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| 2. |
- Chowdhury, F., et al.
(author)
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A phase I/II study to evaluate safety, tolerability and immunogenicity of Hillchol®, an inactivated single Hikojima strain based oral cholera vaccine, in a sequentially age descending population in Bangladesh
- 2021
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In: Vaccine. - : Elsevier BV. - 0264-410X. ; 39:32, s. 4450-4457
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Journal article (peer-reviewed)abstract
- Background: The World Health Organization (WHO) recommends the use of oral cholera vaccines (OCVs) as part of an integrated control program, both in highly endemic settings and during cholera epidemics. The available and internationally recommended WHO-prequalified OCVs (Dukoral, Shanchol, Euvichol) contain multiple heat and formalin-killed V. cholerae strains of Inaba and Ogawa serotypes. MSD Wellcome Trust Hilleman Laboratories Pvt. Ltd. in technical collaboration with University of Gothenburg, Sweden has developed a new single strain OCV, Hillchol. This vaccine consists of formaldehyde-inactivated whole cell El Tor V. cholerae O1 bacteria engineered into the Hikojima serotype for stable expression of both the Ogawa (AB) and Inaba (AC) LPS antigens on the bacterial surface. We evaluated the safety and immunogenicity of this novel and potentially much less expensive OCV in comparison with Shanchol. Methods: We conducted a randomized, non-inferiority, age-descending clinical trial of OCV (Hillchol vs. Shanchol) in the Mirpur area of Dhaka city from July 2016 to May 2017. This study was carried out in three different age cohorts (1–<5, 5–17 and ≥18 years old). Two doses of vaccine were given at 14 days intervals to 560 healthy participants. Findings: No serious adverse events were reported. There were no significant differences in the rates of adverse events between the test vaccine (Hillchol) and the comparator (Shanchol) group. Serum vibriocidal antibody responses in all age groups combined were comparable for all the O1 Ogawa (59% vs. 67%; 90% CI of difference: −14.55, −0.84) and Inaba (70% vs. 71%; 90% CI of difference: −7.24, 5.77) serotypes, showing that the Hillchol vaccine was non-inferior to Shanchol. This new vaccine was also non-inferior to Shanchol in the different age strata. Conclusion: The safety and immunogenicity profile of the new OCV Hillchol is comparable to Shanchol in persons residing in a cholera-endemic setting. ClinicalTrials.gov number: NCT02823899. © 2021
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| 4. |
- Injamul Hoq, Mohammad, et al.
(author)
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Trends in the Prevalence of Hypertension and Type 2 Diabetes in Bangladesh (2010-2020): A Systematic Review and Meta-Analysis
- 2023
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In: Current Diabetes Reviews. - : Bentham Science Publishers Ltd.. - 1573-3998. ; 19:6
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Journal article (peer-reviewed)abstract
- Background The prevalence of cardiovascular diseases (CVDs) and type 2 diabetes mellitus (T2DM) has increased in Bangladesh. This paper has reviewed published studies on hypertension and T2DM from 2010 to 2020 in Bangladesh and conducted a meta-analysis. Methods The PubMed database was used for systematic search. Hypertension and T2DM were considered for measuring pooled prevalence by meta-analysis. The random-effects model was used to calculate the pooled prevalence of hypertension (n = 30) and T2DM (n = 21) in relevant studies. The quality of the reviewed studies was determined by sampling strategy, sample size, and outcome assessment. The meta-analysis protocol was registered at PROSPERO (CRD42020206315). Results The pooled hypertension and T2DM prevalence was 21.6% (95% CI: 18.8%-24.4%) and 13.6% (95% CI: 10.8%-16.5%), respectively. Females were more hypertensive than males (M vs. F: 18.6% vs. 24.8%), and T2DM was higher in females (M vs. F: 12.4% vs. 13.3%). Urban dwellers were more hypertensive and diabetic than rural people (urban vs. rural: 28.5% vs. 20.3% and 18.8% vs. 14.2%, respectively). An 8% increase in the prevalence of hypertension and T2DM became more than double compared to the 1995-2010 period. Conclusion Future research should focus on the underlying factors that increase the prevalence of these diseases and prevention strategies to reduce the trend of increasing prevalence.
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| 5. |
- Razzak, S. B. A., et al.
(author)
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Quantitative and qualitative assessments of microbial contamination in some bottled and tap water with their drug resistant pattern
- 2021
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In: International Food Research Journal. - 1985-4668. ; 28:5, s. 945-952
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Journal article (peer-reviewed)abstract
- The present work focussed on the concerns of the existence of coliform, faecal coliform, and other pathogens in both tap water and commercially available bottled water, along with the drug resistant pattern of the isolates. The physico-chemical features of the bottled water samples were satisfactory, but most of the tap water exceeded the marginal limit. A total of 21 samples (10 of tap water and 11 of bottled water) were collected and processed for microbiological analysis. All the samples were found to be contaminated with total viable bacteria up to 10(8) CFU/mL. Among the 21 samples, seven samples were found to be contaminated with E. coli up to 10(6) CFU/mL, and six samples had Klebsiella spp. up to 10(2) CFU/mL. Faecal contamination was totally absent in all bottled water, but present in four tap water samples. Fungi was found in six samples within the range of 10(2) to 10(3) CFU/mL. Surprisingly, Staphylococcus spp. were observed in all bottled water. Vibrio spp. were detected in three samples. An elevated number of faecal coliforms, Klebsiella spp., Salmonella spp., Shigella spp., Vibrio spp., and Pseudomonas spp. were estimated among the tap water samples up to 10(5) CFU/mL. The water samples, especially tap water, collected from the different areas were microbiologically unsafe, as few pathogenic microorganisms were found in several samples. This indicated as public health threat. Most of the isolates from both tap and bottled water samples were found to be resistant against more than one antibiotic tested, which is extremely alarming for the consumers. Very few antibiotics were found to be effective against the bacterial isolates. (C) All Rights Reserved.
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| 6. |
- Ahmed, Anisuddin, et al.
(author)
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Measuring the effectiveness of an integrated intervention package to improve the level of infection prevention and control : a multi-centre study in Bangladesh
- 2024
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In: Journal of Hospital Infection. - : Elsevier. - 0195-6701 .- 1532-2939. ; 145, s. 22-33
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Journal article (peer-reviewed)abstract
- Background: Infection prevention and control (IPC) is a critical component of delivering safe, effective and high -quality healthcare services, and eliminating avoidable healthcare -associated infections (HAIs) in health facilities, predominantly in populationdense settings such as Bangladesh.Aim: Our study aimed to assess the effect of an integrated intervention package in improving the IPC level of the health facilities in Bangladesh.Methods: We conducted a pre -post intervention study in six district hospitals (DHs) and 13 Upazila Health Complexes (UHCs) in the six districts of Bangladesh. Baseline and endline assessments were conducted between March and December 2021 using the adapted World Health Organization Infection Prevention and Control Assessment Framework (WHO-IPCAF) tool. The IPCAF score, ranging from 0-800, was calculated by adding the scores of eight components, and the IPC promotion and practice level was categorized as Inadequate (0 -200), Basic (201-400), Intermediate (401-600) and Advanced (601-800). The integrated intervention package including IPC committee formation, healthcare provider training, logistics provision, necessary guidelines distribution, triage/flu corners establishment, and infrastructure development was implemented in all facilities.Results: The average IPCAF score across all the facilities showed a significant increase from 16% (95% CI: 11.5-20.65%) to 54% (95% CI: 51.4-57.1%). Overall, the IPCAF score increased by 34 percentage points (P<0.001) in DHs and 40 percentage points (P<0.001) in UHCs. Following the intervention, 12 (three DHs, nine UHCs) of 19 facilities progressed from inadequate to intermediate, and another three DHs upgraded from basic to intermediate in terms of IPC level.Conclusion: The integrated intervention package improved IPCAF score in all facilities.
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| 7. |
- Akhtar, M., et al.
(author)
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dmLT Adjuvant Enhances Cytokine Responses to T Cell Stimuli, Whole Cell Vaccine Antigens and Lipopolysaccharide in Both Adults and Infants
- 2021
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In: Frontiers in Immunology. - : Frontiers Media SA. - 1664-3224. ; 12
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Journal article (peer-reviewed)abstract
- Enhancement of mucosal immune responses in children and infants using novel adjuvants such as double mutant heat labile toxin (dmLT) is an important goal in the enteric vaccine field. dmLT has been shown to enhance mucosal IgA responses to the oral inactivated enterotoxigenic Escherichia coli (ETEC) vaccine ETVAX. dmLT can enhance IL-17A production from adult T cells, which may increase the production and secretion of mucosal IgA antibodies. However, the adjuvant mechanism remains to be fully elucidated and might differ between infants and adults due to age-related differences in the development of the immune system. The main objective of this study was to determine how dmLT influences antigen presenting cells and T cells from infants compared to adults, and the role of IL-1 beta for mediating the adjuvant activity. Peripheral blood mononuclear cells (PBMCs) from Bangladeshi infants (6-11 months) and adults (18-40 years) were stimulated with the mitogen phytohaemagglutinin (PHA), the superantigen Staphylococcal enterotoxin B (SEB), ETVAX whole cell component (WCC) or E. coli lipopolysaccharide (LPS) +/- dmLT, and cytokine production was measured using ELISA and electrochemiluminescence assays. The adjuvant dmLT significantly enhanced SEB- and PHA-induced IL-17A, but not IFN-gamma responses, in PBMCs from both infants and adults. Blocking experiments using an IL-1 receptor antagonist demonstrated the importance of IL-1 signaling for the adjuvant effect. dmLT, ETVAX WCC and LPS induced dose-dependent IL-1 beta responses of comparable magnitudes in infant and adult cells. Depletion experiments suggested that IL-1 beta was mainly produced by monocytes. dmLT enhanced IL-1 beta responses to low doses of WCC and LPS, and the adjuvant effect appeared over a wider dose-range of WCC in infants. dmLT and WCC also induced IL-6, IL-23 and IL-12p70 production in both age groups and dmLT tended to particularly enhance IL-23 responses to WCC. Our results show that dmLT can induce IL-1 beta as well as other cytokines, which in turn may enhance IL-17A and potentially modulate other immunological responses in both infants and adults. Thus, dmLT may have an important function in promoting immune responses to the ETVAX vaccine, as well as other whole cell- or LPS-based vaccines in infants in low- and middle-income countries.
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| 8. |
- Akhtar, M., et al.
(author)
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Kinetics of antibody-secreting cell and fecal IgA responses after oral cholera vaccination in different age groups in a cholera endemic country
- 2017
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In: Vaccine. - : Elsevier BV. - 0264-410X. ; 35:2, s. 321-328
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Journal article (peer-reviewed)abstract
- Immune responses to oral enteric vaccines in children and infants may be influenced by factors such as age, previous priming with related microorganisms and breast feeding. In this study, we aimed to determine optimal time points to assess immune responses to oral enteric vaccines in different clinical specimens. This was done by investigating antibody secreting cell (ASC) and fecal antibody responses on different days after vaccination using the licensed oral cholera vaccine Dukoral, containing cholera toxin B-subunit (rCTB) and inactivated Vibrio cholerae bacteria, as a model vaccine. Two vaccine doses were given 2 weeks apart to infants (6-11 months), young children (12-18 months), toddlers (19 months-5 years) and adults in a cholera endemic country (Bangladesh). IgA ASC responses, as determined by the antibodies in lymphocyte supernatant (ALS) assay, plasma IgA and IgG responses and secretory IgA (SIgA) responses in extracts of fecal samples were evaluated 4/5 and 7 days after each vaccination. After the first vaccine dose, anti-CTB ALS IgA responses in adults and toddlers were high and comparable on day 5 and 7, while responses were low and infrequent in young children. After the second dose, highest ALS responses were detected on day 5 among the time points studied in all age groups and the responses declined until day 7. In contrast, plasma IgA and IgG anti-CTB responses were high both on day 5 and 7 after the second dose. Fecal SIgA responses in young children and infants were highest on day 7 after the second dose. Our results suggest that ASC/ALS responses to two doses of the oral cholera vaccine Dukoral and related oral vaccines should be analyzed earlier than previously recommended (day 7) at all ages. Fecal antibody responses should preferably be analyzed later than ASC/ALS responses to detect the highest antibody responses. (C) 2016 Elsevier Ltd. All rights reserved.
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| 9. |
- Akter, S., et al.
(author)
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The frequency of circulating integrin alpha 4 beta 7(+) cells correlates with protection against Helicobacter pylori infection in immunized mice
- 2019
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In: Helicobacter. - : Wiley. - 1083-4389 .- 1523-5378. ; 24:6
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Journal article (peer-reviewed)abstract
- Background Chronic Helicobacter pylori infection is the cause of peptic ulcers in a subpopulation of individuals and a risk factor for the development of gastric cancer. A vaccine against H pylori infection can prevent the acquisition of the infection and protect against reinfections. Clinical trials to date evaluating the efficacy of H pylori vaccines in human challenge models have shown moderate to poor protection with difficulties in predicting efficacy. Thus, while further studies are needed to design an effective vaccine, we also need to find relevant correlates for vaccine efficacy. Objective To find immune correlates to vaccine efficacy, the frequencies of neutrophils, eosinophils and inflammatory monocytes and CD4(+) T-cell memory and mucosa homing integrin alpha 4 beta 7(+) cells were assessed by flow cytometry in the blood of mice after vaccination. Materials and Methods H pylori antigens and cholera toxin or the multiple mutant CT (mmCT) were administered via the sublingual (SL) and intragastric route (IG). The vaccinated mice were infected with H pylori strain SS1 bacteria, and colonization in the stomach and immune responses were evaluated. Results The H pylori vaccine was effective in reducing bacterial load in the stomach of mice and enhancing immune responses compared to unvaccinated infection controls. In the blood of mice after SL or IG route of vaccination, we observed changes in frequencies of innate and adaptive immune cell subsets compared to infection controls. Remarkably, the frequency of circulating mucosal homing alpha 4 beta 7(+)CD4(+) T cells after vaccination correlated with low bacterial load in the stomach of individual mice irrespective of the immunization route. Conclusions Our study shows that the innate and adaptive immune cell subsets can be measured in the blood after vaccination and that increased frequency of alpha 4 beta 7(+)CD4(+) in the blood after immunization could be used as a predictive marker for the efficacy of vaccine against H pylori infection.
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| 10. |
- Hawlader, M. D. H., et al.
(author)
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Quality of life of COVID-19 recovered patients : a 1-year follow-up study from Bangladesh
- 2023
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In: Infectious Diseases of Poverty. - : Springer Nature. - 2095-5162. ; 12:1
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Journal article (peer-reviewed)abstract
- Background: The COVID-19 pandemic posed a danger to global public health because of the unprecedented physical, mental, social, and environmental impact affecting quality of life (QoL). The study aimed to find the changes in QoL among COVID-19 recovered individuals and explore the determinants of change more than 1 year after recovery in low-resource settings. Methods: COVID-19 patients from all eight divisions of Bangladesh who were confirmed positive by reverse transcription-polymerase chain reaction from June 2020 to November 2020 and who subsequently recovered were followed up twice, once immediately after recovery and again 1 year after the first follow-up. The follow-up study was conducted from November 2021 to January 2022 among 2438 individuals using the World Health Organization Quality of Life Brief Version (WHOQOL-BREF). After excluding 48 deaths, 95 were rejected to participate, 618 were inaccessible, and there were 45 cases of incomplete data. Descriptive statistics, paired-sample analyses, generalized estimating equation (GEE) analysis, and multivariable logistic regression analyses were performed to test the mean difference in participants’ QoL scores between the two interviews. Results: Most participants (n = 1710, 70.1%) were male, and one-fourth (24.4%) were older than 46. The average physical domain score decreased significantly from baseline to follow-up, and the average scores in psychological, social, and environmental domains increased significantly at follow-up (P < 0.05). By the GEE equation approach, after adjusting for other factors, we found that older age groups (P < 0.001), being female (P < 0.001), having hospital admission during COVID-19 illness (P < 0.001), and having three or more chronic diseases (P < 0.001), were significantly associated with lower physical and psychological QoL scores. Higher age and female sex [adjusted odd ratio (aOR) = 1.3, 95% confidence interval (CI) 1.0–1.6] were associated with reduced social domain scores on multivariable logistic regression analysis. Urban or semi-urban people were 49% less likely (aOR = 0.5, 95% CI 0.4–0.7) and 32% less likely (aOR = 0.7, 95% CI 0.5–0.9) to have a reduced QoL score in the psychological domain and the social domain respectively, than rural people. Higher-income people were more likely to experience a decrease in QoL scores in physical, psychological, social, and environmental domains. Married people were 1.8 times more likely (aOR = 1.8, 95% CI 1.3–2.4) to have a decreased social QoL score. In the second interview, people admitted to hospitals during their COVID-19 infection showed a 1.3 times higher chance (aOR = 1.3, 95% CI 1.1–1.6) of a decreased environmental QoL score. Almost 13% of participants developed one or more chronic diseases between the first and second interviews. Moreover, 7.9% suffered from reinfection by COVID-19 during this 1-year time. Conclusions: The present study found that the QoL of COVID-19 recovered people improved 1 year after recovery, particularly in psychological, social, and environmental domains. However, age, sex, the severity of COVID-19, smoking habits, and comorbidities were significantly negatively associated with QoL. Events of reinfection and the emergence of chronic disease were independent determinants of the decline in QoL scores in psychological, social, and physical domains, respectively. Strong policies to prevent and minimize smoking must be implemented in Bangladesh, and we must monitor and manage chronic diseases in people who have recovered from COVID-19. Graphical Abstract: [Figure not available: see fulltext.]
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