Nazrul Hoque

Factors Associated with Misconceptions about HIV Transmission among Ever-Married Women in Bangladesh

The human immunodeficiency virus (HIV) epidemic continues to be associated with misconceptions and misinformed opinions, which increase the risk of HIV transmission. Therefore, the present study aimed to identify the determinant factors among different socioeconomic and demographic factors affecting misconceptions about HIV transmission among ever-married women in Bangladesh. Data and necessary information of 9,272 ever-married women were extracted from the Bangladesh Demographic and Health Survey 2011. Three types of misconceptions were considered. Both bivariate and multivariate analyses were used as the statistical tools to determine the factors affecting misconceptions about HIV transmission. The results revealed that misconceptions are more prevalent among women who are older, less educated, have husbands who are less educated, live in rural areas, have poor economic conditions, and have less access to mass media. The respondents age, education, husbands education, place of residence, wealth index, and exposure to mass media are significantly associated with the misconceptions. Finally, logistic regression analysis identified age, education, place of residence, wealth index, and exposure to mass media as significant predictors. Because socioeconomic factors are the key determinants of misconceptions about HIV transmission, intervention programs should be aimed at HIV prevention via education and awareness programs to reduce misconceptions as important parts of the prevention strategy.

Evaluation of small area population estimates produced by Housing Unit, Ratio-correlation and Component Method II compared to 2000 Census counts

This paper evaluates small area population estimates produced by the Housing Unit Method, Ratio-correlation Method, Component Method II, and the average of all three methods compared to the 2000 Census counts for the 254 counties and 1,279 places in Texas. This evaluation of three estimation methods shows the expected patterns of error by population size and population change. Of the three methods tested, no single method produced more accurate estimates than the average of two or three methods. The assessment of the accuracy of the place-level estimates show substantially higher levels of errors than those found for counties .

Are some women more at risk of obstetric fistula in Uganda? Evidence from the Uganda Demographic and Health Survey

With only four years left for the Millennium Development Goals 2015 deadline for reducing poor maternal health outcomes, developing countries are still bearing a huge burden of maternal morbidity worldwide. Estimates show that over 2 million women worldwide are suffering from obstetric fistula, the majority of which live in sub-Saharan Africa, Southeast Asia, and the Arab region. The purpose of this study is to shed a light on obstetric fistula by examining risk factors associated with this morbidity in Uganda. Descriptive and multivariate analyses were conducted using data from the 2006 Uganda Demographic and Health Survey. Older age at first sexual intercourse was significantly associated with a lower risk of obstetric fistula (OR=0.302) compared to younger age at first intercourse (7–14 years). Lack of autonomy was negatively associated with the risk of obstetric fistula; women who have problems securing permission from their husband to go seek care (OR=1.658) were more likely to suffer from this morbidity. Significant differentials in obstetric fistula have also been observed based on the region of residence: women living in Central (OR=4.923), East Central (OR=3.603), West Nile (OR=2.049), and Southwest (1.846) more likely to suffer from obstetric fistula than women living in North Central. Findings demonstrate the importance of improving geographical accessibility to maternal health care services, and emphasize the need to reinforce intervention programs, which seek to address gender inequalities.

Can an active aging index (AAI) provide insight into reducing elder abuse? A case study in Rajshahi District, Bangladesh.

We use data from respondents aged 60 years and above, collected during April 2009 in the Rajshahi district of Bangladesh, to examine whether high activeness, as captured by an AAI or in sub-domains, can help reduce the risk of elder abuse. The findings suggest that more than half of rural elderly and 14 percent of urban elderly were at some point abused. High activeness in health and security dimensions lowers the risk of being abused while those who are low active in community participation have the lowest risk of being abused in both rural and urban areas. Being literate (elderly with primary/secondary education) is revealed to be a significant factor that lowers the risk of abuse in both rural and urban areas. These results imply a need for educational programs that bolster positive and proper community interaction, in turn promoting a secure later life for elders, and reducing burden for families and society. High activeness in health and security dimensions should also be promoted to keep the elderly healthy and protect from abusive behavior.

Risky sexual behaviors and HIV vulnerability of male migrant workers in Rajshahi City, Bangladesh.

Background: Human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) presents a serious healthcare threat to young individuals in Bangladesh and worldwide. This study aimed at to explore the risky sexual behaviors and HIV vulnerability of male migrant workers in Rajshahi City, Bangladesh. Methods: Data and necessary information were collected from a random sample of 200 male migrant workers living in Rajshahi City, Bangladesh. To analyze the data, both bivariate and multivariate analyses were used as the statistical tools. Results: The results confirmed that migrant workers are more likely to be engaged in risky sexual relationships which increased the risk of HIV infection. The determinants, educational status, watching adult movies or pornographic materials, smoking habit and taking illegal drugs have shown significant effects on the likelihood of engaging in risky sexual behaviors. The respondents know that HIV/AIDS causes sure deaths. It does significantly reduce the likelihood of engaging in risky sexual behaviors and it does not completely mediate the effects of viewing pornographic materials, smoking, consuming illegal drugs and being illiterate. Conclusions: The hypothesis supports that the migrant workers are more engaged in risky sexual behaviors. More research is needed in this area. There is an urgent need for a comprehensive program to prevent the migrant workers from risky sexual behaviors as well as HIV infections.

Active Aging Index and Healthy Life Expectancy in Rajshahi District of Bangladesh

The increase in life expectancy in Bangladesh during the twentieth century has been a remarkable achievement. The average life expectancy at birth has increased from about 40 years in 1960 to 66 years in 2010. However, we do not know whether the increase in life expectancy is keeping pace with the healthy life expectancy in Bangladesh. Advancing age may be associated with a higher likelihood of disability. Studies on health dynamics cite significant evidence of recovery from disability among older people in developed countries, but there is no clear picture of recovery in developing countries. In Japan approximately 30 % of older people who were in a state of disability in 1987 regained their functional ability during the following 3 years (Liu et al. 1995). Among older Americans, 20 % reported recovery from a disability during a 2 year period (Rogers et al. 1990), although these levels should not be compared given the differences in measures and time frames. A host of socioeconomic and environmental factors were found to explain health recovery including age, participation in organizational activities, social support, and self-rated health. The authors are trying to introduce the concept of active aging in connection with healthy life expectancy (HLE), which is a relatively new concept in Bangladesh. This active aging might be a good step toward suppressing morbidity while allowing individuals to enjoy more disability-free life; efforts will additionally help individuals as well as the nation to reduce medical costs for the elderly. Little is known on the levels of active aging, as its differentials vary across socioeconomic levels, demographic settings, and functional health transition patterns among older people in Bangladesh. Active aging can be applied to both individuals and population groups. It allows people to realize their potential for physical, social, and mental well being throughout their lives and to participate in society according to their needs, desires, and capacities, while providing them with adequate protection, security, and care when they require assistance (WHO 2002). According to WHO (2002), if aging is to be a positive experience, longer life must be accompanied by continuing opportunities for health, participation, and security. Older people who retire from work and those who are ill or live with disabilities can remain active contributors to their families, peers, communities, and nations. Active aging aims to extend healthy life expectancy and quality of life for all people as they age, including those who are frail, disabled, and in need of care (WHO 2002), but there are no statistics about the relationship between active aging and healthy life expectancy, which is a critical enquiry. It is also therefore said that individuals should be aware and should prepare themselves in order to maintain health, independence, and security and produce some benefits for society (WHO 2002; Thanakwang and Soonthorndhada 2006).

The Rural-Urban Gradient and Life Expectancy in the United States, 1970–1990

Life expectancy is arguably the single most important indicator of the general health of a population (Lamb and Siegel 2004) and it has long been documented that variations in life expectancy exist among the broad geographic divisions within the United States, as well as among individual states (Dublin et al. 1949; Glover 1921; James and Cossman 2006; Oosse 2003). However, until the work of Swanson and Stockwell (1986), virtually nothing was known about sub-state variations. Using regression analysis, Swanson and Stockwell (1986) examined life expectancy in 1930 and 1980 in Ohio and found that while differences narrowed between 1930 and 1980, significant geographic variations in life expectancy persisted. Subsequent work by Swanson et al. (2009) found significant variations for the U.S. as a whole.

The Implications of Aging and Diversification of Population on Overweight and Obesity and the Cost Associated with Overweight and Obesity in Texas, 2000–2040

Overweight and obesity are major health concerns in contemporary America. The percentage of the population that is considered overweight and obese has increased substantially over the past years for both adults and children. Approximately 133.6 million American adults, or 66.0 % of all adults, are either overweight or obese (NIH 2004). Obesity rates have more than doubled since 1990, increasing from 11.6 % in 1990 to 26.3 % in 2007 (CDC 1991, 2007). This increase is of substantial concern because of the health risks associated with overweight and obesity. Overweight and obesity are related to increased risk for heart disease, type 2 diabetes, and a number of other diseases (Wolk et al. 2001; Calle et al. 2003). Approximately 300,000–400,000 deaths each year in the United States are attributable to overweight and obesity status (Allison et al. 1999; Obesity in America 2004).

Determinants of Blood Pressure Control in Hypertensive Diabetic Patients in Rajshahi District of Bangladesh

Hypertension (HTN), also known as high blood pressure (HBP), is one of the most common chronic health conditions prevalent in most of the developed countries. Approximately 1 in 3 or 73 million adults in the United States has HBP. Many people suffer from HTN in the developing countries as well. Blood pressure is essential to move blood from the heart through veins and arteries to all other parts of the body. However, when the pressure is too high, it becomes dangerous, making the heart work harder and increasing the risk for heart problems, such as heart attacks and strokes. Many diabetic patients develop HTN, which increases the potential risk for various problems including kidney disease, diabetes mellitus, renal disease, blindness, and many other deadly diseases. No specific cause for HTN is found in 95 % of the cases but it is an extremely common co-morbid condition in diabetes, affecting 20–60 % of patients with diabetes, depending on obesity, ethnicity, and age (ADA 2004). Although diabetes mellitus and HTN are not among the top leading causes of deaths, such as cancer and stroke, public attention is increasing as their occurrence increases. Diabetes has been ranked the sixth leading cause of death and is also known as costly disease (ADA 2004). Coronary heart disease (CHD) is projected to be the most common cause of death globally by 2020 (Yusuf et al. 2001). HTN is one of the most important modifiable risk factors for CHD in Western and Asian populations (He and Whelton 1999). Studies from India and Bangladesh have shown an increasing trend in the prevalence of HTN (HTN Study Group 2001). The prevalence of diabetes mellitus and HTN increases with age (Moon et al. 2002). It is estimated that more than 220 million people worldwide have diabetes and the number is likely to more than double by 2030 without any intervention, with 80 % residing in low and middle income countries. Almost 80 % of diabetes deaths occur in low and middle-income countries (Wild et al. 2004). Diabetes increases the risk of coronary events twofold in men and fourfold in women. Hypertensive diabetes patients have approximately twice the risk of cardiovascular disease compared with hypertensive non-diabetic patients. Hypertensive diabetic patients are also at increased risk for diabetes-specific complications including retinopathy and nephropathy along with kidney diseases, diabetic leg ulcers, sexual dysfunction, and sterility.

The impact of future demographic change on overweight and obesity, and the economic cost associated with this phenomenon, in Georgia (USA), 2000-2040

This paper examines the impact of future demographic changes on overweight and obesity, and the cost associated with overweight and obesity in Georgia, a rapidly growing and diversifying U.S. state. The number of overweight and obese adults is projected to increase from 3.7 million in 2000 to 10.2 million in 2040, an increase of 178.6 per cent. The annual costs associated with overweight and obesity is projected to increase from