War Experience, Daily Stressors and Mental Health Among the Inter-taliban Generation Young Adults in Northern Afghanistan: A Cross-Sectional School-Based Study.

OBJECTIVES: The specific objectives of the study are to examine the mental health (depression and anxiety) of the first generation of post-Taliban government and compare these measures with its preceding generation, and to assess war experience of the first generation of post-Taliban government. We also wanted to assess the daily stressors and their contribution to the mental health, and to assess mental health as a result of war experiences and daily stressors with respect to demographic measures such as sex, marital status, age, mother's age, birth order, and ethnicities. METHODS: In a cross-sectional design, 621 high school students, were randomly selected to participate in the study to assess war experience, daily stressors, and mental health among the first generation of young adults under post-Taliban government. RESULTS: The participants had 17.37 ± 0.9 mean years of ages, 94.8% of them were unmarried. Poor mental health was significantly associated with higher exposure to war, but not with the age of participants (P = 0.08). There was no association between war experiences and the age and ethnicity of our participants (p = 0.9, p = 0.7). Age differences were negligible for daily stressors too (P = 0.07). Daily stressors scores were higher for female than male students (P = 0.02). The majority of young adults surveyed, declared themselves in agreement with statements such as the security situation in Afghanistan makes me frustrated (56%), air pollution as a concern (41%), and not having anyone to talk about what is in their heart (28.8%). Gender differences were highly significant for mental health, as appraised by both The Hopkins Symptoms Checklist (HSCL) -depression and HSCL-anxiety. Girls presented higher rates of depression, anxiety, and daily stressors than boys, and boys presented higher rates of war experiences than girls. CONCLUSION: War experience, daily stressors, and mental health were irrelevant with age, ethnicity and marital status. Factor such as being the first-born child of the family, higher reported war experiences, and daily stressors all negatively impact mental health. Alongside war and its direct effects, the existing socio-cultural context must be considered as a potential factor mediating the mental health of girls in Afghanistan

Spinal tuberculosis in Afghanistan: A 2019‐2020 study of patients in Kabul hospitals

Abstract Background Tuberculosis (TB) is endemic in many low‐income countries, which can affect the spine in 1%–5% of those with an active infection. This study reports the clinical characteristics of patients admitted for spinal TB in Kabul, Afghanistan, a country with very limited resources. Methods This was a descriptive study among 26 patients treated for spinal TB in three major referral hospitals in Kabul, Afghanistan, between March 2019 and April 2020. The sociodemographic and clinical details, gender, age, site of infection, presenting complaints, signs, and symptoms of the patients were retrieved from their medical records. Summary statistics were analyzed using SPSS version 20. Ethics approval was obtained from the ethics committee of Shahid Beheshti University of Medical Sciences in Tehran, Iran. Results Data were available for 26 patients with spinal TB admitted consecutively. The mean age of the sample was 38.2 years (SD 17.5), and there were 16 males and 10 females. Median time from symptom onset to hospital admission was 60 days. The most common diagnostic imaging technique used was magnetic resonance imaging (92.3%), followed by computed tomography (7.7%). The majority of the lesions involved the lumbar spine (61.4%), followed by the thoracolumbar spine (30.8%). Back pain was the most common manifestation in 21 patients (80.8%), and varying degrees of neurological impairment were found in 16 (61.5%) patients. There were no deaths among the patients up to the discharge date. Conclusions This study describes the clinical characteristics of spinal TB among patients in Kabul, Afghanistan. It is essential to strengthen preventive strategies and to improve health awareness about clinical features of spinal TB in patients with chronic back pain even in the absence of signs of TB