Helal Uddin Ahmed

Mental disorders in Bangladesh: a systematic review

BackgroundMental disorders constitute a major public health problem globally with higher burden in low and middle-income countries. In Bangladesh, systematically-collected data on mental disorders are scarce and this leaves the extent of the problem not so well defined. We reviewed the literature on mental health disorders in Bangladesh to summarize the available data and identify evidence gaps.MethodsWe identified relevant literature on mental disorders within Bangladesh published between 1975 and October, 2013 through a systematic and comprehensive search. Relevant information from the selected articles was extracted and presented in tables.ResultsWe identified 32 articles which met our pre-defined eligibility criteria. The reported prevalence of mental disorders varied from 6.5 to 31.0% among adults and from 13.4 to 22.9% among children. Some awareness regarding mental health disorders exists at community level. There is a negative attitude towards treatment of those affected and treatment is not a priority in health care delivery. Mental health services are concentrated around tertiary care hospitals in big cities and absent in primary care.ConclusionsThe burden of mental disorders is high in Bangladesh, yet a largely unrecognized and under-researched area. To improve the mental health services in Bangladesh, further well-designed epidemiological and clinical research are needed.

Autism Barta — A smart device based automated autism screening tool for Bangladesh

Autism is a neurodevelopmental disorder which is not fully curable. However, early intervention can improve the condition of the children which requires early detection of autism. For this purpose, screening tools have been immensely used in developed countries. Whereas in developing countries, people are not getting such benefits. In this paper, a new automated approach, Autism Barta is proposed to screen autism in children using smart devices. The application integrates the questions of Bengali version of M-CHAT screening tool with pictorial representation. Therefore, parents can easily understand the interactive questions and use it effectively. The app will automatically screen autism in children, inform the user, store the responses in an online database and will suggest nearby Autism resource center for confirmation and intervention. It is expected that, this system will help to identify and streamline autism for improving the condition in developing countries like Bangladesh.

Suicide and depression in the World Health Organization South-East Asia Region: A systematic review.

Background Depression is the most common comorbid psychiatric disorder in people who die by suicide and 39% of global suicides occur in the World Health Organization (WHO) South-East Asia Region. The aim of this systematic review was to identify, for countries of this region, first the prevalence of depression among people who (i) die by, or (ii) attempt, suicide, and second, the proportion of people with depression who attempt or die by suicide. Methods PubMed, PsycINFO, EMBASE and Google Scholar were searched, together with five available national databases, for quantitative research papers published in English between 1956 and 4 September 2016 from the 11 countries of the WHO South-East Asia Region. Results The 19 articles that met the predefined eligibility criteria were from five countries: Bangladesh (1), India (12), Indonesia (1), Sri Lanka (3) and Thailand (2); no eligible papers from the remaining countries of the region were retrieved. Eight studies, from Bangladesh, India, Indonesia and Sri Lanka, reported the prevalence of depression among people who had died by suicide. The study settings varied, as did the proportion of depression recorded (6.9–51.7%), and the study sample sizes ranged from 27 to 372. Eight studies from India and one from Sri Lanka investigated depression among people who had attempted suicide. Using a range of screening and diagnostic tools, the reported prevalence of depression ranged between 22.0% and 59.7%. The study sample sizes ranged from 56 to 949. Only two articles were found, both from Thailand, that reported on suicide in people with depression. Conclusion Despite the high burden of mortality of suicide in the WHO South-East Asia Region, evidence on the relation between suicide and depression is scarce. There is a need to understand this phenomenon better, in order to inform suicide-prevention strategies in the region.

Quality of the Mental Health Information System in a Specialized Mental Hospital in Bangladesh

Introduction: A good quality Mental Health Information System (MHIS) is essential for the efficient planning and delivery of appropriate care services. Accurate, valid, reliable, complete, legible, timely and accessible data is a vital element to achieve this goal. Aim: This study aims to identify the limitations of the MHIS of the National Institute of Mental Health (NIMH), Bangladesh, by reviewing available data and make recommendations for improvement. Materials and methods: A facility-based cross-sectional study was conducted at NIMH from July to September 2016. Secondary data was collected from various hospital records and reports and was quantitatively analyzed to assess data quality and the MHIS. National quantitative and survey reports were also reviewed. Results: Routine data collected at the NIMH is of poor quality in terms of accuracy and validity, reliability, and completeness. Access to data and the data’s timeliness were also found to be sub-optimal. Various data collection formats were used for monthly and yearly reports at various time points, which has limited the scope of data analysis for further use. Conclusion: The quality of NIMH data is inadequate, thus limiting its usefulness and requiring effective measures for improvement.

Social and Family Determinants of Substance Abuse among the Patients of Two Hospitals in Bangladesh

Substance use related disorders are major concerns for Bangladesh due to the increasing burden on family, society and nation. Various family and social factors contribute to the development of these disorders. However, the relevant factors were yet to be explored in the Bangladesh from multiple sites study. This study aimed to attempt find out the Social and Family determinants of substance abuse. It was a cross sectional study where one hundred and one substance users were interviewed from two tertiary level hospitals in the Dhaka. Peer pressure and parental disputes were significant contributing factors for substance dependence and discussion about the adverse effect of the substance abuse in family had protective role. The study findings will help in planning the preventive program substance dependence.

Autism Express - a cloud based framework for autism screening, confirmation and intervention

Autism is a neurodevelopmental disorder that limits social, behavioral and communication skills of a child. Since early intervention can improve childs condition, early screening and diagnosis are necessary. Different tools were developed for screening, diagnosing and monitoring intervention. However, no tools have integrated all these steps and in developing countries, these discrete tools are not used due to lack of resources and expertise. Autism Express is an integrated cloud based framework that can perform screening, track diagnosis outcome, provide online parent counseling and monitor intervention progress automatically for 0–17 years old children. It includes a smart device based mobile application for autism screening. Then based on the outcome, the Virtual and Actual assessment processes confirm autism. For positive cases, it automatically activates parent counseling, connects resources and tracks intervention status for effective management. It is expected that the proposed system will bring positive changes in autism diagnosis, intervention and management processes especially in a resource limited setting and also raise awareness about it.