Hepatitis E virus seroprevalence in pregnant women in Pakistan: maternal and fetal outcomes

Hepatitis E virus [HEV] is endemic in Pakistan. Although otherwise asymptomatic, HEV infection becomes fatal in pregnancy, with considerable maternal and fetal morbidity and mortality. We conducted a descriptive study from April to October 2015 in 10 tertiary care hospitals throughout Pakistan to determine maternal and fetal morbidity and mortality in HEV-positive pregnant women with acute jaundice or raised liver function tests. Twenty-one of 135 women were HEV positive and in 3rd trimester except for 1 in 1st trimester. Overall prevalence of HEV in pregnancy was 0.19%. Ten women were artificially induced, 3 had premature labour, 4 delivered spontaneously [full term], 3 died and there was 1 intrauterine death. One woman had a home abortion before coming to hospital. There were 7 perinatal infant deaths: 4 intrauterine, 3 stillbirths and 1 abortion. Maternal mortality was significantly associated with delivery, as 17 mothers who lived went into labour spontaneously or were artificially induced, whereas 3 women who continued their pregnancy and did not deliver, died. Case fatality rate of HEV infection in pregnancy was 14.2%

Prevalence of gynecological morbidities among reproductive age women in Bhudni village, Peshawar - Pakistan

Background: Gynecological morbidities is a neglected health issue among women in all developing countries including Pakistan. Lack of awareness and low access to health care facilities led to late diagnosis and increased mortality. Current study was done to assess the prevalence of gynecological morbidities among reproductive age women in Bhudni village. Study design, settings and duration: It was a community-based survey conducted over a period of 06 months [2016] in Bhudni, a locality in Peshawar, Khyber Pakhtun Khwa

Subjects and Methods: Bhudni was divided into four clusters and using random sampling technique, 82 ever married women who has delivered at least one baby [15-49 years], were identified from each cluster. After taking informed written consent, data was collected on a pretested questionnaire regarding demographics, changes in body in last 03 months and healthcare consultation for illness. Analysis was done using Epi Info version 7

Results: A total of 390 completed the interview out of 384 selected females. Median age was 31 years [SD +/- 9.1]. Out of 365 women, 238 [60.5%] were illiterate, 55 [15%] completed matriculation, 38 [12%] had primary education while 31 [8.4%] had qualification above matriculation. Majority [95%] were house wives. The mean age of the last born child was 4.4 months [SD +/- 4.5] and average parity was 4. None of the women had primary infertility. Overall prevalence of gynecological morbidities was 21% which was significantly associated with age [p-value = 0.037]. However, the perceived perception among participants was 45%. Lower backache/ lower abdominal pain were the most common [71%] symptoms while bacterial vaginitis and urinary tract infections [UTI] were the most prevalent morbidities [21.3%]. The prevalence of one gynecological morbidity was 20.1% [95% CI: 0.10-2.20 %]. Out of 365 women, 152 [42%] went to health practitioner for treatment and in 123 [80%] cases, this treatment was provided by a lady health visitor. Fear of surgery was the most common reason for not seeking health care. About 212 [58%] did not go for medical advice despite of presence of symptoms of an illness. Fear of surgery and poverty were barriers for poor health seeking behavior among the participants

Conclusion: A robust health education campaigns is required to bring the change in women's approach towards their health and health seeking behavior in Pakistan especially in Bhudni village