Publications by authors named "Shams E Arifeen"

Article Synopsis
  • This study investigates the perceptions and practices of healthcare providers regarding delayed cord clamping (DCC) in Bangladesh, highlighting benefits and challenges of the procedure.
  • Healthcare providers generally support DCC, suggesting clamping should occur between one to three minutes post-delivery, influenced by international research and training.
  • Observations revealed inconsistency in clamping practices, with immediate clamping in caesarean sections and a lack of standard guidelines, compounded by cultural influences and resource constraints.
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Background: Assessing maternal health care utilisation is imperative for the health of both mother and her child. Maternal education is an important determinant in subsequent maternal health care usage, according to research. There is a dearth of research on the causal relationship between maternal education and maternal health services as well as examining the performance of different propensity score methods for estimating absolute effects.

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  • Anaemia is a major public health issue in Bangladesh, particularly in pregnancy, with a 38% prevalence found among 1500 pregnant women in a recent study, where 48% were also iron deficient.
  • The study revealed that high concentrations of iron in drinking water (≥2 mg/L) could increase ferritin levels but did not significantly affect overall iron deficiency or anaemia rates.
  • Findings indicate that iron deficiency during pregnancy may be more common than previously thought, calling for further research on the role of drinking water iron in managing anaemia in Bangladesh.
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Background: The rapid advancement of digital technologies, particularly in big data analytics (BDA), artificial intelligence (AI), machine learning (ML), and deep learning (DL), is reshaping the global health care system, including in Bangladesh. The increased adoption of these technologies in health care delivery within Bangladesh has sparked their integration into health care and public health research, resulting in a noticeable surge in related studies. However, a critical gap exists, as there is a lack of comprehensive evidence regarding the research landscape; regulatory challenges; use cases; and the application and adoption of BDA, AI, ML, and DL in the health care system of Bangladesh.

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Background/objectives: An Android platform-based customised app and web-linked system was developed to aid in implementing selected nutrition interventions by community health workers (CHWs) in a community-based cluster randomised trial (c-RCT) in rural Bangladesh.

Methods: Here, we describe the architecture of the intervention delivery system, and explore feasibility of employing mHealth as CHWs' job aid, employing a mixed-method study design covering 17 visits per mother-child dyad. We analysed CHWs' real-time visit information from monitoring and documentation data, and CHWs' qualitative interviews to explore the advantages and barriers of using mHealth as a job aid.

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  • Every year, around 20 million neonates are born with low birth weight (LBW), mostly in low- and middle-income countries, but specific factors affecting LBW in rural Bangladesh are poorly understood.
  • This study surveyed 4,651 children under 5 years old to examine the relationship between socioeconomic status and maternal dietary diversity, finding a 13.5% prevalence of LBW which varied significantly across wealth groups.
  • Results indicated that mothers from poorer households are more likely to have LBW babies, and those with inadequate dietary diversity show a higher risk, especially adolescent mothers, who are significantly affected by poor nutrition.
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Antibiotics may alter the gut microbiome, and this is one of the mechanisms by which antimicrobial resistance may be promoted. Suboptimal antimicrobial stewardship in Asia has been linked to antimicrobial resistance. We aim to examine the relationship between oral antibiotic use and composition and antimicrobial resistance in the gut microbiome in 1093 Bangladeshi infants.

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Background: Worldwide, a significant number of girls become mothers during adolescence. In Bangladesh, adolescent childbirth is highly prevalent and has adverse effects on children's health and undernutrition. We aimed to identify the relationship between the undernutrition of children and adolescent motherhood, the factors associated with adolescent mothers' age at first birth, and to examine the programmatic factors and gaps influencing children's undernutrition in Bangladesh.

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  • Extreme hyperbilirubinemia in newborns is a major issue in low- and middle-income countries like Bangladesh, leading to significant health risks, especially since many births occur at home without screening or treatment.
  • A cluster randomized trial will involve 530 pregnant women in rural Bangladesh, where community health workers (CHWs) will screen and provide home treatment for newborns with jaundice, comparing results to traditional care methods.
  • The study aims to determine if CHW-led home phototherapy can effectively increase treatment rates for neonatal hyperbilirubinemia, potentially allowing for similar programs in other low-income settings to improve newborn health outcomes.
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A key element of women's empowerment is the ability to participate in household decision-making. This study presents the qualitative results from the Shonjibon Cash and Counselling Trial baseline process evaluation with the aim of exploring the status of women's decision-making at the trial's outset and to facilitate the exploration of any changes in women's empowerment over the course of the trial. Between January and March 2021, we conducted forty-one in-depth interviews with pregnant women in rural Bangladesh.

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Background: A significant concern for Bangladesh is the high prevalence of adolescent pregnancy and the associated negative consequences for mother and baby, including a teen-related increased risk of preterm birth (PTB). Bangladesh also has one of the highest incidences of PTB (19%). Despite these high numbers of adolescent pregnancies and PTB, little is reported about the experiences of adolescent mothers in caring for their preterm babies, and the interventions needed to support them.

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Article Synopsis
  • * A study in rural Bangladesh, which involved 23 newborns, explored how feasible and acceptable a CHW-led home phototherapy intervention was for families, revealing that it was seen as convenient and cost-saving.
  • * Despite some concerns about CHWs’ skills and power supply reliability, both families and CHWs rated the home phototherapy positively, suggesting further research is needed to assess its impact on treatment rates and health outcomes.
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Background: Malaria is a leading cause of childhood mortality worldwide. However, accurate estimates of malaria prevalence and causality among patients who die at the country level are lacking due to the limited specificity of diagnostic tools used to attribute etiologies. Accurate estimates are crucial for prioritizing interventions and resources aimed at reducing malaria-related mortality.

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The Government of Bangladesh is piloting a non-contributory health protection scheme called Shasthyo Surokhsha Karmasuchi (SSK) to increase access to quality essential healthcare services for the below-poverty-line (BPL) population. This paper assesses the effect of the SSK scheme on out-of-pocket expenditure (OOPE) for healthcare, catastrophic health expenditure (CHE) and economic impoverishment of the enrolled population. A comparative cross-sectional study was conducted in Tangail District, where the SSK was implemented.

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Improved sanitation is indispensable to human health. However, lack of access to improved sanitation remains one of the most daunting public health challenges of the twenty-first century in Bangladesh. The aim of the study was to describe the trends in access to improved sanitation facilities following the inequity gap among households in different socioeconomic groups in Bangladesh.

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Despite substantial progress, Bangladesh still has a high rate of maternal deaths owing to difficulties during pregnancy, delivery, and the postpartum period. Increasing facility delivery is mandatory to reach the goal of bringing down the MMR to <70 deaths/100,000 live births by 2030. In the era of digitalization, the introduction of e-registration and mHealth may aid the government in reaching this target.

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Article Synopsis
  • Invasive Group B Streptococcus (GBS) is a major factor in early-onset neonatal sepsis and stillbirth, which this study evaluated in seven low- and middle-income countries to determine its impact on infant mortality.
  • The research included the analysis of 2,966 deaths from December 2016 to December 2021 using minimally invasive tissue sampling, identifying GBS as a contributing factor in 2.7% of infant deaths, including 2.3% of stillborn cases.
  • Results showed significant variation in GBS-attributed deaths across countries, particularly affecting low-birth-weight infants, highlighting the need for tailored interventions in different regions to address this issue.
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Background: Although Bangladesh has made significant improvements in maternal, neonatal, and child health, the disparity between rich and poor remains a matter of concern.

Objective: The study aimed to increase coverage of skilled maternal healthcare services while minimising the inequity gap among mothers in different socioeconomic groups.

Methods: We implemented an integrated maternal and neonatal health (MNH) intervention between 2009 and 2012, in Shahjadpur sub-district of Sirajganj district, Bangladesh.

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Background And Objective: Estimating the contribution of risk factors of mortality due to COVID-19 is particularly important in settings with low vaccination coverage and limited public health and clinical resources. Very few studies of risk factors of COVID-19 mortality used high-quality data at an individual level from low- and middle-income countries (LMICs). We examined the contribution of demographic, socioeconomic and clinical risk factors of COVID-19 mortality in Bangladesh, a lower middle-income country in South Asia.

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  • Effective management of hypoxaemia is crucial for reducing pneumonia deaths in children, and the use of bubble continuous positive airway pressure (bCPAP) therapy has shown promise in intensive care settings in Bangladesh.
  • A qualitative assessment was conducted to evaluate the structural and functional capacity of district hospitals for implementing bCPAP, involving interviews with healthcare staff and parents, as well as an analysis of pneumonia cases over 12 months.
  • Challenges for implementation included a shortage of essential medical equipment, insufficient staffing, high patient loads, and the need for improved routine care, leading to recommendations for more regular clinical reviews.
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Background: Assessing the quality of antenatal care (ANC) is imperative for improving care provisions during pregnancy to ensure the health of mother and baby. In Bangladesh, there is a dearth of research on ANC quality using nationally representative data to understand its levels and determinants. Thus, the current study aimed to assess ANC quality and identify the sociodemographic factors associated with the usage of quality ANC services in Bangladesh.

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Background: Neonatal mortality remains unacceptably high in many countries. WHO recommends that all newborns be assessed during the postnatal period and should seek prompt medical care if there is any danger sign. However, in many developing countries, only a small proportion of women receive postnatal care.

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Polycyclic aromatic hydrocarbons (PAHs) have endocrine disrupting properties and they cross the placental barrier, but studies on gestational exposure and child anthropometry are inconclusive. We aimed to elucidate the impact of early gestational PAH exposure on anthropometry from birth to 10 years of age in 1295 mother-child pairs from a nested sub-cohort of the MINIMat trial in Bangladesh. Several PAH metabolites [1-hydroxyphenanthrene (1-OH-Phe), Σ2-,3-hydroxyphenanthrene (Σ2-,3-OH-Phe), 4-hydroxyphenanthrene (4-OH-Phe), 1-hydroxypyrene (1-OH-Pyr), Σ2-,3-hydroxyfluorene (Σ2-,3-OH-Flu)] were quantified in spot urine collected around gestational week 8 using LC-MS/MS.

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