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Seroprevalence of Dengue Virus IgG among Children 1 - 15 Years, Selected from an Urban Population in Karachi, Pakistan: Population Based Study

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Open Journal of Pediatrics 2015年第2期5卷 128-133页

作者： Shakeel Ahmed Syed Rehan Ali farhana tabassum Department of Paediatrics and Child Health Aga Khan University Hospital Karachi Pakistan Department of Paediatrics Bahria University Medical and Dental College Karachi Pakistan

Objectives: This was to estimate the proportion of Dengue virus specific IgG ELISA among asymptomatic children between the ages of 1 year to 15 years, residing in an urban population of Karachi. Design: Cross-sectional study. Settings: Subjects were selected from Garden, Karachi;an urban area located adjacent to the Central district of Karachi. Participants: Children of ages 1 year to 15 years, of either sex, residing in the urban area of Garden, Karachi for more than 1 year were selected for the study. Those with a history of yellow fever or using corticosteroids within 1 month of recruitment were excluded. Outcome measures: Data were collected on socioeconomic status of households, medical history, including previous dengue infection, general examination findings and anthropometric indices. Blood samples were collected and sent to Research Laboratories, AKU for determining complete blood counts and serum IgG antibodies for Dengue. All collected information was then analyzed for ascertaining the predicting factors for positive IgG among children less than 15 years. Results: From a total of 900 subjects, 46% were found to have positive IgG in their bloods. Our results revealed that a male child of age more than 10 years was more likely to be IgG positive. Other risk factors identified with the seropositivity included lower household income and absence of anemia, thrombocytopenia and lack of hand washing. Conclusions: The study indicated a significant proportion of children under 15-year-old infected with Dengue virus, with a potential risk of severe complications, if re-infected with dengue. Stringent measures are still needed by both public and private authorities to contain dengue outbreaks, and reducing the proportion of associated mortality, as seen in the previous years. Trial registration: Seed Money Grant (ID# SM090101) was awarded to the corresponding author by Research Committee, Faculty of Health Sciences, Aga Khan University, Pakistan.

关键词： Dengue Virus IgG Cross-Sectional Thrombocytopenia Hand-Washing Anemia

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Risk Factors Associated with Birth Asphyxia in Rural District Matiari, Pakistan: A Case Control Study

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International Journal of Clinical Medicine 2014年第21期5卷 1430-1441页

作者： farhana tabassum Arjumand Rizvi Shabina Ariff Sajid Soofi Zulfiqar A. Bhutta Department of Pediatrics and Child Health Aga Khan University Karachi Pakistan

Background: During the past two decades there has been a sustained decline in child mortality;however, neonatal mortality has remained stagnant. Each year approximately 4 million babies are born asphyxiated resulting in 2 million neonatal deaths and intrapartum stillbirths. Almost all neonatal deaths occur in developing countries, where the majority is delivered at homes with negligible antenatal care and poor perinatal services. Objectives: To identify socio-demographic and clinical risk factors associated with birth asphyxia in Matiari District of Sindh Province, Pakistan. Method: A matched case control study was conducted in Matiari District with 246 cases and 492 controls. Newborn deaths with birth asphyxia diagnosed through verbal autopsy accreditation during 2005 and 2006 were taken as cases. Controls were the live births during the same period, matched on area of residence, gender and age. Result: The factors found to be associated with birth asphyxia mortality in Matiari District of Sindh Province, Pakistan are maternal education, history of stillbirths, pregnancy complications (including smelly or excessive vaginal discharge and anemia), intrapartum complications (including fever, prolong or difficult labour, breech delivery, cord around child’s neck, premature delivery, large baby size) and failure to establish spontaneous respiration after birth. Conclusion and Recommendation: There is an immediate need to develop strategies for early identification and management of factors associated with birth asphyxia by involving women, families, communities, community health workers, health professionals and policy makers. Community health workers should be trained for emergency obstetric care, basic newborn care including preliminary resuscitation measures to provide skilled birth attendance and encourage early recognition and referral.

关键词： Birth Asphyxia Prolong Labor Antenatal Care

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Determinants of Health Care Seeking Behaviors in Puerperal Sepsis in Rural Sindh, Pakistan: A Qualitative Study

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Open Journal of Preventive Medicine 2020年第9期10卷 255-266页

作者： Shabina Ariff Fatima Mir farhana tabassum Farrukh Raza Atif Habib Ali Turab Amnesty LeFevre Linda A. Bartlett Sajid Bashir Soofi Zulfiqar A. Bhutta Department of Paediatric and Child Health Aga Khan University Karachi Pakistan Center of Excellence in Women & Child Health Aga Khan University Karachi Pakistan Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore MD USA

Background: Puerperal sepsis (PS) is one of the major causes of maternal death, contributing to 26,000 deaths per year in developing countries. Early recognition and treatment are essential to managing PS, but numerous social, cultural and technical barriers prevent or delay access to care and necessary medical attention. Through this qualitative study, we identified barriers to care seeking for puerperal sepsis among recently delivered women in Matiari, Pakistan. Methods: We conducted 20 in-depth interviews among recently delivered women with and without sepsis and their family members in September 2012. Key informant interviews were conducted with 14 healthcare providers and traditional birth attendants. The themes used for content analysis were knowledge of danger signs, factors affecting care seeking and local treatment practices for postpartum sepsis. Results: A total of 34 interviews were conducted. Recently delivered women, their family members and traditional birth attendants were unaware of the word PS or the local translated term for PS. However, they were familiar with most of the individual symptoms associated with PS. Healthcare providers were aware of the condition and the associated symptoms. The healthcare providers’ understanding of the seriousness of PS was directly proportional their age and clinical experience. The most common barriers to care seeking was the division of labor within the household, obtaining permission from the primary decision maker, access to transportation, lack of financial resources and support from family members. Conclusion: To improve maternal care seeking behaviors for PS, interventions focusing on increasing knowledge of PS, addressing gender inequality, implementing an affordable community transport service and enhancing TBA’s knowledge and skills to manage PS need to be implemented.

关键词： Puerperal Sepsis Qualitative Care Seeking Barrier Maternal Health

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