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2.
PLoS One ; 17(5): e0267376, 2022.
Article in English | MEDLINE | ID: covidwho-1855016

ABSTRACT

OBJECTIVE: To explore perceived barriers associated with facemask adherence to prevent spread of COVID-19 spread in Pakistani population. METHODOLOGY: A cross sectional study was conducted from 25-July 2020 to 5-August 2020. Participants of both genders of age >17 years, currently residing in Pakistan, who had access to internet and understood English were included in the survey. The survey was designed on Google form and was distributed digitally across different areas of Pakistan via social media. Survey included questions regarding socio-demographics, facemask adherence and perceived barriers related to facemask adherence such as perceived risks, health concerns, comfort, social influences, religious/cultural norms and social protocols and health recommendations. SPSS version 23 was used to analyze data. Independent t-test/One-way ANOVA was applied to assess significant difference between perceived barriers to wear face mask and socio-demographic factors, p-value ≤0.05 was taken as statistically significant. Post-hoc LSD test was also applied where applicable. RESULTS: Only 20% of the participants reported non-adherence to facemask. Amongst these participants, majority agreed that comfort was the main barrier precluding them from wearing a mask, 89.4% subjects saying that it was too hot to wear it and 84.1% saying that a mask was too uncomfortable to wear. Whereas, 82.1% highly agreed that difficulty in breathing is perceived barrier related to facemask usage. Statistically significant difference was found between health concerns with gender (p = 0.031), locality (p = 0.001) and religion (p = 0.03); comfort with locality (p = 0.007); social influences with gender (p = 0.001), ethnicity (p = 0.001) and locality (p = 0.017); cultural/religious norms with religion (p = 0.001) and social protocols and health recommendations with age (p = 0.015). CONCLUSION: Despite of satisfactory facemask adherence, still there are perceived barriers to it. In order to increase utilization of face masks among the general population, strict health policies should be implemented and awareness regarding the importance of face masks should be enhanced by educational interventions.


Subject(s)
COVID-19 , Masks , Adolescent , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Female , Humans , Male , Pakistan/epidemiology , Pandemics/prevention & control
3.
J Ayub Med Coll Abbottabad ; 34(2): 304-308, 2022.
Article in English | MEDLINE | ID: covidwho-1848215

ABSTRACT

BACKGROUND: As a result of the SARS-CoV-2 related government lockdown, academic institutions in Pakistan, including medical and dental colleges and universities, had to forgo on-site classes and make an emergency shift to online teaching. This study explores the perspective of the faculty, as a key stakeholder, on ways to increase the effectiveness of online teaching and learning at these medical and dental colleges and universities. METHODS: A descriptive cross-sectional qualitative survey was conducted in April-July 2020 in 32 medical and dental colleges of Pakistan. The sample size was not pre-determined and the participants included teaching faculty of both clinical and basic sciences. Data were iteratively collected and analyzed till data and time saturation were achieved. Thematic analysis of data was done by running two coding cycles. All authors ensured analytical triangulation by analyzing the data independently before developing consensus on the subthemes and themes. RESULTS: One hundred and thirty-two medical teachers responded. Data analysis revealed three themes regarding suggestions to improve teaching methods improve assessment and increase the effectiveness of online teaching and learning. The participants suggested supplementing real-time classes with recorded lectures, providing broadband internet services, using assignment-based and active learning strategies, continuous formative assessment, faculty training, and standardization of online teaching by higher authorities. CONCLUSIONS: The current study offers actionable steps to decision makers at medical colleges and universities to make online teaching and learning more efficient and valuable, based on the suggestions from their faculty.


Subject(s)
COVID-19 , Education, Distance , Education, Medical , Faculty, Medical , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control , Cross-Sectional Studies , Education, Medical/methods , Faculty, Medical/psychology , Humans , Pakistan/epidemiology , Qualitative Research
4.
BMC Health Serv Res ; 22(1): 656, 2022 May 16.
Article in English | MEDLINE | ID: covidwho-1846837

ABSTRACT

BACKGROUND: This study aimed to document the evolution of perceptions of frontline healthcare workers (FHCW) regarding their well-being and the quality of health systems' response to the COVID-19 pandemic over four months in Pakistan. METHODS: We conducted this prospective longitudinal qualitative study during the four months (June-September 2020) coinciding with the peak and trough of the first wave of Pakistan's COVID-19 pandemic. We approached frontline healthcare workers (physicians and nurses) working in emergency departments (ED) in two hospitals using the WhatsApp group of the Pakistan Society of Emergency Physicians (PSEM). Participants were asked to self-record their perception of their wellness and their level of satisfaction with the quality of their hospitals' response to the pandemic. We transcribed, translated, and analysed manually using MAXQDA 2020 software and conducted the thematic analysis to identify themes and sub-themes. RESULTS: We invited approximately 200 FHCWs associated with PSEM to participate in the study. Of the 61 who agreed to participate, 27 completed the study. A total of 149 audio recordings were received and transcribed. Three themes and eight sub-themes have emerged from the data. The themes were individual-level challenges, health system-level challenges, and hope for the future. Sub-themes for individual-level challenges were: fear of getting or transmitting infection, feeling demotivated and unappreciated, disappointment due to people's lack of compliance with COVID-19 protocols, physical exhaustion, and fatigue. For the healthcare system, sub-themes were: Infrastructure, logistics, management, and communications response of the hospital/healthcare system and financial stressors. For sub-themes under hope for the future were the improved disease knowledge and vaccine development. The overall perceptions and experiences of FHCWs evolved from fear, grief, and negativity to hope and positivity as the curve of COVID-19 went down. CONCLUSION: This study shows that the individuals and systems were not prepared to deal with the challenges of the COVID-19 pandemic. The findings highlight the challenges faced by individuals and health systems during the wake of the Covid-19 pandemic. The healthcare workers were emotionally and physically taxed, while the health systems were overwhelmed by COVID-19. The overall perceptions of FHCWs evolved with time and became negative to positive as the curve of COVID-19 went down during the first wave of COVID-19 in Pakistan.


Subject(s)
COVID-19 , Health Personnel/psychology , SARS-CoV-2 , COVID-19/epidemiology , COVID-19/psychology , Humans , Longitudinal Studies , Nurses/psychology , Pakistan/epidemiology , Pandemics , Physicians/psychology , Prospective Studies , Qualitative Research
5.
East Mediterr Health J ; 28(4): 258-265, 2022 Apr 28.
Article in English | MEDLINE | ID: covidwho-1836430

ABSTRACT

Background: COVID-19 is having many impacts on health, economy and social life; some due to the indirect effects of closure of health facilities to curb the spread. Closures were implemented in Pakistan from March 2020, affecting provision of reproductive, maternal, newborn and child health (RMNCH) services. Aims: To appraise the effects of containment and lockdown policies on RMNCH service utilization in order to develop an early response to avoid the catastrophic impact of COVID-19 on RMNCH in Pakistan. Methods: Routine monitoring data were analysed for indicators utilization of RMNCH care. The analysis was based on Period 1 (January-May 2020, first wave of COVID-19); Period 2 (June-September 2020, declining number of cases of COVID-19); and Period 3 (October-December 2020, second wave of COVID-19). We also compared data from May and December 2020 with corresponding months in 2019, to ascertain whether changes were due to COVID-19. Results: Reduced utilization was noted for all RMNCH indicators during Periods 1 and 3. There was a greater decline in service utilization during the first wave, and the highest reduction (~82%) was among children aged < 5 years, who were treated for pneumonia. The number of caesarean sections dropped by 57%, followed by institutional deliveries and first postnatal visit (37% each). Service utilization increased from June to September, but the second wave of COVID-19 led to another decrease. Conclusion: To reinstate routine services, priority actions and key areas include continued provision of family planning services along with uninterrupted immunization campaigns and routine maternal and child services.


Subject(s)
COVID-19 , Child Health Services , Maternal Health Services , Reproductive Health Services , COVID-19/epidemiology , Child , Child Health , Communicable Disease Control , Female , Humans , Infant, Newborn , Maternal Health , Pakistan/epidemiology , Pandemics , Pregnancy
6.
J Ayub Med Coll Abbottabad ; 33(Suppl 1)(4): S778-S787, 2021.
Article in English | MEDLINE | ID: covidwho-1824266

ABSTRACT

BACKGROUND: Health care workers (HCWs) working on frontlines in COVID-19 pandemic are highly vulnerable to deteriorating physical and mental health. The quality of life of health care workers plays an important role in their skilful delivery of work. Our study assesses their quality of life (QOL) during COVID-19 pandemic so that appropriate measures can be taken to improve their well-being. METHODS: This was an online crosssectional survey among healthcare workers of COVID-19 designated government hospitals in districts Abbottabad, Manshera and Haripur, Khyber Pakhtunkhwa, Pakistan from 23rdJune till 25thJuly, 2020. QOL was assessed using validated WHO QOL BREF. Univariate and multivariate linear regression were used to assess the factors associated with QOL among HCWs. RESULTS: A total of 362 HCWs participated in the study. The mean scores of physical, psychological, social relationships, environmental domains were 60.7 (±17.40), 59.70 (±17.30), 67.90 (±17.90), and 58.20 (±18.40) respectively. Hospital where the respondents were working was the consistent predictor of QOL scores in all four domains with generally lower scores associated with other hospitals compared to Ayub Medical Hospital. Years of experience were positively associated with psychological, social relationship and environmental domains. Designation was associated with social relationship domain only. The scores were lower for trainee medical officers (adjusted ß - 11.5) and higher for house officer (adjusted ß 10.0) and nurses and technicians (adjusted ß 7.0) compared to heads of departments and specialists. CONCLUSION: Quality of life of health care workers has been affected negatively in hospitals of Abbottabad, Pakistan during COVID-19. This calls for hospital administrations, policymakers and the government to take necessary actions to protect the wellbeing of the backbone of the healthcare system.


Subject(s)
COVID-19 , Quality of Life , Health Personnel , Humans , Pakistan/epidemiology , Pandemics , SARS-CoV-2
7.
Mikrobiyol Bul ; 56(2): 357-364, 2022 Apr.
Article in Turkish | MEDLINE | ID: covidwho-1818596

ABSTRACT

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection emerged in China at the end of 2019 and caused coronavirus disease 2019 (COVID-19). The lymphopenia seen in COVID-19 increases the incidence of susceptibility to other microorganisms and may cause co-infections. As the signs and symptoms of the diseases overlap with other infectious diseases and due to the intensity in health services, the diagnosis of co-infections becomes difficult and the treatment may be delayed. Therefore, infections accompanying COVID-19 cause an increase in morbidity and mortality.The isolation and quarantine measures taken during the COVID-19 process have reduced the number of infections transmitted from person to person. However, there was no significant decrease in diseases transmitted by food, such as salmonellosis. During the pandemic, salmonellosis continued to be a problem, especially in endemic areas such as Pakistan, and an increase in Salmonella infections associated with backyard poultry has been reported in countries such as the United States. A co-infection of COVID-19 and enteric fever associated with travel to Pakistan was reported for the first time in the literature in February 2021. In this case report, the first co-infection of COVID-19 and Salmonella in our country was presented. A 56-yearold male patient with no known systemic disease was admitted to the hospital with fever, shortness of breath, weakness and myalgia lasting for three days. SARS-CoV-2 polymerase chain reaction test was positive. The patient has been hospitalized and favipiravir, moxifloxacin, and methylprednisolone were started. Blood cultures were taken from the patient whose clinical picture worsened and fever continued despite of the medical treatment. Salmonella enterica spp. enterica was isolated and ceftriaxone treatment was started. The patient's anamnesis was deepened, but no diarrhea, abdominal pain, suspicious food consumption, travel history were determined. From the second day of the ceftriaxone treatment, the patient's fever decreased and no growth was detected in the control blood cultures. Ceftriaxone treatment was completed in 14 days and the patient was discharged on the 28th day. Approximately 87-95% of Salmonella strains isolated in our country are S.enterica spp. enterica, and S.enterica spp. enterica was also isolated in our case. Salmonella infections most commonly present as gastroenteritis, but the risk of bacteremia increases in case of immunosuppression. Although there was no additional disease in our case, it was considered that the infection in the form of bacteremia occurred due to an immunosuppression caused by COVID-19. In this context; drawing blood cultures of patients hospitalized with the diagnosis of COVID-19 is very important in terms of detecting co-infections and superinfections, and administering appropriate antibiotic therapy at appropriate treatment times. Presentation of first case of Salmonella bacteremia and simultaneous COVID-19 infection in our country was the strong side of our report. In addition, our case is also important as being the first SARS-CoV-2 and Salmonella co-infection unrelated to Pakistan in the literature. The limitation of our case was that S.enterica spp. enterica detected in the blood culture could not be subtyped and the stool culture could not be examined. However, this does not constitute a diagnostic requirement. In addition, the patient's pre-COVID-19 Salmonella carrier status was also unknown. As a result, patients become vulnerable to other infections due to the lymphopenia seen in COVID-19. Therefore, Salmonella bacteremia can be seen with SARS-CoV-2 infection without a comorbid condition. Drawing blood cultures in hospitalized patients with the diagnosis of COVID-19 is very important in terms of detecting concomitant infections in a short time. In patients whose clinical condition does not improve and fever continues despite of treatment, blood cultures should be taken, especially in the case of an advanced immunosuppresive treatment plan, and it should always be kept in mind that secondary infections and co-infections may occur.


Subject(s)
Bacteremia , COVID-19 , Coinfection , Lymphopenia , Salmonella Infections , Salmonella enterica , Bacteremia/drug therapy , Ceftriaxone/therapeutic use , Coinfection/drug therapy , Coinfection/epidemiology , Humans , Lymphopenia/drug therapy , Male , Middle Aged , Pakistan/epidemiology , SARS-CoV-2 , Salmonella Infections/diagnosis , Salmonella Infections/drug therapy , Salmonella Infections/epidemiology
8.
PLoS One ; 17(4): e0266277, 2022.
Article in English | MEDLINE | ID: covidwho-1817482

ABSTRACT

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.


Subject(s)
COVID-19 , Influenza A Virus, H1N1 Subtype , Influenza, Human , COVID-19/epidemiology , Humans , Incidence , Influenza, Human/epidemiology , Male , Middle Aged , Pakistan/epidemiology , Pandemics , Retrospective Studies
9.
J Ayub Med Coll Abbottabad ; 34(1): 101-107, 2022.
Article in English | MEDLINE | ID: covidwho-1812232

ABSTRACT

BACKGROUND: Medical and dental students are the future of health workforce and a potential volunteer pool in the COVID-19 crises. This study aimed to assess the level and gender differences in the awareness, attitude and behaviours of medical and dentals students about COVID-19 in Pakistan. METHODS: An online cross-sectional survey was conducted among medical and dental undergraduate students in Khyber Pakhtunkhwa province. Data was collected using a structured questionnaire having four sections: socio-demographics, knowledge, attitude and practices. RESULTS: A total of 1770 medical and dental students participated and completed the questionnaire. About 1239 (70%) of the respondents were female and 1526 (87%) were MBBS students. We found that 1685 (95%) of the students had adequate knowledge. Majority, 1565 (89%) of the students was concerned about COVID-19 and 1480 (84%) believed that disease will ultimately be controlled. Only about 1129 (64%) of the participants in our study had adequate practices. Male gender was associated with higher risk of inadequate practices. CONCLUSIONS: There were good knowledge and attitudes about COVID-19 among medical and dental students. However, one third of the participants did not have adequate practices and female had better practices than male students. This gap in the knowledge and practice calls for urgent interventions to improve practices.


Subject(s)
COVID-19 , Students, Medical , COVID-19/epidemiology , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Pakistan/epidemiology , SARS-CoV-2 , Sex Factors , Students, Dental , Surveys and Questionnaires
10.
PLoS One ; 17(4): e0267139, 2022.
Article in English | MEDLINE | ID: covidwho-1799047

ABSTRACT

PURPOSE: COVID-19 infection resulting from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began to spread across the globe in early 2020. Patients with hematologic malignancies are supposed to have an increased risk of mortality from coronavirus disease of 2019 (COVID-19) infection. From Pakistan, we report the analysis of the outcome and interaction between patient demographics and tumor subtype and COVID-19 infection and hematological malignancy. PATIENTS AND METHODS: This multicenter, retrospective study included adult patients with a history of histologically proven hematological malignancies who were tested positive for COVID-19 via PCR presented at the oncology department of 5 tertiary care hospitals in Pakistan from February to August 2020. A patient with any known hematological malignancy who was positive for COVID-19 on RT-PCR, was included in the study. Chi-square test and Cox-regression hazard regression model was applied considering p ≤ 0.05 significant. RESULTS: A total of 107 patients with hematological malignancies were diagnosed with COVID-19, out of which 82 (76.64%) were alive, and 25 (23.36%) were dead. The significant hematological malignancy was B-cell Lymphoma in dead 4 (16.00%) and alive group 21 (25.61%), respectively. The majority of the patients in both the dead and alive group were on active treatment for hematological malignancy while they came positive for COVID-19 [21 (84.00%) & 48 (58.54%) p 0.020]. All patients in the dead group were admitted to the hospital 25 (100.00%), and among these, 14 (56.00%) were admitted in ICU with a median 11 (6-16.5) number of days. Among those who had contact exposure, the hazard of survival or death in patients with hematological malignancies and COVID-19 positive was 2.18 (CI: 1.90-4.44) times and 3.10 (CI: 2.73-4.60) times in patients with travel history compared to no exposure history (p 0.001). CONCLUSION: Taken together, this data supports the emerging consensus that patients with hematologic malignancies experience significant morbidity and mortality resulting from COVID-19 infection.


Subject(s)
COVID-19 , Hematologic Neoplasms , Adult , Hematologic Neoplasms/therapy , Humans , Pakistan/epidemiology , Retrospective Studies , SARS-CoV-2
11.
Front Public Health ; 10: 768812, 2022.
Article in English | MEDLINE | ID: covidwho-1792884

ABSTRACT

Aim: This study explored the Coronavirus Disease 2019 (COVID-19) pandemic effects on overseas Pakistani's residing in various parts of the world, particularly in China, Saudi Arabia (SA), and the United Kingdom (UK). Methods: This cross-sectional study was completed between November 2020 and April 2021. An online questionnaire was designed and circulated via various social media mediums to overseas Pakistani communities. The obtained data were statistically analyzed through SPSS version 19 for windows. P < 0.05 was considered statistically significant. Results: A total of 542 overseas Pakistani participated in the current study. In total, 157 (29%) were females and 385 (71%) males. There were 174 (32.1%), 142 (26.45%), 117 (21.6%), and 109 (19.85%) participants from the UK, SA, China, and other countries respectively. Some participants, or their family members, 93 (17.2%), got infected with the COVID-19. About one-third, 165 (30.4%), of the respondents were afraid that their company would violate their contracts or lose their jobs or be paid less. The majority, 469 (86.5%), believed that the lockdown is increasing their psychological stress. More than half of the participants, 314 (57.9%), stated that the Pakistani embassy did not facilitate them in their country of stay. About one-third, 194 (35.8%), of the respondents faced visa-related issues. More than one-third of respondents, 221 (40.8%), faced health issues due to lack of physical activities during the lockdown. Males were afraid that their company would violate their contract, lose jobs, or be paid less than females (p < 0.001). Both genders had psychological stress and health issues because of the pandemic. The participants from SA faced more visa-related issues, and they were less satisfied with the efforts of the Pakistani embassy to facilitate them compared to the UK and China participants (p = 0.013). Conclusion: Our data indicate that the COVID-19 pandemic impacted Pakistanis living in the UK, SA, China, and other parts of the world. They had health-related issues, visa problems and dissatisfaction with Pakistani embassy facilitations. Pakistanis living abroad require government assistance to resolve their issues.


Subject(s)
COVID-19 , COVID-19/epidemiology , China , Communicable Disease Control , Cross-Sectional Studies , Female , Humans , Male , Pakistan/epidemiology , Pandemics , SARS-CoV-2 , Saudi Arabia/epidemiology
12.
PLoS One ; 17(3): e0264534, 2022.
Article in English | MEDLINE | ID: covidwho-1793513

ABSTRACT

The lessening of food wastage, specifically among nations where about half of its worldwide quantity is produced, has turned to be a mammoth challenge for environmental, social and economic sustainability, and represents one of the seventeen Sustainable Development Goals (SDG) within the Agenda 2030. The quantity of food being thrown away in spite of being in an edible condition has become alarming in middle and high income countries. The COVID-19 lockdown strategy, both at local and international levels, has expressively altered work, life and food consumption behaviors globally, directing to food wastage as a multi sectoral issue. Pakistan has no exception to such manifestations. The main objective of this study is to analyze the perceptions of rural people of Pakistan regarding food wastage during the COVID-19 pandemic. To evaluate whether behavior about food wastage among rural households varied or not during the pandemic, a descriptive survey was carried out using a self-administered questionnaire and 963 responses were selected for further empirical investigations. The findings of the study reveal that food waste actually decreased in spite of an increased amount of purchased food during the lockdown. Our results highlight that the effect of the pandemic has led to reduction in food wastage among rural respondents, an increased consciousness for the morals of food waste, and awareness of environmental impacts of food wastage. The conclusions of this study highlight that rural consumers of Pakistan are emerging with a new level of responsiveness about food wastage with possible positive impact on the environment in terms of decreased greenhouse gas (GHG) emission and other pollutants. The study findings imply that this pandemic time provides a suitable window to raise awareness about food wastage among rural as well as urban households while contemplating effective strategies to overcome the issue of food wastage in the country.


Subject(s)
COVID-19/epidemiology , Communicable Disease Control , Consumer Behavior , Food Security , Refuse Disposal , Adult , Consumer Behavior/statistics & numerical data , Female , Food/statistics & numerical data , Food Security/statistics & numerical data , Food Supply/statistics & numerical data , History, 21st Century , Humans , Male , Pakistan/epidemiology , Pandemics , Perception/physiology , Refuse Disposal/statistics & numerical data , Rural Population/statistics & numerical data , Surveys and Questionnaires
13.
BMJ Open ; 12(4): e055381, 2022 04 06.
Article in English | MEDLINE | ID: covidwho-1779374

ABSTRACT

OBJECTIVES: This study adapted WHO's 'Unity Study' protocol to estimate the population prevalence of antibodies to SARS CoV-2 and risk factors for developing SARS-CoV-2 infection. DESIGN: This population-based, age-stratified cross-sectional study was conducted at the level of households (HH). PARTICIPANTS: All ages and genders were eligible for the study (exclusion criteria: contraindications to venipuncture- however, no such case was encountered). 4998 HH out of 6599 consented (1 individual per HH). The proportion of male and female study participants was similar. PRIMARY AND SECONDARY OUTCOME MEASURES: Following were the measured outcome measures- these were different from the planned indicators (i.e. two out of the three planned indicators were measured) due to operational reasons and time constraints: -Primary indicators: Seroprevalence (population and age specific).Secondary indicators: Population groups most at risk for SARS-CoV-2-infection. RESULTS: Overall seroprevalence of SARS-CoV-2 antibodies was 7.1%. 6.3% of individuals were IgG positive while IgM positivity was 1.9%. Seroprevalence in districts ranged from 0% (Ghotki) to 17% (Gilgit). The seroprevalence among different age groups ranged from 3.9% (0-9 years) to 10.1% (40-59 years). There were no significant differences in the overall seroprevalence for males and females. A history of contact with a confirmed COVID-19 case, urban residence and mask use were key risk factors for developing SARS-CoV-2 infection. CONCLUSIONS: This survey provides useful estimates for seroprevalence in the general population and information on risk factors for developing SARS-CoV-2 infection in the country. It is premised that similar studies need to be replicated at the population level on a regular basis to monitor the disease and immunity patterns related to COVID-19.


Subject(s)
COVID-19 , Antibodies, Viral , COVID-19/epidemiology , Child, Preschool , Cross-Sectional Studies , Female , Humans , Male , Pakistan/epidemiology , SARS-CoV-2 , Seroepidemiologic Studies
14.
Telemed J E Health ; 28(2): 227-232, 2022 02.
Article in English | MEDLINE | ID: covidwho-1778873

ABSTRACT

Introduction: Coronavirus disease 2019 (COVID-19) struck Pakistan with a magnitude that required micro- and macro-level adjustments at national and provincial levels. Access to medical consultation became a challenge; hospitals were flooded with cases beyond their capacity and transport was halted due to lockdown. Global Health Directorate of The Indus Health Network supported the provincial government by rolling out several walk-in community-based testing initiatives across Karachi. Results were conveyed to the patients through each district government. With a disproportionate rise in cases, an increasing delay in reporting results was observed. Methods: To help the district government bridge this gap, two physicians were engaged to convey timely results to patients who tested positive, through a helpline. Subsequently, proactive teleconsultation was initiated. We present a retrospective review of data collected during teleconsultation for COVID-19 cases identified through community-based testing between April 5 and June 10, 2020. Results: A total of 4,279 tests were conducted, revealing a 28% positivity rate (1,196 cases). Out of these, 752 (62.9%) baseline positive patients were contactable. Most patients identified either a close contact (46.8%) or a household contact (30.1%) as the source of infection. 41.8% patients were asymptomatic, 52.9% had mild to moderate illness, and 1.1% needed referral to the emergency department. 82.7% patients reported no comorbidities. Conclusion: The rapid surge of cases could not be handled by a small team and an institutional strategy of integration into an existing call center service was adopted. We share our insights to help develop evidence-based policies to effectively tackle current or future threats in similar settings.


Subject(s)
COVID-19 , Remote Consultation , Communicable Disease Control , Humans , Pakistan/epidemiology , Pandemics , Retrospective Studies , SARS-CoV-2
15.
Cancer Invest ; 40(5): 401-405, 2022 May.
Article in English | MEDLINE | ID: covidwho-1778718

ABSTRACT

The study is to evaluate the impact of COVID-19 in the Pediatric Oncology Units (POUs) of Pakistan. Data from 1 April 2019 to 30 June 2019 and 1 April 2020 to 30 June 2020 for the first and second cohort, respectively, in order to compare the registration, abandonment rate, and delay in treatment. Six hundred and thirty-four were registered cases, 379 and 255 in the first and second cohort, respectively, which was significantly different <0.005. Seventy-seven were abandoned, 45 and 32 in the first and second cohort, respectively. Fifty-nine COVID-19 positive cases, 24, 4, 27, and 4 were admitted, referred, home isolated, and leave against medical advice (LAMA), respectively. Delayed treatment and reduction in new cases were observed.


Subject(s)
COVID-19 , Neoplasms , Child , Hospitalization , Humans , Neoplasms/epidemiology , Neoplasms/therapy , Pakistan/epidemiology , SARS-CoV-2
16.
Front Public Health ; 9: 731272, 2021.
Article in English | MEDLINE | ID: covidwho-1775862

ABSTRACT

Background: Loose bowels is a clinical sign of gastrointestinal transport channel proteins, channels, and physical and chemical boundaries being harmed, prompting issues of water and electrolyte transport in the intestinal system. It is still considered as a major reason for emergency visits to hospitals in low-middle income countries. Zinc is a suitable treatment along with ORS for diarrhea. KAP surveys are usually conducted to collect information about general or specific topics of a particular population. The objective of this study was to investigate the knowledge, attitude, practices (KAP), and one health perspective regarding diarrhea among the participants from urban and rural populations of Rawalpindi and Islamabad, Pakistan. Methods: Data was collected by conducting a survey among residents of twin cities over a period of 6 months (from July 2020 to December 2020). The questionnaire compromised socio-demographic features and the degree of KAP with respect to diarrhea management and control. One way ANOVA tests were applied to observe the demographic relationship and various factors influencing knowledge, attitude, practices, and one health perspective about diarrhea. Results: A total of 338 subjects participated in the study. Female subjects were in the majority with 63% while the rest were male. A majority of the participants were between 15-25 years of age and 79.6% participants were un-married. The leading ethnic group was Punjabi with 52.7%; the lowest ethnic group were of Sindhi ethnicity with 8.6%. Age has a significant association with respect to knowledge and attitude. Religion has a significant association with respect to knowledge, practices, and one health, while education/qualification has an association with knowledge. The rest of the variables found no association with each other. Conclusion: It is concluded from the recent study that most residents of the twin cities of Pakistan knew about diarrhea and had a good attitude and practices toward it. Age, religion, and education have different roles regarding different diseases in the population of Pakistan. The current study has its limitations as well. Parts of the study were conducted in the capital of Pakistan which is more developed as compared to other areas of Pakistan. It would be better to explore the remote areas of Pakistan where basic amenities of life such as education, wealth, and unemployment are not available. It is important to create more awareness among community members. They should be aware how dangerous these viruses and bacteria can be. Other parts of Pakistan should also be explored for better understanding that will help in making a nationwide health policy.


Subject(s)
One Health , Aged , Cross-Sectional Studies , Diarrhea , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Pakistan/epidemiology
17.
J Pak Med Assoc ; 72(4): 795, 2022 04.
Article in English | MEDLINE | ID: covidwho-1776912
18.
Front Public Health ; 9: 669278, 2021.
Article in English | MEDLINE | ID: covidwho-1771103

ABSTRACT

Brucellosis is a neglected zoonotic disease of ruminants. It causes severe health problems in humans and significant economic loss. Only a limited number of studies have been conducted in Pakistan to determine the prevalence of human brucellosis and related risk factors. The objectives of the current cross-sectional study were to determine the prevalence of anti-Brucella antibodies in sera collected from symptomatic patients at three hospitals of Abbottabad using a commercial slide agglutination test (SAT) and to determine risk factors for brucellosis for these patients. Five hundred blood samples were collected. A questionnaire was filled in for each patient to obtain information on age, gender, living area, brucellosis associated symptoms, associated risk factors, pregnancy and abortion history. A total of 13.6% (n = 68) patients were found to be SAT positive and in 83.3% (n = 57) of these samples Brucella DNA was detected by genus specific RT-PCR for BCSP-31 gene. Statistical analysis was performed to determine odd ratios, risk ratios, 95% confidence intervals, and p-values. The prevalence of brucellosis by SAT was reported to be higher in women (14.6%, n = 44) than in men (12.1%, n = 24). The age group 25-50 years was found to be at higher risk for brucellosis (14.5%, n = 50) "animal contact" was reported as the main risk factor followed by "consumption of raw animal products." Out of 131 pregnant women and 21 patients had abortion, the seropositivity of Brucellosis was 9.9% and 23.8%, respectively. The present study reports a striking prevalence of brucellosis among patients including pregnant women at three hospitals of Abbottabad. These findings may foster strategies for controlling human brucellosis at household level, raising of awareness about brucellosis in hospital and family doctors, and finally in setting up an eradication program in the dairy industry.


Subject(s)
Brucellosis , Animals , Brucellosis/diagnosis , Brucellosis/epidemiology , Cross-Sectional Studies , Female , Hospitals , Humans , Pakistan/epidemiology , Pregnancy , Risk Factors
20.
PLoS One ; 17(3): e0266028, 2022.
Article in English | MEDLINE | ID: covidwho-1759967

ABSTRACT

BACKGROUND: The coronavirus disease has become a global pandemic, and it continues to wreak havoc on global health and the economy. The development of vaccines may offer a potential eradication of COVID-19. This study evaluated the general knowledge, attitude, and perception of COVID-19 vaccines in the Pakistani population. METHODS: A self-reporting e-survey and questionnaire-based survey from vaccination centers of different cities of Pakistan among 502 participants were conducted. The questionnaire comprised four sections inquiring demographics, vaccination status, and perception or attitude towards the vaccine. Univariate logistic regression was applied to predict the knowledge, attitude and behavior of participants. RESULTS: The mean age of participants was 50.8±20.3 years. 53% of the participants have both doses of vaccine administered. Pain on the site of injection (49.8%) was the most common symptom, followed by asthenia (43.0%), muscle pain (29.5%), and swelling (24.5%) on the site of vaccine administration. Females complain of more symptoms than males. More severe symptoms were reported after the first dose of vaccine administration; these symptoms subsided within a week for most participants. Overall, the respondents have a positive attitude towards the vaccine. 47.4% are sure about the vaccine's efficacy, 48.6% said getting vaccinated was their own decision, and 79.9% also recommended others to get vaccinated. CONCLUSION: The study concluded that the Pakistani population has a positive attitude but inadequate knowledge towards COVID-19 vaccines. Immediate awareness and vaccination education programs should be conducted by the authorities to complete the mass vaccination schedule.


Subject(s)
COVID-19 , Vaccines , Adult , Aged , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Pakistan/epidemiology , SARS-CoV-2 , Surveys and Questionnaires , Vaccination
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