The World Health Organization recommended reducing one’s salt intake below 5 g/day to prevent disability and death from cardiovascular and other chronic diseases. This review aimed to identify salt estimation at the population level in South Asian countries, namely Afghanistan, Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka. We searched electronic databases and government websites for the literature and reports published between January 2011 and October 2021 and also consulted key informants for unpublished reports. We included studies that assessed salt intake from urinary sodium excretion, either spot urine or a 24 h urine sample, on a minimum of 100 samples in South Asian countries. We included 12 studies meeting the criteria after screening 2043 studies, out of which five followed nationally representative methods. This review revealed that salt intake in South Asian countries ranges from 6.7–13.3 g/day. The reported lowest level of salt intake was in Bangladesh and India, and the highest one was in Nepal. The estimated salt intake reported in the nationally representative studies were ranging from 8 g/day (in India) to 12.1 g/day (in Afghanistan). Salt consumption in men (8.9–12.5 g/day) was reported higher than in women (7.1–12.5 g/day). Despite the global target of population salt intake reduction, people in South Asian countries consume a much higher amount of salt than the WHO-recommended level.

Background/Objectives: Front-of-package labeling (FOPL) policies are a useful strategy to inform consumers about foods high in nutrients of concern, but little is known about what type of label works best in Bangladesh, a country with increasing levels of unhealthy food intake and diet-related diseases. Methods: We conducted 10 focus groups with men and women in rural and urban Bangladesh (n = 76). Using a semi-structured discussion guide, we asked consumers for their perceptions of the healthfulness of nutrients and foods, two common FOPLs (a color-coded guideline daily allowance [GDA] label and a warning label), and different visual elements of the warning label (e.g., shape, icon, text). Results: Participants understood the health harms of sugar and salt consumption but were less clear on saturated fat. Both FOPLs were perceived as helpful for identifying unhealthy foods, but the warning labels were perceived as easier to understand and more likely to influence behaviors than the GDA. Regarding the design of warning labels, participants perceived warning devices, holding straps, and octagonal shapes as effective but had mixed reactions to which icons or textual statements were most effective. Conclusions: FOPLs are likely to facilitate Bangladeshi consumers’ ability to identify unhealthy products. Further research is needed to understand the impact on food choices as well as the most effective design in this population.

Processed and ultra-processed foods (PF/UPFs) are becoming a significant public health concern because of their concerningly high nutrient content, including sodium, and rapidly increasing consumption, especially in low- and middle-income countries. This study aimed to analyze sodium levels in commonly consumed PF/UPFs in Bangladesh, compare them to the WHO’s sodium benchmarks, and assess the discrepancies between label-reported and laboratory-analyzed sodium content. A countrywide cross-sectional survey was conducted among adults, adolescents, and children to identify commonly consumed PFs/UPFs. Most common PF/UPFs were analyzed using Mohr’s titration method to estimate sodium content. Discrepancies between actual content and labels were analyzed, accepting a ±20% deviation, to determine gaps. Among the 974 participants surveyed, PF/UPF consumption in the past week was 97%, with higher consumption among metropolitan and urban residents. Amount of sodium, analyzed in 105 PF/UPF across 14 WHO categories and sub-categories, varied by categories, with soups, instant noodles, and chutneys having the highest. Compliance with the WHO’s sodium benchmarks was inconsistent across categories. The accuracy of label reporting was suboptimal, with under-reporting in 40% of products and a lack of sodium labelling in 9%. These findings unveiled high sodium intake from PFs/UPFs and inaccurate labelling as public health concerns in Bangladesh, highlighting the need for appropriate policies and strategies.

To improve hypertension control and prevent cardiovascular disease in Bangladesh, the National Heart Foundation of Bangladesh and Resolve to Save Lives collaborated with the Ministry of Health and Family Welfare to launch the Bangladesh Hypertension Control Initiative (BHCI). The BHCI implemented the WHO-HEARTS hypertension control package in four primary health care facilities (Upazila Health Complexes or UHCs) in 2018, then scaled up to 51 UHCs in 2021, 172 UHCs by 2024, and 320 UHCs by May 2026, covering about 54 million of 108 million adults (~43% coverage). By May 2026, the BHCI had enrolled 739,057 hypertensive patients and achieved 59% blood pressure (BP) control (<140/90 mmHg based on BP measured in the prior three months among all enrolled patients). The BHCI is a scalable model for hypertension control programs in other low- and middle-income countries. For sustained high-quality national scale-up, uninterrupted supply of medicines by the government and accurate information systems are crucial.

Introduction: Exposure to secondhand tobacco smoke increases risk of non-communicable diseases. Globally 1.2 million deaths of non-smokers are attributed to secondhand smoking. According to global Adult Tobacco Survey Bangladesh, 2017, 12.7% of adult populations visiting health care facilities...

Introduction: One-third of annual deaths in Bangladesh are from cardiovascular diseases. Acute Coronary Syndrome (ACS) has various presentations, severity, and treatment options. Information obtained from the ACS registry will help in improved patient management and appropriate planning. This prospective observational study aimed to understand treatment and outcomes, and their associated factors, among Bangladeshi adult ACS patients by establishing a facility-based registry. Methods: The national ACS registry was established in six tertiary-level hospitals—equally representing government and private facilities—across the metropolitan cities of Dhaka, Sylhet, and Chattagram, in collaboration with the Non-communicable Disease Control Programme (NCDC) of the Directorate General of Health Services, Ministry of Health. Patients admitted with a diagnosis of ACS in the selected hospitals were interviewed and their medical records were reviewed. An Android-based app was developed to collect information on socio-demographic characteristics, ACS risk factors, presenting features, treatment-seeking behavior, provided management, in-hospital complications, and immediate outcomes. The long-term outcomes were collected via telephonic follow-up after a minimum of 6 months passed from enrollment. Results: A total of 29,029 patients were enrolled in the registry, and 28,645 had a confirmed diagnosis of ACS; 41.6% STEMI, 38.7% NSTEMI, and 20.7% unstable angina. The majority were male (68.3%), with a mean age of 56.4 ± 12.1 years, and 79% were aged ≥46 years. On admission, 58.1% were hypertensive and 46.4% were diabetic; 60.7% reported a history of tobacco use, and 27.3% had a family history of heart disease. Almost all patients (98.5%) were symptomatic, most commonly presenting with excessive sweating (87.8%) and chest pain or discomfort (73.1%). One-quarter of patients initially sought care at secondary-level or lower public health facilities or private chambers; 8.8% did not receive an initial loading dose of antiplatelet therapy at first contact facility. The majority (75.9%) were treated conservatively with medical management; reperfusion therapy was used infrequently in hospitals below the tertiary level. During initial hospital stay, 32.3% of patients experienced at least one complication, and in-hospital mortality was 1.4%. To date, 78.% of enrolled patients have been contacted by telephone after an average of 10 months; 92.2% were successfully followed up; 86.6% were alive, and 14.5% required rehospitalization. Most of the deaths reported at long-term follow-up were attributed to cardiovascular causes. Conclusion: Under-reporting of NSTEMI was presumed, which demands further research. The provision of cardiac marker testing and safe-affordable thrombolytics at primary healthcare facilities are recommended in addition to the awareness rising to control the rising burden of acute coronary syndrome and its complications in Bangladesh.