BackgroundThe World Health Organization (WHO) declares Chikungunya (CHIK) infection to be endemic in South Asia. Despite its first outbreak in Pakistan, no documented evidence exists which reveals the knowledge or awareness of healthcare students and workers (HCSW) regarding CHIK, its spread, symptoms, treatment and prevention. Since CHIK is an emergent infection in Pakistan, poor disease knowledge may result in a significant delay in diagnosis and treatment. The current study was aimed to evaluate the awareness and knowledge of CHIK among HCSW.MethodsA cross-sectional study was conducted among HCSW from teaching institutes and hospitals in seven provinces of Pakistan. We collected information on socio-demographic characteristics of the participants and their knowledge by using a 30-item questionnaire. The cumulative knowledge score (CKS) was calculated by correct answers with maximum score of 22. The relationship between demographics and knowledge score was evaluated by using appropriate statistical methods.ResultsThere were 563 respondents; mean age 25.2 ± 5.9 years with female preponderance (62.5%). Of these, 319 (56.7%) were aware of CHIK infection before administering the survey. The average knowledge score was 12.8 ± 4.1 (% knowledge score: 58.2%). Only 31% respondents had good disease knowledge while others had fair (36.4%) and poor (32.6%) knowledge. Out of five knowledge domains, domain III (vector, disease spread and transmission) and V (prevention and treatment) scored lowest among all i.e. percent score 44.5% and 54.1%, respectively. We found that socio-demographic characteristics had no influence on knowledge score of the study participants.ConclusionApproximately one-half of participants were not aware of CHIK infection and those who were aware had insufficient disease knowledge. Findings of the current study underscore the dire need of educational interventions not only for health care workers but also for students, irrespective to the discipline of study.

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Background Prison represents an important setting for tuberculosis (TB) control. Higher TB rates have been reported in prison when compared with general population. Aims and objective The current study evaluates the incidence of TB among prison inmates from 4 states of Malaysia to identify factors associated with Mycobacterium tuberculosis infection and treatment outcomes. Methodology A multicenter, cross-sectional, retrospective study was conducted in the 11 prisons in 4 Malaysian states, which were selected based on high burdens of TB in Malaysia (Sabah, Sarawak, Pulau Pinang, and Selangor). Patients with confirmed TB were selected for the study based on tuberculin skin testing and further established by chest radiograph and positive sputum and culture test results. Results A total of 405 inmates were diagnosed as having TB, with most them being male inmates (n = 397; 98%). The mean ± SD age of TB inmates was 39.28 ± 10.12 years. The sample was ethnically diverse and consisted mostly of Malays (203; 50.1%) followed by Chinese (98; 24.2%), Indians (64; 15.8%), and other ethnicities (40; 9.9%). Of the total 405 TB inmates, most belonged to the Selangor state prison (n = 312; 77%), with an incidence rate of 755/100,000. The overall incidence of TB among 4 state prisons in Malaysia was 440/100,000. Treatment outcome for 279 (68.8%) TB inmates was successful, 31 (7.7%) were defaulters, 12 (3%) were transferred out, 34 (8.4%) died, and treatment of TB for 49 (12.1%) inmates was continued. On univariate analysis, patient sex (odds ratio [OR], 2.21; 95% confidence interval [CI], 0.2–6.8; P < 0.001), age group (OR, 1.65; CI, 1.08–2.53; P = 0.02), area (OR, 1.08; CI, 0.3–3.1; P < 0.001), pulmonary TB (OR, 1.96; CI, 1.2–3.1; P = 0.05), extrapulmonary TB (OR, 0.53; CI, 0.3–0.8; P = 0.015), and TB with diabetes mellitus (OR, 2.21; CI, 0.7–2.7; P = 0.01) were statistically significant as predictors of treatment outcomes. These variables were further analyzed on multivariate analysis, and patient age group (OR, 1.60; CI, 1.0–2.5; P = 0.02) was a more likely factor that affected treatment outcome. Conclusion Low TB treatment success rates and multiple factors affecting treatment outcomes refer to the fact that attention is needed in improving existing medical setup at prisons.

HIV/AIDS remains the greatest public health concern in the world. With current scenario, HIV-AIDS is considered as a chronic disease due to the advent of highly active antiretroviral therapy that has significantly improved the status of infected population, making HIV a manageable illness. However, recent studies suggest that exposure to antiretroviral medications may have marked adverse effects, independent of HIV status. All antiretroviral drugs can have both short-term and long-term adverse events. The risk of specific side effects varies from drug to drug, from drug class to drug class, and from patient to patient. A better understanding of the adverse effects of antiretroviral agents is of interest not only for HIV specialists as they try to optimize therapy, but also for other physicians who care for HIV positive patients. Current article reviews a note on demerits of the therapy, major complications and metabolic abnormalities that occur as a consequence of highly active anti-retroviral therapy (HAART). Conclusion: It is critical that all health care providers and patients be trained to recognize the symptoms and signs of most of the adverse drug reactions early on. Proper protocols for management of the condition should be readily available. Adverse event surveillance at facilities offering HAART need to be formalized. Proper surveillance of side-effects will enable evidence-based decisions to be taken to avoid potentially fatal complications.