icddr,b (formerly known as the International Centre for Diarrhoeal Disease Research, Bangladesh) is an international health research organisation located in Dhaka, Bangladesh. Dedicated to saving lives through research and treatment, icddr,b addresses some of the most critical health concerns facing the world today, ranging from improving neonatal survival to HIV/AIDS. In collaboration with academic and research institutions over the world, icddr,b conducts research, training and extension activities, as well as programme-based activities, to develop and share knowledge for global lifesaving solutions. icddr,b is one of the leading research institutes of the Global South, releasing, according to the Thomson Reuters Web of Science, 18 percent of the Bangladesh's publications.icddr,b has a mix of national and international staff, including public health scientists, laboratory scientists, clinicians, nutritionists, epidemiologists, demographers, social and behavioural scientists, IT professionals, and experts in emerging and re-emerging infectious diseases, and vaccine sciences. icddr,b is supported by about 55 donor countries and organisations, including Sweden (SIDA), Canada, UK, Bangladesh, USA, UN specialised agencies, foundations, universities, research institutes and private sector organisations and companies that share the centre's concern for the health problems of developing countries and who value its proven experience in helping solve those problems. The centre is governed by a distinguished multinational Board of Trustees comprising 17 members from all over the world.
Bifidobacterium longum and B. infantis are pioneer colonizers of the neonatal gut and are widely used as probiotics to support infant growth, development, and disease resistance. However, commercial strains derived largely from high-income countries (HICs) may be suboptimal for infants in low- and middle-income countries (LMICs). We assembled a global genomic atlas of more than 4,000 genomes from 48 countries, increasing representation from LMICs by 12- to 17-fold. High-resolution phylogenomic and functional analyses support delineating B. longum and B. infantis as distinct species with divergent functions and epidemiological patterns. B. infantis dominates early-life microbiota in LMICs but is rarely detected in HICs. Natural B. infantis strains show extreme biogeographic stratification and predicted adaptations to local plant-glycan-rich diets and breast-milk-derived substrates, including urea and B vitamins. This genomic resource enables genome-guided selection of geographically matched strains to inform more effective probiotics and precision microbiome therapeutics for diverse infant populations.
BACKGROUND:Low-income and middle-income countries (LMICs) bear the greatest burden of respiratory syncytial virus (RSV) disease. WHO recommends passive immunisation to protect infants younger than 6 months and, in some strategies, infants up to age 12 months, but detailed age data are needed to determine optimal timing and impact. Our study estimates age distributions for the full range of RSV outcomes among children younger than 5 years in LMICs. METHODS:We conducted a systematic review and meta-analysis of RSV age distributions for seven health or health-care outcomes (hereafter, RSV outcomes): community cases, outpatient or clinic visits, emergency room visits, inpatient ward admissions, intensive care unit (ICU) admissions, facility deaths, and non-facility deaths. Inclusion required at least 30 laboratory-confirmed counts of RSV disease in children younger than 5 years, for a single RSV outcome from a single LMIC in the pre-COVID-19 decade (Jan 1, 2010, to Dec 31, 2019). We invited authors of included studies to share RSV counts by week or month of age. Using a Bayesian hierarchical model, we fitted parametric age distributions (by week for children <5 years) to each dataset, and derived pooled estimates of the mode, median, and mean age for each RSV outcome. The study was registered with PROSPERO (CRD42023435080). FINDINGS:We included 160 datasets with 131 124 RSV counts in children younger than 5 years. The mode (peak) age was 3 weeks (95% credible interval 1-6) for non-facility deaths (57% <6 months), 4 weeks (1-8) for facility deaths (57% <6 months), 7 weeks (6-8) for ICU admissions (60% <6 months), 17 weeks (14-19) for inpatient ward admissions (41% <6 months), 10 weeks (5-17) for emergency room visits (40% <6 months), 28 weeks (22-32) for outpatient or clinic visits (19% <6 months), and 22 weeks (17-28) for community cases (26% <6 months). Considering the most severe RSV outcomes, 20% of ICU admissions and 23% of facility deaths were in infants younger than 8 weeks. INTERPRETATION:Our findings reaffirm the importance of immunising the youngest infants who bear the greatest burden of severe RSV outcomes. Our estimates should allow more precise quantification of the potential impact of RSV prevention strategies across the full range of RSV disease severity in children younger than 5 years. FUNDING:WHO.
The seventh pandemic of cholera, caused by the seventh pandemic El Tor lineage of Vibrio cholerae, was previously shown to have emanated in three global waves from the Bay of Bengal, bordering Bangladesh and India1. However, the respective roles of the Ganges Delta and Basin regions in seeding these global pandemic waves were not known. Here we show that, although transmission events occur between Bangladesh and India, V. cholerae in the two countries has largely evolved separately over the past 20 years, apparently constrained by national borders rather than by hydrological features, such as the Ganges Delta and Basin. Evolution within Bangladesh was distinct from that seen in India, involving rapid gain and loss of genes and mobile genetic elements, particularly those involved in phage defence. The loss of these systems was associated with increased risk of severe disease and transmission outside Bangladesh. Lineage replacement in Bangladesh in 2018, resulting in a major change in phage defence systems, was accompanied by a rapid change in the lineage and anti-defence system of lytic phage ICP1. Here we show that the Ganges Basin, falling across Bangladesh and Northern India, rather than the Ganges Delta, probably acts as a global launch pad for pandemic disease. This shifts our understanding of Bangladesh as the purported global source of cholera and underscores the potential role of phage in controlling spread of lineages within the current seventh pandemic.
BACKGROUND:Poor sanitation and fecal sludge management contribute to fecal contamination in Dhaka's urban environment. An exposure assessment through ten environmental pathways was conducted using the SaniPathTM tool to understand the exposure to fecal contamination. METHODS:Data collection took place from 25/04/2017 to 30/01/2018 in ten neighborhoods: four low-income, four high-income, and two transient/floating neighborhoods. A total of 1000 environmental samples were analyzed using the IDEXX QuantiTray/2000 method with IDEXX-Colilert-24® media for the most probable number (MPN) of E. coli. Additionally, 823 household surveys, 28 community surveys, and 35 school surveys on exposure-related behaviors were conducted. Bayesian methods were used to estimate monthly E. coli exposure levels and population exposure percentages for each environmental pathway in the neighborhoods. RESULTS:Findings revealed that children (aged 5-12 years) in low-income and floating neighborhoods had more frequent contact with most environmental pathways (at least one contact per week or month), except surface water, compared to children in high-income neighborhoods. Dominant exposure pathways varied by neighborhood and socioeconomic status. Children experienced higher estimated monthly fecal exposure doses than adults, primarily through ingestion of contaminated municipal water (all community average = 59.2% of population exposed, either adults or children) and contact with open drains (52.3%) and surface waters (29.0%). Adults were mainly exposed via contaminated municipal water (54.2%), produce (87.0%), and street food (64.5%), which were frequently consumed. CONCLUSIONS:These results highlight substantial risks of fecal exposure across diverse urban settings in Dhaka. Integrated, multisectoral, and sustainable approaches are critical to reduce exposure and protect public health. Behavior change interventions targeting children and caregivers can further mitigate these risks and help ensure long-term public health improvements.
Diabetic foot complications represent one of the most severe consequences of diabetes mellitus, with substantial global prevalence of diabetic foot ulcers. In Bangladesh, a significant proportion of type 2 diabetes patients are at risk of diabetic foot ulcers, yet patients’ foot care knowledge and practice remain largely unsatisfactory. This study aimed to explore the effectiveness of a foot care education session among rural diabetic patients in Bangladesh. A single-group pre-post study design was employed to develop and apply a footcare education module among 51 patients with type 2 diabetes mellitus at Shailkupa Diabetic Hospital, Jhenaidah, Bangladesh, from August to December 2023. It included two sessions involving a slide presentation with video demonstrations, and hands-on practice with take-home booklets. Evaluation of the knowledge and practice score was done before and four weeks after the intervention. Knowledge was assessed using a validated 15-item questionnaire, while practice was evaluated using the 29-item Nottingham Assessment of Functional Foot Care (NAFF). Participants had a mean age of 52 (± 12) years (± SD), with 64.7
