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K M Aziz

Publications and source records attributed to K M Aziz.

At least 55 records · Page 3Linked to original sources

Comparability of results obtained by two-week home maintained diarrhoeal calendar with two-week diarrhoeal recall.

Many community based studies of diarrhoea in the developing world employ face-to-face interviews to obtain diarrhoeal histories. An alternative recording device that preserved the accuracy but avoided the expense and time commitment of the interview would be extremely valuable. To evaluate the comparability of episodes of diarrhoea obtained from a home-maintained two-week calendar with those histories given in response to a two-week health recall interview in a largely uneducated population, we studied approximately 1500 families for six months in Dhaka, Bangladesh. The diarrhoea records obtained for children by the two methods were highly comparable (Kappa value 0.83). The comparability was not impaired either by lack of maternal education nor by increased numbers of children in the household. We conclude that the two-week home maintained diarrhoea calendar offers comparable results with the two-week recall and in certain situations could be a useful substitute.

Bangladesh↗

Toxin production by Vibrio mimicus strains isolated from human and environmental sources in Bangladesh.

Vibrio mimicus has recently been isolated from aquatic environments of Bangladesh. A total of 125 of 300 environmental isolates, representing various biotypes, and 19 human isolates were tested for enteropathogenicity by using several models. Less than 1% of the environmental isolates and slightly more than 10% of the clinical isolates produced cholera toxin-like toxin. A significant percentage of the environmental isolates (25%) and of the human isolates (74%) induced fluid accumulation in ligated rabbit ileal loops. One environmental strain produced heat-stable toxin-like enterotoxin, whereas all of the human isolates did not. V. mimicus strains were divided into the following three groups on the basis of their activity in various toxin assays: (i) organisms which produce a heat-labile enterotoxin immunobiologically similar to cholera toxin, (ii) organisms which produce a heat-stable enterotoxin-like toxin, and (iii) organisms whose whole-cell cultures have some activity characteristic of heat-labile toxin (e.g., fluid accumulation in ligated rabbit ileal loops and positive permeability factor) but are not positive by the GM1 enzyme-linked immunosorbent assay. One isolate from this group was able to elicit these results with cell-free culture filtrates. There was no correlation of biotype with toxic activity of V. mimicus isolates.

Animals↗

Twenty-four-hour recall, knowledge-attitude-practice questionnaires, and direct observations of sanitary practices: a comparative study.

Although responses to 24-hour recall and knowledge-attitude-practice questionnaires are commonly used in water-sanitation studies as surrogates for direct observation of behaviour, the validity of this approach is questionable. We therefore compared questionnaire data with those obtained by direct observation of practices related to water storage, handwashing, and defecation among 247 families in urban Dhaka, Bangladesh. Analysis of the results indicates that accord between the replies to the questionnaires and the data collected by direct observation was poor and that the responses to the two questionnaires were often contradictory. Significant disagreements between the results of questionnaires and observations arose usually because desirable practices were over-reported by the respondents. The results of the study suggest that in urban Bangladesh 24-hour recall and knowledge-attitude-practice questionnaires should not be used as proxies for direct observation of hygiene practices.

Bangladesh↗

Dysentery, not watery diarrhoea, is associated with stunting in Bangladeshi children.

To study the interaction between diarrhoea and malnutrition, an average of 300 children aged 5-24 months were followed from January 1981 to January 1983 in Teknaf, Bangladesh. Diarrhoea episodes, differentiated according to stool appearance, were recorded weekly while weight and height measurements were taken every 6 months. Results showed no relationship between the nutritional indicators and diarrhoea incidence recorded within 60 d after anthropometric assessment. However, the duration of dysentery was significantly longer in the severely malnourished children who were stunted but not for those wasted. Although many children with watery diarrhoea had episodes of long duration, these were not associated with any nutritional indicator. We conclude that the key factors in this interaction are the invasive type of pathogen and chronic malnutrition.

Bangladesh↗

Antibiotic resistance patterns of Vibrio mimicus isolated from human and environmental sources in Bangladesh.

Twenty-five environmental and 19 clinical strains of Vibrio mimicus were tested for antibiotic susceptibility patterns. Environmental strains were resistant to streptomycin, kanamycin, and trimethoprim-sulfamethoxazole; clinical strains were susceptible. Environmental strains showed variable resistance to ampicillin (44%), but clinical strains were susceptible. All strains tested were susceptible to chloramphenicol and gentamicin.

Drug Resistance, Microbial↗

Impact of environmental sanitation and crowding on infant mortality in rural Bangladesh.

In two villages of Bangladesh, 2471 infants born in 1976 and 1977 were followed up for a year to study the impact of environmental sanitation and crowding on their mortality. Neonatal and postneonatal mortality rates in the study cohort were 100 and 75 per 1000 live-births, respectively. Multiple logistic regression analysis was done to estimate the effects of the selected risk factors while controlling for some socioeconomic, demographic, and biological characteristics. Risk of postneonatal mortality (PNNM) in the households which did not use latrines was 3 X 12 times (p less than 0.01) higher than in those which did and 1.5 times (p less than 0.05) higher in the households with 10 or more persons than in smaller households. PNNM in the households which did not use tube-wells (hand-pump) water was higher, but not significantly so, than in those which used tube-well water for all purposes. Neonatal mortality was completely unrelated to the environmental factors investigated.

Bangladesh↗

Isolation of enterotoxigenic, hemolytic, and antibiotic-resistant Aeromonas hydrophila strains from infected fish in Bangladesh.

Strains of Aeromonas hydrophila isolated from skin infections of common freshwater fish in Bangladesh were tested for enterotoxin production, hemolysin production, and any correlation between these two activities. We also tested the resistance patterns of A. hydrophila to different drugs, especially in relation to ampicillin. The A. hydrophila strains produced an enterotoxin that was related to their beta-hemolytic activities. Production of beta-hemolysin may thus be an indicator of enterotoxicity. As 50% of the strains of A. hydrophila were found to be susceptible to 12.5 micrograms of ampicillin per ml, media containing this antibiotic may not be suitable for their isolation.

Aeromonas↗

Beliefs and treatment related to diarrhoeal episodes reported in association with measles.

Eighty mothers whose children had measles in the past month were interviewed for beliefs and practices related to the management of measles and measles associated diarrhoea. Beliefs and practices about diarrhoea, associated with measles are described. Diarrhoea during and after measles was considered beneficial by mothers, who believed it helped to flush out impurities from the body. Paradoxically ORS was not used because of an erroneous idea that ORS would stop diarrhoea. Informing mothers that ORS will not stop diarrhoea, but will help in flushing out the impurities, could enhance ORS use, reducing morbidity and mortality. The prevalent belief, that measles patients must be kept in a clean environment is useful and should be encouraged. Other beliefs and practices to hasten the eruption are neutral, but since they encourage cleanliness and isolation, need not be discouraged.

Antidiarrheals↗

A diarrhea clinic in rural Bangladesh: influence of distance, age, and sex on attendance and diarrheal mortality.

Attendance rates at a diarrhea clinic were monitored in a defined population in rural Bangladesh. Weekly home visits were also carried out to determine diarrheal attacks in communities within six miles of the clinic. Within the first one mile radius, 90 per cent of diarrheal cases came to the clinic for treatment. At two miles the attendance fell to 70 per cent for males and 40 per cent for females. On an average, the greater the distance to the clinic, the more severe was the degree of dehydration on presentation, requiring more frequent use of intravenous fluid. Mortality secondary to diarrhea was significantly reduced only within a two-mile radius of the clinic.

Adolescent↗

Patterns of Shigella infection in families in rural Bangladesh.

To assess the mode of transmission of Shigella infection in rural Bangladesh, questionnaire and culture surveys were conducted in baris (neighborhoods) where persons with diarrhea associated with Shigella infection and index controls with non-Shigella diarrhea lived. Nineteen percent of persons in Shigella baris and 7% of persons in control baris were infected during the survey periods (P less than 0.001). The prevalence of Shigella infection was highest for children 1-9 years of age and for females than 39 years and was not related to socioeconomic status, family size or household crowding. Use of surface water for drinking was not a risk factor for Shigella infection; in fact, use of river water was more frequent in control baris. Both household and bari contacts of Shigella index cases frequently excreted different serotypes from that excreted by the person with the index case. In Shigella baris, families with infection were significantly more likely than uninfected families to have a history of an overnight stay away from home by a family member during the previous week. These observations suggest there were multiple introductions of Shigella into some families and that the epidemiology of Shigella infection for families in rural Bangladesh differs from that observed for families living in more industrialized countries.

Adolescent↗

Epidemiology of eltor cholera in rural Bangladesh: importance of surface water in transmission.

In order to define the role of water used for drinking, cooking, bathing, and washing in the transmission of Vibrio cholerae biotype eltor infections in an area with endemic cholera, surveillance was initiated in neighbourhoods with a culture-confirmed cholera index case and others with index cases with non-cholera diarrhoea as controls. In neighbourhoods with cholera infection, 44% of surface water sources were positive for V. cholerae, whereas only 2% of surface sources were positive in control neighbourhoods. Canals, rivers, and tanks were most frequently positive. There was an increased risk of infection for families using water from culture-positive sources for drinking, cooking, bathing, or washing and for those using water sources used by index families for drinking, cooking or bathing. Analysis of the results for individuals showed that in this case there was an increased risk of infection associated with using water from culture-positive sources for cooking, bathing, or washing, but not with using water from culture-positive sources for drinking. Individuals who used the same water source as an index family for bathing were more likely to be infected than those using different sources. For families drinking from a culture-negative source, there was an association between infection and bathing in a positive source. For families using a different bathing source from the index family there was an association between infection and drinking from the same source as the index family, and for families using a different drinking source from the index family there was an association between infection and bathing in the same source as the index family. These data suggest that use of surface water is important in the transmission of V. cholerae and that, in addition to providing safe drinking water, education regarding the risk of transmission of infection by water from potentially contaminated sources used for other purposes, especially bathing, may also be necessary to control transmission in areas where eltor cholera is endemic.

Adolescent↗