“…As such, people are always in contact with animals and their exposure to and risk of zoonotic diseases is greatly increased because of this. Moreover, the frequent shifting of nomads with their livestock [13, 14] plays a significant role in the recurring epidemics of CCHFV in Baluchistan and neighbouring Afghanistan. Internationally studies [2, 15, 16] have reported the epidemiological profile of CCHFV in domestic and wild animals but this data is not available for Pakistan.…”
Section: Introductionmentioning
confidence: 99%
“…Fig. 1Death Toll of Crimean Congo Haemorrhagic Fever cases in Pakistan during 2012-2016 [13, 18, 19]
…”
Pakistan has faced a number of significant healthcare challenges over the past decade. In 2000, one of these events - a deadly epidemic of Crimean Congo Haemorrhagic Fever (CCHF) - struck Pakistan. The people of Pakistan are at a very high risk of acquiring CCHF, due to a number of factors which emerge from a scoping review of the literature. First, the underdeveloped healthcare system of the country is currently not prepared to cope with challenges of this nature. Healthcare professionals and medical institutes are not sufficiently equipped to properly diagnose, manage and prevent CCHF. Second, a large percentage of the general public is unaware of the spread and control of the vector. The agricultural sector of Pakistan is vast and thus many people are involved in animal husbandry and the handling of livestock which can lead to the transmission of the CCHF virus. Even in urban areas the risk of transmission is significantly higher around the time of Eid-ul-Azha, when Muslims slaughter animals. Finally, the political upheavals faced by the country have also increased Pakistan’s vulnerability because a large number of refugees from Afghanistan, a CCHF endemic country, have migrated to Pakistan as a result of the Afghan war. Most of the refugees and their animals settle in Baluchistan and Khyber Pakhtunkhwa provinces, which consequently have a higher prevalence of CCHF. This scoping review of the literature highlights the potential causes of high risk CCHF and draws conclusions and makes recommendations that policy-makers in Pakistan may wish to consider in-order to improve on the current situation.
“…As such, people are always in contact with animals and their exposure to and risk of zoonotic diseases is greatly increased because of this. Moreover, the frequent shifting of nomads with their livestock [13, 14] plays a significant role in the recurring epidemics of CCHFV in Baluchistan and neighbouring Afghanistan. Internationally studies [2, 15, 16] have reported the epidemiological profile of CCHFV in domestic and wild animals but this data is not available for Pakistan.…”
Section: Introductionmentioning
confidence: 99%
“…Fig. 1Death Toll of Crimean Congo Haemorrhagic Fever cases in Pakistan during 2012-2016 [13, 18, 19]
…”
Pakistan has faced a number of significant healthcare challenges over the past decade. In 2000, one of these events - a deadly epidemic of Crimean Congo Haemorrhagic Fever (CCHF) - struck Pakistan. The people of Pakistan are at a very high risk of acquiring CCHF, due to a number of factors which emerge from a scoping review of the literature. First, the underdeveloped healthcare system of the country is currently not prepared to cope with challenges of this nature. Healthcare professionals and medical institutes are not sufficiently equipped to properly diagnose, manage and prevent CCHF. Second, a large percentage of the general public is unaware of the spread and control of the vector. The agricultural sector of Pakistan is vast and thus many people are involved in animal husbandry and the handling of livestock which can lead to the transmission of the CCHF virus. Even in urban areas the risk of transmission is significantly higher around the time of Eid-ul-Azha, when Muslims slaughter animals. Finally, the political upheavals faced by the country have also increased Pakistan’s vulnerability because a large number of refugees from Afghanistan, a CCHF endemic country, have migrated to Pakistan as a result of the Afghan war. Most of the refugees and their animals settle in Baluchistan and Khyber Pakhtunkhwa provinces, which consequently have a higher prevalence of CCHF. This scoping review of the literature highlights the potential causes of high risk CCHF and draws conclusions and makes recommendations that policy-makers in Pakistan may wish to consider in-order to improve on the current situation.
“…6,7 CCHF is a deadly illness, the hosts of which include a wide range of domestic as well as wild animals such as cattle, sheep, goats and hares. The Hyalomma species of the hard tick are the principal vectors of this disease.…”
mentioning
confidence: 99%
“…5,7 Fever is generally unresponsive to antibiotic and antimalarial treatment. These initial symptoms are later followed by haemorrhagic symptoms (petechiae, purpura, ecchymosis, haemoptysis, hematemesis, haematuria, mucosal bleeds and internal bleeding) together with lymphadenopathy and hepatomegaly.…”
mentioning
confidence: 99%
“…14 Since there is no safe and effective commercially available vaccine against CCHF, the recommended way of reducing transmission of the disease is by prevention and control measures. 7 Health care workers are a highrisk occupational group for CCHF infections and hence, probable CCHF patients should immediately be isolated and strict barrier nursing techniques must be adapted to reduce nosocomial transmission. 2 It is essential for health care workers to adapt standard infection control protocols (including personal protective equipment, basic hand hygiene, safe injection practices, safe sampling and safe burial practices) to prevent occupational exposure.…”
Background: Crimean-Congo haemorrhagic fever (CCHF) is a potentially fatal yet preventable zoonotic haemorrhagic disease which has consumed the lives of many health care workers in different regions of Pakistan over the past few years. There is neither a specific therapy nor an effective vaccine for the disease, which makes prevention the most rational approach towards CCHF. Hence, our main objective in this study was to determine the knowledge and practices of doctors regarding Crimean-Congo haemorrhagic fever (CCHF) at a tertiary care teaching hospital in Lahore.Methods: Non-probability convenience sampling was used to recruit the study sample (N=136). A structured questionnaire was used to collect data comprising of 35 multiple response questions pertaining to demographic information and knowledge and practice of the respondents regarding CCHF. Descriptive statistics was used to present data as numbers and percentage.Results: The study participants included 46 house officers, 69 post-graduate trainee/medical officers and 21 consultants. Among the respondents, 80% rated their knowledge regarding CCHF to be insufficient and 71% revealed that they did not feel confident while managing a patient of CCHF. While managing patients with active haemorrhage, 32% of our respondents either never or only sometimes used personal protective equipment. Nearly all study participants (93%) expressed the desire to acquire more education on CCHF in future.Conclusions: Knowledge of doctors regarding CCHF and compliance in terms of standard infection control protocols were inadequate.
Background
The Crimean-Congo Hemorrhagic fever (CCHF) is endemic in Iran and has a high fatality rate. The aim of this study was to investigate the association between CCHF incidence and meteorological variables in Zahedan district, which has a high incidence of this disease.
Methods
Data about meteorological variables and CCHF incidence was inquired from 2010 to 2017 for Zahedan district. The analysis was performed using univariate and multivariate Seasonal Autoregressive Integrated Moving Average (SARIMA) models and Generalized Additive Models (GAM) using R software. AIC, BIC and residual tests were used to test the goodness of fit of SARIMA models, and R2 was used to select the best model in GAM/GAMM.
Results
During the years under study, 190 confirmed cases of CCHF were identified in Zahedan district. The fatality rate of the disease was 8.42%. The disease trend followed a seasonal pattern. The results of multivariate SARIMA showed the (0,1,1) (0,1,1)12 model with maximum monthly temperature lagged 5 months, forecasted the disease better than other models. In the GAM, monthly average temperature lagged 5 months, and the monthly minimum of relative humidity and total monthly rainfall without lag, had a nonlinear relation with the incidence of CCHF.
Conclusions
Meteorological variables can affect CCHF occurrence.
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