Haqiqi (true) development: communities coming together for Polio immunisation in Pakistan

Pakistan is one of only two countries in the world (along with Afghanistan) which is yet to eradicate the highly infectious Wild Polio Virus (WPV1). In this post, Tahira Ali, Savaila Hunzai and Zahra Rao outline how locally-rooted, empathetic and culturally sensitive practices can help overcome barriers, and help increase the percentage of polio vaccination in the especially difficult terrains of Balochistan

Antimicrobial resistance in typhoidal salmonella: Surveillance for enteric fever in Asia project, 2016-2019

Background: Clinicians have limited therapeutic options for enteric as a result of increasing antimicrobial resistance, and therefore typhoid vaccination is recommended as a preventive measure. As a part of the Surveillance for Enteric Fever in Asia Project (SEAP), we investigated the extent measured the burden of antimicrobial resistance (AMR) among confirmed enteric fever cases in Bangladesh, Nepal, and Pakistan.Methods: From September 2016-September 2019, SEAP recruited study participants of all age groups from its outpatient, inpatient, hospital laboratory, laboratory network, and surgical sites who had a diagnosis of febrile illness that was either suspected or blood culture confirmed for enteric fever. Antimicrobial resistance of isolates was determined by disc diffusion using Clinical and Laboratory Standard Institute cut-off points. We reported the frequency of multidrug resistance (MDR)(resistance to ampicillin, cotrimoxazole, and chloramphenicol), extensive drug resistance (XDR) (MDR plus non-susceptible to fluoroquinolone and any 3rd generation cephalosporins), and fluoroquinolone (FQ) and azithromycin non-susceptibility.Results: We enrolled 8,705 blood culture confirmed enteric fever cases: 4,873 (56%) from Bangladesh, 1,602 (18%) from Nepal and 2,230 (26%) from Pakistan. Of these, 7,591 (87%) were Salmonella Typhi and 1114 (13%) were S. Paratyphi. MDR S. Typhi was identified in 17% (701/4065) of isolates in Bangladesh, and 1% (19/1342) in Nepal. In Pakistan, 16 % (331/2084) of S. Typhi isolates were MDR, and 64% (1319/2074) were XDR. FQ nonsusceptibility among S. Typhi isolates was 98% in Bangladesh, 87% in Nepal, and 95% in Pakistan. Azithromycin non-susceptibility was detected in 77 (2%) in Bangladesh, 9 (.67%) in Nepal and 9 (.59%) isolates in Pakistan. In Pakistan, three (2%) S. Paratyphi isolates were MDR; no MDR S. Paratyphi was reported from Bangladesh or Nepal.Conclusions: Although AMR against S. Paratyphi was low across the three countries, there was widespread drug resistance among S. Typhi, including FQ non-susceptibility and the emergence of XDR S. Typhi in Pakistan, limiting treatment options. As typhoid conjugate vaccine (TCV) is rolled out, surveillance should continue to monitor changes in AMR to inform policies and to monitor drug resistance in S. Paratyphi, for which there is no vaccine

Antimicrobial Resistance in Typhoidal Salmonella: Surveillance for Enteric Fever in Asia Project, 2016-2019

Background: Clinicians have limited therapeutic options for enteric as a result of increasing antimicrobial resistance, and therefore typhoid vaccination is recommended as a preventive measure. As a part of the Surveillance for Enteric Fever in Asia Project (SEAP), we investigated the extent measured the burden of antimicrobial resistance (AMR) among confirmed enteric fever cases in Bangladesh, Nepal, and Pakistan. Methods: From September 2016-September 2019, SEAP recruited study participants of all age groups from its outpatient, inpatient, hospital laboratory, laboratory network, and surgical sites who had a diagnosis of febrile illness that was either suspected or blood culture confirmed for enteric fever. Antimicrobial resistance of isolates was determined by disc diffusion using Clinical and Laboratory Standard Institute cut-off points. We reported the frequency of multidrug resistance (MDR)(resistance to ampicillin, cotrimoxazole, and chloramphenicol), extensive drug resistance (XDR) (MDR plus non-susceptible to fluoroquinolone and any 3rd generation cephalosporins), and fluoroquinolone (FQ) and azithromycin non-susceptibility. Results: We enrolled 8,705 blood culture confirmed enteric fever cases: 4,873 (56%) from Bangladesh, 1,602 (18%) from Nepal and 2,230 (26%) from Pakistan. Of these, 7,591 (87%) were Salmonella Typhi and 1114 (13%) were S. Paratyphi. MDR S. Typhi was identified in 17% (701/4065) of isolates in Bangladesh, and 1% (19/1342) in Nepal. In Pakistan, 16 % (331/2084) of S. Typhi isolates were MDR, and 64% (1319/2074) were XDR. FQ nonsusceptibility among S. Typhi isolates was 98% in Bangladesh, 87% in Nepal, and 95% in Pakistan. Azithromycin non-susceptibility was detected in 77 (2%) in Bangladesh, 9 (.67%) in Nepal and 9 (.59%) isolates in Pakistan. In Pakistan, three (2%) S. Paratyphi isolates were MDR; no MDR S. Paratyphi was reported from Bangladesh or Nepal. Conclusions: Although AMR against S. Paratyphi was low across the three countries, there was widespread drug resistance among S. Typhi, including FQ non-susceptibility and the emergence of XDR S. Typhi in Pakistan, limiting treatment options. As typhoid conjugate vaccine (TCV) is rolled out, surveillance should continue to monitor changes in AMR to inform policies and to monitor drug resistance in S. Paratyphi, for which there is no vaccine

understanding and tackling poverty and vulnerability in mountain livelihoods in the hindu kush himalaya

This chapter critically reviews the existing knowledge on livelihoods, poverty, and vulnerability in the Hindu Kush Himalaya (HKH). Development in mountain areas and the practices of people in these areas are uniquely conditioned by distinct characteristics that we term "mountain specificities". Some of these specificities—such as inaccessibility, fragility, and marginality—constrain development. Others—such as abundant biological diversity, ecological niches, and adaptation mechanisms—present development opportunities for mountain people

Translations

Recording of Ghulamuddin Hunzai translationg the story Wahdate Shaan in Urdu

Poems and Songs

Recording of Ghulamuddin Hunzai reciting "Rasmo Riwaaj," a song in the Hunza dialect of Burushaski

A long-term investment in Pakistan: Early childhood education

This article explores the importance of early childhood education in the context of child development and focuses on Pakistan initiatives in the area of early childhood for long-term investment as child development and human development

Conversations and Discussions

Recording of Ghulamuddin Hunzai discussing, in the Hunza dialect of Burushaski, the orthography proposed for the language Burushaski

The concept of pleasure propounded by Nāşir-i Khusraw /

This study is intended to investigate the concept of pleasure as developed by Nasir-i Khusraw, a prominent Isma'ili philosopher and theologian of the fifth century hijrah. This concept seems to be one of the central themes of Nasir's thought system.From Nasir's works, it appears that according to him the concept of pleasure is not simply an ethical problem but a cosmic principle active and functional on all the existential levels. Every being experiences pleasure in its specific way by performing the function assigned to it. Through this function or activity every being perpetuates its existence and preserves its well-being. On the sub-human levels i.e. mineral, vegetative and animal, the principle of pleasure is a driving force which enables these levels to preserve their respective well-being. However, from the human level till the level of the Universal Soul this principle gains an increasingly epistemological character as it is connected with the soul's activity of acquiring knowledge.Nasir has extensively quoted and criticised Muhammad-i Zakariyya-yi Raji's views on pleasure. This situation has called for a comparative study of their concepts of pleasure in their respective metaphysical and historical contexts. This comparative study reveals that Nasir and Razi's concepts of pleasure are ultimately grounded in their metaphysical principles, and their interpretations of pleasure are influenced by Aristotelian and Platonic interpretations respectively, as these models suited their respective metaphysical world-views

Irrigation against rural poverty: an overview of issues and pro-poor intervention strategies in irrigated agriculture in Asia

In Hussain, I.; Biltonen, E. (Eds.) Irrigation against rural poverty: an overview of issues and pro-poor intervention strategies in irrigated agriculture in Asia. Proceedings of National Workshops on Pro-Poor Intervention Strategies in Irrigated Agriculture in Asia, Bangladesh, China, India, Indonesia, Pakistan and Vietnam, [9-10 August 2001, Colombo, Sri Lanka]: International Water Management Institute (IWMI)