formal education, and nearly half of the participants (48.1%) received training regarding antibiotic use and resistance. Penicillin is the most common class of antibiotic used (61.8%) in the study area, followed by other antimicrobials. Only 37.7% of the farmers used antimicrobials on the recommendation of their veterinarian. Overall, 41.5%, 42.5%, and 21.7% of farmers possess adequate knowledge and a satisfactory attitude and perform desirable practices, respectively. Farmers in the 31–40 age group have adequate knowledge, attitude, and ability to implement desired practices compared to farmers in the 18–30 age group. Farmers having a graduate or post-graduate degree scored better in relation to knowledge, attitude, and practice than other farmers. Analysis revealed that farmers who received training on AMU and AMR had 10.014 times (OR = 10.014, 95% CIs: 5.252–19.094), 9.409 times (OR = 9.409, 95% CIs: 4.972–17.806), and 25.994 times (OR = 25.994, 95% CIs: 7.73–87.414) better knowledge, attitude, and performance, respectively, compared to their counterparts. A significant proportion of farmers (97.2%) dispose of leftover antibiotics inappropriately. The findings of the present study will be used to intervene in the education and training of the farmers, which will help to limit the indiscriminate and irrational use of antimicrobials, leading to reducing the chances of developing AMR.

BackgroundBangladesh is currently faced with an emerging scenario of increased number of female physicians in the health workforce which has health system implications. For a health system to attract and retain female physicians, information is needed regarding their motivation to choose medical profession, real-life challenges encountered in home and workplaces, propensity to choose a few particular specialties, and factors leading to drop-out from the system. This exploratory mixed-methods study attempted to fill-in this knowledge gap and help the policy makers in designing a gender-sensitive health system.MethodsThree-hundred and fifteen final year female medical students from four purposively selected medical colleges of Dhaka city (two each from public and private colleges) were included in a quantitative survey using self-administered questionnaire. Besides, 31 in-depth interviews with female students, their parents, and in-service trainee physicians, and two focus group discussions with female students were conducted. Gender disaggregated data of physicians and admitted students were also collected. Data were analysed using Stata version 13 and thematic analysis method, as appropriate.ResultsDuring 2006–2015, the female physicians outnumbered their male peers (52% vs. 48%), which is also supported by student admission data during 2011–2016 from the sampled medical colleges, (67% in private compared to 52% in public). Majority of the female medical graduates specialized in Obstetrics and Gynaecology (96%). Social status (66%), respect for medical profession (91%), image of a ‘noble profession’ (91%), and prospects of helping common people (94%) were common motivating factors for them. Gender disparity in work, career and work environment especially in rural areas, and problems of work-home balance, were a few of the challenges mentioned which forced some of them to drop-out. Also, this scenario conditioned them to crowd into a few selected specialties, thereby constraining health system from delivering needed services.ConclusionsIncreasing number of female physicians in health workforce, outnumbering their male peers, is a fact of life for health system of Bangladesh. It’s high time that policy makers pay attention to this and take appropriate remedial measures so that women can pursue their career in an enabling environment and serve the needs and priorities of the health system.

Despite substantial improvements in several maternal health indicators, childbearing and birthing remain a dangerous experience for many women in Bangladesh. This study assessed the relative importance of maternal healthcare service characteristics to Bangladeshi women when choosing a health facility to deliver their babies. The study used a mixed-methods approach. Qualitative methods (expert interviews, focus group discussions) were initially employed to identify and develop the characteristics which most influence a women’s decision making when selecting a maternal health service facility. A discrete choice experiment (DCE) was then constructed to elicit women’s preferences. Women were shown choice scenarios representing hypothetical health facilities with nine attributes outlined. The women were then asked to rank the attributes they considered most important in the delivery of their future babies. A Hierarchical Bayes method was used to measure mean utility parameters. A total of 601 women completed the DCE survey. The model demonstrated significant predictive strength for actual facility choice for maternal health services. The most important attributes were the following: consistent access to a female doctor, the availability of branded drugs, respectful provider attitudes, a continuum of maternal healthcare including the availability of a C-section delivery and lesser waiting times. Attended maternal healthcare utilisation rates are low despite the access to primary healthcare facilities. Further implementation of quality improvements in maternal healthcare facilities should be prioritised.

Background: As of August 15, 2020, Bangladesh lost 3591 lives since the first Coronavirus disease 2019 (COVID-19) case announced on March 8. The objective of the study was to report the clinical manifestation of both symptomatic and asymptomatic COVID-19-positive patients. Methods: A online-based cross-sectional survey was conducted for initial recruitment of participants with subsequent telephone interview by the three trained physicians in 237 adults with confirmed COVID-19 infection in Bangladesh. The study period was between 27 April to 26th May, 2020. Consent was ensured before commencing the interview. Collected data were entered in a predesigned case report form and subsequently analyzed by SPSS 20. Results: The mean age at presentation was 41.59 (13.73 SD) years and most of the cases were male (73%). A total of 90.29% of patients reside in urban areas. Among the positive cases, 13.1% (n=31) were asymptomatic. Asymptomatic cases were significantly more common in households with 2 to 4 members (p=.008). Both symptomatic and asymptomatic patients shared similar ages of presentation (p=0.23), gender differences (p=0.30), and comorbidities (p=0.11). Only 5.3% of patients received ICU care during their treatment. The most frequent presentation was fever (88.3%), followed by cough (69.9%), chest pain (34.5%), body ache (31.1%), and sore throat (30.1%). Thirty-nine percent (n=92) of the patients had comorbidities, with diabetes and hypertension being the most frequently observed. Conclusion: There has been an upsurge in COVID-19 cases in Bangladesh. Patients were mostly middle-aged and male. Typical presentations were fever and cough. Maintenance of social distancing and increased testing are required to meet the current public health challenge.

Aim: This study aimed to evaluate the effects of discriminate and indiscriminate use of oxytetracycline on hematological parameters, residual status in soft tissue of broiler and of thermal effect on oxytetracycline residual status. Materials and Methods: Eighteen, day-old male broiler chickens were purchased and were divided into three different groups (control group, discriminate group, and indiscriminate group). The control group received no antibiotics. The discriminate group received oxytetracycline 1 g/L drinking water for 5 consecutive days, and 10 days' withdrawal period was maintained before sacrifice. The indiscriminate group received oxytetracycline 1 g/L drinking water till the sacrificed day. Blood samples were collected before sacrificing for hematological analysis. After sacrificing liver, kidney, spleen, and muscle samples were collected for analysis of oxytetracycline residues in raw soft tissues. Since meat is used to cook by traditional method in Bangladesh before consumption that is why positive meat samples were cooked by traditional cooking method to evaluate the thermal effect on oxytetracycline residual status as well. Thin-layer chromatography (TLC) was done for screening of oxytetracycline residues in soft tissues. Results: Mean differences of total erythrocyte count (million/mm3), hemoglobin estimation (gm%), and packed cell volume (%) estimation were not statistically significant among the groups. TLC analysis of raw samples showed 100% positive results of all samples collected from the indiscriminate group. In contrast, samples collected from the discriminate group were negative for oxytetracycline residues. In the control group, all samples were negative for oxytetracycline residue. There was a significant (p<0.05) relationship of oxytetracycline residues among three different groups for liver, kidney, spleen, and muscle samples. Positive liver and muscle samples from the indiscriminate group were subjected to thermal treatment by traditional cooking method of Bangladesh. Oxytetracycline residues had found in cooked meat, liver, and juice part, suggesting that antibiotic residues disseminated to juice part from flesh part after cooking. Conclusion: Evidence suggests that proper maintenance of withdrawal period would minimize oxytetracycline residues in broiler soft tissues, whereas antibiotics retained in soft tissues of broiler in case of indiscriminate use. Traditional cooking does not change oxytetracycline residual status in edible tissues. Therefore, awareness regarding the proper maintenance of withdrawal period after antibiotic treatment of broiler is one of the best strategies which may positively reduce the risk of antimicrobial drugs residue in meat.