To assess the mental health status and identify associated factors among rural adult women in Bangladesh.

Cross-sectional study using face-to-face interviews with a semistructured questionnaire.

Data were collected between January and February 2025 in three rural upazilas (Dhamrai, Nawabganj and Sreepur) using multistage systematic sampling. The semistructured questionnaire included sociodemographic characteristics, household assets and the Depression Anxiety Stress Scale-21 (DASS-21). The wealth index was calculated using principal component analysis. Cases with mild to extreme levels of depression, anxiety and stress were grouped together to indicate the presence of any level of the three mental health problems. Statistical analyses included descriptive statistics, bivariate analyses using ², Fisher’s exact test and Welch two-sample t-test, and multivariable binary logistic regression to identify predictive factors of mental problems. A Venn diagram was generated to display the proportion of patients with anxiety, depression and stress. Data analysis was performed using SPSS (V.26) and R Studio (V.2025.05) with a significance level of p

A total of 1350 women aged 18 years or older who were available at home during the data collection period and gave consent to participate. Women who were unable to participate due to illness were excluded.

Participants had a mean (±SD) age of 36.35 (±12.58) years. The prevalence of depression, anxiety and stress was 47.7%, 60.7% and 23.2%, respectively. Moderate severity was most common among patients with depression (20.34%), anxiety (24.20%) and stress (8.03%). 20% of participants experienced all three conditions simultaneously, with 22% having both depression and anxiety. Multivariable analysis revealed that factors associated with an increased odds of depression, anxiety and stress were chronic diseases (ORs (95% CIs): 2.02 (1.50 to 2.73), 1.44 (1.05 to 1.99) and 1.91 (1.35 to 2.71), respectively) and history of abuse (1.84 (1.28 to 2.66); 3.15 (2.06 to 4.93) and 1.91 (1.28 to 2.83), respectively). Family history of mental illness was associated with an increased odds of anxiety (1.71 (95% CI 1.12 to 2.87)) and stress (1.61 (95% CI 1.01 to 2.52)). So was the presence of a caregiving role (1.68 (95% CI 1.18 to 2.42) and 1.50 (95% CI 1.02 to 2.19) for anxiety and stress, respectively). Having a financial problem was associated with an increased odds of anxiety (1.52 (95% CI 1.16 to 2.00)). A happy family relationship was associated with decreased odds of depression (0.28 (95% CI 0.20 to 0.93)), anxiety (0.22 (95% CI 0.06 to 0.60)) and stress (0.50 (95% CI 0.25 to 1.00)). Conjugal satisfaction was protective against anxiety (0.42 (95% CI 0.18 to 0.80) and stress (0.32 (95% CI 0.17 to 0.59)). Unexpectedly, higher wealth status (being rich) increased depression (1.56 (95% CI 1.04 to 2.34) and anxiety (1.57 (95% CI 1.03 to 2.41) risk.

A major segment of rural adult women of Bangladesh experiences mental health problems. The findings recommend community-based comprehensive mental health screening programmes, interventions and integration of mental healthcare into primary health systems to address this critical public health challenge.

Bipolar disorder affects around 2% of the population and is linked with reduced life expectancy and socioeconomic burden. Depressive episodes are difficult to treat and typically more prevalent, enduring and burdensome than manic episodes. The use of antidepressants alone has limited effect and is associated with significant clinical risk through polarity switch. Current National Institute for Health and Care Excellence guidelines recommend quetiapine, olanzapine (with or without fluoxetine) and lamotrigine; however, these medications have limited efficacy, tolerability and acceptability. The ASCEnD study aims to assess the clinical and cost-effectiveness of aripiprazole plus sertraline compared with quetiapine, offering potential improvements for outcomes in bipolar depression. The study is funded by the National Institute for Health and Care Research Health Technology Assessment programme (NIHR132773).

ASCEnD is a prospective, two-arm, superiority, individually 1:1 randomised, controlled, pragmatic, parallel group, type A open-label clinical trial of aripiprazole/sertraline medication combination compared with quetiapine for bipolar depression. The study is conducted in the UK National Health Service setting with the aim of recruiting and randomising 270 participants followed-up for 24 weeks. Adults with bipolar disorder self-refer or are recruited through primary and secondary care services. The primary outcome is change in depressive symptoms 12–16 weeks after randomisation. Secondary outcomes include measures of symptom change, treatment satisfaction, tolerability, medication adherence, concomitant medication use, psychosocial functioning, quality of life and cost-effectiveness and informal carer measures of quality of life and costs of caring. The exploratory outcome is change in participant reward and punishment responsiveness. Analysis will follow a prespecified statistical analysis plan. A nested qualitative study is included to examine feasibility and acceptability of the trial design.

A Clinical Trial Authorisation from Medicines and Healthcare products Regulatory Agency, and approval from the Health Research Authority (IRAS 1007468) and North East – Newcastle and North Tyneside 1 Research Ethics Committee (23/NE/0132) were obtained. Results will be disseminated through peer-reviewed publications, conference presentations and lay summaries for participants and patient and public groups.

ISRCTN63917405.

This study aimed to investigate the prevalence and associated factors of anaemia and its association with the academic performance of schoolchildren in Kandahar, Afghanistan.

This was a cross-sectional analytical study.

This was a school-based study conducted among 1866 schoolchildren aged 6–14 years in Kandahar city from September to December 2023. Haemoglobin concentration was measured using a portable HemoCue Hb 301 analyser, while the WHO age-adjusted cut-off for haemoglobin was used to classify anaemia. Data were analysed by using descriptive statistics, the ² test and multivariate logistic regression.

In this study, the mean age of the children was 9.1 years, 61.1% (1138/1866) were boys, 83.6% (1560/1866) had illiterate mothers, and 81.3% (1517/1866) belonged to poor families. Prevalence of anaemia among schoolchildren was 64.1% (1196/1866), while 20.8% (388/1866), 41.7% (778/1866), and 1.6% (30/1866) were suffering from mild, moderate and severe anaemia, respectively. Main associated factors of anaemia were being male (adjusted OR (AOR) 1.4, 95% CI 1.1 to 1.7, p=0.003), unemployed father (AOR 1.5, 95% CI 1.1 to 2.2, p=0.020), poor family (AOR 2.3, 95% CI 1.8 to 2.9, p

Prevalence of anaemia was very high and is a severe public health problem in schoolchildren of Kandahar. Based on the known consequences of anaemia on academic performance, the education and health authorities of Afghanistan should take serious steps to alleviate this problem. Periodic iron supplementation and deworming, as well as daily iron-rich mid-day meal programmes, should be started for both boys and girls in schools.