Publications by authors named "Shams El-Arifeen"

Objectives: Nearly 80 % of severe neonatal hyperbilirubinemia cases are identified too late for medical treatment in lower-middle-income countries. Parents' understanding of neonatal jaundice is crucial for early detection and effective treatment. This study evaluated the effectiveness of prenatal sensitization in improving maternal knowledge and attitude toward neonatal hyperbilirubinemia management in Bangladesh.

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Introduction: Malnutrition contributes to 45% of all childhood deaths globally, but these modelled estimates lack direct measurements in countries with high malnutrition and under-5 mortality rates. We investigated malnutrition's role in infant and child deaths in the Child Health and Mortality Prevention Surveillance (CHAMPS) network.

Methods: We analysed CHAMPS data from seven sites (Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone and South Africa) collected between 2016 and 2023.

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  • 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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  • The COVID-19 pandemic significantly disrupted maternal health care services in Bangladesh, with notable declines in service utilization across the country compared to the pre-pandemic period from 2017 to 2019.
  • The study analyzed data from January 2017 to December 2021 to assess the trends in first antenatal visits, institutional deliveries, and caesarean sections, revealing about a 30% overall decrease in these services during the pandemic.
  • Geographical disparities were evident, with the Chattogram and Rajshahi divisions showing the lowest rates of maternal health service utilization, especially in 2020 and 2021, indicating a pronounced impact of the pandemic on specific regions.
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Background: We aimed to evaluate the trend of post-term births over time and their association with perinatal mortality based on prospective pregnancy cohorts in a rural area in Bangladesh.

Methods: This cohort study included 72 373 singleton births with gestational ages ≥28 weeks recorded by a health and demographic surveillance system from 1990 to 2019 in Matlab, Bangladesh. We expressed the gestational age as X (weeks) + Y (days)/7 weeks, where X indicated complete weeks, and Y presented the number of completed days out of seven days or a week.

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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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  • The study investigates the role of meningitis in child mortality under five years old, particularly focusing on data from six sub-Saharan African countries and Bangladesh.
  • It employs post-mortem minimally invasive tissue sampling (MITS) to identify the causes of death and pathogens responsible for meningitis in this age group from December 2016 to December 2023.
  • Findings reveal that meningitis contributed to 7% of child deaths, with common pathogens identified being Acinetobacter baumannii and Klebsiella pneumoniae, particularly affecting neonates and infants.
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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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Background: The coronavirus disease 2019 (COVID-19) pandemic disrupted essential health care services worldwide, including those related to immunisation. National data from Bangladesh shows that child immunisation may have been adversely affected by the pandemic but regional evidence is limited. We therefore aimed to explore the regional differences in the indirect effects of COVID-19 on child immunisation in Bangladesh.

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Background: The coronavirus disease 2019 (COVID-19) had a profound impact worldwide. In Bangladesh, the official number of deaths for COVID-19 was around 29 000. However, many countries including Bangladesh experienced substantial underreporting of COVID-19 deaths due to lack of complete national civil registration system.

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Importance: The emergence of acute neurological symptoms in children necessitates immediate intervention. Although low- and middle-income countries (LMICs) bear the highest burden of neurological diseases, there is a scarcity of diagnostic and therapeutic resources. Therefore, current understanding of the etiology of neurological emergencies in LMICs relies mainly on clinical diagnoses and verbal autopsies.

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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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In resource-limited settings where vital registration and medical death certificates are unavailable or incomplete, verbal autopsy (VA) is often used to attribute causes of death (CoD) and prioritize resource allocation and interventions. We aimed to determine the CoD concordance between InterVA and CHAMPS's method. The causes of death (CoDs) of children <5 were determined by two methods using data from seven low- and middle-income countries (LMICs) enrolled in the Child Health and Mortality Prevention Surveillance (CHAMPS) network.

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Maternal hypertension may be an underrecognized but important risk factor for perinatal death in low resource settings. We investigated the association of maternal hypertension and perinatal mortality in rural Bangladesh. This nested, matched case-control study used data from a 2019 cross-sectional survey and demographic surveillance database in Baliakandi, Bangladesh.

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Introduction: Determining aetiology of severe illness can be difficult, especially in settings with limited diagnostic resources, yet critical for providing life-saving care. Our objective was to describe the accuracy of antemortem clinical diagnoses in young children in high-mortality settings, compared with results of specific postmortem diagnoses obtained from Child Health and Mortality Prevention Surveillance (CHAMPS).

Methods: We analysed data collected during 2016-2022 from seven sites in Africa and South Asia.

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Background: Smoke from biomass fuels used for cooking in traditional cookstoves contains a variety of health-damaging pollutants. Inhalation of these pollutants by pregnant women has been linked to abnormal foetal development and adverse pregnancy outcomes, including low birthweight (LBW). There is a dearth of data on environmental interventions that have the potential to reduce exposure to biomass fuel during pregnancy and improve birth outcomes.

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Article Synopsis
  • 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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Background: Bangladesh experienced impressive reductions in maternal and neonatal mortality over the past several decades with annual rates of decline surpassing 4% since 2000. We comprehensively assessed health system and non-health factors that drove Bangladesh's success in mortality reduction.

Methods: We operationalised a comprehensive conceptual framework and analysed available household surveys for trends and inequalities in mortality, intervention coverage and quality of care.

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  • Decision-making in maternal health care is influenced by various factors, and traditional studies often lack comprehensive insights, which led to a mixed-methods cohort study aimed at understanding antenatal care (ANC) seeking behavior among pregnant women in Bangladesh.
  • The study involved 2,559 pregnant women from urban and rural areas, using both quantitative interviews and qualitative case studies to gather data on their ANC seeking habits and preferences.
  • Findings revealed that urban women preferred facilities offering one-stop services at a reasonable cost, while rural women predominantly sought private facilities due to inadequate public services; key factors affecting their choices included facility reputation and availability of skilled care and diagnostic services.*
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  • The study evaluates the implementation of a standardized register developed by Bangladesh’s National Newborn Health and IMCI program, aimed at improving care for newborns and children under five in hospitals.
  • Implementation research was conducted in two district and two sub-district hospitals in Kushtia and Dinajpur from November 2022 to January 2023, focusing on usability, acceptability, adoption, fidelity, and utility of the register.
  • Results showed good usability (73) and acceptability (82) scores among healthcare providers, with high adoption rates (96%) for children's admissions; however, fidelity was lower for certain data elements, notably investigations completed (24%).
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