https://repository.auw.edu.bd/handle/123456789/718 2026-06-09T21:06:13Z 2026-06-09T21:06:13Z Chowdhury, Mohiuddin Ahsanul Kabir https://repository.auw.edu.bd/handle/123456789/873 2026-02-18T06:15:24Z 2022-01-01T00:00:00Z

Mapping age‐ and sex‐specific HIV prevalence in adults in sub‐Saharan Africa, 2000–2018 Chowdhury, Mohiuddin Ahsanul Kabir Background: Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex- specific 5-year age groups for adults ages 15–59 years across SSA. Methods: We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 coun‐ tries in SSA, from years 2000 to 2018, at a 5×5-km resolution and presented among second administrative level (typi‐ cally districts or counties) units. Results: We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group. Conclusions: As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA.

2022-01-01T00:00:00Z Chowdhury, Mohiuddin Ahsanul Kabir https://repository.auw.edu.bd/handle/123456789/872 2026-02-18T06:15:02Z 2022-01-01T00:00:00Z

Bottleneck analysis of maternal and newborn health services in hard-to-reach areas of Bangladesh using ‘TANAHASHI’ framework’: An explanatory mixed-method study Chowdhury, Mohiuddin Ahsanul Kabir Maternal and Newborn Health (MNH) is of paramount importance in the realm of attaining sustainable development goals that also focuses on universal health coverage (UHC). The study aimed at identifying and exploring the bottlenecks in MNH services in Hard-to-reach (HtR) areas of Bangladesh using the Tanahashi framework exploring the possible remedial approaches. The study was conducted in four different types of HtR areas (hilly, coastal, lowlands, and river islands) by utilizing a sequential explanatory mixed-method design. Overall, we collected information from 20 health facilities and 2,989 households by inter- viewing 2,768 recently delivered women (RDW) with a structured questionnaire and qualita- tive interviews (n = 55) of facility managers, local stakeholders, RDWs, and health care providers (HCP). The quantitative data were analyzed principally for descriptive statistics and the qualitative data was analyzed by utilizing the thematic approach. Antenatal care, under-5 care, and family planning services were available in almost all the facilities. How- ever, Normal vaginal deliveries were performed in 55.6% of the union-level facilities. Only 40% of sub-district level facilities had provision for C-sections. Blood transfusion services were available in only 20.1% of facilities, whereas laboratory services were obtainable in 51.7% of facilities. Overall, the bottlenecks were identified in cases of availability of drugs, human resources, transportation, lack of knowledge regarding different essential services and health components, out of pocket expenditure etc. There have been several remedial approaches suggested from both the demand and supply side that included incentives for care providers for staying in these areas, a coordinated transport/referral system, and health education campaigns. More research works are warranted in HtR areas, especially to test the proposed interventions. Meanwhile, the government should take the necessary steps to overcome the bottlenecks identified.

2022-01-01T00:00:00Z Chowdhury, Mohiuddin Ahsanul Kabir https://repository.auw.edu.bd/handle/123456789/871 2026-02-18T06:15:06Z 2022-01-01T00:00:00Z

Prevalence and correlates of knowledge and practices regarding infection prevention and control, and triage in primary healthcare settings: A cross-sectional study in Bangladesh Chowdhury, Mohiuddin Ahsanul Kabir Background: Despite the high prevalence of healthcare-acquired infection in resource- limited settings, healthcare workers’ (HCWs’) knowledge and practices of infection pre- vention and control (IPC) and triage are not well-researched. We examined thisin Ban- gladesh’s primary healthcare facilities (HCFs) during the COVID-19 pandemic. Methods: We surveyed 312 HCWs in 94 community clinics (CCs) and 90 family welfare centres (FWCs) in six districts from February to April 2021. We assessed HCWs’ self- reported knowledge and observed practices in four domains: personal hygiene, medical instrument processing, waste management, and triage. We constructed a weighted composite knowledge score and estimated the association between knowledge and background characteristics using a generalised linear mixed effects model. Practices were described through univariate analysis. Findings: On a scale of 100, the mean composite knowledge score was 38.3 (SD: 13.3) overall and 44.0 (SD: 13.1) and 33.8 (SD: 11.6) for FWCs and CCs, respectively. The HCWs of FWCs were more aged, experienced, and educated than those of CCs. Knowledge score was the highest in personal hygiene and the lowest in medical waste segregation. Knowledge was significantly associated with HCWs’ designation and education. Concerning practices, not more than one-third of the HCWs or HCFs, on average, followed the rec- ommended protocols, except for wearing face masks while on duty (87.1%) and referring potential COVID-19 patients to higher-level facilities (68.3%). Conclusions: HCWs’ capacity in instrument processing, waste management, and triage needs to be improved through formal education and training initiatives. Our study can contribute to the under-researched IPC and triage domains in resource-limited settings.

2022-01-01T00:00:00Z Chowdhury, Mohiuddin Ahsanul Kabir https://repository.auw.edu.bd/handle/123456789/870 2026-02-18T06:15:02Z 2022-01-01T00:00:00Z

The overlapping burden of the three leading causes of disability and death in sub-Saharan African children Chowdhury, Mohiuddin Ahsanul Kabir

2022-01-01T00:00:00Z