Kulanthayan K. C. Mani

Knowledge and awareness about STDs among women in Bangladesh.

BackgroundKnowledge and awareness concerning sexually transmitted diseases (STDs) has become the burning issue of the day. Although STDs pose serious risks to health security, there is very little literature quantifying the knowledge and awareness of these diseases and their principal socioeconomic determinants. The aim of this study is to determine the effect of different socio-economic and demographic factors on knowledge and awareness about STDs among women in Bangladesh.MethodsThis is a cross-sectional study using data from the Bangladesh Demographic and Health Survey (BDHS) 2011. It involves 10,996 women in six divisions of Bangladesh – Dhaka, Rajshahi, Chittagong, Barisal, Khulna and Sylhet. In this study, the percentage distribution and logistic regression model are used to identify which factors are associated with knowledge and awareness among women in Bangladesh about STDs.ResultsThere is a significant association between geographic division (Dhaka: OR = 1.669, 95% CI = 0.89-2.10, Khulna: OR = 2.234, 95% CI = 1.2-3.2); places of residence (Rural: OR = 0.363, 95% CI = 0.20-1.08), respondent’s age (20-29 years: OR = 1.331; 95% CI = 0.98-2.31); education (Primary: OR = 2.366, 95% CI = 1.98-3.1, secondary: OR = 10.089, 95% CI = 8.98-12.77, higher: OR = 20.241, 95% CI = 18.33-22.65); listening to radio (OR = 1.189, 95% CI = 1.29-3.12) and watching TV (OR = 2.498, 95% CI = 2.22-4.09) with knowledge and awareness among women in Bangladesh about STDs.ConclusionThere is a need to improve the education in Bangladesh about STDs particularly among those in the rural areas and older ages of women (30-49 years). Formal, informal and special educational knowledge and awareness programmes may be implemented to educate people concerning STDs in Rajshahi, Sylhet and Chittangong division. Campaigns and mass media can be used to increase the knowledge and awareness among the community, especially among women. Policies concerning the issue of STDs need to be improved and can be emphasized in collaboration with government agencies to ensure the success of these campaigns.

Prevalence and Determinants of the Gender Differentials Risk Factors of Child Deaths in Bangladesh: Evidence from the Bangladesh Demographic and Health Survey, 2011

Background The number of child deaths is a potential indicator to assess the health condition of a country, and represents a major health challenge in Bangladesh. Although the country has performed exceptionally well in decreasing the mortality rate among children under five over the last few decades, mortality still remains relatively high. The main objective of this study is to identify the prevalence and determinants of the risk factors of child mortality in Bangladesh. Methods The data were based on a cross-sectional study collected from the Bangladesh Demographic and Health Survey (BDHS), 2011. The women participants numbered 16,025 from seven divisions of Bangladesh – Rajshahi, Dhaka, Chittagong, Barisal, Khulna, Rangpur and Sylhet. The 𝟀2 test and logistic regression model were applied to determine the prevalence and factors associated with child deaths in Bangladesh. Results In 2011, the prevalence of child deaths in Bangladesh for boys and girls was 13.0% and 11.6%, respectively. The results showed that birth interval and birth order were the most important factors associated with child death risks; mothers’ education and socioeconomic status were also significant (males and females). The results also indicated that a higher birth order (7 & more) of child (OR=21.421 & 95%CI=16.879-27.186) with a short birth interval ≤ 2 years was more risky for child mortality, and lower birth order with longer birth interval >2 were significantly associated with child deaths. Other risk factors that affected child deaths in Bangladesh included young mothers of less than 25 years (mothers’ median age (26-36 years): OR=0.670, 95%CI=0.551-0.815), women without education compared to those with secondary and higher education (OR =0 .711 & .628, 95%CI=0.606-0.833 & 0.437-0.903), mothers who perceived their child body size to be larger than average and small size (OR= 1.525 & 1.068, 95%CI=1.221-1.905 & 0.913-1.249), and mothers who delivered their child by non-caesarean (OR= 1.687, 95%CI=1.253-2.272). Conclusion Community-based educational programs or awareness programs are required to reduce the child death in Bangladesh, especially for younger women should be increase the birth interval and decrease the birth order. The government should apply the strategies to enhance the socioeconomic conditions, especially in rural areas, increase the awareness program through media and expand schooling, particularly for girls.

Randomized controlled trial on drowning prevention for parents with children aged below five years in Bangladesh: a study protocol

BackgroundDrowning is the third leading cause of death for children aged 0–4 years in many Asian countries, and is a serious but neglected health problem in low and middle-income countries like Bangladesh. The aim of the study is to outline the study protocol of a trial to test the efficacy of a mobile coach based intervention for the prevention of childhood drowning.Method/designA two-arm cluster randomized community trial will be conducted to test the efficacy of the mobile coach intervention for childhood drowning on parents with children below five years of age and compared to an assessment only control group. A total of 1680 parents in the villages with children aged below five years of age will participate. The village will be used as a randomized unit, randomly assigned to an intervention group (N = 840) receiving the mobile coach based intervention or an assessment only control group (N = 840). An individualized mobile coach intervention based on the demographic data and the individual will be developed, and SMSs, audio messages, videos and images about childhood drowning will be sent to the participants of the intervention group over a period of six months. The participants will receive per week one text message (SMS) and image and one video and audio text per month. The primary outcome measure will be increased knowledge and safety awareness, and behaviour practice about childhood drowning assessed at the six-month follow-up, and the secondary outcome measure will be the reduced incidence of childhood drowning in Bangladesh. The study assistants conducting the baseline and the follow-up assessments will be blinded regarding the group assignment.DiscussionThis is the first study testing a fully mobile coach intervention for childhood drowning prevention in Bangladesh. It is hoped that the programme will offer an effective and inexpensive way to prevent childhood drowning among children aged below five years and also increase the awareness of parents concerning the risks to their children from drowning.Trial registrationISRCTN13774693, 08/03/2015.

Vibration exposure and work‐musculoskeletal disorders among traffic police riders in Malaysia: A review

Background: The traffic police force is one of the occupations that utilize motorcycles as the main mode of transport. The main ergonomic hazard with the constant use of motorcycles is exposure of riders to vibration while riding their motorcycles, which can potentially lead to work.related musculoskeletal disorders (WMSDs). Objective: This review is meant to provide an overview of the available vibration exposure with WMSDs for traffic police riders and to review the related guidelines. Method: This study involved comprehensive search of database from 1945 to 2015. Published research paper that reported on the vibration exposure, prevalence, and/or risk factors of WMSDs and occupational riders were assessed and reviewed. Result: The review suggests that the main factors involving vibration in motorcycles come from the motorcycles itself, the posture of the hands and arms during the gripping of the handlebars, the surrounding environment, and the period of riding motorcycles. Majority of the studies agreed that police riders had higher percentage of WMSDs especially in lower back, neck, and shoulder. Conclusion: Overall, police riders have a high incidence of WMSDs, which in combination with exposure to vibrations with prolonged sitting and static posture may increase their susceptibility to WMSDs. Further research is required to explore the level of exposure to vibrations and WMSDs among traffic police riders, its potentially consequences, and ways to reduce exposure and risk associated with vibrations and WMSDs.

The development of an intervention package to prevent children under five years old drowning in rural Bangladesh.

There are an estimated 372 000 worldwide deaths by drowning every year, and it has been described as a secret epidemic in Bangladesh. The aim of this study was to develop an intervention package to prevent children under the age of five from drowning in rural Bangladesh.

PW 2564 Implementation and dissemination of a smartphone application to prevent child injuries in malaysia

Unintentional injuries are a growing problem hindering progress towards the SDGs, especially among children in low- and middle-income countries (LMICs). Each year, approximately 8 75 000 children die of unintentional injuries and tens of millions more are hospitalized or disabled. Most childhood injuries occur within the home and can be prevented. Proven-effective interventions exist; however, scale up has been limited mainly due to insufficient resources. Thus, the problem of child injuries remains unaddressed. Mobile phones are increasingly recognized as a means of improving reach in low-resource settings. We developed and pilot-tested a smartphone application with the aim of reducing childhood injuries in Malaysia. This application presents an innovative, evidence-informed, and cost-effective strategy to deliver injury prevention interventions. However, there is minimal evidence on the effectiveness and implementation of smartphone applications, especially when scaled up within broader health systems. The aim of this study is to explore the implementation and dissemination of a smartphone application to prevent child injuries in Malaysia. We will conduct 15 in-depth interviews with decision-makers who are purposefully selected for their role in child health and safety interventions including program managers, health and day care providers, and community leaders. We will explore child health and safety interventions, perceptions on the use of smartphone applications, and strategies for dissemination. Transcripts will be uploaded to Nvivo 11 and thematic content analysis will be applied to identify relevant themes. From this study, we hope to gain an understanding of the implementation characteristics and dissemination strategies for a smartphone application to prevent child injuries in Malaysia. This knowledge will be used to inform a strategy for scale up as part of a future study, as well as contribute to the evidence base on the use of smartphone applications to deliver injury prevention and other interventions in low resource settings.

SM 03-2673 Assessing the effectiveness of intervention strategies to address home injuries among children in malaysia: a cluster randomized trial evaluation of evidence

Background Malaysia is facing an increasing burden of childhood injuries, not unlike many other low- and middle-income countries (LMICs). Across the globe, more than 95 percent of total child injury mortality occurs in LMICs. A considerable proportion of these injuries occur in and around the home. Effective approaches to prevention include home safety education, parenting education and home modification. Through this study, we aim to evaluate the effectiveness of two intervention strategies in reducing in-home hazards for unintentional injuries among children. Methods We conducted a prospective cluster randomized controlled trial (cRCT) to compare the effectiveness of an in-home safety tutorial program and an educational pamphlet intervention in reducing safety hazards to child injuries. The study randomized 39 clusters to two study arms (home safety tutorial vs educational pamphlet), with around 30 households per cluster. Our exposure and outcome were assessed using a household survey instrument with self-reported and observer-reported components. Results Our initial analysis is a comparison of overall safety scores across the baseline arm that found a mean safety score of 30 of a maximum possible 45 (translating to a mean percentage of 66.7%), with improvement on average in both intervention arms. The overall safety score mean for educational pamphlets was 32.3 with a mean percentage of 71.7%, and the corresponding numbers for the in-home tutorial were 31.8 and 71%. Discussion This study compares a labor-intensive and ‘active’ intervention, the in-home safety tutorial, with a more passive intervention through handing out educational pamphlets. In our preliminary findings from the cRCT, we see an improvement in the mean safety scores between baseline and follow-up measurement in both intervention arms; between the two intervention arms, the safety scores are comparable. We believe that educational pamphlets can be an effective intervention to reduce child injuries, with particular relevance to resource-constrained settings.

790 A randomised control trial study on biopsychosocial coaching intervention

Background Physical injury is one of the outcomes due to road traffic accidents. These survivors, who are left with temporary or permanent disability, may result in continuous restriction on their physical functioning which gives impact to their health related quality of life (HRQOL). The aim of this study was to evaluate the impact of a biopsychosocial intervention on HRQOL among road traffic accident survivors. Methods A randomised control trial study design was applied among 200 respondents who were equally divided into the intervention and control group. All respondents in both groups were required to answer SF36 questionnaire at baseline to determine their HRQOL status after accident. However only those in the intervention group were given coaching, which was delivered concurrent to usual care. The effectiveness of this intervention was measured after all respondents in both groups had finished intervention and usual care respectively-they were required to answer SF36 questionnaire once again. Results The follow up stage is still ongoing. However, the result will be ready at the time of this conference. Potential results are the mean of HRQOL will be reduced more significantly among those in the intervention group compare to those who are only receive usual care. Low self-esteem among these survivors will be improved as this intervention provides support to regain self-confidence that has lost due to the injury. Conclusions We are absolutely convinced that the module in this intervention is able to assist injured person to improve their emotional wellbeing. Therefore the combination of biopsychosocial coaching intervention with usual care is believed to give synergistic effect to the positive changes on HRQOL status.

405 Preventing home injuries among children in Malaysia: a cluster randomised controlled trial

Background Child injury at home has become a growing concern in developing countries. This project aims to evaluate the effectiveness of two intervention strategies—home-based safety tutorial program and educational pamphlet—to reduce in-home hazards for unintentional child injuries within the home in Malaysia. Methods We conducted a prospective cluster randomised controlled trial in Hulu Langat district, Malaysia. We randomised 59 clusters to two study arms (30 for tutorial and 29 for pamphlet) with 30 households per cluster. On an initial household visit, a baseline home safety hazard assessment was conducted, followed by the intervention and two follow-up visits at 2 and 4 months. The outcome measures are in-home hazards for child injuries, and incidence of child home injuries. Results The study enrolled 1170 households, with 13324 children 1–5 years of age. Overall, almost 40% (5061) of children experienced an injury at home in the 3 months preceding our initial visit. The three most common types of injuries reported were falls (86.2%), poisoning (2.9%), and animal bites (2.1%). The most common types of safety hazards for such injuries observed were having pedestal fan within reach of children in living/sleeping area (tutorial: 45% vs. pamphlet: 46%, p = 0.13), presence of open buckets of water (45% vs. 44%), and having lock of the bathroom door within reach of children (41% vs. 45%). Adjusting for socio-demographic factors at household level and caregiver characteristics, estimates of a generalised linear model fit showed that presence of open buckets of water significantly predicts child injuries (OR = 1.8, 95% CI: 1.4–2.4). Conclusions The study improves understanding of the burden of household injuries among children in a Malaysian district, and findings can guide intervention strategies for addressing home injuries among children. Materials and interventions developed in this study can be adapted to other settings.