Chenyang Feng1,2, Ruixue Li1,2, Abu Ahmed Shamim3, Md Barkat Ullah4, Mengjie Li1, Rubee Dev5, Yijing Wang1, Tingting Zhao1, Jing Liao1,6, Zhicheng Du1, Yuheng Ling7, Yingsi Lai8,9, Yuantao Hao1,6. 1. Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China. 2. Department of Information, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China. 3. James P Grant School of public Health, BRAC University, Dhaka, Bangladesh. 4. Department of Nutrition, University of California Davis, California, USA. 5. Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal. 6. Sun Yat-sen Global Health Institute, Sun Yat-Sen University, Guangzhou, China. 7. CNRS UMR 6240, Universite de Corse Pascal Paoli, 20250, Corti, France. 8. Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China. laiys3@mail.sysu.edu.cn. 9. Sun Yat-sen Global Health Institute, Sun Yat-Sen University, Guangzhou, China. laiys3@mail.sysu.edu.cn.
Abstract
BACKGROUND: Reproductive tract infections (RTIs) have become major but silent public health problems devastating women's lives in Bangladesh. Accurately and precisely identifying high-risk areas of RTIs through high-resolution risk maps is meaningful for resource-limited settings. METHODS: We obtained data reported with RTI symptoms by women of childbearing age in the years 2007, 2011 and 2014 from Bangladesh Demographic and Health Survey. High-spatial Environmental, socio-economic and demographic layers were downloaded from different open-access data sources. We applied Bayesian spatial-temporal models to identify important influencing factors and to estimate the infection risk at 5 km spatial resolution across survey years in Bangladesh. RESULTS: We estimated that in Bangladesh, there were approximate 11.1% (95% Bayesian credible interval, BCI: 10.5-11.7%), 13.9% (95% BCI: 13.3-14.5%) and 13.4% (95% BCI: 12.8-14.0%) of women of childbearing age reported with RTI symptoms in 2007, 2011 and 2014, respectively. The risk of most areas shows an obvious increase from 2007 to 2011, then became stable between 2011 and 2014. High risk areas were identified in the southern coastal areas, the western Rajshahi Division, the middle of Khulna Division, and the southwestern Chittagong Division in 2014. The prevalence of Rajshahi and Nawabganj District were increasing during all the survey years. CONCLUSION: The high-resolution risk maps of RTIs we produced can guide the control strategies targeted to priority areas cost-effectively. More than one eighth of women of childbearing age reported symptoms suggesting RTIs and the risk of RTIs varies in different geographical area, urging the government to pay more attention to the worrying situation of female RTIs in the country.
BACKGROUND: Reproductive tract infections (RTIs) have become major but silent public health problems devastating women's lives in Bangladesh. Accurately and precisely identifying high-risk areas of RTIs through high-resolution risk maps is meaningful for resource-limited settings. METHODS: We obtained data reported with RTI symptoms by women of childbearing age in the years 2007, 2011 and 2014 from Bangladesh Demographic and Health Survey. High-spatial Environmental, socio-economic and demographic layers were downloaded from different open-access data sources. We applied Bayesian spatial-temporal models to identify important influencing factors and to estimate the infection risk at 5 km spatial resolution across survey years in Bangladesh. RESULTS: We estimated that in Bangladesh, there were approximate 11.1% (95% Bayesian credible interval, BCI: 10.5-11.7%), 13.9% (95% BCI: 13.3-14.5%) and 13.4% (95% BCI: 12.8-14.0%) of women of childbearing age reported with RTI symptoms in 2007, 2011 and 2014, respectively. The risk of most areas shows an obvious increase from 2007 to 2011, then became stable between 2011 and 2014. High risk areas were identified in the southern coastal areas, the western Rajshahi Division, the middle of Khulna Division, and the southwestern Chittagong Division in 2014. The prevalence of Rajshahi and Nawabganj District were increasing during all the survey years. CONCLUSION: The high-resolution risk maps of RTIs we produced can guide the control strategies targeted to priority areas cost-effectively. More than one eighth of women of childbearing age reported symptoms suggesting RTIs and the risk of RTIs varies in different geographical area, urging the government to pay more attention to the worrying situation of female RTIs in the country.
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