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Background Self‐harm remains a significant public health issue worldwide, with university students being particularly affected. This study examines its prevalence and associated factors among university students in Dhaka, Bangladesh, while considering broader global, regional, and local trends. Methods This study utilized a cross‐sectional design, surveying 200 students from the University of Dhaka and the Bangladesh University of Business and Technology. Data were gathered through in‐person interviews and analyzed using SPSS version 26. Results The study found that self‐harm was prevalent at 17%, with a striking gender difference—females exhibited a four times higher occurrence than males. Bivariate analysis indicated no significant variations across institutions, academic disciplines, habitat, or socioeconomic status. However, logistic regression revealed key associations: females were more prone to self‐harm, while middle and high socioeconomic status served as protective factors. Conclusion This study highlights the critical need for customized mental health programs targeting university students in Dhaka. The identified prevalence and influencing factors provide a foundation for future research and support the development of evidence‐based strategies to reduce self‐harm and promote overall mental well‐being on campus.

BackgroundMental health disparities persist as a pressing public health concern globally. Gender disparities in mental health are evident, with women disproportionately affected by conditions such as depression and anxiety. Despite the apparent need, studies from Bangladesh indicate that women are less likely to seek mental healthcare compared with men.ObjectiveThis study aims to investigate gender differences in mental health help-seeking behaviour in Bangladesh.MethodsA cross-sectional online survey was conducted from 15 to 30 October 2021, targeting individuals with perceived mental health problems through the Facebook page of LifeSpring, a mental health and well-being organisation based in Bangladesh. Data (n=3031; women: 2140; men: 891) were collected using the JotForm online survey tool and analysed using descriptive statistics, bivariate analyses and multinomial logistic regression.ResultsThe majority of participants were female (70.6%), aged between 18 and 34 years (87.3%), and from urban areas (85.4%). Overall, 28.4% received non-professional help, with females at 30.9% and males at 22.3%. Additionally, 22.9% received help from professionals, with females at 20.8% and males at 28.1%. Notable disparities were observed in mental health help-seeking behaviour between genders. While females exhibit higher odds of seeking non-professional support (OR 1.49, 95% CI 1.21 to 1.84, p value <0.001), they have lower odds of obtaining professional assistance compared with males (OR 0.70, 95% CI 0.56 to 0.86, p value 0.001). Factors such as stigma, financial constraints and marital status significantly influenced help-seeking behaviours.ConclusionThis study contributes to our understanding of gender disparities in mental healthcare utilisation in Bangladesh, highlighting the need for gender-sensitive approaches in mental healthcare service delivery.

Background and aims Bangladesh faces a high burden of mental health disorders, yet gender-based disparities in prevalence and access to care remain critically understudied. This narrative review aims to identify important gaps in the existing literature by focusing on common mental disorders and specifically on gender-based inequities in accessing mental healthcare services in Bangladesh. Methods To address the objectives, a narrative review was conducted using both research and grey literature articles, following PRISMA guidelines in database searches. Results Results depict that in Bangladesh, gender-based mental health inequity is pervasive, and women may be more susceptible to common mental health disorders, such as depression and anxiety, which have been largely overlooked in previous studies. However, women are less likely to access mental health care than men. Conclusion Addressing these disparities requires targeted policies. We recommend expanding the female mental health workforce, integrating mental health into primary care with outreach to women, and launching anti-stigma campaigns (including digital and media-based interventions) to normalize help-seeking. These gender-sensitive strategies, alongside broader system strengthening efforts, can improve access for women and, by extension, benefit the overall population’s mental health. Highlights Women in Bangladesh bear a higher depression/anxiety burden than men. Yet women are half as likely as men to seek mental-health care. Gender-based violence, stigma, and poverty are key barriers. Policy must integrate female providers, digital tools, and anti-stigma campaigns.

Thousands of Rohingya refugee mothers at the world's largest refugee camp located in Bangladesh are at risk of poor mental health. Accordingly, their children are also vulnerable to delayed cognitive and physical development. The aim of this study is to evaluate the effectiveness of an integrated care package in reducing the prevalence of developmental delays among children aged 1 year and improving their mothers' mental health status. This is a parallel, two-arm, single-blind, cluster randomized controlled trial (cRCT). A total of 704 mother-child dyads residing at the Kutupalong refugee camp in Cox's Bazar, Bangladesh, will be recruited from 22 clusters with 32 mother-child dyads per cluster. In the intervention arm, an integrated early childhood development and maternal mental health package will be delivered every quarter to mothers of newborns by trained community health workers until the child is 1 year old. Our primary outcome is a reduction in the prevalence of two or more childhood developmental delays of infants aged 1 year compared to the usual treatment. The secondary outcomes include reduced stunting among children and the prevalence of maternal depression. We will also assess the cost-effectiveness of the integrated intervention, and will further explore the intervention's acceptability and feasibility. At the time of submission, the study was at the stage of endpoint assessment. The data analysis started in December 2020, and the results are expected to be published after the first quarter of 2021. This study will address the burden of childhood developmental delays and poor maternal mental health in a low-resource setting. If proven effective, the delivery of the intervention through community health workers will ensure the proposed intervention's sustainability. ISRCTN Registry ISRCTN10892553; https://www.isrctn.com/ISRCTN10892553. DERR1-10.2196/25047.

This paper documents, and reflects on key strengths and weaknesses of, existing patient feedback management systems at primary health care in Bangladesh and proposes key implications for future policy and practice. A mixed-method study was conducted in two Upazila (sub-district) Health Complexes (UHC) within one district in Bangladesh. It reports qualitative data from thematic analysis of in-depth interviews (n = 15) with key stakeholders; non-participant observations of feedback environment at UHCs; document review; and a stakeholder workshop. Patient feedback data from publicly available web portals were also analyzed. Multiple parallel patient feedback systems exist at health facilities. Key strengths across all systems included common goals of ensuring accountability and patient voice and high-level commitment. Common weaknesses included lack of documented processes, limited awareness of available channels among patients and a lack of documented actions following feedback. The findings helped to provide a few implications for future policy and practice on patient feedback management.

Background Antibiotic resistance is a global threat to human health, and inappropriate use of antibiotics in humans and animals is widely considered to be a key driver of antibiotic resistant infections. Antibiotic use in humans and animals is growing rapidly in low- and, particularly, middle-income countries. However, there is little detailed understanding about practices related to the use of antibiotics in humans and animals within community settings in such countries. Here we aimed to understand the antibiotic practices of rural households across Cumilla district, Bangladesh, in relation to household members and their domestic animals. Methods In 2018 we conducted a cross-sectional survey using representative cluster sampling methods. We collected self-reported information from 682 female and 620 male household heads, with women also asked about their children’s antibiotic practices. Results Only 48% (95% CI: 40, 56%) of women and men had heard of antibiotics, and among those women and men who were aware of antibiotics and the children of those women 70% (95% CI: 64, 76%) reported having previously taken antibiotics, while among these individuals who reported previously taking antibiotics 21% (95% CI: 18, 25%) said they had done so most recently within the last month. Risky/inappropriate antibiotic practices in humans and animals were often reported. For example, among women and men who were aware of antibiotics and the children of those women 52% (95% CI: 40, 63%) reported previously taking antibiotics for a “cough/cold”, despite antibiotics being typically inappropriate for use against viral upper respiratory tract infections. Among poultry-owning respondents who were aware of antibiotics 11% (95% CI: 8, 15%) reported previously giving healthy poultry antibiotics, mainly for growth/prophylaxis, while among cattle-owning respondents who were aware of antibiotics and reported previously giving their cattle feed 20% (95% CI: 9, 37%) said the feed had contained antibiotics at least sometimes. Conclusions Our results highlight the need for context-adapted interventions at both the community level and the health systems level to reduce inappropriate antibiotic use among humans and domestic animals in rural Bangladesh. Successfully reducing inappropriate use of antibiotics among humans and animals is a required and critical step in tackling antimicrobial resistance.

Background Second-hand smoke exposure from tobacco significantly contributes to morbidity and mortality worldwide. A cluster RCT in Bangladesh compared a community-based smoke-free home (SFH) intervention delivered in mosques, with or without indoor air quality (IAQ) feedback to households to no intervention. Neither was effective nor cost-effective compared to no intervention using an objective measure of second-hand smoke. This paper presents the process evaluation embedded within the trial and seeks to understand this. Methods A mixed method process evaluation comprising interviews with 30 household leads and six imams (prayer leader in mosque), brief questionnaire completed by 900 household leads (75% response), fidelity assessment of intervention delivery in six (20%) mosques and research team records. Data were triangulated using meta-themes informed by three process evaluation functions: implementation, mechanisms of impact and context. Results IMPLEMENTATION: Frequency of SFH intervention delivery was judged moderate to good. However there were mixed levels of intervention fidelity and poor reach. Linked Ayahs (verses of the Qur’an) with health messages targeting SHS attitudes were most often fully implemented and had greatest reach (along with those targeting social norms). Frequency and reach of the IAQ feedback were good. MECHANISMS OF IMPACT: Both interventions had good acceptability. However, views on usefulness of the interventions in creating a SFH were mixed. Individual drivers to behaviour change were new SFH knowledge with corresponding positive attitudes, social norms and intentions. Individual barriers were a lack of self-efficacy and plans. CONTEXT: Social context drivers to SFH intervention implementation in mosques were in place and important. No context barriers to implementation were reported. Social context drivers to SHS behaviour change were children’s requests. Barriers were women’s reluctance to ask men to smoke outside alongside general reluctance to request this of visitors. (Not) having somewhere to smoke outside was a physical context (barrier) and driver. Conclusions Despite detailed development and adaption work with relevant stakeholders, the SFH intervention and IAQ feedback became educational interventions that were motivational but insufficient to overcome significant context barriers to reduce objectively measured SHS exposure in the home. Future interventions could usefully incorporate practical support for SFH behaviour change. Moreover, embedding these into community wide strategies that include practical cessation support and enforcement of SFH legislation is needed. Trial registration Current Controlled Trials ISRCTN49975452

Fahr's disease is a rare neurodegenerative disorder characterized by abnormal brain calcifications, typically presented in middle age. This case report describes an unusual presentation in a 14-year-old boy, highlighting the importance of considering Fahr's disease in pediatric patients. The patient had a 5-year history of seizures, cognitive decline, and behavioral disturbances, along with obesity, short stature, low intelligence, and a clumsy gait. Imaging revealed extensive symmetrical calcifications in the basal ganglia, dentate nucleus, and cerebral white matter, confirming Fahr's disease. The condition can present diverse neurological and psychiatric symptoms, including seizures, movement disorders, cognitive impairment, and mood disturbances. Diagnosis requires excluding secondary causes of brain calcification and is supported by characteristic radiological findings and the absence of biochemical abnormalities. This case underscores the need for early recognition and comprehensive evaluation to optimize management and improve the patient's quality of life, even in the absence of family history. J Bangladesh Coll Phys Surg 2025; 43: 183-185

Background Brief behavioural support can effectively help tuberculosis (TB) patients quit smoking and improve their outcomes. In collaboration with TB programmes in Bangladesh, Nepal and Pakistan, we evaluated the implementation and scale-up of cessation support using four strategies: (1) brief tobacco cessation intervention, (2) integration of tobacco cessation within routine training, (3) inclusion of tobacco indicators in routine records and (4) embedding research within TB programmes. Methods We used mixed methods of observation, interviews, questionnaires and routine data. We aimed to understand the extent and facilitators of vertical scale-up (institutionalization) within 59 health facility learning sites in Pakistan, 18 in Nepal and 15 in Bangladesh, and horizontal scale-up (increased coverage beyond learning sites). We observed training and surveyed all 169 TB health workers who were trained, in order to measure changes in their confidence in delivering cessation support. Routine TB data from the learning sites were analysed to assess intervention delivery and use of TB forms revised to report smoking status and cessation support provided. A purposive sample of TB health workers, managers and policy-makers were interviewed (Bangladesh n  = 12; Nepal n  = 13; Pakistan n  = 19). Costs of scale-up were estimated using activity-based cost analysis. Results Routine data indicated that health workers in learning sites asked all TB patients about tobacco use and offered them cessation support. Qualitative data showed use of intervention materials, often with adaptation and partial implementation in busy clinics. Short (1–2 hours) training integrated within existing programmes increased mean confidence in delivering cessation support by 17% (95% CI: 14–20%). A focus on health system changes (reporting, training, supervision) facilitated vertical scale-up. Dissemination of materials beyond learning sites and changes to national reporting forms and training indicated a degree of horizontal scale-up. Embedding research within TB health systems was crucial for horizontal scale-up and required the dynamic use of tactics including alliance-building, engagement in the wider policy process, use of insider researchers and a deep understanding of health system actors and processes. Conclusions System-level changes within TB programmes may facilitate routine delivery of cessation support to TB patients. These strategies are inexpensive, and with concerted efforts from TB programmes and donors, tobacco cessation can be institutionalized at scale.

BackgroundWell-functioning patient feedback systems can contribute to improved quality of healthcare and systems accountability. We used realist evaluation to examine patient feedback systems at health facilities in Bangladesh, informed by theories of citizenship and principal–agent relationships.MethodsWe collected and analysed data in two stages, using: document review; secondary analysis of data from publicly available web-portals; in-depth interviews with patients, health workers and managers; non-participant observations of feedback environments; and stakeholder workshops. Stage 1 focused on identifying and articulating the initial programme theory (PT) of patient feedback systems. In stage 2, we iteratively tested and refined this initial theory, through analysing data and grounding emerging findings within substantive theories and empirical literature, to arrive at a refined PT.ResultsMultiple patient feedback systems operate in Bangladesh, essentially comprising stages of collection, analysis and actions on feedback. Key contextual enablers include political commitment to accountability, whereas key constraints include limited patient awareness of feedback channels, lack of guidelines and documented processes, local political dynamics and priorities, institutional hierarchies and accountability relationships. Findings highlight that relational trust may be important for many people to exercise citizenship and providing feedback, and that appropriate policy and regulatory frameworks with clear lines of accountability are critical for ensuring effective patient feedback management within frontline healthcare facilities.ConclusionTheories of citizenship and principal–agent relationships can help understand how feedback systems work through spotlighting the citizenship identity and agency, shared or competing interests, and information asymmetries. We extend the understanding of these theories by highlighting how patients, health workers and managers act as both principals and agents, and how information asymmetry and possible agency loss can be addressed. We highlight the importance of awareness raising and non-threatening environment to provide feedback, adequate support to staff to document and analyse feedback and timely actions on the information.