Intergenerational trauma: A silent contributor to mental health deterioration in Afghanistan.

Multiple theories, including family systems, epigenetics, attachments, and many others, have proposed mechanisms for trauma transmission from generation to generation. Intergenerational trauma is today one of the most important psychosocial issues affecting Afghans' mental health and psychology, with the potential to affect subsequent generations. A variety of factors have impacted the mental health of the Afghan population over the years, including years of conflict, socioeconomic instability, natural disasters, chronic drought conditions, economic turmoil, and food insecurity, all of which have been exacerbated by recent political turbulence and the The Coronavirus pandemic COVID-19 pandemic that has further increased the susceptibility to intergenerational trauma among the Afghan population. International bodies must play a role in addressing intergenerational trauma among Afghans. Breaking the chain in future generations will be possible by resolving political issues, providing adequate health facilities, financial support, and eliminating stigmas associated with mental health issues.

The rise of diarrheal illnesses in the children of Pakistan amidst COVID-19: A narrative review.

Background: In Pakistan, 74 children out of 1000 lose their lives annually due to diarrheal illness. This commentary addresses the contributing factors aggravating this growing dilemma and the effect of a simultaneous rise in COVID-19 cases in a healthcare system ready to collapse, along with providing recommendations to alleviate the problems causing this spike in diarrheal cases. Methods: This narrative review has emphasized the causes of the spike in pediatric diarrheal illnesses in Pakistan as well as recommendations offered to lessen the burden by incorporating recent literature (n = 68). Tactics to tackle COVID-19 alongside diarrheal illnesses were also included. Pakistan was chosen to be assessed due to its high burden of child and infant mortality due to preventable causes. Results: The provision of safe drinking water, the proper use of Integrated Management of Newborn and Childhood Illnesses (IMNCI), adequate awareness of the benefits of breastfeeding, the use of correct rehydration techniques such as Oral Rehydration Therapy, and the crucial implementation of the EPI vaccination schedule can curb this increase in diarrheal cases. Conclusion: The increased prevalence of diarrheal diseases amongst the pediatric population of Pakistan can be attributed largely due to unsanitary drinking water. Emphasis must be put in the provision of safe drinking water. During the first years of life, children can be kept safe from deadly pathogens just by adequate breastfeeding. IMNCI and EPI must also be properly implemented.

COVID-19 vaccine hesitancy in conflict zones: A review of current literature.

Background: Vaccine hesitancy (VH) is prevalent in conflict zones due to a lack of essential resources and knowledge, thereby escalating the coronavirus disease of 2019 (COVID-19) cases in these territories. This has resulted in a higher incidence of cases from exposure to a single COVID-19 positive case and further burdens the health care system of conflict zones which are already on the brink of collapsing. Aim: This narrative review aims to determine VH to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine in five conflict zones that include Somalia, Yemen, Palestine, Syria, and Afghanistan. Methodology: A Boolean search was carried out in MEDLINE-PubMed from inception till 6 June 2022. The search was performed by using the following keywords: "(SARS-CoV-2 OR covid OR covid 19) AND (vaccine hesitancy OR covid vaccine acceptance OR intention to vaccinate) AND (Syria OR Yemen OR Palestine OR Afghanistan OR Somalia"). The full text of all relevant articles in English along with their supplementary material was extracted. Results: All the included studies reported at least 30% or more increase in vaccine hesitancy among conflict settings. VH was mostly due to a lack of available resources, lack of appropriate knowledge, and believing misleading rumors about the vaccine. Discussion: Considering the massive amount of reluctance among people residing in conflict zones, the need to take effective measures against VH is undoubtedly apparent. This can be accomplished by carrying out mass vaccinations by the governments and proper health education through raising the public awareness regarding vaccines, thereby eliminating rumors that exacerbate the fear of adverse effects. Conclusion: The approach described in this article to combat VH can be implemented to increase vaccination rates and significantly alleviate R0 across the globe.

The impact of COVID-19 followed by extreme flooding on vector borne diseases in Pakistan: A mini narrative review.

While the Coronavirus pandemic continues to spread havoc across the world, countries like Pakistan are faced with another challenge: the steady rise of vector borne diseases alongside a spike in COVID-19 cases. Moreover, signs and clinical manifestations of multiple arbovirus infections mimic those experienced in COVID-19, causing further complications in management and diagnosis. Without urgent adequate management and testing equipment, the recent surge of COVID-19 along with the steady rise in Vector Borne Diseases (VBDs) could collapse the exhausted Pakistani healthcare system. This article explores the impact of COVID-19 on the management, diagnosis, and treatment of the common arbovirus infections of Pakistan, including dengue (DENV), malaria, chikungunya (CHIKV), and other foreign infections that are on a hazardous rise.

The impact of violence on healthcare workers' mental health in conflict based settings amidst COVID-19 pandemic, and potential interventions: A narrative review.

Healthcare workers (HCWs) have faced an increased amount of mental health struggles amidst the COVID-19 pandemic. However, those in conflict-based settings with fragile healthcare systems meet additional challenges. This study reviews violence, conflict and mental health among HCWs in five countries: Syria, Palestine, Yemen, Afghanistan and Lebanon. Our study reports that HCWs are targeted by violence, bombings, mistreatment and different forms of abuse, including verbal and physical. With the additional burdens of the pandemic including prolonged working hours, limited resources and insufficient humanitarian aid, the healthcare workers fall victim to increased levels of burnout and mental illnesses. The situation leads to dire consequences on their personal lives and professional development, compelling them to quit their job or country all together. Although healthcare workers remain resilient in these conflict-based settings, immediate interventions are required to prevent violence against them and cater to their rapidly declining mental health.

Food Insecurity during COVID-19 in Yemen.

The United Nations has declared Yemen as the world's worst humanitarian crisis with 21 million people in need of humanitarian assistance. Due to the convergence of severe economic instability exacerbated by the COVID-19 pandemic, stifling war, and spiking food prices, the Yemeni people are at the brink of famine with women and children especially malnourished. Desperate to feed their families, civilians are forced to resort to begging, participate in child marriages, or plunge into debt. An inflated currency has significantly diminished the purchasing power of the Yemeni population, and COVID-19 restrictions have made acquisition of food and essential commodity imports arduous. Immediate action by global and local governments is essential to prevent the deaths of thousands of people in the wake of severe food scarcity.

MDR-TB in Pakistan: Challenges, efforts, and recommendations.

Tuberculosis (TB), a global health concern is also a leading cause of mortality and morbidity across Pakistan affecting a major proportion of the population. The absence of an integrated system to control the spread of TB has led to a rise in multidrug resistant strains of TB (MDR-Tb) which do not exhibit any sensitivity towards the first line therapy for TB. Such adverse circumstances call for effective planning strategies to mitigate the health hazards of MDR-TB. This article briefly highlights the challenges encountered by the already burdened healthcare system and suggests relatively inexpensive approaches to tackle the ongoing crisis associated with MDR-TB on a national scale.