Public Health Commons^™

Years Of Life Lost Associated With Covid-19 Deaths In The Usa During The First 2 Years Of The Pandemic, Troy Quast, Ross Andel, Sean Gregory, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Background: Prior estimates of the years of life lost (YLLs) in the USA associated with coronavirus disease 2019 (COVID-19) were 1.2 million through 11 July 2020 and 3.9 million through 31 January 2021 (which roughly coincides with the first full year of the pandemic). The aim of this study is to update YLL estimates through the first 2 years of the pandemic.

Methods: We employed data regarding COVID-19 deaths through 5 February 2022 by jurisdiction, gender and age group. We used actuarial life expectancy tables by gender and age to estimate YLLs.

Results: We estimated roughly 9.7 million YLLs due …

Ohiohealth Population Health Diabetes Prevention Program, Erica Kick

Masters Theses/Capstone Projects

OhioHealth Population Health works to provide programs for the community in which they are of no cost. This allows for individuals to be provided with the education they need to live a more sustainable life. The following Program "ENGAGE" looks at diabetes education and management in ways that helps the participants better understand their disease and how to handle things going forward.

2022-08-24_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services

Michigan COVID-19 Hospital Data

Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.

Health Rankings: Mountain West States, 2021, Hira Ahmed, Sofia Takhtadjian, Olivia K. Cheche, Elia Del Carmen Solano-Patricio, Caitlin J. Saladino, William E. Brown Jr.

Health

Using data from the United Health Foundation’s “America’s Health Rankings Annual Report 2021,” this fact sheet compares various measures of health in the Mountain West using data from 2014 to 2021. The original report includes data on the five determinants of health including social and economic factors, physical environment, clinical care, behaviors, and health outcomes. This fact sheet examines health metrics for the Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah.

2022-08-24_Michiganoverview_Covidoutbreakschools, Michigan Department Of Health & Human Services

Michigan COVID-19 Outbreak Reports

The School Outbreak Data page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/stats/school-outbreak.

This report is created by the Michigan Department of Health & Human Services from data self-reported by local health departments. Data is updated every week.

K-12 School-Related Outbreak Reporting: In accordance with the Council of State and Territorial Epidemiologists' outbreak definition, a K-12 school-associated COVID-19 case (confirmed or probable) is defined as a student, teacher, or staff member physically present in the school setting or participated in a school sanctioned extracurricular activity within 14 days prior to illness onset (or a positive test result) OR …

2022-08-24_Michiganoverview_Covidvaccinestats, Michigan Department Of Health & Human Services

Michigan COVID-19 Vaccine Data

The COVID Vaccine Dashboard page was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus/resources/covid-19-vaccine/covid-19-dashboard.

First-dose tracker above is for entire Michigan Population. Coverage maps below are for age 5+.

Previously reported numbers of administered vaccine doses may change as new data are received. A possible lag in reporting vaccine doses will result in increases in numbers previously reported.

This report is created by the Michigan Department of Health and Human Services Division of Immunization from data reported to the Michigan Care Improvement Registry (MCIR).

The dashboard contained the tabs Primary Series Doses Administered, Primary Series Doses by Vaccine, …

Relationship Power, Antiretroviral Adherence, And Physical And Mental Health Among Women Living With Hiv In Rural Kenya, Rachel L. Burger, Craig R. Cohen, A. Rain Mocello, Shari L. Dworkin, Edward A. Frongillo Jr. Ph.D., Elly Weke, Lisa M. Butler, Harsha Thirumurthy, Elizabeth A. Bukusi, Sheri D. Weiser

Faculty Publications

Little is known about the association of gender-based power imbalances and health and health behaviors among women with HIV (WWH). We examined cross-sectional baseline data among WWH in a cluster-randomized control trial (NCT02815579) in rural Kenya. We assessed associations between the Sexual Relationship Power Scale (SRPS) and ART adherence, physical and mental health, adjusting for sociodemographic and social factors. SRPS consists of two subscales: relationship control (RC) and decision-making dominance. Women in the highest and middle tertiles for RC had a 7.49 point and 8.88 point greater Medical Outcomes Study-HIV mental health score, and a 0.27 and 0.29 lower odds …

Igg Antibodies To Sars-Cov-2 In Asymptomatic Blood Donors At Two Time Points In Karachi, Muhammad Hasan, Bushra Moiz, Shama Qaiser, Kiran I. Masood, Zara Ghous, Areeba Hussain, Natasha Bahadur Ali, Syed Hani Abidi, Kulsoom Ghias, Erum Khan, Zahra Hasan

Department of Pathology and Laboratory Medicine

Introduction: An estimated 1.5 million cases were reported in Pakistan until 23 March, 2022. However, SARS-CoV-2 PCR testing capacity has been limited and the incidence of COVID-19 infections is unknown. Volunteer healthy blood donors can be a control population for assessment of SARS-CoV-2 exposure in the population. We determined COVID-19 seroprevalence during the second pandemic wave in Karachi in donors without known infections or symptoms in 4 weeks prior to enrollment.
Materials and methods: We enrolled 558 healthy blood donors at the Aga Khan University Hospital between December 2020 and February 2021. ABO blood groups were determined. Serum IgG reactivity …

2022-08-23_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus/stats/coronavirus-symptoms. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated twice a week on Mondays and Thursdays.

Syndromic Surveillance System data is obtained from approximately 216 facilities participating in syndromic surveillance (139 Emergency Departments (ED), 77 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, triage notes, …

Covid-19 Newsletter (Vol. 133), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

2022-08-23_Michiganoverview_Covidlongtermcare, Michigan Department Of Health & Human Services

Michigan COVID-19 Long Term Care Data

The COVID Long Term Care Facilities page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/stats/data-about-places/long-term-care-data.

This report is created by the Michigan Department of Health & Human Services from data self-reported by long-term care facilities into EMResource. Data for all reporting facilities is posted weekly each Monday.

The information below represents COVID-19 data reported directly to MDHHS by licensed and operating Skilled Nursing, Home for the Aged and Adult Foster Care facilities (licensed to serve 13 or more individuals) in Michigan from January 1, 2020. All long-term care facilities additionally have an obligation to report COVID-positive residents and/or staff …

2022-08-23_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services

Cumulative Michigan COVID-19 Data

The COVID Overview page was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus/stats.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled. COVID case and testing data will be posted once a week on Tuesdays.

This report is provisional and subject to change. City of Detroit and Wayne County are reported separately. MDHHS began tracking probable cases April 5, 2020. FCI indicates federal correctional institute. MDOC indicates Michigan Department of Corrections. Diagnostic tests, including nucleic acid amplification/real-time polymerase chain reaction (NAAT/RT-PCR) …

2022-08-23_Michiganoverview_Covidcounts, Michigan Department Of Health & Human Services

Michigan COVID-19 Confirmed Cases by Date of Onset Data

Data was downloaded as an Excel spreadsheet which appeared in the Public Use Datasets section under the Cumulative Data link of Michigan's Coronavirus webpage, under the url https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173---,00.html.

Cases are aggregated by the date of onset of COVID-19 symptoms, if known, otherwise by laboratory specimen date if known, otherwise by case referral date. Deaths are aggregated by the date of death if known, otherwise by the last date of a change to the case status.

2022-08-23_Michiganoverview_Isdreporting, Michigan Department Of Health & Human Services

Michigan COVID-19 Outbreak Reports

The K-12 Aged ISD Reporting page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/stats/k-to-12-aged-isd-reporting.

This report is created from data reported by the Michigan Disease Surveillance System (MDSS) the Michigan Department of Health and Human Services' web-based communicable disease reporting system. Data is updated every week.

The purpose of the dashboard is to report the 7 day average of COVID-19 cases in Michigan school students aged 5 through 18 at the intermediate school district and school district levels, as well as display trends over time to better illustrate the changing nature of the COVID-19 pandemic. Cases are attributed to …

The Need For Sexual Health Clinics, Their Future Role, And Contribution To Public Health, Meena S. Ramchandani, Christopher Bourne, Lindley A. Barbee, Elske Hoornenborg, Preeti Pathela, Stephanie N. Taylor, Henry De Vries

School of Medicine Faculty Publications

Specialised sexual health clinics (SHCs) play an important role in addressing the staggering rates of STIs seen in many high-income nations. Despite increasing healthcare coverage in the US and nationalised health care in some countries, there is a continued need for SHCs to meet the needs of patients and the community, especially for high-priority populations: those at high risk of STI acquisition and/or groups historically marginalised and underserved in the traditional healthcare system. We need to mobilise resources to support a stronger clinical infrastructure in specialised SHCs. This review describes the importance of SHCs, their future role, and some of …

Genome-Wide Interaction Analysis Identified Low-Frequency Variants With Sex Disparity In Lung Cancer Risk, Yafang Li, Xiangjun Xiao, Jianrong Li, Jinyoung Byun, Chao Cheng, Yohan Bossé, James Mckay, Demetrios Albanes, Stephen Lam, Adonina Tardon, Chu Chen, Stig E Bojesen, Maria T Landi, Mattias Johansson, Angela Risch, Heike Bickeböller, H-Erich Wichmann, David C Christiani, Gad Rennert, Susanne Arnold, Gary Goodman, John K Field, Michael P A Davies, Sanjay S Shete, Loic Le Marchand, Olle Melander, Hans Brunnström, Geoffrey Liu, Rayjean J Hung, Angeline S Andrew, Lambertus A Kiemeney, Hongbing Shen, Ryan Sun, Shan Zienolddiny, Kjell Grankvist, Mikael Johansson, Neil Caporaso, Dawn M Teare, Yun-Chul Hong, Philip Lazarus, Matthew B Schabath, Melinda C Aldrich, Ann G Schwartz, Ivan Gorlov, Kristen Purrington, Ping Yang, Yanhong Liu, Younghun Han, Joan E Bailey-Wilson, Susan M Pinney, Diptasri Mandal, James C Willey, Colette Gaba, Paul Brennan, Christopher I Amos, Integral-Ilcco Lung Cancer Consortium

Faculty, Staff and Students Publications

Differences by sex in lung cancer incidence and mortality have been reported which cannot be fully explained by sex differences in smoking behavior, implying existence of genetic and molecular basis for sex disparity in lung cancer development. However, the information about sex dimorphism in lung cancer risk is quite limited despite the great success in lung cancer association studies. By adopting a stringent two-stage analysis strategy, we performed a genome-wide gene-sex interaction analysis using genotypes from a lung cancer cohort including ~ 47 000 individuals with European ancestry. Three low-frequency variants (minor allele frequency < 0.05), rs17662871 [odds ratio (OR) = 0.71, P = 4.29×10-8); rs79942605 (OR = 2.17, P = 2.81×10-8) and rs208908 (OR = 0.70, P = 4.54×10-8) were identified with different risk effect of lung cancer between men and women. Further expression quantitative trait loci and functional annotation analysis suggested rs208908 affects lung cancer risk through differential regulation of Coxsackie virus and adenovirus receptor gene expression in lung tissues between men and women. Our study is one of the first studies to provide novel insights about the genetic and molecular basis for sex disparity in lung cancer development.

2022-08-22_Michiganoverview_Covidoutbreak, Michigan Department Of Health & Human Services

Michigan COVID-19 Outbreak Reports

The Outbreak Data page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/stats/outbreak-reporting.

This report is created by the Michigan Department of Health & Human Services from data self-reported by local health departments. Data is updated every week.

COVID-19 outbreaks are generally defined as two or more cases with a link by place and time indicating a shared exposure outside of a household. Local health departments report the number of new and ongoing outbreaks they are investigating by the setting of the outbreak. New outbreaks are those outbreaks that were first identified during the current reporting week. Ongoing outbreaks are …

2022-08-22_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services

Michigan COVID-19 Hospital Data

Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.

Immunohistochemical Detection And Prognostic Significance Of P53, Epidermal Growth Factor Receptor, Murine Double Minute 2, And Isocitrate Dehydrogenase 1 In Glioblastoma Multiforme Patients Of Pakistan, Syed Muhammad Adnan Ali, Muhammad Shahzad Shamim, Syed Ather Enam, Zubair Ahmad, Yumna Adnan, Hasnain Ahmed Farooqui

Department of Surgery Docs

Introduction: Glioblastoma multiforme (GBM) is one of the deadliest cranial tumors occurring in adults. Various biomarkers have been tested for their significance in diagnosis, prognosis, and treatment of GBM. Some well-studied markers in GBM are Isocitrate dehydrogenase 1 (IDH1), Murine double minute 2 (MDM2), Epidermal Growth Factor Receptor (EGFR), and p53. The aim of this study was to investigate the protein expression of these markers in GBM patients of Pakistan.
Methods: A total of 102 surgically resected formalin-fixed paraffin-embedded specimens from patients diagnosed and treated at Aga Khan University Hospital were included in this study. Immunohistochemistry (IHC) for IDH1, MDM2, …

Non-Linear Machine Learning Models Incorporating Snps And Prs Improve Polygenic Prediction In Diverse Human Populations, Michael Elgart, Genevieve Lyons, Santiago Romero-Brufau, Nuzulul Kurniansyah, Jennifer A Brody, Xiuqing Guo, Henry J Lin, Laura Raffield, Yan Gao, Han Chen, Paul De Vries, Donald M Lloyd-Jones, Leslie A Lange, Gina M Peloso, Myriam Fornage, Jerome I Rotter, Stephen S Rich, Alanna C Morrison, Bruce M Psaty, Daniel Levy, Susan Redline, Nhlbi’S Trans-Omics In Precision Medicine (Topmed) Consortium, Tamar Sofer

Faculty, Staff and Student Publications

Polygenic risk scores (PRS) are commonly used to quantify the inherited susceptibility for a trait, yet they fail to account for non-linear and interaction effects between single nucleotide polymorphisms (SNPs). We address this via a machine learning approach, validated in nine complex phenotypes in a multi-ancestry population. We use an ensemble method of SNP selection followed by gradient boosted trees (XGBoost) to allow for non-linearities and interaction effects. We compare our results to the standard, linear PRS model developed using PRSice, LDpred2, and lassosum2. Combining a PRS as a feature in an XGBoost model results in a relative increase in …

Feasibility And Acceptability Of An Active Video Game-Based Physical Activity Support Group (Pink Warrior) For Survivors Of Breast Cancer: Randomized Controlled Pilot Trial, Maria C Swartz, Zakkoyya H Lewis, Rachel R Deer, Anna L Stahl, Michael D Swartz, Ursela Christopherson, Karen Basen-Engquist, Stephanie J Wells, H Colleen Silva, Elizabeth J Lyons

Faculty, Staff and Student Publications

BACKGROUND: Survivors of breast cancer with functional limitations have a 40% higher mortality rate than those without. Despite the known benefits of physical activity (PA),

OBJECTIVE: We aimed to determine the feasibility and acceptability of a group AVG-based multicomponent PA intervention and estimate its effect size and variability on PA and physical function in female survivors of breast cancer in a clinic setting.

METHODS: Female survivors of breast cancer (N=60) were recruited through the clinic and randomly assigned to the intervention group (12 weekly sessions) or the control group (existing support group). The intervention group received game-based pedometers and participated …

Behavioural Support And Nicotine Replacement Therapy For Smokeless Tobacco Cessation: Protocol For A Pilot Randomised-Controlled Multi-Country Trial, Faraz Siddiqui, Linda Bauld, Ray Croucher, Cath Jackson, Ian Kellar, Mona Kanaan, Subhash Pokhrel, Rumana Huque, Romaina Iqbal, Javaid Ahmed Khan

Community Health Sciences

Background: Smokeless tobacco (ST) is consumed globally by more than 350 million people, with approximately 85% of all users based in South and Southeast Asia. In this region, ST products are cheap and easily accessible. Evidence-based interventions to people quit ST use are lacking. This study aims to test the feasibility of conducting a future definitive trial of ST cessation, using a culturally adapted behavioural intervention, and/or nicotine replacement therapy (NRT) in three South Asian countries.
Methods: We will conduct a factorial design, randomised-controlled pilot trial in Bangladesh, India and Pakistan. Daily ST users will be recruited from primary health …

Practical Approaches To Improve Vancomycin-Related Patient Outcomes In Pediatrics- An Alternative Strategy When Auc/Mic Is Not Feasible, Kashif Hussain, Muhammad Sohail Salat, Shahzad Rauf, Manoj Rathi, Midhat Khan, Fizzah Naz, Wasif Ahmed Khan, Rahila Ikram, Gul Ambreen

Department of Biological & Biomedical Sciences

Background: Anecdotal experience and studies have shown that most pediatric patients fail to reach target therapeutic vancomycin trough levels (VTLs) and required higher total daily doses (TDD). This retrospective study aims to evaluate the frequency of hospitalized children who achieved target VTLs with a vancomycin (VNCO) dosing regimen of 40-60 mg/kg/d q6h and to assess the VNCO-TDD required to attain the target and their effects on clinical outcomes in pediatric patients.
Methods: After ethical approval, patients of 3 month-12 years were evaluated in this chart review study who received ≥ 3 intravenous-VNCO doses and appropriately drawn blood samples of VTLs …

Effectiveness And Adherence To Closed Face Shields In The Prevention Of Covid-19 Transmission: A Non-Inferiority Randomized Controlled Trial In A Middle-Income Setting (Covproshield), Andrea Ramirez Varela, Alejandro Pacheco Gurruchaga, Silvia Restrepo Restrepo, Juan David Martin, Yessica Daniela Campaz Landazabal, Guillermo Tamayo-Cabeza, Sandra Contreras-Arrieta, Yuldor Caballero-Díaz, Luis Jorge Hernandez Florez, John Mario González, Juan Carlos Santos-Barbosa, José David Pinzón, Juan José Yepes-Nuñez, Rachid Laajaj, Giancarlo Buitrago Gutierrez, Martha Vives Florez, Janner Fuentes Castillo, Gianni Quinche Vargas, Andres Casas, Antonio Medina, Eduardo Behrentz, Covida Working Group

Faculty, Staff and Student Publications

BACKGROUND: The use of respiratory devices can mitigate the spread of diseases such as COVID-19 in community settings. We aimed to determine the effectiveness of closed face shields with surgical face masks to prevent SARS-CoV-2 transmission in working adults during the COVID-19 pandemic in Bogotá, Colombia.

METHODS: An open-label non-inferiority randomized controlled trial that randomly assigned participants to one of two groups: the intervention group was instructed to wear closed face shields with surgical face masks, and the active control group was instructed to wear only surgical face masks. The primary outcome was a positive reverse transcription polymerase chain reaction …

2022-08-19_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services

Michigan COVID-19 Hospital Data

Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.

Proteomic Profiling Platforms Head To Head: Leveraging Genetics And Clinical Traits To Compare Aptamer- And Antibody-Based Methods, Daniel H. Katz, Jeremy M. Robbins, Shuliang Deng, Usman A. Tahir, Alexander G. Bick, Akhil Pampana, Zhi Yu, Debby Ngo, Mark D. Benson, Zsu-Zsu Chen, Daniel E. Cruz, Dongxiao Shen, Yan Gao, Claude Bouchard, Mark A. Sarzynski Facsm, Adolfo Correa, Pradeep Natarajan, James G. Wilson, Robert E. Gerszten

Faculty Publications

High-throughput proteomic profiling using antibody or aptamer-based affinity reagents is used increasingly in human studies. However, direct analyses to address the relative strengths and weaknesses of these platforms are lacking. We assessed findings from the SomaScan1.3K (N = 1301 reagents), the SomaScan5K platform (N = 4979 reagents), and the Olink Explore (N = 1472 reagents) profiling techniques in 568 adults from the Jackson Heart Study and 219 participants in the HERITAGE Family Study across four performance domains: precision, accuracy, analytic breadth, and phenotypic associations leveraging detailed clinical phenotyping and genetic data. Across these studies, we show evidence …

Cmv And Ebv Co-Infection In Hiv-Infected Children: Infection Rates And Analysis Of Differential Expression Of Cytokines In Hiv Mono- And Hiv-Cmv-Ebv Co-Infected Groups, Fizza Nazim, Hammad Afzal Kayani, Aspara Ali Nathwani, Fatima Mir, Syed Hani Abidi

Department of Biological & Biomedical Sciences

Background: CMV and EBV co-infections can affect the HIV disease progression by modulating the immune system. The disease dynamics can differ in HIV-positive adults and children. In Pakistan, HIV is rapidly expanding, especially in children; however, the prevalence of CMV and EBV co-infection and the effect on immune modulation in HIV-positive children are not known. This study aimed to bridge this gap by estimating the rate of active CMV and EBV co-infection in HIV-positive children, followed by the analysis of differential expression of cytokines in HIV mono- and HIV/CMV/EBV co-infected children.
Methods: DNA samples from 319 HIV-positive children, previously recruited …

Food Insecurity Among Low-Income Households With Children Participating In A School-Based Fruit And Vegetable Co-Op, Allison N Marshall, Ru-Jye Chuang, Joanne Chow, Nalini Ranjit, Jayna M Dave, Mallika Mathur, Christine Markham, Shreela V Sharma

Faculty, Staff and Student Publications

The purpose of this study was to evaluate the impact of a nutrition intervention on food insecurity among low-income households with children. Data were collected from 371 parent−child dyads in a quasi-experimental evaluation study of a 1-year intervention (n = 6 intervention schools receiving Brighter Bites, n = 6 wait-list control schools), and longitudinal follow-up of the intervention group 2 years post-intervention in Houston, Texas. Data were collected at three timepoints: at baseline and 1 year for all participants, and at 2 year follow-up for the intervention group (the wait-list control group received the intervention during that time). At baseline, …

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

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 …