Faculty members at the School of Public Health (SPH), IUB are engaged in numerous international collaborations with some of the world’s leading research organizations and universities, which include the following:
• McMaster University, Canada
• SHARE (South Asian Hub for Advocacy, Research and Education on Mental Health)
• School of Public Health, Harvard University, US
• Heidelberg University, Germany
SPH works closely with McMaster University, Canada to supervise the Prospective Urban and Rural Epidemiological (PURE) study in Bangladesh. A part of a larger worldwide study in 20 countries involving 400,000 participants, PURE is the largest study of its kind which investigates the impact of modernization, urbanization and globalization on obesity and other risk factors for CVD and diabetes.
PURE’s research has already been published in highly esteemed peer-reviewed journals such as The Lancet, The Journal of the American Medical Association (JAMA), The New England Journal of Medicine (NEJM).
SPH faculty members are actively involved with SHARE. Funded by SHARE, SPH is currently conducting research using cluster randomized control trial to determine the impact of automated text messaging reminders on increasing rates of care seeking for depressed women. SPH faculty members are also enrolled in several training programs organized by SHARE in India and Sri Lanka.
SPH maintains a strong connection with Harvard University through Professor Omar Rahman, who is concurrently the Dean of SPH and also the Vice Chancellor of IUB and an adjunct faculty member in Demography at the Department of Global Health and Population at the Harvard School of Public Health. He was also an alumnus of the Harvard School of Public Health. Professor Rahman was previously Associate Professor of Epidemiology and Demography at Harvard University and a Research Fellow in Psychiatry at Harvard Medical School. SPH also works in close collaboration with Heidelberg University, Germany.
Apart from international collaborations, SPH partners with the School of Liberal Arts and Social Science, IUB to conduct a biannual survey of over 1200 randomly selected households in rural areas across several districts in Bangladesh. SPH uses data from this survey to work with MPH students to complete a culminating project/thesis on various topics such as healthcare seeking behavior; socio-demographic factors that affect medicine consumption; effects of fuel type on breathing difficulties among women; and depressive symptoms as a risk factor for injuries.
Bangladesh Prospective Urban and Rural Epidemiological Study (PURE)
Principal Investigator: Professor Omar Rahman
Co-PI: Dr. Rita Yusuf
Research Associates: Mariz Sintaha; Tarzia Choudhury; Dr. Raysul Haque;
Background
In the last few decades, the epidemic of chronic diseases has shifted from the high income countries (HIC) to low income countries (LIC). It is being expected that by 2020 more than 80% of cardiovascular disease (CVD) cases will be in middle and low income countries like Bangladesh. The societal influence in lifestyle is being cited as one of the prime reasons behind this change. Therefore it has become imperative firstly, to understand the societal determinants of biological risk factors and CVD and secondly, to evaluate how these factors are distributed in a given urban and rural population.
Objective
The project aims to assess the combined effect of household and societal community level factors on individuals' lifestyles, and thereby on its contribution to the development of biological risk factors for CVD and other chronic diseases. This study in Bangladesh is a part of a larger world wide study in 20 different countries conducted by McMaster University, Canada.
In the worldwide PURE study, 153 996 adults (151 966 aged 35-70 years, 1444 aged < 35 years, and 586 aged > 70 years) were recruited from 628 (348 urban and 280 rural) communities in 17 countries of the world, representing various levels of development and encompassing a large sociocultural diversity. These countries included 3 high-income countries (Canada, Sweden, United Arab Emirates), 7 upper–middle-income (Argentina, Brazil, Chile, Poland, Turkey, Malaysia, South Africa) and 3 low–middle-income (China, Colombia, Iran), and 4 low-income countries (Bangladesh, India, Pakistan, Zimbabwe). Common and standardized approaches were used for the enumeration of households, identification of individuals, recruitment procedures, and data collection.
Supervised by IUB, the Bangladesh portion of the Prospective Urban and Rural Epidemiological (PURE) carried out the baseline survey of around 3000 adults in 2008. Data collection was done by administering questionnaires, collecting urine & blood samples and by taking anthropometric measurements. The data will be analyzed to understand the determinants of chronic diseases (with a particular focus on coronary artery disease) and differences therein between the urban and rural populations.
The baseline survey will be followed up by limited data collection at around 5, 9 and 12 years following the baseline. The first follow-up of the baseline was completed in 2013. The aim of the PURE follow-up study is to document the number of fatal and non-fatal events experienced by the baseline survey respondents since the time of baseline study.
PURE’s research has already been published in highly respected peer-reviewed journals – The Lancet, The Journal of the American Medical Association (JAMA), and The New England Journal of Medicine (NEJM). Most recently, two PURE research articles were published in the same issue of The New England Journal of Medicine. The articles investigated the association of urinary sodium and potassium excretion with blood pressure, mortality, and cardiovascular events.
A Cluster Randomized Control Trial: Text messaging reminders to raise care seeking among depressed women in rural Bangladesh
The research is collaboration between IUB and SHARE (South Asian Hub for Advocacy, Research and Education on Mental Health.
Principal Investigator: Professor Omar Rahman
Co-PI: Dr. NafisaHuq
Research Associates: Dr. Raysul Haque; Tarzia Chowdhury
Background
Major depression is the most common mental health disorder and one of the leading causes of the global disease burden and disability.It afflicts twice as many women as men across different countries and settings. A nationally representative study in 2003-2005, carried out by the National Institute of Mental Health in Bangladesh in collaboration with WHO showed the prevalence of major depressive disorder in the general adult population to be 4.6%. However, lack of initiation and poor adherence with health care providers’ is a major barrier to treating depression in South Asia. Text messaging reminders have been shown to be very effective in raising rates of adherence to treatment in other chronic disorders. However, no study has looked specifically at using text messaging reminders to raise rates of care seeking among depressed women in a developing country.
Objective
The current study aims to determine the impact of automated text messaging reminders to depressed women on rates of care seeking.
‘Scoping review of literature on suicide in South Asia’.
The research was done by Center for Health Population and Development (CHPD) in collaboration with Health net TPO, Amsterdam, funded by DFID (2013).
Principal Investigator: Dr. Nafisa Huq
Background
The high suicide rates in the South Asian region are a concern and context to provide a scientific basis for developing an adequate response in future. The review followed a broad approach to mapping the available research and evidence specifically related to the South Asian region. The report is due for publication in 2015
Objective
The objectives of the scooping review were to explore the extent of literature in this domain to (a) summarize and disseminate research findings, and (b) identify gaps in the existing literature.
Development of “HIV Web Depository” for Bangladesh.
(www.hivwebportal.org).
This web portal was a collaboration between Joint United Nations Program on HIV/AIDS (UNAIDS) and Center for Health Population and Environment (CHPD) at Independent University, Bangladesh (IUB) in 2009.
Principal Investigator: Dr. Nafisa Huq
Background
The web portal is an open data depository of published/unpublished research articles, reports, training materials, BCC materials, posters, and other relevant works done in HIV and AIDS sector in Bangladesh in the last 10-12 years.
This project was taken up with an objective to collect relevant HIV/AIDS materials from various institutions /organizations /authors as well as from the web and list them in order to make available at one site the diverse range of works done in HIV and AIDS sector in Bangladesh.
Objective
The aim is to facilitate distinct stakeholders to know and find out what has been done, find out gaps as well as reduce duplication of works in relevant HIV/AIDS sector in Bangladesh.
Rapid Assessment Report on Knowledge, Attitude and Behavior of at Risk Male Population in the context of Spousal Transmission of HIV /AIDS in Bangladesh, October 2009.
This project was a collaboration between Joint United Nations Program on HIV/AIDS (UNAIDS) and Center for Health Population and Environment (CHPD) at Independent University, Bangladesh (IUB) in 2009.
Principal Investigator: Professor Omar Rahman
Co-PI: Dr. Nafisa Huq, Dr. Farhana Haque
Background
The phenomenon of spousal transmission is a rising concern globally among the HIV prevention and control community. Spousal transmission programs aims to address an emerging risk group of married women who are liable to become infected with HIV from their infected husbands and hence are likely to broaden the limits of HIV/AIDS epidemic in Asia. This vulnerable sub-population includes wives of men who engage in high-risk behaviors such as buying commercial unprotected sex, using injecting drugs (IDUs) and having sex with men (MSM). The actions of these men who are regarded as the Most at Risk Populations (MARPs) put not only their wives, but also their subsequent children at risk of acquiring the deadly infection.
Objective
The objective of the study was to identify factors (knowledge, attitude and risk perception) affecting spousal transmission of HIV/AIDS among married men and other relevant stakeholders in Bangladesh in order to support designing appropriate and pragmatic intervention programs for the prevention of spousal transmission of HIV/AIDS in Bangladesh.
Desk Review: ‘Spousal Transmission of HIV among Married Women in Bangladesh: a country assessment report, October 2008’.
The desk review was done in collaboration with UNAIDS in October 2008.
Principal Investigator: Tarzia Chowdhury
Investigators: Dr. Nafisa Huq, Dr. Farhana Haque
Background
As per the AIDS commission report, increasing number of women in spite of having a single sex partner gets infected from their husbands or sex partners outside wedlock. Also, many married men are regular clients of sex workers or are injecting drug users and thus faithful female partners cannot be presumed to be safe. This poses a potential route of pushing ‘low risk females’ to ‘high risk groups’ by way of spousal transmission. Thus it is of vital importance to find out ways of dealing with such routes of spreading HIV/AIDS infection.
Objective
The objective of the study was to analyze existing data and evidence to help design a comprehensive prevention strategy including favorable policies and pragmatic interventions to protect married women getting infected through ‘spousal transmission’
Relationship Between Health Care Seeking Behavior and Socio- Demographic Characteristics Among Rural People of Bangladesh
Principal Investigator: Dr. Shabareen Tisha
Background
Health care seeking is a vital issue in all kinds of morbidity. Illness or deviation from normal state of health is mostly a subjective awareness of an individual for the relief which can be sought within or outside of medical and health facilities. Illness behavior refers to the activities undertaken by individuals in response to symptom experience. It typically includes mental debate about the significance and seriousness of these symptoms, lay consultation, decisions about action including self-medication, and constant with health professionals. Symptom perception has a well-recognized social and even ethnic dimension. Perception of illness has been found to vary with cultural, ethnic and socioeconomic difference. Socio-economic status, education, income or other indices of social class, has long been known to be associated with attitudes and health care practices. The impact of socio-demographic factors on health care seeking behavior is important. Patient compliance depends on many psychological and sociological factors and the interaction of patient’s own ideas with the disease. Knowledge about the existing disease pattern and health seeking behavior is essential to provide need based health care delivery to any population.
Objective
The objectives of this study are to examine self-rated health status and health care-seeking behavior of Bangladeshis, and to ascertain the socio-economic determinants of health care seeking behavior as well as good health status.
Self-reported chronic-illness overrules socio-demographic factors for medicine consumption in rural Bangladesh
Principal Investigator: Dr. S. M. Raysul Haque
Background
Medications are important therapeutic tools used in health as well as in disease, accounting for a significant part of the increased life expectancy and quality of life. Drug use is influenced by population structure, socioeconomic factors, behavioral and cultural shape of the morbidity and also by the characteristic of the pharmaceutical market. In general, these population-based studies have pointed to a higher consumption of drugs in women, with increasing age, among those with greater purchasing power, among the more educated, with a greater number of chronic diseases, whereas the patterns of drug use differ between regions and change over time depending on the profile changes health or illness and health policies implemented.
Objective
The aim of our study is to focus on self-reported chronic-illness and its impacts on medicine consumption in relation with other socio-demographic factors in four different districts of Bangladesh.
Effects of fuel type on breathing difficulties among the women of rural community in Bangladesh.
Principal Investigator: Samia Aziz
Background
In 2004, indoor air pollution from solid fuel use was responsible for almost 2 million annual deaths and 2.7% of the global burden of disease (in Disability-Adjusted Life Years or DALYs). This makes this risk factor the second biggest environmental contributor to ill health, behind unsafe water and sanitation. More than two billion people in developing countries still rely on the use of solid biomass fuels such as, cow dung, wood, crop residue and coal for cooking daily meals. This attributes a major source of indoor air pollution and is now regarded as major public health hazard in the developing world. Burning of biomass fuel in the kitchen releases smoke and particulate matters which may cause breathing difficulties.
Objective
The study aims to examine the relationship between breathing difficulty and types of fuel use among the rural women in Bangladesh.
Depressive Symptoms as a Risk Factor for Injuries
Principal Investigator: Tarzia Chowdhury
Background
Injuries and depressive symptoms pose a significant burden on the healthcare system and society. Injury is the fifth leading cause of death and disability worldwide among those aged 15-59 years, whereas more than 350 million people of all ages suffer from depression globally. Several studies have reported associations between depressive symptoms and falls in older people, and it has been suggested that common pathways for both conditions can explain such associations. The association between depressive symptoms such as disturbed sleep and increased risk of occupational injury has been observed in several cross-sectional and case–control studies, but prospective evidence is lacking.
Objective
This study aims to address depressive symptoms as a risk factor for injuries resulting from falls, motor accidents and other events. Using longitudinal data from IUB Health and Socio Economic Survey, this study will examine whether self-reported depressive symptoms at baseline predicts injuries at follow-up among adults living in rural areas of Bangladesh.