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Community Health Sciences

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Full-Text Articles in Diseases

Removing Lead From The Global Economy, Stephen P. Luby, Jenna E. Forsyth, Zafar Fatmi, Mahbubur Rahman, Jesmin Sultana, Erica L. Plambeck, N Grant Miller, Eran Bendavid, Peter J. Winch, Howard Hu Nov 2024

Removing Lead From The Global Economy, Stephen P. Luby, Jenna E. Forsyth, Zafar Fatmi, Mahbubur Rahman, Jesmin Sultana, Erica L. Plambeck, N Grant Miller, Eran Bendavid, Peter J. Winch, Howard Hu

Community Health Sciences

No abstract provided.


Oral Health Related Quality Of Life In Head And Neck Cancer Survivors Within The First Year Following Treatment: A Cross-Sectional Study In Karachi, Pakistan, Sana Qamar, Shafquat Rozi, Sobia Sawani, Mohammad Sohail Awan, Shabbir Akhtar, Moghira Siddiqui, Syed Akbar Abbas, Shazia Taimoor, Farhan Raza Khan Jan 2024

Oral Health Related Quality Of Life In Head And Neck Cancer Survivors Within The First Year Following Treatment: A Cross-Sectional Study In Karachi, Pakistan, Sana Qamar, Shafquat Rozi, Sobia Sawani, Mohammad Sohail Awan, Shabbir Akhtar, Moghira Siddiqui, Syed Akbar Abbas, Shazia Taimoor, Farhan Raza Khan

Community Health Sciences

After completing treatment for head and neck cancer (HNC), patients often face oral complications like oral pain, limited mouth opening and dry mouth which significantly reduce their oral health related quality of life (OHRQoL). These issues impact their overall well-being, social activities and long-term survival. The primary objective of this study was to evaluate OHRQoL and its association with sociodemographic characteristics, oral hygiene practices and oral clinical parameters such as oral hygiene status and oral mucositis grade in patients who have completed treatment for head and neck cancer. This cross-sectional study involved 79 HNC-treated patients within first year after completion …


Improving Maternal, Neonatal And Child Health Outcomes In Low-Resource Settings: Translating Research Evidence To Practice - Report From The Third International Conference On Maternal, Newborn And Child Health, Robert L. Goldenberg, Shivaprasad S. Goudar, Nancy F. Krebs, Richard Derman, Sarah Saleem, Elizabeth M. Mcclure Aug 2023

Improving Maternal, Neonatal And Child Health Outcomes In Low-Resource Settings: Translating Research Evidence To Practice - Report From The Third International Conference On Maternal, Newborn And Child Health, Robert L. Goldenberg, Shivaprasad S. Goudar, Nancy F. Krebs, Richard Derman, Sarah Saleem, Elizabeth M. Mcclure

Community Health Sciences

No abstract provided.


Community Centred Co-Design Methodology For Designing And Implementing Socio-Behavioural Interventions To Counter Covid-19 Related Misinformation Among Marginalized Population Living In The Squatter Settlements Of Karachi, Pakistan: A Methodology Paper, Rubina Qasim, Waqas Ahmed Farooqui, Atiya Rahman, Rukhsana Haroon, Madiha Saleem, Muhammad Rafique, Fiza Noor, Afifa Ghani, Muhammad Yaqoob, Mohammad Tahir Yousafzai Jul 2023

Community Centred Co-Design Methodology For Designing And Implementing Socio-Behavioural Interventions To Counter Covid-19 Related Misinformation Among Marginalized Population Living In The Squatter Settlements Of Karachi, Pakistan: A Methodology Paper, Rubina Qasim, Waqas Ahmed Farooqui, Atiya Rahman, Rukhsana Haroon, Madiha Saleem, Muhammad Rafique, Fiza Noor, Afifa Ghani, Muhammad Yaqoob, Mohammad Tahir Yousafzai

Community Health Sciences

Background: Misinformation regarding COVID-19 pandemic and vaccination is damaging COVID-19 vaccine trust and acceptance in Low- and Middle-Income Countries (LMIC). Identification of misinformation and designing locally acceptable solutions are needed to improve COVID-19 vaccine acceptance. This study aimed to utilize community-led co-design methodology to evaluate misinformation regarding COVID-19 and develop contextual interventions to address misinformation in a marginalized peri urban slum communities of Landhi town Karachi, Pakistan.
Methods: This study was conducted between January and December 2021, in marginalized peri-urban slum dwellers of Muslimabad Colony, Landhi Town Karachi, Pakistan. We used a community-centred co-design methodology embedded within mixed study design …


Exploring Stakeholders' Experiences And Perceptions Regarding Barriers To Effective Surveillance Of Communicable Diseases In A Rural District Of Pakistan: A Qualitative Study, Imran Naeem Abbasi, Sameen Siddiqi, Mmna Rehana Sididiqui, Rumina Hasan Nov 2022

Exploring Stakeholders' Experiences And Perceptions Regarding Barriers To Effective Surveillance Of Communicable Diseases In A Rural District Of Pakistan: A Qualitative Study, Imran Naeem Abbasi, Sameen Siddiqi, Mmna Rehana Sididiqui, Rumina Hasan

Community Health Sciences

Objective: To explore the experiences and perceptions of health system stakeholders of a rural district of Sindh, Pakistan regarding the barriers to effective surveillance of communicable diseases.
Design: This qualitative descriptive exploratory design comprised in-depth interviews. Both inductive and deductive thematic analysis was applied to identify key themes from the data.
Settings: The study was conducted in public sector healthcare facilities and the district health office of the rural district of Thatta, in Sindh province, Pakistan.
Participants: Fifteen healthcare managers and healthcare providers working in the eight public sector primary and secondary healthcare facilities were interviewed using an open-ended in-depth …


Understanding The Mental Health Impact And Needs Of Public Healthcare Professionals During Covid-19 In Pakistan : A Qualitative Study, Waqas Hameed, Anam Shahil Feroz, Bilal Iqbal Avan, Bushra Khan, Zafar Fatmi, Noreen Afzal, Hussain Jafri, Mansoor Ali Wassan, Sameen Siddiqi Nov 2022

Understanding The Mental Health Impact And Needs Of Public Healthcare Professionals During Covid-19 In Pakistan : A Qualitative Study, Waqas Hameed, Anam Shahil Feroz, Bilal Iqbal Avan, Bushra Khan, Zafar Fatmi, Noreen Afzal, Hussain Jafri, Mansoor Ali Wassan, Sameen Siddiqi

Community Health Sciences

Objectives: A dearth of qualitative studies constrains in-depth understanding of health service providers' perspectives and experiences regarding the impact of COVID-19 on their mental health. This study explored the mental health impact and needs of of public sector healthcare workers during COVID-19 who working in secondary-level and tertiary-level healthcare settings of Pakistan.
Design: An exploratory qualitative study.
Setting: Twenty-five secondary-level and eight tertiary-level public hospitals of Sindh and Punjab provinces of Pakistan.
Participants: In-depth interviews were conducted with 16 health service providers and 40 administrative personnel. Study data were analysed on NVivo V.11 using the conventional content analysis technique.
Results: …


Association Of Respiratory Symptoms And Lung Function With Occupation In The Multinational Burden Of Obstructive Lung Disease (Bold) Study, Jate Ratanachina, Andre F S Amara, Sara De Matteis, Herve Lawin, Kevin Mortimer, Daniel O. Obaseki, Imed Harrabi, Meriam Denguezli, Emiel F M Wouters, Asaad Ahmed Nafees Aug 2022

Association Of Respiratory Symptoms And Lung Function With Occupation In The Multinational Burden Of Obstructive Lung Disease (Bold) Study, Jate Ratanachina, Andre F S Amara, Sara De Matteis, Herve Lawin, Kevin Mortimer, Daniel O. Obaseki, Imed Harrabi, Meriam Denguezli, Emiel F M Wouters, Asaad Ahmed Nafees

Community Health Sciences

Chronic obstructive pulmonary disease has been associated with exposures in the workplace. We aimed to assess the association of respiratory symptoms and lung function with occupation in the Burden of Obstructive Lung Disease study. We analysed cross-sectional data from 28,823 adults (≥40 years) in 34 countries. Eleven occupations were considered and grouped by likelihood of exposure to organic dusts, inorganic dusts and fumes. The association of chronic cough, chronic phlegm, wheeze, dyspnoea, FEV1/FVC and FVC with occupation was assessed, per study site, using multivariable regression. These estimates were then meta-analysed. Sensitivity analyses explored differences between sexes and gross national income …


Estimating The Pre- And Post-Diagnosis Costs Of Tuberculosis For Adults In Pakistan: Household Economic Impact And Costs Mitigating Strategies, Shama Razzaq, Aysha Zahidie, Zafar Fatmi Jul 2022

Estimating The Pre- And Post-Diagnosis Costs Of Tuberculosis For Adults In Pakistan: Household Economic Impact And Costs Mitigating Strategies, Shama Razzaq, Aysha Zahidie, Zafar Fatmi

Community Health Sciences

Background: Despite free tuberculosis (TB) care in Pakistan, patients still have to bear high costs, which push them into poverty. This study estimated the pre- and post-diagnosis costs households bear for TB care, and investigated coping mechanisms among adults ≥ 18 years in Karachi, Pakistan.
Methods: We conducted a cross-sectional study comprising of 516 TB patients identified with completion of at least one month intensive treatment from four public sector health facilities from two institutes in Karachi, Pakistan. A standardized questionnaire to estimate patient's costs was administered. The study outcomes were direct medical and non-medical costs, and indirect costs. The …


The Response To Covid-19 Among Drug Retail Outlets In Indonesia: A Cross-Sectional Survey Of Knowledge, Attitudes, And Practices, Yusuf Ari Mashuri, Luh Putu Lila Wulandari, Mishal Khan, Astri Ferdiana, Ari Probandari, Tri Wibawa, Neha Batura, Marco Liverani, Richard Day, Stephen Jan Mar 2022

The Response To Covid-19 Among Drug Retail Outlets In Indonesia: A Cross-Sectional Survey Of Knowledge, Attitudes, And Practices, Yusuf Ari Mashuri, Luh Putu Lila Wulandari, Mishal Khan, Astri Ferdiana, Ari Probandari, Tri Wibawa, Neha Batura, Marco Liverani, Richard Day, Stephen Jan

Community Health Sciences

Background: Pharmacists have been at the frontline of the COVID-19 response in Indonesia, providing medicines, advice, and referral services often in areas with limited healthcare access. This study aimed to explore their knowledge, attitudes, and practices during the pandemic, so that we can be better prepared for future emergencies.
Methods: A cross-sectional online survey of community pharmacists and pharmacy technicians in Indonesia was conducted between July and August 2020. The dataset was analysed descriptively, and logistic regression was used to explore willingness to participate in COVID-19 interventions.
Findings: 4716 respondents participated in the survey. Two-thirds (66·7%) reported knowing only "a …


Determinant Of Repeat Revascularization Within 5 Years Of Percutaneous Coronary Lntervention At A Tertiary Care Hospital, Karachi: A Matched Case-Control Study, Komal Valliani, Azmina Artani, Iqbal Azam, Javed Tai, M. Masood Kadir Mar 2022

Determinant Of Repeat Revascularization Within 5 Years Of Percutaneous Coronary Lntervention At A Tertiary Care Hospital, Karachi: A Matched Case-Control Study, Komal Valliani, Azmina Artani, Iqbal Azam, Javed Tai, M. Masood Kadir

Community Health Sciences

Objective: To determine factors associated with repeat revascularization among adults aged 25 years and above within 5 years of first Percutaneous Coronary Intervention (PCI) at a tertiary care hospital.
Methods: A matched case-control study was conducted through a hospital records review. A total of 90 cases with repeat revascularization and 180 controls without repeat revascularization were included. Data was analyzed using Multiple Conditional Logistic Regression.
Results: The mean age was similar in cases and controls (60.05 ± 10.01 vs 62.20 ± 10.43 years) and sex (male: 77.8% vs. 76.1%). History of being an ever-smoker (40% vs. 25%), overweight (36.3% vs. …


Understanding The Needs Of A Mobile Phone-Based Telemonitoring Program For Pregnant Women At High Risk For Pre-Eclampsia: Interpretive Qualitative Description Study, Anam Shahil Feroz, Kristina De Vera, Nadia D. Bragagnolo, Sarah Saleem, Zulfiqar Ahmed Bhutta, Emily Seto Feb 2022

Understanding The Needs Of A Mobile Phone-Based Telemonitoring Program For Pregnant Women At High Risk For Pre-Eclampsia: Interpretive Qualitative Description Study, Anam Shahil Feroz, Kristina De Vera, Nadia D. Bragagnolo, Sarah Saleem, Zulfiqar Ahmed Bhutta, Emily Seto

Community Health Sciences

Background: Lack of early risk detection, diagnosis, and treatment of pregnant women at high risk for pre-eclampsia can result in high maternal mortality and morbidity not only in Pakistan but also in other low- to middle-income countries (LMICs). A potential tool for supporting pregnant women at high risk for pre-eclampsia for early detection is telemonitoring (TM). However, there is a limited body of evidence on end-user needs and preferences to inform the design of the TM programs for pregnant women at high risk for pre-eclampsia, specifically in LMICs such as Pakistan.
Objective: This study aims to explore the needs of …


The Unspoken Grief Of Multiple Stillbirths In Rural Pakistan: An Interpretative Phenomenological Study, Muhammad Asim, Sehrish Karim, Hajra Khwaja, Waqas Hameed, Sarah Saleem Feb 2022

The Unspoken Grief Of Multiple Stillbirths In Rural Pakistan: An Interpretative Phenomenological Study, Muhammad Asim, Sehrish Karim, Hajra Khwaja, Waqas Hameed, Sarah Saleem

Community Health Sciences

Background: Pakistan has the highest rate of stillbirth (30.6 stillbirths per 1000 total births) as compared to other South Asian countries. The psychological impact of stillbirths on bereaved women is well documented; however, there is a dearth of literature on lived experiences of women with multiple stillbirths in Pakistan.
Objective: The purpose of this research is to understand the lived experiences of women who had multiple stillbirths in Thatta, Pakistan.
Methods: An interpretative phenomenological study was conducted in district Thatta with eight women who experienced more than one stillbirth. A semi-structured in-depth interview guide was used for data collection. The …


Human Papillomavirus Associated Prevention: Knowledge, Attitudes, And Perceived Risks Among Men Who Have Sex With Men And Transgender Women In Pakistan: A Qualitative Study, Muslima Ejaz, Anna Mia Ekström, Alyan Ahmed, Aymen Haroon, Dania Ali, Tazeen Saeed Ali, Mariano Salazar Feb 2022

Human Papillomavirus Associated Prevention: Knowledge, Attitudes, And Perceived Risks Among Men Who Have Sex With Men And Transgender Women In Pakistan: A Qualitative Study, Muslima Ejaz, Anna Mia Ekström, Alyan Ahmed, Aymen Haroon, Dania Ali, Tazeen Saeed Ali, Mariano Salazar

Community Health Sciences

Objectives: Men who have sex with men (MSM) and transgender individuals are at higher risk of genital warts and anal cancer due to sexually transmitted human papillomavirus infection. This study explores MSM and transgender women's perceptions of Human papillomavirus (HPV) infection and HPV prevention strategies (screening and vaccination) in Pakistan.
Design: A qualitative study using focus group discussions (FGD) with self-identified MSM, male sex workers and transgender women were conducted between March 2019 to August 2019 in Karachi, Pakistan.
Methods: Participants were recruited from community-based organization (CBO) working for MSM and transgender women. A total of 38 men and 10 …


Knowledge, Attitude And Practices Of Pregnant Women Related To Covid-19 Infection: A Cross-Sectional Survey In Seven Countries From The Global Network For Women's And Children's Health, Farnaz Naqvi, Seemab Naqvi, Sk Masum Billah, Sarah Saleem, Elizabeth Fogleman, Nalini Peres Da-Silva, Lester Figueroa, Manolo Mazariegos, Ana L. Garces, Sana Yousaf Feb 2022

Knowledge, Attitude And Practices Of Pregnant Women Related To Covid-19 Infection: A Cross-Sectional Survey In Seven Countries From The Global Network For Women's And Children's Health, Farnaz Naqvi, Seemab Naqvi, Sk Masum Billah, Sarah Saleem, Elizabeth Fogleman, Nalini Peres Da-Silva, Lester Figueroa, Manolo Mazariegos, Ana L. Garces, Sana Yousaf

Community Health Sciences

Objective: We sought to understand knowledge, attitudes and practices (KAP) regarding COVID-19 in pregnant women in seven low and middle-income countries (LMIC).
Design: Population-based prospective, observational study.
Settings: Study sites in DRC, Kenya, Zambia, Bangladesh, India (two sites), Pakistan and Guatemala.
Population and sample: Pregnant women in the Global Network's Maternal and Neonatal Health Registry (MNHR).
Methods: A KAP questionnaire was administered in face-to-face interviews with pregnant women from September 2020 through October 2021 in the MNHR.
Main outcome measures: KAP regarding COVID-19 during pregnancy.
Results: In all, 25 260 women completed the survey. Overall, 56.8% of women named ≥3 …


Do Empowered Women Receive Better Quality Antenatal Care In Pakistan? An Analysis Of Demographic And Health Survey Data, Muhammad Asim, Waqas Hameed, Sarah Saleem Jan 2022

Do Empowered Women Receive Better Quality Antenatal Care In Pakistan? An Analysis Of Demographic And Health Survey Data, Muhammad Asim, Waqas Hameed, Sarah Saleem

Community Health Sciences

Introduction: Quality antenatal care is a window of opportunity for improving maternal and neonatal outcomes. Numerous studies have shown a positive effect of women empowerment on improved coverage of maternal and reproductive health services, including antenatal care (ANC). However, there is scarce evidence on the association between women's empowerment and improved ANC services both in terms of coverage and quality. Addressing this gap, this paper examines the relationship between multi-dimensional measures of women empowerment on utilization of quality ANC (service coverage and consultation) in Pakistan.
Methods: We used Pakistan Demographic and Health Survey 2017-18 (PDHS) data which comprises of 6,602 …


Gender-Specific Psychological And Social Impact Of Covid-19 In Pakistan, Fauziah Rabbani, Hyder Ali Khan, Suneel Piryani, Areeba Raza Khan, Fahad Abid Jan 2022

Gender-Specific Psychological And Social Impact Of Covid-19 In Pakistan, Fauziah Rabbani, Hyder Ali Khan, Suneel Piryani, Areeba Raza Khan, Fahad Abid

Community Health Sciences

Background: COVID-19 has rapidly spread across the world. Women may be especially vulnerable to depression and anxiety as a result of the pandemic.
Aims: This study attempted to assess how gender affects risk perceptions, anxiety levels and behavioural responses to the COVID-19 pandemic in Pakistan, to recommend gender-responsive health policies.
Methods: A cross-sectional online survey was conducted. Participants were asked to complete a sociodemographic data form, the Hospital Anxiety and Depression Scale, and questions on their risk perceptions, preventive behaviour and information exposure. Multiple logistic regression analysis was used to assess the effects of factors such as age, gender and …


Psychosocial Risk Factors And Cardiovascular Disease And Death In A Population-Based Cohort From 21 Low-, Middle-, And High-Income Countries, Ailiana Santosa, Annika Rosengren, Chinthanie Ramasundarahettige, Sumathy Rangarajan, Jephat Chifamba, Scott A. Lear, Paul Poirier, Karen E. Yeates, Rita Yusuf, Romaina Iqbal Dec 2021

Psychosocial Risk Factors And Cardiovascular Disease And Death In A Population-Based Cohort From 21 Low-, Middle-, And High-Income Countries, Ailiana Santosa, Annika Rosengren, Chinthanie Ramasundarahettige, Sumathy Rangarajan, Jephat Chifamba, Scott A. Lear, Paul Poirier, Karen E. Yeates, Rita Yusuf, Romaina Iqbal

Community Health Sciences

Importance: Stress may increase the risk of cardiovascular disease (CVD). Most studies on stress and CVD have been conducted in high-income Western countries, but whether stress is associated with CVD in other settings has been less well studied.
Objective: To investigate the association of a composite measure of psychosocial stress and the development of CVD events and mortality in a large prospective study involving populations from 21 high-, middle-, and low-income countries across 5 continents.
Design, setting, and participants: This population-based cohort study used data from the Prospective Urban Rural Epidemiology study, collected between January 2003 and March 2021. Participants …


The Impact Of Disease Control Measures On The Spread Of Covid-19 In The Province Of Sindh, Pakistan, Bilal Ahmed Usmani, Mustafain Ali, Muhammad Abul Hasan, Amna Rehana Siddiqui, Sameen Siddiqi, Aaron Guanliang Lim, Saad Ahmed Qazi Nov 2021

The Impact Of Disease Control Measures On The Spread Of Covid-19 In The Province Of Sindh, Pakistan, Bilal Ahmed Usmani, Mustafain Ali, Muhammad Abul Hasan, Amna Rehana Siddiqui, Sameen Siddiqi, Aaron Guanliang Lim, Saad Ahmed Qazi

Community Health Sciences

The province of Sindh reported the first COVID-19 case in Pakistan on 26th February 2020. The Government of Sindh has employed numerous control measures to limit its spread. However, for low-and middle-income countries such as Pakistan, the management protocols for controlling a pandemic are not always as definitive as they would be in other developed nations. Given the dire socio-economic conditions of Sindh, continuation of province-wise lockdowns may inadvertently cause a potential economic breakdown. By using a data driven SEIR modelling framework, this paper describes the evolution of the epidemic projections because of government control measures. The data from reported …


Human Papillomavirus-Associated Anal Squamous Intraepithelial Lesions In Men Who Have Sex With Men And Transgender Women Living With And Without Hiv In Karachi Pakistan: Implications For Screening And Prevention, Muslima Ejaz, Muhammad Mubarak, Tazeen Saeed Ali, Sören Andersson, Anna Mia Ekström Nov 2021

Human Papillomavirus-Associated Anal Squamous Intraepithelial Lesions In Men Who Have Sex With Men And Transgender Women Living With And Without Hiv In Karachi Pakistan: Implications For Screening And Prevention, Muslima Ejaz, Muhammad Mubarak, Tazeen Saeed Ali, Sören Andersson, Anna Mia Ekström

Community Health Sciences

Background: Anal squamous intraepithelial lesions (ASIL), strongly related to human papilloma virus (HPV) infection, is more prevalent among men who have sex with men (MSM). However, no such data are available for Pakistan yet, and neither HPV vaccination nor anal-cytology screening is implemented in Pakistan. The purpose of this first ever study was to assess the prevalence of HPV-related anal cytological abnormalities among MSM and transgender women living with and without HIV infection in Pakistan.
Methods: We conducted a cross-sectional study from March 2016 to November 2017 at sexual health centers run by the Perwaaz Trust and the National AIDS …


Unintended Pregnancy And The Associated Factors Among Pregnant Females: Sukh Survey-Karachi, Pakistan, Shama Razzaq, Saleem Jessani, Narjis Rizvi, Sarah Saleem Nov 2021

Unintended Pregnancy And The Associated Factors Among Pregnant Females: Sukh Survey-Karachi, Pakistan, Shama Razzaq, Saleem Jessani, Narjis Rizvi, Sarah Saleem

Community Health Sciences

Objective: Unintended pregnancy has become a substantially growing reproductive health concern in South Asian region. The objective of this survey was to assess the magnitude of unintended pregnancy along with its correlates among currently pregnant women residing in Karachi.
Methods: A community based, multistage, cross-sectional study was carried out among 612 currently pregnant women from squatter settlements of Karachi, inquiring for "unintended pregnancy", outcome of interest. Multivariable logistic analysis was done using SPSS v.19 to determine associated factors.
Results: Of 612 pregnant women interviewed, 168(27.4%) reported their pregnancies as unintended. The multivariable regression identified a high likelihood of unintended pregnancy …


Anal Human Papillomavirus Infection Among Men Who Have Sex With Men And Transgender Women Living With And Without Hiv In Pakistan: Findings From A Cross-Sectional Study, Muslima Ejaz, Soren Andersson, Salma Batool, Tazeen Saeed Ali, Anna Mia Ekström Nov 2021

Anal Human Papillomavirus Infection Among Men Who Have Sex With Men And Transgender Women Living With And Without Hiv In Pakistan: Findings From A Cross-Sectional Study, Muslima Ejaz, Soren Andersson, Salma Batool, Tazeen Saeed Ali, Anna Mia Ekström

Community Health Sciences

Objectives: The aim of this study was to determine the prevalence of infection, genotypes and risk factors for human papillomavirus (HPV) among men who have sex with men (MSM) and transgender women living with and without HIV in Pakistan. Anal infection with HPV is very common worldwide among MSM, particularly among MSM living with HIV. The high prevalence of HIV among MSM and male-to-female transgendered individuals in Pakistan is a significant health concern since access to screening and health-seeking is often delayed in this stigmatised key population.
Design: This cross-sectional study was conducted between March 2016 and November 2017.
Participants, …


Covid-19 Vaccination In Sindh Province, Pakistan: A Modelling Study Of Health Impact And Cost-Effectiveness, Carl A B. Pearson, Fiammetta Bozzani, Simon R. Procter, Nicholas G. Davies, Maryam Huda, Henning Tarp Jensen, Marcus Keogh-Brown, Muhammad Khalid, Sedona Sweeney, Sergio Torres-Rueda Oct 2021

Covid-19 Vaccination In Sindh Province, Pakistan: A Modelling Study Of Health Impact And Cost-Effectiveness, Carl A B. Pearson, Fiammetta Bozzani, Simon R. Procter, Nicholas G. Davies, Maryam Huda, Henning Tarp Jensen, Marcus Keogh-Brown, Muhammad Khalid, Sedona Sweeney, Sergio Torres-Rueda

Community Health Sciences

Background: Multiple Coronavirus Disease 2019 (COVID-19) vaccines appear to be safe and efficacious, but only high-income countries have the resources to procure sufficient vaccine doses for most of their eligible populations. The World Health Organization has published guidelines for vaccine prioritisation, but most vaccine impact projections have focused on high-income countries, and few incorporate economic considerations. To address this evidence gap, we projected the health and economic impact of different vaccination scenarios in Sindh Province, Pakistan (population: 48 million).
Methods and findings: We fitted a compartmental transmission model to COVID-19 cases and deaths in Sindh from 30 April to 15 …


The Influence Of The Urban Food Environment On Diet, Nutrition And Health Outcomes In Low-Income And Middle-Income Countries: A Systematic Review, Susannah Westbury, Iman Ghosh, Helen Margaret Jones, Daniel Mensah, Folake Samuel, Ana Irache, Nida Azhar, Lena Al-Khudairy, Romaina Iqbal, Oyinlola Oyebode Oct 2021

The Influence Of The Urban Food Environment On Diet, Nutrition And Health Outcomes In Low-Income And Middle-Income Countries: A Systematic Review, Susannah Westbury, Iman Ghosh, Helen Margaret Jones, Daniel Mensah, Folake Samuel, Ana Irache, Nida Azhar, Lena Al-Khudairy, Romaina Iqbal, Oyinlola Oyebode

Community Health Sciences

Introduction: Diet and nutrition are leading causes of global morbidity and mortality. Our study aimed to identify and synthesise evidence on the association between food environment characteristics and diet, nutrition and health outcomes in low-income and middle-income countries (LMICs), relevant to urban settings, to support development and implementation of appropriate interventions.
Methods: We conducted a comprehensive search of 9 databases from 1 January 2000 to 16 September 2020 with no language restrictions. We included original peer-reviewed observational studies, intervention studies or natural experiments conducted in at least one urban LMIC setting and reporting a quantitative association between a characteristic of …


Exploring Digital Health Interventions To Support Community Health Workers In Low-And-Middle-Income Countries During The Covid-19 Pandemic: A Scoping Review Protocol, Anam Shahil Feroz, Komal Valliani, Hajra Khwaja, Sehrish Karim Sep 2021

Exploring Digital Health Interventions To Support Community Health Workers In Low-And-Middle-Income Countries During The Covid-19 Pandemic: A Scoping Review Protocol, Anam Shahil Feroz, Komal Valliani, Hajra Khwaja, Sehrish Karim

Community Health Sciences

Introduction: COVID-19 has significantly affected community health workers' (CHWs) performance as they are expected to perform pandemic-related tasks along with routine essential healthcare services. A plausible way to optimise CHWs' functioning during this pandemic is to couple the efforts of CHWs with digital tools. So far, no systematic evidence is available on the use of digital health interventions to support CHWs in low-middle-income countries (LMICs) amid the COVID-19 pandemic. The article describes a protocol for a scoping review of primary research studies that aim to map evidence on the use of unique digital health interventions to support CHWs during COVID-19 …


Quality Of Inpatient Care Of Small And Sick Newborns In Pakistan: Perceptions Of Key Stakeholders, Nousheen Pradhan, Ammarah Ali, Sana Roujani, Sumera Aziz Ali, Samia Rizwan, Sarah Saleem, Sameen Siddiqi Sep 2021

Quality Of Inpatient Care Of Small And Sick Newborns In Pakistan: Perceptions Of Key Stakeholders, Nousheen Pradhan, Ammarah Ali, Sana Roujani, Sumera Aziz Ali, Samia Rizwan, Sarah Saleem, Sameen Siddiqi

Community Health Sciences

Background: In LMICs including Pakistan, neonatal health and survival is a critical challenge, and therefore improving the quality of facility-based newborn care services is instrumental in averting newborn mortality. This paper presents the perceptions of the key stakeholders in the public sector to explore factors influencing the care of small and sick newborns and young infants in inpatient care settings across Pakistan.
Methods: This exploratory study was part of a larger study assessing the situation of newborn and young infant in-patient care provided across all four provinces and administrative regions of Pakistan. We conducted 43 interviews. Thirty interviews were conducted …


The Double Burden Of Malnutrition And Associated Factors Among South Asian Adolescents: Findings From The Global School-Based Student Health Survey, Sara Estecha Querol, Romaina Iqbal, Laura Kudrna, Lena Al-Khudairy, Paramijit Gill Aug 2021

The Double Burden Of Malnutrition And Associated Factors Among South Asian Adolescents: Findings From The Global School-Based Student Health Survey, Sara Estecha Querol, Romaina Iqbal, Laura Kudrna, Lena Al-Khudairy, Paramijit Gill

Community Health Sciences

The health and nutrition of the global adolescent population have been under-researched, in spite of its significant size (1.2 billion). This study investigates the prevalence and associated factors of malnutrition (stunting, thinness and overweight) among adolescents living in South Asia. The sample analysed was 24,053 South Asian schooled adolescents aged 12-15 years that participated in the cross-sectional Global School-Based Student Health Survey (GSHS) between 2009 and 2016. The prevalence of stunting, thinness and overweight was calculated using the World Health Organization (WHO) Child Growth Reference 2007. Associations between the three forms of malnutrition and their possible associated factors were assessed …


Exploring Community Perceptions, Attitudes And Practices Regarding The Covid-19 Pandemic In Karachi, Pakistan, Anam Shahil Feroz, Naureen Akber Ali, Ridah Feroz, Noshaba Akber, Salima Nazim Meghani Aug 2021

Exploring Community Perceptions, Attitudes And Practices Regarding The Covid-19 Pandemic In Karachi, Pakistan, Anam Shahil Feroz, Naureen Akber Ali, Ridah Feroz, Noshaba Akber, Salima Nazim Meghani

Community Health Sciences

Background: The Government of Pakistan is facing difficulty to contain the surge of COVID-19 due to the country's social, political, economical and cultural context. Experiences from the previous epidemic suggest that community perceptions, social norms and cultural practices can impede COVID-19 containment. To understand social responses towards COVID-19, the study aims to explore the understanding of COVID-19 and the acceptance of control measures among community members.
Methods: We conducted an exploratory qualitative study using a purposive sampling approach, at two communities of Karachi, Pakistan. In-depth interviews were conducted with community members including, young, middle-aged and older adults of both genders. …


Perceptions And Experiences Of Healthcare Providers During Covid-19 Pandemic In Karachi, Pakistan: An Exploratory Qualitative Study, Anam Shahil Feroz, Nousheen Pradhan, Zarak Hussain Ahmed, Mashal Murad Shah, Nargis Asad, Sarah Saleem, Sameen Siddiqi Aug 2021

Perceptions And Experiences Of Healthcare Providers During Covid-19 Pandemic In Karachi, Pakistan: An Exploratory Qualitative Study, Anam Shahil Feroz, Nousheen Pradhan, Zarak Hussain Ahmed, Mashal Murad Shah, Nargis Asad, Sarah Saleem, Sameen Siddiqi

Community Health Sciences

Objective: To explore healthcare provider's perspectives and experiences of the barriers and facilitators to treat and manage COVID-19 cases.
Design and setting: We conducted an exploratory qualitative study using a purposive sampling approach, at a private tertiary care teaching hospital in Karachi, Pakistan. Study data were analysed manually using the conventional content analysis technique.
Participants: Key-informant interviews (KIIs) were conducted with senior management and hospital leadership and in-depth interviews (IDIs) were conducted with front-line healthcare providers.
Results: A total of 31 interviews (KIIs=19; IDIs=12) were conducted, between April and May 2020. Three overarching themes emerged. The first was 'challenges faced …


Frequency Of Primiparous Mother Initiated Breastfeeding Earlier After Birth And Factors Associated With It In Sindh, Pakistan: A Secondary Analysis, Asma A. Bham, Sucheta Sharma, Akash Sardool, Umer F. Mujahid, Amrat Ayaz, Komal Valliani, Nawaal Maredia Aug 2021

Frequency Of Primiparous Mother Initiated Breastfeeding Earlier After Birth And Factors Associated With It In Sindh, Pakistan: A Secondary Analysis, Asma A. Bham, Sucheta Sharma, Akash Sardool, Umer F. Mujahid, Amrat Ayaz, Komal Valliani, Nawaal Maredia

Community Health Sciences

Background: Initiation of breastfeeding within one hour after delivery plays a vital role in a newborns life by not only increasing their survival rate but also reducing many life-threatening diseases in the newborn. The aim of the study was to determine frequency of early initiation of breastfeeding among primiparous mothers in a rural district of Thatta, Pakistan.
Methods: This study was conducted using survey data extracted from a cross-sectional study conducted in 2019 on prevalence of exclusive breastfeeding and factors associated with it among women in Thatta. The outcome was early initiation of breastfeeding. To determine factors associated with it, …


Barriers To Access Of Healthcare Services For Rural Women – Applying Gender Lens On Tb In A Rural District Of Sindh, Pakistan, Shifa Salman Habib, Wafa Zehra Jamal, Syed Muhammad Asad Zaidi, Junaid Ur-Rehman Siddiqui, Hira Mustafa Khan, Jacob Creswell, Srichand Batra, Anna Versfeld Jul 2021

Barriers To Access Of Healthcare Services For Rural Women – Applying Gender Lens On Tb In A Rural District Of Sindh, Pakistan, Shifa Salman Habib, Wafa Zehra Jamal, Syed Muhammad Asad Zaidi, Junaid Ur-Rehman Siddiqui, Hira Mustafa Khan, Jacob Creswell, Srichand Batra, Anna Versfeld

Community Health Sciences

Background: Women in rural districts of Pakistan face numerous barriers to healthcare, rendering gender-responsive health programming important, including for Tuberculosis (TB). This study was conducted to assess the general understanding of TB and of access to healthcare for women, as a first step towards implementation of a gender responsive TB programme in TandoAllayar, a rural district of Pakistan.
Methods: A total of 36 participants were interviewed. The focus group discussion guide comprised of questions on: (1) family/household dynamics (2) community norms (3) healthcare system (4) women’s access to healthcare (5) TB Awareness;, and (6) women’s access to TB Care.
Results: …