The Interplay Between Food Security, Dietary Diversity, and Disease Patterns Among Pregnant Rohingya Women in Cox’s Bazar Makeshift Camps

The Interplay Between Food Security, Dietary Diversity, and Disease Patterns Among Pregnant Rohingya Women in Cox’s Bazar Makeshift Camps | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Interplay Between Food Security, Dietary Diversity, and Disease Patterns Among Pregnant Rohingya Women in Cox’s Bazar Makeshift Camps Abeer Mohammad Hossain, Abu Ansar Md Rizwan, A B M Alauddin Chowdhury This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5703625/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The health and nutritional well-being of pregnant women in refugee populations are critical concerns due to heightened vulnerabilities associated with displacement and inadequate living conditions. This study examines the interplay between food security, dietary diversity, and disease patterns among pregnant Rohingya women residing in the makeshift camps of Ukhiya, Cox's Bazar. Methods A descriptive cross-sectional study was conducted among 96 pregnant Rohingya women from June to September 2022. Data was collected using structured questionnaires assessing socio-demographic characteristics, food security, dietary diversity, and disease patterns. Food security was evaluated using the Household Food Insecurity Access Scale (HFIAS), while dietary diversity was assessed through a 24-hour dietary recall and 7-day food frequency questionnaire. Data were analyzed using SPSS (Version 26) and Stata (Version 13), employing descriptive statistics and logistic regression. Results Most participants (57.3%) were food secure, and 85.4% demonstrated high dietary diversity by consuming seven or more food groups. However, 21.9% of households experienced severe food insecurity. The prevalence of health issues was notable, with 51.0% reporting at least one disease during pregnancy, the most common being acidity (36.5%), viral fever (15.6%), and cough (13.5%). No significant associations were found between food security or dietary diversity and most disease outcomes, except for a significant relationship between jaundice and lower dietary diversity. Conclusions Despite the high dietary diversity among participants, severe food insecurity and health disparities remain critical challenges. Tailored interventions focusing on improving food security, promoting dietary diversity, and providing integrated health services are essential to address the unique needs of pregnant Rohingya women. Future research should explore causal relationships and evaluate the effectiveness of different food aid models to enhance maternal health outcomes in refugee settings. Food security Dietary diversity Maternal health Rohingya refugees Pregnancy nutrition Figures Figure 1 Figure 2 Introduction The health and well-being of pregnant women in refugee populations have long been critical concerns in global health due to their heightened vulnerability and compounded risks resulting from displacement and precarious living conditions. The Rohingya crisis, one of the most significant humanitarian emergencies of the past decade, has led to an unprecedented influx of refugees into Bangladesh, particularly in the Cox's Bazar region. This crisis has underscored the urgent need for targeted studies focusing on the health and nutritional challenges faced by pregnant women in these camps. Pregnancy is a period of heightened physiological and nutritional demands, which are often unmet in refugee settings due to factors such as food insecurity, inadequate access to healthcare, and poor living conditions (Toole, 2019 ; Corley, 2021 ; Naja et al., 2019 ). These conditions are further compounded by the psychological stress associated with displacement, increasing the risk of both morbidity and adverse pregnancy outcomes. Research by Parmar et al. (2018) highlighted the dire health outcomes among Rohingya women in Bangladesh, emphasizing the critical need for focused investigations into their nutritional and health statuses. Nutritional deficiencies and food insecurity are central challenges in these settings. Studies by Souza et al. ( 2024 ) have established a correlation between younger maternal age and increased risks of anemia, hypertension, and other morbidities, which are exacerbated in the context of displacement and resource constraints. Dietary diversity and food security play pivotal roles in determining health outcomes for pregnant women, as insufficient dietary intake and limited access to nutrient-rich foods can lead to poor maternal and fetal health outcomes (Schrey-Petersen et al., 2021 ). Gestational diabetes and anemia have been linked to suboptimal dietary practices in refugee populations (Jahan, 2022 ). In the context of the Rohingya crisis, Akter et al. ( 2020 ) have highlighted the intricate interplay of social, environmental, and individual factors influencing the health of pregnant women in the camps. These findings underscore the importance of addressing not only the immediate healthcare needs but also the broader determinants of health, such as food security and dietary diversity. The Household Food Insecurity Access Scale (HFIAS) and other dietary assessment tools have proven effective in identifying the degree of food insecurity and dietary inadequacies in similar settings (Coates et al., 2007 ). Given the gaps in the current literature, particularly concerning the relationship between food security, dietary diversity, and disease patterns among pregnant Rohingya women, this study aims to provide empirical evidence to address these critical issues. By evaluating the interplay between these factors, the study seeks to inform more effective health and nutritional interventions tailored to the unique challenges of this marginalized population. This research contributes to a deeper understanding of the determinants of health disparities among pregnant women in refugee settings, with implications for improving maternal health outcomes in the Rohingya camps and similar contexts globally. Methodology A descriptive cross-sectional study was conducted among Rohingya pregnant women residing in the makeshift camps of Ukhiya, Cox's Bazar, from June to September 2022. The sample size was determined to be 96 using the statistical formula, with a 95% confidence interval and a 5% level of significance. Severely ill and mentally unstable pregnant women were excluded from the study. Participants were selected through a simple random sampling technique, adhering to specific inclusion criteria with the cooperation of the community leaders in the camps (Lim et al., 2023 ). Data was collected using a structured questionnaire developed for this study consisting of different types of questions to capture a broad range of information (Nedjat-Haiem & Cooke., 2021; Douthit et al., 2021 ) such as socio-demographic characteristics, food security status, dietary diversity, and disease patterns. The socio-demographic section collected data on age, educational level, and marital status. Food security was assessed using a modified Household Food Insecurity Access Scale (HFIAS) (Coates et al., 2007 ), which included nine questions about the household’s experiences with food insecurity over the past 30 days. Responses were categorized on a frequency-based scale (never, rarely, sometimes, often), allowing households to be classified into varying levels of food security. Dietary diversity was evaluated through a 24-hour dietary recall method (Steyn & Labadarios, 2000 ) and a 7-day food frequency questionnaire (Zulkifli & Stella, 1992 ). In the 24-hour dietary recall, participants reported all foods consumed in the previous 24 hours, assessing dietary variety and quality. The 7-day food frequency questionnaire captured the frequency of consumption of specific food groups over the past week, providing insights into dietary patterns and nutrient intake. Data collection was conducted by trained enumerators fluent in the Rohingya language. Enumerators administered the questionnaires face-to-face at participants’ homes or in designated safe spaces within the camps, ensuring privacy and comfort. Questions were read aloud, and enumerators assisted participants in providing responses. Translators were available to address language barriers when necessary. To ensure data accuracy, collection and entry were performed simultaneously, and multiple review and cross-checking procedures were implemented to remove the error from the dataset (Ahuja et al., 2024 ). Data entry, cleaning, and analysis were conducted using SPSS (Version 26), while SPSS (Version 26), Stata (Version 13), and R were utilized for statistical analysis. Descriptive statistics, correlation analyses, and regression models were employed to examine relationships between food security, dietary diversity, and disease patterns. The dependent variables included types of diseases reported, while independent variables encompassed food security, dietary diversity, and food consumption scores. Food security and Food Consumption Scores were assessed using the Household Food Security & Nutrition Assessment (HFSNA, 2009) scale, and dietary diversity scores were calculated following FAO guidelines for Individual Dietary Diversity Scores (Kennedy et al., 2011 ). Advanced statistical techniques, such as logistic regression, were applied to model the likelihood of disease occurrences based on dietary inputs. Mediating variables, including age, duration of pregnancy, and educational level, were controlled to isolate the effects of diet and food security on health outcomes. The analysis aimed to identify significant predictors of health disparities and provide guidance for future nutritional interventions. Ethical approval for the study was obtained from the Faculty of Allied Health Sciences Research Ethics Committee of Daffodil International University. Verbal informed consent was acquired from all participants before data collection. Anonymity and confidentiality were maintained throughout the study, adhering to strict ethical guidelines. Results A total of 96 pregnant women participated in the study. The age ranged from 15 to 33 years, with a mean age of 22.83 years ( SD = 4.02). This indicates that most of the pregnant women in this sample were relatively young, which reflects early reproductive age groups commonly observed in similar settings. The household size of the participants showed significant variation, ranging from 1 to 12 members, with an average household size of 5.29 members ( SD = 2.60). This suggests that many participants lived in moderately sized families, a pattern commonly seen in rural or low-income settings where extended families may reside together. Regarding family structure, most women (70.8%) reported living in single/nuclear families, while 29.2% resided in joint-family households. This reflects a shift towards nuclear families, which may have implications for the support systems available to pregnant women in this population. The predominance of nuclear family settings may indicate a societal trend toward smaller, independent households, which can affect family support during pregnancy (Table 1 ). Table 1 Demographic characteristics of the pregnant women ( N = 96) Demographic characteristics Age Min Max Age (year) 15 33 Age ( M ± SD) 22.83 ± 4.02 Household size Min Max Household size (number) 1 12 Household size ( M ± SD) 5.29 ± 2.60 Family type n % Single/nuclear 68 70.8% Joint 28 29.2% Most of the participants ( n = 49, 51.0%) received religious education from Madrasha/Religious institutions. A notable proportion of the women ( n = 26, 27.1%) were 2nd Grade pass, while 15.6% ( n = 15) had completed elementary school. Only 6.3% ( n = 6) of the women reported having no education. These findings indicate that most participants had limited formal education, with a significant reliance on religious schooling, which might impact their health literacy and access to health information. Most of the pregnant women were married, with 93.8% ( n = 90) currently in a marital relationship. Only 6.3% ( n = 6) reported being separated from their spouses. The high percentage of married women is consistent with cultural norms in many communities, where early marriage is common. Regarding the duration of pregnancy, 43.8% ( n = 42) of the women were in the first trimester (less than 4 months pregnant). Another 32.3% ( n = 31) were in the second trimester (4–6 months), while 24.0% ( n = 23) were in the third trimester (more than 6 months pregnant). This distribution shows an even representation across different stages of pregnancy, providing a comprehensive look at pregnant women across all trimesters (Fig. 1 ). All pregnant women in the study ( n = 96, 100%) reported receiving rations. This indicates that every participant had access to some form of supplementary food assistance, likely as part of a government or community-based food support program aimed at ensuring adequate nutrition during pregnancy. The respondent’s household food security was assessed using the formula of HFIAS for measurement guidelines (Coates et al., 2007 ). Most of the households ( n = 55, 57.3%) were classified as food secure, indicating that these families had consistent access to sufficient food. However, 20.8% ( n = 20) of the households experienced mild to moderate food insecurity, and 21.9% ( n = 21) faced severe food insecurity. This suggests that a substantial number of the pregnant women in the sample lived in households where food insecurity was a concern, potentially impacting their overall health and nutritional status during pregnancy. In the last 24 hours, including both day and night, the food eaten at home was divided into 9 different food groups. The consumption of each food group during the last 24 hours (day and night) was recorded as 0 (not eaten) or 1 (eaten). Then, the dietary diversity score (WDDS) was calculated at the person level by counting the daily consumption of 9 food groups, with scores ranging from 0 to 9 (FAO, 2010 ). This study showed that the majority ( n = 82, 85.4%) consumed seven or more food groups, reflecting a relatively diverse diet. A smaller proportion of the women ( n = 12, 12.5%) consumed six food groups, while only 2.1% ( n = 2) reported consuming five food groups. This high level of dietary diversity among most participants suggests that many pregnant women had access to a variety of foods, which is crucial for meeting their nutritional needs during pregnancy. To calculate household-level food consumption scores (FCS), data was collected on the frequency of food consumption over the past seven days (Rabbani, 2014 ). Households reported how many days they consumed various food items, which were categorized into 8 key food groups: staple (e.g., rice, wheat, potatoes, maize), lentils (pulses, nuts, seeds), milk & milk products, meat, fruits, vegetables, sugar and oil (Rabbani, 2014 ). These food groups are essential for a nutritionally adequate diet if consumed daily. Each food group was assigned a weight based on its nutritional importance, and the FCS was calculated by multiplying the number of days each food group was consumed by its respective weight (Rabbani, 2014 ). This score reflects the diversity and frequency of food consumption at the household level, indicating the dietary quality of the household (Rabbani, 2014 ). According to this study, all participants ( n = 96, 100%) were classified as having an "acceptable" food consumption score, indicating that they were consuming an adequate quantity and quality of food. This aligns with the high dietary diversity observed, suggesting that the food support programs in place may be contributing to the overall nutritional well-being of pregnant women (Fig. 2 ). Among the 96 pregnant women surveyed, 51.0% ( n = 49) reported having at least one disease, while 49.0% ( n = 47) indicated they were free from any illness. This shows that half of the pregnant women experienced some form of health complication during pregnancy, highlighting a significant burden of disease within the study population. A variety of diseases were reported among the women. The most prevalent condition was acidity, affecting 36.5% ( n = 35) of the participants, which is a common issue during pregnancy due to hormonal changes and pressure on the digestive system. Viral fever was the second most common illness, reported by 15.6% ( n = 15) of the women, followed by cough ( n = 13, 13.5%) and skin infections ( n = 6, 6.3%). Other conditions reported included diarrhea ( n = 3, 3.1%), typhoid ( n = 2, 2.1%), jaundice ( n = 1, 1.0%), and hypertension ( n = 1, 1.0%). An additional 19.8% ( n = 19) of participants experienced various other health issues not categorized under the specific conditions listed (Table 2 ). Table 2 Disease status of the pregnant women ( N = 96) Variables n % Disease status Disease present 49 51.0% Disease absent 47 49.0% Disease type Diarrhea 3 3.1% Cough 13 13.5% Viral fever 15 15.6% Skin infection 6 6.3% Acidity 35 36.5% Typhoid 2 2.1% Jaundice 1 1.0% Hypertension 1 1.0% Others 19 19.8% The association between disease status and food security was analyzed using chi-square test for independence (Table 3 ). Out of 49 women with a disease, 51.0% ( n = 25) were from food-secure households, 24.5% ( n = 12) from mildly/moderately food-insecure households, and 24.5% ( n = 12) from severely food-insecure households. The results of chi-square test ( χ² = 1.64, df = 2, p = .440) showed that there was not a significant association between overall disease presence and food security status. Among the 3 women with diarrhea, 66.7% ( n = 2) were from food-secure households, and 33.3% ( n = 1) from a severely food-insecure household. The chi-square test ( χ² = 0.898, df = 2, p = .638) showed no significant association between diarrhea and food security status. Of the 13 women with cough, 46.2% ( n = 6) were food secure, 23.1% ( n = 3) were mildly/moderately food insecure, and 30.8% ( n = 4) were severely food insecure. The association between cough and food security status was not significant ( χ² = 0.650, df = 2, p = .722). Of the 15 women with viral fever, 46.7% ( n = 7) were from food-secure households, 26.7% ( n = 4) were mildly/moderately food insecure, and 26.7% ( n = 4) were severely food insecure. The chi-square test ( χ² = 0.607, df = 2, p = .738) did not reveal a significant association. Six women had skin infections, with 33.3% ( n = 2) from food-secure households, 16.7% ( n = 1) from a mildly food-insecure household, and 50.0% ( n = 3) from severely food-insecure households. The chi-square test ( χ² = 2.677, df = 2, p = .262) did not show a significant association. Of the 35 women with acidity, 54.3% ( n = 19) were food secure, 22.9% ( n = 8) were mildly food insecure, and 22.9% ( n = 8) were severely food insecure. The chi-square test ( χ² = 0.115, df = 2, p = .944) indicated no significant association between acidity and food security. For typhoid ( χ² = 1.279, p = .528), jaundice ( χ² = 3.315, p = .191), hypertension ( χ² = 0.838, p = .658), and other diseases ( χ² = 2.799, p = .247), none of the associations with food security status were statistically significant. Table 3 Association between disease status and food security status among pregnant women Disease status Food security status χ² df p Food secure (55) Mild/moderate food insecure (20) Severe food insecure (21) n % n % n % Disease present (49) 25 51.0% 12 24.5% 12 24.5% 1.642 2 .440 Diarrhea (3) 2 66.7% 0 0.0% 1 33.3% 0.898 2 .638 Cough (13) 6 46.2% 3 23.1% 4 30.8% 0.650 2 .722 Viral fever (15) 7 46.7% 4 26.7% 4 26.7% 0.607 2 .738 Skin infection (6) 2 33.3% 1 16.7% 3 50.0% 2.677 2 .262 Acidity (35) 19 54.3% 8 22.9% 8 22.9% 0.115 2 .944 Typhoid (2) 1 50.0% 1 50.0% 0 0.0% 1.279 2 .528 Jaundice (1) 0 0.0% 0 0.0% 1 100.0% 3.315 2 .191 Hypertension (1) 1 100.0% 0 0.0% 0 0.0% 0.838 2 .658 Others (19) 13 68.4% 2 10.5% 4 21.1% 2.799 2 .247 The chi-square test was conducted to determine the association between disease status (overall and specific diseases) and dietary diversity among pregnant women (Table 4 ). There was no significant association between overall disease presence and dietary diversity ( χ² = 4.074, p = .130). Among the women with diseases, none had diets limited to 5 food groups, while 8.2% ( n = 4) consumed 6 food groups and 91.8% ( n = 45) consumed 7 or more food groups. Similarly, for those without disease, 4.3% ( n = 2) consumed 5 food groups, 17.0% ( n = 8) consumed 6 food groups, and 78.7% ( n = 37) consumed 7 or more food groups. These results suggest that disease status was not strongly linked to dietary diversity. The association between diarrhea and dietary diversity was not statistically significant ( χ² = 0.346, p = .556). All women with diarrhea ( n = 3, 100.0%) consumed diets from 7 or more food groups, suggesting that dietary diversity did not differ significantly for those with or without diarrhea. There was no significant association between cough and dietary diversity ( χ² = 0.614, p = .433). Most women with cough ( n = 11, 84.6%) consumed 7 or more food groups, with 15.4% ( n = 2) consuming 6 food groups. Similarly, no significant association was found between viral fever and dietary diversity ( χ² = 0.299, p = .584). Among the 15 women with viral fever, 86.7% ( n = 13) consumed 7 or more food groups, and 13.3% ( n = 2) consumed 6 food groups. The association between skin infections and dietary diversity was also not significant ( χ² = 0.362, p = .547). 83.3% ( n = 5) women with skin infections consumed diets from 7 or more food groups, and 16.7% ( n = 1) consumed 6 food groups. There was no significant association between acidity and dietary diversity ( χ² = 0.192, p = .662). Most women with acidity ( n = 32, 91.4%) consumed 7 or more food groups, while 8.6% ( n = 3) consumed 6 food groups. The association between typhoid and dietary diversity was not significant ( χ² = 0.226, p = .634). Both women with typhoid consumed diets from 7 or more food groups. The association between jaundice and dietary diversity was statistically significant ( χ² = 9.384, p = .002). One woman with jaundice consumed 6 food groups, and none consumed 7 or more food groups. This suggests that lower dietary diversity may be associated with jaundice, although the number of cases is small. There was no significant association between hypertension and dietary diversity ( χ² = 0.111, p = .739). One woman with hypertension consumed 7 or more food groups. For other diseases, no significant association was found with dietary diversity ( χ² = 0.018, p = .894). Among those with other diseases, 89.5% ( n = 17) consumed 7 or more food groups, and 10.5% ( n = 2) consumed 6 food groups. Table 4. Association between disease status and dietary diversity status among pregnant women Among the study participants, the highest frequency of consumption was observed for starch, flesh foods, dark green leafy vegetables, and vitamin A-rich fruits and vegetables, with 95 participants (99.0%) reporting intake from these groups. Similarly, high consumption was observed for other fruits and vegetables, with 94 participants (97.9%) including them in their diet. The intake of eggs was also relatively high, with 80 participants (83.3%) reporting consumption, and legumes were consumed by 82 participants (85.4%). In contrast, dairy products were less frequently consumed, with only 67 participants (69.8%) reporting intake. Organ meat had the lowest consumption frequency, with 33 participants (34.4%) indicating intake from this food group (Table 5 ). These findings indicate that most study participants have a diet that includes starches, flesh foods, dark green leafy vegetables, and vitamin A-rich fruits and vegetables, suggesting an inclination towards these food groups in their dietary patterns. The high consumption of other fruits and vegetables also indicates a general preference for or availability of plant-based foods in the participants' diet. However, the lower consumption of dairy products and especially organ meat suggests either a lack of availability, cultural preferences, or dietary habits that do not prioritize these food groups. The variation in consumption frequencies across food groups reflects the diversity and preferences within the study population’s dietary practices. Table 5 Descriptive statistics of consumption from different food groups among study participants ( N = 96) Food groups n % Starch 95 99.0% Legumes 82 85.4% Dairy products 67 69.8% Organ meat 33 34.4% Eggs 80 83.3% Flesh food 95 99.0% Dark green leafy vegetables 95 99.0% Vitamin A-rich fruits & vegetables 95 99.0% Other fruits and vegetables 94 97.9% Discussion This study aimed to examine the interplay between food security, dietary diversity, and disease patterns among pregnant Rohingya women residing in the makeshift camps of Ukhiya, Cox's Bazar. The findings provide critical insights into the health and nutritional challenges faced by this marginalized population. A significant proportion of the study participants (57.3%) were classified as food secure, with 85.4% demonstrating high dietary diversity by consuming seven or more food groups. While compared with another study of Bhasan Char, it was found that 46% of pregnant mothers had low WDDS (< 4) (Fahim et al., 2023 ) indicating a notable disparity in dietary diversity between the two settings. This suggests that the food support programs in Ukhiya camps may be more effective in promoting diverse diets compared to those in Bhasan Char, where limited access to diverse food groups remains a critical challenge. However, this study also found that 21.9% of households experienced severe food insecurity, reflecting persistent gaps in food access despite intervention programs. Similarly, a Syrian study highlights that over half of refugee households in Lebanon are food insecure, relying on an e-voucher system that introduces socio-technical challenges and power asymmetries (Talhouk et al., 2020 ). Both studies underscore the critical need for adaptive and context-specific approaches to food aid to address persistent inequities in refugee settings. The prevalence of diseases among the participants was notable, with 51.0% reporting at least one health issue during pregnancy. Acidity was the most reported condition (36.5%), followed by viral fever (15.6%) and cough (13.5%). These findings are consistent with prior research by Pavli & Maltezou ( 2017 ) among refugees in Europe, which documented high rates of gastrointestinal and respiratory illnesses among refugee women, attributed to poor living conditions and limited access to healthcare. Additionally, the high prevalence of acidity aligns with study by Müller et al. ( 2018 ), which identified dietary deficiencies and stress as significant contributors to gastrointestinal issues in refugee populations. While no statistically significant associations were found between food security or dietary diversity and most disease outcomes, the trends observed provide important implications for future interventions. For instance, the chi-square test revealed no significant relationship between dietary diversity and diseases such as diarrhea, cough, and viral fever, mirroring findings by Schrey-Petersen et al. ( 2021 ). These studies suggest that while dietary diversity is critical for overall nutritional adequacy, its direct impact on acute disease outcomes may be limited in resource-constrained settings. However, the significant association between jaundice and lower dietary diversity observed in this study highlights the potential role of targeted nutritional interventions in preventing specific diseases, a conclusion also supported by de Toro-Martín et al. ( 2017 ). The findings of this study align with those of Akter et al. ( 2020 ), who highlighted the effectiveness of food support programs in improving dietary diversity but emphasized the ongoing challenges of food insecurity in refugee camps. Similarly, the prevalence of health issues, particularly gastrointestinal conditions, corroborates the results of Owoaje et al. ( 2016 ) and Ekezie et al. ( 2020 ), who reported high rates of morbidity linked to inadequate sanitation and healthcare in displaced populations. Moreover, this study’s findings on the influence of socio-demographic factors, such as age and pregnancy duration, on health outcomes are consistent with the work of Souza et al. ( 2024 ), who demonstrated a strong association between younger maternal age and increased risk of pregnancy-related complications. The study underscores the importance of addressing food insecurity and promoting dietary diversity to improve maternal health outcomes in refugee settings. While current food support programs appear effective in ensuring high dietary diversity for many participants, the persistent prevalence of severe food insecurity and its association with health disparities highlights the need for more targeted interventions. Enhancing access to nutrient-rich foods and healthcare services, particularly for high-risk groups, could mitigate the observed health challenges. Furthermore, the study highlights the need for integrated health and nutrition programs that address both immediate and underlying determinants of health. Interventions aimed at improving sanitation, healthcare access, and mental health support could complement food security initiatives to reduce disease burden among pregnant women in refugee settings. This study provides valuable insights into the interplay between food security, dietary diversity, and health outcomes in a vulnerable population. However, it is not without limitations. The cross-sectional design precludes causal inferences, and the reliance on self-reported data may introduce bias. Future longitudinal studies could provide more robust evidence on the relationships explored here. Conclusion This study highlights the significant interplay between food security, dietary diversity, and health outcomes among pregnant Rohingya women in the Ukhiya makeshift camps. Although 85.4% of participants demonstrated high dietary diversity, 21.9% of households faced severe food insecurity, underscoring persistent challenges despite food support programs. The prevalence of health issues, particularly gastrointestinal conditions such as acidity, highlights the compounded effects of inadequate nutrition and poor living conditions. These findings emphasize the importance of strengthening food aid programs and promoting dietary diversity to improve maternal health outcomes. Tailored interventions are needed to address food insecurity and provide access to culturally appropriate, nutrient-rich foods for high-risk groups. To mitigate health disparities, integrated health and nutrition programs should focus on enhancing access to healthcare, improving sanitation, and providing mental health support. Future research should explore longitudinal data to establish causal relationships between dietary diversity, food security, and health outcomes. Policymakers and humanitarian organizations must adopt context-specific strategies to ensure that food aid programs effectively meet the nutritional needs of vulnerable populations in refugee settings. Human ethics and Consent to Participate declarations This study meticulously adhered to ethical guidelines, obtaining approval from the Faculty of Allied Health Sciences Research Ethics Committee at Daffodil International University. A core aspect of its ethical rigor was ensuring that all participants, Rohingya pregnant women from makeshift camps in Ukhiya, Cox's Bazar, provided verbal informed consent. This consent was not merely procedural but was obtained by thoroughly explaining the study's aims, methods, potential benefits, and risks in an accessible manner, ensuring participants' full comprehension and voluntary participation. The research emphasized the participants' autonomy, allowing them to withdraw at any time without repercussion, thus upholding their dignity and rights. Additionally, the study's commitment to maintaining participants' confidentiality and anonymity showcases a strong adherence to the ethical principles of beneficence, non-maleficence, autonomy, and justice, particularly crucial when dealing with vulnerable populations in a research context. Declarations Ethics approval and consent to participate This study was conducted in strict adherence to ethical standards and received approval from the Faculty of Allied Health Sciences Research Ethics Committee at Daffodil International University. Informed consent was obtained from all participants. For participants aged 18 and above, consent was obtained verbally after they were fully briefed on the study's objectives, methodology, potential benefits, and risks. For participants under the age of 18, informed consent was obtained from their parents or legal guardians in accordance with the ethical guidelines. All participants, and the parents or guardians of minor participants, were informed that participation was voluntary and that they had the right to withdraw at any time without any consequences. Consent for publication Not applicable. Availability of data and materials The datasets generated and/or analyzed during the current study are not publicly available due to ethical restrictions related to participant consent and confidentiality but are available from the corresponding author upon reasonable request. Competing interests The authors declare that they have no competing interests. There are no financial, personal, or professional conflicts of interest that could have influenced the work reported in this manuscript. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or non-profit sectors. The study was conducted with the support of the authors' institutions. Authors' contributions Abeer Mohammad Hossain conceptualized the study. A B M Alauddin Chowdhury and Abu Ansar Md Rizwan designed the study. Abeer Mohammad Hossain, and Abu Ansar Md Rizwan contributed to data collection and analysis. A B M Alauddin Chowdhury and Abu Ansar Md Rizwan provided overall supervision, and played the key role in manuscript writing, and quality assurance. All authors contributed to the manuscript review and editing process. Acknowledgements We extend our gratitude to the Faculty of Allied Health Sciences at Daffodil International University for their support. We also thank the study participants for their willingness to participate in this research. Special thanks to W A N Research & Consultancy for their consultancy assistance in designing the study and evaluating the data. Authors' Information Abeer Mohammad Hossain, MPH Student, Department of Public Health, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, Bangladesh. Abu Ansar Md Rizwan, Graduate student of Nutritional Sciences, Texas Tech University, 2500 Broadway W, Lubbock, TX 79409, USA and Senior Consultant, W A N Research & Consultancy, Dhaka, Bangladesh A B M Alauddin Chowdhury, Professor & Head, Department of Public Health, Faculty of Health and Life Sciences, Daffodil International University. References Ahuja, L., Singh, B., & Simon, R. (2024). Data Cleaning: Paving a Way for Accurate and Clean Data. Global Journal of Enterprise Information System, 16 (1), 18-25. Akter, F., Rahman, M., Pitchik, H. O., Winch, P. J., Fernald, L. C., Nurul Huda, T. M., ... & Tofail, F. (2020). Adaptation and integration of psychosocial stimulation, maternal mental health, and nutritional interventions for pregnant and lactating women in rural Bangladesh. International Journal of Environmental Research and Public Health, 17 (17), 6233. Coates, J., Swindale, A., & Bilinsky, P. (2007). Household Food Insecurity Access Scale (HFIAS) for measurement of food access: Indicator guide Version 3. Washington, D.C.: FHI 360/FANTA. Corley, A. G. (2021). Linking armed conflict to malnutrition during pregnancy, breastfeeding, and childhood. Global Food Security, 29 , 100531. Douthit, N. T., Norcini, J., Mazuz, K., Alkan, M., Feuerstein, M. T., Clarfield, A. M., ... & Biswas, S. (2021). Assessment of global health education: the role of multiple-choice questions. Frontiers in Public Health, 9 , 640204. de Toro-Martín, J., Arsenault, B. J., Després, J. P., & Vohl, M. C. (2017). Precision nutrition: A review of personalized nutritional approaches for the prevention and management of metabolic syndrome. Nutrients, 9 (8), 913. Ekezie, W., Adaji, E. E., & Murray, R. L. (2020). Essential healthcare services provided to conflict-affected internally displaced populations in low and middle-income countries: A systematic review. Health Promotion Perspectives, 10 (1), 24. FAO. (2010). Guidelines for measuring household and individual dietary diversity. Rome, Italy: FAO. https://doi.org/613.2KEN Fahim, S. M., Das, S., Rasul, M. G., Zaman, M. U., Alam, M. A., Afrin, S., ... & Ahmed, T. (2023). Nutritional status and dietary diversity of pregnant and nonpregnant reproductive-age Rohingya women. Food Science & Nutrition, 11 (9), 5523-5531. HFSNA. (2009). Bangladesh Household Food Security and Nutrition Assessment Report 2009. Conducted by the World Food Programme, UNICEF, Institute of Public Health Nutrition, Ministry of Health and Family Welfare, and Government of the People's Republic of Bangladesh. Retrieved from www.unicef.org/bangladesh. Jahan, T. E. (2022). Assessment of knowledge & practices regarding antenatal care guidelines and impact of dietary practice on the nutritional status of pregnant women in the Rohingya community (Doctoral dissertation, Chattogram Veterinary & Animal Sciences University). Kennedy, G., Ballard, T., & Dop, M. (2011). Guidelines for measuring household and individual dietary diversity. Rome, Italy: FAO. Lim, S. E. R., Meredith, S. J., Agnew, S., Clift, E., Ibrahim, K., & Roberts, H. C. (2023). Volunteer-led online group exercise for community-dwelling older people: A feasibility and acceptability study. BMC Geriatrics, 23 (1), 461. Müller, M., Khamis, D., Srivastava, D., Exadaktylos, A. K., & Pfortmueller, C. A. (2018). Understanding refugees' health. In Seminars in Neurology, 38 (2), 152-162. Thieme Medical Publishers. Naja, F., Shatila, H., El Koussa, M., Meho, L., Ghandour, L., & Saleh, S. (2019). Burden of non-communicable diseases among Syrian refugees: A scoping review. BMC Public Health, 19 , 1-13. Nedjat-Haiem, M., & Cooke, J. E. (2021). Student strategies when taking open-ended test questions. Cogent Education, 8 (1), 1877905. Owoaje, E. T., Uchendu, O. C., Ajayi, T. O., & Cadmus, E. O. (2016). A review of the health problems of the internally displaced persons in Africa. Nigerian Postgraduate Medical Journal, 23 (4), 161-171. Parmar, P. K., Jin, R. O., Walsh, M., & Scott, J. (2019). Mortality in Rohingya refugee camps in Bangladesh: Historical, social, and political context. Sexual and Reproductive Health Matters, 27 (2), 39-49. Pavli, A., & Maltezou, H. (2017). Health problems of newly arrived migrants and refugees in Europe. Journal of Travel Medicine, 24 (4), tax016. Rabbani, A. (2014). Household food security in Bangladesh: Going beyond poverty measures. Bangladesh Development Studies, 37 (1-2). Schrey-Petersen, S., Tauscher, A., Dathan-Stumpf, A., & Stepan, H. (2021). Diseases and complications of the puerperium. Deutsches Ärzteblatt International, 118 (25), 436. Souza, J. P., Day, L. T., Rezende-Gomes, A. C., Zhang, J., Mori, R., Baguiya, A., ... & Oladapo, O. T. (2024). A global analysis of the determinants of maternal health and transitions in maternal mortality. The Lancet Global Health, 12 (2), e306-e316. Steyn, N. P., & Labadarios, D. (2000). Dietary intake: 24-hour recall method. The National Food Consumption Survey. Pretoria: Department of Health. Talhouk, R., Coles-Kemp, L., Jensen, R. B., Balaam, M., Garbett, A., Ghattas, H., ... & Montague, K. (2020). Food aid technology: The experience of a Syrian refugee community in coping with food insecurity. Proceedings of the ACM on Human-Computer Interaction, 4 (CSCW2), 1-25. Toole, M. (2019). Health in humanitarian crises. In The Health of Refugees: Public Health Perspectives from Crisis to Settlement (pp. 54-84). Zulkifli, S. N., & Stella, M. Y. (1992). The food frequency method for dietary assessment. Journal of the American Dietetic Association, 92 (6), 681-686. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5703625","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":395716098,"identity":"1189bd64-1b42-4a0c-b209-84a05fd45a9b","order_by":0,"name":"Abeer Mohammad Hossain","email":"","orcid":"","institution":"Daffodil International University","correspondingAuthor":false,"prefix":"","firstName":"Abeer","middleName":"Mohammad","lastName":"Hossain","suffix":""},{"id":395716099,"identity":"3e983181-403c-4103-a4b4-d31ccc9d965d","order_by":1,"name":"Abu Ansar Md Rizwan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA20lEQVRIiWNgGAWjYJACCQYDEMV8AMSWIUULWwKIzUOkFjDgAWskrIW//XTi7YqCusT+2T2fX92oseBhYD98dANeG87kbrY8Y8CWOOPO2W3WOceADuNJS7uB15oDudskGwx4chtu5G4zzmEDapHgMcOrRf78W5AWidz5N3KeGef8I0KLwQ2wLQa5G27kMD/ObSNCi+GNt5stGwwS6jfeSDNjzu2T4GEj5Be587kbbzb8qTOWu5H8+HPOtzo5fvbDx/B7HwmwgSOIjVjlIMD8gRTVo2AUjIJRMHIAANQmSTxIBEemAAAAAElFTkSuQmCC","orcid":"","institution":"Texas Tech University","correspondingAuthor":true,"prefix":"","firstName":"Abu","middleName":"Ansar Md","lastName":"Riz","suffix":"Md"},{"id":395716100,"identity":"16b4aa3b-d676-4795-aaf4-f599ded3b2ce","order_by":2,"name":"A B M Alauddin Chowdhury","email":"","orcid":"","institution":"Daffodil International University","correspondingAuthor":false,"prefix":"","firstName":"A","middleName":"B M Alauddin","lastName":"Chowdhury","suffix":""}],"badges":[],"createdAt":"2024-12-24 05:38:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5703625/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5703625/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":72739342,"identity":"246e4a67-e725-433e-a065-f7a3a9bf713d","added_by":"auto","created_at":"2025-01-01 09:23:31","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":12627,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSocio-economic characteristics of the pregnant women (\u003c/strong\u003e\u003cem\u003e\u003cstrong\u003eN\u003c/strong\u003e\u003c/em\u003e\u003cstrong\u003e=96)\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5703625/v1/90d5d4b4a9326c4887f8d017.png"},{"id":72738760,"identity":"f452f7f0-8795-4c93-b7ce-c3bcea093930","added_by":"auto","created_at":"2025-01-01 09:15:31","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":20570,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eHealth and nutrition status of the pregnant women (\u003c/strong\u003e\u003cem\u003e\u003cstrong\u003eN\u003c/strong\u003e\u003c/em\u003e\u003cstrong\u003e=96)\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-5703625/v1/658016b4852da5676fce2f1e.png"},{"id":72740410,"identity":"fd528000-d7d8-485c-879e-5145ac66af7f","added_by":"auto","created_at":"2025-01-01 09:31:31","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":721772,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5703625/v1/4a4f852b-ef4f-40cc-8a95-a7caf0734efb.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Interplay Between Food Security, Dietary Diversity, and Disease Patterns Among Pregnant Rohingya Women in Cox’s Bazar Makeshift Camps","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe health and well-being of pregnant women in refugee populations have long been critical concerns in global health due to their heightened vulnerability and compounded risks resulting from displacement and precarious living conditions. The Rohingya crisis, one of the most significant humanitarian emergencies of the past decade, has led to an unprecedented influx of refugees into Bangladesh, particularly in the Cox's Bazar region. This crisis has underscored the urgent need for targeted studies focusing on the health and nutritional challenges faced by pregnant women in these camps. Pregnancy is a period of heightened physiological and nutritional demands, which are often unmet in refugee settings due to factors such as food insecurity, inadequate access to healthcare, and poor living conditions (Toole, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Corley, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Naja et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). These conditions are further compounded by the psychological stress associated with displacement, increasing the risk of both morbidity and adverse pregnancy outcomes. Research by Parmar et al. (2018) highlighted the dire health outcomes among Rohingya women in Bangladesh, emphasizing the critical need for focused investigations into their nutritional and health statuses. Nutritional deficiencies and food insecurity are central challenges in these settings. Studies by Souza et al. (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) have established a correlation between younger maternal age and increased risks of anemia, hypertension, and other morbidities, which are exacerbated in the context of displacement and resource constraints. Dietary diversity and food security play pivotal roles in determining health outcomes for pregnant women, as insufficient dietary intake and limited access to nutrient-rich foods can lead to poor maternal and fetal health outcomes (Schrey-Petersen et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Gestational diabetes and anemia have been linked to suboptimal dietary practices in refugee populations (Jahan, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). In the context of the Rohingya crisis, Akter et al. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) have highlighted the intricate interplay of social, environmental, and individual factors influencing the health of pregnant women in the camps. These findings underscore the importance of addressing not only the immediate healthcare needs but also the broader determinants of health, such as food security and dietary diversity. The Household Food Insecurity Access Scale (HFIAS) and other dietary assessment tools have proven effective in identifying the degree of food insecurity and dietary inadequacies in similar settings (Coates et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). Given the gaps in the current literature, particularly concerning the relationship between food security, dietary diversity, and disease patterns among pregnant Rohingya women, this study aims to provide empirical evidence to address these critical issues. By evaluating the interplay between these factors, the study seeks to inform more effective health and nutritional interventions tailored to the unique challenges of this marginalized population. This research contributes to a deeper understanding of the determinants of health disparities among pregnant women in refugee settings, with implications for improving maternal health outcomes in the Rohingya camps and similar contexts globally.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003eA descriptive cross-sectional study was conducted among Rohingya pregnant women residing in the makeshift camps of Ukhiya, Cox's Bazar, from June to September 2022. The sample size was determined to be 96 using the statistical formula, with a 95% confidence interval and a 5% level of significance. Severely ill and mentally unstable pregnant women were excluded from the study. Participants were selected through a simple random sampling technique, adhering to specific inclusion criteria with the cooperation of the community leaders in the camps (Lim et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Data was collected using a structured questionnaire developed for this study consisting of different types of questions to capture a broad range of information (Nedjat-Haiem \u0026amp; Cooke., 2021; Douthit et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) such as socio-demographic characteristics, food security status, dietary diversity, and disease patterns. The socio-demographic section collected data on age, educational level, and marital status. Food security was assessed using a modified Household Food Insecurity Access Scale (HFIAS) (Coates et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2007\u003c/span\u003e), which included nine questions about the household\u0026rsquo;s experiences with food insecurity over the past 30 days. Responses were categorized on a frequency-based scale (never, rarely, sometimes, often), allowing households to be classified into varying levels of food security. Dietary diversity was evaluated through a 24-hour dietary recall method (Steyn \u0026amp; Labadarios, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2000\u003c/span\u003e) and a 7-day food frequency questionnaire (Zulkifli \u0026amp; Stella, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e1992\u003c/span\u003e). In the 24-hour dietary recall, participants reported all foods consumed in the previous 24 hours, assessing dietary variety and quality. The 7-day food frequency questionnaire captured the frequency of consumption of specific food groups over the past week, providing insights into dietary patterns and nutrient intake. Data collection was conducted by trained enumerators fluent in the Rohingya language. Enumerators administered the questionnaires face-to-face at participants\u0026rsquo; homes or in designated safe spaces within the camps, ensuring privacy and comfort. Questions were read aloud, and enumerators assisted participants in providing responses. Translators were available to address language barriers when necessary. To ensure data accuracy, collection and entry were performed simultaneously, and multiple review and cross-checking procedures were implemented to remove the error from the dataset (Ahuja et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Data entry, cleaning, and analysis were conducted using SPSS (Version 26), while SPSS (Version 26), Stata (Version 13), and R were utilized for statistical analysis. Descriptive statistics, correlation analyses, and regression models were employed to examine relationships between food security, dietary diversity, and disease patterns. The dependent variables included types of diseases reported, while independent variables encompassed food security, dietary diversity, and food consumption scores. Food security and Food Consumption Scores were assessed using the Household Food Security \u0026amp; Nutrition Assessment (HFSNA, 2009) scale, and dietary diversity scores were calculated following FAO guidelines for Individual Dietary Diversity Scores (Kennedy et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). Advanced statistical techniques, such as logistic regression, were applied to model the likelihood of disease occurrences based on dietary inputs. Mediating variables, including age, duration of pregnancy, and educational level, were controlled to isolate the effects of diet and food security on health outcomes. The analysis aimed to identify significant predictors of health disparities and provide guidance for future nutritional interventions. Ethical approval for the study was obtained from the Faculty of Allied Health Sciences Research Ethics Committee of Daffodil International University. Verbal informed consent was acquired from all participants before data collection. Anonymity and confidentiality were maintained throughout the study, adhering to strict ethical guidelines.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 96 pregnant women participated in the study. The age ranged from 15 to 33 years, with a mean age of 22.83 years (\u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;4.02). This indicates that most of the pregnant women in this sample were relatively young, which reflects early reproductive age groups commonly observed in similar settings. The household size of the participants showed significant variation, ranging from 1 to 12 members, with an average household size of 5.29 members (\u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.60). This suggests that many participants lived in moderately sized families, a pattern commonly seen in rural or low-income settings where extended families may reside together. Regarding family structure, most women (70.8%) reported living in single/nuclear families, while 29.2% resided in joint-family households. This reflects a shift towards nuclear families, which may have implications for the support systems available to pregnant women in this population. The predominance of nuclear family settings may indicate a societal trend toward smaller, independent households, which can affect family support during pregnancy (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eDemographic characteristics of the pregnant women (\u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;96)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003eDemographic characteristics\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMin\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMax\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (year)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (\u003c/strong\u003e\u003cstrong\u003eM\u003c/strong\u003e\u0026thinsp;\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;\u003cstrong\u003eSD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e22.83\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;4.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eHousehold size\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eMin\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eMax\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eHousehold size (number)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eHousehold size (\u003c/strong\u003e\u003cstrong\u003eM\u003c/strong\u003e\u0026thinsp;\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;\u003cstrong\u003eSD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.29\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;2.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily type\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSingle/nuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e70.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eJoint\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eMost of the participants (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;49, 51.0%) received religious education from Madrasha/Religious institutions. A notable proportion of the women (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;26, 27.1%) were 2nd Grade pass, while 15.6% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;15) had completed elementary school. Only 6.3% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;6) of the women reported having no education. These findings indicate that most participants had limited formal education, with a significant reliance on religious schooling, which might impact their health literacy and access to health information. Most of the pregnant women were married, with 93.8% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;90) currently in a marital relationship. Only 6.3% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;6) reported being separated from their spouses. The high percentage of married women is consistent with cultural norms in many communities, where early marriage is common. Regarding the duration of pregnancy, 43.8% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;42) of the women were in the first trimester (less than 4 months pregnant). Another 32.3% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;31) were in the second trimester (4\u0026ndash;6 months), while 24.0% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;23) were in the third trimester (more than 6 months pregnant). This distribution shows an even representation across different stages of pregnancy, providing a comprehensive look at pregnant women across all trimesters (Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003eAll pregnant women in the study (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;96, 100%) reported receiving rations. This indicates that every participant had access to some form of supplementary food assistance, likely as part of a government or community-based food support program aimed at ensuring adequate nutrition during pregnancy. The respondent\u0026rsquo;s household food security was assessed using the formula of HFIAS for measurement guidelines (Coates et al., \u003cspan class=\"CitationRef\"\u003e2007\u003c/span\u003e). Most of the households (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;55, 57.3%) were classified as food secure, indicating that these families had consistent access to sufficient food. However, 20.8% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;20) of the households experienced mild to moderate food insecurity, and 21.9% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;21) faced severe food insecurity. This suggests that a substantial number of the pregnant women in the sample lived in households where food insecurity was a concern, potentially impacting their overall health and nutritional status during pregnancy. In the last 24 hours, including both day and night, the food eaten at home was divided into 9 different food groups. The consumption of each food group during the last 24 hours (day and night) was recorded as 0 (not eaten) or 1 (eaten). Then, the dietary diversity score (WDDS) was calculated at the person level by counting the daily consumption of 9 food groups, with scores ranging from 0 to 9 (FAO, \u003cspan class=\"CitationRef\"\u003e2010\u003c/span\u003e). This study showed that the majority (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;82, 85.4%) consumed seven or more food groups, reflecting a relatively diverse diet. A smaller proportion of the women (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;12, 12.5%) consumed six food groups, while only 2.1% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2) reported consuming five food groups. This high level of dietary diversity among most participants suggests that many pregnant women had access to a variety of foods, which is crucial for meeting their nutritional needs during pregnancy. To calculate household-level food consumption scores (FCS), data was collected on the frequency of food consumption over the past seven days (Rabbani, \u003cspan class=\"CitationRef\"\u003e2014\u003c/span\u003e). Households reported how many days they consumed various food items, which were categorized into 8 key food groups: staple (e.g., rice, wheat, potatoes, maize), lentils (pulses, nuts, seeds), milk \u0026amp; milk products, meat, fruits, vegetables, sugar and oil (Rabbani, \u003cspan class=\"CitationRef\"\u003e2014\u003c/span\u003e). These food groups are essential for a nutritionally adequate diet if consumed daily. Each food group was assigned a weight based on its nutritional importance, and the FCS was calculated by multiplying the number of days each food group was consumed by its respective weight (Rabbani, \u003cspan class=\"CitationRef\"\u003e2014\u003c/span\u003e). This score reflects the diversity and frequency of food consumption at the household level, indicating the dietary quality of the household (Rabbani, \u003cspan class=\"CitationRef\"\u003e2014\u003c/span\u003e). According to this study, all participants (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;96, 100%) were classified as having an \u0026quot;acceptable\u0026quot; food consumption score, indicating that they were consuming an adequate quantity and quality of food. This aligns with the high dietary diversity observed, suggesting that the food support programs in place may be contributing to the overall nutritional well-being of pregnant women (Fig. \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003eAmong the 96 pregnant women surveyed, 51.0% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;49) reported having at least one disease, while 49.0% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;47) indicated they were free from any illness. This shows that half of the pregnant women experienced some form of health complication during pregnancy, highlighting a significant burden of disease within the study population. A variety of diseases were reported among the women. The most prevalent condition was acidity, affecting 36.5% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;35) of the participants, which is a common issue during pregnancy due to hormonal changes and pressure on the digestive system. Viral fever was the second most common illness, reported by 15.6% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;15) of the women, followed by cough (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;13, 13.5%) and skin infections (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;6, 6.3%). Other conditions reported included diarrhea (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3, 3.1%), typhoid (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2, 2.1%), jaundice (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1, 1.0%), and hypertension (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1, 1.0%). An additional 19.8% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;19) of participants experienced various other health issues not categorized under the specific conditions listed (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eDisease status of the pregnant women (\u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;96)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003eDisease status\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDisease present\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDisease absent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisease type\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDiarrhea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCough\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eViral fever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSkin infection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAcidity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTyphoid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eJaundice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThe association between disease status and food security was analyzed using chi-square test for independence (Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e). Out of 49 women with a disease, 51.0% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;25) were from food-secure households, 24.5% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;12) from mildly/moderately food-insecure households, and 24.5% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;12) from severely food-insecure households. The results of chi-square test (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 1.64, \u003cem\u003edf\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.440) showed that there was not a significant association between overall disease presence and food security status. Among the 3 women with diarrhea, 66.7% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2) were from food-secure households, and 33.3% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1) from a severely food-insecure household. The chi-square test (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 0.898, \u003cem\u003edf\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.638) showed no significant association between diarrhea and food security status. Of the 13 women with cough, 46.2% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;6) were food secure, 23.1% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3) were mildly/moderately food insecure, and 30.8% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;4) were severely food insecure. The association between cough and food security status was not significant (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 0.650, \u003cem\u003edf\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.722). Of the 15 women with viral fever, 46.7% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;7) were from food-secure households, 26.7% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;4) were mildly/moderately food insecure, and 26.7% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;4) were severely food insecure. The chi-square test (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 0.607, \u003cem\u003edf\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.738) did not reveal a significant association. Six women had skin infections, with 33.3% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2) from food-secure households, 16.7% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1) from a mildly food-insecure household, and 50.0% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3) from severely food-insecure households. The chi-square test (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 2.677, \u003cem\u003edf\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.262) did not show a significant association. Of the 35 women with acidity, 54.3% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;19) were food secure, 22.9% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;8) were mildly food insecure, and 22.9% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;8) were severely food insecure. The chi-square test (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 0.115, \u003cem\u003edf\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.944) indicated no significant association between acidity and food security. For typhoid (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 1.279, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.528), jaundice (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 3.315, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.191), hypertension (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 0.838, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.658), and other diseases (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 2.799,\u0026nbsp;\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.247), none of the associations with food security status were statistically significant.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eAssociation between disease status and food security status among pregnant women\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"10\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eDisease status\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"6\"\u003e\n \u003cp\u003eFood security status\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cem\u003edf\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eFood secure (55)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eMild/moderate food insecure (20)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eSevere food insecure (21)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDisease present (49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e51.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.642\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.440\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDiarrhea (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e66.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e33.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.898\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.638\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCough (13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e46.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e23.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.650\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.722\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eViral fever (15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e46.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.607\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.738\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSkin infection (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e33.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e16.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e50.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.677\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.262\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAcidity (35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e54.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.944\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTyphoid (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e50.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e50.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.279\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.528\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eJaundice (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e100.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.191\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHypertension (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e100.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.838\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.658\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOthers (19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e68.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e21.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.799\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.247\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThe chi-square test was conducted to determine the association between disease status (overall and specific diseases) and dietary diversity among pregnant women (Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e). There was no significant association between overall disease presence and dietary diversity (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 4.074, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.130). Among the women with diseases, none had diets limited to 5 food groups, while 8.2% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;4) consumed 6 food groups and 91.8% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;45) consumed 7 or more food groups. Similarly, for those without disease, 4.3% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2) consumed 5 food groups, 17.0% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;8) consumed 6 food groups, and 78.7% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;37) consumed 7 or more food groups. These results suggest that disease status was not strongly linked to dietary diversity. The association between diarrhea and dietary diversity was not statistically significant (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 0.346, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.556). All women with diarrhea (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3, 100.0%) consumed diets from 7 or more food groups, suggesting that dietary diversity did not differ significantly for those with or without diarrhea. There was no significant association between cough and dietary diversity (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 0.614, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.433). Most women with cough (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;11, 84.6%) consumed 7 or more food groups, with 15.4% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2) consuming 6 food groups. Similarly, no significant association was found between viral fever and dietary diversity (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 0.299, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.584). Among the 15 women with viral fever, 86.7% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;13) consumed 7 or more food groups, and 13.3% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2) consumed 6 food groups. The association between skin infections and dietary diversity was also not significant (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 0.362, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.547). 83.3% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;5) women with skin infections consumed diets from 7 or more food groups, and 16.7% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1) consumed 6 food groups. There was no significant association between acidity and dietary diversity (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 0.192, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.662). Most women with acidity (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;32, 91.4%) consumed 7 or more food groups, while 8.6% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3) consumed 6 food groups. The association between typhoid and dietary diversity was not significant (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 0.226, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.634). Both women with typhoid consumed diets from 7 or more food groups. The association between jaundice and dietary diversity was statistically significant (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 9.384, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.002). One woman with jaundice consumed 6 food groups, and none consumed 7 or more food groups. This suggests that lower dietary diversity may be associated with jaundice, although the number of cases is small. There was no significant association between hypertension and dietary diversity (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 0.111, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.739). One woman with hypertension consumed 7 or more food groups. For other diseases, no significant association was found with dietary diversity (\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e = 0.018, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.894). Among those with other diseases, 89.5% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;17) consumed 7 or more food groups, and 10.5% (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2) consumed 6 food groups.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4. Association between disease status and dietary diversity status among pregnant women\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cimg 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\"\u003e\u003c/strong\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u003cbr\u003e\u003c/div\u003e\n\u003cp\u003eAmong the study participants, the highest frequency of consumption was observed for starch, flesh foods, dark green leafy vegetables, and vitamin A-rich fruits and vegetables, with 95 participants (99.0%) reporting intake from these groups. Similarly, high consumption was observed for other fruits and vegetables, with 94 participants (97.9%) including them in their diet. The intake of eggs was also relatively high, with 80 participants (83.3%) reporting consumption, and legumes were consumed by 82 participants (85.4%). In contrast, dairy products were less frequently consumed, with only 67 participants (69.8%) reporting intake. Organ meat had the lowest consumption frequency, with 33 participants (34.4%) indicating intake from this food group (Table \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e). These findings indicate that most study participants have a diet that includes starches, flesh foods, dark green leafy vegetables, and vitamin A-rich fruits and vegetables, suggesting an inclination towards these food groups in their dietary patterns. The high consumption of other fruits and vegetables also indicates a general preference for or availability of plant-based foods in the participants\u0026apos; diet. However, the lower consumption of dairy products and especially organ meat suggests either a lack of availability, cultural preferences, or dietary habits that do not prioritize these food groups. The variation in consumption frequencies across food groups reflects the diversity and preferences within the study population\u0026rsquo;s dietary practices.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab5\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eDescriptive statistics of consumption from different food groups among study participants (\u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;96)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFood groups\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStarch\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e99.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLegumes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e85.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDairy products\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e69.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOrgan meat\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e34.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEggs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e83.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFlesh food\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e99.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDark green leafy vegetables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e99.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVitamin A-rich fruits \u0026amp; vegetables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e99.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOther fruits and vegetables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e97.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study aimed to examine the interplay between food security, dietary diversity, and disease patterns among pregnant Rohingya women residing in the makeshift camps of Ukhiya, Cox's Bazar. The findings provide critical insights into the health and nutritional challenges faced by this marginalized population. A significant proportion of the study participants (57.3%) were classified as food secure, with 85.4% demonstrating high dietary diversity by consuming seven or more food groups. While compared with another study of Bhasan Char, it was found that 46% of pregnant mothers had low WDDS (\u0026lt;\u0026thinsp;4) (Fahim et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) indicating a notable disparity in dietary diversity between the two settings. This suggests that the food support programs in Ukhiya camps may be more effective in promoting diverse diets compared to those in Bhasan Char, where limited access to diverse food groups remains a critical challenge. However, this study also found that 21.9% of households experienced severe food insecurity, reflecting persistent gaps in food access despite intervention programs. Similarly, a Syrian study highlights that over half of refugee households in Lebanon are food insecure, relying on an e-voucher system that introduces socio-technical challenges and power asymmetries (Talhouk et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Both studies underscore the critical need for adaptive and context-specific approaches to food aid to address persistent inequities in refugee settings. The prevalence of diseases among the participants was notable, with 51.0% reporting at least one health issue during pregnancy. Acidity was the most reported condition (36.5%), followed by viral fever (15.6%) and cough (13.5%). These findings are consistent with prior research by Pavli \u0026amp; Maltezou (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) among refugees in Europe, which documented high rates of gastrointestinal and respiratory illnesses among refugee women, attributed to poor living conditions and limited access to healthcare. Additionally, the high prevalence of acidity aligns with study by M\u0026uuml;ller et al. (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), which identified dietary deficiencies and stress as significant contributors to gastrointestinal issues in refugee populations. While no statistically significant associations were found between food security or dietary diversity and most disease outcomes, the trends observed provide important implications for future interventions. For instance, the chi-square test revealed no significant relationship between dietary diversity and diseases such as diarrhea, cough, and viral fever, mirroring findings by Schrey-Petersen et al. (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). These studies suggest that while dietary diversity is critical for overall nutritional adequacy, its direct impact on acute disease outcomes may be limited in resource-constrained settings. However, the significant association between jaundice and lower dietary diversity observed in this study highlights the potential role of targeted nutritional interventions in preventing specific diseases, a conclusion also supported by de Toro-Mart\u0026iacute;n et al. (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). The findings of this study align with those of Akter et al. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2020\u003c/span\u003e), who highlighted the effectiveness of food support programs in improving dietary diversity but emphasized the ongoing challenges of food insecurity in refugee camps. Similarly, the prevalence of health issues, particularly gastrointestinal conditions, corroborates the results of Owoaje et al. (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) and Ekezie et al. (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2020\u003c/span\u003e), who reported high rates of morbidity linked to inadequate sanitation and healthcare in displaced populations. Moreover, this study\u0026rsquo;s findings on the influence of socio-demographic factors, such as age and pregnancy duration, on health outcomes are consistent with the work of Souza et al. (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), who demonstrated a strong association between younger maternal age and increased risk of pregnancy-related complications. The study underscores the importance of addressing food insecurity and promoting dietary diversity to improve maternal health outcomes in refugee settings. While current food support programs appear effective in ensuring high dietary diversity for many participants, the persistent prevalence of severe food insecurity and its association with health disparities highlights the need for more targeted interventions. Enhancing access to nutrient-rich foods and healthcare services, particularly for high-risk groups, could mitigate the observed health challenges. Furthermore, the study highlights the need for integrated health and nutrition programs that address both immediate and underlying determinants of health. Interventions aimed at improving sanitation, healthcare access, and mental health support could complement food security initiatives to reduce disease burden among pregnant women in refugee settings. This study provides valuable insights into the interplay between food security, dietary diversity, and health outcomes in a vulnerable population. However, it is not without limitations. The cross-sectional design precludes causal inferences, and the reliance on self-reported data may introduce bias. Future longitudinal studies could provide more robust evidence on the relationships explored here.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study highlights the significant interplay between food security, dietary diversity, and health outcomes among pregnant Rohingya women in the Ukhiya makeshift camps. Although 85.4% of participants demonstrated high dietary diversity, 21.9% of households faced severe food insecurity, underscoring persistent challenges despite food support programs. The prevalence of health issues, particularly gastrointestinal conditions such as acidity, highlights the compounded effects of inadequate nutrition and poor living conditions. These findings emphasize the importance of strengthening food aid programs and promoting dietary diversity to improve maternal health outcomes. Tailored interventions are needed to address food insecurity and provide access to culturally appropriate, nutrient-rich foods for high-risk groups. To mitigate health disparities, integrated health and nutrition programs should focus on enhancing access to healthcare, improving sanitation, and providing mental health support. Future research should explore longitudinal data to establish causal relationships between dietary diversity, food security, and health outcomes. Policymakers and humanitarian organizations must adopt context-specific strategies to ensure that food aid programs effectively meet the nutritional needs of vulnerable populations in refugee settings.\u003c/p\u003e\n\u003ch3\u003eHuman ethics and Consent to Participate declarations\u003c/h3\u003e\n\u003cp\u003e This study meticulously adhered to ethical guidelines, obtaining approval from the Faculty of Allied Health Sciences Research Ethics Committee at Daffodil International University. A core aspect of its ethical rigor was ensuring that all participants, Rohingya pregnant women from makeshift camps in Ukhiya, Cox's Bazar, provided verbal informed consent. This consent was not merely procedural but was obtained by thoroughly explaining the study's aims, methods, potential benefits, and risks in an accessible manner, ensuring participants' full comprehension and voluntary participation. The research emphasized the participants' autonomy, allowing them to withdraw at any time without repercussion, thus upholding their dignity and rights. Additionally, the study's commitment to maintaining participants' confidentiality and anonymity showcases a strong adherence to the ethical principles of beneficence, non-maleficence, autonomy, and justice, particularly crucial when dealing with vulnerable populations in a research context.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in strict adherence to ethical standards and received approval from the Faculty of Allied Health Sciences Research Ethics Committee at Daffodil International University. Informed consent was obtained from all participants. For participants aged 18 and above, consent was obtained verbally after they were fully briefed on the study\u0026apos;s objectives, methodology, potential benefits, and risks. For participants under the age of 18, informed consent was obtained from their parents or legal guardians in accordance with the ethical guidelines. All participants, and the parents or guardians of minor participants, were informed that participation was voluntary and that they had the right to withdraw at any time without any consequences.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are not publicly available due to ethical restrictions related to participant consent and confidentiality but are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests. There are no financial, personal, or professional conflicts of interest that could have influenced the work reported in this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research did not receive any specific grant from funding agencies in the public, commercial, or non-profit sectors. The study was conducted with the support of the authors\u0026apos; institutions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAbeer Mohammad Hossain conceptualized the study.\u003c/p\u003e\n\u003cp\u003eA B M Alauddin Chowdhury and Abu Ansar Md Rizwan designed the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAbeer Mohammad Hossain, and Abu Ansar Md Rizwan contributed to data collection and analysis.\u003c/p\u003e\n\u003cp\u003eA B M Alauddin Chowdhury and Abu Ansar Md Rizwan provided overall supervision, and played the key role in manuscript writing, and quality assurance.\u003c/p\u003e\n\u003cp\u003eAll authors contributed to the manuscript review and editing process.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe extend our gratitude to the Faculty of Allied Health Sciences at Daffodil International University for their support. We also thank the study participants for their willingness to participate in this research. Special thanks to W A N Research \u0026amp; Consultancy for their consultancy assistance in designing the study and evaluating the data.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; Information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAbeer Mohammad Hossain, MPH Student, Department of Public Health, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, Bangladesh.\u003c/p\u003e\n\u003cp\u003eAbu Ansar Md Rizwan, Graduate student of Nutritional Sciences, Texas Tech University, 2500 Broadway W, Lubbock, TX 79409, USA and Senior Consultant, W A N Research \u0026amp; Consultancy, Dhaka, Bangladesh\u003c/p\u003e\n\u003cp\u003eA B M Alauddin Chowdhury, Professor \u0026amp; Head, Department of Public Health, Faculty of Health and Life Sciences, Daffodil International University.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eAhuja, L., Singh, B., \u0026amp; Simon, R. (2024). 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Dietary intake: 24-hour recall method.\u0026nbsp;\u003cem\u003eThe National Food Consumption Survey.\u003c/em\u003e Pretoria: Department of Health.\u003c/li\u003e\n \u003cli\u003eTalhouk, R., Coles-Kemp, L., Jensen, R. B., Balaam, M., Garbett, A., Ghattas, H., ... \u0026amp; Montague, K. (2020). Food aid technology: The experience of a Syrian refugee community in coping with food insecurity.\u0026nbsp;\u003cem\u003eProceedings of the ACM on Human-Computer Interaction, 4\u003c/em\u003e(CSCW2), 1-25.\u003c/li\u003e\n \u003cli\u003eToole, M. (2019). Health in humanitarian crises. In \u003cem\u003eThe Health of Refugees: Public Health Perspectives from Crisis to Settlement\u003c/em\u003e (pp. 54-84).\u003c/li\u003e\n \u003cli\u003eZulkifli, S. N., \u0026amp; Stella, M. Y. (1992). The food frequency method for dietary assessment. \u003cem\u003eJournal of the American Dietetic Association, 92\u003c/em\u003e(6), 681-686.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Food security, Dietary diversity, Maternal health, Rohingya refugees, Pregnancy nutrition","lastPublishedDoi":"10.21203/rs.3.rs-5703625/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5703625/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe health and nutritional well-being of pregnant women in refugee populations are critical concerns due to heightened vulnerabilities associated with displacement and inadequate living conditions. This study examines the interplay between food security, dietary diversity, and disease patterns among pregnant Rohingya women residing in the makeshift camps of Ukhiya, Cox's Bazar.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e \u003cp\u003eA descriptive cross-sectional study was conducted among 96 pregnant Rohingya women from June to September 2022. Data was collected using structured questionnaires assessing socio-demographic characteristics, food security, dietary diversity, and disease patterns. Food security was evaluated using the Household Food Insecurity Access Scale (HFIAS), while dietary diversity was assessed through a 24-hour dietary recall and 7-day food frequency questionnaire. Data were analyzed using SPSS (Version 26) and Stata (Version 13), employing descriptive statistics and logistic regression.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003e Most participants (57.3%) were food secure, and 85.4% demonstrated high dietary diversity by consuming seven or more food groups. However, 21.9% of households experienced severe food insecurity. The prevalence of health issues was notable, with 51.0% reporting at least one disease during pregnancy, the most common being acidity (36.5%), viral fever (15.6%), and cough (13.5%). No significant associations were found between food security or dietary diversity and most disease outcomes, except for a significant relationship between jaundice and lower dietary diversity.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusions\u003c/b\u003e\u003c/p\u003e \u003cp\u003eDespite the high dietary diversity among participants, severe food insecurity and health disparities remain critical challenges. Tailored interventions focusing on improving food security, promoting dietary diversity, and providing integrated health services are essential to address the unique needs of pregnant Rohingya women. Future research should explore causal relationships and evaluate the effectiveness of different food aid models to enhance maternal health outcomes in refugee settings.\u003c/p\u003e","manuscriptTitle":"The Interplay Between Food Security, Dietary Diversity, and Disease Patterns Among Pregnant Rohingya Women in Cox’s Bazar Makeshift Camps","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-01-01 09:15:26","doi":"10.21203/rs.3.rs-5703625/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"97b45785-41bd-4c70-a6cf-a19c73a44a32","owner":[],"postedDate":"January 1st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-06-05T20:10:50+00:00","versionOfRecord":[],"versionCreatedAt":"2025-01-01 09:15:26","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5703625","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5703625","identity":"rs-5703625","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}