Zakiul Hassan

• MBBS
• Researcher at International Centre for Diarrhoeal Disease Research

Background Despite completing the COVID-19 vaccination series, healthcare workers (HCWs) remain at an elevated risk of re-infection. Booster uptake, though essential for this group, remains poorly characterized among Bangladeshi HCWs. This study identified the prevalence and driving factors behind booster hesitancy among Bangladeshi HCWs, providing...

Background To better understand the true mortality burden among SARS-CoV-2-infected patients with severe respiratory illnesses, in resource-limited settings in Bangladesh, it is crucial to consider post-discharge deaths along with in-hospital deaths. We estimated the proportion of SARS-CoV-2-associated adult SARI patients who died after discharge a...

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...

The 2024 Nipah outbreak in Kerala, India—its fifth in six years—and the recurring annual outbreaks in Bangladesh underscore the persistent threat posed by the Nipah virus (NiV) in the region. With a high mortality rate, human-to-human transmission potential, and the widespread presence of Pteropus bats, the natural reservoir, NiV remains a signific...

Background To optimize vaccination strategies, it is useful to detect breakthrough infections and assess vaccine effectiveness in programmatic use. Monitoring emerging SARS-CoV-2 variants and vaccine effectiveness against them is also essential to determine the most effective vaccine options. This study aims to monitor SARS-CoV-2 breakthrough infec...

Background Frontline healthcare workers (HCWs) were particularly vulnerable to contracting SARS-CoV-2 infection as a result of occupational exposure. There is a scarcity of data characterizing the risk of SARS-CoV-2 infection among HCWs, particularly in low-income hospital settings. This study aimed to assess the prevalence of COVID-19 among HCWs a...

Background: Bangladesh carries a substantial health and economic burden of seasonal influenza, particularly among the World Health Organization (WHO)-defined high-risk populations. We implemented a modelling study to determine the cost-effectiveness of influenza vaccination in each of five high-risk groups (pregnant women, children under five year...

Background Antimicrobial resistance (AMR) is a major global public health crisis and around the last decade, newspapers were one of the main sources of public dissemination of information for so. This study highlights how Bangladeshi mainstream newspapers represented AMR-related news and how they created the narrative of AMR in Bangladesh. Methods...

Background Antimicrobial resistance (AMR) is a major global public health crisis and around the last decade, newspapers were one of the main sources of public dissemination of information for so. This study highlights how Bangladeshi mainstream newspapers represented AMR-related news and how they created the narrative of AMR in Bangladesh. Methods...

Background Enhancing outcomes post-hospitalisation requires an understanding of predictive factors for adverse events. This study aimed to estimate post-discharge mortality rates among patients with severe acute respiratory infection (SARI) in Bangladesh, identify associated factors, and document reported causes of death. Methods From January 2012...

Background In Bangladesh, seasonal influenza imposes considerable disease and economic burden, especially for those at high-risk of severe disease. The most successful approach for influenza prevention is the administration of a vaccine. Many poor and middle-income nations, including Bangladesh, do not have a national strategy or program in place f...

Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory infections in young children worldwide. RSV-associated deaths in children are underreported in Bangladesh. We analyzed hospital-based surveillance data on severe acute respiratory infections (SARIs) in under-five children before (August 2009–February 2020) and during th...

Background Severe acute respiratory infection (SARI) is a leading cause of mortality globally, peaking during the COVID-19 pandemic. We analyzed SARI-associated deaths during the pre-and-pandemic periods in Bangladesh to identify the contributing factors. Methods We analyzed data from hospital-based influenza surveillance at nine tertiary-level ho...

Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory infections in young children worldwide. RSV-associated deaths in children are underreported in Bangladesh. We analyzed hospital-based surveillance data on severe acute respiratory infections (SARI) in under-five children before (August 2009–February 2020) and during the...

Background: In South Asia, a region of almost 2 billion people across 8 countries, acute respiratory infections (ARIs) are associated with significant morbidity and mortality in children aged <5 years. Although ~80% of ARIs are due to viral etiology and are often self-limiting, they remain the single largest reason for antibiotic use in children ag...

Background: Irrational antibiotic use among hospitalized patients can lead to antibiotic resistance. For rational use, the WHO introduced the Access, Watch, and Reserve (AWaRe) classification of antibiotics. We explored antibiotic use according to the AWaRe classification among patients hospitalized with severe acute respiratory infection (SARI) be...

Background: Candida auris is a multidrug-resistant yeast capable of invasive infection with high mortality and healthcare-associated outbreaks globally. Due to limited labratory capacity, the burden of C. auris is unknown in Bangladesh. We estimated the extent of C. auris colonization and infection among patients in Dhaka city intensive care units....

Background We explored whether hospital‐based surveillance is useful in detecting severe acute respiratory infection (SARI) clusters and how often these events result in outbreak investigation and community mitigation. Methods During May 2009–December 2020, physicians at 14 sentinel hospitals prospectively identified SARI clusters (i.e., ≥2 SARI c...

Background: Interpreting rRT-PCR results for human avian influenza A virus (AIV) detection in contaminated settings like live bird markets (LBMs) without serology or viral culture poses a challenge. Methods: During February-March 2012 and November 2012-February 2013, we screened workers at nine LBMs in Dhaka, Bangladesh to confirm molecular dete...

Background: Non-alcoholic Fatty Liver Disease (NAFLD) is a growing public health concern globally. NAFLD has been linked with adverse pregnancy outcome. The prevalence of NAFLD among women in childbearing age is 10%. During pregnancy both physiologic and pathologic fluctuation in estrogen as well as rapid weight gain plays an important role in the...

Background: Low- and middle-income countries bear a disproportionate burden of antimicrobial resistance (AMR) but often lack adequate surveillance to inform mitigation efforts. Colonization can be a useful metric to understand AMR burden. We assessed the colonization prevalence of Enterobacterales with resistance to extended-spectrum cephalosporin...

Background: Hand hygiene (HH) is a fundamental element of patient safety. Adherence to HH among healthcare workers (HCW) varies greatly depending on a range of factors, including risk perceptions, institutional culture, auditing mechanisms, and availability of HH supplies. Aims: This study aims to evaluate HH compliance and associated factors am...

Background Antimicrobial resistant (AMR) organisms are an increasing global health threat that are spreading within communities. Understanding the risk factors for colonization with AMR organisms is critical for implementing prevention and control strategies, particularly in resource-limited settings such as Bangladesh. Methods During 2019, we con...

Despite the enormous disruption of tuberculosis (TB) services reported globally, Bangladesh’s impact is not well documented. We aimed to assess the effect of the COVID-19 pandemic on the TB control program in Bangladesh from patients’ and service providers’ perspectives. We conducted a cross-sectional study from November–December 2021 at six conven...

Introduction The high burden of respiratory syncytial virus (RSV) infection in young children disproportionately occurs in low- and middle-income countries (LMICs). The PROUD (Preventing RespiratOry syncytial virUs in unDerdeveloped countries) Taskforce of 24 RSV worldwide experts assessed key needs for RSV prevention in LMICs, including vaccine an...

Background We explored whether hospital-based surveillance is useful in detecting severe acute respiratory infection (SARI) clusters and how often these events result in outbreak investigation and community mitigation. Methods During May 2009– December 2020, physicians at 14 sentinel hospitals prospectively identified SARI clusters (i.e., ≥2 SARI c...

Due to the significant number and its effects on quality of life, depression is becoming a major concern worldwide. Though its prevalence among junior healthcare professionals is also increasing day by day, still very few data are available regarding this. So, we’ve conducted a study to find out the prevalence and associated factors of depression a...

Epidemiological data of specific respiratory pathogens from the pre-COVID-19 period are essential to determine the effects of the COVID-19 pandemic on other respiratory infections. In this study, we revealed the pre-COVID-19 molecular epidemiology of respiratory syncytial virus (RSV) among children in Bangladesh. We tested 3170 samples collected fr...

Although national and international guidelines have strongly discouraged use of antibiotics to treat COVID-19 patients with mild or moderate symptoms, antibiotics are frequently being used. This study aimed to determine antibiotics-prescribing practices among Bangladeshi physicians in treating COVID-19 patients. We conducted a cross-sectional surve...

Background Hospital-acquired infections (HAIs) and antimicrobial resistance (AMR) are major global health challenges. Drug-resistant infectious diseases continue to rise in developing countries, driven by shortfalls in infection control measures, antibiotic misuse, and scarcity of reliable diagnostics. These escalating global challenges have highli...

Introduction Infection prevention and control (IPC) in healthcare settings is imperative for the safety of patients as well as healthcare providers. To measure current IPC activities, resources, and gaps at the facility level, WHO has developed the Infection Prevention and Control Assessment Framework (IPCAF). This study aimed to assess the existin...

Background Healthcare workers (HCWs), such as doctors, nurses, and support staffs involved in direct or indirect patient care, are at increased risk of influenza virus infections due to occupational exposures. Vaccination is the most effective way to prevent influenza. Despite the World Health Organization (WHO) recommendations, Bangladesh lacks a...

The emergence of virulent extended spectrum β-lactamase producing Klebsiella pneumoniae (ESBL-KP) including carbapenem-resistant Klebsiella pneumoniae (CRKP) in hospital-acquired infections has resulted in significant morbidity and mortality worldwide. We investigated the antibiotic resistance and virulence factors associated with ESBL-KP and CRKP...

Background: Hand hygiene (HH) is a core element of patient safety and the single most essential strategy for preventing healthcare-associated infections (HAIs). Adherence to HH among healthcare workers (HCWs) varies greatly depending on a range of factors, including risk perceptions, institutional culture, auditing mechanisms, and availability of H...

A cross-sectional study investigating physicians' engagement in research at a tertiary level medical school in Bangladesh.

The WHO Essential Medicines List Access, Watch, and Reserve (AWaRe) classification could facilitate antibiotic stewardship and optimal use. In Bangladesh, data on antibiotic dispensing in pharmacies according to the AWaRe classification are scarce. We aimed to explore antibiotic dispensing pattern in pharmacies according to the WHO AWaRe classifica...

Background Whilst very limited studies have demonstrated a correlation between the COVID-19 pandemic and depressive symptoms amongst Bangladeshi medical students, the prevalence and associated factors of depressive symptoms as measured by the Patient Health Questionnaire (PHQ-9) remains widely unknown. Objective The study aimed to investigate the...

Background Baseline assessment of standard precaution relating to infection prevention and control (IPC) preparedness to fight health crisis within healthcare facilities at different levels and its associated factors in Bangladesh remains unknown. Methods We analyzed the nationally representative Bangladesh health facility survey (BHFS) data condu...

Background Antimicrobials are empirically used in COVID-19 patients resulting in inappropriate stewardship and increased antimicrobial resistance. Our objective was to assess antimicrobial use among suspected COVID-19 in-patients while waiting for the COVID-19 test report. Methods From March to August 2020, we collected data from in-patients of 12...

Objective We aimed to estimate the proportion of symptomatic and asymptomatic laboratory-confirmed COVID-19 cases among Bangladesh's population. Design We conducted a cross-sectional survey in Dhaka City and other districts of Bangladesh between April 18 and October 12, 2020. We randomly selected 32 districts outside Dhaka, where one village and o...

Fever in children under five years of age is a common and predominantly self-limiting sign of illness. However, in low- and middle-income countries, antibiotics are frequently used in febrile children, although these children may not benefit from antibiotics. In this study, we explored the prevalence of, and factors associated with, antibiotic use...

The general population has been excessively using antibiotics during the COVID-19 pandemic. Therefore, the use of antibiotics for any reported illnesses in the preceding four weeks and knowledge of antibiotics among the general population in the community were assessed for possible interventions. A mobile phone survey among a general population acr...

Antimicrobials are empirically used in COVID-19 patients resulting in increased antimicrobial resistance. Our objective was to assess antimicrobial use among suspected COVID-19 in-patients. From March to August 2020, we collected data from in-patients of 12 tertiary-level hospitals across Bangladesh. We identified suspected COVID-19 patients; colle...

Introduction: Despite acute respiratory infections (ARIs) being the single largest reason for antibiotic use in under-5 children in Bangladesh, the prevalence of antibiotic use in the community for an ARI episode and factors associated with antibiotic use in this age group are unknown. Methods: We analysed nationally representative, population-bas...

Introduction Vitamin D is important for its immunomodulatory role and there is an independent association between vitamin D deficiency and pneumonia. We assessed the effect of vitamin D supplementation on the outcome in children hospitalized for severe pneumonia. Methods This was a randomised, double blinded, placebo-controlled clinical trial in c...

Abstract Background: South Asian region has been experiencing the increasing burden of antimicrobial resistance (AMR) primarily due to over and irrational prescribing of antibiotics. Acute respiratory infections (ARIs) are the leading cause of out-patients’ visits in the region. Despite commonly known viral aetiology, ARI is the single largest reas...

Background Hospital-acquired infections (HAI) are a rising global public health concern that disproportionately affects low and middle-income countries. Healthcare workers (HCWs) are the frontline work-stream against HAIs in healthcare settings. As part of a pilot infection prevention and control (IPC) program, we assessed the acceptability of infe...

Introduction Emerging evidence suggests young children are at greater risk of COVID-19 infection than initially predicted. However, a comprehensive understanding of epidemiology of COVID-19 infection in young children under five years, the most at-risk age-group for respiratory infection, remain unclear. We conducted a systematic review and meta-an...

Background: Despite gradual economic growth in Bangladesh, healthcare facilities are still resource limited and do not measure up to the standard to practice for infection prevention and control (IPC) in reducing the risk of hospital-acquired infections. We assessed the existing resources and facilities in tertiary-care public hospitals to guide a...

Objective To determine the predictors of mortality within 30 days of hospital admission in a diarrhoeal disease hospital in Bangladesh. Methods Cohort study of hospitalised children aged 0–59 months with severe acute malnutrition (SAM) and severe pneumonia in Dhaka Hospital, icddr,b, Bangladesh from April 2015 to March 2017. Those discharged were...

Background: Dengue fever is endemic in Bangladesh. Its incidence has been increasing and spreading from urban Dhaka to rural areas. In 2019, over 100,000 cases reported with deaths over 250. Clinical profiles varied from classical signs and symptoms to alarming severity and complications, such as, Expanded Dengue Syndrome (EDS), Dengue Shock Syndro...

Bangladesh is a densely populated country with about 165 million population. Health is a basic need of the people and it is recognized by the constitution of the country. Bangladesh has been showing remarkable performances in health sector and setting extraordinary examples for the developing countries in recent years. Meeting specific targets, the...

Protecting frontline healthcare workers should be the top priority in low-resource health systems: Bangladesh and COVID-19 - Md. Zakiul Hassan, Mohammad R. Monjur, Ashley Rene Styczynski, Mahmudur Rahman, Sayera Banu

Early phases of COVID-19 management in a low-income country: Bangladesh - Mohammad R. Monjur, Md. Zakiul Hassan

Background Recent studies have reported that height is inversely associated with blood pressure and hypertension. However, there is lack of comprehensive findings from Bangladesh in this regard. Objective The purpose of this study was to explore the association between height and blood pressure in a Bangladeshi population. Setting Rural and urban...

Background In Bangladesh, pneumonia has a higher mortality among malnourished children aged <5 years. Evaluating pneumonia etiology among malnourished children may help improve empiric treatment guidelines. Methods During April 2015—December 2017, we conducted a case-control study among severe acute malnourished (SAM) children aged <5 years admitt...

Background Because of the rapid increase of non-communicable diseases (NCDs) and high burden of healthcare-related financial issues in Bangladesh, there is a concern that out-of-pocket (OOP) payments related to illnesses may become a major burden on household. It is crucial to understand what are the major illnesses responsible for high OPP at the...

Nipah virus (NiV) is an ssRNA, enveloped paramyxovirus in the genus Henipaveridae with a case fatality rate >70%. We analyzed the NGS RNA-Seq gene expression data of NiV to detect differentially expressed genes (DEGs) using the statistical R package limma. We used the Cytoscape, Ensembl, and STRING tools to construct the gene-gene interaction tree,...

Nipah virus (NiV) is an ssRNA, enveloped paramyxovirus in the genus Henipaveridae with a case fatality rate >70%. We analyzed the NGS RNA-Seq gene expression data of NiV to detect differentially expressed genes (DEGs) using the statistical R package limma. We used the Cytoscape, Ensembl, and STRING tools to construct the gene-gene interaction tree,...

Background: In Bangladesh, pneumonia has a higher mortality among malnourished children aged <5 years. Evaluating pneumonia etiology among malnourished children may help improve empiric treatment guidelines. Methods: During April 2015—December 2017, we conducted a prospective case-control study among severe acute malnourished (SAM) children aged <5...

With limited infection control practices in overcrowded Bangladeshi hospitals, surfaces may play an important role in the transmission of respiratory pathogens in hospital wards and pose a serious risk of infection for patients, health care workers, caregivers and visitors. In this study, we aimed to identify if surfaces near hospitalized patients...

Highly pathogenic avian influenza (HPAI) has been a public health threat in Bangladesh since the first reported outbreak in poultry in 2007. The country has undertaken numerous efforts to detect, track, and combat avian influenza viruses (AIVs). The predominant genotype of the H5N1 viruses is clade 2.3.2.1a. The persistent changing of clades of the...

Introduction: Life threatening cardiovascular events (CVEs), such as ischemic or coronary heart disease are more likely to cause deaths in low-income countries with limited resources compared to high-income countries. Although influenza illnesses can trigger CVEs, little is known about their prevalence in low-income countries like Bangladesh. We es...

Background: Globally, influenza-associated severe acute respiratory infections (SARI) are estimated to cause 3-5 million severe illnesses. Except for hajj pilgrims, Bangladesh does not vaccinate persons at high risk of severe influenza illness, in part because, of the dearth of local data about influenza vaccines’ potential value. Country-specific...

Background: Respiratory viruses are the leading cause of early life wheezing that may contribute to the development of childhood asthma leading to increasing morbidity and socioeconomic burden. The aim of this review is to identify whether respiratory viral infections during first year of life were associated with development of childhood asthma....

Introduction Bangladesh has made significant strides in maternal and neonatal death by ensuring qualified antenatal care (ANC) visits during the pregnancy period of women. To ensure this qualified ANC, the government of Bangladesh has increased the number of qualified physicians and skilled birth attendants at health facilities and encouraged pregn...

Background Severe acute respiratory infection (SARI) is one of the leading causes of morbidity and mortality worldwide. Annually, it causes 4.25 million deaths with 40% of deaths occurring in four Asian countries, including Bangladesh. While in-hospital SARI mortality is well-characterized in Bangladesh, there is limited information about post-disc...

Objectives: 'Negligence of Physicians' and 'Wrong Treatment' have become commonly-used phrases in print and electronic media of Bangladesh, while violence against healthcare workers has always been under-reported. Unfortunately, there is little evidence regarding physical violence against healthcare workers, while there is no data on the magnitude...

Background Healthcare-associated respiratory illness (HARI) leads to increased hospitalization, costs, and mortality. In Bangladesh, the rate of HARI is 17 per 1000 patients hospitalized >72 hours in tertiary care hospitals. Although overcrowding and poor hygiene practices like sharing medical equipment are common in hospitals, data are limited on...

Background: In Bangladesh, influenza A/H5N1 is endemic in poultry. Live bird markets (LBMs) are implicated as a source of A/H5N1 transmission and often lack infrastructure such as hand washing facility to limit the spread of the virus. We designed portable workstations for poultry workers and explored its acceptability and feasibility for hand wash...

Objective To determine the trends, prevalence and risk factors of overweight and obesity among Bangladeshi women of reproductive age from 1999 to 2014. Design We analysed nationally representative data from the 1999, 2004, 2007, 2011 and 2014 cross-sectional Bangladesh Demographic and Health Surveys. Setting Bangladesh. Participants Women aged 1...

Table S1. Prevalence of non‐alcoholic fatty liver disease by gender and place of residence, Bangladesh 2017. Figure S1. Receiver operating characteristic curve.

Background and Aim Non‐alcoholic fatty liver disease (NAFLD) is a significant cause of hepatic dysfunction and liver‐related mortality. As there is a lack of population‐based prevalence data in a representative sample of general population, we aimed to estimate the prevalence and risk factors of NAFLD in Bangladesh. Methods A cross‐sectional study...

Nipah virus–specific primers, epidemiologic link between cases within each Nipah virus cluster, and clustered and isolated case-patients, Bangladesh, December 2013–April 2014.

Nipah virus (NiV) has been transmitted from patient to caregivers in Bangladesh presumably through oral secretions. We aimed to detect whether NiV-infected patients contaminate hospital surfaces with the virus. During December 2013–April 2014, we collected 1 swab sample from 5 surfaces near NiV-infected patients and tested surface and oral swab sam...

Wheezing in early life is associated with an increased risk of asthma and viral acute respiratory illnesses are primarily responsible for wheezing in young children. We estimated the incidence and impact of respiratory viruses in early childhood wheezing. From May 2015–February 2017, children in a low-income community in Dhaka were enrolled during...

In Bangladesh, H5N1 has now become endemic in poultry and there are 8 human infections reported since 2008. Live bird markets have been implicated as a source of H5N1 and identified as lacking infrastructure required to maintain biosecurity. To reduce risk of environmental contamination and improve handwashing practices, we designed and piloted por...

In Bangladesh, H5N1 has now become endemic in poultry and there are 8 human infections reported since 2008. Live bird markets have been implicated as a source of H5N1 and identified as lacking infrastructure required to maintain biosecurity. To reduce risk of environmental contamination and improve handwashing practices, we designed and piloted por...

Background: Overweight and obesity are the leading causes of mortality worldwide. Although previously they were mostly prevalent in developed countries, recent studies show that overweight and obesity in increasing significantly in developing countries. In this study, we aimed to estimate the 15-year (1999-2014) trends in the prevalence of overweig...

p> Background : Chotpoti is a popular street food among all groups of people from low to high income in most cities of Bangladesh. Objective : This study was conducted to describe the vending sites, the stalls and equipments used for food preparation, current level of food safety knowledge of vendors and the way to prepare foods to understand the...

p>Contaminated street food has been linked to food-borne illness and food-borne outbreak. Chotpoti is a popular street food in Bangladesh. This study was conducted to identify enteric bacteria in chotpoti sold in different parts of the capital city Dhaka. From July to October, 2012 we purposively selected 18 sites where chotpoti was sold in Dhaka c...