Background : This study is a sub analysis of data submitted on behalf of Bangladesh to an international study (2013-2014) involving Asian ICUs and merits comparison with prior study done in Bangladesh in 2007 which had similar objective. Objective : To assess structure, organization and delivery of ICU care in ICUs of Bangladesh with attention to hospital organizational characteristics, ICU organizational characteristics, staffing etc. Method : Prospective cohort study involving ICUs of 51 hospitals of Bangladesh done in 2013-2014. The hospitals in our study were divided into three groups : clinics/hospitals less than 50 beds (n =18), clinics/hospitals more than 50 beds(n=24) and Govt. hospitals/academic hospitals/ medical colleges hospitals (n=9). Results : Most respondent hospitals were from Dhaka (77.4%). Only 17.6% hospitals were university affiliated. The average number of hospital beds were 225. The average number of ICU beds were 14. 19.6 % hospitals had infection control committees. Basic life support training was required for doctors and nurses in 31.4 % and 27.5 % hospitals respectively. Small clinics/ hospitals (less than 50 bed capacity [n=18]) had significantly less government funding (p < 0.0001), were less attached to university hospital (p < 0.0001), had fewer referral centers (p < 0.001), had less total hospital beds (p < 0.004) and were less in case of ICU beds : hospital beds percentage (p < 0.003). 28 ICUs had no single room. Govt. hospitals/academic hospitals/Medical colleges had relatively more ICU beds .(12.33% - p < 0.004). 60.8% ICUs were operated as open units. Open units were more likely present in hospitals/clinics more than 50 beds. Multivariable analysis showed that the presence of 1:1 nursing staff was much lower in private hospitals. Funding sources and types of hospitals were independently associated with lower percentage of ICU beds (p < 0.002) and (p < 0.0001) respectfully. University affiliations was more likely associated with closed ICU (p < 0.002). Presence of MD CCM qualified intensivists are more in government funded hospitals (p < 0.003) than those of private hospitals Conclusions : Our study demonstrates considerable variation in the organization and staffing among Bangladeshi ICUs. Compared to 2007 study it shows increased trend in number of closed units( 39% vs 15%) and percentage of ICU beds relative to number of hospital beds (6.5% vs 4.8%) . Bangladesh Crit Care J March 2019; 7(1): 3-11

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This study aims to find out the prevalence of the American Heart Association’s (AHA)’s cardiovascular health metrics and associated socio-demographic factors. A secondary analysis of the World Health Organization (WHO) STEPwise approach to surveillance survey 2018 (STEPS 2018) data was conducted. Ideal Cardiovascular Health (ICH) was defined as the presence of 5–7 ideal metrics as defined by the AHA. Design-adjusted multivariable logistic regression was used to determine the associated factors of ICH. In total, 5930 respondents were included in our analysis, and 43.1% of the participants had ICH. The odds of ICH decreased with age [compared to 18–29 years old individuals, 30–49 years: AOR (Adjusted Odds Ratio): 0.4; 95% Confidence Interval (CI): 0.4–0.5; 50–69 years: AOR: 0.7; 95% CI: 0.6–0.8], and higher educational attainment (compared to those who received no formal education, being educated up to primary level: AOR:0.7; 95% CI: 0.6–0.8; being educated up to secondary level: AOR: 0.4; 95% CI: 0.4–0.5; being educated up to college and higher: AOR: 0.4; 95% CI: 0.3–0.5). Compared with female and urban residents, the odds were 30% and 40% less among male and rural residents, respectively. The public health promotion programs of Bangladesh should raise awareness among high-risk groups to prevent cardiovascular diseases.

Objective: To assess compliance of Intensive Care Units (ICUs) of Bangladesh to the components of resuscitation & management bundles of Surviving Sepsis Campaign (SSC). Secondary objective was to assess the impact of compliance on mortality and to determine how its compliance & mortality compared with other Asian and Western countries. Design: Prospective Cohort study. Setting: 14 ICUs of Bangladesh. Participants: 65 adult patients with severe sepsis admitted into these ICUs in July 2009. The organizational characteristics of the participating centers, the patients’ baseline characteristics, the achievement of target within the resuscitation & management bundle & outcome data were recorded. Outcome: Compliance with the Surviving Sepsis Campaign’s resuscitation (6 hrs) & management (24 hrs) bundles. Results: Hospital mortality in ICU patients of Bangladesh suffering from severe sepsis was 49·2%. It was significantly higher than countries reported. Compliance to entire components of both resuscitation & management bundles were reported to be zero in ICUs of Bangladesh. Compliance of individual components of the bundles did not predict improved survival. Conclusion: In ICUs of Bangladesh, high mortality of severe sepsis and failure of compliance of SSC bundle guidelines to have positive impact on survival were presumably attributed to delayed diagnosis, poor adherence to & delayed application of SSC guidelines on sepsis bundles. DOI: http://dx.doi.org/10.3329/bccj.v1i1.14359 Bangladesh Crit Care J March 2013; 1: 8-17