Disease Profile the spectrum of common diseases that are distinctive of a country or a geographical region. Tropical countries, for example, will have diseases that are not ordinarily to be found in temperate countries. Similarly, developing countries, irrespective of their geographical locations display a spectrum of diseases that are linked more to inadequate nutrition than to climatic or health and sanitation factors, although the latter certainly may contribute to the extent and severity of these diseases. Even within a country, the types of diseases and their incidence can markedly differ, depending on socio-economic class, profession of subjects, age groups etc, and on factors such as deficiency of essential nutrients. Mineral deficiency, such as iodine deficiency in food for example, can lead to thyroid diseases. On the other hand, excessive amount of harmful minerals, such as arsenic, for instance, can cause arsenicosis.

Table Disease profile computed from hospital records (1988-1997) at the district level and below

Bangladesh has some unique socio-economic and geographic features. A country with the world's highest population density, a per capita income which is among the world's lowest few, extremely high man-to-land ratio, over-crowding, malnutrition, very poor health and sanitation conditions, etc, inevitably mean that the country is destined to bear a heavy burden of deficiency disorders and various infectious diseases caused by viruses, bacteria and parasites.

Diarrhoea is by far the commonest illness in Bangladesh. It is followed by intestinal worm infestations. This would indicate poor sanitation and personal hygiene practices that tend to enhance spread of causative germs and parasites through a cycle of what is called the faecal-oral-transmission route of enteric pathogens.

The profile presented above is admittedly not an exhaustive one because of the lack of adequate infrastructure for accurate disease surveillance. Thus many other common diseases are not represented in the profile. It has been well documented that with economic growth of nations, the disease profile changes. A growing economy slowly transits into a developed economy. The disease profile in a pre-transition economy and post-transition economy is substantially different. Under-development and poverty in developing countries are directly related to poor personal hygiene and sanitation, and to contaminated drinking water, factors which tend to favour spread of water-borne diseases of bacterial, viral and parasitic origin. Polluted air and dense, crowded living conditions likewise spread air-borne diseases.

Thus, the infectious disease load is high in the pre-transition economy, as is currently the case in Bangladesh. But the transition phenomenon is beginning to be evident in the country particularly in the relatively affluent urban population. The characteristic spectrum of post-transition diseases such as psychiatric and neurological diseases, cancer, cardiovascular diseases, diabetes, and other metabolic disorders and illnesses due to drug abuse etc are being detected in increasing numbers. [Zia Uddin Ahmed]