Impact of COVID-19 on Women Who Are Refugees and Mothering: A Critical Ethnographic Study.

Refugee women often experience trauma and social disconnection in a new country and are at risk of experiencing reduced physical, mental, and emotional well-being. Globally, COVID-19 has affected the health and well-being of the population at large. This critical ethnographic study aimed to explore the effects of COVID-19 on women who are refugees and mothering in Saskatchewan, Canada. In-depth interviews were undertaken with 27 women who are refugees and mothering young children aged 2 years and under. This study suggests that during COVID-19, refugee women are at high risk of experiencing add-on stressors due to isolation, difficulty in accessing health care, COVID-19-related restrictions in hospitals, limited follow-up care, limited social support, financial difficulties, and compromised nutrition. During COVID-19, collaborative efforts by nurses, other health-care professionals, and governmental and non-governmental organizations are essential to provide need-based mental health support, skills-building programs, nutritional counseling, and follow-up care to this vulnerable group.

Updates on Measles Incidence and Eradication: Emphasis on the Immunological Aspects of Measles Infection.

Measles is an RNA virus infectious disease mainly seen in children. Despite the availability of an effective vaccine against measles, it remains a health issue in children. Although it is a self-limiting disease, it becomes severe in undernourished and immune-compromised individuals. Measles infection is associated with secondary infections by opportunistic bacteria due to the immunosuppressive effects of the measles virus. Recent reports highlight that measles infection erases the already existing immune memory of various pathogens. This review covers the incidence, pathogenesis, measles variants, clinical presentations, secondary infections, elimination of measles virus on a global scale, and especially the immune responses related to measles infection.

Household COVID-19 secondary attack rate and associated determinants in Pakistan; A retrospective cohort study.

BACKGROUND: COVID-19 household transmissibility remains unclear in Pakistan. To understand the dynamics of Severe Acute Respiratory Syndrome Coronavirus disease epidemiology, this study estimated Secondary Attack Rate (SAR) among household and close contacts of index cases in Pakistan using a statistical transmission model. METHODOLOGY: A retrospective cohort study was conducted using an inclusive contact tracing dataset from the provinces of Punjab and Khyber-Pakhtunkhwa to estimate SAR. We considered the probability of an infected person transmitting the infection to close contacts regardless of residential addresses. This means that close contacts were identified irrespective of their relationship with the index case. We assessed demographic determinants of COVID-19 infectivity and transmissibility. For this purpose based on evolving evidence, and as CDC recommends fully vaccinated people get tested 5-7 days after close contact with a person with suspected or confirmed COVID-19. Therefore we followed the same procedure in the close contacts for secondary infection. FINDINGS: During the study period from 15th May 2020 to 15th Jan 2021, a total of 339 (33.9%) index cases were studied from 1000 cases initially notified. Among close contact groups (n = 739), households were identified with an assumed mean incubation period of 8.2+4.3 days and a maximum incubation period of 15 days. SAR estimated here is among the household contacts. 117 secondary cases from 739 household contacts, with SAR 11.1% (95% CI 9.0-13.6). All together (240) SAR achieved was 32.48% (95% CI; 29.12-37.87) for symptomatic and confirmed cases. The potential risk factors for SAR identified here included; old age group (>45 years of age), male (gender), household members >5, and residency in urban areas and for index cases high age group. Overall local reproductive number (R) based on the observed household contact frequencies for index/primary cases was 0.9 (95% CI 0.47-1.21) in Khyber Pakhtunkhwa and 1.3 (95% CI 0.73-1.56) in Punjab. CONCLUSIONS: SAR estimated here was high especially in the second phase of the COVID-19 pandemic in Pakistan. The results highlight the need to adopt rigorous preventive measures to cut the chain of viral transmission and prevent another wave of COVID-19.

The clinical and demographical profile of Coronavirus illness: The tale of Tablighi Jamaat and Zaireen in Quarantine / Isolation center at Sukkur and Hyderabad.

OBJECTIVES: To determine the clinical and demographical profile of corona-virus illness among Tablighi Jamaat and Zaireen kept in quarantine / isolation center at Sukkur and Hyderabad Sindh. METHODS: The cross-sectional descriptive study (late March-2020 to mid of April-2020) was conducted at Diagnostic & Research Laboratory LUMHS Jamshoro / Hyderabad. All the suspected cases for COVID-19 were recruited and screened for corona virus infection. The study explored the data of the suspected and diagnosed (confirmed) case of COVID-2019 (Tablighi Jamaat and Zaireen) reported by Diagnostic Research Laboratory Liaquat University of Medical and Health Sciences (LUMHS) Jamshoro who belonged to various parts of the country in general and province Sindh in particular. All the individuals regardless of age and gender presented either as asymptomatic, critical ill or having non-specific symptoms as fever, flu, cough; sore throat and shortness of breath were screened for COVID-19 by real time PCR after taking informed consent whereas the frequency / percentages (%) and means ±SD computed for study variables. RESULTS: During study period total 920 patients were explored and screened for Corona virus infection. The mean ± SD for age (yrs) of overall population of city Sukkur and Hyderabad was 57.83±8.84 and 59.62±9.72 respectively. The 700 people from Sukkur city was screened and out of them 276 (39.4%) were positive and 424 (60.5) were negative while the cure rate was 245 (88.7%) along with mean ± SD for recovery time was 9.41±2.97. The 220 people from Hyderabad city was screened and out of them 106 (48.1%) were positive and 114 (51.8%) were negative while the cure rate was 106 (100%) along with mean ± SD for recovery time was 11.54±3.42. The majority of cases at both centers were asymptomatic (90%), symptomatic (7%) and critically ill (3%). The mortality accounted for 2.8% cases at Hyderabad isolation center and all were having smoking history and co-morbidities as ischemic heart diseases, diabetes mellitus, obstructive lung disease and cerebrovascular accident whereas no mortality was observed at Sukkur isolation center. CONCLUSION: RT-PCR measure allowed fast, delicate, and explicit discovery of SARS-CoV in biochemical diagnosis. The majority of cases at both centers were asymptomatic while the mortality was identified in 2.8% cases (having co-morbidities) at Hyderabad isolation center whereas no mortality was observed at Sukkur isolation center.

Investigation and forecast of COVID-19 Wave-II: a case study of Pakistan

This study has investigated and forecasted the number of confirmed, deaths, active, and recovered cases of COVID-19 for Wave-II using the ARIMA model in Pakistan. An exponential growth forecast for all the series has been observed under the fitted model for 1 October 2020 to 19 December 2020. Based on our empirical results of forecasted models, the numeral COVID-19 confirmed cases will increase by 1.26 times with a 95% confidence interval at the end of January 2021. Similarly, the number of deaths due to COVID-19 will increase by 1.34 times with a 95% confidence interval until January 2021. Moreover, the number of active cases of COVID-19 will increase by 0.11 times with a 95% confidence interval till the end of January 2021. Besides these, Pakistan has an 89.2% rate of recoveries which will increase by 1.38 times until January 2021. Finally, results show an alarming situation for January 2021 in Pakistan.

Knowledge mobilization tool to promote, protect, and support breastfeeding during COVID-19.

SETTING: This knowledge mobilization project was conceptualized to increase awareness among breastfeeding mothers and the general public on safe infant feeding practices during the COVID-19 pandemic by addressing myths and misconceptions associated with breastfeeding practices, guiding breastfeeding mothers to make informed decisions around child feeding practices, and offering meaningful guidance in simple language through a short online animated video. INTERVENTION: This project was undertaken in four phases. During phase 1, an informal discussion was held with the breastfeeding mothers, service providers, and community partner in identifying issues surrounding lactation counselling facilities during the COVID-19 pandemic. During phase 2, recommendations from 23 organizations with regard to breastfeeding during COVID-19 were reviewed and analyzed. During phase 3, using evidence from reliable sources, a 5-minute animated e-resource on breastfeeding during COVID-19 was conceptualized and developed. During phase 4, the e-resource was disseminated to the breastfeeding mothers, general public, post-secondary institutions, and organizations providing services to breastfeeding mothers in Canada. OUTCOMES: This evidence-based e-resource facilitated addressing misconceptions around breastfeeding during COVID-19 and raising public awareness on safe infant feeding practices during this pandemic. Overall, the video was described as an informative, user-friendly, useful, and easily accessible resource by breastfeeding mothers who were in self-isolation with little access to healthcare services during the pandemic. IMPLICATIONS: This project highlighted the importance of patient engagement and collaboration with the community partner in protecting breastfeeding during the COVID-19 pandemic. It further illustrated how informational e-resources can protect breastfeeding in situations where breastfeeding mothers' access to healthcare services is compromised.

RéSUMé: LIEU: Notre projet de mobilisation des connaissances vise à sensibiliser les mères allaitantes et le grand public aux pratiques d'alimentation sûres pour les nourrissons durant la pandémie de COVID-19 en abordant les mythes et les idées fausses associés aux pratiques d'allaitement maternel, en aidant les mères allaitantes à prendre des décisions éclairées quant aux pratiques d'alimentation des bébés et en offrant des conseils utiles, en langage simple, dans une courte vidéo animée accessible en ligne. INTERVENTION: Le projet a été mené en quatre phases. Pendant la phase 1, nous avons eu une discussion informelle avec les mères allaitantes, les dispensateurs de services et le  partenaire associatif pour définir les problèmes entourant les services-conseils sur la lactation durant la pandémie de COVID-19. Pendant la phase 2, nous avons vu et analysé les recommandations de 23 organismes concernant l'allaitement durant la COVID-19. Pendant la phase 3, à l'aide de données probantes provenant de sources fiables, nous avons conceptualisé et créé une cyberressource animée de cinq minutes sur l'allaitement durant la COVID-19. Pendant la phase 4, nous avons diffusé cette cyberressource aux mères allaitantes, au grand public, à des établissements d'enseignement postsecondaires et à des organismes de services aux mères allaitantes au Canada. RéSULTATS: Cette cyberressource factuelle a permis d'aborder plus facilement les idées fausses entourant l'allaitement durant la COVID-19 et de sensibiliser le public aux pratiques sûres d'alimentation des nourrissons durant la pandémie. Dans l'ensemble, des mères allaitantes en isolement, qui avaient peu accès aux services de soins de santé durant la pandémie, ont trouvé notre vidéo informative, conviviale, utile et facilement accessible. CONSéQUENCES: Ce projet souligne l'importance du contact avec la patiente et de la collaboration avec le partenaire associatif pour protéger l'allaitement maternel durant la pandémie. Il montre aussi que des ressources informationnelles accessibles en ligne peuvent protéger l'allaitement dans les situations où les mères allaitantes ont moins accès aux services de soins de santé.