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Vulnerability of Newborns to Environmental Factors: Findings from Community Based Surveillance Data in Bangladesh
Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Suite E8138, Baltimore, MD 21205, USA
Save the Children, H 1(A) 2, Road 91, Dhaka 1212, Bangladesh
International Center for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka 1212, Bangladesh
* Author to whom correspondence should be addressed.
Received: 6 May 2011; in revised form: 12 August 2011 / Accepted: 16 August 2011 / Published: 22 August 2011
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
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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.
Mannan I, Choi Y, Coutinho AJ, Chowdhury AI, Rahman SM, Seraji HR, Bari S, Shah R, Winch PJ, El Arifeen S, Darmstadt GL, Baqui AH. Vulnerability of Newborns to Environmental Factors: Findings from Community Based Surveillance Data in Bangladesh. International Journal of Environmental Research and Public Health. 2011; 8(8):3437-3452.
Mannan, Ishtiaq; Choi, Yoonjoung; Coutinho, Anastasia J.; Chowdhury, Atique I.; Rahman, Syed Moshfiqur; Seraji, Habib R.; Bari, Sanwarul; Shah, Rasheduzzaman; Winch, Peter J.; El Arifeen, Shams; Darmstadt, Gary L.; Baqui, Abdullah H. 2011. "Vulnerability of Newborns to Environmental Factors: Findings from Community Based Surveillance Data in Bangladesh." Int. J. Environ. Res. Public Health 8, no. 8: 3437-3452.