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Background Little is known about parental coronavirus disease 2019 (COVID-19) vaccine hesitancy in children with neurodevelopmental disorders (NDD). This survey estimated the prevalence and predictive factors of vaccine hesitancy among parents of children with NDD. Methods A nationally representative cross-sectional survey was conducted from October 10 to 31, 2021. A structured vaccine hesitancy questionnaire was used to collect data from parents aged ≥ 18 years with children with NDD. In addition, individual face-to-face interviews were conducted at randomly selected places throughout Bangladesh. Multiple logistic regression analysis was conducted to identify the predictors of vaccine hesitancy. Results A total of 396 parents participated in the study. Of these, 169 (42.7%) parents were hesitant to vaccinate their children. Higher odds of vaccine hesitancy were found among parents who lived in the northern zone (AOR = 17.15, 95% CI = 5.86–50.09; p  < 0.001), those who thought vaccines would not be safe and effective for Bangladeshi children (AOR = 3.22, 95% CI = 1.68–15.19; p  < 0.001), those who were either not vaccinated or did not receive the COVID-19 vaccine themselves (AOR = 12.14, 95% CI = 8.48–17.36; p  < 0.001), those who said that they or their family members had not tested positive for COVID-19 (AOR = 2.13, 95% CI = 1.07–4.25), and those who did not lose a family member to COVID-19 (AOR = 2.12, 95% CI = 1.03–4.61; p  = 0.040). Furthermore, parents who were not likely to believe that their children or a family member could be infected with COVID-19 the following year (AOR = 4.99, 95% CI = 1.81–13.77; p  < 0.001) and who were not concerned at all about their children or a family member being infected the following year (AOR = 2.34, 95% CI = 1.65–8.37; p  = 0.043) had significantly higher odds of COVID-19 vaccine hesitancy. Conclusions Given the high prevalence of vaccine hesitancy, policymakers, public health practitioners, and pediatricians can implement and support strategies to ensure that children with NDD and their caregivers and family members receive the COVID-19 vaccine to fight pandemic induced hazards.

Objective: This case-control study investigated the association between SARS-CoV-2 infection and musculoskeletal health complaints (MHC). The specific aims of the study were (1) to compare the 1-month prevalence of MHC among post-acute COVID-19 patients and participants who never tested positive for COVID-19 matched by the former group’s age and gender; (2) to identify the predictors of MHC among all participants, and (3) define the factors independently associated with MHC in post-acute COVID-19 patients. Methods and Analysis: The study was conducted in Bangladesh from February 24 to April 7, 2022. The face-to-face interview was taken using a paper-based semi-structured questionnaire. MHC was measured using the musculoskeletal subscale of subjective health complaints produced by Eriksen et al. Descriptive analysis was conducted to compute MHC prevalence and compare them across groups. Multiple logistic analyses were employed to identify MHC predictors for the participants. Results: The prevalence of MHC was 38.7%. Adjusted analysis suggested that the SARS-CoV-2 infection was independently associated with MHC (AOR = 3.248,95% CI = 2.307-4.571). Furthermore, unemployment (AOR = 4.156, 95% CI = 1.308-13.208), moderate illness (AOR = 2.947,95% CI = 1.216-7.144), treatment in hospitals’ general word (AOR = 4.388,95% CI = 1.878-10.254) and health complaints after COVID-19 (AOR = 4.796,95% CI = 2.196-10.472) were found to be the predictors of MHC among post-acute COVID-19 patients. Conclusion: Our study found a robust association between SARS-CoV-2 infection and MHC and recommends that healthcare authorities be prepared to deal with the high burden of MHC among post-acute COVID-19 patients.

Viruses that induce pulmonary difficulties and auto‐inflammation are more common in people with Down syndrome. They also have a higher number of comorbidities associated with a worse prognosis than the overall population. Adult patients with acute COVID‐19 are increasingly being diagnosed with Long COVID. However, patients with Down syndrome with later long COVID‐19 are the first example documented in Bangladesh. COVID‐19: Diagnosis & Hospitalization of a Person with Down Syndrome.

Background : Coronavirus disease 2019 (COVID-19) requires mass immunization to control the symptoms and global spread of severe acute respiratory syndrome coronavirus 2. Data from developed countries reported a high prevalence of parental COVID-19 vaccine hesitancy. However, parental vaccine hesitancy data in countries with low and middle income are scarce. The goal of this study was to assess the prevalence of parental vaccine hesitancy and identify subgroups with higher odds of vaccine hesitancy. Methods: A cross-sectional study was conducted on parents of children aged <18 years from October 10, 2021, to October 31, 2021. Parents aged ≥18 years underwent face-to-face interviews in randomly selected places in Bangladesh using a vaccine hesitancy questionnaire. Predictors were identified using binary logistic regression analysis. Results: Data from 2633 eligible parents were analyzed. Overall, 42.8% reported COVID-19 vaccine hesitancy for their youngest child. The final model suggested that children's age, parent's age, religion, occupation, monthly household income, permanent address, living location, the status of tobacco use, adherence with the regular government vaccination programs (other than COVID-19), perception about COVID-19 vaccine efficacy among Bangladeshi children, self-vaccination intention, report about family members' illness or death from COVID-19, and perceived COVID-19 threat were the independent predictors of parental vaccine hesitancy. Conclusions : Vaccine hesitation varied based on sociodemographic characteristics, religion, behavior, and perceived COVID-19 threat. Therefore, interventions focused on addressing vaccine hesitancy among subgroups are warranted.

ObjectivesUnderutilisation of thrombolysis is a major problem in patients with stroke in Bangladesh as patients do not arrive within the therapeutic window due to delays in their way to emergency department. This study aims to assess the time delay from patients’ symptom onset to arrival in the hospital and the factors that are associated with it.MethodsThis cross-sectional survey of a prospective cohort of stroke patients was conducted between January and March 2023. 448 stroke patients meeting the inclusion criteria were enrolled in the study from five tertiary-level hospitals in Bangladesh. After obtaining informed consent, trained data collectors conducted face-to-face interviews of the patient/patients’ guardians via a pretested structured questionnaire. Stata (V.16) was used to analyse data. Median and IQRs were used to summarise quantitative variables, and qualitative variables were summarised using frequency and relative frequency. Pearson’s χ2 test and Mann-Whitney U test were used to explore the bivariate relationship between predictor and outcome variables. Finally, a binary logistic regression model was fit to explore the factors associated with delayed arrival (>4.5 hours) at the hospital.ResultsThe median age of the patients was 61 years (54–70) and 63% were men. The majority hailed from rural (59.6%) areas and had primary (25.89%) education. The patients had an overall median prehospital delay of 14 (8–28) hours, 3 (1–6) hours of decision delay, 1 (0–2) hours of medical contact delay, and 14 (6.5–25.75) hours of referral delay. Patients with master’s education (adjusted OR (AOR): 0.04, p=0.023) and private transport (AOR: 0.26, p=0.029) had a lower chance of late arrival. However, patients having unknown onset, self-medicating, having a previous history of stroke, and being admitted to a private hospital had a significantly higher chance of late arrival.ConclusionNearly 90% of the patients were late to arrive (>4.5 hours) at hospital and referral delay comprises the majority of the prehospital delay. Therefore, fast symptom recognition and the urgency of seeking healthcare as soon as symptoms appear should be the focus of public awareness efforts.

Immunization campaigns and Expanded Program on Immunization (EPI) were launched by Government of Bangladesh (GoB) in collaboration with WHO and other Non-governmental Organizations (NGOs) to tackle the increased risk of vaccine preventable disease outbreak in the Rohingya refugee camps. Immunization coverage was found to be lower than expected. However, a few studies explored the factors behind low vaccine uptake among Refugee children. Therefore, this study was aimed. A cross sectional study was carried out among Rohingya parents living in registered camps and makeshift settlements located in Teknaf and Ukhiya upazilla of Cox's Bazar, Bangladesh. A total of 224 Rohingya parents were conveniently selected (122 parents from each type of camps). Data was collected using a pretested interviewer-administered semi-structured questionnaire with the help of bilingual volunteers who understand Rohingya dialect. All statistical analyses were carried out in IBM SPSS Version 26 (New York, USA). Total 63.1% of Rohingya parents had good practice regarding childhood immunization (completed EPI vaccination) as per schedule. Of all, 74.6% had good knowledge and 94.7% had positive attitude towards EPI vaccination. Good practice regarding vaccination was significantly more common among parents living in registered camps (77%) than those living in makeshift settlements (49.2%, p<0.001). Multivariable logistic regression analysis revealed that living in registered camps (Adjusted Odds Ratio [aOR]: 2.99; 95% Confidence Interval [CI]: 1.41-6.32) and good knowledge level (aOR: 2.88; 95%CI: 1.32-15.82) were independent determinants of good practice. A separate analysis in both type of camps revealed that in registered camps, good knowledge level (aOR: 3.62; 95%CI: 1.45-9.04) and having >2 children (aOR: 3.71; 95%CI: 1.34-10.27), and in makeshift settlements, father's employment (aOR: 2.33; 95%CI: 1.34-6.72), father's education (aOR: 3.00; 95%CI: 1.34-6.72) and presence of any electronic device (e.g., radio, television, mobile phone) (aOR: 4.01; 95%CI: 0.96-16.84) were significant determinants of good childhood immunization practice. Health education and promotion strategies should be implemented to increase knowledge and awareness about EPI immunization benefits among Rohingya parents to ensure greater coverage.

Background: Coronavirus disease 2019 (COVID-19) requires mass immunization to control the severity of symptoms and global spread. Data from developed countries have shown a high prevalence of parental COVID-19 vaccine hesitancy. However, parental vaccine hesitancy data in low- and middle-income countries are scarce. This study aimed to assess the prevalence of parental vaccine hesitancy and identify subgroups with higher odds of vaccine hesitancy in parents in Bangladesh. Methods: A cross-sectional study was conducted on the parents of children aged <18 years from October 10, 2021 to October 31, 2021. Parents participated in face-to-face interviews in randomly selected locations in Bangladesh using a vaccine hesitancy questionnaire. Factors associated with COVID-19 vaccine hesitancy were identified using binary logistic regression analysis. Results: Data from 2,633 eligible parents were analyzed. Overall, 42.8% reported COVID-19 vaccine hesitancy for their youngest child. The final model suggested the following factors were associated with hesitancy: children's age; parent's age, religion, occupation, monthly household income, permanent address, living location, status of tobacco use, adherence with regular government vaccination programs (other than COVID-19), perceptions of COVID-19 vaccine efficacy among Bangladeshi children, self-vaccination intentions, reported family members' illness or death from COVID-19, and perceived threat of COVID-19 were the independent predictors of parental COVID-19 vaccine hesitancy. Conversely, participants who were not tobacco users, parents who were very likely to believe that their children or family members could be infected with COVID-19 in the following year and who were very concerned about their children or a family member contracting COVID-19 in the next year had significantly lower odds of COVID-19 vaccine hesitancy. Conclusions: Our study suggested that vaccine hesitation varied based on sociodemographic characteristics, religion, behavior, and perceived COVID-19 threat. Therefore, interventions focused on addressing vaccine hesitancy among specific subgroups are warranted.

Background and Aims Antibiotic misuse represent a significant global health challenge, with medical students positioned as key figures in promoting responsible antibiotic usage. This study investigates the knowledge, attitudes, and practices (KAP) regarding antibiotic use among medical students in Bangladesh, aiming to identify areas for targeted educational and policy interventions. Methods This cross‐sectional survey was conducted among 501 medical students across various years of study in Bangladesh, collecting data over a 3‐month period. The survey assessed antibiotic knowledge, usage practices, and attitudes towards misuse, employing descriptive statistics and multiple logistic regression analyses to explore associations between students’ demographic characteristics and their KAP towards antibiotics. Significance was assigned at p‐value < 0.05. Results In our study involving 501 medical students from four medical colleges in Bangladesh, we achieved a 76% response rate. Among the participants, 78.24% correctly identified antibiotics’ effectiveness against bacterial infections, but 45.71% were uncertain about their efficacy against viral infections. Notably, 21.20% reported self‐prescribing antibiotics, predominantly sourced from physician prescriptions (54.89%). The most common reason for antibiotic use was fever (19.02%). Senior students were less likely to have good knowledge compared to junior students, and urban students demonstrated a higher likelihood of good knowledge and positive attitude towards antibiotic resistance. Conclusion This study highlights the critical need for educational reforms and antimicrobial stewardship among medical students in Bangladesh to combat antibiotic misuse and mitigate antimicrobial resistance.

Background Adherence to inhaler medication is an important contributor to optimum asthma control along with adequate pharmacotherapy. The objective of the present study was to assess self-reported adherence levels and to identify the potential factors associated with non-adherence to the inhalers among asthma patients. Methods This facility-based cross-sectional study was conducted in the medicine outpatient department of Rajshahi Medical College Hospital from November 2020 to January 2021. A total of 357 clinically confirmed adult asthma patients were interviewed. Inhaler adherence was measured using the 10-item Test of Adherence scale (TAI).. Both descriptive and inferential statistics were used to express the socio-demographic of the patients and predictors of poor adherence to inhaler. Results A substantial number of participants were non-adherent (86%) to inhaler medication. Patients non-adherent to inhaler medication are often younger (23.15, 95% CI 3.67–146.08), lived in the rural area (23.28, 95% CI 2.43–222.66), less year of schooling (5.69, 95% CI 1.27–25.44), and belonged to the middle income (aOR 9.74, 95% CI 2.11–44.9) than those adherent with the inhaler. The presence of comorbidities (12.91, 95% CI 1.41–117.61), prolonged duration of inhaler intake (5.69, 95% CI 1.22–26.49), consulting non-qualified practitioners (13.09, 95% CI 3.10–55.26) were the significant contributor of non-adherence. Conclusion Despite ongoing motivation and treatment, non-adherence to inhalation anti-asthmatic is high and several factors have been found to contribute. Regular monitoring and a guided patient-centered self-management approach might be helpful to address them in long run.

Background: We do not fully comprehend the medical problems that COVID-19 causes in children. Most children infected with the SARS-CoV-2 virus exhibit no symptoms or only minor COVID-19 signs, while a few children develop severe sickness. The main aim of the study is to describe the protocol of a systematic review that will evaluate the available scientific information on the role of the cardiovascular system in the outcomes of children with COVID-19 in low- and middle-income countries (LMICs). Methods: Protocols for Preferred Reporting Items in Systematic Reviews and Meta-Analyses provide the basis for this study. PubMed, Scopus, SciELO, ScienceDirect, COCHRANE, and EMBASE are the databases to be searched from January 2020. Studies will be analyzed in order to obtain the following information: authors, year of publication, location of the research, type of study, sample size and age, clinical manifestations, treatment plan, follow-up duration, important variables, and key findings. Following the preliminary examination conducted by two unbiased review authors, the selected papers will be subjected to the appropriate evaluation in order to be sorted according to the inclusion criteria. Two impartial review authors will also evaluate risk bias using the appropriate techniques. Additionally, evaluation, publication bias analysis, and study heterogeneity evaluation will be carried out. Results: We anticipate our research will lead to articles that reinforce clinical judgments for the best management of cardiovascular involvement and repercussions in the outcomes of children with COVID-19. Conclusions: The systematic review will discuss the findings to shed light on the cardiovascular involvement and consequences in children with COVID-19, allowing medical professionals to treat COVID-19 in children with cardiovascular issues better.