ABSTRACT
Background Understanding health trends and estimating the burden of disease at the national and subnational levels helps policy makers track progress and identify disparities in overall health performance. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides comprehensive estimates for Pakistan. Comparison of health indicators since 1990 provides valuable insights about Pakistan's ability to strengthen its health-care system, reduce inequalities, improve female and child health outcomes, achieve universal health coverage, and meet the UN Sustainable Development Goals. We present estimates of the burden of disease, injuries, and risk factors for Pakistan provinces and territories from 1990 to 2019 based on GBD 2019 to improve health and health outcomes in the country. Methods We used methods and data inputs from GBD 2019 to estimate socio-demographic index, total fertility rate, cause-specific deaths, years of life lost, years lived with disability, disability-adjusted life-years, healthy life expectancy, and risk factors for 286 causes of death and 369 causes of non-fatal health loss in Pakistan and its four provinces and three territories from 1990 to 2019. To generate estimates for Pakistan at the national and subnational levels, we used 68 location-years of data to estimate Pakistan-specific demographic indicators, 316 location-years of data for Pakistan-specific causes of death, 579 location-years of data for Pakistan-specific non-fatal outcomes, 296 location-years of data for Pakistan-specific risk factors, and 3089 location-years of data for Pakistan-specific covariates. Findings Life expectancy for both sexes in Pakistan increased nationally from 61 center dot 1 (95% uncertainty interval [UI] 60 center dot 0-62 center dot 1) years in 1990 to 65 center dot 9 (63 center dot 8-67 center dot 8) years in 2019;however, these gains were not uniform across the provinces and federal territories. Pakistan saw a narrowing of the difference in healthy life expectancy between the sexes from 1990 to 2019, as health gains for women occurred at faster rates than for men. For women, life expectancy increased by 8 center dot 2% (95% UI 6middot3-13middot8) between 1990 and 2019, whereas the male life expectancy increased by 7 center dot 6% (3 center dot 5-11 center dot 8). Neonatal disorders, followed by ischaemic heart disease, stroke, diarrhoeal diseases, and lower respiratory infections were the leading causes of all-age premature mortality in 2019. Child and maternal malnutrition, air pollution, high systolic blood pressure, dietary risks, and tobacco consumption were the leading all-age risk factors for death and disability-adjusted life-years at the national level in 2019. Five non-communicable diseases-ischaemic heart disease, stroke, congenital defects, cirrhosis, and chronic kidney disease-were among the ten leading causes of years of life lost in Pakistan. Burden varied by socio-demographic index. Notably, Balochistan and Khyber Pakhtunkhwa had the lowest observed gains in life expectancy. Dietary iron deficiency was the leading cause of years lived with disability for both men and women in 1990 and 2019. Low birthweight and short gestation and particulate matter pollution were the leading contributors to overall disease burden in both 1990 and 2019 despite moderate improvements, with a 23 center dot 5% (95% UI 3 center dot 8-39 center dot 2) and 27 center dot 6% (14 center dot 3-38 center dot 6) reduction in age-standardised attributable DALY rates during the study period. Interpretation Our study shows that progress has been made on reducing Pakistan's disease burden since 1990, but geographical, age, and sex disparities persist. Equitable investment in the health system, as well as the prioritisation of high-impact policy interventions and programmes, are needed to save lives and improve health outcomes. Pakistan is facing several domestic and foreign challenges-the Taliban's return to power in Afghanistan, political turmoil, catastrophic flooding, the COVID-19 pandemic-that will shape the trajectory of the country's health and development. Pakistan must address the burden of infectious disease and curb rising rates of non-communicable diseases. Prioritising these three areas will enhance Pakistan's ability to achieve universal health coverage, meet its Sustainable Development Goals, and improve the overall health outcomes.
ABSTRACT
Background: Despite several challenges, the SARS-CoV-2 pandemic is still not over. Rapid mass-scale immunization is critical to prevent further COVID-19-associated deaths. Objectives: Herein, we aimed to evaluate the rapid ramp-up effects of spike antibodies in response to Sputnik V, Sinopharm, and SinoVac first dose administration in the general public of Pakistan. Methods: A cross-sectional study was conducted on 2000 participants to examine Sputnik V, Sinopharm, and SinoVac first dose effects 21 days post-administration. From 1200 real-time PCR negative subjects, the samples were subjected to SARS-CoV-2 spike antibody levels using electro-chemiluminescence immunoassay (ECLIA) (Elecsys, # 09289267190 Roche, USA). Results: SARS-CoV-2 spike protein positivity was detected highest at 87% among participants receiving SputnikV with SARS-CoV-2 spike protein antibodies > 1.5 AU/mL compared to 47.6% and 25% in individuals receiving Sinopharm and SinoVac, respectively. Also, 36.04% of the Sputnik-administered individuals depicted antibody levels > 250 AU/mL. Of the participants, 55% had a previous history of COVID-19. Also, 14.86%, 4.76%, and 0% of the SputnikV, Sinopharm, and SinoVac administered subjects showed antibodies > 100 AU/mL, respectively, while > 25 AU/mL antibodies were found in 10.70% of SputnikV, 19.04% of Sinopharm and 10.71% of SinoVac administered individuals. Moreover, > 1.5-2.5 AU/mL antibodies levels were found in 25.10%, 23.80%, and 14.28% of participants with SputnikV, Sinopharm, and SinoVac administered vaccines, respectively. The antibody titers of < 1.5 AU/mL were detected among 13.30%, 52.38%, and 46.42% of subjects administered with SputnikV, Sinopharm, and SinoVac vaccines, respectively. Conclusions: Even before administrating the second booster dose of SputnikV, a significantly higher number of patients depicted rapid ramp-up of SARS-CoV-2 specific spike antibodies, which can significantly contribute to rapid mass-immunization. Despite all challenges, persistent antibody plateau monitoring is critical to attaining humoral immunity against SARS-CoV-2 infections. © 2022, Author(s).
ABSTRACT
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) preferentially infects respiratory tract cells, but it has organotropism. Middle East respiratory syndrome coronavirus (MERS-CoV) is significantly distinct from common cold and SARS coronavirus. In past few years, the SARS-CoV-2 and MERS-CoV caused several deaths in South Korea. The aim of current study was to assess SARS-CoV-2 and MERS-CoV awareness and epidemic prevention ability in South Koreans.According to our results, out of 1500 participants, 98.8% and 64.3% were aware of SARS-CoV-2 and MERS-CoV, respectively. Moreover, 97% of the participants used masks for prevention of airborne diseases, while 65.3% of the participants reused the same mask for several days. In addition, 50% of the participants were not satisfied with the government support. Future viral epidemics can be prevented by disseminating advanced knowledge and awareness among general public.