Association of awareness about hepatitis C infection with patterns of health seeking behavior among hepatitis C patients in Karachi, Pakistan

Background: Hepatitis C infection is one of the significant causes of morbidity and mortality throughout the world. In Pakistan, hepatitis C infection rate is 4.8%, which is the second highest prevalence rate among all developing countries. This study aimed to identify the association between awareness about hepatitis C infection and pattern of health seeking behavior among patients living with hepatitis C in Karachi, Pakistan. Methods: A descriptive, cross-sectional study was conducted among 250 hepatitis C patients who were recruited from the Aga Khan University Hospital and the Civil Hospital Karachi, Pakistan between March and May 2013. Data were collected through a modified questionnaire on ‘awareness about hepatitis C and patterns of health seeking behavior among hepatitis C patients’. Results: We did not find any association between participants’ awareness of hepatitis C infection and their primary contact with a health care provider. However, this study found that only half of the study participants (52%) had correct knowledge of hepatitisC. The patterns of health seeking behavior showed that a majority of the study participants approached a medical doctor (n=368), followed by spiritual healers (n=206), and a few participants approached traditional healers (n=39) and homeopaths (n=11). Conclusions: The study did not find any association between the patients’ level of awareness about hepatitis C infection and their primary contact with health careproviders. However, it has been found that patterns of health seeking behavior are strongly related to the patients’ cultural practices and beliefs, which affect their choiceof health care providers. This study has provided a basis for planning interventional studies aimed at improving patients’ level of awareness about hepatitis C and their health seeking behavior

The patterns of health seeking behavior among patients with hepatitis C in Karachi, Pakistan

Background: The study aimed to assess the patterns of health seeking behavior and the level satisfaction with the health care providers among hepatitis C patients in Karachi, Pakistan. Methodology: A descriptive, cross-sectional study was conducted among 250 hepatitis C patients, who were recruited from the Aga Khan University Hospital and the Civil Hospital Karachi, Pakistan, between March and May 2013. Results: The patterns of health seeking behavior showed that a majority of the study participants approached a medical doctor (n=359), followed by spiritual healers (n=103), and a few participants approached traditional healers (n=38) and homeopaths (n=11). The pattern of health seeking behavior also revealed that the participants were taking treatment from more than one health care provider at the same time. Participants who visited doctors had effective treatment outcomes and they were satisfied with their doctors. However, those participants who visited homeopaths, traditional healers and spiritual healers had ineffective treatment outcomes and they were not satisfied with these health care providers. Conclusion: The patterns of health seeking behavior are strongly related to the patients\u27 cultural practices and beliefs, which affect their choice of health care providers. This study has provided a basis for planning interventional studies aimed at improving patients\u27 health seeking behaviors

Awareness about hepatitis C among patients suffering from hepatitis C in Karachi, Pakistan

Objectives: To assess the level of awareness about hepatitis C among patients suffering from hepatitis C in Karachi,Pakistan. Study design settings and duration: A descriptive, cross sectional study, conducted among hepatitis C patients recruited from the Aga Khan University Hospital and the Civil Hospital Karachi, between March and May 2013. Patients and Methods A sample size of 247 was calculated using the Open Epi software. Data were collected using a questionnaire and all eligible patients were briefed about the study purpose, risks, benefits, and their rights as participants. All patients who agreed to participate gave written informed consent. The completed questionnaire took a maximum of 25 30 minutes. For the data analysis, frequencies and percentages were computed to find out the estimated proportions of different variables. Results: A total of 250 HCV patients participated in the study. Most of the patients had incorrect knowledge about transmission of disease where 76.8% said that it is transmitted through sharing of towel/clothes, coughing (75.2%) or eating in same utensils (53.6%). Tattooing (66.4%), kissing (66%), sexual intercourse (54.4%), ear and nose piercing (53.6%) were also identified as transmission sources. Almost 91% patients had misconceptions that preventive vaccine for hepatitis C infection is available. Almost 61% patients thought that exposure to needles/syringeswas the cause of their hepatitis C while 22% said it was medical instruments. Food and water as the cause of their hepatitis was reported by 19.1%. Conclusion: Patients suffering from hepatitis C have misconceptions about disease transmission, its risk f actors, and the availability of preventive vaccine for hepatitis C. There is a dire need to improve public awareness about common diseases and their preventio

Physical violence and its associated factors among married women in Multan, Southern Punjab, Pakistan

Background: Physical violence is considered as a routine matter and is a neglected issue in the heavily populated society of Pakistan. The study aimed to estimate the physical violence and its associated factors among married women living in the district Multan, a city of Southern Punjab, Pakistan. Methods: A Cross-Sectional study was conducted among 375 married women living in the community of six towns of Multan. The data was collected from March 2013 to May 2013, through a questionnaire, based on the World Health Organization Multi-country Study on Women\u27s Health and Life Experiences of Violence against Women. A univariate and multivariate analyses were recorded. Results: Out of 375 women surveyed, 62.93% reported physical violence. In the univariate analysis, women\u27s age (28-60 years), women\u27s occupation (non-professional,) and family categories, (combined/extended) were found to be significant, at 95% confidence interval (CI). In multivariate analysis, women\u27s employment status, as non-earning (OR; 0.57CI:0.33, 0.98) was significant in last year, and in life time multivariate analysis, husband\u27s nonprofessional status (OR; 1.06; CI: 0.635 1, 0.793) and women\u27s non-earning status (OR; 0.57; CI: 0.33, 0.98) became significant. The combined family system (OR; 1.795, CI: 1.120, 2.878) was found to be significant in multivariate analyses. Conclusion: Physical violence of different forms is considered as a social and cultural norm by intimate partner. There is a pressing need for appropriate mechanisms particularly in primary health care, to identify and deal with physical violenc

Trauma and post traumatic growth in young survivors of a terrorist attack: An experiential account of supportive interventions in a tertiary care hospital in Pakistan

In the winter of 2014, four terrorists attacked a school in Khyber Pakhtunkhwa (KPK), resulting in more than a hundred students’ death. Twenty-two survivors (aged 10–18 years) with physical injuries were admitted to a private hospital in Karachi for further surgical and psychological interventions. The aim of this paper is to share a retrospective experiential account of a trauma management plan, based on the bio-psycho-socio-spiritual model for young survivors of terrorism. In biological management, children with hyper-arousal symptoms and sleep disturbances were started on Prazosin and those meeting criteria for Post-Traumatic Stress Disorders were started on Selective serotonin reuptake inhibitors. The Psychosocial interventions included individual therapy, physical therapy, family education, and music groups. Children and their families were also encouraged to draw on their religious support. At the time of discharge, these children were evaluated through clinical interview to assess for improvement. A massive decrease in their hyper-arousal symptoms was seen as evidenced by improvements in their sleeping patterns, mood and behaviour. Moreover, signs of psychosocial development based on the principles of Post Traumatic Growth were visible. Our main limitations were the short period of time and a lack of follow up opportunity. However, this framework provides a basis to establish trauma services at tertiary care hospitals in developing countries like Pakistan where access to overall health care is limited and specifically psychiatric care is lacking in health care institutes