CDC in Bangladesh
CDC has been collaborating with Bangladesh for the past 40 years—most recently to strengthen the country’s capacity to detect emerging infectious diseases and to provide training and other interventions to partners. In 2012, CDC designated Bangladesh as a CDC Global Disease Detection Center for enhancing global health security for rapid detection and response to infectious diseases.
Bangladesh at a Glance
Per capita income: $2,100
Life expectancy at birth women/men: 68/72 yrs
Infant mortality rate: 45/1000 live births
Central Intelligence Agency, The World Factbook, 2014
Top 10 Causes of Death
Source: GBD CompareExternal, 2010
- Cancer 13%
- Lower Respiratory Infections 7%
- Chronic Obstructive Pulmonary Disease 7%
- Ischemic Heart Disease 6%
- Stroke 5%
- Preterm Birth Complications 4%
- Tuberculosis 3%
- Neonatal Encephalopathy 3%
- Diabetes 3%
- Cirrhosis 3%
What CDC Is Doing
- 28 acute disease outbreak investigations in collaboration with the government of Bangladesh in 2013.
- 24 national influenza surveillance sites at district and tertiary care hospitals established within Bangladesh since 2009.
- 16 sites for avian influenza surveillance among poultry workers established within Dhaka City Live Bird Markets in 2012.
- 1,305 public health professionals received short course trainings since 2011
CDC and icddr,b, in partnership with IEDCR, conduct surveillance for emergent and zoonotic strains of influenza and for severe respiratory disease and influenza-like illness in the general population and in hospitals across Bangladesh. In addition, they participate in outbreak investigations of respiratory illness and conduct research studies on seasonal and avian influenza and other respiratory viruses (e.g., estimating disease burden and mortality through enhanced surveillance, assessing pharmacy dispensing practices for respiratory illness, developing and evaluating novel surveillance and diagnostic methods for respiratory diseases, evaluating the effectiveness of intervention programs, and estimating disease burden in high risk populations). Since 2007, CDC has provided resources, training, and technical support to laboratories at IEDCR and icddr,b to strengthen diagnostics capacity for influenza and other respiratory pathogens.
CDC works collaboratively with icddr,b and MOHFW to conduct public health research to learn more about the transmission and burden of select pathogens that cause diseases, such as encephalitis, rotavirus, polio, and viral hepatitis. Additionally, CDC assignees assist government staff on effective outbreak investigation techniques and guide them on how to effectively respond to public health threats. Study results inform Bangladesh policy makers and help them reach decisions about introducing vaccines and other interventions to most effectively reduce burden of disease in the country.
CDC works collaboratively with icddr,b and Bangladesh’s National Tuberculosis Programme to better characterize the transmission and treatment of TB and drug-resistant TB in Bangladesh. Research activities, focused on improving prevention and treatment efforts, currently include ongoing surveillance of drug-resistant TB at 14 sites across the country, an investigation of hospital-acquired TB transmission, and evaluations of two TB program activities: hospital-based TB infection control and a new nationwide model for community-based treatment of multi-drug-resistant TB.
CDC works with icddr,b and MOHFW to develop and evaluate strategies to mitigate risk of animal-to-human transmission of influenza through surveillance for new strains of influenza in swine and swine herders, poultry workers, live bird markets, and nomadic waterfowl. CDC also works with partners to improve the safety of slaughtering and backyard poultry-raising practices in villages. Since 2007, CDC has provided support for Nipah virus (a rapidly fatal encephalitis in humans, carried by fruit bats) surveillance at six hospitals in Bangladesh. In addition, CDC supports the government of Bangladesh in investigating and responding to outbreaks of anthrax, avian influenza, rabies and Japanese encephalitis.
CDC is working with icddr,b , MOHFW, Bangladesh’s Ministry of Fisheries and Livestock, Bangladesh’s Ministry of the Environment, and other One Health-Bangladesh partners (including scientists, veterinarians, physicians) to institutionalize a One Health framework for preventing, detecting, and responding to diseases at the animal-human-environmental interface. Examples of such diseases include avian influenza, Japanese encephalitis, Nipah virus, and anthrax.
CDC works in close collaboration with icddr,b and MOHFW to train public health personnel and to develop the capacity of local junior scientists to become independent health science researchers. CDC supported the establishment of the Bangladesh Field Epidemiology Training Program (FETP) in 2013 (see section below) and provides support for two icddr,b staff who are seconded to IEDCR to assist with the management of outbreak investigations. At Icddr,b , approximately 35 Bangladeshi scientists are currently working on CDC-supported projects. CDC also supports the Centre for Communicable Diseases’ Training Support Group at icddr,b , which conducted 59 training courses in 2013 on a wide variety of topics that included scientific writing, statistical analysis, clinical epidemiology, training of rapid response teams, and FETP courses.
CDC is the key partner in establishing the FETP in Bangladesh in 2013 at the MOHFW in partnership with other public health institutions in Bangladesh. The FETP is modeled after CDC’s Epidemic Intelligence Service. The FETP is building sustainable capacity to detect and respond to health threats and is developing epidemiologic expertise within the MOHFW, including building expertise in detecting outbreaks locally and preventing their further spread. The two-year, intensive, hands-on training program will strengthen Bangladesh’s public health workforce through multidisciplinary training in disease surveillance, outbreak investigation, public health research, program evaluation, communication, and other areas of epidemiology through a mix of 20% classroom-based instruction and 80% mentored, in-service work. After completion of the FETP, graduates will be able to apply the skills they gain in their daily work for the MOHFW by enhancing Bangladesh’s epidemiologic capacity and informing data-driven public health policies and programs. The first cohort is expected to graduate at the end of 2015.
CDC is working with Bangladesh to improve their ability to prevent, detect and respond to infectious disease threats. This work helps meet the U.S. commitment to assist at least 31 countries in reaching the targets outlined in the Global Health Security Agenda. CDC’s extensive global health presence and experience are critical to achieving these targets.