Background: Influenza remains a significant public health challenge in low- and middle-income countries (LMICs) like Bangladesh, where vaccine uptake remains low despite the substantial disease burden. Physicians play a vital role in promoting vaccination, yet their intentions and influencing factors are not well understood. Methods: We conducted a cross-sectional study from June to October 2022 across four tertiary-level hospitals in Bangladesh using a questionnaire grounded in the Theory of Planned Behavior (TPB). Hierarchical logistic regression was employed to identify factors associated with vaccine recommendation intentions. Results: Among 972 physicians with an average age of 32.1 years, 40.1% intended to recommend and administer the influenza vaccine. Most (85.3%) agreed vaccination reduces risk, 65.5% desired vaccination for self-protection, 63.5% would vaccinate if available at work, and 85.3% anticipated Ministry of Health support. Male (OR = 1.9, 95% CI: 1.5–2.3) and married (OR = 1.5, 95% CI: 1.1–1.9) physicians were more likely to recommend vaccination. Each unit increase in attitude score doubled the likelihood of recommending the vaccine (OR = 2.0, 95% CI: 1.4–3.0). Conclusions: Physicians’ influenza vaccine recommendations in Bangladesh are suboptimal, influenced by gender, marital status, and attitudes. Targeted educational interventions addressing attitudinal barriers and leveraging institutional support could improve recommendation practices.

: Globally, acute respiratory infections (ARI), including pneumonia, remain the leading infectious causes of morbidity and mortality among children under-two years of age. We conducted this longitudinal birth cohort study in a low-income urban community in Dhaka, Bangladesh, to estimate the incidence of ARI and pneumonia and assess their viral etiology. From May 2015 to March 2016, 447 children were enrolled and followed till 2022. In this analysis, we included data from the first two years of children’s lives, which contributed to a total observation of 778 child-years. Nasopharyngeal wash samples were collected during symptomatic episodes, which were tested using rRT-PCR for rhinovirus (RV), respiratory syncytial virus (RSV), human metapneumovirus (hMPV), influenza virus, human parainfluenza virus (HPIV), and adenovirus. We calculated incidence rates using Poisson-based methods with 95% confidence intervals (CI) and stratified age-specific rates into three groups: 0 to <6 months, 6 to <12 months, and 12 to 24 months. A total of 2,335 ARIs and 314 pneumonia episodes were documented. At least one respiratory virus was detected in 71% of ARI and 75% of pneumonia episodes. RV was the most frequently detected virus (54% in ARI, 40% in pneumonia), followed by RSV, HPIV, and influenza. The incidence of viral ARI was 212/100 child-years (95% CI: 202–223), and that of viral pneumonia was 30/100 child-years (95% CI: 27–35). The observed incidence of viral ARI and pneumonia during early childhood underscores the need for targeted interventions. Future research should examine environmental and socioeconomic influences, assess preventive strategies, and improve early detection and treatment.

Respiratory syncytial virus (RSV) is the leading cause of respiratory morbidity and mortality in children under five years of age, especially in low- and middle-income countries (LMICs). In 2023, two RSV immunisation options, including a maternal RSV vaccine and a monoclonal antibody (mAb), became approved in several high-income countries. The World Health Organization has recently prequalified the maternal vaccine and the Gavi has committed funding for its introduction, raising the prospect of RSV vaccine availability in LMICs in the near future. This analysis thus underscores the need for country-specific data on the burden of disease and seasonality, as well as the acceptability of new immunisation options and evaluations of their cost-effectiveness. Achieving successful implementation will require health system strengthening, targeted strategies to address unwillingness to vaccinate, securing sustainable financing for immunisation, and ensuring sustained policy commitment. As in many other LMICs, the RSV infection continues to pose a substantial public health concern in Bangladesh. However, evidence gaps persist regarding RSV epidemiology, healthcare system readiness, and public perceptions and willingness regarding new immunisation options. We use Bangladesh as a model to identify gaps, review available evidence, and outline strategies for integrating maternal vaccine and infant mAb into the country’s maternal and child health programmes. Lessons drawn from this case study may be directly applicable to other LMICs, offering a pathway to equitable adoption of these life-saving interventions and reducing the substantial global burden of RSV.

The Bangladesh HCW Cohort is a prospective study established to assess the physical and psychological effects of COVID-19 on Bangladeshi HCWs. This paper outlines the study design and baseline characteristics of the cohort participants. The cohort was initiated in February 2021 and enrolled 3,697 HCWs. Baseline demographic, clinical, and occupational risk data were collected through face-to-face interviews. Participants were followed up biweekly to monitor changes in risk factors over time. Validated instruments were used to assess mental health outcomes and infection prevention and control practices. In January 2023, a second phase of the study was initiated to examine breakthrough COVID-19 infections, immune responses by vaccine type, long-term consequences of COVID-19, and booster vaccine uptake. The median age of the HCWs recruited to the cohort was 36 years (IQR: 30-44), and 53.5% were female. Nurses accounted for approximately half of the participants (47.8%), followed by support staff (31.8%) and physicians (20.4%). Nearly half of participants (47%) reported symptomatic COVID-19, most commonly fever (82%) and cough (56%). Additionally, 32% reported hospitalization due to COVID-19.The Bangladesh HCW Cohort provides a prospective platform to evaluate the occupational, physical, and psychological impacts of COVID-19 among HCWs, generating evidence to inform occupational health policy and workforce protection strategies in Bangladesh.

This research aimed to figure out the applications of HbA1c protein and HbA1 gene as the prognostic biomarkers for assessing the risks of different cancers among male T2D patients in Bangladesh considering their serological and oncoinformatic parameters. Depending on the concentrations of HbA1c (%) of the T2D patients (n=300), their individual FBS (mmol/L); THABF (mmol/L); creatinine (mg/dl); SC (mg/dl); STGs (mg/dl); HDLC (mg/dl); and LDLC (mg/dl) were estimated. The values of the patients were compared with the control (n=60) group as the serological analysis. Besides, HbA1 gene (encoding hBA1c protein) overexpression and promotor methylation responsible for BLCA, BRCA, CHOL, COAD, LUAD, LUSC, PAAD, and PRAD cancers in the male T2D patients were profiled as the oncoinformatic parameters based on the sample types; caner stages; racial footprints; gender; age; nodal metastasis; p53 methylations; pancreatitis; diabetes status; smoking behaviors; and overall/disease-free survivability. Finally, the ‘HbA1 gene strings’ responsible for genetic coexpression; endophytic vesicle regulation; antioxidant regulation; oxygen species metabolic regulation; and gene-mediated response to the reactive oxygen molecules were studied comprehensively. A strong correlation between BMI and FBS was observed in both the patients and the control (P<0.0001). Similarly, the values of FBS, THABF, and creatinine resulted in equal significance (P<0.0001) as compared to the HbA1c concentrations of all the T2D and control individuals. The SC, STGs, HDLC, and LDLC concentrations regulated ardently in both the control (P<0.0001), and patients group (P<0.0001), while HbA1c ranged from 3.8-5.8%, and 5.11-15.8% respectively. HbA1 gene is found downregulating with cancer progressed in most of the oncoinformatic parameters. According to the DA, CS, EI, CE, PC, NC, GF, H, and AT profiles; the HbA1 gene interacts with 8 other genes responsible for creating a protein cluster comprising- AHSP, HBA1, HBA2, HBB, HBD, HBE1, HBG2, RPS12, and RPS19 proteins for cancer formation. To recapitulate, HbA1c protein and HbA1 gene can be used as the prognostic serological and molecular biomarkers respectively for determining the risks of cancers among male chronic T2D patients.

The effect of SARS-CoV-2 pandemic has been subsided significantly following the rapid development of vaccine. However, patients with cancer and immunosuppressed state, who are more prone to mortality and morbidity due to this infection, were excluded from majority of the vaccine trials. Moreover, suggested dose modification for cancer and immunosuppressed patients are often not followed because of lack of awareness or unavailability of vaccination schedule. This review will try to bridge this knowledge gap by summarizing the current suggestions of dose modification of COVID-19 vaccine for patients with cancer and immunosuppression.