Situated on the Pakistan-Afghan border, Quetta is home to growing numbers of Afghan refugees. We studied HIV knowledge and risk behaviors among Pakistani and Afghani drug users between July 2001 and November 2001. Of 959 drug users, all were male and the majority used heroin. Most were Pakistani (84.8%), 14.9% were Afghani, and 0.3% were Iranian. Relative to Pakistani drug users, a higher proportion of Afghanis reported no formal education, homelessness, and unemployment ( p <.001). Afghanis were more likely to have used an opiate as their first illicit drug (16% vs. 7%, p <.001), to have ever injected (18.8% vs. 12.3%, p =.04), to report needle sharing (72.2% vs. 48.2%, p =.08), or to report a drug user in their family ( p =.08). None of sexually active Afghanis had ever used a condom compared with 5.0% of the Pakistanis ( p =.01). Only 4.3% of Afghans had ever heard of HIV/AIDS compared with 18.3% of Pakistanis ( p <.001). Extremely low levels of HIV/AIDS awareness and high HIV risk behaviors were evident among drug users in Quetta, among whom Afghanis were especially vulnerable. Interventions to prevent transition to injection, needle exchange, and drug treatment are urgently required to prevent blood-borne infections.
Abstract. In the Holy City of Makkah, during Hajj "season 1428 Hegira (2007)", 504 food handlers from twenty one countries were investigated for the infection of intestinal parasites. Stool samples were examined by direct smear techniques; Ritchie concentration technique and trichrome permanent staining technique. Intestinal parasites were detected in 31.94% of food handlers. Fifteen different intestinal parasites were identified; Trichuris trichiura (10.70%), Blastocystis hominis (9.33%), Hook worms (7.54%), Endolimax nana (6.15%), Entamoeba coli (4.37%), Entamoeba histolytica (2.78%), Giardia lamblia (1.98%), Entamoeba hartmanni (1.79%), Schistosoma mansoni (1.59%), Strongyloides stercoralis (1.00%), Iodamoeba buetschlii (0.8%), Ascaris lumbricoides (0.8%), Hymenolepis nana (0.6%), Dientamoeba fragilis (0.2%) and Enterobius vermicularis (0.2%). In conclusion, the high prevalence of intestinal parasitic infections suggest; stool analysis for intestinal parasites should be periodically carried out in addition to the sanitation education and health special care for food handlers working in Makkah. This study is the first during the Hajj season to investigate distribution of intestinal parasites among food handlers in The Holy City of Makkah.
IntroductionHIV and HCV risk behaviors among injection drug users (IDUs) in two urban areas in Pakistan were identified.MethodsFrom May to June 2003, 351 IDUs recruited in harm-reduction drop-in centers operated by a national non-governmental organization in Lahore (Punjab province) and Quetta (Balochistan province) completed an interviewer-administered survey and were tested for HIV and HCV. Multivariable logistic regression identified correlates of seropositivity, stratifying by site. All study participants provided written, informed consent.ResultsAll but two were male; median age was 35 and <50% had any formal education. None were HIV-positive; HCV seroprevalence was 88%. HIV awareness was relatively high, but HCV awareness was low (19%). Injection behaviors and percutaneous exposures such as drawing blood into a syringe while injecting ('jerking'), longer duration of injection, and receiving a street barber shave were significantly associated with HCV seropositivity.DiscussionDespite no HIV cases, overall HCV prevalence was very high, signaling the potential for a future HIV epidemic among IDUs across Pakistan. Programs to increase needle exchange, drug treatment and HIV and HCV awareness should be implemented immediately.
Our objective was to describe HIV/STD risk behaviours and awareness among a community-based sample of drug users in Pakistan. Drug users contacted through street outreach by a non-governmental organization in Quetta, Peshawar and Rawalpindi underwent interviewer-administered questionnaires. Descriptive statistics were used to characterize sexual behaviours by city, marital status and the use of injection drugs. Logistic regression was used to identify correlates of ever having an STD. Of 608 drug users studied, all but one was male; median age was 32 years and 45% had no formal education. Half were married, of whom 25% were living with their wives. Sexual behaviours were reported as follows: 14% had sex with other males, 28% reported sex with both males and females, 49% had paid money to have sex and only 10% had ever used condoms. One-fifth reported having had an STD and about 40% reported having suffered from either one or more STD-related symptoms. Only 41% had heard about HIV/AIDS, of whom 17% knew that HIV/AIDS could be transmitted through sexual contact. In conclusion, high-risk sexual behaviours are prevalent among male drug users in Pakistan, and awareness of transmission risks is low. These data attest to the urgent need for effective and specific interventions in Pakistan to prevent transmission of HIV and STDs among drug users and their sex partners.
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