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Biomedical subjects

R Bairagi

Publications and source records attributed to R Bairagi.

At least 19 recordsLinked to original sources
PubMed2000

Contraceptive failure: levels, trends and determinants in Matlab, Bangladesh.

This study investigated the levels, trends and determinants of contraceptive use-failure in Matlab, Bangladesh, using a set of prospective data on 25,960 women of reproductive age. The data were extracted from the Record Keeping System (RKS) of Matlab for the period 1978-94. If there was any live birth during the use or within 7 months after the discontinuation of use, it was considered as a failure. The life table technique and hazard model were used as analytical tools. The results suggest that use-failure for pills, IUDs (TCu 200) and injectables and other temporary methods increased from 1978 to 1988, but began to decline after 1988. The cumulative probability of first-method failure within 1 year of method acceptance of the cohort of 1990-94 acceptors was 12.9% for pills, 2.0% for IUDs, 0.5% for injectables, 22.0% for condoms and 13.4% for 'other' methods (sampoon, foam, jelly and traditional methods). For pills, condoms and 'other' methods, the likelihood of failure declined with the duration of use; by contrast, the probability of an IUD failure increased over time, peaking at 3 years of use. The injectables maintained a low likelihood of failure regardless of the duration of use. The quality of Community Health Workers' (CHWs) performance was associated with the risk of failure of all temporary methods except condoms; women's background characteristics associated with failure varied by method. The effect of the quality of the CHWs' performance and the background variables on failure did not change much over time. It is felt that contraceptive failure deserves the serious attention of programme managers and policy makers to make the Bangladesh national family planning programme more successful.

Adult↗
PubMed1998

Inconsistencies in the findings of child nutrition surveys in Bangladesh.

BACKGROUND: The Bangladesh Bureau of Statistics (BBS) has been conducting nutrition surveys of young children at 2-3-y intervals since 1985. However, data on malnutrition determined on the basis of weight-for-age and height-for-age in different surveys are inconsistent. OBJECTIVE: The aim of this study was to investigate the reasons for inconsistencies in the findings of these surveys. DESIGN: Although the regular personnel of the BBS collected data on anthropometry and age in the previous surveys, 1995-1996 data were collected by locally recruited workers. Data on 100 children included in the 1995-1996 survey were also independently collected by BBS personnel. A comparison of the data from these 2 sources and the inconsistencies therein form the basis of this study. RESULTS: The average difference between the 2 sources (bias) was found to be approximately 1.8 mo for age and 0.13 cm for midupper arm circumference. Differences in weight and height were negligible; however, random error was found to be substantial in data on height. CONCLUSIONS: Bias in age was thought to be mainly responsible for the inconsistencies in the measures of malnutrition in the different child nutrition surveys in Bangladesh. A method for accurately collecting age data needs to be developed on the basis of a study in a demographic surveillance area where accurate age data are available. Until such a method is fully developed, midupper arm circumference should be routinely collected in all nutrition surveys. The importance of accuracy in weight and height data is emphasized.

Age Factors↗
PubMed1997

Estimating childhood mortality trends from routine data: a simulation using the preceding birth technique in Bangladesh.

The Preceding Birth Technique (PBT) has been proposed as a method suitable for ascertaining the prevailing level of under-2 mortality in countries without full vital registration. It is a monitoring tool rather than a method that will replace other established approaches to measuring childhood mortality levels and differentials that other demographers have developed over the last 30 years. The principle obstacle to the wider adoption of the PBT is the low proportion of women who give birth in maternity clinics and hospitals. A larger proportion of mothers, however, visit clinics and hospitals for antenatal care and to vaccinate their newborn. We used data from the Matlab surveillance system to test the accuracy of mortality estimates derived using the PBT with data obtained from mothers at antenatal visits and at the vaccination of their youngest children. The study shows that the PBT estimates under-3 rather than under-2 mortality in Bangladesh due to the long birth intervals. The data when used to stimulate the collection of the information at antenatal or postnatal visits, nonetheless provide an accurate description of under-3 mortality trends and differences for the two periods examined--before 1984 and before 1989.

Bangladesh↗
PubMed1994

Socioeconomic and anthropometric status, and mortality of young children in rural Bangladesh.

This article investigates the interrelationship of socioeconemic status, anthropometric status and mortality of young children in rural Bangladesh. Data for this study come from Matlab, the vital registration area of the International Centre for Diarrhoeal Disease Research, Bangladesh, where anthropometric and socioeconomic data concerning 1976 children aged 12-23 months were collected in November-December 1975. From these data, anthropometric indices are created, and the relationships of socioeconomic status measured by dwelling space and anthropometric indices with mortality during the 2 years following measurement of these children are investigated. It is found that both socioeconomic status and anthropometric indices are related to mortality. However, the relationship of anthropometric indices is much stronger. Among the anthropometric indices considered, weight-for-age, height-for-age and arm circumference reflect socioeconomic status better than weight-for-height does; and, the first three indices are equally good, and individually better than weight-for-height, as predictors of mortality. The degree of the effect of socioeconomic status (dwelling space) on mortality explained by the best performing anthropometric index, weight-for-age, was not more than 25%. It is concluded that an anthropometric index that can classify socioeconomic status more efficiently is a better predictor of 2-year mortality than any other anthropometric index.

Anthropometry↗
PubMed1993

Mortality-discriminating power of some nutritional, sociodemographic, and diarrheal disease indices.

This study compared the predictive power of selected nutritional (anthropometric), socioeconomic, and diarrheal disease morbidity variables for subsequent childhood mortality over a 1-year period. The data consisted of observations of approximately 1,900 children aged 6-36 months obtained from a longitudinal demographic surveillance system located in a rural area of Bangladesh in 1988-1990. The results suggested that weight-for-age (%) was the best predictor of subsequent mortality over a 1-year period, followed by weight velocity (monthly weight gain or loss in grams). Standardization of weight velocity by the US National Center for Health Statistics standard did not improve the mortality-discriminating power of this variable. Reported diarrheal morbidity was also a useful criterion for predicting mortality. Neither maternal education nor sex of the child had significant mortality-discriminating power.

Age Factors↗
PubMed1993

Effects of family sex composition on fertility preference and behaviour in rural Bangladesh.

The effects of family sex composition on fertility preferences and behaviour during the period 1977-88 are examined using longitudinal data from Matlab, Bangladesh. The sex composition of living children was found to be systematically related to fertility preferences and behaviour, with a higher number of sons at each family size associated with a higher percentage of women wanting no more children, a higher percentage currently using contraception, and lower subsequent fertility. However, the highest percentage wanting no more children, using contraception and having lowest subsequent fertility was found among women who already had one daughter as well as at least one son. The effects of sex preference on fertility preferences and behaviour were measured using an index developed by Arnold (1985). The results suggest that while sex preference remained largely unchanged during the study period, its effect on contraceptive use declined and its impact on actual fertility remained modest and fairly stable.

Adult↗
PubMed1990

Sex differences and sustained excess in mortality among discordant twins in Matlab, Bangladesh: 1977-1985.

This paper reports findings from a study that compared survival of 204 pairs of liveborn twins discordant for sex and a random sample of 2371 singleton live births from the same population in Matlab, Bangladesh during the period 1977-1985. The discordant twins showed no evidence of sex differential in neonatal survival. They had neonatal mortality of 287 and infant mortality of 468, both per 1000 live births. These rates were respectively five and four times the rate for singletons in the study. Survival from 12 months through age nine years was similar overall for both discordant twins and singletons for each sex. However, higher female than male mortality was present among discordant twins after the first few months of life. This differential was most prominent during the second year of life and appeared wider than that observed for the singletons.

Bangladesh↗
PubMed1990

Does malnutrition predispose to diarrhoea during childhood? Evidence from a longitudinal study in Matlab, Bangladesh.

It is posited that diarrhoeal illness during one period has influence on diarrhoeal illness in a subsequent period. This relationship may potentially mask the association between malnutrition and subsequent diarrhoea. To test this, we analysed data on cross-sectional anthropometry in combination with data on diarrhoeal morbidity collected longitudinally in a community-based study of 1262 children (aged 6-60 months) during March-December, 1976, in Matlab, Bangladesh. The results confirmed the posited relationship between diarrhoeal morbidities in two consecutive periods and showed that the risks of diarrhoeal attack and longer diarrhoeal illness increased more than threefold during the 2 months following diarrhoeal illness during the preceding 2 months (previous diarrhoea). Children with no previous diarrhoea indicated a positive association between malnutrition and subsequent diarrhoea, but the pattern found among children with previous diarrhoea was not understandable. Logistic regression analyses performed separately for younger and older children showed that controlling for effects of previous diarrhoea, maternal illiteracy and household poverty, severe malnutrition as assessed by weight-for-age was found to be strongly associated with the risk of longer diarrhoeal illness in a 2-month interval in the age group 24-60 months; in the same age group the association with the risk of diarrhoeal attack was significant at the 10 per cent level. No such association for malnutrition, however, was found in the age group 6-23 months.

Bangladesh↗
PubMed1989

Parental sex preference and its effects on fertility intention and contraceptive use in Calcutta.

This study investigated parental sex preference and its effects on fertility intention and contraceptive use in Calcutta. It also investigated the socioeconomic differentials of these effects. Data on 4536 married women of childbearing age came from a cross-sectional survey of slum and non-slum areas conducted in 1970. Desired numbers of sons and daughters in the slum area were 1.89 and 1.30, respectively, and in the non-slum area, 1.63 and 1.17, respectively. 35% of slum women and 30% of non-slum women wanted to have more children, and 22% of slum women and 45% of non-slum women were reported to use contraceptives. The authors estimate that in the absence of parental sex preference, 11% fewer slum women and 12% fewer non-slum women would desire more children. On the other hand, 20% more slum women and 8% more non-slum women would use contraceptives in absence of parental sex preference.

Asia↗
PubMed1987

A comparison of five anthropometric indices for identifying factors of malnutrition.

Five anthropometric indices--weight-for-age, height-for-age, weight-for-height, weight velocity, and height velocity--are compared for identifying factors of nutritional status of children. Data come from Matlab, the field station of the International Centre for Diarrhoeal Disease Research, Bangladesh. Weights and heights on approximately 1,400 children aged 12-60 months were taken 11 times at two-month intervals. Dwelling floor space, a proxy for socioeconomic status, is considered a long-term factor; the 1974-1975 Bangladesh famine, a medium-term factor; and season, a short-term factor of nutritional status. The figures of the indices by socioeconomic status at different times show their power to identify the factors visually; the regression analyses test statistical significance of the factors; and the standardized regression coefficients provide relative power of the indices to identify the factors. Weight-for-age and height-for-age appear best for identifying long- and medium-term factors; weight velocity, for identifying short-term factors. Weight-for-height is third in identifying long- and medium-term factors, second for identifying short-term factors. Height velocity identifies short-term factors only. The effect of short-term factors on height velocity appears approximately four months later than it appears on weight velocity. This study clarifies why certain indices do not predict mortality in this study population and others.

Anthropometry↗
PubMed1987

The association between malnutrition and diarrhoea in rural Bangladesh.

The interaction between diarrhoeal disease and nutritional status measured by anthropometry was investigated in approximately 1000 children aged 1 to 4 years during April-December 1976 in a rural area of Bangladesh. Data on diarrhoeal disease were provided by the mothers interviewed at seven-day intervals. Weight and height data were collected bimonthly. Children classified using anthropometric criteria--weight-for-age, height-for-age, and weight-for-height--were prospectively evaluated for incidence and duration of diarrhoea during a short (two-month) period and a long (eight-month) period. Incidence of diarrhoea was not found to be related to nutritional status measured by any of the anthropometric criteria for any of the periods. But duration of diarrhoea was found to be related consistently to nutritional status measured by weight-for-age and weight-for-height. Diarrhoea in the short term affected weight increment in the short term, but not in the long term and did not affect height increment for any of these periods. Diarrhoea in the long term affected both weight increment and height increment in the long term.

Anthropometry↗
PubMed1987

Effects of age misstatement on the utility of age-dependent anthropometric indicators of nutritional status in rural Bangladesh.

We report the effects of age error on use of weight-for-age and height-for-age for assessing and screening malnutrition, and for identifying factors of malnutrition in 679 children aged 22-59 months in Companiganj, in rural Bangladesh. Overreporting and random error in age and correlation of age error with each of the anthropometric indices are observed. As a result, the proportion of children having less than or equal to 60 per cent of median weight-for-age is overestimated by five percentage points and the proportion having less than 80 per cent of median height-for-age is overestimated by six points. Loss in sensitivity (proportion of malnourished children correctly identified) for the above cutoff points is 20 per cent for weight-for-age and 28 per cent for height-for-age, compared to the situation in the absence of age error. Although mother's education is not a significant determinant of weight-for-age and height-for-age, age error makes mother's education appear artifactually significant in the analysis of variance.

Age Factors↗