Identifying factors to develop and validate a heat vulnerability tool for Pakistan – A review

Objective: This review will provide better insight into developing and validating a heat vulnerability assessment tool for Pakistan. Methods: A literature search was done to identify studies onon heat vulnerability assessment published from January 2012 to January 2021 (10 years). Online databases PubMed, Google Scholar, Scopus, and Web of science were used for the literature search. Results: Heat vulnerability can be evaluated by some specific determinants that have heat-related health events, including social, economic, environmental, housing, and geographical factors. Conclusion: This tool will identify heat vulnerability risks and mitigate morbidity and mortality

Determinants of domestic violence among women of reproductive age (15-49 years) in Quetta, Balochistan-a mixed-method protocol

Background: Worldwide, domestic violence (DV) is a cause of death and disability among women aged 15-49 years. In Pakistan, DV appears in different forms, and only 3.2% of women report any DV. There are various factors associated with DV against women. The data are sparse for the Balochistan province due to the under-reporting and scattered population. This research study aims to determine the factors associated with DV and the types of violence among women of reproductive age. Also, to understand the perspective of community leaders and healthcare workers (HCWs) for developing interventions for DV prevention against women of reproductive age in Quetta Balochistan.Methods and analysis: A sequential explanatory mixed-method (quantitative study followed by qualitative) study design will be used to fulfil the study\u27s objectives. Women of reproductive age (15-49 years), both married and unmarried, local residents, community leaders and community HCWs of Quetta Balochistan, will be made part of the study. A structured questionnaire will be used as the quantitative tool. Focus group discussions will be conducted using a semistructured guide for the qualitative data collection. The multivariable logistic regression analysis will be performed for the quantitative part. P value ≤0.05 will be considered significant. In the qualitative part, data will be transcribed, and recurrent themes/subthemes will be developed to understand the perspective and opinion regarding DV prevention.Ethics and dissemination: Ethical Approval was taken from Aga Khan University, Karachi, Pakistan. Informed written consent will be obtained from all participants. The article will be published after data collection and analysis in the journal to disseminate the results

Managing epileptic women in pregnancy

Epilepsy is commonly seen in women of reproductive age and it is affecting their reproductive and pregnancy outcomes in an adverse manner [1]. It has seen that there are increased numbers of maternal deaths of pregnant women with epilepsy than those who have no any epilepsy symptoms or episodes. In many studies the common outcome observed is spontaneous miscarriage, ante partum hemorrhage or early pre term deliveries. Malformation and congenital anomalies are quite common in new born of epileptic women and also those who are on some kind of anti-epileptic medicines like valproate sodium. Death or still birth of new born babies is another complication witnessed because of epilepsy in pregnant women [2]

COVID-19 vaccine acceptance and hesitancy among the general population of Pakistan: A population-based survey

Objectives: This study aims to determine the COVID-19 vaccination coverage and the factors associated with vaccine acceptance and hesitancy in the general population of Pakistan. Setting: This population-based study covers all major areas of Pakistan, including Sindh, Punjab, Khyber Pakhtunkhwa and Baluchistan provinces and the capital Islamabad. Participants: A total of 541 male and female Pakistani adults above 18 years were interviewed to determine the COVID-19 vaccination coverage and understand the factors associated with vaccine acceptance and hesitancy. Outcome: The outcome was COVID-19 vaccination status (not vaccinated or vaccinated). Results: Of 541 participants, 227 (41.96%) were non-vaccinated and 314 (58.04%) were vaccinated. Two-thirds of the participants from both the non-vaccinated and vaccinated groups (185 (81.50%) vs 236 (75.16%), p=0.008) reside in Sindh. Nearly one-third of participants from both groups were ever infected with COVID-19 (77 (33.92%) and 90 (28.66%)). The odds of COVID-19 vaccination among the age group 34–42 years were 1.75 times higher (95% CI 1.35 to 2.09, p=0.008) than the other age groups. The odds of COVID-19 vaccination among those with COVID-19 ever-infected family members were 1.87 times higher (95% CI 1.56 to 2.34, p=0.032) than those with uninfected family members. Conclusions: Targeted interventions for subsets of populations reluctant to vaccination can improve vaccine coverage. Moreover, advocacy and explaining the public health benefits of vaccination can enhance the coverage in Pakistan

The serological confirmation and outcome of the pediatric dengue patients presenting to emergency department: A cross-sectional study

Background: In the emergency department, it is very uncommon perform a differential diagnosis to serologically differentiate between dengue, dengue hemorrhagic fever, and dengue shock syndrome. Prompt differential diagnosis and treatment is essential with the presentation of dengue. This study aims to determine the serological confirmation and outcome of the dengue epidemic in the pediatric population presenting to the ED in a tertiary care hospital. Methods: A single-center cross-sectional study was conducted. All pediatric patients aged less than 18years presented to ED with clinical features suggestive of DF, DFF, and DSS while also doing the serological confirmation for the dengue were enrolled in the study. Data was collected on demographics, clinical characteristics, diagnosis, and outcomes of 324 pediatric patients. Multivariable binary logistic regression was applied for the analysis. Results: Out of 324 patients, 191 (59.13%) underwent NS1 testing and 132 (40.87%) did the IgM test. Most participants were in the age range of 13 to 18years in both groups. Fever was the most common complaint in both groups 191 (100%) and 132 (100%). In each group, around one-third of the participants complained about body aches 69 (36.13%) and 44 (33.33%). The patient having a history of traveling within the past 14days created a 1.51 (95% CI: 1.27-2.25) times higher odds of contracting dengue fever as compared to no history of travel. Conclusion: The serologic confirmation of dengue in the ED helps in both the adequate and timely treatment as well as patient disposition and ultimately saves live

The Serological Confirmation and Outcome of the Pediatric Dengue Patients Presenting to Emergency Department: A Cross-Sectional Study

Background In the emergency department, it is very uncommon perform a differential diagnosis to serologically differentiate between dengue, dengue hemorrhagic fever, and dengue shock syndrome. Prompt differential diagnosis and treatment is essential with the presentation of dengue. This study aims to determine the serological confirmation and outcome of the dengue epidemic in the pediatric population presenting to the ED in a tertiary care hospital. Methods A single-center cross-sectional study was conducted. All pediatric patients aged less than 18 years presented to ED with clinical features suggestive of DF, DFF, and DSS while also doing the serological confirmation for the dengue were enrolled in the study. Data was collected on demographics, clinical characteristics, diagnosis, and outcomes of 324 pediatric patients. Multivariable binary logistic regression was applied for the analysis. Results Out of 324 patients, 191 (59.13%) underwent NS1 testing and 132 (40.87%) did the IgM test. Most participants were in the age range of 13 to 18 years in both groups. Fever was the most common complaint in both groups 191 (100%) and 132 (100%). In each group, around one-third of the participants complained about body aches 69 (36.13%) and 44 (33.33%). The patient having a history of traveling within the past 14 days created a 1.51 (95% CI: 1.27-2.25) times higher odds of contracting dengue fever as compared to no history of travel. Conclusion The serologic confirmation of dengue in the ED helps in both the adequate and timely treatment as well as patient disposition and ultimately saves lives

Thirty-year trends of triple burden of disease in the adult population of Pakistan

Background: The triple burden of disease, i.e. communicable diseases, non-communicable diseases and injuries, has significantly affected the healthcare system of Pakistan during the last three decades. Therefore, this study aims to determine and analyse the 30-year disease burden trends through prevalence, death rates and percentages.Methods: The data for the last three decades, i.e. 1990 to 2019, was extracted from the Global Burden of Disease for Pakistan. Percentage change in prevalence and deaths over 30 years was calculated. Poisson regression analysis was performed to evaluate the triple disease burden trends and the incidence rate ratio.Results: A relative decrease of 23.4% was noted in the prevalence rate of communicable diseases except for human immunodeficiency virus and dengue fever. A relative increase of 1.4% was noted in the prevalence rate of non-communicable diseases. A relative increase of 56.1% was recorded in the prevalence rate of injuries. The prevalence rate ratios of communicable diseases significantly decreased to 0.9796 [95% CI: 0.9887-0.9905], but the prevalence rate of injury increased to 1.0094 [95% CI: 1.0073-1.01145], respectively.Conclusion: Pakistan must take the next steps and develop strategies to decrease this burden and mortality rates in the population to create better outcomes and therefore help the healthcare system overall