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Highlights • Tobacco use was highest, followed by alcohol and marijuana use. • The prevalence of substance use was higher in male than female adolescents. • Parental homework supervision significantly lowered the odds of alcohol and tobacco use. • Parental free-time supervision significantly reduced the odds of alcohol and tobacco use. • No significant association was found between parent-child connectedness and marijuana use. Background Adolescent substance use is recognized as a global health crisis that threatens adolescents’ physical and mental health worldwide. Alcohol is the most available one; WHO findings suggest that more than 155 million adolescents, representing over a quarter of the adolescent population aged between 11 and 15, use alcohol-based drinks worldwide. Since adolescents are the future of the world, protecting them from substance use is of paramount importance. Objectives This study aimed to explore the prevalence of adolescent substance use (alcohol, marijuana, and tobacco) among Bhutanese adolescents and examine the association with parent-child connectedness as a protective factor while controlling sociodemographic, socio-emotional distress, and other contextual factors. Methods A total of 7576 school-going adolescents’ data from the 2016 Global School-based Student Health Survey (GSHS) Bhutan dataset were used in this study. To analyze the relationship between predictor and outcome variables, both univariate and multivariate binary logistic regression models were constructed utilizing the “complex samples” tool of SPSS 25. A significance level of p  ≤ 0.05 was used for the analyses. Results An estimated 30.7% of the Bhutanese school-going adolescents used tobacco, 25.8% consumed alcohol, and 12.7% used marijuana. Parent-child connectedness: (i) child’s homework supervision and (ii) child’s free time supervision by parents significantly lower the odds of using tobacco and alcohol consumption, while parents understanding child’s problem showed no significant association with substance use among the respondents. However, no significant association was found between parent-child connectedness and marijuana use. Besides parental connectedness, anxiety, bullying, passive smoking, school truancy, being involved in fights, or being attacked were also significantly associated with adolescents’ substance use. Conclusion Parental connectedness has been found to be an important factor that can lead to a substantive reduction in substance use among the adolescents of Bhutan. However, the lesson is pertinent for any global initiatives aiming to prevent the harmful use of substances among global adolescents.

Background Adolescence is a critical developmental stage in the life course, and loneliness during this period has been linked to various mental health issues, social challenges, and academic difficulties. Hence, the study aimed to identify gender- and spatial variations in loneliness and its correlates among in-school adolescents in three South Asian countries. Methods We analyzed data from 7,903 adolescents using the latest Global School-based Student Health Survey (GSHS) datasets from Afghanistan, Bangladesh, and Pakistan. Multiple logistic regression models, adjusted for socio-demographic variables, were conducted using STATA 14. Results The prevalence of loneliness among male respondents was 12.28% [95% CI: 11.3–13.3], and 18.1% [95% CI: 16.8–19.5] in females. The prevalence of loneliness was highest among Afghan adolescents (34.8%), followed by Pakistani (11.4%) and Bangladeshi adolescents (8.4%). For both genders (male and female), loneliness was higher among the adolescents who were school truants, bullied, involved in physical fights, and experienced physical attacks. In addition, both male and female adolescents with anxiety-induced sleep disturbance, current tobacco users, and suicidal ideation had significantly higher odds of loneliness than their counterparts. Moreover, several poor mental health conditions, such as anxiety-induced sleep disturbance, bullying, suicidal ideation, and suicide plan, were significantly associated with higher odds of loneliness among in-school adolescents in Afghanistan, Bangladesh, and Pakistan. Additionally, respondents who were involved in physical fights were more likely to report feeling lonely. Conclusion We identified gender and spatial variations in adolescent loneliness across three South Asian countries, highlighting the need for gender-sensitive and region-specific interventions. Policies should prioritize promoting inclusive environments and addressing cultural and resource-based challenges. To design targeted interventions, further research is needed to explore the socio-economic, environmental, and behavioral factors that influence loneliness.

Adequate and effective disaster preparedness in each sector is indispensable to abate disaster impacts and intensify disaster resilience in Bangladesh for achieving sustainable development goals by 2030. Though university students can play a significant role in promoting and strengthening disaster management activities in the community by sharing their knowledge and experience on disasters, very few studies focused on students' disaster preparedness. In this study, we assessed university students' perceived and actual disaster preparedness and explored the factors influencing disaster preparedness of male and female students. The cross-sectional survey method was adopted to collect 704 student respondents' data from the Dhaka University using a structured questionnaire by face-to-face interview. We found that university students perceived that they were moderately prepared for disaster; however, their actual disaster preparedness was relatively low. Disaster likelihood and disaster knowledge significantly influenced students’ perceived and actual disaster preparedness. However, no statistically significant mean differences were found between the male and female respondents regarding their perceived and actual disaster preparedness. In addition, students with higher disaster knowledge were more likely to have a higher perceived and actual disaster preparedness. Moreover, gender-segregated multiple linear regression analyses showed that disaster knowledge was significantly associated with the male students' actual and perceived preparedness, and female students' perceived preparedness. Besides, disaster concern and university preparedness were significant predictors of the female students' perceived preparedness, whereas male students' perceived preparedness was significantly influenced by disaster likelihood and university preparedness. Therefore, it is recommended that disaster education should be introduced into the university curricula, including disaster management training, drills, and simulations. The study provides strong evidence of the need for developing a comprehensive disaster plan at the university and has policy implications. However, further research is needed to explore college and school students' disaster preparedness knowledge and practice in Bangladesh.

Objectives This study aimed to evaluate the level of knowledge and practices related to menstrual hygiene among adolescent schoolgirls in a flood-affected rural area of Bangladesh and identify the factors influencing their menstrual hygiene knowledge and practices. Methods A cross-sectional study was conducted in northern Bangladesh between May 25 and June 1, 2023, involving 448 adolescent girls in the flood-affected region. Data was collected through a self-administered descriptive questionnaire. The collected data was entered and analyzed using SPSS 26.0 (IBM SPSS, Chicago, IL, USA). Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were used to determine significant variables through multivariate binary logistic regression models. Results The study found that more than half (69%) of the in-school adolescent girls had good knowledge about menstrual hygiene, while only one-fourth (28.6%) demonstrated good menstrual hygiene practices. Remarkably, only 1.6% of the girls disposed of their used sanitary napkins in dustbins. The results also indicated that girls aged 17 to 19 [AOR = 7.78, 95% CI: 1.83–32.99] and those from middle-class families [AOR = 0.51, 95% CI: 0.31–0.85] showed a significant positive association with menstrual hygiene knowledge. Additionally, the study revealed that the respondents’ mothers’ education level, particularly having secondary or higher education [AOR = 1.69, 95% CI: 1.04–2.77], was significantly associated with better menstrual hygiene practices. Conclusions The findings underscore the low level of menstrual hygiene practices among the respondents, emphasizing the urgent need for action. This highlights the urgency of enhancing awareness about the significance of adopting good menstrual hygiene practices. Therefore, it is imperative to incorporate menstrual hygiene knowledge and practices into school curricula and to organize meetings and sessions with schoolgirls’ parents, stressing the importance of community support in addressing this issue. Highlights ▪ A total of 448 adolescent schoolgirls’ data on menstrual hygiene knowledge and practices were collected from the flood-affected region in Bangladesh. ▪ 69% of adolescent girls had good knowledge about menstrual hygiene, while 28.6% demonstrated good practices. ▪ The respondents’ age was significantly associated with good menstrual hygiene knowledge. ▪ Mothers’ education level was significantly associated with better menstrual hygiene practices.

Hospitals’ medical surge preparedness or surge capacity preparedness plays a significant role in reducing mortalities and in the treatment of severe injuries in disasters and emergencies. Though actions or activities for surge capacity preparedness of hospitals are discussed in several studies, they remain fragmented and need to be compiled. This systematic review will provide a comprehensive synthesis of evidence of actions or steps taken to strengthen hospitals’ medical surge preparedness in disasters and emergencies, which will eventually help develop surge capacity programs and relevant policies. All the studies published in peer-reviewed journals between 1 January 2016 and 30 July 2022, with full text available, will be included in this review. Seven electronic databases—PubMed, Scopus, MEDLINE, CINAHL, Embase, PsycINFO, and Ovid—will be searched. Two reviewers will independently screen the titles and abstracts using the eligibility criteria, review full-text articles, and extract data with the help of CADIMA software. A third reviewer will help resolve any discrepancies during the whole process. The extracted data will be narratively synthesized with the key characteristics and findings of the studies. The NIH quality assessment tools will be used to scale up the the quality of the retrieved quantitative studies. Moreover, the mixed methods appraisal tool (MMAT) and Noyes et al. guidelines will be used to assess the mixed methods studies and qualitative studies quality assessment, respectively.

The co-occurring flood and coronavirus disease (COVID-19) increase the consequences for health and life. This study examined the strategies to manage the health consequences of the co-occurring flood and COVID-19, with a specific focus on these 2 challenges. This review included all the studies published in peer-reviewed journals between January 1980 and June 2021. Several electronic databases were searched, including Scopus, Web of Science, and PubMed. Mixed Methods Appraisal Tools (MMT), version 2018, assessed the articles retrieved through a comprehensive and systematic literature search. Descriptive and thematic analyses were carried out to derive strategies for managing the health consequences of the simultaneous flood and COVID-19. Among 4271 identified articles, 10 were eligible for inclusion. In total, 199 strategies were identified in this review for managing the multi-hazard health consequences of flooding and COVID-19, which were classified into 9 categories and 25 subcategories. The categories included policy making and decision making, coordination, risk communication, logistics, planning, preparedness measures, response measures, social and humanitarian support, and actions of local communities and non-governmental organizations. Managing a multi-hazard and reducing its health consequences requires various actions. Flood management must be needed, and flood-affected people and their health should be protected.

Trace metals contamination is ubiquitous in the riverine environments of Bangladesh. Trace metals contamination is increasing rapidly in Dhaleshwari River due to rapid urbanization and industrialization along the riverbank, especially after the establishment of the Tannery Industrial Estate at Savar in Dhaka District. As a result, aquatic ecosystems, including fish and prawn species of the river, are contaminated by various trace and toxic metals. We examined the concentrations of 10 trace metals (Cr, Fe, Zn, Mn, Co, Ni, Cu, As, Hg, and Pb) in 20 different fish and prawn species ( n  = 41) which are commonly found in the Dhaleshwari River using energy-dispersive X-ray fluorescence (EDXRF) method. The potential human health risks (noncarcinogenic and carcinogenic) of the trace metals were calculated by using Target Hazard Quotient (THQ), Hazard Index (HI), and Target Cancer Risk (TR) indices. The mean concentration (mg/kg; ww) of the trace metals in analyzed riverine fish and prawn species was in the order of Fe > Zn > Cu > Cr > Mn > Co > Hg > Ni > Pb > As. The highest concentration of Fe (74.67 mg/kg) and Cr (4.64 mg/kg) was found in Mystus bleekeri , whereas Zn (38.89 mg/kg) and Cu (17.47 mg/kg) were found in Rohtee cotio and Glossogobius guiris, respectively. The target hazard quotient (THQ) values were less than 1 (no detrimental health effects) for all the specific metals in most of the species except M. bleekeri (1.61), G. guiris (1.29), Corica soborna (1.28) for Cr, and Macrobrachium malcolmsonii (1.19) for Hg indicate that the noncarcinogenic health risk to humans by consuming those species was relatively low. However, nine out of twenty species found higher Hazard Index (HI) values than the recommended value (HI = 1), indicating that regular consumption of these fishes may have considerable harmful effects on human health. The highest HI value (2.85) was found in  M. bleekeri . Moreover, target cancer risk (TR) values showed that frequent intake of some species for prolonged periods might pose a carcinogenic risk due to Cr and Ni contamination as they were higher than the maximum accepted value of 10 −4 . Based on the present study, it is imperative to take an urgent initiative to control or prevent the trace metals contamination in the Dhaleshwari River and minimize the human health risks associated with the consumption of fish and prawn species in this river in Bangladesh.

The associations between digital media use and mental well-being among children and adolescents have been inconclusive. We examined (i) the associations between digital media use and mental health outcomes, anxiety, depression, and ADHD, (ii) whether family resilience and neighborhood factors attenuate the associations, and (iii) whether sleep mediates these associations. We used the National Survey of Children’s Health data from 2019 to 2020. A total of 45,989 children’s (6–17 years) data were analyzed in this study. Multivariate logistic regression was used to assess the associations between digital media use and anxiety, depression, and ADHD. Path models and Paramed command in STATA were used to test the role of sleep as a mediator of these associations. The prevalence of heavy digital media users (who spent 4 or more hours per day) among the analytic sample was 30.52%, whereas anxiety was 13.81%, depression was 5.93%, and ADHD was 12.41%. Children in the heavy media user group had 63% increased odds of anxiety (95% CI: 1.32–2.01) and 99% increased odds of depression (95% CI: 1.35–2.94) after adjusting for sociodemographic factors, compared to the children in light media user group (who spent < 2 h per day), and these relations were significant at 0.01 level. However, family resilience and community factors significantly attenuated the effect of digital media use on anxiety and depression. Sleep did not mediate the associations between digital media use and anxiety or depression.   Conclusions : Family resilience and neighborhood factors protect against the harmful effects of digital media use. Further research is needed to examine the relationships of media contents, the presence of electronic devices in bedrooms, and sleep quality with mental health. What is Known: • Spending long hours on digital media may adversely affect children and adolescents' health and development. However, the mediating role of sleep in the association between digital media use and mental health outcomes is inconclusive. What is New: • Digital media use has detrimental effects on anxiety and depression. However, family resilience and neighborhood factors attenuated the association. The study highlights the importance of positive family functioning and neighborhood conditions reducing the harmful effects of digital media use.

Heatwaves, characterized by prolonged high temperatures, have become a recurrent and severe phenomenon in Bangladesh, posing significant risks to public health, agriculture, and socioeconomic stability. This study analyzed the characterization and long-term projections of heatwave patterns in Bangladesh’s western and northwestern climatic zones, addressing a critical gap in understanding regional vulnerabilities to extreme temperature events. Heatwave thresholds were defined using the Bangladesh Meteorological Department Criterion, a percentile-based criterion, and the Indian Meteorological Department Criterion, providing a comprehensive framework for assessing heatwave intensity and frequency. Using nine bias-corrected general circulation models from CMIP6 (Coupled Model Intercomparison Project Phase 6), the study examined historical heatwave patterns (1990–2014) across five cities, Bogra, Chuadanga, Dinajpur, Ishwardi, and Rajshahi, and evaluated future projections for three epochs: Epoch 1 (2026–2050), Epoch 2 (2051–2075), and Epoch 3 (2076–2100). The findings revealed a significant increase in heatwave days under the high-emission Shared Socioeconomic Pathway 585 (SSP 585 ) scenario compared to SSP 245 , with SSP 585 projected to have 46.7% more heatwave days on average across the three epochs. The largest disparities are observed in Chuadanga (49.4%) and Rajshahi (44.5%), with Chuadanga emerging as the most vulnerable region, experiencing 1629 cumulative heatwave days under SSP 585 in Epoch 3 , compared to 1301 under SSP 245 —a 25.2% increase. These findings underscore the profound impact of human activities on heatwave frequency and emphasize the urgent need for climate change mitigation. By offering a novel approach to heatwave characterization, this study provides critical insights to inform regional climate resilience planning and develop targeted adaptation measures.