Nazmul Alam
University of Alabama at Birmingham
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Publication
Featured researches published by Nazmul Alam.
BMC Public Health | 2010
Nazmul Alam; Eric Chamot; Sten H. Vermund; Kim Streatfield; Sibylle Kristensen
BackgroundThe feasibility and acceptability of partner notification (PN) for sexually transmitted infections (STIs) in developing countries was assessed through a comprehensive literature review, to help identify future intervention needs.MethodsThe Medline, Embase, and Google Scholar databases were searched to identify studies published between January 1995 and December 2007 on STI PN in developing countries. A systematic review of the research extracted information on: (1) willingness of index patients to notify partners; (2) the proportion of partners notified or referred; (3) client-reported barriers in notifying partners; (4) infrastructure barriers in notifying partners; and (5) PN approaches that were evaluated in developing countries.ResultsOut of 609 screened articles, 39 met our criteria. PN outcome varied widely and was implemented more often for spousal partners than for casual or commercial partners. Reported barriers included sociocultural factors such as stigma, fear of abuse for having an STI, and infrastructural factors related to the limited number of STD clinics, and trained providers and reliable diagnostic methods. Client-oriented counselling was found to be effective in improving partner referral outcomes.ConclusionsSTD clinics can improve PN with client-oriented counselling, which should help clients to overcome perceived barriers. The authors speculate that well-designed PN interventions to evaluate the impact on STI prevalence and incidence along with cost-effectiveness components will motivate policy makers in developing countries to allocate more resources towards STI management.
Archive | 2009
Quamrun Nahar; M. Shah Alam; Ezazul Islam Chowdhury; Tasnim Azim; Nazmul Alam; Rumana Saifi; Sharful Islam Khan; Elizabeth Oliveras; Masud Reza
This report synthesizes data from surveillance, behavioral surveys and published and unpublished research to better understand emerging patterns and trends in the HIV epidemic in Bangladesh. Taking stock of 20 years of experience with HIV in Bangladesh, this report summarizes what is known about the coverage and impact of HIV prevention services, including knowledge on risk and protective behaviors. The report is divided into nine chapters. Chapter one provides a brief introduction and an overview of the methodology used for this exercise. Chapter two discusses the risks and vulnerabilities of the high risk groups including female sex workers, injecting drug users, male who have sex with male, hijra and overlapping populations, while chapter three discusses the trend of the infection amongst partners of high risk groups. Bangladesh continues to report low condom use, which is analyzed and discussed in chapter four. Structural factors including macro level and intermediate level factors that affect HIV interventions in Bangladesh are addressed in chapter five. The national HIV response is discussed in chapter six. The report concludes with a discussion of the main findings, with recommendations for the future in chapter seven, and chapter eight and nine are annexes and references.
Sexually Transmitted Diseases | 2007
Nazmul Alam; Motiur Rahman; Kaniz Gausia; Yunus; Nazrul Islam; Parwez Chaudhury; Shirajum Monira; Ellen Funkhouser; Sten H. Vermund; Japhet Killewo
Objective: This study was conducted to determine the prevalence of selected sexually transmitted infections (STIs) and their risk factors among workers in and near a truck stand in Dhaka, Bangladesh. Study Design: A random sample of 696 men and 206 women were recruited into a cross-sectional study using a census that enumerated transport agents, motor mechanics, laborers, and vendors in Tejgaon truck stand. Results: The prevalence rates of syphilis (rapid plasma reagin and Treponema pallidum hemagglutination), gonorrhea (polymerase chain reaction [PCR]), and chlamydial infections (PCR) among men were 4.1%, 7.7%, and 2.3%, respectively, and among women were 2.9%, 8.3%, and 5.2%. Multivariable analysis revealed that having ≥2 sex partners in the last month, never using a condom with sex workers, and ever injecting narcotics were significant predictors of STI among men. Being never married, working as a laborer, older age, and living within the truck stand were significant predictors of practicing high-risk behaviors among men, but none predicted infection with STIs. Conclusions: Both behavioral and STI data suggest that truck stand workers should be included in the STI/HIV intervention programs.
Social Science & Medicine | 2010
Nazmul Alam; Peter Kim Streatfield; Sharful Islam Khan; Dalia Momtaz; Sibylle Kristensen; Sten H. Vermund
Understanding the demographic, behavioural and psychosocial factors associated with partner referral for patients with sexually transmitted infections (STIs) is important for designing appropriate intervention strategies. A survey was conducted among STI clients in three government and three non-governmental organization-operated clinics in Dhaka and Chittagong city in Bangladesh. Demographic and psychosocial information was collected using a questionnaire guided by the Attitude-Social Influence-Self Efficacy model. Partner referral data were collected by verification of referral cards when partners appeared at the clinics within one month of interviewing the STI clients. Of the 1339 clients interviewed, 81% accepted partner referral cards but only 32% actually referred their partners; 37% of these referrals were done by clients randomly assigned to a single counselling session vs. 27% by clients not assigned to a counselling session (pxa0<xa00.0001). Among psychosocial factors, partner referral intention was best predicted by attitudes and perceived social norms of the STI clients. Actual partner referral was significantly associated with intention to refer partner and attitudes of the index clients. Married clients were significantly more likely to refer their partners, and clients with low income were less likely to refer partners. Intervention programmes must address psychosocial and socio-economic issues to improve partner referral for STIs in Bangladesh.
Sexually Transmitted Infections | 2011
Nazmul Alam; Peter Kim Streatfield; Mohammad Shahidullah; Dipak Kumar Mitra; Sten H. Vermund; Sibylle Kristensen
Objectives This study evaluated the role of single session counselling on partner referral among index cases diagnosed as having sexually transmitted infections (STIs) in Bangladesh. Methods A quasirandomised trial was conducted in 1339 index cases with symptomatic STIs in 3 public and 3 non-government organisation operated clinics. Results Out of 1339 index cases, partner referral was achieved by 37% in the counselling group and 27% in the non-counselling group. Index cases in the counselling group and non-counselling group were similar in terms of condom use rates, STI symptoms and duration of disease. A quarter of the index cases reported having more than one sex partner in last 3 months, and 39% reported having commercial sex partners. Only 8% of the index cases reported using condoms during their last sex act. Partner referral rates were higher among index clients with higher age, higher income, those who attended NGO clinics, those who had only one partner and among those who had no commercial partners, but counselling had significantly positive impact in all of these subgroups. In multivariate analysis, the probability of partner referral was 1.3 times higher among index cases in the counselling group (prevalence ratio 1.3; 95% CI 1.1 to 1.6) as compared to index cases in the non-counselling group. Conclusions Patient-oriented single session counselling was found to have a modest but significant effect in increasing partner referral for STIs in Bangladesh, greater emphasis should be placed on examining further development and dissemination of partner referral counselling in STI care facilities.
Sexually Transmitted Diseases | 2012
Anisuddin Ahmed; Laura Reichenbach; Nazmul Alam
Background In Bangladesh, male clients (MCs) of female sex workers (FSWs) represent diverse occupational categories from different socioeconomic strata, and they are considered a bridging group to transmit sexually transmitted infections (STIs) to their spousal and nonspousal female partners. This study aimed to better understand sexual behaviors, STI symptoms, and care-seeking behaviors among MCs of FSWs in Bangladesh. Methods A cross-sectional study was conducted among MCs from November 2005 to July 2006 in 3 types of sex trade settings in Bangladesh. Of 1565 MCs included in this study, 531 were from brothels, 515 from hotels, and 519 from street-based settings. Results Among the MCs, 32.2% reported having had STI symptoms within the last 1 year before the interview and 81.5% sought care for those symptoms. Among those who reported symptoms, 44.5% received treatment from pharmacies, 37.4% received treatment from qualified medical professionals, 8.6%, received treatment from nongovernment organization clinics, and 7.8% went to herbal providers. Male clients who had only 1 to 4 years of schooling were 2.4 times more likely to have STI symptoms (adjusted odds ratio [OR], 2.4; 95% confidence interval [CI], 1.5–3.8) compared with the MCs having 10 or more years of schooling. The MCs who had sex with more than 3 nonmarital sexual partners in the last month were 2 times more likely to have STI symptoms (adjusted OR, 2.0; 95% CI, 1.4–2.8). The MCs who used condoms consistently in their non-marital sexual contacts were significantly less likely (adjusted OR, 0.4; 95% CI, 0.3–0.6) to have STI symptoms. Conclusions Reported risk behaviors, STI symptoms and care-seeking behavior suggest that MCs are a potential risk group for transmission of HIV and STIs. The study findings underscore the need to target HIV/STI prevention intervention for MCs, which are predominantly geared toward FSWs.
American Journal of Tropical Medicine and Hygiene | 2017
David M Silvestri; Meridith Blevins; Kenneth A. Wallston; Arfan R Afzal; Nazmul Alam; Ben Andrews; Miliard Derbew; Simran Kaur; Mwapatsa Mipando; Charles A Mkony; Philip Mwachaka; Nirju Ranjit; Sten H. Vermund
AbstractWe sought to identify independent, nonacademic predictors of medical and nursing student intent to migrate abroad or from rural to urban areas after graduation in low- and middle-income countries (LMIC). This was a cross-sectional survey of 3,199 first- and final-year medical and nursing students at 16 training institutions in eight LMIC. Questionnaires assessed demographics, career intentions, and preferences regarding selected career, location, and work-related attributes. Using principal component analysis, student preferences were reduced into four discrete categories of priorities: 1) work environment resources, 2) location livability, 3) altruistic job values, and 4) individualistic job values. Students preferences were scored in each category. Using students characteristics and priority scores, multivariable proportional odds models were used to derive independent predictors of intentions to emigrate for work outside the country, or to work in a rural area in their native country. Students prioritizing individualistic values more often planned international careers (adjusted odds ratio [aOR] = 1.44, 95% confidence interval [CI] = 1.16-1.78), whereas those prioritizing altruistic values preferred rural careers (aOR = 1.82, 95% CI = 1.50-2.21). Trainees prioritizing high-resource environments preferentially planned careers abroad (aOR = 1.38, 95% CI = 1.12-1.69) and were unlikely to seek rural work (aOR = 0.60, 95% CI = 0.49-0.73). Independent of their priorities, students with prolonged prior rural residence were unlikely to plan emigration (aOR = 0.67, 95% CI = 0.50-0.90) and were more likely to plan a rural career (aOR = 1.53, 95% CI = 1.16-2.03). We conclude that use of nonacademic attributes in medical and nursing admissions processes would likely increase retention in high-need rural areas and reduce emigration brain drain in LMIC.
Archive | 2012
Khandkar-Siddikur Rahman; Nazmul Alam; Nazrul Islam
Archive | 2012
Nazmul Alam; Nazrul Islam; Khandkar-Siddikur Rahman
World Bank Other Operational Studies | 2009
Tasnim Azim; Sharful Islam Khan; Quamrun Nahar; Masud Reza; Nazmul Alam; Rumana Saifi; M. Shah Alam; Ezazul Islam Chowdhury; Elizabeth Oliveras