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Welcome to the website for the “Dengue in Bangladesh” Project

This website illustrates the Dengue Research in Bangladesh Group (DRBG) who are working under the Climatic Variability and Social-Ecological Changes and dengue in Bangladesh Project. The research project is being funded by the International Development Research Centre, Ottawa, Canada, and led by Prof. Dr. G.U. Ahsan, Dean, School of Health & Life Sciences and Chair, Department of Public Health, North South University, Dhaka, Bangladesh and Dr. Emdad Haque, Professor in Environmental and Natural Resource Governance and Management at the Natural Resources Institute, University of Manitoba, Winnipeg, Canada.

DRBG are looking primarily into four areas:

i) Dengue virus prevalence in the City of Dhaka, Bangladesh,

ii) Mosquito abundance and its relationship with dengue prevalence;

iii) Effects of climatic, social-ecological and human behavioural factors on mosquito abundance; and

iv) Local community capacity building for public participation in health interventions and development policy forums.

DRBG researchers are affiliated with the University of Manitoba (Canada); National Microbiology Laboratory, Public Health Agency of Canada; North South University (Bangladesh); International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b); Director General of Public Health, Ministry of Health and Family Welfare, Government of Bangladesh; Population Services Training Centre (NGO partner in Bangladesh).

DRBG has 6 researchers, 2 PhD students, 1 Masters Student from Canada, and 6 researchers, and 2 Masters Students from Bangladesh. 2 staff members from Canada and 3 staff members from Bangladesh are supporting the activities of DRBG.

 

Vision

The specific objectives the Discovery Phase of the Project (2010-15) is to:

Determine dengue virus (DENV) prevalence in the City of Dhaka over time and space to estimate the potential for outbreaks and epidemics (i.e., prevalence includes DENV exposure rates and identification of circulating stereotypes among both the general population and suspect cases in representative hospitals / clinics);

Determine the patterns in dengue vector distribution (spatial and temporal-seasonal patterns) and density in the City of Dhaka, Bangladesh, and their correlation with dengue prevalence;

Examine the effects on vector density, of: a) selected climatic variables (specifically, temperature, rainfall, humidity/vapor pressure) and, b) local community level social-ecological factors (specifically, dwelling type, population density, water storage, garbage disposal, type of vegetation and land use pattern);

Enhance local community capacity to participate and assess options in community-centered, social-ecological system management interventions for vector control, by developing a cross-scale partnership and applying an Integrated Ecohealth and Adaptive Management approach.








Research

Research Methodology and Components

The methodology for achieving each of the four specific objectives of the project and project components are described below.

OBJECTIVE 1: Seroprevalence

In order to attain objective 1, particularly to determine dengue exposure rate and circulating serotypes, a community-based population serosurvey and a small-scale diagnostic study of suspected hospitalized patients will be conducted. The serum samples will be obtained from 1200 members of the community population and 50 acute cases of suspect DENV infections in clinics / hospitals. These specimens will be subjected to a number of diagnostic tests based upon established algorithms for dengue and related flaviviruses. The testing of serum will be primarily serological to identify individuals with IgM and IgG antibodies to DENV, however, acute cases of illness from clinics / hospitals will also be tested for the presence of DENV RNA by PCR amplification procedures.

Community population serosurvey: A total of 1200 members of the community population will be selected for the collection of serum samples from 12 Wards, representing high, moderate and low dengue vector infested zones of the Dhaka city corporation.

Clinical study of suspected cases in hospitals/clinics: The purpose of this component of the present project is to pursue a clinical study of 50 patients which present to the Emergency Room with an acute febrile illness suggestive of Dengue or DHF in the 3 months post monsoon season. These patients will undergo the conventional diagnostic work up and receive the conventional therapy.

OBJECTIVE 2: Vector Abundance and Distribution

The attainment of Objective 2 will require two sequential steps with the assignment of a survey team: i) determination of vector (Aedes aegypti and Aedes albopictus) distribution (i.e., density) across the City of Dhaka; and ii) examination of the spatial correlation between vector density and dengue prevalence.

Entomological surveys in City Wards: The Dhaka City Corporation is comprised of 90 Wards. Of these 90, a total of 12 Wards will be selected to cover the entire Dhaka City Corporation area. By following a Probability Proportional to Sampling (PPS) method, 5 Wards will finally be selected from the Low Socioeconomic Status (SES), 5 from Medium SES, and 2 from High SES for carrying out the entomological surveys.

OBJECTIVE 3: Climatic and Social-Ecological Determinants

Climatic and social-ecological determinants: A temporal study of prevalence of dengue in the Dhaka City Corporation area, based on hospital and clinic reports to the Directorate of Public Health, will be performed for the period of 2000-2012. Climatic conditions (represented by temperature, rainfall and relative humidity) and vector density level have been linked with the transmission level of dengue fever and can be applied as a warning indicator of this disease. Based on the 12 monthly (April 2010 March 2011) data on Breatue Index and other indices for the 12 selected Dhaka City Wards, and minimum, mean and maximum monthly data on climatic variables, the degree of influence of these explanatory variables on vector density will be determined.

The degradation of elements within social-ecological systems that may play a more critical role in the spread of dengue virus and their evolution require serious attention. Change in vegetation cover and land-use, water supply provisions, solid waste management facilities, dwelling type, and population density, which are indicators of local social-ecological conditions could be no less significant than water containers, flower vases within households, and tires in the close vicinity of households. Data on these aspects will be collected from three selected Wards, representing Low, Medium and High SES).

Ethnographic study of 3 urban communities: For achieving Objective 3, a total of three Case Studies will be carried out by purposively selecting one Ward from each of High, Moderate and Low SES. Attempts will be made to understand the environmental conditions and social, economic political and cultural contexts, and to determine the effects local community level social-ecological factors (specifically, dwelling type, population density, water storage, garbage disposal, type of vegetation and land use pattern) on vector density.

OBJECTIVE 4: Community Capacity Enhancement

Community capacity enhancement for vector control through building cross-scale partnerships: Baseline surveys will be conducted in the pilot study communities to determine the characteristics of Knowledge, Attitude and Practice (KAP) concerning family and community health, dengue disease and vector breeding sites. Using a Participatory Action Research (PAR) method, assessments of local organizational capacity will be made. Also, intervention strategies will be formulated to strengthen social capital (i.e., local networks), with the aim of enhancing the capacity of the community members to effectively participate in the processes, developing a sense of empowerment and ownership of health issues and sustainable community development.

Capacity building efforts should be viewed as social learning process. The pertinent training programs will therefore be designed in a way whereby the “trainers” will have the responsibility to train, guide and coordinate the process while training as well as learning from the participants simultaneously. Under the present study, fresher (3 x 2 = 6) and re-fresher (3) community training sessions on public forum participation will be organized, with a particular focus on women and low socio-economic groups.







Research and Project Management Teams


Team Members- Canada
University of Manitoba, Canada

 Team Members - Bangladesh
 North South University, Bangladesh

Principal Investigator and Project Director (Canada):

Dr. C. Emdad Haque, Professor, Natural Resources Institute, University of Manitoba, Winnipeg, Canada

Researcher (Immunology):

Dr. Ethan Rubinstein, H.E. Sellers Research Chair in Infectious Diseases and Professor, Department of Internal Medicine, University of Manitoba, Winnipeg, Canada

Researcher (Medical Anthropology and Ethnographic Studies):

Dr. Stacie Burke, Associate Professor, Department of Anthropology, University of Manitoba, Winnipeg, Canada

Researcher (Serology and Cytokine Studies):

Dr. Yoav Keynan, Assistant Professor, Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada

Researcher (Statistical Analysis):

Dr. Shakhawat Hossain,
Assistant Professor, Department of Mathematics and Statistics, University of Winnipeg, Winnipeg, Canada

Project Manager and Coordinator (Canada):

Ms. Parnali Dhar Chowdhury, Natural Resources Institute, University of Manitoba, Winnipeg, Canada

Principal Investigator and Project Director (Bangladesh):

Prof. Dr. G.U. Ahsan, Dean, School of Health & Life Science, Chair, Department of Public Health, North South University, Dhaka, Bangladesh

Researcher (Ethnographic Study and Community Capacity Enhancement):

Dr. Quamrun Nahar, Associate Professor, Department of Public Health, North South University, and Associate Scientist, Centre for Population, Urbanization and Climate Change, icddrb, Dhaka, Bangladesh

Resarcher (Entomology):

Dr. Kabirul Bashar,
Associate Professor, Department of Zoology, Jahangirnagar University, Savar, Bangladesh

Researcher (Climatology and Ecology):

Dr. Tawhidul Islam, Associate Professor, Department of Geography and Environment, Jahangirnagar University, Savar, Bangladesh

Researcher (GIS and Spatial Analysis):

Mr. Hasan Mahmud, Assistant Professor, Department of Geography and Environment, Jahangirnagar University, Savar, Bangladesh

Project Manager and Coordinator (Bangladesh):

Ms. Mobashera Jahan, Project Management Officer, and Program Officer, Department of Public Health, North South University, Dhaka, Bangladesh

National Microbiology Laboratory, Public Health Agency of Canada (PHAC)

Principal Investigator (Virology and Serology):

Dr. Michael Drebot, Chief, Viral Zoonoses, and Director, Science Technology and Core Services, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada

Researcher (Entomology):

Dr. Robbin Lindsay, Research Scientist, Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada

Laboratory Technician:

Ms. Antonia Dibernardo, Biologist / Lab Manager, Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada

Laboratory Technician:

Mr. Kai Makowski, Technician, Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada

Visiting Student Researcher:  

Ms. Parnali Dhar Chowdhury, PhD Student, Natural Resources Institute, University of Manitoba, Winnipeg, Canada

International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)

Principal Investigator (Infectious Diseases and Serology):

Dr. W. Abdullah Brooks, Head, Infectious Diseases, and Associate Scientist, icddrb, and Research Scientist, Bloomberg School of Public Health, John Hopkins University, USA

Researcher (Serology):

Dr. Doli Rani Goswami, Project Coordinator, Respiratory Vaccines, Centre for Vaccine Sciences, icddrb, Dhaka, Bangladesh

Researcher and Serosurvey Field Coordinator:

Dr. Kishor Kumar Paul, Research Trainee, Respiratory Vaccines, Centre for Vaccine Sciences, icddrb, Dhaka, Bangladesh


Researcher (Serology):

Dr. Ujjal Kumar Raha, Office Manager, Respiratory Vaccines, Centre for Vaccine Sciences, icddrb, Dhaka, Bangladesh

 

 

Population Services Training Centre (PSTC), Dhaka, Bangladesh

NGO and Community Program Coordinator:

Dr. Netai Das, Director, PSTC, New Circular Road, Dhaka, Bangladesh

Field Investigator and Coordinator:

Mr. Sushanto Chakrabarty, Field Manager, PSTC, New Circular Road, Dhaka, Bangladesh

 

Research Progress (in terms of outputs)

Outcome (End of project result)

Output (direct result of activities carried out during the project period 2010-2015)

Status/Progress

Enhanced knowledge of dengue virus (DENV) prevalence, by serotype, in the City of Dhaka over time and space

 

  • dengue virus prevalence among 951 community members (951 x 4 seasons = 3,804 blood samples) determined (revised to 1,200 x 3 seasons = 3,600 blood samples)
  • dengue virus prevalence among suspected hospitalized cases determined (revised to 50 cases)

 

  • 3,000 blood samples in 3 seasons have been collected
  • IgG and IgM ELISA have completed on these samples.
  • PCR work in progress for IgM positive samples
  • PRNTs is progresson selected samples to see actual DENV infection
  • 47 samples have been collected from 2 hospitals in Dhaka and ELISA diagnostics completed

Enhanced knowledge of patterns in dengue vector density in the City of Dhaka, and their correlation with dengue prevalence

 

  • GIS-based maps of nine City Wards of Dhaka, depicting vector density produced
  • digital maps revealing seasonal variations (monthly) in vector density produced (revised to seasonal – monsoon and dry)
  • digital maps and statistical analysis revealing spatial correlation between vector density and dengue prevalence in nine City Wards completed

 

  • 4 vector surveys in 12 Wards completed (2,164 households visited) and 500 open spaces, including construction sites surveyed
  • 3 monsoon and 1 dry season vector data collected; GPS-based coordinates being produced
  • Work in progress

Increased understanding of the effects on vector density of: a) selected climatic variables and, b) local community level social-ecological factors

 

  • statistical analysis of the effects of temperature, rainfall and relative humidity on dengue incidence, 2000-2009 (based on official data) completed (revised to 2000-2012)
  • land-use maps showing changes in vegetation and settlement over time and space, in three selected City Wards produced
  • statistical analysis of the effects of temperature, rainfall and relative humidity on dengue prevalence in nine selected City Wards completed
  • ethnographic study of community livelihoods, social and environmental conditions, economic, political and cultural contexts and their effects on vector density completed

 

  • data being collected from secondary sources

 

  • Work in progress

 

 

  • Work in progress

 

  • Ethnographic field study of 2 urban communities completed; data being analysed

Strengthened local community capacity to participate and assess options in community-centered, social-ecological system management interventions for vector control, by developing a cross-scale partnership and applying an Integrated Ecohealth and Adaptive Management approach

 

  • KAP study report concerning family and community health, dengue disease and vector breeding sites in three selected City Wards produced
  • capacity of community members in three selected three City Wards to participate in community planning, implementation and policy forums enhanced
  • options for effective implementation of community-oriented interventions determined
  • multi-stakeholders dengue disease prevention and control network formed, particularly for testing interventions and contributing to policy formulation

 

  • KAP survey of 300 households completed and data being analysed; 12 Focus Group Discussions (FGDs); and 18 Key Informant Interviews completed and data being analysed
  • Need and capacity assessments completed in 3 Wards; community programs being formulated
  • Work in progress

 

  • Work in progress

 

Publications:

Dhar Chowdhury, P. and Haque, C.E. (in Press). “Why is an Integrated Social-Ecological Systems (ISES) Lens Needed to Explain Causes and Determinants of Disease?: A Case Study of Dengue in Dhaka, Bangladesh,” In Gislason, M.K. (ed.). Ecological Health: Society, Ecology and Health, Advances in Medical Sociology series, Vol. 15, Emerald, London, UK.

Dhar Chowdhury, P. and Haque, C.E. 2012. Eco-bio-social determinants of Aedes infestation in Dhaka, Bangladesh. International Journal of Infectious Diseases, Vol. 16, p. e254

Dhar Chowdhury, P. and Haque, C.E. 2012. Understanding Dengue Transmission by Using Participatory Research and Community-Focused Strategies for Prevention and Control in Bangladesh. BMC Infectious Diseases, Vol. 12 (supppl 1), p.92

Conference papers/posters:

 Dhar Chowdhury, P., Haque, C.E., Lindsay, R., Drebot, M., Brooks, A. and Paul, K. 2013. “Understanding dengue transmission through Ecohealth Approach”, Paper (poster) presented at the Canadian Student Health Research Forum (CSHRF) – Manitoba Provincial Competition, on “Big Science, Informatics and Biomedicine”, University of Manitoba, Winnipeg, Canada, June 4-6.

 Dhar Chowdhury, P., Haque, C.E., Lindsay, R., Drebot, M., Brooks, A. and Paul, K. 2013. “Understanding dengue transmission through Ecohealth Approach”, Paper (poster) presented at the Canadian Student Health Research Forum (CSHRF) – CIHR National Competition, on "Big Science, Informatics and Biomedicine”, University of Manitoba, Winnipeg, Canada, June 4-6.

Dhar Chowdhury, P., Haque, C.E., Drebot, M. and Lindsay, R. 2012. “A Model of Transdisciplinary Study Design for Understanding Dengue Transmission in the Developing World: Application of an Ecohealth Approach in Bangladesh,” Paper (poster) presented at the American Society of Tropical Medicine and Hygiene 61st Annual Meeting, Atlanta, Georgia, U.S.A., November 11-15.

Dhar Chowdhury, P., Haque, C.E., Drebot, M. and Lindsay, R. 2012. “Dengue risk perception and behavioral responses by local members in Dhaka, Bangladesh,” Paper (poster) presented at the American Society of Tropical Medicine and Hygiene 61st Annual Meeting, Atlanta, Georgia, U.S.A., November 11-15.

Dhar Chowdhury, P., Haque, C.E. and Lindsay, R. 2012.“An Analysis of Dengue Risk Perception in Bangladesh by Using Ecohealth Approach,” Paper presented at the Ecohealth 2012 Conference, Kunming, China, October 15-18.

Dhar Chowdhury, P., and Haque, C.E. 2012. “ Understanding Dengue Transmission by using Participatory Research and Community-focused Strategies for Prevention and Control in Bangladesh” Paper (poster) presented at the HIV Science and Infectious Diseases 2012 Conference, Chennai, India, January 20-22.

Dhar Chowdhury, P. and Haque, C.E. 2011. “Dengue Disease Transmission in Bangladesh: Prevention and Control through Community-Focused Strategies,” A paper (poster) presented at the Manitoba-India Symposium for Higher Learning, University of Manitoba, Winnipeg, Canada, October 28-29.

Dhar Chowdhury, P. 2011. “Determinants of Dengue Disease in Bangladesh: Prevention and Control through Eco-Bio-Social Approach” Paper presented at the Perspectives on South Asia Student Symposium, University of Manitoba, Winnipeg, Canada. March 11.

Dhar Chowdhury, P. and Haque, C.E. 2010. “Dengue Disease in Bangladesh: Development of an Integrated Ecohealth and Adaptive Management (IEAM) Approach,” Paper (poster) presented at the Ecohealth 2010 Conference, the London School of Hygiene and Tropical Medicine, London, UK, August 18-20.

Haque, C.E., Ahsan, G.U., and Dhar Chowdhury, P. 2010. “The Bangladesh IDRC project on Dengue-Scoping, Methods, and an Integrated Ecohealth and Adaptive Management (IEAM) Approach” Paper presented at the International Symposium on “Eco-Bio-Social Research on Dengue Hemorrhagic Fever in Tropical Countries”, Dhaka, Bangladesh, May 23-25.

Dhar Chowdhury, P. and Haque, C.E. 2010. “Application of Integrated Ecohealth and Adaptive Management Approach in Dengue Prevention and Control in Bangladesh,” Paper (poster) presented at the Conference on “Emerging Diseases in a Changing European Environment”, Montpellier, France, May 10-12.

Partners

  • University of Manitoba, Canada: Natural Resources Institute, Winnipeg, Manitoba, Canada
  • North South University, Bangladesh: Department of Public Health, Bashundhara, Dhaka, Bangladesh
  • ICDDRB (International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b): Infectious Diseases Section, icddrb, Mohakhali, Dhaka, Bangladesh
  • PHAC (Public Health Agency of Canada): National Microbiology Laboratory, Winnipeg, Manitoba, Canada
  • PSTC (Population Services Training Centre), NGO in Bangladesh: Education, and Training and Communication Divisions, PSTC, New Circular Road, Dhaka, Bangladesh
  • DGHS (Directorate General of Health Services), Bangladesh: Communicable Disease Control (CDC) Division, DGHS, Ministry of Health and Family Welfare, Government of Bangladesh, Mohakhali, Dhaka, Bangladesh

Graduate Students

Parnali Dhar Chowdhury

PhD student, Natural Resources Institute, University of Manitoba, Winnipeg, Manitoba, Canada: Ecological approaches to health, entomology, serology, community perspectives and capacity building

Sabrina Islam

PhD student, Natural Resources Institute, University of Manitoba, Winnipeg, Manitoba, Canada: Climate, urban and vector ecology, human migration and disease dispersal

Afroza Sultana

Masters student, Department of Anthropology, University of Manitoba, Winnipeg, Manitoba, Canada: Ethnography, family structure, power relations, community views

Syaket Ahmed Shakil

Master student, Department of Public Health, North South University, Bashundhara, Dhaka, Bangladesh: Ethnography, public health, sociology of diseases

Gallery




Dr. Haque, Canadian Principal Investiagtor, speaking with local
participants in a community workshop in Dhaka, 2013





















Field entomologists are looking into an outdoor barrel for mosquito
larvae and pupae in Dhaka during 2013 monsoon survey











Instructors are training field investigators with GPS units during
2013 monsoon survey



Trainees are in dialogue with the Project Research Team at
North South University, Dhaka


Two field invetigators are collecting mosquito larvae and pupae
in a local community in Dhaka during 2013 monsoon survey