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Missed opportunities in methanol poisoning: a qualitative exploration of the socio-material practices of health professionals responding to acute methanol poisoning in Bangladesh

Por: Perkins · J. E. · Sorensen · J. B. · Islam · M. S. · Hovda · K. E. · Chowdhury · F. R. · Ghose · A. · Rahman · A. S. M. M. · Eddleston · M. · Street · A.
Objective

This study applied a socio-material practice lens to examine health professionals’ responses to methanol poisoning in Bangladesh and to compare these practices with established guidelines.

Design

This study employed a rapid ethnographic design.

Setting

Data were generated in primary-level, secondary-level and tertiary-level health facilities in six districts of western Bangladesh between September 2024 and May 2025.

Participants

We carried out semi-structured interviews with 50 health professionals with responsibilities for managing patients experiencing alcohol-related or poisoning-related conditions.

Results

Among health professionals, the meanings of methanol poisoning as a diagnostic category, its symptoms and treatments are obscured by moral concerns about alcohol. Materials, including antidotes, for managing methanol poisoning were scarce, and health professionals reported using readily available medical supplies for supportive treatment, though not specifically adapted for methanol poisoning. Health professionals’ care practices for responding to methanol poisoning were often structured by these meanings and materials, with guidelines remaining largely invisible.

Conclusions

Socio-material practices of health professionals in response to methanol poisoning in Bangladesh are characterised by missed opportunities. Improving responses requires shifting the meanings of methanol poisoning as a diagnostic category, ensuring that materials such as treatment guidelines and appropriate antidotes, such as ethanol and fomepizole, are available and supporting providers to enact care practices that reflect these guidelines.

Diabetes-related treatment costs and catastrophic health expenditure at a tertiary care hospital in Rajshahi, Bangladesh: a cross-sectional study

Por: Akter · F. · Hossain · M. G. · Mothashin · M. · Hasan · F. · Al Mamun · A. S. M. · Alam · S. N. · Aufi · S. S. · Hasnin · K.
Background

Diabetes is a chronic disease characterised by elevated blood sugar levels, which can lead to damage across various body systems. Bangladesh has the second highest number of adults with diabetes in South Asia and faces a significant economic burden from this condition. The objective of this study was to investigate the economic burden of diabetes and its associated factors among patients with diabetes registered at a tertiary-level diabetes hospital in the Rajshahi region of Bangladesh.

Design

This was a cross-sectional hospital-based study.

Setting

Primary data were collected from patients with diabetes at a tertiary-level diabetes hospital in Bangladesh.

Participants

The study recruited 400 patientswith diabetes, who were randomly selected. The economic burden was assessed using the Catastrophic Health Expenditure (CHE) threshold of ≥10% of household income. Descriptive statistics, 2 tests, t-tests, linear regression and binary logistic regression were employed for analysis, with statistical significance set at p

Results

The proportion of diabetes-related burden among patients with diabetes was 50.7%. 95.8% of patients had type 2 diabetes, and over half (52.5%) were overweight or obese. Treatment costs were significantly associated with diabetes duration, insulin use and age (35–55 vs ≥56 years). The economic burden was strongly associated with lower income levels (poor income and middle income vs high income) and longer diabetes duration. Participants not adhering to a healthy diet had 43% lower odds of experiencing economic burden than those following a healthy diet.

Conclusions

Approximately half of the patients experienced catastrophic health expenditure due to diabetes, indicating a substantial economic burden in the Rajshahi region of Bangladesh. This burden was significantly higher among lower-income and middle-income groups and patients with longer disease duration, and treatment-related factors such as insulin use were associated with greater financial strain. These findings emphasise the need for targeted financial protection strategies, including subsidised care and preventive interventions.

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