Case-control Study In Bangladesh Research Articles

Determinants of overweight and obesity among urban school-going children and adolescents: a case-control study in Bangladesh.

Childhood overweight and obesity is a major public health concern all over the world. Overweight or obese children have a higher risk of becoming obese in adulthood and are at higher risk of associated chronic diseases. The aim of this study was to determine the risk factors associated with overweight and obesity among urban school children and adolescents in Bangladesh. A case-control study was conducted among students aged 10-16 years in 10 schools of Dhaka city. A structured questionnaire was used to collect socio-demographic information and students' exposure to various risk factors. Data were analyzed by using SPSS 23. Family income (p = 0.000), mother's weight (p = 0.036), school activity (p = 0.046), total physical activity (p = 0.008), sedentary activities (p = 0.014), eating fast food (0.008) and cakes/biscuits (p = 0.018) were found as potential determinants of overweight and obesity of children and adolescents. A multiple logistic regression revealed family income >50,000 per month [adjusted odds ratio (AOR) = 3.07, p = 0.001], no physical activity (AOR = 38.3, p = 0.004), more than 4 h of sedentary activities (AOR = 4.84, p = 0.02), regular consumption of fast food (AOR = 3.05, p = 0.042) are risk factors associated with childhood overweight/obesity. Whereas, having a normal weight mother (AOR = 0.51, p = 0.037) and eating cakes/biscuits less than 3 days a week (AOR = 0.33, p = 0.02) were found as protective factors. Findings from this study will be very useful for public health professionals to increase awareness regarding risk factors of overweight and obesity, in order to reduce the future burden of obesity-associated chronic diseases.

Associations between post translational histone modifications, myelomeningocele risk, environmental arsenic exposure, and folate deficiency among participants in a case control study in Bangladesh

ABSTRACTArsenic exposure may contribute to disease risk in humans through alterations in the epigenome. Previous studies reported that arsenic exposure is associated with changes in plasma histone concentrations. Posttranslational histone modifications have been found to differ between the brain tissue of human embryos with neural tube defects and that of controls. Our objectives were to investigate the relationships between plasma histone 3 levels, history of having an infant with myelomeningocele, biomarkers of arsenic exposure, and maternal folate deficiency. These studies took place in Bangladesh, a country with high environmental arsenic exposure through contaminated drinking water. We performed ELISA assays to investigate plasma concentration of total histone 3 (H3) and the histone modification H3K27me3. The plasma samples were collected from 85 adult women as part of a case-control study of arsenic and myelomeningocele risk in Bangladesh. We found significant associations between plasma %H3K27me3 levels and risk of myelomeningocele (P<0.05). Mothers with higher %H3K27me3 in their plasma had lower risk of having an infant with myelomeningocele (odds ratio: 0.91, 95% confidence interval: 0.84, 0.98). We also found that arsenic exposure, as estimated by arsenic concentration in toenails, was associated with lower total H3 concentrations in plasma, but only among women with folate deficiency (β = −9.99, standard error = 3.91, P=0.02). Our results suggest that %H3K27me3 in maternal plasma differs between mothers of infants with myelomeningocele and mothers of infants without myelomeningocele, and may be a marker for myelomeningocele risk. Women with folate deficiency may be more susceptible to the epigenetic effects of environmental arsenic exposure.

Socio-Demographic Determinants of Adult Tuberculosis: A Matched Case-Control Study in Bangladesh

Tuberculosis (TB) is a multi-systemic infectious disease that has evoked a substantial disease burden in developing countries, including Bangladesh. The aim of this study is to determine the socio-demographic risk factors for adult tuberculosis. A matched case-control study was conducted with 178 cases and 179 controls from a selected TB hospital in Dhaka. Data was collected via face-to-face interview using a standard structured questionnaire, posing questions about socio-demographic, clinical and behavioral factors where tuberculosis patients were matched for age and sex to controls. Crude and multivariate logistic regression analyses were used to analyze the data. The multivariate logistic regression analysis indicated that over-crowding in a house (OR = 3.49, CI = 2.08-5.93), contact with TB patients during the last 6 months (OR = 1.789, CI = 0.917-3.559) and employed participants (OR = 1.99, CI = 1.175-3.458) were positively associated with the development of TB. Besides, monthly income (>25000 taka) (OR = 0.291, CI = 0.151-0.547) and urban living (OR = 0.295, CI = 0.163-0.527) are found negatively associated with the TB status. The identified determinants for the development of adult tuberculosis reflect a complex interaction among socio-demographic conditions. Tuberculosis control would benefit from a collaboration of broad public health activities in improving the socio-demographic factors.

Does arsenic increase the risk of neural tube defects among a highly exposed population? A new case–control study in Bangladesh

Neural tube defects are debilitating birth defects that occur when the developing neural plate fails to close in early gestation. Arsenic induces neural tube defects in animal models, but whether environmental arsenic exposure increases risk of neural tube defects in humans is unknown. We describe a new case-control study in Bangladesh, a country currently experiencing an epidemic of arsenic poisoning through contaminated drinking water. We plan to understand how arsenic influences risk of neural tube defects in humans through mechanisms that include disruption of maternal glucose and folate metabolism, as well as epigenetic effects. We also investigate whether sweat chloride concentration, a potential new biomarker for arsenic toxicity, can be used to identify women at higher risk for having a child affected by neural tube defect. We will collect dural tissue from cases, obtained at the time of surgical closure of the defect, and believe investigation of these samples will provide insight into the epigenetic mechanisms by which prenatal arsenic exposure affects the developing nervous system. These studies explore mechanisms by which arsenic may increase risk of neural tube defects in humans and use a unique population with high arsenic exposure to test hypotheses. If successful, these studies may assist countries with high arsenic exposure such as Bangladesh to identify populations at high risk of neural tube defects, as well as direct development of novel screening strategies for maternal risk.Birth Defects Research 109:92-98, 2017.© 2016 The Authors Birth Defects Research Published by Wiley Periodicals, Inc.

Vitamin D and Parathyroid Hormone Status in Female Garment Workers: A Case-Control Study in Bangladesh.

Despite the abundant sunlight, vitamin D deficiency is prevalent in South Asian countries including Bangladesh. Information on vitamin D level is insufficient in adults particularly in female garment workers in Bangladesh. This study was designed to evaluate the status of vitamin D, parathormone (PTH), calcium, and alkaline phosphatase (ALP) among the female garment workers in Bangladesh. Blood samples were collected from female garment workers (n = 40, case group) and general female workers (n = 40, control group) in Dhaka. Serum vitamin D, PTH, calcium, and ALP were measured by chemiluminescence microparticle immunoassay. The mean level of vitamin D was significantly (p < 0.001) lower in case (14.2 ± 2.6 ng/mL) than in the control (22.4 ± 2.4 ng/mL) group. No significant difference was found at mean of PTH and calcium between case (33.9 ± 17.2 pg/mL; 9.1 ± 0.6 mg/dL, resp.) and control (35.9 ± 16.3 pg/mL; 9.3 ± 0.6 mg/dL, resp.) group. The mean ALP in case (117.2 ± 14.4 U/L) group was significantly (p < 0.001) higher than the control group (80.5 ± 30.6 U/L). Overall, PTH level did not show significant correlation with vitamin D. However, calcium and ALP levels showed a significant positive (p < 0.05) and negative (p < 0.001) correlation with vitamin D, respectively. This study indicates a high prevalence of vitamin D deficiency in the female garment workers in Bangladesh.

Risk factors and therapy for goat mastitis in a hospital-based case-control study in Bangladesh

Bangladesh has a large population of goats, which contribute to the income, nutrition and welfare of the households of many families. Mastitis in goats has a low incidence, but is often very severe, making veterinary care necessary. The aim of this study was to identify seasonality and risk factors for goat mastitis in a hospital-based matched case-control study in a teaching veterinary hospital in Chittagong, Bangladesh and to describe the range of antimicrobial treatments applied in this situation. Cases of mastitis and controls were drawn from the hospital patient recording system, along with their risk factor status. Multiple imputation was applied to deal with the missing values in the data analysis. Mastitis occurred somewhat more in the rainy season, and comprised about 3% of all goats admitted to the hospital during January 2011–June 2014. Free-ranging farming system, poor body condition score and non-native goat breeds were significantly associated with case status. Treatment of clinical mastitis was variable and unsystematic, but the use of gentamicin was commonly recorded. The need for more prudent and evidence-based antimicrobial therapies is discussed.

Arsenic is associated with reduced effect of folic acid in myelomeningocele prevention: a case control study in Bangladesh.

BackgroundArsenic induces neural tube defects in several animal models, but its potential to cause neural tube defects in humans is unknown. Our objective was to investigate the associations between maternal arsenic exposure, periconceptional folic acid supplementation, and risk of posterior neural tube defect (myelomeningocele) among a highly exposed population in rural Bangladesh.MethodsWe performed a case–control study that recruited physician-confirmed cases from community health clinics served by Dhaka Community Hospital in Bangladesh, as well as local health facilities that treat children with myelomeningocele. Controls were selected from pregnancy registries in the same areas. Maternal arsenic exposure was estimated from drinking water samples taken from wells used during the first trimester of pregnancy. Periconceptional folic acid use was ascertained by self-report, and maternal folate status was further assessed by plasma folate levels measured at the time of the study visit.ResultsFifty-seven cases of myelomeningocele were identified along with 55 controls. A significant interaction was observed between drinking water inorganic arsenic and periconceptional folic acid use. As drinking water inorganic arsenic concentrations increased from 1 to 25 μg/L, the estimated protective effect of folic acid use declined (OR 0.22 to 1.03), and was not protective at higher concentrations of arsenic. No main effect of arsenic exposure on myelomeningocele risk was identified.ConclusionsOur study found a significant interaction between drinking water inorganic arsenic concentration from wells used during the first trimester of pregnancy and reported intake of periconceptional folic acid supplements. Results suggest that environmental arsenic exposure reduces the effectiveness of folic acid supplementation in preventing myelomeningocele.

Choice of Controls for a Case-control Study in Bangladesh: Hospital Controls versus Community Controls

The study aimed to determine whether hospital controls could be used in case-control studies with minimal bias, where resource constraints limit recruitment of community controls. Hospital controls and community controls were compared for socio-demographic and risk factor variables in a study of Smokeless Tobacco (SLT) use and Coronary Heart Disease (CHD) in Bangladesh in 2010. Incident cases of CHD and hospital controls were selected from cardiac hospitals. Community controls were selected from neighbourhoods of CHD cases. We enrolled 302 cases, 302 hospital controls, and 1208 community controls. Distribution of age, gender, marital status, occupation, and socio-economic status was similar between hospital controls and community controls. Compared to community controls, hospital controls were more educated, had higher rates of hypertension and reported more family history of heart diseases. But they reported relatively less physical activity. Current use of SLT was higher amongst community controls compared to hospital controls, but was not significant (adjusted OR 0.81, 95% CI 0.58-1.12). Current use of SLT was not associated with an increased risk of CHD when community controls were used (adjusted OR 0.87, 95% CI 0.63 to 1.19, p>0.05), nor when hospital controls were used (adjusted OR 1.00, 95% CI 0.63 to 1.60, p>0.05). There were significant differences between two control groups but only on confounding variables which could be measured and adjusted for during multivariate analyses. For comparable future studies in resource-scarce settings, it is possible to enrol hospital controls with careful planning which are similar to potential community controls, whilst minimising selection bias.

Social contact patterns and leprosy disease: a case-control study in Bangladesh.

Socioeconomic and culturally defined social contact patterns are expected to be an important determinant in the continuing transmission of Mycobacterium leprae in leprosy-endemic areas. In a case-control study in two districts in Bangladesh, we assessed the association between social contact patterns and the risk of acquiring clinical leprosy. Social contacts of 90 recently diagnosed patients were compared to those of 199 controls. Leprosy was associated with a more intensive social contact pattern in the home [odds ratio (OR) 1·09, 95% confidence interval (CI) 1·00-1·19, P = 0·043] and in the nearby neighbourhood (OR 1·07, 95% CI 1·03-1·11, P = 0·001). Although it is known that M. leprae spreads most easily within households of infected persons, in endemic areas social contacts within the neighbourhood, village or urban ward, also appear to be important for transmission. We advise that disease control measures in leprosy-endemic areas should not be limited to households, but include high-risk groups in the nearby neighbourhood of patients.

SP2-2 Community controls vs hospital controls: choice for a case-control study in Bangladesh

ObjectiveTo determine whether hospital controls could be used in case-control studies where resource constraints limit recruitment of community controls.MethodsHospital controls and community controls were compared in terms of socio-demographic and...

Association between chronic arsenic exposure and nutritional status among the women of child bearing age: a case-control study in Bangladesh.

The role of nutritional factors in arsenic metabolism and toxicity is yet to be fully elucidated. A low protein diet results in decreased excretion of DMA and increased tissue retention of arsenic in experimental studies. Malnourished women carry a higher risk of adverse pregnancy outcomes. Chronic exposure to high arsenic (>50 μg/L) through drinking water also increases the risk of adverse pregnancy outcomes. The synergistic effects (if any) of malnutrition and chronic arsenic exposure may worsen the adverse pregnancy outcomes. This population based case control study reports the association between chronic arsenic exposure and nutritional status among the rural women in Bangladesh. 348 cases (BMI < 18.5) and 360 controls (BMI 18.5–24.99) were recruited from a baseline survey conducted among 2,341 women. An excess risk for malnutrition was observed among the participants chronically exposed to higher concentrations of arsenic in drinking water after adjusting for potential confounders such as participant’s age, religion, education, monthly household income and history of oral contraceptive pills. Women exposed to arsenic >50 μg/L were at 1.9 times (Odds Ratio = 1.9, 95% CI = 1.1–3.6) increased risk of malnutrition compared to unexposed. The findings of this study suggest that chronic arsenic exposure is likely to contribute to poor nutritional status among women of 20–45 years.

Apolipoprotein E genetic polymorphism and stroke subtypes in a Bangladeshi hospital-based study.

The association between apolipoprotein E (apoE) genetic polymorphism and stroke has not been concordant in different racial populations. We investigated the association between apoE genotypes and stroke subtypes by a case-control study in Bangladesh for the first time among south Asian countries. First-ever-stroke patients (n=227; cerebral infarction, n=147, cerebral hemorrhage, n=80) and 190 controls were recruited from a hospital in Dhaka, Bangladesh. The diagnosis of stroke was based on CT and clinical findings. Cerebral infarction was classified anatomically into cortical and penetrating region. Infarction in the cortical region was further categorized etiologically into thrombosis and embolism. Cerebral hemorrhage was considered as a whole in all analyses. ApoE genotypes were determined by restriction fragment length polymorphism. In the multivariate conditional logistic regression analysis adjusted for potential confounders both the epsilon3/epsilon4 genotype and epsilon4 carrier conferred an approximately 3-fold increased risk for cerebral thrombosis in the cortical artery region (OR 3.5, 95% CI 1.2 to 10.4 and OR 3.1, 95% Cl 1.1 to 9.0, respectively) compared with epsilon3/epsilon3 genotype. However, when the analysis was restricted to the elderly (>60 years), epsilon 2 carrier was associated with a risk of hemorrhagic stroke (OR 19.2, 95% CI 1.3 to 295.2). Our study suggested that both apoE epsilon3/epsilon4 genotype and epsilon4 carriers were risk factors for cerebral thrombosis in cortical artery region, whereas epsilon 2 carrier was a risk factor for hemorrhagic stroke in the elderly.