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Background: Endemic polio in Pakistan is threatening the Global Polio Eradication Initiative (PEI). In recent years, vaccine refusals have surged, spiking polio cases. The current study was conducted to understand the ethnic, religious and cultural roots of vaccine refusals in Charsadda District and explore the remedial options. Methods We conducted 43 in-depth interviews with parents who had refused polio vaccines for their children and the PEI staff. Interviews were audio-recorded, written in verbatim and analysed with Atlis.ti. We conducted a thematic analysis of our data. Results The fear of American and Jewish conspiracies was the primary cause of vaccine refusals. Militant groups like Tehrek-i-Taliban Pakistan capitalised on this fear, through social media. The Pashtun ethnic group considers itself at the centre of conspiracies. They are suspicious of mass investment and mobilisation behind the polio campaign. Our respondents feared that polio vaccines were making children vulgar. They also feared a reduction in the male to female ratio in childbirth. In Pashtun communities, the iconic conventional community gatherings ["Hujras"] are being replaced by provocative digital Hujra [social media], which the PEI and the Government of Pakistan (GOP) are failing to influence or regulate. The PEI uses the misleading term 'religious refusal'. Some factions in the clergy are maligning people from vaccinations, but not through religious dictum. The anti-state elements have stirred sentiments to weaken the state initiative. Fear of adverse effects, attitudinal barriers of health care providers, unmet basic needs and alleged haram composition of the vaccine were among the reasons for vaccine refusals. The PEI needs to revise its misleading nomenclature and ensue open discussion to dispel the myths of infertility, vulgarity and gender ratio related to the vaccines. Simultaneously, the GOP should stop disinformation on social media and rebrand polio vaccination with popular initiatives like the government-sponsored health insurance schemes. Conclusions The ethnic, cultural and religious dispositions of community members shape polio vaccine refusals in Charsadda District, in different ways. In synch with existing conspiracy theories and medical misconceptions, these three factors make refusals harder to counter. Awareness campaigns with content addressing these three dimensions can improve the situation. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess the knowledge, attitude and practice regarding hepatitis B virus (HBV) infection among nurses working in a public hospital of Peshawar, Pakistan. METHODS: This descriptive, cross sectional was conducted on 100 (96 females, 4 males) staff nurses of Haytabad Medical Complex, Peshawar, Pakistan, from 15th November 2010 to 15th January 2011. The sampling technique was simple random sampling. Qualitative variables were analyzed by calculating means and standard deviations. Quantitative variables were analyzed by calculating frequencies and percentages. RESULTS: The mean age of the respondents was 34.8±9.5 years. Sixty one percent had job duration >4 years. Previous source of knowledge about HBV, during nursing training school was 91% through workshops. Knowledge about HBV infection was 94%. 95% responded that it spread through blood transfusions. Ninety-six percent responded that they do not have separate dressing sets for hepatitis B patient. The practice of vaccination against HBV in nurses was 66% and use of disposable gloves while handling hepatitis B patient was 45%. Increase in duration of job was significantly associated with knowledge about hepatitis B virus and its spread (p-value <0.001). Intravenous cannulas and syringes were properly discarded with increasing job experience (p-value <0.001). Nurses with job duration of more than four years used gloves while handling hepatitis B patient (p-value <0.001). CONCLUSION: Knowledge of hospital staff nurses regarding HBV infection was adequate. The attitude of the hospital staff nurses regarding HBV infection was good. The practices of the hospital staff nurse regarding HBV infection were very poor. [ABSTRACT FROM AUTHOR]

Background: In several countries health related quality of life (HRQoL) scales have been used for adolescents, to assess the impact of disease. Health related quality of life scales are used on a range of different domains: physical, psychological, social and spiritual focusing on personal life including the concept of the World Health Organization definition of health., Methods: Health related quality of life in adolescent going to schools in the cantonment area of Peshawar garrison was assessed in a cross sectional descriptive study. Data was gathered by using a self-administered questionnaire (Kiddo-KINDL-R Questionnaire), previously tested to assess quality of life across six dimensions of health i.e. Physical and emotional well-being, self-esteem, family, social and school., Results: A total of 300 students of average age 13.41±1.34 years, with 145 (48.3%) females. Mean (SD) of total QoL score was 86.98 (12.86). The mean total scores were 86.28±12.34 and 87.64±13.34 for girls and boys, respectively., Conclusion: On the whole quality of life scores of the adolescent are good in the four dimensions. Special attention is needed towards the school environment, as majority of the participants are not satisfied with their schools. Similarly self-esteem scores are also low in the majority. However it is encouraging that most of the participants have scored highest scales in dimensions of family and physical health. Any effort to assess quality of life of the adolescents at the national level will give better view of quality of life of our youth.

Background: The magnitude of under nutrition among children below five years of age is high in Pakistan. Undernutrition and infections are the two most important factors that affect the growth of children. This study explains the extent of undernutrition and prevalence of wasting and stunting among preschool children., Methods: This cross sectional study with a sample size of 446 covered the age group 6-59 months in Jalozai Camp, District Nowshera. Height for age, weight for age and weight for height were measured as per WHO guidelines. Systematic random sampling technique was used for sample selection. Data was collected using a questionnaire., Results: According to height for age Z-score, out of 446 children studied, 8.5% were stunted and 4.0% were severely stunted. According to weight for age Z score, 11.4% were underweight and 3.6% were severely underweight. According to weight for height Z-score, 4.0% were wasted and 2.7% were severely wasted., Conclusion: The undernutrition in children is comparable to the national figures. Although our study found that absence of formal education, big family size, late and early weaning, absence of exclusive breast feeding and poverty were the factors associated with undernutrition in children, they could cause increase in under nutrition in future if not improved.