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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.

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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.