MPhil Thesis

Association of socioeconomic condition with serum uric acid, urea & creatinine profile of women reproductive age in some selected areas of Bangladesh

2026-08-09T05:07:41Z

Association of socioeconomic condition with serum uric acid, urea & creatinine profile of women reproductive age in some selected areas of Bangladesh Ara, Ferdous Background: In the human body the kidney plays a significant role in the homeostatic mechanism. Any disruption in kidney functionality is reflected through high levels of serum creatinine, urea and uric acid. Disruption in kidney functionality can be associated with the nutritional status of a population and their socioeconomic conditions. However, information is limited on the association between socioeconomic conditions and abnormal kidney function markers in women of reproductive age (WRA). Therefore, the goal of the study was to determine the association of socioeconomic condition and nutritional status with serum uric acid, urea and creatinine of WRA in selected areas of Bangladesh. Methodology: A cross-sectional study was directed among 178 WRA in different places of Bangladesh (rural Chittagong, rural Gazipur, Meherpur and Kushtia, Shatkhira). Data on demographic, socioeconomic and anthropometric variables were collected. Blood samples were also collected. DIALAB GmbH semi-automatic biochemistry analyzer DTN-405 (Austria) was used to conduct biochemical tests of the blood samples. Logistic regression analysis was used to control the association between kidney function abnormalities and associated factors. Results: The study results showed that about 23.6% of the study participants were underweight, 56.7 % had normal body mass index (BMI) whereas 19.7% of participants were overweight or obese. The average (mean ± SD) serum levels (mg/dl) were 5.74±2.07 for uric acid, 17.93±9.83 for urea, and 0.89±0.28 for creatinine and 92.18±35.86 mL/min/1.73 m² for estimated glomerular filtration rate (eGFR). Elevated levels of creatinine, uric acid, and urea were observed in 27%, 31.5%, and 41% of the participants, respectively. Additionally, chronic kidney disease (CKD) vi was identified in 18% of the participants. Overall, normal kidney function markers were found among about 31% of the respondents, while 5% showed elevated levels for all three markers. The odds of having at least one or more elevated kidney function markers were significantly higher (AOR=2.8; 95% CI: 1.22-6.42; p < 0.05) among individuals with a BMI greater than 18.5 kg/m² compared to underweight women. After adjusting for related factors, BMI was found to be significantly associated with the risk of elevated kidney function markers. Conclusion: The study found that only one-third of the WRA had all normal kidney function markers. After adjusting for related factors BMI was found to be significantly associated with the risk of elevated kidney function markers. The findings highlight alarming information about women’s health and suggest that routine analysis is desirable to improve women’s health in our country. Further studies are required with a larger sample size to understand deeply and assist the relevant ministries in policy making. This thesis is submitted for the degree of Master of Philosophy.

Diet Quality and Affordability of Healthy Diets among Workers of Selected Garments Industries in Bangladesh

2026-08-09T05:04:53Z

Diet Quality and Affordability of Healthy Diets among Workers of Selected Garments Industries in Bangladesh Afrin, Shazia Background: The ready-made garment (RMG) sector is key to Bangladesh's economy, significantly contributing to Gross Domestic Product (GDP) and foreign exchange earnings. However, RMG workers, predominantly women, face critical challenges related to health, nutrition, and productivity. Despite their socio-economic importance, research on diet quality and the affordability of nutritious diets by RMG workers remains limited. This study aimed to evaluate the diet quality as well as the affordability of healthy diets among RMG workers of selected garment industries in Bangladesh. Methods: This study used baseline survey data from the “Strengthening Workers' Access to Pertinent Nutrition Opportunities” (SWAPNO) project, funded by the Global Alliance for Improved Nutrition (GAIN). A secondary analysis was conducted on cross-sectional data collected from 801 RMG workers (333 males and 468 females) employed in two apparel industries in Dhaka and Mymensingh. Participants were selected using convenience sampling. Data on socio-demographic characteristics, dietary intake (assessed using the 24-hour recall method), nutrient adequacy, and micronutrient intake expressed as a percentage of the Estimated Average Requirement (EAR) were evaluated, along with anthropometric measurements. Nutritional status was assessed using body mass index (BMI) classified according to both World Health Organization and Asian-specific criteria. The affordability of a healthy diet was evaluated, and statistical analyses were performed to examine associations between diet quality, nutritional status, mean probability of adequacy (MPA), and relevant socioeconomic factors. Results: Among the 801 RMG workers studied, 58.4% were female, and 90.3% were aged 18 to 34 years. Female workers generally had lower educational attainment and income levels compared to males. The dietary analysis showed a heavy reliance on calorie-dense foods, particularly rice, with a low intake of fruits, vegetables, and pulses. Macronutrient distribution indicated excessive carbohydrate intake (67.0% of total energy), while fat intake was often below ideal levels in 43.4% of participants (less than 15% of total energy). Calcium consumption among RMG workers was alarmingly low, with most consuming less than 50% of the Estimated Average Requirement (EAR). Similarly, intakes of iron, zinc, riboflavin, and vitamin A are at or below the EAR, viii indicating a high risk of inadequacies. While niacin and folate exceeded the EAR, vitamin C intake was highly variable. A dual burden of malnutrition was observed, with 7.4% of workers underweight and 21.5% overweight or obese based on Global WHO BMI standards, while it was 44% overweight or obese based on WHO Asian BMI standards. The logistic regression analysis showed that the mean probability of adequacy (MPA) for micronutrients was significantly higher among RMG workers in Mymensingh (AOR 1.68, p = 0.004) and among those aged 25 to 34 years (AOR 1.40, p = 0.049), while other socio-economic factors had no significant effect. Regarding the affordability of healthy diet, this study found that most workers could afford energy-sufficient diets; however, 68% of the workers were unable to afford a healthy diet due to economic constraints. Logistic regression analysis further showed that higher income (BDT > 13,000), smaller household size, and the presence of multiple earning members were significantly associated with better affordability of a healthy diet. Conclusion: This study highlights significant nutritional challenges among RMG workers in Bangladesh, marked by widespread micronutrient inadequacy and a dual burden of malnutrition, particularly among female workers. Economic barriers remain a critical impediment to accessing healthy diets. These findings underscore the urgent need for targeted interventions to improve diet quality, address micronutrient inadequacies, and promote balanced macronutrient intake while addressing affordability constraints. This thesis is submitted for the degree of Master of Philosophy.

Vitamin-D status among adolescent attending in the Out Patient Department of Selected Tertiary Hospitals in Bangladesh

2026-03-03T08:32:21Z

Vitamin-D status among adolescent attending in the Out Patient Department of Selected Tertiary Hospitals in Bangladesh Jaiswal, Sanni Context/Background: Lack of vitamin D is a global issue that has been linked to a number of health problems. In Bangladesh, it is quite prevalent in all age categories, but it is particularly prevalent in children and adolescents of both sexes. Since vitamin D is produced by cutaneous synthesis when exposed to plenty of sunlight, the incidence of vitamin D insufficiency in Bangladesh is often disregarded. The objective of the current study was to assess the vitamin D status of adolescents attending in the outpatient department (OPD) of selected tertiary hospitals in Bangladesh, as well as the relationship between vitamin D status and dietary habits and socio-demographic traits. Techniques/Methods Two chosen hospitals' outpatient departments recruited adolescents (10–19 years old) for a cross-sectional survey. The study employed convenience sampling of 384 adolescents who came to these hospitals and their medical reports were available at the hospital. Vitamin D status was evaluated based on the medical reports. Alongside, dietary habits were recorded using the Food Frequency Questionnaire (FFQ). A multinomial logistic regression model was built to determine the predictors of the participants' vitamin D status. Results: More than 58% of the respondents were younger adolescents (aged 10-14 years) and around two-thirds were girls. It was discovered that 36.7% of the adolescents had inadequate amounts of vitamin D, and 32% were vitamin D deficient. Deficiency level was significantly higher among older adolescents (15-19 years of age). Girls were significantly more deficient 36.2% than boys 24.6%. In addition to other socio-demographic factors, mothers with low- paying jobs, mothers whose education level was primary/below or no institutional education, families with lower incomes, etc., had higher prevalence of vitamin D deficiency. Regarding dietary habits, the study found that respondents who regularly consumed foods high in vitamin D i.e. beef, fatty fish, egg, dairy, fortified oils, nuts, fruits and vegetables, Horlicks had lower rate of vitamin D deficiency. A multinomial logistic regression analysis showed 7 that the occupation level of the mother (service holder), the less frequent consumption of beef, dairy, fortified oil, and Horlicks (a nutritional supplement drink) as significant predictors for vitamin D deficiency. Conclusion: The present study found a positive impact of consumption of certain vitamin D-rich food items (beef, dairy, fortified oil, and Horlicks) on vitamin D levels of adolescents. Adolescents who consumed these items frequently had a lower risk of vitamin D deficiency than those who did so occasionally or never. Therefore, if any awareness programs or campaigns could be conducted for both parents and adolescents, it might be beneficial for reducing vitamin D deficiency. Additionally, if it's feasible, more study can be done to fortify food with vitamin D through further research. This thesis is submitted for the degree of Master of Philosophy.

Dengue Viral Infection in Children: Epidemiological, Nutritional and Genomic Analysis

2026-03-03T08:17:44Z

Dengue Viral Infection in Children: Epidemiological, Nutritional and Genomic Analysis Ghosh, Kinkar Background: The epidemiology and genomic characteristics of dengue viral infection in children have been poorly explored in Bangladesh. The study aimed to delineate the epidemiological, nutritional, and genomic characteristics of the dengue viral infection in Bangladeshi children. Method: A cross-sectional study was carried out in the in-patient department of Bangladesh Shishu Hospital and Institute from June 2023 to May 2024. Children of age <18 years admitted with presumptive positive dengue infection and presumptive negative dengue infection (NS1 and/IgM negative) with features like dengue infection were enrolled in this study. A total of 722 presumptive dengue-positive children were included for epidemiological analysis, 349 children under the age of five for nutritional assessment; 104 dengue-positive children, and 50 dengue-negative children (from another group) for genomic analysis and concomitant viral infections respectively. MedCalc online tools and SPSS version 21 were used for genomic and statistical analysis. Results: Among 722 children, 600(83%) were from Dhaka City Corporation (494 and 106 were from North and South City Corporation respectively) and 122(17%) were from outside of Dhaka. The age group of <1 Year were 91(12%), 1- <5 Year 258(36%),5- <10 Year 238(33%) and > 10 Year 135(19%). Out of all, fever was the compulsory presenting complaint, and vomiting 355(49%), abdominal pain 192(27%), loose motion 135(19%), cough 49(7%), headache 30(4%), reluctant to feed 23(3%), bleeding 18(2%), convulsion 16(2%) were present. Among all 516(71%) presented with warning signs and 206(29%) without warning signs; 82(16%) children with warning signs and 23(11%) without warning signs were admitted to the intensive care unit. Reinfection was in 39(5.4%), a comorbid condition in 79(10%) and shock was the predominant complication. Among 349 under-five children, 7 (2%) were overweight, 178(51%) normal, 153(44%) moderately underweight, and 11(3%) severely underweight. Real-Time PCR results reveal that out of 104 positive cases, 96(92%) were true positive and 8(8%) were false positive. Among 50 negative cases 17(34%) were false negative and 33(66%) true negative. Real-time PCR of nasopharyngeal swabs reveals that 12(12%) had Flu or Respiratory Syncytial Virus (RSV) in true positive cases(n=103) and 5 (19%) in true negative cases(n=26). Circulating serotypes were DEN2 87% and DEN3 13%. Genomic footprint shows that DEN-2-2023 in Bangladesh was most similar to 2018 and DEN-3-2023 most similar to 2017. Conclusion: In children, DEN2 was the most predominant serotype in 2023 among children which might be responsible for more severe diseases. Concomitant viral infection could be an upcoming concern for the dengue outbreak. Authorities should prioritize the feasibility of using Real-time PCR for dengue screening in the coming years and a laboratory network system like COVID-19 should be considered. This thesis is submitted for the degree of Master of Philosophy.