Typhoid, and its extra drug resistant form which is highly prevalent Pakistan, is increasing the burden on healthcare through multiple factors. These range from lack of sanitation, the collapsing economy, and poor access to clean drinking water which have made it arduous for the government and various other organizations in containing it. With the COVID-19 pandemic, treatment of typhoid became a challenge as focus was driven towards limiting the COVID-19 spread, and hence preferential use of antibiotics such as azithromycin may limit future empirical antibiotic therapy for typhoid. Socioeconomic disparities and geographical as well as demographic barriers further limit access to appropriate typhoid management. Lastly, illiteracy and self-medication with antibiotics may predispose Pakistan to another outbreak of typhoid. These concerns, although largely unaddressed effectively, need immediate action. Previously, the government and international organizations have made efforts to control the spread through the introduction of TCV as a part of EPI and awareness, additional improvements are needed. These include: improving access to telemedicine in rural areas, extensive vaccination programs, and routine awareness programs especially in schools.
Over the years, several developing countries have been suffering from high infant and child mortality rates, however, according to the recent statistics, Pakistan falls high on the list. Our narrative review of copious research on this topic highlights that several factors, such as complications associated with premature births, high prevalence of birth defects, lack of vaccination, unsafe deliveries, poor breastfeeding practices, complications during delivery, sudden infant death syndrome (SIDS), poor socioeconomic conditions, and a struggling healthcare system, have influenced these rates. Bearing in mind the urgency of addressing the increased infant and child mortality rate in Pakistan, multiple steps must be taken in order to prevent unnecessary deaths. An effective initiative could be spreading awareness and education among women, as a lack of education among women has been indirectly linked to increased child mortality in Pakistan across many researches conducted on the issue. Furthermore, the government should invest in healthcare by hiring more physicians and providing better supplies and improving infrastructure, especially in underdeveloped areas, to decrease child mortality due to lack of clean water and poor hygiene. Lastly, telemedicine should be made common in order to provide easy access to women who cannot visit the hospital.
Background Vaccine hesitancy is not a new phenomenon to Pakistan. This is evidenced through the slow progress of previous vaccination campaigns and programs against MMR, BCG, and especially polio. This issue continues to persist and is therefore becoming the cause of low COVID‐19 vaccination rates in Pakistan. Aim To provide insights about COVID‐19 vaccine hesitancy among Pakistanis, and its potential harm on public health. Moreover, we aim provide recommendations to counter the factors limiting the COVID‐19 vaccination in Pakistan. Methodology A Boolean search was conducted to find the literature in MEDLINE‐PubMed, Google Scholar, and Clinicaltrials.gov databases up till March 16, 2022. Specific keywords were used which comprised of “SARS‐CoV‐2,” “COVID‐19,” “vaccine hesitancy,” “vaccine acceptance,” “intention to vaccinate,” and “Pakistan,” with use of “OR” and “AND.” Only free full‐text original studies in English language were used to compare and contrast. Results As proven by various studies, COVID‐19 vaccination rates are influenced by multiple factors, including inaccurate beliefs about COVID‐19, hesitancy amongst healthcare workers, uncertainty regarding vaccine's efficacy and fear of side effects. Various conspiracy theories and lower testing rates among others also add up to impose a negative impact on the vaccination rates and public health of Pakistan. This may lead to newer strains of potentially harmful COVID‐19, mental health deterioration, and prolonged lockdowns. Conclusion Vaccine hesitancy is a global public health threat, and its impacts are pronounced in Pakistan. This is reflected in the COVID‐19 pandemic; low vaccination rates in Pakistan may lead to future outbreaks of new, potentially harmful, strains of COVID‐19 which can prolong lockdowns in the country and affect mental health of the population. To improve the current situations, it is imperative for the government, educational institutes, and healthcare systems to develop trust and continually use dialogue, communication, and education to address misconceptions to improve COVID‐19 vaccination in Pakistan.
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