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  1. Bong Y, Shariff A, Majid A, Merican A
    Iran J Public Health, 2012;41(2):27-38.
    PMID: 23113132
    Reference charts are widely used in healthcare as a screening tool. This study aimed to produce reference growth charts for school children from West Malaysia in comparison with the United States Centers for Disease Control and Prevention (CDC) chart.
  2. Bong YB, Shariff AA, Mohamed AM, Merican AF
    Asia Pac J Public Health, 2015 Mar;27(2):NP1217-27.
    PMID: 22652249 DOI: 10.1177/1010539512446959
    In this article, the authors propose reference curves for height and weight for school children in the Kuching area, Sarawak. The school children were from primary to secondary schools (aged 6.5 to 17 years old) and comprised both genders. Anthropometric measurements and demographic information for 3081 school-aged children were collected (1440 boys and 1641 girls). Fitted line plots and percentiles for height and weight (3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles) were obtained. The height of school boys and school girls were almost similar at the start of their school-going age. For school girls, height and weight values stabilized when they reached 16 or 17 years old but kept increasing for school boys. School boys were taller than school girls as they entered adolescence. Height differences between school boys and school girls became significantly wider as they grew older. Chinese school children were taller and heavier than those of other ethnic groups.
  3. Bong Y, Shariff AA, Mohamed AM, Merican AF
    Ann Hum Biol, 2015 Mar;42(2):108-15.
    PMID: 24853607 DOI: 10.3109/03014460.2014.912679
    Growth references are useful for the screening, assessment and monitoring of individual children as well as for evaluating various growth promoting interventions that could possibly affect a child in early life.
  4. Khan MN, Kabir MA, Shariff AA, Rahman MM
    PLOS Glob Public Health, 2022;2(2):e0000091.
    PMID: 36962249 DOI: 10.1371/journal.pgph.0000091
    Caesarean section (CS) use is rising rapidly in Bangladesh, though lack of CS use remains common among disadvantage women. This increases risks of long-term obstetric complications as well as maternal and child deaths among disadvantage women. We aimed to determine the interaction effects of women's disadvantage characteristics on CS use in Bangladesh. For this we have analysed a total of 27,093 women's data extracted from five rounds of Bangladesh Demographic and Health Survey conducted during 2004 and 2017/18. The outcome variable was CS use, coded as use (1) and non-use (0). The major exposure variables were individual level, household level, and community level characteristics. Multilevel logistic regression model was used to determine association of CS use with socio-demographic characteristics and the interactions of three variables: working status, wealth quintile, and place of residence. We found a 751% increase of CS use over the last 13 years-from 3.88% in 2004 to 33% in 2017/18. Nearly, 80% of the total CS operation occurred in the private health facilities followed by the government health facilities (15%). Women living in rural areas with no engagement in formal income generating activities showed a 11% (OR, 0.89, 95% CI, 0.71-0.99) lower use of CS in 2004. This association was further strengthened over time, and a 51% (OR, 0.49, 0.03-0.65) lower in CS use was reported in 2017/18. Similarly, around 12%-83% lower likelihoods of CS use were found among rural poor and poorer women. These indicate Bangladesh is facing a double burden of CS use, that is a group of women with improved socio-economic condition are using this life saving procedure without medical necessity while their counterpart of disadvantage characteristics could not access the service. Improved monitoring from the government along with support to use CS services for the disadvantage groups on necessity are important.
  5. Rahman M, Shariff AA, Shafie A, Saaid R, Tahir RM
    PMID: 26825988 DOI: 10.1186/s41043-015-0020-2
    Caesarean delivery (C-section) rates have been increasing dramatically in the past decades around the world. This increase has been attributed to multiple factors such as maternal, socio-demographic and institutional factors and is a burning issue of global aspect like in many developed and developing countries. Therefore, this study examines the relationship between mode of delivery and time to event with provider characteristics (i.e., covariates) respectively.
  6. Khan MN, Rahman MM, Shariff AA, Rahman MM, Rahman MS, Rahman MA
    Arch Public Health, 2017;75:12.
    PMID: 28174626 DOI: 10.1186/s13690-017-0181-0
    BACKGROUND: Overweight and obesity are increasing in low- and middle-income countries, while underweight remains a significant health problems. However, the association between double burden of nutrition and risk of adverse birth and health outcomes is still unclear in Bangladesh. The aim of this study was to determine the effect of maternal undernutrition and excessive body weight on a range of maternal and child health outcomes.

    METHODS: In this study, we used Bangladesh Demographic and Health Survey (BDHS) 2011 and 2014 data sets to cover the maternal, child and non-communicable diseases related health outcomes. The study considered a range of outcome variables including pregnancy complication, cesarean delivery, diabetes, hypertension, stunting, and wasting, low birth weight, genital discharge, genital sore/ulcer, stillbirth, early neonatal mortality, perinatal mortality, preterm birth and prolonged labor. The key exposure variable was maternal body mass index. Multilevel regression analysis was performed to examine the association between outcomes and exposure variables.

    RESULTS: Maternal overweight and obesity has increased from 10% in 2004 to 24% in 2014, a 240% increase in 10 years. Between 2004 and 2014, maternal undernutrition declined from 33% to 18%, a reduction rate of only 54% in 10 years. Compared to normal-weight women, overweight and obese women were more likely to have experienced pregnancy complication, cesarean delivery, diabetes, and hypertension. Underweight women were 1.3 times more likely to have children with stunting and 1.6 times more likely to experience wasting compared to normal weight women. Maternal BMI was not significantly associated with increased risk of genital sore or ulcer, genital discharge, menstrual irregularities, or low birth weight though in certain cases risk was higher.

    CONCLUSIONS: High maternal overweight and obesity were observed to have significant adverse effects on health outcomes, while underweight was a risk factor for newborn health. The findings show that weight management is necessary to prevent adverse birth and health outcomes in Bangladesh.

    TRIAL REGISTRATION: Data related to health was collected by following the guidelines of ICF international and Bangladesh Medical Research Council. The registration number of data collection is 132989.0.000 and the data-request was registered on March 11, 2015.
  7. Khan MN, Islam MM, Shariff AA, Alam MM, Rahman MM
    PLoS One, 2017;12(5):e0177579.
    PMID: 28493956 DOI: 10.1371/journal.pone.0177579
    BACKGROUND: Globally the rates of caesarean section (CS) have steadily increased in recent decades. This rise is not fully accounted for by increases in clinical factors which indicate the need for CS. We investigated the socio-demographic predictors of CS and the average annual rates of CS in Bangladesh between 2004 and 2014.

    METHODS: Data were derived from four waves of nationally representative Bangladesh Demographic and Health Survey (BDHS) conducted between 2004 and 2014. Rate of change analysis was used to calculate the average annual rate of increase in CS from 2004 to 2014, by socio-demographic categories. Multi-level logistic regression was used to identify the socio-demographic predictors of CS in a cross-sectional analysis of the 2014 BDHS data.

    RESULT: CS rates increased from 3.5% in 2004 to 23% in 2014. The average annual rate of increase in CS was higher among women of advanced maternal age (≥35 years), urban areas, and relatively high socio-economic status; with higher education, and who regularly accessed antenatal services. The multi-level logistic regression model indicated that lower (≤19) and advanced maternal age (≥35), urban location, relatively high socio-economic status, higher education, birth of few children (≤2), antenatal healthcare visits, overweight or obese were the key factors associated with increased utilization of CS. Underweight was a protective factor for CS.

    CONCLUSION: The use of CS has increased considerably in Bangladesh over the survey years. This rising trend and the risk of having CS vary significantly across regions and socio-economic status. Very high use of CS among women of relatively high socio-economic status and substantial urban-rural difference call for public awareness and practice guideline enforcement aimed at optimizing the use of CS.

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