Knowledge,Attitudes and Practices of Contraception among Afghan Refugee Women in Pakistan: A Cross-Sectional Study

Background

During the 1980s, approximately three million people migrated from Afghanistan to Pakistan and sought refuge in several cities including the city of Karachi. After the initial settlement of the refugees, the international organizations transitioned the health care of these refugees to the two local non-profit service agencies in Karachi. One of these agencies subsidized health care to the refugees under their care and the other agency encouraged the refugees under their care to utilize governmental and non-governmental private health resources at the disposal of general public. Our objective was to measure the effect of health subsidy on the uptake of contraception among Afghan refugee women and compare them to the group of Afghan women without such a subsidy.

Methodology/Principal Findings

A randomly selected group of 650 married Afghan women-325 women in each group-participated in a detailed survey regarding the knowledge, attitude and practices of family planning and contraceptive use. 90 percent of the women in the health subsidy group had had heard of family planning, compared to the 45 percent in the non-subsidized group. The use of contraceptives was greater than two-fold in the former versus the latter. Results of logistic regression analysis revealed that the refugee women who had had access to subsidized healthcare were significantly more likely to use the contraceptive methods with advancing age as compared to the women in the non-health subsidy group. The difference remained significant after adjusting for other variables.

Conclusions/Significance

Refugee women who are provided subsidized healthcare are more inclined to use contraceptives. It is therefore important that Afghan refugee women living elsewhere in Pakistan be provided healthcare subsidy, whereby their reproductive health indicators could improve with reduced fertility. We strongly encourage facilities introducing such subsidies to refugees in resource poor settings to assess the impact through similar inquiry.     

Health issues of Afghan refugees in California.

Since the 1979 Soviet invasion of Afghanistan, more than 6 million Afghan refugees have become the world''s largest refugee population. Although refugees in Pakistan and Iran are now beginning to repatriate, continuing political turmoil in Afghanistan and children''s acculturation and educational opportunities will keep many Afghans in the United States permanently. Although there are no accurate statistics, local resettlement agencies and Afghan community leaders estimate that there are 10,000 to 35,000 Afghans in northern California. They suffer from a variety of problems common to refugees: language, economic and occupational problems, and substantial challenges in psychological, family, social, and cultural adjustment to the United States. Although many Afghans are doing well, many others have depression, psychosomatic symptoms, and posttraumatic stress disorder.     

Afghan project identifies 150,000 refugees,cuts abuse of system

More than 150,000 Afghan refugees in Pakistan registered their iris patterns as identification during their return journey to Afghanistan over the last year, the UN Refugee Agency has announced.This is a short news story only. Visit www.compseconline.com for the latest computer security news.     

The taste of freedom: commensality,liminality, and return amongst Afghan transnational migrants in the UK and Pakistan

This study follows UK Afghan migrants on a return visit to Northwest Pakistan. Combining theorizations of mobility, liminality, and commensality, it takes the picnic trip (chakar) as a little‐explored cultural lens through which to analyse symbolic formations of freedom, the shaping of Pakhtun transnational labour, and social hierarchies constituted through migration and return. As potent imaginary sites of remembering and forgetting, chakar map destinations left and not‐yet arrived at, routes of flight and return, and the burden of multi‐levelled constellations of political and economic insecurity on refugees living between the UK and Pakistan. The article argues that chakar are at once therapeutic and reproductive of ways in which personal and systemic realities combine features of hierarchy, exploitation, and patriarchy. They sustain participants in a tension between desires to preserve the hierarchies they conceal, and desires for more freedom. These contradictory experiences are usefully analysed through the emblematic arc of the ‘round trip’.     

"Fewer children, better life" or "as many as God wants"? Family planning among low-income Iranian and Afghan refugee families in Isfahan, Iran

In the West it is often assumed that religion (esp. Islam) and contraception are mutually exclusive. Yet, the Islamic Republic of Iran has one of the most successful family-planning programs in the developing world, and is often looked to as a potential model for other Muslim countries. Although Iran's family-planning program has been extremely successful among Iranians, it has been far less successful among Afghan refugees and other ethnic groups. Afghans and Iranians both seek services in Iran's public health sector for family health care, treatment of infectious disease, and childhood vaccinations. On these occasions, all adult married patients are strongly encouraged to use family planning to reduce the number of offspring. In this article, we explore how Iran's family-planning program is differentially perceived and utilized among low-income Iranian and Afghan refugee families in rural and urban locations. Particular attention is given to how different interpretations of Islam may or may not influence reproductive health-related behaviors and how cultural factors influence reproductive strategies.     

Experience of a Clinic for Afghan Refugees in Pakistan

Since the Soviets invaded Afghanistan in 1979, 3.5 to 4 million refugees have moved into Pakistan and Iran. Even before the war, the health status of the Afghans was extremely poor and the medical personnel limited. Various international efforts are attempting to cope with the health care needs of the refugees. Economic, language, and cultural problems hamper the projects. One clinic found the most common problems were of the gastrointestinal tract, then the respiratory tract, with a problem ranking similar to that of pre-war Afghanistan. Many of the health problems are linked to deficiencies in sanitation and nutrition.     

Cesarean Sections Among Syrian Refugees in Lebanon from December 2012/January 2013 to June 2013: Probable Causes and Recommendations

Introduction: There are nearly 3 million Syrian refugees, with more than 1 million in Lebanon. We combined quantitative and qualitative methods to determine cesarean section (CS) rates among Syrian refugees accessing care through United Nations High Commissioner for Refugees (UNHCR)-contracted hospitals in Lebanon and possible driving factors.Methods: We analyzed hospital admission data from UNHCR’s main partners from December 2012/January 1, 2013, to June 30, 2013. We collected qualitative data in a subset of hospitals through semi-structured informant interviews.Results: Deliveries accounted for almost 50 percent of hospitalizations. The average CS rate was 35 percent of 6,366 deliveries. Women expressed strong preference for female providers. Clinicians observed that refugees had high incidence of birth and health complications diagnosed at delivery time that often required emergent CS.Discussion: CS rates are high among Syrian refugee women in Lebanon. Limited access and utilization of antenatal care, privatized health care, and male obstetrical providers may be important drivers that need to be addressed.     

Association of blood groups with hepatitis C viremia

Hepatitis C virus remained a public health problem with approximately half of the patients untreated and undiagnosed. Chronic HCV is a leading cause of cirrhosis, fibrosis, hepatocellular carcinoma and other hepatic morbidities. Active HCV has a prevalence rate of about 1% (71 million). By July, 2019, 10 million population of Pakistan was declared to have active HCV infection. According to World Health Organization, 23,720 people died of hepatitis-related complexities in Pakistan in 2016. Individuals with certain types of ABO blood groups were more susceptible to diverse kinds of infections. For instance, blood types A and AB predisposed individuals to severe malaria, while type O conferred resistance to the many of the protozoan agent.This study was designed to explore the association of hepatitis C viremia to blood groups, Rh factors, age and gender distribution among Pakistani population. Total 246 participants were screened for HCV in Taqwa diagnostics laboratory, Multan and 200 were found positive. They were divided into 4 groups on the basis of their age. First group included patients ranging from 17 to 25 (52), second, third and fourth group included patients from 26 to 34 (92), 35 to 43 (42) and 44 to above (14) respectively. Confirmed Hepatitis C patients were subjected to analysis of blood group, Rh factor and viral load. Results demonstrated that patients having ‘O’ blood group (60.37%) were reported for high viral load than any of the other blood groups in the patients of Southern Punjab, Pakistan. Furthermore, Rh-negative factor (26.42) was associated with high viral load than that of the Rh-positive factor (73.58). Disclosure practiced that age group (26–34) was reported for the high viral load than that of the any other group of this study. Females were more aggressively affected by HCV Viremia than male because the mean viral load among the females was higher than that of the males. Greater social awareness and gender-sensitive healthcare is necessary to improve the experiences of patients with HCV.     

Unconditional hospitality: HIV, ethics and the refugee 'problem'

Refugees, as forced migrants, have suffered displacement under conditions not of their own choosing. In 2000 there were thought to be 22 million refugees of whom 6 million were HIV positive. While the New Zealand government has accepted a number of HIV positive refugees from sub-Saharan Africa, this hospitality is under threat due to negative public and political opinion. Epidemic conditions raise the social stakes attached to sexual exchanges, contagion becomes a major figure in social relationships and social production, and the fears of the contagious nature of those 'just off the plane' connect refugees to an equally deep-seated fear of racial miscegenation. Jacques Derrida's notion of unconditional hospitality is a dream of a democracy which would have a cosmopolitan form. This means that one cannot decide in advance which refugees one might choose to resettle. This paper will use Derrida's notion of unconditional hospitality to emphasise the fragility of HIV positive refugees' position, caught between becoming newly made New Zealand subjects while at the same time having that subjecthood threatened. For Derrida, both ethics and politics demand both an action and a need for a thoughtful response (a questioning without limit).     

Environmental refugees: a growing phenomenon of the 21st century

There is a new phenomenon in the global arena: environmental refugees. These are people who can no longer gain a secure livelihood in their homelands because of drought, soil erosion, desertification, deforestation and other environmental problems, together with the associated problems of population pressures and profound poverty. In their desperation, these people feel they have no alternative but to seek sanctuary elsewhere, however hazardous the attempt. Not all of them have fled their countries, many being internally displaced. But all have abandoned their homelands on a semi-permanent if not permanent basis, with little hope of a foreseeable return. In 1995, environmental refugees totalled at least 25 million people, compared with 27 million traditional refugees (people fleeing political oppression, religious persecution and ethnic troubles). The total number of environmental refugees could well double by the year 2010, and increase steadily for a good while thereafter as growing numbers of impoverished people press ever harder on overloaded environments. When global warming takes hold, there could be as many as 200 million people overtaken by sea-level rise and coastal flooding, by disruptions of monsoon systems and other rainfall regimes, and by droughts of unprecedented severity and duration.     

Who has time for Ćejf? Postsocialist migration and slow coffee in neoliberal Chicago

The official end to communism in Eastern Europe marked the onset of major migratory movements. Perhaps the most abrupt of these population shifts was the displacement of more than two million people in Yugoslavia's violent dissolution. Much of the existing literature on refugee migration has focused on victimization and citizenship claims. Alternatively, I draw on ethnographic research among Bosnian refugee-immigrants in Chicago to examine how a group of adult women migrants used one commodity - coffee - to manage and evaluate their displacements. The kind of slow-coffee drinking described here is informed by an ethics of consumption developed under Yugoslav socialism, nostalgias for pre-Yugoslav Islam and pre-Ottoman Bosnia, and exposure to U.S. neoliberalism. Placing consumption at the center of analysis reveals the structural constraints of the postconflict period and brings to light refugees’ active navigations of everyday life and society in their postsocialist present, lived out as refugees in the United States.     

The health status of Russian-speaking immigrants in Germany.

INTRODUCTION: Germany developed today into a country of immigration, which creates an additional burden for the social security system and results in a new challenge for the healthcare. In the last 17 years more than two million "Russia Germans" have been repatriated and about two hundred thousand Jewish refugees have resettled in Germany from the former Soviet Union. Nevertheless relevant data concerning migration-related public health care are very scare. METHODS: Search of PubMed and Journals extracts combined with the own researches, analysing the health status indices of the Russian-speaking immigrants in Germany. RESULTS: Both repatriates of German origin and Jewish refugees demonstrated higher prevalence of impaired lipid metabolism in comparison with native population. 42 % of the 503,040 HBsAg (hepatitis B s-Antigen) carriers in Germany were migrants. The Jewish refugees demonstrated the highest rates of depression and anxiety and the highest levels of awakening cortisol. On the other side German resettlers showed lower cardiovascular as well as all-cause death rates compared to the native Germans. CONCLUSION: The development of adequate health care programmes to address migratory aspects as well as the establishment of quality standards will realistically enhance the capability of responding rapidly to migrant health aspects and help to tackle inequalities in health.     

The CRHR1 gene: a marker for suicidality in depressed males exposed to low stress

The risk of suicide, which causes about 1 million deaths each year, is considered to augment as the levels of stress increases. Dysregulation in the stress response of the hypothalamic-pituitary-adrenocortical (HPA) axis, involving the corticotrophin-releasing hormone (CRH) and its main receptor (CRHR1), is associated with depression, frequent among suicidal males. Here we have analyzed single nucleotide polymorphisms (SNPs) in these genes, in family trios with suicide attempter offspring ( n = 542), by using the transmission disequilibrium test both in a two-staged screening/replication sample design and in detailed reanalysis in the entire sample. Stratification based on the levels of lifetime stress showed reproducible association and linkage of an SNP in the CRHR1 gene (rs4792887) to suicide attempters exposed to low levels of stress ( P = 0.002), among whom most males were depressed ( P = 0.001). The identified allele may represent a part of the genetic susceptibility for suicidality by increasing HPA axis activity upon exposure to low levels of stress.     

Preparation of purified vaccine from local isolate of foot and mouth disease virus and its immune response in bovine calves

Foot and Mouth Disease (FMD) is globally pandemic which badly affect the economics of livestock based countries like Pakistan. There are different types of Foot and Mouth Disease Virus (FMDV) among these types O is most prevalent in Pakistan. Recently Pakistan is producing approximately fifteen million doses of non-purified FMD vaccine against the demand of 160 million doses annually. More over the Pakistan is still striving for the development and optimization of concentration as well as purification of FMDV. The present project was designed to develop the technology for the purification of FMDV indigenously. The locally isolated and adapted FMDV type O virus was propagated on adherent culture of BHK-21cells to get final volume of virus one liter. This virus suspension was concentrated by peggylation as well as ultra-filtration method. The purification and quantification of concentrated virus was done by size exclusion chromatography. The results showed that peggylation is better method of concentration up to 603.75 µg/ml with 82.80 % recovery rate than ultra-filtration with 43.90 % followed by chromatography for purification. The PD₅₀ was calculated in bovines at 24, 12, 6, 3 and 1.5 µg of FMDV Ag/dose and it revealed that antigen load of 1.98 µg is the dose, where the 50 % of inoculated animals showed the protective antibody level based upon percent inhibition through antibody detecting ELISA. According to the British pharmacopeia, the vaccine should contain 3PD₅₀ which found equivalent to our findings about 6 µg/dose. The group of animal injected with 6/dose (3.23PD50) showed protective titer up to 20th week post priming.     

A conspectus of Barley Yellow Dwarf in Pakistan

Wheat is an important cereal crop worldwide and in Pakistan. Among the wheat producing countries, Pakistan ranks 6th with an annual wheat production of 24.214 million tons. Burgeoning population of the country demands increase in its production that is hindered by a number of pests, pathogens and environmental stresses. Among the yield limiting constraints, Barley Yellow Dwarf Virus (BYDV) is important, inflicting approximately 75% wheat production losses in diseased crop nationally. Research on BYDV and its management is mandatory for sustainable agriculture in the country. This review focuses on BYDV, its relationship with vectors, classification and management practices. Additionally, its currents status in Pakistan has been reviewed.     

Of mice and men: Fossil-based divergence dates and molecular “clocks”

The magnitude of immunological differences between species has been used to estimate the time of divergence of lineages, especially among primates. Calibration of “clocks” based on immunological differences has relied heavily on data from Pakistan suggest that the lineages leading to Mus and Rattus diverged between 14 and 8 million years ago rather than 30 or more million years ago as suggested by techniques invoking constant rates of molecular evolution. Molecular analyses of pairs of mammal species which appear well documented paleontologically should be undertaken in order to expand our understanding of the tempo and mode of molecular evolution.     

Defense of females, but not social status, predicts plasma androgen levels in male spotted hyenas

A positive correlation between male social status and testosterone levels is expected and often found in social species with high rates of agonistic interactions or when social relationships among males are unstable. In contrast, in species with low rates of agonistic interactions or when social relationships are stable, testosterone levels should not correlate with social status. The "challenge hypothesis" predicts that androgen levels should rise during periods of courtship or mate guarding. We addressed these questions in free-ranging spotted hyenas, a species with low rates and low intensities of aggression among males but where males spend extensive effort to court females. In males, we measured testosterone, its precursor androstenedione, and its metabolite 5alpha-dihydrotestosterone. As predicted, testosterone levels were significantly higher and androstenedione levels tended to be higher in males that, at the time of sampling, defended a female, compared with males that did not defend a female. Also, as predicted, there was no correlation between social status and androgen levels in male spotted hyenas.     

Asymptomatic Malaria in Refugees Living in a Non-Endemic South African City

Background

Asymptomatic malaria infection in refugees is both a threat to the lives of the individuals and the public in the host country. Although South Africa has been experiencing an unprecedented influx of refugees since 1994, data on malaria infection among refugees is lacking. Such information is critical since South Africa is among the countries that have planned to eliminate malaria. The objective of this study was to determine prevalence of asymptomatic malaria infection among a refugee population living in a city of KwaZulu-Natal province, South Africa.

Methods and Findings

A survey was conducted on adult refugee participants who attended a faith-based facility offering social services in a city of KwaZulu-Natal province, South Africa. The participants were screened for the presence of malaria using rapid diagnostic tests and microscopy. Demographic data for the participants were obtained using a closed ended questionnaire. Data was obtained for 303 participants consisting of 51.5% females and 47.5% males, ranging from 19 to 64 years old. More than 95% of them originated from sub-Saharan African countries. Two hundred and ninety participants provided a blood sample for screening of malaria. Of these, 3.8% tested positive for rapid diagnostic test and 5.9% for microscopy. The majority of malaria infections were due to Plasmodium falciparum.

Conclusions

The study confirms the presence of asymptomatic malaria infections among a refugee population residing in a city of KwaZulu-Natal province that is not endemic for malaria. The results have important implications for both public health and malaria control in South Africa, particularly since the country has decided to eliminate malaria by 2018. To achieve this goal, South Africa needs to expand research, surveillance and elimination activities to include non-endemic areas, particularly with high refugee populations. We further recommend use of powerful diagnostic tests such as PCR for these interventions.     

Geographic variation in sperm traits reflects predation risk and natural rates of multiple paternity in the guppy

Guppies (Poecilia reticulata) are models for understanding the interplay between natural and sexual selection. In particular, predation has been implicated as a major force affecting female sexual preferences, male mating tactics and the level of sperm competition. When predation is high, females typically reduce their preferences for showy males and engage more in antipredator behaviours, whereas males exploit these changes by switching from sexual displays to forced matings. These patterns are thought to account for the relatively high levels of multiple paternity in high‐predation populations compared to low‐predation populations. Here, we assess the possible evolutionary consequences of these patterns by asking whether variation in sperm traits reflect differences in predation intensity among four pairs of Trinidadian populations: four that experience relatively low levels of predation from a gape‐limited predator and four that experience relatively high levels of predation from a variety of piscivores. We found that males in high‐predation populations had faster swimming sperm with longer midpieces compared to males in low‐predation populations. However, we found no differences among males in high‐ and low‐predation populations with respect to sperm number, sperm head length, flagellum length and total sperm length.