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Aga Khan University

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Full-Text Articles in Medicine and Health Sciences

Omicron Spike Function And Neutralizing Activity Elicited By A Comprehensive Panel Of Vaccines, John E. Bowen, Amin Addetia, Ha V Dang, Cameron Stewart, Jack T. Brown, William K. Sharkey, Kaitlin R. Sprouse, Kumail Ahmed, Asefa Shariq Ansari, Najeeha Talat Iqbal Aug 2022

Omicron Spike Function And Neutralizing Activity Elicited By A Comprehensive Panel Of Vaccines, John E. Bowen, Amin Addetia, Ha V Dang, Cameron Stewart, Jack T. Brown, William K. Sharkey, Kaitlin R. Sprouse, Kumail Ahmed, Asefa Shariq Ansari, Najeeha Talat Iqbal

Department of Paediatrics and Child Health

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant of concern comprises several sublineages, with BA.2 and BA.2.12.1 having replaced the previously dominant BA.1 and with BA.4 and BA.5 increasing in prevalence worldwide. We show that the large number of Omicron sublineage spike mutations leads to enhanced angiotensin-converting enzyme 2 (ACE2) binding, reduced fusogenicity, and severe dampening of plasma neutralizing activity elicited by infection or seven clinical vaccines relative to the ancestral virus. Administration of a homologous or heterologous booster based on the Wuhan-Hu-1 spike sequence markedly increased neutralizing antibody titers and breadth against BA.1, BA.2, BA.2.12.1, BA.4, and …


Barriers And Facilitators To Exclusive Breastfeeding In Rural Pakistan: A Qualitative Exploratory Study, Atif Riaz, Shelina Bhamani, Sheraz Ahmed, Fayyaz Umrani, Sadaf Jakhro, Abdul Khaliq Qureshi, Syed Asad Ali Aug 2022

Barriers And Facilitators To Exclusive Breastfeeding In Rural Pakistan: A Qualitative Exploratory Study, Atif Riaz, Shelina Bhamani, Sheraz Ahmed, Fayyaz Umrani, Sadaf Jakhro, Abdul Khaliq Qureshi, Syed Asad Ali

Department of Paediatrics and Child Health

Background: Exclusive breastfeeding (EBF) of children until six months of age is considered one of the most critical interventions in tackling childhood undernutrition. EBF rates are suboptimal in Pakistan, particularly in rural areas where child undernutrition is most prevalent. This study aimed to explore barriers to EBF in a rural context of Pakistan.
Methods: The study was conducted in the rural district Matiari of Sindh, Pakistan, during Jan-March 2020. We used a qualitative exploratory study design and conducted 36 focus group discussions (FGDs). Participants were purposively selected mothers who had not practiced EBF during their previous childbirth, their spouses and …


Social Contributors For The Rise Of Covid-19 Infections In South Asia: A Large Cross-Sectional Survey, Zouina Sarfraz, Azza Sarfraz, Muzna Sarfraz, Nishwa Azeem, Namrata Hange, Miguel Felix, Ivan Cherrez-Ojeda Aug 2022

Social Contributors For The Rise Of Covid-19 Infections In South Asia: A Large Cross-Sectional Survey, Zouina Sarfraz, Azza Sarfraz, Muzna Sarfraz, Nishwa Azeem, Namrata Hange, Miguel Felix, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Background: The ongoing global coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was first reported in South Asia on 30th January 2020 in India. Ever since, certain countries have witnessed multiple waves of COVID-19, requiring attention by public health experts and strategists in the region. The objectives of this study are to assess social contributors to the recurrent waves of COVID-19 in South Asia including first demographic traits, second household characteristics and social measures, third workplace trends and personal protective equipment use, and fourth satisfaction and attitudes concerning public health measures and vaccination status. …


Impact Of Biosecurity Measures, Social Pressure And Bullying On Attitudes, Perceptions, And Job Satisfaction Levels Among Healthcare Workers During The Covid-19 Pandemic: A Cross-Sectional Survey, Azza Sarfraz, Zouina Sarfraz, Genesis Camacho-Leon, Geovanny Efraín Alvarado-Villa, Derly Madeleiny Andrade-Molina, Juan Carlos Fernandez-Cadena, Arjola Agolli, Zeynep Yukselen, Miguel Felix, Juan Carlos Gallardo Bastidas Jul 2022

Impact Of Biosecurity Measures, Social Pressure And Bullying On Attitudes, Perceptions, And Job Satisfaction Levels Among Healthcare Workers During The Covid-19 Pandemic: A Cross-Sectional Survey, Azza Sarfraz, Zouina Sarfraz, Genesis Camacho-Leon, Geovanny Efraín Alvarado-Villa, Derly Madeleiny Andrade-Molina, Juan Carlos Fernandez-Cadena, Arjola Agolli, Zeynep Yukselen, Miguel Felix, Juan Carlos Gallardo Bastidas

Department of Paediatrics and Child Health

Introduction: The extent and nature of social pressure and bullying towards healthcare workers (HCWs) during the COVID-19 remains unclear. The following study identifies the effect of social pressure and bullying directed towards HCWs when using biosecurity measures during the COVID-19 pandemic; further, the impact on perceptions, attitudes and job satisfaction level is also explored.
Methodology: We conducted a cross-sectional survey-based study among 684 Ecuadorian HCWs. The survey consisted of 38 questions related to the frequency, attitudes, and perceptions of biosecurity measures during the COVID-19 pandemic. Exploratory factor analysis was performed to assess the validity of the questionnaire. Associations between variables …


Implementation Evaluation Of A Leadership Development Intervention For Improved Family Experience In A Private Paediatric Care Hospital, Pakistan, Muneera A. Rasheed, Ayesha Hussain, Amin Hashwani, Johannes T. Kedzierski, Babar S. Hasan Jul 2022

Implementation Evaluation Of A Leadership Development Intervention For Improved Family Experience In A Private Paediatric Care Hospital, Pakistan, Muneera A. Rasheed, Ayesha Hussain, Amin Hashwani, Johannes T. Kedzierski, Babar S. Hasan

Department of Paediatrics and Child Health

Background: A study from a tertiary care center in Pakistan demonstrated that a leadership development intervention led to improved family experience of care outcomes. The objective of the current paper is to assess the implementation of this intervention and identify barriers and facilitators to inform sustainability and scalability.
Methods: A working group designed the intervention using a theory-of-change model to strengthen leadership development to achieve greater employee engagement. The interventions included: i) purpose and vision through purpose-driven leadership skills trainings; ii) engaging managers via on-the-job mentorship programme for managers, iii) employee voice i.e., facilitation of upward communication to hear the …


Measuring Contraceptive Method Mix, Prevalence, And Demand Satisfied By Age And Marital Status In 204 Countries And Territories, 1970-2019: A Systematic Analysis For The Global Burden Of Disease Study 2019, Annie Haakenstad, Olivia Angelino, Caleb M S Irvine, Zulfiqar Ahmed Bhutta, Kelly Bienhoff, Corinne Bintz, Kate Causey, M Ashworth Dirac, Nancy Fullman, Emmanuela Gakidou Jul 2022

Measuring Contraceptive Method Mix, Prevalence, And Demand Satisfied By Age And Marital Status In 204 Countries And Territories, 1970-2019: A Systematic Analysis For The Global Burden Of Disease Study 2019, Annie Haakenstad, Olivia Angelino, Caleb M S Irvine, Zulfiqar Ahmed Bhutta, Kelly Bienhoff, Corinne Bintz, Kate Causey, M Ashworth Dirac, Nancy Fullman, Emmanuela Gakidou

Department of Paediatrics and Child Health

Background: Meeting the contraceptive needs of women of reproductive age is beneficial for the health of women and children, and the economic and social empowerment of women. Higher rates of contraceptive coverage have been linked to the availability of a more diverse range of contraceptive methods. We present estimates of the contraceptive prevalence rate (CPR), modern contraceptive prevalence rate (mCPR), demand satisfied, and the method of contraception used for both partnered and unpartnered women for 5-year age groups in 204 countries and territories between 1970 and 2019.
Methods: We used 1162 population-based surveys capturing contraceptive use among women between 1970 …


Multiplex Pcr Assay To Detect High Risk Lineages Of Salmonella Typhi And Paratyphi A, Fahad Khokhar, Derek Pickard, Zoe Dyson, Junaid Iqbal, Agila Pragasam, Jobin Jacob John, Balaji Veeraraghavan, Farah Qamar, Gordon Dougan, Hilary Macqueen Jul 2022

Multiplex Pcr Assay To Detect High Risk Lineages Of Salmonella Typhi And Paratyphi A, Fahad Khokhar, Derek Pickard, Zoe Dyson, Junaid Iqbal, Agila Pragasam, Jobin Jacob John, Balaji Veeraraghavan, Farah Qamar, Gordon Dougan, Hilary Macqueen

Department of Paediatrics and Child Health

Enteric fever infections remain a significant public health issue, with up to 20 million infections per year. Increasing rates of antibiotic resistant strains have rendered many first-line antibiotics potentially ineffective. Genotype 4.3.1 (H58) is the main circulating lineage of S. Typhi in many South Asian countries and is associated with high levels of antibiotic resistance. The emergence and spread of extensively drug resistant (XDR) typhoid strains has increased the need for a rapid molecular test to identify and track these high-risk lineages for surveillance and vaccine prioritisation. Current methods require samples to be cultured for several days, followed by DNA …


Performance Of Machine Learning Classifiers In Classifying Stunting Among Under-Five Children In Zambia, Obvious Nchimunya Chilyabanyama, Roma Chilengi, Roma Chilengi, Michelo Simuyandi, Caroline C. Chisenga, Masuzyo Chirwa, Kalongo Hamusonde, Rakesh Kumar Saroj, Najeeha Talat Iqbal, Innocent Ngaruye Jul 2022

Performance Of Machine Learning Classifiers In Classifying Stunting Among Under-Five Children In Zambia, Obvious Nchimunya Chilyabanyama, Roma Chilengi, Roma Chilengi, Michelo Simuyandi, Caroline C. Chisenga, Masuzyo Chirwa, Kalongo Hamusonde, Rakesh Kumar Saroj, Najeeha Talat Iqbal, Innocent Ngaruye

Department of Paediatrics and Child Health

Stunting is a global public health issue. We sought to train and evaluate machine learning (ML) classification algorithms on the Zambia Demographic Health Survey (ZDHS) dataset to predict stunting among children under the age of five in Zambia. We applied Logistic regression (LR), Random Forest (RF), SV classification (SVC), XG Boost (XgB) and Naïve Bayes (NB) algorithms to predict the probability of stunting among children under five years of age, on the 2018 ZDHS dataset. We calibrated predicted probabilities and plotted the calibration curves to compare model performance. We computed accuracy, recall, precision and F1 for each machine learning algorithm. …


Diagnostic Accuracy Of Various Immunochromatographic Tests For Ns1 Antigen And Igm Antibodies Detection In Acute Dengue Virus Infection, Mughees Haider, Saira Yousaf, Asifa Zaib, Azza Sarfraz, Zouina Sarfraz, Ivan Cherrez-Ojeda Jul 2022

Diagnostic Accuracy Of Various Immunochromatographic Tests For Ns1 Antigen And Igm Antibodies Detection In Acute Dengue Virus Infection, Mughees Haider, Saira Yousaf, Asifa Zaib, Azza Sarfraz, Zouina Sarfraz, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Introduction: Rapid diagnostic tests (RDTs) were evaluated, in this paper, for their utility as a reliable test, using resource-constrained studies. In most studies, NS1 antigen and immunoglobulin M (IgM)-based immunochromatographic tests (ICTs) were considered for acute phase detection. We aimed to evaluate the diagnostic accuracy of NS1, IgM, and NS1/IgM-based ICTs to detect acute dengue virus (DENV) infection in dengue-endemic regions.
Methods: Studies were electronically identified using the following databases: MEDLINE, Embase, Cochrane Library, Web of Science, and CINAHL Plus. Keywords including dengue, rapid diagnostic test, immunochromatography, sensitivity, specificity, and diagnosis were applied across databases. In total, 15 studies were …


Community-Based Asthma Assessment In Young Children: Adaptations For A Multicentre Longitudinal Study In South Asia, Mohammad Shahidul Islam, Samin Huq, Steven Cunningham, Jurgen Schwarze, Asmd Ashraful Islam, Mashal Amin, Farrukh Raza, Benazir Baloch, Muhammad Imran Nisar, Sajid Bashir Soofi Jul 2022

Community-Based Asthma Assessment In Young Children: Adaptations For A Multicentre Longitudinal Study In South Asia, Mohammad Shahidul Islam, Samin Huq, Steven Cunningham, Jurgen Schwarze, Asmd Ashraful Islam, Mashal Amin, Farrukh Raza, Benazir Baloch, Muhammad Imran Nisar, Sajid Bashir Soofi

Department of Paediatrics and Child Health

Background: Systematic assessment of childhood asthma is challenging in low- and middle-income country (LMIC) settings due to the lack of standardised and validated methodologies. We describe the contextual challenges and adaptation strategies in the implementation of a community-based asthma assessment in four resource-constrained settings in Bangladesh, India, and Pakistan.
Method: We followed a group of children of age 6-8 years for 12 months to record their respiratory health outcomes. The study participants were enrolled at four study sites of the 'Aetiology of Neonatal Infection in South Asia (ANISA)' study. We standardised the research methods for the sites, trained field staff …


Newborn Weight Change And Predictors Of Underweight In The Neonatal Period In Guinea-Bissau, Nepal, Pakistan And Uganda, Valerie J. Flaherman, Amy S. Ginsburg, Muhammad Imran Nisar, Muddassir Altaf, Khushboo Liaquat, Benazir Baloch, Najeeb Rehman, Yasir Shafiq, Shabina Ariff, Fyezah Jehan Jul 2022

Newborn Weight Change And Predictors Of Underweight In The Neonatal Period In Guinea-Bissau, Nepal, Pakistan And Uganda, Valerie J. Flaherman, Amy S. Ginsburg, Muhammad Imran Nisar, Muddassir Altaf, Khushboo Liaquat, Benazir Baloch, Najeeb Rehman, Yasir Shafiq, Shabina Ariff, Fyezah Jehan

Department of Paediatrics and Child Health

In low- and middle-income countries (LMIC), growth impairment is common; however, the trajectory of growth over the course of the first month has not been well characterised. To describe newborn growth trajectory and predictors of growth impairment, we assessed growth frequently over the first 30 days among infants born ≥2000 g in Guinea-Bissau, Nepal, Pakistan and Uganda. In this cohort of 741 infants, the mean birth weight was 3036 ± 424 g. For 721 (98%) infants, weight loss occurred for a median of 2 days (interquartile range, 1-4) following birth until weight nadir was reached 5.9 ± 4.3% below birth …


A Changing Epidemic And The Rise Of Opioid-Stimulant Co-Use, Saeed Ahmed, Zouina Sarfraz, Azza Sarfraz Jul 2022

A Changing Epidemic And The Rise Of Opioid-Stimulant Co-Use, Saeed Ahmed, Zouina Sarfraz, Azza Sarfraz

Department of Paediatrics and Child Health

No abstract provided.


Incidence Of Typhoid And Paratyphoid Fever In Bangladesh, Nepal, And Pakistan: Results Of The Surveillance For Enteric Fever In Asia Project, Mohammad Tahir Yousafzai, Sadia Shakoor, Irum Fatima Dehraj, Junaid Mehmood, Rozina Thobani, Aneeta Hotwani, Najeeb Rehman, Seema Irfan, Abdul Momin Kazi, Mohammed J. Hunzai Jul 2022

Incidence Of Typhoid And Paratyphoid Fever In Bangladesh, Nepal, And Pakistan: Results Of The Surveillance For Enteric Fever In Asia Project, Mohammad Tahir Yousafzai, Sadia Shakoor, Irum Fatima Dehraj, Junaid Mehmood, Rozina Thobani, Aneeta Hotwani, Najeeb Rehman, Seema Irfan, Abdul Momin Kazi, Mohammed J. Hunzai

Department of Paediatrics and Child Health

Background: Precise enteric fever disease burden data are needed to inform prevention and control measures, including the use of newly available typhoid vaccines. We established the Surveillance for Enteric Fever in Asia Project (SEAP) to inform these strategies.
Methods: From September, 2016, to September, 2019, we conducted prospective clinical surveillance for Salmonella enterica serotype Typhi (S Typhi) and Paratyphi (S Paratyphi) A, B, and C at health facilities in predetermined catchment areas in Dhaka, Bangladesh; Kathmandu and Kavrepalanchok, Nepal; and Karachi, Pakistan. Patients eligible for inclusion were outpatients with 3 or more consecutive days of fever in the last 7 …


Gender-Based Violence In Pakistan And Public Health Measures: A Call To Action, Azza Sarfraz, Zouina Sarfraz, Muzna Sarfraz, Zul Qarnain Jul 2022

Gender-Based Violence In Pakistan And Public Health Measures: A Call To Action, Azza Sarfraz, Zouina Sarfraz, Muzna Sarfraz, Zul Qarnain

Department of Paediatrics and Child Health

No abstract provided.


Pneumococcal Carriage In Infants Post-Pcv10 Introduction In Pakistan: Results From Serial Cross-Sectional Surveys, Shahira Shahid, Amala Khan, Muhammad Imran Nisar, Farah Khalid, Muhammad Farrukh Qazi, Sheraz Ahmed, Furqan Kabir, Aneeta Hotwani, Sahrish Muneer, Syed Asad Ali, Anita K. M. Zaidi, Fyezah Jehan Jun 2022

Pneumococcal Carriage In Infants Post-Pcv10 Introduction In Pakistan: Results From Serial Cross-Sectional Surveys, Shahira Shahid, Amala Khan, Muhammad Imran Nisar, Farah Khalid, Muhammad Farrukh Qazi, Sheraz Ahmed, Furqan Kabir, Aneeta Hotwani, Sahrish Muneer, Syed Asad Ali, Anita K. M. Zaidi, Fyezah Jehan

Department of Paediatrics and Child Health

The 10-valent pneumococcal vaccine was introduced in Pakistan's Expanded Program on Immunization (EPI) in 2013 as a 3 + 0 schedule without catchup. We conducted three annual cross-sectional surveys from 2014-2016 to measure vaccine-type (VT) carriage in infants from a rural part of Pakistan. Nasopharyngeal specimens were collected by random sampling of infants from two union councils of Matiari. Samples were then transported to the Infectious Disease Research Laboratory (IDRL) at the Aga Khan University within 6-8 h of collection. Serotypes were established using sequential multiplex PCR. Of the 665 children enrolled across three surveys, 547 were culture-positive for pneumococcus. …


Frequency Of Use And Preferences For Information And Communication Technologies In Patients With Sleep Apnea: A Multicenter, Multinational, Observational Cross-Sectional Survey Study, Veronica R. Jaritos, Emanuel Vanegas, Juan Facundo Nogueira, Sebastian Leiva Agüero, Vanina Giovini, Jorge Rey De Castro, Yadira Rodríguez Reyes, José Luis Carrillo Alduenda, Pammela Torres Gittaim, Zaira Romero, Azza Sarfraz Jun 2022

Frequency Of Use And Preferences For Information And Communication Technologies In Patients With Sleep Apnea: A Multicenter, Multinational, Observational Cross-Sectional Survey Study, Veronica R. Jaritos, Emanuel Vanegas, Juan Facundo Nogueira, Sebastian Leiva Agüero, Vanina Giovini, Jorge Rey De Castro, Yadira Rodríguez Reyes, José Luis Carrillo Alduenda, Pammela Torres Gittaim, Zaira Romero, Azza Sarfraz

Department of Paediatrics and Child Health

Background: Obstructive sleep apnea (OSA) is a condition characterized by repeated episodes of partial or complete obstruction of the upper airway during sleep. An accessible method to facilitate self-management education is through information and communication technologies (ICTs).
Purpose: To assess the frequency of and preferences for ICT use in patients with sleep apnea.
Methods: A multicenter, multinational, observational cross-sectional survey study was conducted between 2018 and 2019 in sleep units in different countries of Latin America, including patients of both genders older than 18 years with a diagnosis of sleep apnea. Participants were asked to complete 20 questions in a …


Women's Health: Optimal Nutrition Throughout The Lifecycle, Edith J M Feskens, Regan Bailey, Zulfiqar Ahmed Bhutta, Hans-Konrad Biesalski, Heather Eicher-Miller, Klaus Krämer, Wen-Harn Pan, James C. Griffiths May 2022

Women's Health: Optimal Nutrition Throughout The Lifecycle, Edith J M Feskens, Regan Bailey, Zulfiqar Ahmed Bhutta, Hans-Konrad Biesalski, Heather Eicher-Miller, Klaus Krämer, Wen-Harn Pan, James C. Griffiths

Department of Paediatrics and Child Health

Sex differences are an important consideration when researching and establishing policies for nutrition and optimal health. For women's health, there are important physiologic, neurologic, and hormonal distinctions throughout the lifecycle that impact nutritional needs. Distinct from those for men, these nutritional needs must be translated into appropriate nutrition policy that aims to not only avoid overt nutritional deficiency, but also to promote health and minimize risk for chronic disease. Through a series of webinars, scientific experts discussed the advances in the understanding of the unique nutritional needs, challenges and opportunities of the various life stages for women across the life …


Effect Of Bovine Lactoferrin On Seroconversion Following Polio Vaccine Administration In Children: Protocol For A Double-Blinded Randomised Controlled Trial, Atif Habib, Sidrah Nausheen, Shanila Nooruddin, Tooba Javed, Tariq Samejo, Amjad Hussain, Suneeta Namdave, Sehrish Amirali, Muhammad Umer, Lumaan Sheikh May 2022

Effect Of Bovine Lactoferrin On Seroconversion Following Polio Vaccine Administration In Children: Protocol For A Double-Blinded Randomised Controlled Trial, Atif Habib, Sidrah Nausheen, Shanila Nooruddin, Tooba Javed, Tariq Samejo, Amjad Hussain, Suneeta Namdave, Sehrish Amirali, Muhammad Umer, Lumaan Sheikh

Department of Paediatrics and Child Health

Introduction: The oral polio vaccine (OPV) has substantial results in eliminating wild poliovirus and the vaccine of choice in polio eradication. However, the mucosal immunity induced by the OPV is still uncertain. Literature has shown that bovine lactoferrin (BLF) is a safe and useful protein found in cow's milk with extraordinary antimicrobial, antiviral, antiinflammatory and immune-modulatory functions that help children's gut to fight against micro-organisms like poliovirus. However, limited data exist regarding the effect of BLF on polio vaccine immune response. The primary objective is to evaluate the effect of BLF in enhancing mucosal and humoral immunity in children following …


Childhood Mortality During And After Acute Illness In Africa And South Asia: A Prospective Cohort Study, Childhood Acute Illness And Nutrition (Chain) Network, Abdoulaye Hama Diallo, Abu Sadat Mohammad Sayeem Bin Shahid, Ali Fazal Khan, Ali Faisal Saleem, Benson O. Singa, Blaise Siezanga Gnoumou, Caroline Tigoi, Syed Asad Ali, Zaubina Kazi May 2022

Childhood Mortality During And After Acute Illness In Africa And South Asia: A Prospective Cohort Study, Childhood Acute Illness And Nutrition (Chain) Network, Abdoulaye Hama Diallo, Abu Sadat Mohammad Sayeem Bin Shahid, Ali Fazal Khan, Ali Faisal Saleem, Benson O. Singa, Blaise Siezanga Gnoumou, Caroline Tigoi, Syed Asad Ali, Zaubina Kazi

Department of Paediatrics and Child Health

Background: Mortality among children with acute illness in low-income and middle-income settings remains unacceptably high and the importance of post-discharge mortality is increasingly recognised. We aimed to explore the epidemiology of deaths among young children with acute illness across sub-Saharan Africa and south Asia to inform the development of interventions and improved guidelines.
Methods: In this prospective cohort study, we enrolled children aged 2-23 months with acute illness, stratified by nutritional status defined by anthropometry (ie, no wasting, moderate wasting, or severe wasting or kwashiorkor), who were admitted to one of nine hospitals in six countries across sub-Saharan Africa and …


Anakinra Treatment Efficacy In Reduction Of Inflammatory Biomarkers In Covid-19 Patients: A Meta-Analysis, Zunaira Naveed, Musharraf Sarwar, Zahid Ali, Danish Saeed, Khadija Choudhry, Azza Sarfraz, Zouina Sarfraz, Miguel Felix, Ivan Cherrez-Ojeda Apr 2022

Anakinra Treatment Efficacy In Reduction Of Inflammatory Biomarkers In Covid-19 Patients: A Meta-Analysis, Zunaira Naveed, Musharraf Sarwar, Zahid Ali, Danish Saeed, Khadija Choudhry, Azza Sarfraz, Zouina Sarfraz, Miguel Felix, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Introduction: Anakinra is being empirically considered for the treatment of COVID-19 patients. The aim is to assess the efficacy of anakinra treatment on inflammatory marker reduction, including c-reactive protein (CRP) concentrations, serum ferritin, and serum d-dimer levels.
Methods: Adhering to PRISMA 2020 statement guidelines, a systematic search was conducted across the following databases from December 2019 until January 10, 2022: PubMed/MEDLINE, Cochrane Central, Web of Science, Scopus, and EMBASE. The following keywords were employed: Anakinra, COVID*, SARS-CoV-2, inflammatory, CRP, D-dimer, Ferritin, hematological, laboratory, clinical, trials. The findings were collated and presented in a tabulated manner, and statistically analyzed using Review …


Physician's Attitudes On Pulmonary Rehabilitation Following Covid-19: A Brief Perspective From A Developing Country, Ivan Cherrez-Ojeda, Emanuel Vanegas, Miguel Felix, María José Farfán Bajaña, Azza Sarfraz, Zouina Sarfraz, Genesis Camacho, Alanna Barrios-Ruiz, Jack Michel Apr 2022

Physician's Attitudes On Pulmonary Rehabilitation Following Covid-19: A Brief Perspective From A Developing Country, Ivan Cherrez-Ojeda, Emanuel Vanegas, Miguel Felix, María José Farfán Bajaña, Azza Sarfraz, Zouina Sarfraz, Genesis Camacho, Alanna Barrios-Ruiz, Jack Michel

Department of Paediatrics and Child Health

Despite the uncertainty about the follow up of COVID-19 survivors, there is a growing body of evidence supporting specific interventions including pulmonary rehabilitation, which may lead to a reduced hospital stay and improved overall respiratory function. The aim of this short report was to assess the attitudes toward pulmonary rehabilitation following COVID-19 among Ecuadorian physicians. A cross-sectional study was conducted, in which a 5-question survey was used to assess the level of agreement to specific statements with a 5-point Likert scale. Out of the 282 participants, 48.2% (n=136) were male, with a mean of 12.6 (SD=11.3) years of experience. More …


The Who Global Tuberculosis 2021 Report - Not So Good News And Turning The Tide Back To End Tb, Chakaya Jeremiah, Eskild Petersen, Rebecca Nantanda, Brenda N. Mungai, Giovanni Battista Migliori, Farhana Amanullah, Patrick Lungu, Francine Ntoumi, Nagalingeswaran Kumarasamy Mar 2022

The Who Global Tuberculosis 2021 Report - Not So Good News And Turning The Tide Back To End Tb, Chakaya Jeremiah, Eskild Petersen, Rebecca Nantanda, Brenda N. Mungai, Giovanni Battista Migliori, Farhana Amanullah, Patrick Lungu, Francine Ntoumi, Nagalingeswaran Kumarasamy

Department of Paediatrics and Child Health

Objective: To review the data presented in the 2021 WHO global TB report and discuss the current constraints in the global response.
Introduction and methods: The WHO global TB reports, consolidate TB data from countries and provide up to date assessment of the global TB epidemic. We reviewed the data presented in the 2021 report.
Results: We noted that the 2021 WHO global TB report presents a rather grim picture on the trajectory of the global epidemic of TB including a stagnation in the annual decline in TB incidence, a decline in TB notifications and an increase in estimated TB …


Optimal Iron Content In Ready-To-Use Therapeutic Foods For The Treatment Of Severe Acute Malnutrition In The Community Settings: A Protocol For The Systematic Review And Meta-Analysis, Aamer Imdad, Melissa François, Fanny F. Chen, Abigail Smith, Olivia Tsistinas, Emily Tanner Smith, Jai K. Das, Zulfiqar Ahmed Bhutta Mar 2022

Optimal Iron Content In Ready-To-Use Therapeutic Foods For The Treatment Of Severe Acute Malnutrition In The Community Settings: A Protocol For The Systematic Review And Meta-Analysis, Aamer Imdad, Melissa François, Fanny F. Chen, Abigail Smith, Olivia Tsistinas, Emily Tanner Smith, Jai K. Das, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Introduction: The current standard of care for children with severe acute malnutrition (SAM) involves using ready-to-use therapeutic food (RUTF) to promote growth; however, the precise formulation to achieve optimal recovery remains unclear. Emerging research suggests that alternative RUTF formulations may be more effective in correcting SAM-related complications such as anaemia and iron deficiency. This systematic review commissioned by the WHO aims to synthesise the most recent research on the iron content in RUTF and related products in the community-based treatment of uncomplicated severe malnutrition in children aged 6 months and older.
Methods and analysis: We will search multiple electronic databases. …


An Epidemiological, Strategic And Response Analysis Of The Covid-19 Pandemic In South Asia: A Population-Based Observational Study, Hafiz Muhammad Salman, Javaria Syed, Atif Riaz, Zouina Sarfraz, Azza Sarfraz, Syed Hashim Abbas Ali Bokhari, Ivan Cherrez Ojeda Mar 2022

An Epidemiological, Strategic And Response Analysis Of The Covid-19 Pandemic In South Asia: A Population-Based Observational Study, Hafiz Muhammad Salman, Javaria Syed, Atif Riaz, Zouina Sarfraz, Azza Sarfraz, Syed Hashim Abbas Ali Bokhari, Ivan Cherrez Ojeda

Department of Paediatrics and Child Health

Introduction: South Asia has had a dynamic response to the ongoing COVID-19 pandemic. The overall burden and response have remained comparable across highly-burdened countries within the South Asian Region.
Methodology: Using a population-based observational design, all eight South Asian countries were analyzed using a step-wise approach. Data were obtained from government websites and publicly-available repositories for population dynamics and key variables.
Results: South Asian countries have a younger average age of their population. Inequitable distribution of resources centered in urban metropolitan cities within South Asia is present. Certain densely populated regions in these countries have better testing and healthcare facilities …


Knowledge And Practices On The Prevention And Management Of Diarrhea In Children Under-2 Years Among Women Dwelling In Urban Slums Of Karachi, Pakistan, Asif Khaliq, Amreen 1, Nazia Jameel, Stefanie J. Krauth Mar 2022

Knowledge And Practices On The Prevention And Management Of Diarrhea In Children Under-2 Years Among Women Dwelling In Urban Slums Of Karachi, Pakistan, Asif Khaliq, Amreen 1, Nazia Jameel, Stefanie J. Krauth

Department of Paediatrics and Child Health

Background: Diarrhea is the second leading cause of death especially among children. The age-proportionate mortality of diarrheal disease in infants under 2 years is 72%, among children under 5 years of age. Children living in urban slums are more prone to develop diarrhea. Although the disease can be prevented by many simple cost-effective interventions, i.e. proper sanitation and hygiene, appropriate feeding, and timely vaccination, poverty and lack of basic life amenities often potentiate diarrhea mortality. Gadap town is the largest town of Karachi with a deprived health system. This study aims to assess pediatric diarrhea prevalence and related knowledge-practice gaps …


The Correlation Of D-Dimer To Stroke Diagnosis Within 24 Hours: A Meta-Analysis, Adeel Ahmad, Zara Islam, Saad Manzoor Ahmad, Zouina Sarfraz, Azza Sarfraz, Miguel Felix, Ivan Cherrez-Ojeda Mar 2022

The Correlation Of D-Dimer To Stroke Diagnosis Within 24 Hours: A Meta-Analysis, Adeel Ahmad, Zara Islam, Saad Manzoor Ahmad, Zouina Sarfraz, Azza Sarfraz, Miguel Felix, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Background: Diagnosing D-Dimer early is essential to optimize clinical treatment and quality of life and reduce mortality. This study aims to identify the difference of D-Dimer levels (ng/ml) in patients with stroke within the 6- and 24-h period compared to patients that mimic stroke.
Methods: An electronic database search across PubMed/MEDLINE, Cochrane, Web of Science, CINAHL, EMBASE, and Scopus was conducted until December 10, 2021. Studies were eligible if they included adult patients with stroke compared to stroke mimics or controls reporting D-Dimer values. Quality assessment was conducted using GRADE. The standardized mean difference and 95% confidence intervals were calculated …


Optimizing Prevention And Community-Based Management Of Severe Malnutrition In Children, Zulfiqar Ahmed Bhutta Mar 2022

Optimizing Prevention And Community-Based Management Of Severe Malnutrition In Children, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Zulfiqar A. Bhutta discusses prevention and treatment strategies for optimization of community-based management of severe acute malnutrition in children


Characteristics And Birth Outcomes Of Pregnant Adolescents Compared To Older Women: An Analysis Of Individual Level Data From 140,000 Mothers From 20 Rcts, Nadia Akseer, Emily Catherine Keats, Pravheen Thurairajah, Simon Cousens, Ana Pilar Bétran, Brietta M. Oaks, David Osrin, Ellen Piwoz, Exnevia Gomo, Zulfiqar Ahmed Bhutta Feb 2022

Characteristics And Birth Outcomes Of Pregnant Adolescents Compared To Older Women: An Analysis Of Individual Level Data From 140,000 Mothers From 20 Rcts, Nadia Akseer, Emily Catherine Keats, Pravheen Thurairajah, Simon Cousens, Ana Pilar Bétran, Brietta M. Oaks, David Osrin, Ellen Piwoz, Exnevia Gomo, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Adolescence is a critical period of maturation when nutrient needs are high, especially among adolescents entering pregnancy. Using individual-level data from 140,000 participants, we examined socioeconomic, nutrition, and pregnancy and birth outcomes for adolescent mothers (10-19 years) compared to older mothers in low and middle-income countries.
Methods: This study was conducted between March 16, 2018 and May 25, 2021. Data were obtained from 20 randomised controlled trials of micronutrient supplementation in pregnancy. Stratified analyses were conducted by age (10-14 years, 15-17 years, 18-19 years, 20-29 years, 30-39 years, 40+ years) and geographical region (Africa, Asia). Crude and confounder-adjusted means, …


Understanding The Context Of Healthcare Utilisation For Children Under-Five With Diarrhoea In The Drc: Based On Andersen Behavioural Model, Siyu Zou, Xinran Qi, Keiko Marshall, Maria Asif Bhura, Rie Takesue, Kun Tang Feb 2022

Understanding The Context Of Healthcare Utilisation For Children Under-Five With Diarrhoea In The Drc: Based On Andersen Behavioural Model, Siyu Zou, Xinran Qi, Keiko Marshall, Maria Asif Bhura, Rie Takesue, Kun Tang

Department of Paediatrics and Child Health

Background: Diarrhoea is one of the leading causes of death among children under 5 years old in the Democratic Republic of the Congo (DRC). Despite positive effects on prognosis, there is limited literature about the healthcare-seeking behaviours of children with diarrhoea, especially in the DRC. This study used the Andersen Behavioural Model, a theoretical framework, which was commonly adopted to study healthcare utilisation, to investigate and predict factors associated with the use of healthcare to treat diarrhoea in the DRC.
Methods: Data collected from 2626 under-five children with diarrhoea in the last 2 weeks from the Multiple Indicators Cluster Survey …


Early Postoperative Arrhythmias After Pediatric Congenital Heart Disease Surgery: A 5-Year Audit From A Lower- To Middle-Income Country, Sidra Ishaque, Saleem Akhtar, Asma Akbar Ladak, Russell Seth Martins, Muhammad Kamran Younis Memon, Alisha Raza Kazmi, Fatima Mahmood, Anwar Ul Haque Feb 2022

Early Postoperative Arrhythmias After Pediatric Congenital Heart Disease Surgery: A 5-Year Audit From A Lower- To Middle-Income Country, Sidra Ishaque, Saleem Akhtar, Asma Akbar Ladak, Russell Seth Martins, Muhammad Kamran Younis Memon, Alisha Raza Kazmi, Fatima Mahmood, Anwar Ul Haque

Department of Paediatrics and Child Health

Background: Postoperative arrhythmias are a known complication after surgical repair for congenital heart disease (CHD). This study aimed to identify and discuss the prevalence, diagnosis, and management of common rhythm disturbances seen in the immediate postoperative period after surgery for CHD in the pediatric population at a tertiary care hospital in Pakistan.
Methods: A retrospective study was conducted at a tertiary care hospital in Pakistan between January 2014 and December 2018. All pediatric (old) patients admitted to the intensive care unit and undergoing continuous electrocardiographic monitoring after surgery for CHD were included in this study. Data pertaining to the incidence, …