Matlab was an upazila of the Chandpur District of the Chittagong Division, Bangladesh. [1] In 2000, the administrative area was subdivided into Matlab Dakshin Upazila and Matlab Uttar Upazila. [1]
The Matlab Health and Demographic Surveillance Site (HDSS) was established in 1963 by the International Centre for Diarrhoeal Disease Research, Bangladesh, (icddr,b, former Pakistan SEATO Cholera Research Laboratory). [2] Matlab contains the largest population under continuous PSCRL surveillance in the world. The area is representative of many rural and riverine deltas in Bangladesh, and is one of the richest and longest-running longitudinal data sources within the developing world. [3]
In 1960, a group of American and Bangladeshi scientists journeyed across a cholera-prone sub-district of Bangladesh on a barge-turned-floating cholera hospital. This particular barge was used around Matlab to treat patients with cholera otherwise inaccessible due to their remote location. This is the story of the Matlab HDSS which would develop into the Matlab Health Research Centre - a full-fledged health care facility and one of the most important research sites in the world.
In 1966, a Health and Demographic Surveillance System (HDSS) was established in Matlab to record data regarding birth, death and migration. Initially the main purpose was to conduct cholera vaccine trials and to track the trends of public health problems of rural Bangladesh. One of the most important roles Matlab played in the field of public health was through the development of an oral rehydration solution (ORS). The ORS, at the time created from salt, molasses and water, was first trialed in 1968 at Matlab. It is now considered one of the most important medical advances of the 20th century and estimated to have saved around 50 million lives globally. [4]
Matlab is a former thana of the Chandpur district of Bangladesh, situated 55 km southeast of Dhaka. its total area in regards to the HDSS is 184 km2. Three seasons are typical: monsoon, cool-dry, and hot-dry, and the climate is sub-tropical. It is subject to annual flooding due to its position within low-lying flatlands. Average annual rainfall is approximately 2159mm, concentrated mainly during monsoon season (June to September). [5]
During its inception, 132 villages were included and 101 villages were added in 1968. Traditional Birth Attendants (dais, elderly illiterate women mostly) used to work to detect and record data of the vital events through weekly household visit. Health Assistants (HA) along with the Dais visited households every six weeks with standard registration forms. In 1977, major modification of field structure and programme activities were made, leading to the exclusion of 84 villages and the retention of 149 villages. The Family Planning and Health Services Project was then launched in 70 villages with the remaining 79 villages not included intentionally to serve as a comparison area. The Dais of both treated areas and comparison areas were eventually replaced by female Community Health Workers (CHW). In 1993, due to river erosion, 7 villages within the comparison area disappeared, reducing the project to 142 villages. However, the majority of villagers resettled within nearby villages still participating in the HDSS. [6]
A typical village in Bangladesh consists of several baris – groups of houses centered around courtyards – which function as economic and social units. The HDSS system covers all houses within these areas. Data is collected from individuals who are regular residents (either permanent or those who have resided continuously within these areas for at least 6 months). Birth, death, and migrations have been recorded since 1966, and the recording of marriages and divorces began in 1975. Recording of split households and changes in family type began after the 1993 census.
Data is collected within treatment and comparison areas through the Record Keeping System (RKS). The health data currently covers married women of reproductive age (data includes reproductive status, contraception, tetanus, etc.) and children under 5 (immunization, diarrhea, acute lower respiratory infection, breastfeeding, etc.). The Geographical Information System (GIS) was introduced in 1993. In HDSS's administrative term, three projects are running in the area: DSS, RKS and GIS. The system also collects socioeconomic data.
a) Initial census and regular update rounds - CHWs collect data through monthly household visits. They also provide health services to mothers and children in treatment areas, while in comparison areas they simply advise residents to visit government health facilities.
b) Continuous surveys - CHWs enquire about demographic events which have occurred since their last visit. Special forms and record keeping books (RKBs) are used to keep health data.
c) Supervision and quality control - field research assistants supervise CHWs, while overall field activities are supervised by field managers.
Fertility, reproductive health, maternal and child health, child morbidity and causes of death, health equity, and climate change.
The development of oral rehydration saline.
Family planning: the introduction of CHWs in 1970 greatly increased contraceptive use and reduced fertility. These methods were later adopted internationally.
Immunization: Matlab showed that 63% of childhood deaths were due to vaccine-preventable disease and could be prevented by effective immunization campaigns.
Child health and family planning: child mortality has been reduced by about 75% within the last 25 years due to the combined efforts of childhood health and family planning programmes.
Cholera is an infection of the small intestine by some strains of the bacterium Vibrio cholerae. Symptoms may range from none, to mild, to severe. The classic symptom is large amounts of watery diarrhea that lasts a few days. Vomiting and muscle cramps may also occur. Diarrhea can be so severe that it leads within hours to severe dehydration and electrolyte imbalance. This may result in sunken eyes, cold skin, decreased skin elasticity, and wrinkling of the hands and feet. Dehydration can cause the skin to turn bluish. Symptoms start two hours to five days after exposure.
G. Balakrish Nair is an Indian microbiologist. At present, he is the Ag. Regional Adviser, Research Policy and Cooperation Unit, Department of Communicable Diseases, World Health Organization. Before joining WHO, he was the executive director of Translational Health Science and Technology Institute (THSTI), Faridabad, NCR, India. Before joining THSTI, he was working in NICED as the director. He has also served as the director of Laboratory Sciences Division at the International Center for Diarrhoeal Diseases Research,, Dhaka, Bangladesh.
Oral rehydration therapy (ORT) is a type of fluid replacement used to prevent and treat dehydration, especially due to diarrhea. It involves drinking water with modest amounts of sugar and salts, specifically sodium and potassium. Oral rehydration therapy can also be given by a nasogastric tube. Therapy should routinely include the use of zinc supplements. Use of oral rehydration therapy has been estimated to decrease the risk of death from diarrhea by up to 93%.
A cloth filter is a simple and cost-effective appropriate technology method for reducing the contamination of drinking water, developed for use mainly in Bangladesh. Water collected in this way has a greatly reduced pathogen count. Though not always perfectly safe, it is an improvement for poor people with limited options.
ICDDR,B is an international health research organisation located in Dhaka, Bangladesh. Dedicated to saving lives through research and treatment, ICDDR,B addresses some of the most critical health concerns facing the world today, ranging from improving neonatal survival to HIV/AIDS. In collaboration with academic and research institutions over the world, ICDDR,B conducts research, training and extension activities, as well as programme-based activities, to develop and share knowledge for global lifesaving solutions.
Dilip Mahalanabis was an Indian paediatrician known for pioneering the use of oral rehydration therapy to treat diarrhoeal diseases. Mahalanabis had begun researching oral rehydration therapy in 1966 as a research investigator for the Johns Hopkins University International Center for Medical Research and Training in Calcutta, India. During the Bangladeshi war for independence, he led the effort by the Johns Hopkins Center that demonstrated the dramatic life-saving effectiveness of oral rehydration therapy when cholera broke out in 1971 among refugees from East Bengal who had sought asylum in West Bengal. The simple, inexpensive Oral Rehydration Solution (ORS) gained acceptance, and was later hailed as one of the most important medical advances of the 20th century.
Haziganj or Hajiganj is an upazila of Chandpur District in the Division of Chittagong, Bangladesh.
Shahrasti is an upazila of Chandpur District in the Division of Chittagong, Bangladesh.
Health care services in Nepal are provided by both public and private sectors and are generally regarded as failing to meet international standards. Prevalence of disease is significantly higher in Nepal than in other South Asian countries, especially in rural areas. Moreover, the country's topographical and sociological diversity results in periodic epidemics of infectious diseases, epizootics and natural hazards such as floods, forest fires, landslides, and earthquakes. A large section of the population, particularly those living in rural poverty, are at risk of infection and mortality by communicable diseases, malnutrition and other health-related events. Nevertheless, some improvements in health care can be witnessed; most notably, there has been significant improvement in the field of maternal health. These improvements include:
With less than 0.1 percent of the population estimated to be HIV-positive, Bangladesh is a low HIV-prevalence country.
The International Vaccine Institute (IVI) is an independent, nonprofit, international organization founded on the belief that the health of children in developing countries can be dramatically improved by the use of new and improved vaccines. Working in collaboration with the international scientific community, public health organizations, governments, and industry, IVI is involved in all areas of the vaccine spectrum – from new vaccine design in the laboratory to vaccine development and evaluation in the field to facilitating sustainable introduction of vaccines in countries where they are most needed.
Richard Alan Cash, M.D., M.P.H. is an American global health researcher, public health physician, and internist. He is a Senior Lecturer in International Health at the Harvard T.H. Chan School of Public Health in Boston.
Hili is a community development block that forms an administrative division in Balurghat subdivision of Dakshin Dinajpur district in the Indian state of West Bengal.
Shah Mohammad Faruque is a professor in the School of Environment and Life Sciences at Independent University Bangladesh (IUB). He is widely recognized for his research in Vibrio cholerae, the bacterium which causes the epidemic diarrhoeal disease Cholera. Among other positions, previously he was a professor at BRAC University; director of the Genomics Centre at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), and formerly director of the Centre for Food and Water Borne Diseases in ICDDR,B. His areas of research interest include microbial genomics, bacteriophages, environmental microbiology, ecology, and evolution of bacterial pathogens, particularly those associated with waterborne and foodborne diseases. Faruque is primarily known for his work in genomics, epidemiology and ecology of the cholera pathogen, and its bacteriophages.
As of 24 September 2012, a cholera outbreak in Sierra Leone had caused the deaths of 392 people. It was the country's largest outbreak of cholera since first reported in 1970 and the deadliest since the 1994–1995 cholera outbreak. The outbreak has also affected Guinea, which shares a reservoir near the coast. This was the largest cholera outbreak in Africa in 2012.
Firdausi Qadri is a Bangladeshi scientist with specialization in immunology and infectious disease research. She has worked over 25 years on the development of vaccines for cholera and has expertise on other infectious disease like ETEC, Typhoid, Helicobacter pylori, rotavirus, etc. Currently, she is working as a director for Centre for Vaccine Sciences of International Centre for Diarrhoeal Disease and Research, Bangladesh (icddr,b). She also serves as chairperson of the Institute for developing Science and Health initiatives. Her scientific achievements lie in enteric infections and vaccines including Vibrio cholerae and enterotoxigenic Escherichia coli—major causes of severe diarrhea. She has also focused on studying the immune response in H.pylori infected people in Bangladesh and the responses in patients with typhoid fever as well as vaccinees. The Government of Bangladesh awarded her the Independence Day Award in 2023.
Matlab Uttar is an upazila of Chandpur District in the division of Chittagong, Bangladesh. The former Matlab Upazila was divided into two in 2000, Matlab Dakshin and Matlab Uttar.
In the fields of demographics and public health, a demographic surveillance system (DSS), also called a health and demographic surveillance system (HDSS), gathers longitudinal health and demographic data for a dynamic cohort of the total population in a specified geographic area. An HDSS is created by first executing a census of households in the area as a baseline, followed by regular visits to each household to gather health and demographic data. The cohort is dynamic in that members are added through birth or immigration and members are subtracted through death or emigration. Tracking population migration is particularly important for understanding of HDSS data.
Samir Kumar Saha is an eminent Bangladeshi microbiologist and public health expert. He is the professor, senior consultant and head of the department of Diagnostic Division of Microbiology at the Dhaka Shishu Hospital for children and also the executive director of The Child Health Research Foundation (CHRF) at the Bangladesh Institute of Child Health.
Wiley Henry Mosley is an epidemiologist and international public health professional. He is Emeritus Professor in the Department of Population, Family and Reproductive Health at Johns Hopkins Bloomberg School of Public Health.