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.

Tuberculosis: A Global Health Problem

Abstract: Tuberculosis (TB) is an ancient disease that has affected mankind for more than 4,000 years (1). It is a chronic disease caused by the bacillus Mycobacterium tuberculosis and spreads from person to person through air. TB usually affects the lungs but it can also affect other parts of the body, such as brain, intestines, kidneys, or the spine. Symptoms of TB depend on where in the body the TB bacteria are growing. In the cases of pulmonary TB, it may cause symptoms, such as chronic cough, pain in the chest, haemoptysis, weakness or fatigue, weight loss, fever, and night-sweats.TB remains a leading cause of morbidity and mortality in developing countries, including Bangladesh. With the discovery of chemotherapy in the 1940s and adoption of the standardized short course in the 1980s, it was believed that TB would decline globally. Although a declining trend was observed in most developed countries, this was not evident in many developing countries (2). In developing countries, about 7% of all deaths are attributed to TB which is the most common cause of death from a single source of infection among adults (3). It is the first infectious disease declared by the World Health Organization (WHO) as a global health emergency (4). In 2007, it was estimated globally that there were 9.27 million incident cases of TB, 13.7 million prevalent cases, 1.32 million deaths from TB in HIV-negative and 0.45 million deaths in HIV-positive persons (5). Asia and Africa alone constitute 86% of all cases (5). Bangladesh ranked the 6th highest for the burden of TB among 22 high-burden countries in 2007, with 353,000 new cases, 70,000 deaths, and an incidence of 223/100,000 people per year (5).Implementation of directly-observed therapy short course (DOTS) has been a 'breakthrough' in the control of tuberculosis. In many countries, it has become the cornerstone in the treatment of tuberculosis. The number of countries and the coverage of DOTS within the countries have increased over the years (5). Over the last 15 years, about 35 million people have been cured, and eight million deaths have been averted with the adoption of DOTS (6). Implementation of DOTS was started in 1993 in Bangladesh, and it gradually covered the whole country (7).Men are more commonly affected than women. The case notifications in most countries are higher in males than in females. There were 1.4 million smear-positive TB cases in men and 775,000 in women in 2004 (8). The ratio of female to male TB cases notified globally is 0.47:0.67 (9). The reasons for these gender differences are not clear. These may be due to differences in the prevalence of infection, rate of progression from infection to disease, under- reporting of female cases, or the differences in access to services.The association between poverty and TB is wellrecognized, and the highest rates of TB were found in the poorest section of the community (10). TB occurs more frequently among low-income people living in overcrowded areas and persons with little schooling (11). Poverty may result in poor nutrition which may be associated with alterations in immune function. On the other hand, poverty resulting in overcrowded living conditions, poor ventilation, and poor hygiene-habits is likely to increase the risk of transmission of TB (12).Various surveys have been conducted to understand the knowledge, attitudes, and practices regarding tuberculosis (13-14). One survey in India reported that most (93%) people had heard of TB but only 20.5% of the people demonstrated sufficient knowledge of TB (13). This issue of the Journal includes an article by Rundi who explored healthcare- seeking behaviour with regard to TB among the people of Sabah in East Malaysia and the impact of TB on patients and their families (15). The author used qualitative methods and interviewed patients with TB and their relatives. It was found that most (96%) respondents did not know the cause of TB. TB also affected life-styles of the people. …

How to do a good systematic review of effects in international development: a tool kit

Abstract: We provide a ‘how to’ guide to undertake systematic reviews of effects in international development, by which we mean, synthesis of literature relating to the effectiveness of particular development interventions. Our remit includes determining the review's questions and scope, literature search, critical appraisal, methods of synthesis including meta-analysis, and assessing the extent to which generalisable conclusions can be drawn using a theory-based approach. Our work draws on the experiences of the International Initiative for Impact Evaluation's (3ie's) systematic reviews programme.

Susceptibility to Vibrio cholerae Infection in a Cohort of Household Contacts of Patients with Cholera in Bangladesh

Abstract: Background Despite recent progress in understanding the molecular basis of Vibrio cholerae pathogenesis, there is relatively little knowledge of the factors that determine the variability in human susceptibility to V. cholerae infection. Methods and findings We performed an observational study of a cohort of household contacts of cholera patients in Bangladesh, and compared the baseline characteristics of household members who went on to develop culture-positive V. cholerae infection with individuals who did not develop infection. Although the vibriocidal antibody is the only previously described immunologic marker associated with protection from V. cholerae infection, we found that levels of serum IgA specific to three V. cholerae antigens-the B subunit of cholera toxin, lipopolysaccharide, and TcpA, the major component of the toxin-co-regulated pilus-also predicted protection in household contacts of patients infected with V. cholerae O1, the current predominant cause of cholera. Circulating IgA antibodies to TcpA were also associated with protection from V. cholerae O139 infection. In contrast, there was no association between serum IgG antibodies specific to these three antigens and protection from infection with either serogroup. We also found evidence that host genetic characteristics and serum retinol levels modify susceptibility to V. cholerae infection. Conclusions Our observation that levels of serum IgA (but not serum IgG) directed at certain V. cholerae antigens are associated with protection from infection underscores the need to better understand anti-V. cholerae immunity at the mucosal surface. Furthermore, our data suggest that susceptibility to V. cholerae infection is determined by a combination of immunologic, nutritional, and genetic characteristics; additional factors that influence susceptibility to cholera remain unidentified.

Maternal cadmium exposure during pregnancy and size at birth: a prospective cohort study.

Abstract: Background: Cadmium (Cd) is an embryotoxic and teratogenic metal in a variety of animal species, but data from humans are limited. Objectives: The aim of the present study was to assess the effects of maternal Cd exposure in pregnancy on size at birth. Methods: This prospective cohort study was nested in a population-based nutritional supplementation trial in pregnancy conducted in rural Bangladesh. We selected women recruited from February 2002 through January 2003 who had a singleton birth with measurements of size at birth and had donated a urine sample in early pregnancy for Cd analyses (n = 1,616). Urinary Cd was measured with inductively coupled plasma mass spectrometry and adjusted for specific gravity. Results: Multiple linear regression analyses adjusted for sex and other potential confounders showed that maternal urinary Cd (median, 0.63 μg/L) was significantly negatively associated with birth weight [unstandardized regression coefficient B = –31.0; 95% confidence interval (CI): –59, –2.8] and head circumference (B = –0.15; 95% CI: –0.27, –0.026). However, associations appeared to be limited to girls, with little evidence of effects in boys. A 1-μg/L increase in Cd in maternal urine was associated with a 0.26-cm (95% CI: –0.43, –0.088 cm) and 0.24-cm (95% CI: –0.44, –0.030 cm) decrease in girls’ head and chest circumferences, respectively, and a 45-g (95% CI: –82.5, 7.3 g) decrease in birth weight. Quantile regression analyses indicated that associations with maternal Cd were similar for girls of smaller (25th percentile) and larger (50th and 75th percentiles) sizes at birth. Conclusion: We found evidence of a sex difference in the association between maternal Cd exposure and birth size, which was apparent only in girls. Results add support for the need to reduce Cd pollution to improve public health.