Gender, culture, and migration: A qualitative study of the socioeconomic challenges facing Afghan women refugees in Khyber Pakhtunkhwa, Pakistan.

The research explores Afghan refugee women's challenges in accessing education, employment, and legal rights in Khyber Pakhtunkhwa, Pakistan. It seeks to inform policy changes to improve their socioeconomic circumstances and mitigate these hardships. The study employs qualitative methodologies, utilizing interviews, observation, and document analysis to capture rich, in-depth narratives from three Afghan refugee women. Each narrative provides unique insights into the women's struggles with education, employment, and securing legal rights. The research highlights challenges from forced migration, gender inequality, cultural norms, and socioeconomic marginalization, causing a holistic crisis for Afghan refugee women in Khyber Pakhtunkhwa, Pakistan. These issues hinder access to education, employment, financial vulnerabilities, and legal uncertainties. The study suggests a comprehensive, multi-pronged approach to policy changes, including education reform for refugee girls, gender-responsive recruitment practices, and legal reforms to secure refugees' rights. It emphasizes gender-responsive support services and involves Afghan refugee women in policy development processes, leveraging their experiences for more effective and inclusive policies.

La recherche explore les difficultés rencontrées par les femmes réfugiées afghanes pour accéder à l'éducation, à l'emploi et aux droits légaux à Khyber Pakhtunkhwa, au Pakistan. Il cherche à éclairer les changements politiques pour améliorer leur situation socio-économique et atténuer ces difficultés. L'étude utilise des méthodologies qualitatives, utilisant des entretiens, des observations et des analyses de documents pour recueillir des récits riches et approfondis de trois femmes réfugiées afghanes. Chaque récit fournit un aperçu unique des luttes des femmes en matière d'éducation, d'emploi et d'obtention de leurs droits légaux. La recherche met en évidence les défis liés à la migration forcée, à l'inégalité entre les sexes, aux normes culturelles et à la marginalisation socio-économique, provoquant une crise holistique pour les femmes réfugiées afghanes à Khyber Pakhtunkhwa, au Pakistan. Ces problèmes entravent l'accès à l'éducation, à l'emploi, souffrent de vulnérabilités financières et d'incertitudes juridiques. L'étude suggère une approche globale et multidimensionnelle des changements politiques, y compris une réforme de l'éducation pour les filles réfugiées, des pratiques de recrutement sensibles au genre et des réformes juridiques pour garantir les droits des réfugiés. Il met l'accent sur les services de soutien sensibles au genre et implique les femmes réfugiées afghanes dans les processus d'élaboration des politiques, en tirant parti de leurs expériences pour des politiques plus efficaces et inclusives.

Epidemiology of cutaneous leishmaniasis in children of Khyber Pakhtunkhwa, Pakistan.

OBJECTIVES: In Pakistan, cutaneous leishmaniasis is an emerging tropical disease and a very high number (>70%) of children are afflicted by this marring infection. This study aimed to scrutinise the prevalence, spatial distribution and socio-demographic and behavioural risk factors associated with cutaneous leishmaniasis in children aged <5-15 years in Khyber Pakhtunkhwa. METHODS: A total of 1, 559 clinically confirmed records of children diagnosed with cutaneous leishmaniasis (January-December) from 2020 and 2022 were obtained from selected district hospitals. In addition, a risk factors-related questionnaire was administered to 1, 011 households (400 in 2020 and 611 in 2022) in nine districts during a household survey. RESULTS: The maximum number of cutaneous leishmaniasis cases was recorded in 2022 (n = 877, 56.25%) as compared to 2020 (n = 682, 43.75%). The hospital records showed a greater number of male patients in the 2022 cohort (n = 603, 68.76%). The highest number of cases were observed in children aged 5-9 years in 2022 (n = 282, 32.16%) and 2020 (n = 255, 37.39%). In 2020 and 2022, cutaneous leishmaniasis cases showed peak aggregation in March (n = 118, 17.3%) and January (n = 322, 36.72%). From a spatial analysis, the maximum number of cutaneous leishmaniasis cases was recorded at 59-1700 m elevation in various land-use/land-cover and climatic regions with quaternary alluvium rock formations. A multivariate logistic regression model analysis of risk factors from the households survey suggested that age group, socio-economic status, construction materials of the house, use of insect repellents, Afghan refugee camps in the village/district, knowledge and biting times of sand flies, frequent use of mosquito bed nets, presence of domestic animals in the house, knowledge of the transmission period and peak month of leishmaniasis infection increased the risk of acquiring cutaneous leishmaniasis (p value < 0.05). CONCLUSION: Our analysis demonstrated that cutaneous leishmaniasis in children is influenced by a variety of environmental, socio-demographic and behavioural risk factors in Khyber Pakhtunkhwa. The increase in recorded cases of cutaneous leishmaniasis in children in 2022 compared to 2020 suggests that the infection likely extended to new foci in the province.

Prevalence of crimean Congo hemorrhagic fever in Khyber Pakhtunkhwa, Pakistan.

BACKGROUND: CCHFV is well recognized as a major public health threat and its prevalence and epidemiological distribution in Pakistan and specifically in KP province is not well documented. METHODS: We used a gold-standard PCR-based diagnostic assay for confirmation of CCHFV among suspected patients. A total of 150 patients were enrolled from June 2022 to September 2022 and their blood samples were collected for PCR confirmation. RESULTS: The overall positivity rate for CCHFV was 26.67 %, with the virus mostly prevalent in the middle-aged group (21-40 years). In the July of 2022, a significant spike in the prevalence of CCHFV was observed in provincial capital Peshawar with the highest burden (31.57 %). CONCLUSION: Our findings indicate the necessity of strengthening CCHFV monitoring programs and intensifying efforts to identify hotspot regions for effective surveillance and control of CCHFV. The months before the Eid-ul-Adha are crucial in the context of CCHFV control.

Dynamics of Malaria Incidence in Khyber Pakhtunkhwa, Pakistan: Unveiling Rapid Growth Patterns and Forecasting Future Trends.

BACKGROUND: Malaria remains a formidable worldwide health challenge, with approximately half of the global population at high risk of catching the infection. This research study aimed to address the pressing public health issue of malaria's escalating prevalence in Khyber Pakhtunkhwa (KP) province, Pakistan, and endeavors to estimate the trend for the future growth of the infection. METHODS: The data were collected from the IDSRS of KP, covering a period of 5 years from 2018 to 2022. We proposed a hybrid model that integrated Prophet and TBATS methods, allowing us to efficiently capture the complications of the malaria data and improve forecasting accuracy. To ensure an inclusive assessment, we compared the prediction performance of the proposed hybrid model with other widely used time series models, such as ARIMA, ETS, and ANN. The models were developed through R-statistical software (version 4.2.2). RESULTS: For the prediction of malaria incidence, the suggested hybrid model (Prophet and TBATS) surpassed commonly used time series approaches (ARIMA, ETS, and ANN). Hybrid model assessment metrics portrayed higher accuracy and reliability with lower MAE (8913.9), RMSE (3850.2), and MAPE (0.301) values. According to our forecasts, malaria infections were predicted to spread around 99,301 by December 2023. CONCLUSIONS: We found the hybrid model (Prophet and TBATS) outperformed common time series approaches for forecasting malaria. By December 2023, KP's malaria incidence is expected to be around 99,301, making future incidence forecasts important. Policymakers will be able to use these findings to curb disease and implement efficient policies for malaria control.

Epidemiological survey, molecular profiling and phylogenetic analysis of cutaneous leishmaniasis in Khyber Pakhtunkhwa, Pakistan.

BACKGROUND: Cutaneous leishmaniasis (CL), an emerging vector-borne ailment in Khyber Pakhtunkhwa (KPK), Pakistan, exhibits diverse spread patterns and outbreaks. METHODS: To comprehend its epidemiology and identify parasite species, we conducted an active survey on suspected CL cases (n=8845) in KPK. RESULTS: Microscopy and internal transcribed spacer-1 PCR-restriction fragment length polymorphism (RFLP) molecular techniques detected Leishmania spp. in blood samples. Phylogenetic analysis gauged genetic affinities with other areas. District Bannu displayed the highest CL impact (14.58%), while Swat had the lowest impact (4.33%) among cases. Annual blood examination rate, parasite incidence and slide positivity rate were 4.96 per 1000 people, 0.0233 and 0.047%, respectively. CL infections were prevalent in 1- to 20-y-olds, with males (57.17%) more vulnerable than females (42.82%). Single lesions occurred in 43.73% of patients, while 31.2% people had two lesions, 17.31% had three lesions and 7.74% had more than three lesions. Most had sand-fly exposure but lacked preventive measures like repellents and bed nets. Leishmania tropica was confirmed via RFLP analysis in amplified samples. Phylogenetic analysis unveiled genetic parallels between L. tropica of KPK and isolates from China, Iran, Afghanistan, India, Syria and Morocco. CONCLUSIONS: Urgent comprehensive control measures are imperative. Early detection, targeted interventions and raising awareness of CL and sand-fly vectors are vital for reducing the disease's impact. International collaboration and monitoring are crucial to tackle Leishmania spp.'s genetic diversity and curtail its cross-border spread.

Ethnomedicinal and traditional uses of the Ferns of Khyber Pakhtunkhwa, Pakistan

Abstract Ferns are often used by indigenous people in Khyber Pakhtunkhwa, Pakistan. This study was designed to collect the ethnomedicinal and traditional knowledge of these locals about this group of vascular plants. Forty taxa belong to nineteen genera and ten families are used in the treatment of different diseases. The Pteridaceae was the most representative family with twelve taxa (30%), followed by Athyriaceae and Dryopteridaceae with six taxa each (30%), and Thelypteridaceae with five taxa (12.5%). Regarding the genera, Adiantum, Asplenium and Dryopteris ranked first with four taxa each (30%), followed by Aleuritopteris, Diplazium, Pteris and Equisetum with three taxa each (30%), followed by Athyrium, Oeosporangium, Polystichum and Pseudophegopteris with two taxa each (20%). These taxa were commonly used in the treatment of respiratory disorders i.e. asthma, bronchitis, emphysema, pneumonia; intestinal ulcer, stomach, urinary ailments and skin disorders by the methods of decoction and infusion. Traditional knowledge about ethnomedicinal plants is a valuable and essential source for the discovery of allopathic, herbal and homeopathic medicines.

Resumo As samambaias são frequentemente usadas pelos indígenas em Khyber Pakhtunkhwa, Paquistão. Este estudo foi desenhado para coletar o conhecimento etnomedicinal e tradicional desses moradores sobre este grupo de plantas vasculares. Quarenta táxons pertencem a dezenove gêneros, e dez famílias são utilizadas no tratamento de diferentes doenças. Pteridaceae foi a família mais representativa com doze táxons (30%), seguida por Athyriaceae e Dryopteridaceae com seis táxons cada (30%), e Thelypteridaceae com cinco táxons (12,5%). Em relação aos gêneros, Adiantum, Asplenium e Dryopteris ficaram em primeiro lugar com quatro táxons cada (30%), seguidos por Aleuritopteris, Diplazium, Pteris e Equisetum com três táxons cada (30%), e Athyrium, Oeosporangium, Polystichum e Pseudophegopteris com dois táxons cada (20%). Estes táxons foram comumente usados no tratamento de distúrbios respiratórios, isto é, asma, bronquite, enfisema, pneumonia; úlcera intestinal, estômago, doenças urinárias e doenças da pele pelos métodos de decocção e infusão. O conhecimento tradicional sobre plantas etnomedicinais é uma fonte valiosa e essencial para a descoberta de medicamentos alopáticos, fitoterápicos e homeopáticos.

Ethnomedicinal and traditional uses of the Ferns of Khyber Pakhtunkhwa, Pakistan / Usos etnomedicinais e tradicionais das samambaias de Khyber Pakhtunkhwa, Paquistão

Abstract Ferns are often used by indigenous people in Khyber Pakhtunkhwa, Pakistan. This study was designed to collect the ethnomedicinal and traditional knowledge of these locals about this group of vascular plants. Forty taxa belong to nineteen genera and ten families are used in the treatment of different diseases. The Pteridaceae was the most representative family with twelve taxa (30%), followed by Athyriaceae and Dryopteridaceae with six taxa each (30%), and Thelypteridaceae with five taxa (12.5%). Regarding the genera, Adiantum, Asplenium and Dryopteris ranked first with four taxa each (30%), followed by Aleuritopteris, Diplazium, Pteris and Equisetum with three taxa each (30%), followed by Athyrium, Oeosporangium, Polystichum and Pseudophegopteris with two taxa each (20%). These taxa were commonly used in the treatment of respiratory disorders i.e. asthma, bronchitis, emphysema, pneumonia; intestinal ulcer, stomach, urinary ailments and skin disorders by the methods of decoction and infusion. Traditional knowledge about ethnomedicinal plants is a valuable and essential source for the discovery of allopathic, herbal and homeopathic medicines.

Resumo As samambaias são frequentemente usadas pelos indígenas em Khyber Pakhtunkhwa, Paquistão. Este estudo foi desenhado para coletar o conhecimento etnomedicinal e tradicional desses moradores sobre este grupo de plantas vasculares. Quarenta táxons pertencem a dezenove gêneros, e dez famílias são utilizadas no tratamento de diferentes doenças. Pteridaceae foi a família mais representativa com doze táxons (30%), seguida por Athyriaceae e Dryopteridaceae com seis táxons cada (30%), e Thelypteridaceae com cinco táxons (12,5%). Em relação aos gêneros, Adiantum, Asplenium e Dryopteris ficaram em primeiro lugar com quatro táxons cada (30%), seguidos por Aleuritopteris, Diplazium, Pteris e Equisetum com três táxons cada (30%), e Athyrium, Oeosporangium, Polystichum e Pseudophegopteris com dois táxons cada (20%). Estes táxons foram comumente usados ​​no tratamento de distúrbios respiratórios, isto é, asma, bronquite, enfisema, pneumonia; úlcera intestinal, estômago, doenças urinárias e doenças da pele pelos métodos de decocção e infusão. O conhecimento tradicional sobre plantas etnomedicinais é uma fonte valiosa e essencial para a descoberta de medicamentos alopáticos, fitoterápicos e homeopáticos.

Epidemiological analysis of anaplasmosis in cattle from Khyber Pakhtunkhwa, Pakistan.

Background and Aim: Anaplasmosis, a tick-borne disease affecting livestock caused by the bacteria Anaplasma, poses a global concern. This study aimed to estimate the prevalence, spatiotemporal variation, and associated risk factors of anaplasmosis in cattle from the Bannu and Lakki Marwat districts of Khyber Pakhtunkhwa, Pakistan. Materials and Methods: This study used 197 cattle exhibiting clinical symptoms of anaplasmosis in natural settings. Microscopic examination was used to estimate the prevalence. Potential risk factors, such as sampling regions and months, gender, breed, and age were studied. Results: The study revealed an overall anaplasmosis prevalence of 19.79%. Bannu district exhibited a higher occurrence at 22.10%, compared to Lakki Marwat district at 17.64%. Young cattle (<2 years) demonstrated a notably higher incidence of anaplasmosis (26.78%) compared to adults (>5 years), which had a prevalence of 12.35% (p < 0.05). Female cattle (22.36%) were more susceptible than male cattle (11.11%). Prevalence peaked in June (45.71%) and was lowest in February (3.57%). Crossbred cattle had a higher prevalence (23.52%) than purebred cattle (11.47%). Conclusion: Anaplasmosis can be effectively controlled using a comprehensive approach encompassing selective breeding for resilience, targeted care of young calves and females, effective tick control during warmer months, consistent use of insecticides, and proactive risk factor management. Raising awareness among farmers through diverse channels, including media, is pivotal to bolster tick-borne disease management strategies.

Cancer incidence in Khyber Pakhtunkhwa, Pakistan, 2020.

BACKGROUND: To present the population-based cancer statistics for Khyber Pakhtunkhwa (KP), Pakistan, an incidence study was conducted at the Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) in Lahore, Pakistan, in 2023. METHODS: Records from various centres on new cancers diagnosed among residents of KP between January and December 2020 were gathered. Both active and passive methods of data collection were applied, and the information was saved in a central repository at SKMCH&RC. The incidence rates were computed by age group and sex and presented per 100,000 population. RESULTS: Among children (0-14 years), the Age-Standardised Incidence Rate (ASIR) was 4.0 in girls and 6.1 in boys, and haematologic malignancies were more prevalent; in adolescents (15-19 years), the ASIR was 7.7 in females, 9.4 in males, and bone tumours, haematologic malignancies, and neurological cancers were prominent; in adult females (> / = 20 years), the ASIR was 84.9, and cancers of the breast, digestive system, and reproductive organs were predominant; and adult males, the ASIR was 73.0, and cancers of the gastrointestinal tract, lip/oral cavity/pharynx, prostate, and Non-Hodgkin Lymphoma (NHL) were common. CONCLUSIONS: It is crucial to investigate the aetiology of these diseases at the community level because dietary elements, infectious diseases, and tobacco use all appear to be significant contributors. Prospective studies could play a key role in highlighting the factors linked to these diseases. Therefore, cancer registration must continue in conjunction with the exploration of risk factors.

Psychiatric Illnesses, Somatic Complaints, and Treatments in a Tertiary Care Hospital in Khyber Pakhtunkhwa, Pakistan: A Cross-Sectional Study.

BACKGROUND: Psychiatric disorders differ in frequency and symptoms based on the cultural and ethnic background of patients. This can make diagnosing and treating patients challenging globally. In Pakistan, most psychiatric patients report multiple somatic complaints. Our goal was to investigate the causes of these complaints, identify common psychiatric conditions, and analyze their various manifestations in clinical practice. We also aimed to identify ways to improve the quality of care provided to our patients. METHODOLOGY: We collected and organized data by utilizing predetermined tables from a sample of 231 patients who visited the outpatient clinics. Inpatients were not included in this study because of the absence of a psychiatric unit at our facility. Patients' past medical and psychiatric records were thoroughly examined, and pertinent information was extracted. The most common psychiatric disorders within the studied population were diagnosed based on the International Classification of Diseases, Tenth Revision (ICD-10) diagnostic criteria. RESULTS: In this study, a sample size of 231 was examined to determine the most common diseases (ICD-10) in males and females. In males, the most prevalent diseases were mixed anxiety and depression (MAD), depression, generalized anxiety disorder (GAD), bipolar affective disorder (BPAD), social phobia, and obsessive-compulsive disorder (OCD). Females, on the other hand, presented more with depression, GAD, mixed anxiety and depression, conversion or dissociative disorder, OCD, and panic attacks. Headaches were the most frequently reported symptom, experienced by 61.9% the of participants, followed by lethargy, extremity pains, palpitations, loss of appetite, heartburn or acidity, heaviness on the head, shoulder pains, bloating, dizziness, chest pains, hot flashes or shivering, and constipation. Meanwhile, a quarter of the males did not complain of any somatic symptoms, compared to 10% of the females. Additionally, 7.3% of females reported more than six somatic symptoms, compared to 5.7% of males. When it came to treatment preferences, 73.6% of the participants preferred medication over psychotherapy and over a combination of both. The Statistical Product and Service Solutions (SPSS) Statistics version 22 (IBM SPSS Statistics, Armonk, NY, USA) was used to conduct a chi-square test of independence to analyze the obtained data. For post hoc analysis of quantitative data (i.e., the number of somatic symptoms reported by participants), one-way analysis of variance (ANOVA) was applied, followed by Tukey's honestly significant difference (HSD) test. CONCLUSIONS: This is the first comprehensive study of its kind for this population and region. It emphasizes that clinicians should be aware of the variety of somatic symptoms and psychiatric presentations among this population. Such awareness can improve clinical practices and reduce the burden on health services.

Prevalence and risk factors of bluetongue in small and large ruminants maintained on Government farms in North-western Pakistan.

This study reports prevalence of antibodies against bluetongue virus (BTV) in animals kept on Government farms/research stations in North-western Pakistan and its association with different risk factors. In total, 1257 blood samples were collected, at random, from animals on 12 separate Government farms/research stations. The prevalence of antibodies against BTV was evaluated using a competitive ELISA. Mixed effects univariate and multivariate logistic regressions were applied to ascertain different risk factors associated with the prevalence of the infection using farm as random effect variable. The overall weighted seroprevalence was recorded as 52%. In univariate analysis, a significant association between sero-conversion to BTV infection and species (P < 0.0001), sex (P < 0.0001), herd size (P = 0.0295) and age of animal (P < 0.0001) was recorded. In multivariate mixed effects logistic regression analysis, prevalence of the infection was found to be 7 (95% CI =2-28) times higher in goats and buffalo than in sheep. Prevalence of the infection was found to be 2.5 (95% CI =1.7-3.3) times higher in female than male animals. However, no significant association was found between sero-conversion of BTV and herd size in multivariate mixed effects logistic regression. Age was found to be a risk factor for the sero-conversion; odds of sero-conversion to BTV increased by 1.29, 1.4, 1.32 and 1.6 times per year increase in age of sheep, goats, buffalo and cattle, respectively. Prevalence of bluetongue was found higher in animals maintained on Government owned farms than that in individual holdings, as previously reported in Pakistan.

A multi-criteria decision-making approach to vulnerability assessment of rural flooding in Khyber Pakhtunkhwa Province, Pakistan.

Assessment of rural regions' vulnerability to flooding is gaining prominence on a global scale. However, researchers are greatly undermined in their efforts to make a comprehensive assessment owing to the multidimensional and non-linear link between different indicators and flood risk. Thus, a multi-criteria decision-making (MCDM) approach is proposed to assess the multifaceted vulnerability of rural flooding in Khyber Pakhtunkhwa Province, Pakistan. This research presents a hybrid model for flood vulnerability assessment by combining TOPSIS and the entropy weight method. Households' vulnerability to flooding in rural areas is assessed through four components (social, economic, physical, and institutional) and twenty indicators. All indicator weights are derived using the entropy weight method. The TOPSIS method is then used to rank the selected research areas based on their flood vulnerability levels. The ranking results reveal that flood vulnerability is highest in the Nowshehra District, followed by the Charsadda, Peshawar, and D.I. Khan Districts. The weighting results show that physical vulnerability is the most important component, while location of household's house from the river source (< 1 km) is the key indicator for assessing flood vulnerability. A sensitivity analysis is provided to study the impact of indicator's weights on the comprehensive ranking results. The sensitivity results revealed that out of twenty indicators, fourteen indicators had the lowest sensitivity, three indicators were reported with low sensitivity while the other three were considered highly sensitive for flood vulnerability assessment. Our research has the potential to offer policymakers specific guidelines for lowering flood risk in flood-prone areas.

Frequency of Congenital Cardiac Disease in Various Divisions of Khyber Pakhtunkhwa (KPK) Based on a Six-Month Analysis of Inpatients at a Tertiary Care Hospital's Pediatric Cardiology Unit.

OBJECTIVE: To identify the frequency of congenital heart disease (CHD) in various Khyber Pakhtunkhwa (KPK) divisions. MATERIALS AND METHODS: To perform this research, we reviewed the medical records of pediatric cardiology patients hospitalized between January 2022 and July 2022. Data was taken from the cardiology department's computerized data system between January 1 and July 31, 2022. To prevent any errors in diagnosis and address them during input by the ward clerk, patients' addresses, diagnoses, and gender were verified with the computerized medical record. Data were analyzed, and frequency and percentages were calculated. Per the digital mapping of KPK districts, we stratified and examined the data among various KPK divisions. RESULTS: Out Of the 371 patients with CHD who were admitted, 36.98% (137) were from the Peshawar division, 28.84% (107) from the Malakand division, 16.71% (62) from the Mardan division, 6.1% (23) from the Kohat division, 4.3% (16) from the Bannu division, 3.5% (13) from the Dera Ismail Khan division, and 3.5% (13) from the Hazara division. A total of 371 had CHD, of which 234 (63.07%) were cyanotic and 137 (36.92%) were cyanotic. The most prevalent acynotic congenital heart defect was patent ductus arteriosus (PDA) at 36.32% (85), followed by a ventricular septal defect (VSD) at 35.04 (82). The most frequent acyanotic congenital cardiac abnormality was tetralogy of Fallot (TOF) at 49.63% (68), which was followed by transposition of the great arteries (TGA) at 33.57% (46). CONCLUSION: In KPK, congenital heart disease is most prevalent in the divisions of Peshawar and Malakand, while it is least prevalent in Hazara.

Distribution and Risk of Cutaneous Leishmaniasis in Khyber Pakhtunkhwa, Pakistan.

Cutaneous leishmaniasis (CL) is a zoonotic infection caused by obligate intracellular protozoa of the genus Leishmania. This study aimed to investigate CL in Khyber Pakhtunkhwa, Pakistan and to estimate the risk of epidemics. Clinico-epidemiological data of 3188 CL patients were collected from health facilities in 2021. Risk factors were analyzed using the chi-square test. ArcGIS V.10.7.1 was applied for spatial analysis. The association between CL occurrence and climatic variables was examined by Bayesian geostatistical analysis. The clinical data revealed males or individuals younger than 20 years old were more affected. Most patients presented with a single lesion, and the face was the most attacked body part. CL was prevalent in the southern region in winter. A proportional symbol map, a choropleth map, and a digital elevation model map were built to show the distribution of CL. Focal transmission was predicted by inverse distance weighting interpolation. Cluster and outlier analysis identified clusters in Bannu, Dir Lower, and Mardan, and hotspot analysis suggested Bannu as a high-risk foci. Bayesian geostatistical analysis indicated that increasing precipitation and temperature as well as low altitudes were associated with CL infection. The study has provided important information for public health sectors to develop intervention strategies for future CL epidemics.

Ticks Infesting Dogs in Khyber Pakhtunkhwa, Pakistan: Detailed Epidemiological and Molecular Report.

Ticks and tick-borne diseases are considered a major challenge for human and animal health in tropical, sub-tropical, and temperate regions of the world. However, only scarce information is available on the characterization of tick species infesting dogs in Pakistan. In this study, we present a comprehensive report on the epidemiological and phylogenetic aspects of ticks infesting dogs in Pakistan using the mitochondrial markers i.e. Cytochrome c oxidase subunit 1 (cox1) and 16S ribosomal RNA (16S rRNA) nucleotide sequences. A total of 300 dogs were examined and 1150 ixodid ticks were collected across central Khyber Pakhtunkhwa, Pakistan. The morpho-molecular characterization of hard ticks revealed the presence of two ixodid tick genera on dogs, i.e., Hyalomma and Rhipicephalus, including six tick species viz. Hyalomma dromedarii (15.9%), Hyalomma excavatum (3%), Rhipicephalus sanguineus s.l. (41.3%), Rhipicephalus turanicus s.s. (28.7%), Rhipicephalus haemaphysaloides (10.2%), and Rhipicephalus microplus (2%). The total prevalence of tick infestation in dogs was 61%. The district with the highest tick prevalence rate in dogs was Mardan (14.7%), followed by Peshawar (13%), Swabi (12%), Charsadda (11%), and Malakand (10.3%), respectively. Risk factors analysis indicated that some demographic and host management-associated factors such as host age, breed, exposure to acaricides treatment, and previous tick infestation history were associated with a higher risk of tick infestation on dogs. This is the first molecular report confirming the infestation of Hyalomma and Rhipicephalus tick species in the dog population from the study area. The present study also reported a new tick−host association between Hy. excavatum, Hy. dromedarii, and dogs. Phylogenetic analysis revealed that cox1 partial nucleotide sequences of Hy. excavatum in our dataset were 100% identical to similar tick specimens identified in Turkey, and those of Hy. dromedarii were identical to tick specimens from Iran. Whereas, Rh. haemaphysaloides and Rh. microplus' cox1 partial nucleotide sequences were identical to sequences previously published from Pakistan. Rhipicephalus turanicus s.s. 's cox1 isolates from the present study were 99.8−100% identical to Pakistani-reported isolates, and those of Rh. sanguineus s.l. were 100% identical to Chinese specimens. Results on the genetic characterization of ticks were further confirmed by 16S rRNA partial nucleotide sequences analysis, which revealed 100% identity between the tick isolates of this study and those of Hy. excavatum reported from Turkey; Hy. dromedarii specimens reported from Senegal; Rh. haemaphysaloides, Rh. microplus, and Rh. turanicus s.s., previously published from Pakistan, and Rh. sanguineus s.l., published from China. Furthermore, phylogenetic analysis showed that the Rh. sanguineus s.l. isolates of this study clustered with specimens of the tropical lineage with 7.7−10% nucleotide divergence from the specimens of the temperate lineage. Further molecular works need to be performed throughout Pakistan to present a more detailed map of tick distribution with information about dog host associations, biological characteristics, and pathogen competence.

"Having a guru is like having a licence": analysing financial relationships between khwaja sira gurus and chelas in Swat, Pakistan.

The focus of this study was on identifying themes regarding the financial relationships between gurus (leaders) and chelas (disciples) in khwaja sira communities in Khyber Pakhtunkwa, Pakistan. We interviewed 45 khwaja sira in Mingora, Swat on their experiences of guru-chela culture. All interviews were digitally audio recorded, then translated and transcribed directly from Pashto into English. Transcripts of the interviews were analysed using thematic content analysis in a manner informed by both social reproduction theory and notions of Islamic capital. We identified four major themes related to relationships within guru-chela culture: (1) financial relationships are highly structured; (2) financial exchanges can be mutually beneficial; (3) systems of payment and debt can be exploitative; and (4) financial ties to gurus continue throughout the life course of khwaja sira. Findings show how financial interactions within guru-chela relationships are reflective of larger social forces, reproducing kinship structures, systems of Islamic gift-giving, and capitalist processes occurring within Pakhtun society.

Spatio-temporal change detection of land use and land cover in Malakand Division Khyber Pakhtunkhwa, Pakistan, using remote sensing and geographic information system.

The land use land cover (LULC) change due to the rapidly growing population is a common feature of the urban area. The rapidly growing population in Malakand Division is a greater threat to the LULC of the area due to its negative impact on environment and ecology. This research aims to detect the variations in LULC from 1991 to 2017 in the Malakand Division, Khyber Pakhtunkhwa (KP) province of Pakistan. The study relies on secondary dataset downloaded from the US Geological Survey (1991, 2001, 2011, and 2017 imageries) and the United Nations Office for the Coordination of Humanitarian Affairs (UN OCHA) website. Maximum likelihood technique under supervised image classification was opted to analyze the LULC changes in between 1991 and 2017. The results were based on six major land use classes including agriculture built-up area, vegetation cover, water bodies, snow cover, and barren land. The results from 1991 to 2017 show a substantial reduction in snow cover and barren land which is consequence of climate change. A known change has been recorded in built-up area which shows an increase from 1.02 to 6.2% with a change of 5.18% of the total land. The vegetation cover water bodies were also showing increase in area. The vegetation cover increased from 28.89 to 44.67% while barren land decreased from 45.68 to 40.29% of the total area. Furthermore, the built-up area increased from 1.02 to 6.2%, whereas water covers increased from 0.63% (1991) to 0.86% (2017) of the total area. The study concludes that there is an immense need for planning to preserve the natural habitat for sustainable development in the area.

Wild Edible Fruits as a Source of Food and Medicine: A Study among Tribal Communities of Southern Khyber Pakhtunkhwa.

Botanical surveys in all parts of Pakistan are mainly focused on ethnomedicinal uses of plants, and very little attention has been paid to documenting edible wild fruit species (EWFs). Multiple methodologies and tools were used for data collection. In a recent survey 74 EWF species belonging to 29 families were documented, including their medicinal uses for the treatment of various diseases. The most cited (23%) preparation method was raw, fresh parts. The UV and RFC of EWF species ranged from 0.08 to 0.4 and from 0.02 to 0.18, respectively. In terms of specific disease treatments and their consensus, the ICF ranged from 0 to 0.38. Sexual, gastrointestinal, and respiratory disorders had the highest use reports, and 11 species of plants had the highest FL of 100%. On the basis of uses reported by the inhabitants of seven districts of Southern Khyber Pakhtunkhwa Province, the CSI ranged from the lowest 1.3 to the highest 41. It is concluded that the traditional uses of EWF species depend mainly on socio-economic factors rather than climatic conditions or the number of species. However, there is a gradual loss of traditional knowledge among the younger generations. The present survey is the first baseline study about the socio-economic dimension of local communities regarding the use of EWF species for food as well as medicine.

Wild birds trade in Dera Ismael Khan and Bannu divisions of Khyber PakhtunKhwa (KPK) Province, Pakistan / Comércio de aves selvagens nas divisões Dera Ismail Khan e Bannu da província de Khyber Pakhtunkhwa (KPK), Paquistão

Abstract Wildlife trade is a profitable economic activity. Birds are among the most heavily traded animals worldwide, with numerous species threatened by pet trade. The present case study was stretched for period of one year to find out the status of wild birds' trade in Bannu and Dera Ismael Khan Divisions. The study was aimed to find out the types of species, commercial prices of bird, trade routes, overall income generated from birds' trade and the status of dealers whether licensed or not. Bimonthly visits were conducted to interview 52 bird dealers/pet shops owners/venders (23 in Dera Ismael Khan and 29 in Bannu). A sum of 16 conceivable sites were visited during the study period. Out of these, 8 sites were located in Dera Ismael Khan and 8 sites in Bannu Division. The highest priced species was Demoiselle crane (Grus virgo) and the lowest priced species was house sparrow (Passer domesticus). Total number of species traded in both regions were 8 and 14 while the income generated by bird trade was amounting to PkR 1,322,200 and 7,128,950 in Dera Ismael Khan and Bannu respectively. Majority of the birds were trapped locally with the exception of few from adjacent areas. Commercial activity led by illegal bird traders was found 75% and 100% species in Dera Ismael Khan and Bannu respectively. There was no significant difference between prices of birds, number of species sold and income generated by bird trade in two divisions.

Resumo O comércio de animais selvagens é uma atividade econômica lucrativa. Os pássaros estão entre os animais mais comercializados em todo o mundo, com inúmeras espécies ameaçadas pelo comércio de animais de estimação. O presente estudo de caso foi estendido por um período de um ano para descobrir a situação do comércio de aves selvagens nas Divisões Bannu e Dera Ismael Khan. O estudo teve como objetivo descobrir os tipos de espécies, os preços comerciais das aves, as rotas comerciais, a receita geral gerada pelo comércio de aves e o status dos negociantes, licenciados ou não. Visitas bimestrais foram realizadas para entrevistar 52 comerciantes de pássaros / proprietários / vendedores de pet shops (23 em Dera Ismael Khan e 29 em Bannu). Uma soma de 16 locais concebíveis foram visitados durante o período de estudo. Destes, 8 sites estavam localizados em Dera Ismael Khan e 8 sites na Divisão Bannu. A espécie com preço mais alto foi o guindaste Demoiselle (Grus virgo) e a espécie com preço mais baixo foi o pardal (Passer domesticus). O número total de espécies comercializadas em ambas as regiões foi de 8 e 14, enquanto a receita gerada pelo comércio de aves foi de PkR 1.322.200 e 7.128.950 em Dera Ismael Khan e Bannu, respectivamente. A maioria das aves foi capturada localmente, com exceção de algumas das áreas adjacentes. A atividade comercial liderada por comerciantes ilegais de aves foi encontrada com 75% e 100% de espécies em Dera Ismael Khan e Bannu, respectivamente. Não houve diferença significativa entre os preços das aves, o número de espécies vendidas e a receita gerada pelo comércio de aves nas duas divisões.

Wild birds trade in Dera Ismael Khan and Bannu divisions of Khyber PakhtunKhwa (KPK) Province, Pakistan / Comércio de aves selvagens nas divisões Dera Ismail Khan e Bannu da província de Khyber Pakhtunkhwa (KPK), Paquistão

Wildlife trade is a profitable economic activity. Birds are among the most heavily traded animals worldwide, with numerous species threatened by pet trade. The present case study was stretched for period of one year to find out the status of wild birds’ trade in Bannu and Dera Ismael Khan Divisions. The study was aimed to find out the types of species, commercial prices of bird, trade routes, overall income generated from birds' trade and the status of dealers whether licensed or not. Bimonthly visits were conducted to interview 52 bird dealers/pet shops owners/venders (23 in Dera Ismael Khan and 29 in Bannu). A sum of 16 conceivable sites were visited during the study period. Out of these, 8 sites were located in Dera Ismael Khan and 8 sites in Bannu Division. The highest priced species was Demoiselle crane (Grus virgo) and the lowest priced species was house sparrow (Passer domesticus). Total number of species traded in both regions were 8 and 14 while the income generated by bird trade was amounting to PkR 1,322,200 and 7,128,950 in Dera Ismael Khan and Bannu respectively. Majority of the birds were trapped locally with the exception of few from adjacent areas. Commercial activity led by illegal bird traders was found 75% and 100% species in Dera Ismael Khan and Bannu respectively. There was no significant difference between prices of birds, number of species sold and income generated by bird trade in two divisions.

O comércio de animais selvagens é uma atividade econômica lucrativa. Os pássaros estão entre os animais mais comercializados em todo o mundo, com inúmeras espécies ameaçadas pelo comércio de animais de estimação. O presente estudo de caso foi estendido por um período de um ano para descobrir a situação do comércio de aves selvagens nas Divisões Bannu e Dera Ismael Khan. O estudo teve como objetivo descobrir os tipos de espécies, os preços comerciais das aves, as rotas comerciais, a receita geral gerada pelo comércio de aves e o status dos negociantes, licenciados ou não. Visitas bimestrais foram realizadas para entrevistar 52 comerciantes de pássaros / proprietários / vendedores de pet shops (23 em Dera Ismael Khan e 29 em Bannu). Uma soma de 16 locais concebíveis foram visitados durante o período de estudo. Destes, 8 sites estavam localizados em Dera Ismael Khan e 8 sites na Divisão Bannu. A espécie com preço mais alto foi o guindaste Demoiselle (Grus virgo) e a espécie com preço mais baixo foi o pardal (Passer domesticus). O número total de espécies comercializadas em ambas as regiões foi de 8 e 14, enquanto a receita gerada pelo comércio de aves foi de PkR 1.322.200 e 7.128.950 em Dera Ismael Khan e Bannu, respectivamente. A maioria das aves foi capturada localmente, com exceção de algumas das áreas adjacentes. A atividade comercial liderada por comerciantes ilegais de aves foi encontrada com 75% e 100% de espécies em Dera Ismael Khan e Bannu, respectivamente. Não houve diferença significativa entre os preços das aves, o número de espécies vendidas e a receita gerada pelo comércio de aves nas duas divisões.