IntroductionIn April 2019, 14 children were diagnosed with HIV infection by a private healthcare ... more IntroductionIn April 2019, 14 children were diagnosed with HIV infection by a private healthcare provider in Larkana district, Sindh province, Pakistan. Over the next 3 months, 930 individuals were diagnosed with HIV, >80% below 16 years, the largest ever outbreak of HIV in children in Pakistan. In this protocol paper, we describe research methods for assessing likely modes of HIV transmission in this outbreak and investigate spatial and molecular epidemiology.Methods and analysisA matched case–control study will be conducted with 406 cases recruited. Cases will be children aged below 16 years registered for care at the HIV treatment centre at Shaikh Zayed Children Hospital in Larkana City. Controls will be children who are HIV-uninfected (confirmed by a rapid HIV test) matched 1:1 by age (within 1 year), sex and neighbourhood. Following written informed consent from the guardian, a structured questionnaire will be administered to collect data on sociodemographic indices and expo...
Background The HIV epidemic in Pakistan is concentrated in key populations and is one of the fast... more Background The HIV epidemic in Pakistan is concentrated in key populations and is one of the fastest growing epidemics in South Asia. Over the years the number of people infected with the human immunodeficiency virus initiated on antiretroviral therapy has gradually increased. The effectiveness of the treatment programmes depends on retention in care and treatment adherence. The aim of the study is to the explore the sociodemographic characteristics and magnitude of loss to follow-up in patients initiated on ART in three provinces of Pakistan.Methods A retrospective cross-sectional study was conducted in the National AIDS Control Programme. Case-based data (n=5,215) of 16 treatment centres for all patients initiated on anti-retroviral therapy from 1 st January 2017 to 31 st December 2018 was extracted from the national management information system. Loss to follow-up was defined as a patient who has not visited/attended the ART clinic for >180 days (6 months) and has not been rep...
ObjectivesWe examined data collected as part of the fifth round of integrated biological and beha... more ObjectivesWe examined data collected as part of the fifth round of integrated biological and behavioural surveillance to determine the prevalence and factors associated with HIV infection among female sex workers (FSWs) in Pakistan.MethodsFSWs were defined as ‘all females, age 13 years and above, who receive money or goods in exchange for sexual services, regardless of the site of operation’. Data were collected between October 2016 and January 2017 in 18 cities using multistage sampling techniques to randomly select FSWs from spots facilitated by peers. Behavioural data were collected by interviewers using structured questionnaires, which was followed by obtaining finger prick blood samples tested for HIV using two rapid tests. Multivariate logistic regression analysis was done to assess independent associations of potential correlates using HIV status as dependent variable.ResultsWe invited 5728 FSWs to participate, of which 68 refused to participate (refusal rate=1.2%). Of the 56...
Background: Pakistan is facing challenges regarding the availability of reliable data for malaria... more Background: Pakistan is facing challenges regarding the availability of reliable data for malaria surveillance. These include lack of coordination between different reporting systems and fragmented information system. This study aimed to compare the reporting of malaria surveillance systems in Pakistan. Methods: There are two parallel reporting systems for malaria surveillance in Pakistan, the District Health Information System (DHIS) and Malaria Information System (MIS). DHIS reports on all morbidity at health facility level, while MIS is only used for malaria surveillance in the donor supported districts. A cross sectional study was conducted between July-September 2018 by using the retrospective records of DHIS and MIS data reported to the Directorate of Malaria Control (DOMC) Islamabad during 2013-17. Descriptive and inferential analysis was performed to compare the coverage, outcome and impact indicators. Results: During 2013-17, all districts (n=145, 100%) across Pakistan repo...
To explore the effectiveness of wound care programme for emergency traumatic patient in Taiwan. W... more To explore the effectiveness of wound care programme for emergency traumatic patient in Taiwan. Wound care is one of the most major issues for trauma patients at home. Wound infection has been alerted mostly on medical treatment. Little is known about how healthcare education impact patient care of traumatic wound after discharged from emergency department. A quasi-experimental design was used by using two groups post-test. Random sampling was used to recruited participants, 89 participants in each group in emergency department at a medical centre in Taiwan. A 25-minute wound care programme was given to patients in the intervention group. A questionnaire was used to evaluate the effectiveness of the programme after 72 hours as patient followed up in out-patient department. The data of wound infection were collected from patient's medical record by followed 2 weeks after injured. After wound care programme, the knowledge, skills of wounds care, the satisfaction of health education in experimental group are better than the control group (p < 0·05). Wound infection rate in experimental group (9%) is lower than control group (20·2%), and statistically significant (p < 0·05). The wound care programme could increase the knowledge, skills of wound care of emergency patient and reduce the wound infection rate. Wound care requites technical knowledge; thus, practical demonstration of teaching and self-practice is more effectiveness for patients in learning their wound care. An appropriated health programme can improve the patients' wound care and care quality.
International Journal of Environmental Research and Public Health
Anemia is a multifactorial condition, with a complex etiology that involves nutritional and non-n... more Anemia is a multifactorial condition, with a complex etiology that involves nutritional and non-nutritional factors. The misconception that iron deficiency is equivalent to anemia may mask the need to address other potential causative factors. This review paper aims to (1) assess the burden of anemia vs. iron deficiency anemia (IDA) amongst women of reproductive age (WRA), pregnant women (PW), and children under five years old (underfive children, U5C) in the Eastern Mediterranean region (EMR); (2) evaluate trends in anemia prevalence and whether countries are on track towards meeting the World Health Assembly (WHA) target for 2025; and (3) characterize anemia reduction efforts and provide a road map for future programs. A search of pertinent literature and databases was conducted. Anemia prevalence in the EMR ranged between 22.6% and 63% amongst PW, 27% and 69.6% amongst WRA, and 23.8% and 83.5% amongst U5C. Data showed that the EMR is not on course towards meeting the WHA target. ...
IntroductionIn April 2019, 14 children were diagnosed with HIV infection by a private healthcare ... more IntroductionIn April 2019, 14 children were diagnosed with HIV infection by a private healthcare provider in Larkana district, Sindh province, Pakistan. Over the next 3 months, 930 individuals were diagnosed with HIV, >80% below 16 years, the largest ever outbreak of HIV in children in Pakistan. In this protocol paper, we describe research methods for assessing likely modes of HIV transmission in this outbreak and investigate spatial and molecular epidemiology.Methods and analysisA matched case–control study will be conducted with 406 cases recruited. Cases will be children aged below 16 years registered for care at the HIV treatment centre at Shaikh Zayed Children Hospital in Larkana City. Controls will be children who are HIV-uninfected (confirmed by a rapid HIV test) matched 1:1 by age (within 1 year), sex and neighbourhood. Following written informed consent from the guardian, a structured questionnaire will be administered to collect data on sociodemographic indices and expo...
Background The HIV epidemic in Pakistan is concentrated in key populations and is one of the fast... more Background The HIV epidemic in Pakistan is concentrated in key populations and is one of the fastest growing epidemics in South Asia. Over the years the number of people infected with the human immunodeficiency virus initiated on antiretroviral therapy has gradually increased. The effectiveness of the treatment programmes depends on retention in care and treatment adherence. The aim of the study is to the explore the sociodemographic characteristics and magnitude of loss to follow-up in patients initiated on ART in three provinces of Pakistan.Methods A retrospective cross-sectional study was conducted in the National AIDS Control Programme. Case-based data (n=5,215) of 16 treatment centres for all patients initiated on anti-retroviral therapy from 1 st January 2017 to 31 st December 2018 was extracted from the national management information system. Loss to follow-up was defined as a patient who has not visited/attended the ART clinic for >180 days (6 months) and has not been rep...
ObjectivesWe examined data collected as part of the fifth round of integrated biological and beha... more ObjectivesWe examined data collected as part of the fifth round of integrated biological and behavioural surveillance to determine the prevalence and factors associated with HIV infection among female sex workers (FSWs) in Pakistan.MethodsFSWs were defined as ‘all females, age 13 years and above, who receive money or goods in exchange for sexual services, regardless of the site of operation’. Data were collected between October 2016 and January 2017 in 18 cities using multistage sampling techniques to randomly select FSWs from spots facilitated by peers. Behavioural data were collected by interviewers using structured questionnaires, which was followed by obtaining finger prick blood samples tested for HIV using two rapid tests. Multivariate logistic regression analysis was done to assess independent associations of potential correlates using HIV status as dependent variable.ResultsWe invited 5728 FSWs to participate, of which 68 refused to participate (refusal rate=1.2%). Of the 56...
Background: Pakistan is facing challenges regarding the availability of reliable data for malaria... more Background: Pakistan is facing challenges regarding the availability of reliable data for malaria surveillance. These include lack of coordination between different reporting systems and fragmented information system. This study aimed to compare the reporting of malaria surveillance systems in Pakistan. Methods: There are two parallel reporting systems for malaria surveillance in Pakistan, the District Health Information System (DHIS) and Malaria Information System (MIS). DHIS reports on all morbidity at health facility level, while MIS is only used for malaria surveillance in the donor supported districts. A cross sectional study was conducted between July-September 2018 by using the retrospective records of DHIS and MIS data reported to the Directorate of Malaria Control (DOMC) Islamabad during 2013-17. Descriptive and inferential analysis was performed to compare the coverage, outcome and impact indicators. Results: During 2013-17, all districts (n=145, 100%) across Pakistan repo...
To explore the effectiveness of wound care programme for emergency traumatic patient in Taiwan. W... more To explore the effectiveness of wound care programme for emergency traumatic patient in Taiwan. Wound care is one of the most major issues for trauma patients at home. Wound infection has been alerted mostly on medical treatment. Little is known about how healthcare education impact patient care of traumatic wound after discharged from emergency department. A quasi-experimental design was used by using two groups post-test. Random sampling was used to recruited participants, 89 participants in each group in emergency department at a medical centre in Taiwan. A 25-minute wound care programme was given to patients in the intervention group. A questionnaire was used to evaluate the effectiveness of the programme after 72 hours as patient followed up in out-patient department. The data of wound infection were collected from patient's medical record by followed 2 weeks after injured. After wound care programme, the knowledge, skills of wounds care, the satisfaction of health education in experimental group are better than the control group (p < 0·05). Wound infection rate in experimental group (9%) is lower than control group (20·2%), and statistically significant (p < 0·05). The wound care programme could increase the knowledge, skills of wound care of emergency patient and reduce the wound infection rate. Wound care requites technical knowledge; thus, practical demonstration of teaching and self-practice is more effectiveness for patients in learning their wound care. An appropriated health programme can improve the patients' wound care and care quality.
International Journal of Environmental Research and Public Health
Anemia is a multifactorial condition, with a complex etiology that involves nutritional and non-n... more Anemia is a multifactorial condition, with a complex etiology that involves nutritional and non-nutritional factors. The misconception that iron deficiency is equivalent to anemia may mask the need to address other potential causative factors. This review paper aims to (1) assess the burden of anemia vs. iron deficiency anemia (IDA) amongst women of reproductive age (WRA), pregnant women (PW), and children under five years old (underfive children, U5C) in the Eastern Mediterranean region (EMR); (2) evaluate trends in anemia prevalence and whether countries are on track towards meeting the World Health Assembly (WHA) target for 2025; and (3) characterize anemia reduction efforts and provide a road map for future programs. A search of pertinent literature and databases was conducted. Anemia prevalence in the EMR ranged between 22.6% and 63% amongst PW, 27% and 69.6% amongst WRA, and 23.8% and 83.5% amongst U5C. Data showed that the EMR is not on course towards meeting the WHA target. ...
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Papers by Baseer Achakzai