Nazma Begum - Academia.edu (original) (raw)

Papers by Nazma Begum

Background: Many community-based programs promote birth and newborn care preparedness (BNCP) to i... more Background: Many community-based programs promote birth and newborn care preparedness (BNCP) to increase skilled attendance at delivery and to improve maternal and perinatal outcomes. However, evidence for birth and newborn care preparedness (BNCP) to enhance skilled care seeking at birth is scarce. Objective: To examine the association between birth preparedness and use of a skilled birth attendant in a rural Bangladesh. Methods: This analysis uses data from a community- based cluster randomized trial conducted during 2002-2006 in three rural sub-districts in Bangladesh. Female community health workers (CHWs) made home visits to promote BNCP and counseled pregnant women and their families on importance of maternal care and essential newborn care. They also counseled on four BNCP steps: 1) identifying a skilled or a trained delivery assistant, 2) identifying an immediate newborn care person, 3) arranging transport for emergency transfer, and 4) saving money for emergencies. Bivariat...

Bangladesh Journal of Infectious Diseases

Background: Encephalitis is an acute inflammatory process that affects brain tissue and is almost... more Background: Encephalitis is an acute inflammatory process that affects brain tissue and is almost always accompanied by inflammation of the adjacent meninges. The disease is most commonly caused by viral infection. Objective: The purpose of the present study was to determine the clinical and cerebrospinal fluid profile of childhood encephalitis and to document Herpes simplex antibody status in cerebrospinal fluid. Methodology: This descriptive analytical study was conducted in Department of Paediatrics of Shaheed Suhrawardy Medical College Hospital and Dhaka Medical College Hospital from May 2011 to October 2011. A total of 30 children of encephalitis were included in this study. Cerebrospinal fluid (CSF) routine and Herpes Simplex virus (HSV) antibody in CSF were done to all patient. Result: Fever and convulsion was found in 29(96.7%) and 28(93.3%) cases respectively in studied patients. Altered level of consciousness was present in 29(96.7%) cases. Fever, convulsion and altered le...

The Journal of Physical Chemistry B

PloS one, 2018

Reducing neonatal mortality rate (NMR) is a challenge in many low- and middle-income countries in... more Reducing neonatal mortality rate (NMR) is a challenge in many low- and middle-income countries including Bangladesh. In 2014, the estimated NMR in this country was 28 per 1,000 live births. This rate is higher in rural regions compared to the national average. Currently, Sylhet Division has the highest NMR in Bangladesh. Investigating rates and determinants of neonatal mortality in rural regions of this high-risk division is particularly important to implement evidence-based programs. This study examined rates and determinants of neonatal deaths in a large rural cohort in Sylhet Division. We analyzed data from a multi-country cohort study, Aetiology of Neonatal Infections in South Asia. From November 2011 to December 2013, this study was conducted in two rural sub-districts in Sylhet Division. Community health workers followed 28,960 pregnant women and their newborns up to two months postpartum and collected data on pregnancy outcomes and newborns' survival status. The NMR was o...

Journal of global health, 2018

Short birth intervals are associated with an increased risk of adverse perinatal outcomes. Howeve... more Short birth intervals are associated with an increased risk of adverse perinatal outcomes. However, reduction of rates of short birth intervals is challenging in low-resource settings where majority of the women deliver at home with limited access to family planning services immediately after delivery. This study examines the feasibility of integrating a post-partum family planning intervention package within a community-based maternal and newborn health intervention package, and evaluates the impact of integration on reduction of rates of short birth intervals and preterm births. In a quasi-experimental trial design, unions with an average population of about 25 000 and a first level health facility were allocated to an intervention arm (n = 4) to receive integrated post-partum family planning and maternal and newborn health (PPFP-MNH) interventions, or to a control arm (n = 4) to receive the MNH interventions only. Trained community health workers were the primary outreach service...

Journal of global health, 2017

The objective of the Alliance for Maternal and Newborn Health Improvement (AMANHI) gestational ag... more The objective of the Alliance for Maternal and Newborn Health Improvement (AMANHI) gestational age study is to develop and validate a programmatically feasible and simple approach to accurately assess gestational age of babies after they are born. The study will provide accurate, population-based rates of preterm birth in different settings and quantify the risks of neonatal mortality and morbidity by gestational age and birth weight in five South Asian and sub-Saharan African sites. This study used on-going population-based cohort studies to recruit pregnant women early in pregnancy (<20 weeks) for a dating ultrasound scan. Implementation is harmonised across sites in Ghana, Tanzania, Zambia, Bangladesh and Pakistan with uniform protocols and standard operating procedures. Women whose pregnancies are confirmed to be between 8 to 19 completed weeks of gestation are enrolled into the study. These women are followed up to collect socio-demographic and morbidity data during the preg...

Journal of Health Population and Nutrition

Excessive use of antibiotics for diarrhoea is a major contributing factor towards increasing rate... more Excessive use of antibiotics for diarrhoea is a major contributing factor towards increasing rates of antimicrobial resistance in developing countries. Zinc therapy for diarrhoea has been shown to be beneficial in controlled efficacy trials, and it is of interest to determine if availability of zinc syrup for treatment of diarrhoea would satisfy the demand for a 'medicine' for diarrhoea, thus reducing the use of antibiotics, without competing with the use of oral rehydration therapy (ORT). This community-based controlled trial was conducted from November 1998 to October 2000, and all children aged 3-59 months in the study area were included. In this trial, the availability of zinc supplements, along with ORT and appropriate education programmes, was associated with significantly higher use of ORT and lower use of antibiotics.

A community based cluster-randomized trial (known as Projahnmo study) was conducted in Sylhet, Ba... more A community based cluster-randomized trial (known as Projahnmo study) was conducted in Sylhet, Bangladesh during 2002 2006 to study the impact of an integrated community-based package of interventions on neonatal mortality and maternal health knowledge, behavior and practices. The study results demonstrated Community Health Workers (CHWs) successes as an effective agent to significantly increase coverage of essential primary health services as well as to improve critical maternal and child health caring behaviors leading to significant reduction in neonatal mortality in areas served by CHWs. After 3 years of completion of Projahnmo study, a household level survey was employed in 2009 with underlying research questions : to what extent individuals retain knowledge from community based behavior change interventions and whether individuals continue sustaining improved behaviors and practices as they were found in Projahnmo study results in 2006. The household survey was conducted in on...

Bangladesh Development Studies, 1991

Bangladesh Journal of Animal Science, 2012

In Bangladesh, livestock are affected by different types of helminth parasites of which amphistom... more In Bangladesh, livestock are affected by different types of helminth parasites of which amphistomiasis in cattle is known to be widespread and death may occur in some cases. An experiment was conducted to investigate the status of amphistomiasis in cattle, 64 visceral and 360 faecal samples were collected from different areas of Joypurhat district during May 2009 to April 2010. Faecal and visceral sample examinations showed 70.8% and 90.6% infection with amphistomiasis, respectively. It was observed that age had a significant influence on the prevalence of amphistomiasis. In faecal samples, higher prevalence was observed in adult cattle (84.9%) followed by the young (77.3%) and lowest in calf (16.7%). On the basis of examination of visceral sample, females (93.8%) were found to be significantly more infected than male (89.9%) with the amphistome. The prevalence of amphistomiasis in crossbred cattle (90.9% in faeces and 93.9% in viscera) was significantly higher than indigenous cattl...

Bangladesh Journal of Child Health, 2010

Introduction Neonatal haemochromatosis, also known as neonatal iron storage disease is a rare dis... more Introduction Neonatal haemochromatosis, also known as neonatal iron storage disease is a rare disease in which severe liver injury of foetal or perinatal onset is associated with massive intrahepatic and extra hepatic deposition of iron. Iron deposition typically affects the liver, salivary glands, heart, pancreas and thyroid but spares the reticuloendethelial system 1-5. It presents with acute liver failure around birth. Patients have features of liver failure with hypoalbuminemia, hypoglycemia, coagulopathy, low fibrinogen and frequently thrombocytopenia and anaemia. Ascites develops shortly after birth as does hyperbilirubinemia 2,5,6. The cause remains obscure, but it may develop secondary to abnormal fetoplacental iron handling or perinatal liver disease or be familial. There is an association with maternal lupus antibodies and with abnormal bile acid production 7. To date, no rate of this disease is reported. Studies suggest a genetic prevalence of 0.03-0.038 or a heterozygosity prevalence of 6-7%. No known sex or racial predilection 8. There is high recurrence rate within families. Transmission of disorder has been described as autosomal recessive, codominant and autosomal dominant with variable penetrance 9. The description of neonatal haemochromtosis in 50% of the siblings born to the same mother has led to the suggestion that the disease could be due to gonadal mosaicism for a dominant disorder or a mitochondrial defect rather than be an autosomal recessive, but exact precise pattern of inheritance is unknown 4,5. Neonatal haemochromatosis originally was described in 1957 and more than 100 cases have been reported 10. Because of rarity of problem in children, we find it of academic interest to report the case of neonatal haemochromtosis, who was admitted in paediatric gastroenterology and nutrition department of 1. Student MD-thesis part (Paediatric Gastroenterology),

Background: More than a quarter of early neonatal mortality in developing countries is attributab... more Background: More than a quarter of early neonatal mortality in developing countries is attributable to lack of perinatal care seeking. A better understanding of the barriers and challenges to appropriate care-seeking is critical to enhance care-seeking for neonates, particularly for preterm babies who are at higher risks of morbidity and mortality. Method: Prospective data from 30,944 live births, including 6,378 preterm babies, were collected during June 2007 -September 2009. Log binomial regression and multinomial logistic regression model were employed for data analysis. Results: Almost one-fifth (19.8%) preterm newborns sought care from outside home (6.2% from qualified providers and 13.6% from non-qualified providers), while preterm newborns without care seeking were found higher in proportion compared to babies born at term (80.2% vs. 78.7%). Homeopath practitioners were found as the most preferred health care provider (50.0%). Compared to males, female preterm babies were 8% ...

The Journal of nutrition, 2003

Given the high prevalence of micronutrient deficiencies and infectious diseases in infants in dev... more Given the high prevalence of micronutrient deficiencies and infectious diseases in infants in developing countries, an evaluation of the efficacy of different micronutrient formulations on infant morbidity is a priority. The efficacy of weekly supplementation of four different micronutrient formulations on diarrhea and acute lower respiratory infection (ALRI) morbidity was evaluated in Bangladeshi infants. In a double-blind, randomized, controlled community trial, 799 infants aged 6 mo were randomly assigned to one of the following 5 groups: 1) 20 mg elemental iron with 1 mg riboflavin, 2) 20 mg elemental zinc with 1 mg riboflavin, 3) 20 mg iron and 20 mg zinc with 1 mg riboflavin, 4) a micronutrient mix (MM) containing 20 mg iron, 20 mg zinc, 1 mg riboflavin along with other minerals and vitamins and 5) a control treatment, 1 mg riboflavin only. Health workers visited each infant weekly until age 12 mo to feed the supplement and to collect data on diarrhea and ALRI morbidity. Hemog...

Journal of health, population, and nutrition, 2004

Journal of Shaheed Suhrawardy Medical College, 2013

Coeliac disease is an autoimmune disorder that occurs in genetically predisposed people of all ag... more Coeliac disease is an autoimmune disorder that occurs in genetically predisposed people of all ages from middle infancy to onwards. It is a disease in which the mucosal lining of the small intestine is damaged in response to ingestion of gluten and similar proteins, which are found in wheat, oats, rye, barley and other grains. Symptoms include chronic diarrhoea, failure to thrive and fatigue; however these may be absent and symptoms in other organ systems have been reported. In this case report, a 6 year-old girl presented with recurrent diarrhoea with growth failure and itchy skin rashes. Physical examination showed that the patient was moderately pale and had generalized oedema with discrete erythematous, papular lesions over different parts of the body. Serum for tissue transglutaminase (IgA) antibody was raised. Duodenal biopsy was obtained and histopathological diagnosis was compatible with coeliac disease. The patient was treated with supportive management and was advised for life long gluten free diet. The patient improved within short period after withdrawal of gluten from diet. [

The Lancet, 2012

Background Up to half of neonatal deaths in high mortality settings are due to infections, many o... more Background Up to half of neonatal deaths in high mortality settings are due to infections, many of which can originate through the freshly cut umbilical cord stump. We aimed to assess the eff ectiveness of two cord-cleansing regimens with the promotion of dry cord care in the prevention of neonatal mortality. Design We did a community-based, parallel cluster-randomised trial in Sylhet, Bangladesh. We divided the study area into 133 clusters, which were randomly assigned to one of the two chlorhexidine cleansing regimens (single cleansing as soon as possible after birth; daily cleansing for 7 days after birth) or promotion of dry cord care. Randomisation was done by use of a computer-generated sequence, stratifi ed by cluster-specifi c participation in a previous trial. All livebirths were eligible; those visited within 7 days by a local female village health worker trained to deliver the cord care intervention were enrolled. We did not mask study workers and participants to the study interventions. Our primary outcome was neonatal mortality (within 28 days of birth) per 1000 livebirths, which we analysed on an intention-to-treat basis. This trial is registered with ClinicalTrials.gov, number NCT00434408. Results Between June, 2007, and September, 2009, we enrolled 29 760 newborn babies (10 329, 9423, and 10 008 in the multiple-cleansing, single-cleansing, and dry cord care groups, respectively). Neonatal mortality was lower in the single-cleansing group (22•5 per 1000 livebirths) than it was in the dry cord care group (28•3 per 1000 livebirths; relative risk [RR] 0•80 [95% CI] 0•65-0•98). Neonatal mortality in the multiple-cleansing group (26•6 per 1000 livebirths) was not statistically signifi cantly lower than it was in the dry cord care group (RR 0•94 [0•78-1•14]). Compared with the dry cord care group, we recorded a statistically signifi cant reduction in the occurrence of severe cord infection (redness with pus) in the multiple-cleansing group (risk per 1000 livebirths=4•2 vs risk per 1000 livebirths=1•2; RR 0•35 [0•15-0•81]) but not in the single-cleansing group (risk per 1000 livebirths=3•3; RR 0•77 [0•40-1•48]). Interpretation Chlorhexidine cleansing of a neonate's umbilical cord can save lives, but further studies are needed to establish the best frequency with which to deliver the intervention. Funding United States Agency for International Development and Save the Children's Saving Newborn Lives program, through a grant from the Bill & Melinda Gates Foundation. Dry cord care Single chlorhexidine cleansing Multiple chlorhexidine cleansing p value Coverage of cord intervention* Received seven interventions 8358 (84%) 7962 (85%) 8677 (84%) <0•0001 Received six interventions 394 (4%) 329 (4%) 449 (4%) <0•0001 Received fi ve interventions 372 (4%) 321 (3%) 369 (4%) <0•0001 Received four interventions 202 (2%) 171 (2%) 211 (2%) <0•0001 Received three interventions 193 (2%) 150 (2%) 146 (1%) <0•0001 Received two interventions 240 (2%) 193 (2%) 185 (2%) <0•0001 Received one intervention 236 (2%) 237 (3%) 189 (2%) <0•0001 Received no intervention 13 (<0•5%) 60 (1%) 103 (1%) <0•0001

Journal of Shaheed Suhrawardy Medical College, 2013

Breast feeding by sucking is the norm. However sometimes expression is the only way by which brea... more Breast feeding by sucking is the norm. However sometimes expression is the only way by which breast milk can be given to babies. There are many situations when expressing breast milk is useful and necessary to enable a mother to initiate or to continue breast feeding. Hand or breast pump are used to express breast milk. Hand expression is the most preferred method. There are some mechanical pumps though pumps cause discomfort and are usually ineffective. The Marmet technique of expressing breast milk with hand is a fabulous alternative to using a breast pump. Until recently hand expression of breast milk has been as underutilized skill. However, there are many benefits of knowing how to express milk from the breast without the use of expensive and cumbersome breast pumps. Expressed breast milk can be feed by spoon, cup and nasogastric tube. It is essential to collect and store breast milk properly to prevent the risk of bacterial overgrowth. Feeding with breast milk is quite safe if...

Tropical Medicine & International Health, 2009

Objectives-To validate trained community health workers' (CHWs') recognition of signs and symptom... more Objectives-To validate trained community health workers' (CHWs') recognition of signs and symptoms of newborn illnesses and classification of illnesses using a clinical algorithm during routine home visits in rural Bangladesh. Methods-Between August 2005 and May 2006, 288 newborns were assessed independently by a CHW and a study physician. Based on a 20-sign algorithm, sick neonates were classified as having very severe disease (VSD), possible very severe disease (PVSD) or no disease. Physician's assessment was considered as the gold standard. Results-CHWs correctly classified VSD in newborns with a sensitivity of 91%, specificity of 95%, and kappa value of 0.85 (p<0.001) indicating almost perfect agreement with physicians' classification of VSD. CHWs' recognition showed a sensitivity of more than 60% and a specificity of 97-100% for almost all signs and symptoms. Conclusion-CHWs with minimal training can use a diagnostic algorithm to identify severely ill newborns with high validity.

The Lancet, 2008

Background Guidelines on integrated management of childhood illness (IMCI) for severe pneumonia r... more Background Guidelines on integrated management of childhood illness (IMCI) for severe pneumonia recommend referral to hospitals. However, in many settings, children who are referred do not actually attend hospital, which severely limits appropriate care. We aimed to assess the safety and eff ectiveness of modifi ed guidelines that allowed most children with severe pneumonia to be treated locally in fi rst-level facilities, with referral only for those with danger signs or other severe classifi cations. Methods We did an observational cohort study in ten fi rst-level health facilities in Matlab, rural Bangladesh that had implemented IMCI guidelines. We assessed children with severe pneumonia who were aged between 2 and 59 months, and for whom we could obtain complete information, in two cohorts: 261 children who presented to these facilities between May, 2003, and April, 2004 (before implementation of the modifi ed guidelines) and 1271 children between September, 2004, and August, 2005 (after full implementation). We obtained information about the characteristics and management of their illness, including referrals and admissions to hospital, from facility records. Staff visited households to obtain details of treatment, socioeconomic information, and fi nal outcome, including mortality data. Findings 245 (94%) of 261 children who had severe pneumonia were referred to hospital before the guidelines were modifi ed, compared with 107 (8%) of 1271 after implementation (p<0•0001). 94 (36%) children with severe pneumonia received correct management before the guidelines were modifi ed, compared with 1145 (90%) children after implementation (p<0•0001). Before modifi cation of the guidelines, three children with severe pneumonia who presented at fi rst-level facilities died, with a case-fatality rate of 1•1%; after modifi cation, seven children died, with a case-fatality rate of 0•6% (p=0•39). Interpretation Local adaptation of the IMCI guidelines, with appropriate training and supervision, could allow safe and eff ective management of severe pneumonia, especially if compliance with referral is diffi cult because of geographic, fi nancial, or cultural barriers.

Bangladesh Journal of Infectious Diseases

The Journal of Physical Chemistry B

PloS one, 2018

Journal of global health, 2018

Journal of global health, 2017

Journal of Health Population and Nutrition

Bangladesh Development Studies, 1991

Bangladesh Journal of Animal Science, 2012

Bangladesh Journal of Child Health, 2010

The Journal of nutrition, 2003

Journal of health, population, and nutrition, 2004

Journal of Shaheed Suhrawardy Medical College, 2013

The Lancet, 2012

Journal of Shaheed Suhrawardy Medical College, 2013

Tropical Medicine & International Health, 2009

The Lancet, 2008