Anir Chowdhury | Brown University (original) (raw)

Papers by Anir Chowdhury

IT workers in countries such as Bangladesh will be able to make a living through online freelance... more IT workers in countries such as Bangladesh will be able to make a living through online freelancer marketplaces, writes Anir Chowdhur

BackgroundThe COVID-19 pandemic, that has resulted in millions of deaths and hundreds of millions... more BackgroundThe COVID-19 pandemic, that has resulted in millions of deaths and hundreds of millions of cases worldwide, continues to affect the lives, health and economy of various countries including Bangladesh. Despite the high proportion of asymptomatic cases and relatively low mortality, the virus’s spread had been a significant public health problem for densely populated Bangladesh. With the healthcare system at stress, understanding the disease dynamics in the unique Bangladesh context became essential to guide policy decisions.MethodsWith a goal to capture the COVID-19 disease dynamics, we developed two stochastic Agent-Based Models (ABMs) considering the key characteristics of COVID-19 in Bangladesh, which vastly differ from the developed countries. We have implemented our ABMs extending the popular (but often inadequate) SIR model, where the infected population is sub-divided into Asymptomatic, Mild Symptomatic and Severe Symptomatic populations. One crucial issue in Banglade...

BackgroundNon-pharmaceutical interventions (NPIs) used to limit SARS-CoV-2 transmission vary in t... more BackgroundNon-pharmaceutical interventions (NPIs) used to limit SARS-CoV-2 transmission vary in their feasibility, appropriateness and effectiveness in different contexts. In Bangladesh a national lockdown implemented in March 2020 exacerbated poverty and was untenable long-term, and a resurgence in 2021 warranted renewed NPIs.MethodsWe developed an SEIR model for Dhaka District, parameterised from literature values and calibrated to data from Bangladesh. We discussed scenarios and parameterisations with policymakers with the aid of an interactive app. These discussions guided modelling of lockdown and two post-lockdown measures considered feasible to deliver; symptoms-based household quarantining and compulsory mask-wearing. We examined how testing capacity affects case detection, and compared NPI scenarios on deaths, hospitalisations relative to capacity, working days lost, and cost-effectiveness.ResultsLockdowns alone were predicted to delay the first epidemic peak but could not ...

Limitations in laboratory diagnostic capacity and reporting delays have hampered efforts to mitig... more Limitations in laboratory diagnostic capacity and reporting delays have hampered efforts to mitigate and control the ongoing coronavirus disease 2019 (COVID-19) pandemic globally. To augment traditional lab and hospital-based surveillance, Bangladesh established a participatory surveillance system for the public to self-report symptoms consistent with COVID-19 through multiple channels. Here, we report on the use of this system, which received over 3 million responses within two months, for tracking the COVID-19 outbreak in Bangladesh. Although we observe considerable noise in the data and initial volatility in the use of the different reporting mechanisms, the self-reported syndromic data exhibits a strong association with lab-confirmed cases at a local scale. Moreover, the syndromic data also suggests an earlier spread of the outbreak across Bangladesh than is evident from the confirmed case counts, consistent with predicted spread of the outbreak based on population mobility data...

Developing countries are often notorious for their inefficient public service delivery. However, ... more Developing countries are often notorious for their inefficient public service delivery. However, the Bangladeshi government is seeking to vastly improve the citizen experience of government services through empathy-led innovation, write Anir Chowdhury and Nick Beresford. This involves arranging for civil servants to act as secret shoppers to identify weaknesses and come up with solutions, often using new technologies.

Background New data streams are being used to track the pandemic of SARS-CoV-2, including genomic... more Background New data streams are being used to track the pandemic of SARS-CoV-2, including genomic data which provides insights into patterns of importation and spatial spread of the virus, as well as population mobility data obtained from mobile phones. Here, we analyse the emergence and outbreak trajectory of SARS-CoV-2 in Bangladesh using these new data streams, and identify mass population movements as a key early event driving the ongoing epidemic. Methods We sequenced complete genomes of 67 SARS-CoV-2 samples (March-July 2020) and combined this dataset with 324 genomes from Bangladesh. For phylogenetic context, we also used 68,000 GISAID genomes collected globally. We paired this genomic data with population mobility information from Facebook and three mobile phone operators. Findings The majority (85%) of the Bangladeshi sequenced isolates fall into either pangolin lineage B.1.36 (8%), B.1.1 (19%) or B.1.1.25 (58%). Bayesian time-scaled phylogenetic analysis predicted SARS-COV...

A dramatic resurgence of COVID-19 cases and deaths in Bangladesh in March 2021 coincided with the... more A dramatic resurgence of COVID-19 cases and deaths in Bangladesh in March 2021 coincided with the SARS-CoV-2 B.1.351 (501Y.V2) variant of concern rapidly becoming the dominant circulating variant. Concurrently, increasing numbers of reinfections have been detected and the effective Reproductive number, Rt, has doubled, despite high levels of prior infection in Dhaka city. These data support the prediction that acquired immunity from past infection provides reduced protection against B.1.351, and highlights the major public health concern posed by immune escape variants, especially in populations where vaccination coverage remains low.

Nature Microbiology

Genomics, combined with population mobility data, used to map importation and spatial spread of S... more Genomics, combined with population mobility data, used to map importation and spatial spread of SARS-CoV-2 in high-income countries has enabled the implementation of local control measures. Here, to track the spread of SARS-CoV-2 lineages in Bangladesh at the national level, we analysed outbreak trajectory and variant emergence using genomics, Facebook ‘Data for Good’ and data from three mobile phone operators. We sequenced the complete genomes of 67 SARS-CoV-2 samples (collected by the IEDCR in Bangladesh between March and July 2020) and combined these data with 324 publicly available Global Initiative on Sharing All Influenza Data (GISAID) SARS-CoV-2 genomes from Bangladesh at that time. We found that most (85%) of the sequenced isolates were Pango lineage B.1.1.25 (58%), B.1.1 (19%) or B.1.36 (8%) in early-mid 2020. Bayesian time-scaled phylogenetic analysis predicted that SARS-CoV-2 first emerged during mid-February in Bangladesh, from abroad, with the first case of coronavirus ...

Health Research Policy and Systems, Dec 1, 2015

Background: National level policymaking and implementation includes multiple stakeholders with va... more Background: National level policymaking and implementation includes multiple stakeholders with varied interests and priorities. Multi-stakeholder dialogues (MSDs) can facilitate consensus building through collective identification of challenges, recognition of shared goals and interests, and creation of solution pathways. This can shape joint planning and implementation for long-term efficiency in health and other sectors. Scaling up the effective use of information and communication technologies (ICTs) requires cohesive strategic planning towards a shared goal. In Bangladesh, the government and partners convened an MSD in March 2015 to increase stakeholder engagement in policymaking and implementation of a national ICT or electronic or mobile health (eHealth or mHealth) strategy, which seeks to incorporate ICTs into the national health system, aligning with the Digital Bangladesh Vision 2021. Methods: Relevant stakeholders were identified and key priorities and challenges were mapped through key informant interviews. An MSD was conducted with key stakeholders in Dhaka, Bangladesh. The MSD included presentations, group option generation, agreement and prioritization of barriers to scaling up ICTs. Results: The MSD approach to building consensus on key priorities highlights the value of dialogue and collaboration with relevant stakeholders to encourage country ownership of nationwide efforts such as ICT scale-up. This MSD showed the dynamic context in which stakeholders operate, including those from academia, donors and foundations, healthcare professionals, associations, multilateral organizations, non-governmental organizations, partner countries and the private sector. Through this MSD, participants improved understanding of each other's contributions and interests, identified existing relationships, and agreed on policy and implementation gaps that needed to be filled. Collaboration among stakeholders in ICT efforts and research can promote a cohesive approach to scaling up, as well as improve policymaking by integrating interests and feedback of different key cross sectoral actors. Conclusion: MSDs can align stakeholders to identify challenges and solution pathways, and lead to coordinated action and accountability for resources and results. In addition, the MSD template and approach has been useful to guide ICT scale up in Bangladesh and could be replicated in other contexts to facilitate multi-constituency, multi-sector collaboration.

Bulletin of the World Health Organization, Jul 23, 2019

Lessons from the field 637 Problem Bangladesh has no national system for registering deaths and d... more Lessons from the field 637 Problem Bangladesh has no national system for registering deaths and determining their causes. As a result, policy-makers lack reliable and complete data to inform public health decisions. Approach In 2016, the government of Bangladesh introduced a pilot project to strengthen the civil registration and vital statistics system and generate cause of death data in Kaliganj Upazila. Community-based health workers were trained to notify births and deaths to the civil registrar, and to conduct verbal autopsy interviews with family members of a deceased person. International experts in cause-of-death certification and coding trained master trainers on how to complete the international medical certificate of cause of death. These trainers then trained physicians and coders. Local setting Kaliganj Upazila has an estimated population of 304 600, and 5600 births and 1550 deaths annually. Health assistants and family welfare assistants make regular visits to households to track certain health outcomes. Relevant changes Following the start of the project in 2016, the number of births registered within 45 days rose from 873 to 4630 in 2018. The number of deaths registered within 45 days increased from 458 to 1404. During this period, health assistants conducted 7837 verbal autopsy interviews. Between January 2017 and December 2018, 105 master trainers and more than 7000 physicians were trained to complete the international medical certificate of cause of death and they completed more than 12 000 certificates. Lessons learnt Training community-based health workers, physicians and coders were successful approaches to improve death registration completeness and availability of cause-of-death data.

Economic and political weekly

Software teams are invariably bound by a set of constraints when designing and coding complex sof... more Software teams are invariably bound by a set of constraints when designing and coding complex software systems. Constraints are imposed on a system's design and imple-mentation to ensure that the product is reliable, readable, maintainable and portable. Unfortunately, because ...

Nature Microbiology

Health Research Policy and Systems, Dec 1, 2015

Bulletin of the World Health Organization, Jul 23, 2019

Economic and political weekly