International Centre for Diarrhoeal Disease Research, Bangladesh

About: International Centre for Diarrhoeal Disease Research, Bangladesh is a facility organization based out in Dhaka, Bangladesh. It is known for research contribution in the topics: Population & Vibrio cholerae. The organization has 3103 authors who have published 5238 publications receiving 226880 citations. The organization is also known as: SEATO Cholera Research Laboratory & Bangladesh International Centre for Diarrhoeal Disease Research.

Risk factors of stunting among children living in an urban slum of Bangladesh: findings of a prospective cohort study

Abstract: Bangladesh is one of the 20 countries with highest burden of stunting globally. A large portion (around 2.2 million) of the population dwells in the slum areas under severe vulnerable conditions. Children residing in the slums are disproportionately affected with higher burden of undernutrition particularly stunting. In this paper, findings of a prospective cohort study which is part of a larger multi-country study are presented. Two hundred and sixty five children were enrolled and followed since their birth till 24 months of age. Anthropometric measurements, dietary intake and morbidity information were collected monthly. Data from 9 to 12, 15–18 and 21–24 months were collated to analyze and report findings for 12, 18 and 24 months of age. Generalized estimating equation models were constructed to determine risk factors of stunting between 12 and 24 months of age. Approximately, 18% of children were already stunted (LAZ < -2SD) at birth and the proportion increased to 48% at 24 months of age. Exclusive breastfeeding prevalence was only 9.4% following the WHO definition at 6 months. Dietary energy intake as well as intakes of carbohydrate, fat and protein were suboptimal for majority of the children. However, in regression analysis, LAZ at birth (AOR = 0.40, 95% CI: 0.26, 0.61), household with poor asset index (AOR = 2.81, 95% CI: 1.43, 5.52; ref.: average asset index), being male children (AOR = 1.75, 95% CI: 1.04, 2.95; ref.: female) and age (AOR = 2.34, 95% CI: 1.56, 3.52 at 24 months, AOR = 2.13, 95% CI: 1.55, 2.92 at 18 months; ref.: 12 months of age) were the significant predictors of stunting among this population. As the mechanism of stunting begins even before a child is born, strategies must be focused on life course approach and preventive measurement should be initiated during pregnancy. Alongside, government and policymakers have to develop sustainable strategies to improve various social and environmental factors those are closely interrelated with chronic undernutrition particularly concentrating on urban slum areas.

Self-assessed health among Thai elderly

Abstract: The ageing of the population is rapidly progressing in Thailand. Self-assessed health status can provide a holistic view of the health of the elderly. This study aims to identify the determinants of self-assessed health among older Thai people. The data for this study were drawn from a national survey of older persons conducted in 2007. Stratified two-stage random sampling was used for data collection. The analysis was restricted to the population aged 60 and above. The study used univariate, bivariate, and multivariate analysis procedures to analyze the data. Bivariate analysis was used to identify the factors associated with self assessment of health status. After controlling for other variables, the variables were further examined using multivariate analysis (binary logistic regression) in order to identify the significant predictors of the likelihood of reporting poor health. Overall, 30,427 elderly people were interviewed in this study. More than half of the sampled respondents (53%) were aged 60-69 years and about one out of seven (13%) were aged 80 years or above. About three in five respondents (56%) reported that their health was either fair or very bad/bad. Logistic regression analysis found that age, education, marital status, working status, income, functional status, number of chronic diseases, and number of psychosocial symptoms are significant predictors in determining health status. Respondents who faced more difficulty in daily life were more likely to rate their health as poor compared to those who faced less such difficulty. For instance, respondents who could not perform 3 or more activities of daily living (ADLs) were 3.3 times more likely to assess their health as poor compared to those who could perform all the ADLs. Similarly, respondents who had 1, 2, or 3 or more chronic diseases were 1.8 times, 2.4 times, and 3.7 times, respectively, more likely to report their health as poor compared to those who had no chronic disease at all. Moreover, respondents who had 1-2, 3-4, or 5 or more psychosocial symptoms in the previous months were 1.6 times, 2.2 times, and 2.7 times, respectively, more likely to report poor health compared to those who did not have any psychosocial symptoms during the same period. Self-assessed poor health is not uncommon among older people in Thailand. No single factor accounts for the self-assessed poor health. The study has found that chronic disease, functional status, and psychosocial symptoms are the strongest determinants of self-assessed poor health of elderly people living in Thailand. Therefore, health-related programs should focus on all the factors identified in this paper to improve the overall well-being of the ageing population of Thailand.

Mothers' knowledge about vaccine preventable diseases and immunization coverage of a population with high rate of illiteracy

Abstract: In a case-control analysis of cross-sectional data, 328 children aged 12-35 months and their mothers were studied to identify the factors associated with delayed or non-immunization of their children. Delayed or non-immunization was associated with low socio-economic status, maternal illiteracy, and lack of mothers' knowledge on vaccine preventable diseases as recommended by the Expanded Programme on Immunization (EPI). The association of this lack of mother's knowledge with no or delayed immunisation persisted after adjusting the effects of others in logistic regression analysis (Odds Ratio 16.7; 95 per cent confidence interval: 15.65-17.8; P < 0.0001). The results indicate that even in the presence of maternal illiteracy, educating mothers about the vaccines and vaccine preventable diseases may be highly effective in increasing the immunization coverage.

Lipopolysaccharide- and Cholera Toxin-Specific Subclass Distribution of B-Cell Responses in Cholera

Abstract: The immunoglobulin subclass responses to homologous lipopolysaccharide (LPS) and to cholera toxin (CT) in adult patients infected with Vibrio cholerae O1 and V. cholerae O139 were studied. LPS-specific antibody-secreting cells (ASC) of both the immunoglobulin A1 (IgA1) and IgA2 subclasses were seen, with the IgA1 ASC response predominating in both V. cholerae O1- and O139-infected patients. For antibodies in plasma, by day 11 after onset of disease, all V. cholerae O1- infected patients responded to homologous LPS with the IgA1 subclass (P = 0.001), whereas fewer (68%) responded with the IgA2 subclass (P = 0.007). About 89% of V. cholerae O139-infected patients responded with the IgA1 subclass (P = 0.003), and only 21% responded with the IgA2 subclass (not significant [NS]). Both groups of cholera patients showed significant increases in LPS-specific IgG1, IgG2, and IgG3 antibodies in plasma. In feces, the response to homologous LPS occurred in both groups of patients with the IgA1 and IgA2 subclasses, with 55 to 67% of patients showing a positive response. V. cholerae O1- and O139-infected patients showed CT-specific ASC responses of the different IgG and IgA subclasses in the circulation, and the pattern followed the order IgG1 > IgA1 > IgG2 > IgA2, with low levels of IgG3 and IgG4 ASC. Plasma anti-CT antibody responses in all subclasses were seen by day 11 after onset of disease. Although there were no increases in CT-specific ASC of the IgG3 (NS) and IgG4 (NS) subtypes, there were significant increases of these two subclasses in plasma (P ≤ 0.001). The response to CT in the fecal extracts was contributed to by both IgA1 and IgA2 isotypes, with 67 to 75% of the patients responding. Thus, the mucosa-derived ASC and fecal antibodies to LPS and CT were of both the IgA1 and IgA2 subclasses; in plasma, the contribution from IgA2 was lower. Very little difference in the B-cell responses to LPS and CT in the different subclasses was seen in the two groups of cholera patients. Vaccines against O1 and O139 cholera ideally should stimulate antibody subclasses that are likely to offer protection.

Acute respiratory infections prevent improvement of vitamin A status in young infants supplemented with vitamin A

Abstract: At immunization contact, 165 infants 2.5 mo old were randomly assigned to receive either 15 mg vitamin A (retinyl palmitate) or placebo. Three doses were given at monthly intervals with each diphtheria, pertussis, tetanus and oral polio (DPT/OPV) immunization dose. The diarrhea and acute respiratory infection (ARI) morbidity was similar in the vitamin A and placebo groups. However, the duration (days per child-year, mean +/- SD) of ARI was less in the vitamin A group compared with placebo group (27.6 +/- 17.1 vs. 40.8 +/- 22.7; P = 0.005). Fasting retinol concentrations were measured at entry and in 61 infants, the relative dose response (RDR) test was done 1 mo after the third dose of vitamin A. Eighty-five percent of the infants had serum retinol concentration < 0.70 mol/L at entry. After 3 mo the serum retinol levels improved significantly in both groups, and in the vitamin A-supplemented group the serum retinol concentration was significantly better than that in the placebo group (P= 0.02). However, 61% of the infants remained deficient despite vitamin A supplementation. Among vitamin A-supplemented infants only, diarrhea and ARI morbidity during the 3-mo period were compared in children with normal versus children with abnormal RDR at the end of the supplementation period. The ARI episodes were more frequent in the supplemented infants who remained vitamin A deficient at the end of the 3 mo (P = 0.027). Also, the cumulative duration (days, mean +/- SD) of fever and cough was 5.0 +/- 2.8 in the normal versus 11.2 +/- 6.0 in the deficient group (P = 0.04). The results of this study suggest that a large proportion of infants remain vitamin A deficient even after large dose vitamin A supplementation because of frequent respiratory infections, particularly those accompanied by fever.