Publications by authors named "Zubair Akhtar"

Background: There is limited global evidence on whether influenza sentinel surveillance platforms can be effectively adapted for long-term SARS-CoV-2 monitoring in low-resource contexts. We explored the utility of the hospital-based influenza sentinel surveillance (HBIS) platform for monitoring SARS-CoV-2 in Bangladesh by comparing SARS-CoV-2 detection in HBIS platform with national COVID-19 platform and assessing how its integration into influenza surveillance aligns with national trends.

Methods: From March 2020 to December 2024, we analysed data from patients with severe acute respiratory infection (SARI) and influenza-like illness (ILI) enrolled in HBIS.

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Introduction: Nipah virus (NiV) is a deadly zoonotic disease with pandemic potential, prioritized by the World Health Organization for research and vaccine development. Since Bangladesh has faced annual NiV outbreaks and repeated spillovers since 2001, it is likely to be the site of a Phase II vaccine trial. This study explored people's knowledge about NiV and their willingness to participate in a NiV vaccine trial in Bangladesh.

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Background: Over-the-counter antibiotic sales in community-pharmacies significantly drive antimicrobial resistance (AMR) in low- and middle-income countries (LMICs) due to inappropriate use and early treatment discontinuation. In Bangladesh, community pharmacies, which dispense 56.6 % of antibiotics without prescriptions, serve as the first health-seeking touchpoint, yet conventional stewardship strategies often overlook these informal providers, heightening AMR risks.

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In Australia, 2017 was a severe A/H3N2 season and, therefore, we estimated the effectiveness of standard-dose quadrivalent influenza vaccine in preventing hospitalization for cardiovascular disease (CVD) among New South Wales (NSW) residents aged ≥50 years. We conducted a nested, matched case-control study within the 45 and Up study, linking data from the Australian Immunization Register, NSW Admitted Patient Data Collection and Pharmaceutical Benefits Schedule. Cases were individuals hospitalized for CVD and controls were those who were hospitalized for gastrointestinal diseases.

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Background: Melioidosis, which is caused by Burkholderia pseudomallei, is a disease with a high case fatality rate and a wide variety of disease manifestations causing diagnostic dilemmas for medical professionals. Risk factors such as diabetes contribute to a worse prognosis if not treated with appropriate antibiotics during the course of management. This case report describes a diabetic melioidosis case with a rare presentation of venous thrombosis of the lower limb and a successful course of treatment.

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Epidemic surveillance using traditional approaches is dependent on case ascertainment and is delayed. Open-source intelligence (OSINT)-based syndromic surveillance can overcome limitations of delayed surveillance and poor case ascertainment, providing early warnings to guide outbreak response. It can identify outbreaks of unknown cause for which no other global surveillance exists.

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Background: Antibiotic nonadherence significantly contributes to poor treatment outcomes and antimicrobial resistance. In Southeast Asia, including Bangladesh, community pharmacies are crucial in primary healthcare, and are key sources of over-the-counter antibiotics. However, understanding of adherence to the full course of community-dispensed antibiotics is limited.

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Article Synopsis
  • Antimicrobial resistance (AMR) is particularly problematic in low- and middle-income countries like Bangladesh, where a large portion of antibiotics are used inappropriately within community settings.
  • A study surveyed 385 customers and observed 1000 pharmacy events, finding that 25.9% involved antibiotics, primarily macrolides and cephalosporins, with most being obtained without prescriptions for mild symptoms.
  • The likelihood of purchasing antibiotics without a prescription was significantly higher in individuals aged 6-59, with certain infections showing a greater tendency to require prescriptions, underscoring the need for better regulations and healthcare practices.
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  • Formal infectious disease surveillance in Ukraine has been severely affected by Russia's invasion in 2022, hindering the ability to track epidemics effectively.
  • An analysis using data from EPIWATCH showed significant increases in infections such as cholera, botulism, tuberculosis, and more during the conflict compared to before the invasion.
  • Open-source data emerged as a valuable tool for tracking infectious diseases in the absence of formal surveillance, although there were still limitations in data availability and accuracy during the war.
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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 to December 2019, we conducted follow-up calls to patients or their families 30 days after discharge to assess the status of patients with SARI.

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  • The study examined the link between recent respiratory illnesses, particularly influenza, and acute myocardial infarction (AMI) in patients at a Dhaka hospital between May 2017 and October 2018.
  • Of the 744 AMI patients studied, 11.3% reported respiratory illnesses, primarily during the 2017 influenza season, with influenza confirmed in 1.5% of cases, all of whom had STEMI.
  • Despite higher rates of respiratory illness in STEMI patients and those with elevated troponin levels, the research found no significant relationship between these illnesses and the severity of AMI, highlighting the need for further investigation into potential preventive measures like vaccinations.
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Current evidence suggests that recent acute respiratory infections and seasonal influenza may precipitate acute myocardial infarction (AMI). This study examined the potential link between recent clinical respiratory illness (CRI) and influenza, and AMI in Bangladesh. Conducted during the 2018 influenza season at a Dhaka tertiary-level cardiovascular (CV) hospital, it included 150 AMI cases and two control groups: 44 hospitalized cardiac patients without AMI and 90 healthy individuals.

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We estimated the effectiveness of influenza vaccines in preventing laboratory-confirmed influenza among older adults in aged care. Electronic database searches were conducted using search terms, and studies were selected as per the selection criteria. Fourteen studies were included for final review.

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Article Synopsis
  • - The IAMI trial studied 2571 patients with acute myocardial infarction to assess the impact of influenza vaccination on cardiovascular events, comparing outcomes between early and late season vaccinations over a 12-month period.
  • - Results showed no significant difference in the effectiveness of the vaccine whether given early or late, with similar percentages of primary composite endpoints observed in both groups (6% early, 4.7% late for vaccinated participants).
  • - Although early vaccination demonstrated a potentially greater effect on overall mortality, the findings were not statistically significant; thus, the study reinforces recommending influenza vaccination for all cardiovascular patients, regardless of timing.
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Article Synopsis
  • Researchers studied if hospitals can spot serious lung infections (SARI) and if these cases lead to public health investigations.
  • They found 464 groups of patients with SARI over 11 years, mainly involving young boys. Most of these groups did not show the same virus infection.
  • Despite finding many clusters, none led to emergency responses, suggesting that better surveillance could focus on bigger groups of sick people.
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Background: Pregnant women with their infants are considered at higher risk for influenza-associated complications, and the World Health Organization (WHO) recommends influenza vaccination during pregnancy to protect them, including their infants (0-6 months). There are limited data on the influenza burden among pregnant women and their infants (0-6 months), and there are no routine influenza vaccinations in Bangladesh.

Methods: Five annual cohorts (2013-2017) of pregnant women were enrolled from the eight sub-districts of Bangladesh before the influenza season (May-September); they were contacted weekly to identify new onset of influenza-like illness (ILI) (subjective or measured fever and cough) and acute respiratory illness (ARI) (at least two of these symptoms: cough, rhinorrhea, or difficulty in breathing) among their infants from birth to 6 months of age.

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COVID-19 is an independent risk factor for cardiovascular disease. COVID-19 vaccination may prevent this, but in some cases, COVID-19 vaccination may cause myocarditis or pericarditis. Patients with COVID-19 may present with non-specific symptoms that have a cardiac origin.

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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 and newer preventive measures.

Methods: A global, survey-based study was undertaken in 2021.

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Background: Influenza vaccination early after myocardial infarction (MI) improves prognosis but vaccine effectiveness may differ dependent on type of MI.

Methods: A total of 2,571 participants were prospectively enrolled in the Influenza vaccination after myocardial infarction (IAMI) trial and randomly assigned to receive in-hospital inactivated influenza vaccine or saline placebo. The trial was conducted at 30 centers in eight countries from October 1, 2016 to March 1, 2020.

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Background: Irrational and inappropriate use of antibiotics in aquaculture can contribute to the development of antibiotic resistance.

Objectives: In this study, we aimed to assess antibiotic usage in inland and coastal fish farms in Bangladesh and identify factors associated with this practice.

Methods: We conducted a cross-sectional study to collect antibiotic usage information from 672 fish farmers in Bangladesh.

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Irrational and inappropriate use of antibiotics in commercial chicken production can contribute to the development of antimicrobial resistance. We aimed to assess antibiotic usage in commercial chicken production in Bangladesh, and identify factors associated with this practice. We conducted a large-scale cross-sectional study to collect information on antibiotic usage in commercial chickens from January to May 2021.

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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 conducted by the Ministry of Health and Family Welfare (MoHFW) during July-October 2017. We used the World Health Organization (WHO) Service Availability and Readiness Assessment (SARA) manual to determine the standard precautions related to the IPC readiness index.

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