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Int. J. Environ. Res. Public Health 2011, 8(8), 3437-3452; doi:10.3390/ijerph8083437
Article

Vulnerability of Newborns to Environmental Factors: Findings from Community Based Surveillance Data in Bangladesh

1,2,* , 1
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1 Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Suite E8138, Baltimore, MD 21205, USA 2 Save the Children, H 1(A) 2, Road 91, Dhaka 1212, Bangladesh 3 International Center for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka 1212, Bangladesh
* Author to whom correspondence should be addressed.
Received: 6 May 2011 / Revised: 12 August 2011 / Accepted: 16 August 2011 / Published: 22 August 2011
(This article belongs to the Special Issue Environmental Health Risk Assessment)
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Abstract

Infection is the major cause of neonatal deaths. Home born newborns in rural Bangladeshi communities are exposed to environmental factors increasing their vulnerability to a number of disease agents that may compromise their health. The current analysis was conducted to assess the association of very severe disease (VSD) in newborns in rural communities with temperature, rainfall, and humidity. A total of 12,836 newborns from rural Sylhet and Mirzapur communities were assessed by trained community health workers using a sign based algorithm. Records of temperature, humidity, and rainfall were collected from the nearest meteorological stations. Associations between VSD and environmental factors were estimated. Incidence of VSD was found to be associated with higher temperatures (odds ratios: 1.14, 95% CI: 1.08 to 1.21 in Sylhet and 1.06, 95% CI: 1.04 to 1.07 in Mirzapur) and heat humidity index (odds ratios: 1.06, 95% CI: 1.04 to 1.08 in Sylhet and, 1.03, 95% CI: 1.01 to 1.04 in Mirzapur). Four months (June-September) in Sylhet, and six months in Mirzapur (April-September) had higher odds ratios of incidence of VSD as compared to the remainder of the year (odds ratios: 1.72, 95% CI: 1.32 to 2.23 in Sylhet and, 1.62, 95% CI: 1.33 to1.96 in Mirzapur). Prevention of VSD in neonates can be enhanced if these interactions are considered in health intervention strategies. 
Keywords: neonatal; infection; sepsis; community health workers; environment; heat humidity index; Bangladesh neonatal; infection; sepsis; community health workers; environment; heat humidity index; Bangladesh
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Mannan, I.; Choi, Y.; Coutinho, A.J.; Chowdhury, A.I.; Rahman, S.M.; Seraji, H.R.; Bari, S.; Shah, R.; Winch, P.J.; El Arifeen, S.; Darmstadt, G.L.; Baqui, A.H. Vulnerability of Newborns to Environmental Factors: Findings from Community Based Surveillance Data in Bangladesh. Int. J. Environ. Res. Public Health 2011, 8, 3437-3452.

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