[This retracts the article DOI: 10.1016/j.heliyon.2023.e13162.].

Introduction Optimising the micronutrient status of women before and during reproduction confers benefits to them and their offspring. Antenatal multiple micronutrient supplements (MMS), given as a daily tablet with nutrients at ~1 recommended dietary allowance (RDA) or adequate intake (AI) reduces adverse birth outcomes. However, at this dosage, MMS may not fully address micronutrient deficiencies in settings with chronically inadequate diets and infection. A bioefficacy study to determine amounts required to attain nutrient adequacy among women of reproductive age (WRA) and pregnant women (PW) aims to address this gap.Methods and analysis Two, four-arm, dose-response trials (n=240 participants/trial) with a double-blind, individually randomised, controlled design are underway in 18–35 year-old WRA and PW in rural northern Bangladesh. The trials will test dose response to four levels of 19 micronutrients from 1 RDA/AI up to ~75% of the tolerable upper intake level (UL), where applicable. These levels of micronutrients are delivered in the form of a reconstituted (in water) powdered drink, daily, including a placebo drink in the control arm, plus a fortified, balanced energy and protein (BEP) food product containing each micronutrient at ~1 RDA per serving. The supplement duration is 3 months in WRA and~6 months (until birth) in PW, who are enrolled at 12–16 weeks of pregnancy; women are randomised to one of the four arms at enrolment. Supplement consumption is directly observed by study staff and weekly side effects and adverse events are monitored. Blood and urine are collected at baseline, a midpoint, and at/near the end of supplementation, with a birth visit and postpartum biospecimen collection (post supplementation) for PW. Outcomes are biomarkers of nutrient status. Pharmacokinetic modelling will estimate micronutrient intakes at which sufficiency for each nutrient without excess is achieved. Enrolment was initiated on 22 October 2023.Ethics and dissemination The study was approved by the Institutional Review Board of Johns Hopkins Bloomberg School of Public Health and the research and ethical review committees of icddr,b, Bangladesh. A data safety and monitoring board is in place for the study. Findings will be disseminated in peer-reviewed papers and in-country meetings.Trial registration number NCT06081114Cite Now

Background: Vaccination has played a crucial role in mitigating the spread of COVID-19 and reducing its severe outcomes. While over 90% of Bangladesh’s population has received at least one COVID-19 vaccine dose, the comparative effectiveness of homologous versus heterologous booster strategies, along with the complex interplay of factors within the population, remains understudied. This study aimed to compare antibody responses between these booster approaches. Methods: This cross-sectional study enrolled 723 adults in urban Dhaka who had received COVID-19 booster doses within the last six months. Participants were grouped based on homologous or heterologous booster vaccination. Data were collected through structured household surveys, and 2 mL blood samples were collected for measuring antibody titers. Results: Heterologous booster recipients showed higher median antibody titers (8597.0 U/mL, IQR 5053.0–15,482.3) compared to homologous recipients (6958.0 U/mL, IQR 3974.0–12,728.5). In the adjusted analysis, the type of booster dose had no significant impact on antibody levels. However, the duration since the last booster dose was significantly associated with antibody levels, where each additional month since receiving the booster corresponded to approximately a 15–16% reduction in antibody levels (Adj. coeff: 0.85, 95% CI: 0.81, 0.88; p < 0.001). Participants over 40 years demonstrated higher antibody levels than younger individuals (Adj. coeff: 1.23, 95% CI: 1.07, 1.43; p = 0.005). Sex, BMI, and prior COVID-19 infection showed no significant associations with antibody levels after adjustment. Conclusion: The results underscore the complexity of immune responses across different demographic groups and suggest potential benefits of ongoing heterologous booster strategies in sustaining immunity.

Using two rounds of serosurveillance, we aimed to observe the COVID-19 vaccination status and the dynamics of antibody responses to different vaccines among urban slum and non-slum populations of Bangladesh. Adults (>18 years) and children (10-17 years) were enrolled in March and October 2022. Data including COVID-19 vaccine types and dosage uptake were collected. SARS-CoV-2 spike (S)-specific antibodies were measured in blood. The proportion of vaccinated children was significantly lower among slum than non-slum populations. Two doses of vaccines showed an increase in the level of anti-S-antibodies up to 2 months, followed by reduced levels at 2-6 months and a resurgence at 6-12 months. Children showed significantly higher anti-S-antibodies after two doses of the Pfizer-BioNTech vaccine than adults; however, after 6 months, the level of antibodies declined in younger children (10 - < 12 years). In a mixed vaccine approach, mRNA vaccines contributed to the highest antibody response whether given as the first two doses or as the third dose. Our findings emphasized the need for increasing the coverage of COVID-19 vaccination among slum children and booster dosing among all children. The use of mRNA vaccines in the mixed vaccination approach was found to be useful in boosting the antibody response to SARS-CoV-2.

COVID-19 vaccines have been effective in preventing severe illness, hospitalization and death, however, the effectiveness diminishes with time. Here, we evaluated the longevity of antibodies generated by COIVD-19 vaccines and the risk of (re)infection in Bangladeshi population. Adults receiving two doses of AstraZeneca, Pfizer, Moderna or Sinopharm vaccines were enrolled at 2–4 weeks after second dosing and followed-up at 4-monthly interval for 1 year. Data on COVID-like symptoms, confirmed COVID-19 infection, co-morbidities, and receipt of booster dose were collected; blood was collected for measuring spike (S)- and nucleocapsid (N)-specific antibodies. S-specific antibody titers reduced by ~ 50% at 1st follow-up visit and continued to decline unless re-stimulated by booster vaccine dose or (re)infection. Individuals infected between follow-up visits showed significantly lower S-antibody titers at preceding visits compared to the uninfected individuals. Pre-enrolment infection between primary vaccination dosing exhibited 60% and 50% protection against reinfection at 5 and 9 months, respectively. mRNA vaccines provided highest odds of protection from (re)infection up to 5 months (Odds Ratio (OR) = 0.08), however, protection persisted for 9 months in AstraZeneca vaccine recipients (OR = 0.06). In conclusion, vaccine-mediated protection from (re)infection is partially linked to elevated levels of S-specific antibodies. AstraZeneca vaccine provided the longest protection.

Background Hepatitis B virus (HBV) infection is a worldwide issue. Nurses are particularly at risk of occupational HBV contamination. In Bangladesh, there is little understanding of the knowledge, attitude, and practices (KAP) of nurses regaarding HBV. Therefore, the study aimed to assess the KAP of nurses regarding HBV. Methods This cross-sectional study was conducted among 120 nurses through face-to-face interviews through a semi-structured questionnaire using a convenient sample technique. Different statistical tools including frequency distribution, Pearson Chi-square test, and t-tests were used in data analysis. Results The average age of the participants was 34.5 years where majority of them were 31-40 years old (50.0%) and female (83%). This study revealed that 25.0% had good knowledge, 43.3% exhibited a good (positive) attitude, and 56.7% of nurses demonstrated good practices regarding HBV. Conversely, nurses exhibit a poor knowledge rate of 30.0%, a poor attitude rate of 30.8%, and a poor practice rate of 29.2% regarding HBV. The independent sample t-test and one-way ANOVA demonstrated that nurses’ from rural residences had a significantly higher knowledge [0.80 (0.79-0.82) versus 0.78 (0.77-0.79)]; p=0.001] regarding HBV. Similarly, female [mean attitude score: 0.88 (0.85-0.91) versus 0.77 (0.86-0.69); p=0.009] and nurses from Muslim [0.79(0.61-0.97) versus 0.79(0.76-0.83); p=0.035] faiths has significantly higher positive attitude and good practice behaviors compared to their counterparts. Conclusions Increasing the vaccination coverage rate of all nurses, as well as implementing additional techniques for preventing exposure in the workplace, training programs on HBV infection, including PEP, comes highly recommended. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study received no specific funds from any agencies or organizations. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The permission of this study was approved by the Institutional Animal, Medical Ethics, Biosafety and Biosecuirity Committee (IAMEBBC) of Institute of Biological Sciences, University of Rajshahi [Ref. Memo No. 12(22)/320/IAMEBBC/IBSc] I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request to meshbah037{at}gmail.com.

Background:Soybean and palm oils are widely consumed in Bangladesh. Objective:The study aimed to investigate the levels of heavy metals and estimate their health risks in nationally representative samples of branded and unbranded soybean and palm oils sold in retail stores in Bangladesh. Methods:A total of 1,521 soybean and palm oil samples were collected from eight administrative divisions. National composites of branded oil were prepared by combining at least 12 samples for each brand. In the case of unbranded oil, composites were prepared for each administrative division. A total of 44 composite samples, including 23 soybean oil samples (19 branded and 4 unbranded) and 21 palm oil samples (13 branded and 8 unbranded), were tested. Twenty-five individual samples (11 crude and 14 refined) collected from the refineries were also analyzed to trace the origin of the heavy metals. Market samples were analyzed for arsenic (As), cadmium (Cd), chromium (Cr), and lead (Pb) and only mercury (Hg) in both market and refinery samples using various atomic absorption spectrophotometric techniques. The possible adverse health effects of exposure to heavy metals content in edible oil were estimated using the tools of daily exposure ( D E ) and noncarcinogenic risk assessment hazard quotient (HQ). Results:The median values of As, Cd, Cr, Pb, and Hg content in soybean and palm oil respectively ranged between 6.9  and  8.8 μ g / kg   ( As ) , 4.3  and  6.9 μ g / kg   ( Cd ) , 12.3  and  42.3 μ g / kg   ( Cr ) , 19.4  and  27.8 μ g / kg   ( Pb ) , and 1.73  and  5.11 mg / kg   ( Hg ) . The differences in heavy metal contents between branded and unbranded oils were not statistically significant. Except for Hg, all other metal concentrations were within national and international standard limits. The estimated D E of Hg through edible oil represented a considerable risk for noncarcinogenic health effects ( HQ > 1 ). The ranking orders of HQ for the oil samples were as follows: unbranded soybean oil (3.99) > branded soybean oil (3.50) > branded palm oil (2.61) > unbranded palm oil (1.69). Discussion:The present study evaluated the level of heavy metal contamination in soybean and palm oils and conducted risk assessments associated with their consumption in Bangladesh. It appears that the source of this contamination is the imported crude oil. Strong and effective monitoring infrastructure is needed to regulate the import of safe crude oils for refineries. https://doi.org/10.1289/JHP1072.

Abstract Background Small-for-gestational-age (SGA), commonly caused by poor placentation, is a major contributor to global perinatal mortality and morbidity. Maternal serum levels of placental protein and angiogenic factors are changed in SGA. Using data from a population-based pregnancy cohort, we estimated the relationships between levels of second-trimester pregnancy-associated plasma protein-A (PAPP-A), placental growth factor (PlGF), and serum soluble fms-like tyrosine kinase-1 (sFlt-1) with SGA. Methods Three thousand pregnant women were enrolled. Trained health workers prospectively collected data at home visits. Maternal blood samples were collected, serum aliquots were prepared and stored at -80℃. Included in the analysis were 1,718 women who delivered a singleton live birth baby and provided a blood sample at 24–28 weeks of gestation. We used Mann-Whitney U test to examine differences of the median biomarker concentrations between SGA (< 10th centile birthweight for gestational age) and appropriate-for-gestational-age (AGA). We created biomarker concentration quartiles and estimated the risk ratios (RRs) and 95% confidence intervals (CIs) for SGA by quartiles separately for each biomarker. A modified Poisson regression was used to determine the association of the placental biomarkers with SGA, adjusting for potential confounders. Results The median PlGF level was lower in SGA pregnancies (934 pg/mL, IQR 613–1411 pg/mL) than in the AGA (1050 pg/mL, IQR 679–1642 pg/mL; p < 0.001). The median sFlt-1/PlGF ratio was higher in SGA pregnancies (2.00, IQR 1.18–3.24) compared to AGA pregnancies (1.77, IQR 1.06–2.90; p = 0.006). In multivariate regression analysis, women in the lowest quartile of PAPP-A showed 25% higher risk of SGA (95% CI 1.09–1.44; p = 0.002). For PlGF, SGA risk was higher in women in the lowest (aRR 1.40, 95% CI 1.21–1.62; p < 0.001) and 2nd quartiles (aRR 1.30, 95% CI 1.12–1.51; p = 0.001). Women in the highest and 3rd quartiles of sFlt-1 were at reduced risk of SGA delivery (aRR 0.80, 95% CI 0.70–0.92; p = 0.002, and aRR 0.86, 95% CI 0.75–0.98; p = 0.028, respectively). Women in the highest quartile of sFlt-1/PlGF ratio showed 18% higher risk of SGA delivery (95% CI 1.02–1.36; p = 0.025). Conclusions This study provides evidence that PAPP-A, PlGF, and sFlt-1/PlGF ratio measurements may be useful second-trimester biomarkers for SGA.

Abstract Background: Workplace bullying (WPB) and nurses’ turnover intention (TI) are important challenges in the healthcare sector, particularly in developing countries like Bangladesh. Understanding this relationship is crucial for developing targeted interventions to improve retention and well-being among male nurses in Bangladesh. Thus, this study aimed to explore the relationship between WPB and TI among Bangladeshi male nurses. Method: We conducted a cross-sectional study among 379 Bangladeshi registered male nurses between April 26 and July 10, 2021. The study sites included indoor or outdoor settings where nurses provide healthcare. We used the Short Negative Acts Questionnaire-9 (S-NAQ-9) to measure WPB and the Turnover Intention Scale-6 (TIS-6) to assess TI. We performed a multiple linear regression model to explore the association of WPB and other variables with TI. Results: The study participants were predominantly young male nurses, with a significant proportion employed in urban settings and holding a Bachelor of Science (B.Sc.) degree. The study found a significant positive association between WPB and TI, suggesting that higher levels of WPB were related to increased TI. Likewise, some other factors such as educational degree, smoking status, job types, professional titles, timely payment, and violence-related training showed significant associations with TI. Conclusion: This study highlights the need for focused interventions to reduce WPB and enhance working conditions for male nurses in Bangladesh. Addressing WPB, as well as improving work satisfaction through targeted initiatives, is critical for reducing TI among this demographic.

Background: Job satisfaction is one of the most important but least researched issues in the nursing profession in Bangladesh. This study aimed to investigate how workplace bullying and burnout are related to job satisfaction, as well as determine the factors that are associated with job satisfaction among Bangladeshi nurses. Methods: Data were collected from Bangladeshi registered nurses between February 26, 2021, and July 10, 2021, in this cross-sectional study. Bullying, burnout, and job satisfaction were measured with the Short Negative Acts Questionnaire [S-NAQ], the Burnout Measure-Short version (BMS), and the Short Index of Job Satisfaction (SIJS-5), respectively. The correlations between age, bullying, burnout, and job satisfaction were assessed using a Pearson's correlation test. In order to investigate the adjusted association of demographic characteristics, occupational variables, bullying, and burnout with job satisfaction, multiple linear regression models were fitted. Results: The study included 1,264 nurses (70.02% were female) with a mean age of 28.41 (±5.54) years. Job satisfaction was significantly negatively correlated with bullying and burnout (p < 0.001). According to the multiple linear regression models, the private-employed nurses had lower job satisfaction than the government-employed nurses (β = −0.901, CI: −1.640 to −0.162). Compared to the nurses in the Dhaka division, the nurses in the Chattogram division (β = 0.854, CI: 0.099 to 1.609) and other divisions (β = 0.993, CI: 0.273 to 1.713) had higher job satisfaction. Nurses without sufficient equipment to manage patients (β = −1.230, CI: −1.696 to −0.763), and nurses not paid on time (β = −1.475, CI: −2.221 to −0.729) were predicted to have significantly lower job satisfaction. Nurses’ job satisfaction levels were decreased with higher levels of workplace bullying (β = −0.086, CI: −0.120 to −0.053), and burnout (β = −1.040, CI: −1.242 to −0.838). Conclusions: Nurses' job satisfaction was correlated with workplace bullying and burnout. Moreover, insufficient professional support from the authorities predicted nurses' job satisfaction. Reducing the instances of bullying and burnout among nurses, as well as improving their working environment, are essential to increase job satisfaction. This is possible with the support of hospital management, policymakers, and government authorities.

Suicidal ideation is a complex phenomenon influenced by several predisposing, contextual, and mediating factors that seem more common among healthcare workers, especially nurses. We investigated the association of bullying and burnout with suicidal ideation among Bangladeshi nurses and identified the associated factors. We conducted a cross-sectional study among 1264 nurses in Bangladesh between February 2021 and July 2021. We applied a modified Poisson regression model with robust error variance to determine the association of bullying and burnout with suicidal ideation. Among 1264 nurses, the female was 882 (70.02%), and the mean age was 28.41 (SD = 5.54) years. The prevalence of high levels of suicidal ideation was 13.26%. In the Poison regression model, high risk bullying (RR = 6.22, 95% CI 3.13–12.38), targeted to bullying (RR = 7.61, 95% CI 3.53–16.38), and burnout (RR = 8.95, 95% CI 2.84–28.20) were found to be significantly associated with suicidal ideation. Furthermore, we found significant interaction between workplace bullying and burnout with suicidal ideation ( p < 0.05). The high prevalence of bullying, burnout, suicidal ideation, and their association indicate an unsafe workplace for the nurses. Initiatives are needed to make a favorable work environment to improve nurses' overall mental health and reduce suicide ideation.

BACKGROUND:Each year, an estimated 15 million babies are born preterm. Micronutrient deficiencies, including vitamin D deficiency (VDD), are common in many low- and middle-income countries (LMICs), and these conditions are often associated with adverse pregnancy outcomes. Bangladesh experiences a high prevalence of VDD. The country also has a high preterm birth (PTB) rate. Using data from a population-based pregnancy cohort, we estimated the burden of VDD during pregnancy and its association with PTB. METHODS:Pregnant women (N = 3,000) were enrolled after ultrasound confirmation of gestational age at 8-19 weeks of gestation. Trained health workers prospectively collected phenotypic and epidemiological data at scheduled home visits. Trained phlebotomists collected maternal blood samples at enrollment and 24 -28 weeks of gestation. Aliquots of serum were stored at -800 C. We conducted a nested case-control study with all PTB (n = 262) and a random sample of term births (n = 668). The outcome, PTB, was defined as live births < 37 weeks of gestation, based on ultrasound. The main exposure was vitamin D concentrations of 24-28 weeks maternal blood samples. The analysis was adjusted for other PTB risk factors. Women were categorized as VDD (lowest quartile of 25(OH)D; < = 30.25 nmol/L) or not deficient (upper-three quartiles of 25(OH)D; > 30.25 nmol/L). We used logistic regression to determine the association of VDD with PTB, adjusting for potential confounders. RESULTS:The median and interquartile range of serum 25(OH)D was 38.0 nmol/L; 30.18 to 48.52 (nmol/L). After adjusting for co-variates, VDD was significantly associated with PTB [adjusted odds ratio (aOR) = 1.53, 95% confidence interval (CI) = 1.10 - 2.12]. The risk of PTB was also higher among women who were shorter (aOR = 1.81, 95% CI: 1.27-2.57), primiparous (aOR = 1.55, 95% CI = 1.12 - 2.12), passive smokers (aOR = 1.60, 95% CI = 1.09 - 2.34), and those who received iron supplementation during pregnancy (aOR = 1.66, 95% CI: 1.17, 2.37). CONCLUSION:VDD is common in Bangladeshi pregnant women and is associated with an increased risk of PTB.

Abstract Background: Childhood obesity and vitamin D deficiency (VDD) are recent health concerns associated with several clinical, psychosocial, and genetic manifestations like cardiovascular diseases, diabetes, depression, and cancer. This study aimed to investigate the association between lifestyle variables and vitamin D levels and VDR gene polymorphism with obesity among Bangladeshi school-going children. Methods: Epidemiological data and blood samples were collected from a total of 164 participants aged 6-13. Serum vit-D level was measured using electrochemiluminescence immunoassay (ECLIA) and four single nucleotide polymorphisms (SNPs) of the VDR gene such as TaqI, BsmI, ApaI, and FokI were genotyped by polymerase chain reaction-restriction fragment length polymorphism assay (PCR-RFLP). Results: The vit-D level was significantly lower in obese children (37.54 ± 14.39 ng/mL) compared to the underweight, normal, and overweight groups (44 .08 ± 15.57 to 50.46 ± 19.25 ng/mL) (p=0.013). Among the lifestyle variables, sunlight exposure during the daytime had a significant effect on the vit-D level of the participants regardless of their BMI status (p=0.003). The SNPs of the VDR gene study demonstrated that the Bb allele of the BsmI gene in obese children (58.62%) was significantly different from the control groups (73.33%) (p=0.02). 24.14% of obese children were of BB genotype, 58.62% of Bb genotype, and 17.24% of bb genotype, while in controls, BB, Bb, and bb genotypes were 20%, 73.33%, and 6.67%, respectively. Importantly, 66.67% of children with vit-D deficiency were BsmI-bb genotype carriers whereas only 5% of children were BsmI-bb genotype carriers who had sufficient vit-D concentrations. Conclusion: A significant association of reduced vitamin D levels and Bb alleles of the BsmI with childhood obesity has been identified. Hence, reduced vitamin D levels and VDR-BsmI polymorphism are risk factors for childhood obesity and suggest further study with a larger number of participants and lifestyle as well as therapeutic interventions in obese children.

Background: Poor immune function increases children's risk of infection and mortality. Several maternal factors during pregnancy may affect infant immune function during the postnatal period. Objectives: We aimed to evaluate whether maternal micronutrients, stress, estriol, and immune status during the first or second trimester of pregnancy were associated with child immune status in the first two years after birth.Methods: We conducted observational analyses within the water, sanitation, and hygiene (WASH) Benefits Bangladesh randomized controlled trial. We measured biomarkers in 575 pregnant women and postnatally in their children. Maternal biomarkers measured during the first and second trimester of pregnancy included nutrition status via vitamin D (25-hydroxy-D [25(OH)D]), ferritin, soluble transferrin receptor (sTfR), and retinol-binding protein (RBP); cortisol; estriol. Immune markers were assessed in pregnant women at enrollment and their children at ages 14 and 28 mo, including C-reactive protein (CRP), alpha-1-acid glycoprotein (AGP), and 13 cytokines (including IFN-& gamma;). We generated a standardized sum score of log-transformed cytokines. We analyzed IFN-& gamma; individually because it is a critical immuno-regulatory cytokine. All outcomes were prespecified. We used generalized additive models and reported the mean difference and 95% confidence intervals at the 25th and 75th percentiles of exposure distribution.Results: At child age 14 mo, concentrations of maternal RBP were inversely associated with the cytokine sum score in children (-0.34 adjusted difference between the 25th and 75th percentile [95% confidence interval-0.61, -0.07]), and maternal vitamin A deficiency was positively associated with the cytokine sum score in children (1.02 [0.13, 1.91]). At child age of 28 mo, maternal RBP was positively associated with IFN-& gamma; in children (0.07 [0.01, 0.14]), whereas maternal vitamin A deficiency was negatively associated with child AGP (-0.07 [-0.13,-0.02]). Maternal iron deficiency was associated with higher AGP concentrations in children at age 14 mo (0.13 [0.04, 0.23]), and maternal sTfR concentrations were positively associated with child CRP concentrations at age 28 mo (0.18 [0, 0.36]). Conclusion: Maternal deficiencies in vitamin A or iron during the first 2 trimesters of pregnancy may shape the trajectory of a child's immune status.

AbstractLittle is known about the usefulness of biomarkers to study the influence of prenatal nutrition supplementation in improving child growth. Anthropometry is not always straightforward to understand how nutrition might impact growth, especially in settings with high rates of malnutrition and infections. We examined the effects of prenatal supplementation on growth and growth biomarkers and the relationship between anthropometric measures and growth biomarkers of children at 4.5 and 9 years of age. Children were enrolled from a longitudinal cohort, where mothers were randomized into daily supplementation with either early‐food (≤9 gestation week [GW]) or usual‐food (~20 GW) (608 kcal 6 days/week); they were further randomized to receive 30‐mg or 60‐mg iron with 400‐μg folic acid, or multiple micronutrients (MM) in rural Bangladesh. Anthropometric data were collected from mothers at GW8 and children at 4.5 (n = 640) and 9 years (n = 536). Fasting blood was collected from children at each age. Early‐food supplementation showed reduced stunting and underweight at 4.5 and 9 years age respectively compared to usual‐food. Prenatal supplementations did not have any effect on growth biomarkers except for STAT5b expression which was lower in the early‐food compared to the usual‐food group (β = −0.21; 95 CI% = −0.36, −0.07). Plasma concentrations of 25‐hydroxy vitamin D and calcium were both inversely associated with weight‐for‐age and body mass index‐for‐age Z‐scores at 9 years, particularly in early‐food and MM groups. Although there was minimal effect on child growth by prenatal supplementations, the associations of biomarkers with anthropometric indices were predominantly driven by timing of food or MM supplementations.

During the COVID-19 pandemic, workplace violence was widespread against healthcare personnel. Workplace violence (WPV) against nurses exhilarates their turnover intention (TI). The objective of this study was to investigate the association between workplace violence and turnover intention and also identify other factors associated with TI among Bangladeshi female nurses. An exploratory cross-sectional study was carried out among 881 female nurses between April 26 and July 10, 2021. The TI of the female nurses was the outcome variable of this study. The primary exposure variable was WPV faced by the nurses. Workplace Violence Scale (WPVS) was used to measure the WPV, and Turnover Intention Scale-6 (TIS-6) was used to measure the TI of the nurses. Multiple linear regression model was fitted to find the adjusted association of TI with WPV and other study variables. A stratified analysis by type of job (government vs. private) was also performed. The majority of the nurses (74.46%) faced low to high levels of WPV. The overall mean score of TIS was found 16.33 (± 4.72). Multiple linear regression analysis revealed that compared to government jobholders, the mean score of TIS (15.81 vs. 17.20) was found significantly higher among the private jobholders (p < 0.001). Nurses exposed to the intermediate and high level of WPV had a significantly higher TI score (β = 4.35, 95% CI: 3.36, 5.34) than the non-exposures. The TI of private jobholders was found significantly higher (β = 2.04, 95% CI: 1.09, 3.00) than the government jobholders. Compared to diploma degree holders, significantly higher TI was observed among the B.Sc. degree holders (β = 0.86, 95% CI: 0.22, 1.55) and M.Sc. degree holders (β = 1.46, 95% CI: 0.58, 2.34). Besides, the nurses who did not get timely salaries scored higher TI (β = 1.17, 95% CI: 0.12, 2.22). Moreover, the nurses who did not receive any training against WPV scored significantly higher TI (β = 1.89, 95% CI: 1.03, 2.74). The stratified analysis by type of job also revealed significant factors of TI in government and private settings. This study found a high prevalence of WPV and a high rate of TI among Bangladeshi female nurses. Moreover, this study explored an association between WPV and TI. The study findings could help policymakers facilitate a comfortable working environment by preventing WPV and addressing the factors to reduce nurses' frequent TI.

Vitamin B12 deficiency is associated with an increased risk of pregnancy complications and adverse birth outcomes. However, data on vitamin B12 deficiency in pregnant Bangladeshi women are limited. This study examines vitamin B12 deficiency and marginal deficiency in rural Bangladeshi women during early and late pregnancies. Some 522 women whose gestational age was <20 weeks were recruited. Serum vitamin B12 concentrations were measured at baseline and after 14 weeks of iron-folate supplementation. Logistic regression analysis examined the association of various socio-demographic, dietary, and pregnancy-related factors with vitamin B12 deficiency and marginal deficiency. Overall, 19% of the women during early pregnancy had vitamin B12 deficiency (serum vitamin B12 concentration < 203 pg/mL) and nearly 40% had marginal deficiency (serum vitamin B12 concentration 203 to <300 pg/mL). Vitamin B12 deficiency doubled to 38% during late pregnancy, while marginal deficiency slightly increased to 41.7%. The pregnant women with a gestational age of ≥27 weeks had a higher risk of developing vitamin B12 deficiency (OR = 2.61; 95% CI = 1.096–6.214) than those of a gestational age of <27 weeks. Vitamin B12 deficiency was significantly higher in pregnant women in rented accommodation (OR = 13.32; 95% CI = 1.55–114.25) than in those living in their own house. Vitamin B12 deficiency was significantly higher among women who consumed red or organ meat <3 times a week than in those who consumed it more often (OR = 2.327, 95% CI = 1.194–4.536). None of these factors were significantly associated with marginal vitamin B12 deficiency. In conclusion, vitamin B12 deficiency and marginal deficiency among pregnant rural Bangladeshi women increased as their pregnancies progressed. Increasing gestational age, living in a rented house, and the consumption of red or organ meat <3 times a week were identified as the independent risk factors of vitamin B12 deficiency in this population. Further research with more in-depth assessments of dietary vitamin B12 intakes is needed to develop an intervention program preventing vitamin B12 deficiency in this population.

Background Seroprevalence studies have been carried out in many developed and developing countries to evaluate ongoing and past infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Data on this infection in marginalized populations in urban slums are limited, which may offer crucial information to update prevention and mitigation policies and strategies. We aimed to determine the seroprevalence of SARS-CoV-2 infection and factors associated with seropositivity in slum and non-slum communities in two large cities in Bangladesh. Methods A cross-sectional study was carried out among the target population in Dhaka and Chattogram cities between October 2020 and February 2021. Questionnaire-based data, anthropometric and blood pressure measurements and blood were obtained. SARS-CoV-2 serology was assessed by Roche Elecsys® Anti-SARS-CoV-2 immunoassay. Results Among the 3220 participants (2444 adults, ≥18 years; 776 children, 10–17 years), the overall weighted seroprevalence was 67.3% (95% confidence intervals (CI) = 65.2, 69.3) with 71.0% in slum (95% CI = 68.7, 72.2) and 62.2% in non-slum (95% CI = 58.5, 65.8). The weighted seroprevalence was 72.9% in Dhaka and 54.2% in Chattogram. Seroprevalence was positively associated with limited years of formal education (adjusted odds ratio [aOR] = 1.61; 95% CI = 1.43, 1.82), lower income (aOR = 1.23; 95% CI = 1.03, 1.46), overweight (aOR = 1.2835; 95% CI = 1.26, 1.97), diabetes (aOR = 1.67; 95% CI = 1.21, 2.32) and heart disease (aOR = 1.38; 95% CI = 1.03, 1.86). Contrarily, negative associations were found between seropositivity and regular wearing of masks and washing hands, and prior BCG vaccination. About 63% of the population had asymptomatic infection; only 33% slum and 49% non-slum population showed symptomatic infection. Conclusion The estimated seroprevalence of SARS-CoV-2 was more prominent in impoverished informal settlements than in the adjacent middle-income non-slum areas. Additional factors associated with seropositivity included limited education, low income, overweight and pre-existing chronic conditions. Behavioral factors such as regular wearing of masks and washing hands were associated with lower probability of seropositivity.