Background: Very few studies have been reported on hepatitis B in the State of Azad Jammu and Kashmir, Pakistan, and none of them are specific to the prevalence and causes of hepatitis B spread among educational institutes. This study aimed to estimate the prevalence of hepatitis B infection and its associated risk factors among the University of AJ and K population. Methods: An observational, cross-sectional, and analytical study was conducted with 7015 students and employees. Hepatitis B was detected by rapid immunochromatographic tests (ICTs), enzyme-linked immunosorbent assay (ELISA), and real-time quantitative PCR. A questionnaire and interview method was used to assess the disease knowledge and associated risk factors with hepatitis B through Chi-square, Fisher’s exact test, and paired t-test. Results: Of the participants, 150 (2.13%) were found positive for the hepatitis B surface antigen (57.3% male and 42.7% female). Only 0.3% participants were found fully vaccinated against the hepatitis B virus. Among ethnic groups, the Syed tribe was found more prevalent for hepatitis B infection (40.6%), while use of contaminated mourning blades (95% CI: p = 0.0001) was found as an overlooked risk factor. Hepatitis preventive awareness sessions were found to be very significant (p = 0.0001). Conclusions: The study showed that an overlooked risk factor is playing a key role in the spread of HBV in a tribe living worldwide, which must be addressed globally to eradicate hepatitis B. In Pakistan, a country-wide annual HBV vaccination program should be launched to control hepatitis B.

OBJECTIVE: To determine the seroprevalence of hepatitis B and C among immigrants residing refugee camps in Muzaffarabad, Azad Kashmir, Pakistan, and to identify possible risk factors for HBV and HCV transmission. METHODS: Around 1,225 individuals inhabiting Muzaffarabad refugee camps, participated in the study. A qualitative Immuno-Chromatographic Technique was used for initial screening and PCR test was used for detection of HBV and HCV in participants. The major risk factors for HBV and HCV transmission were assessed using a questionnaire approach. RESULTS: Around 86 (7.0%) individuals were observed for HBsAg presence, and 215 (17.5%) individuals were found positive for Anti-HCV. Only 32 (2.6%) individuals were confirmed for HBV DNA and 126 (10.3%) individuals were positive for HCV RNA after PCR. Demographically, both HBsAg and Anti-HCV were found more prevalent in female (4.4% HBsAg and 10.8% Anti-HCV) population as compared to male (2.6% HBsAg and 6.7% Anti-HCV) population. Surprisingly, the HBsAg (23.5%) and Anti-HCV (41.1%) appeared to be more frequent in the age group 62–75 years. Previous history of hepatitis in the family (p < 0.0001), blood transfusion (p = 0.0197) dental treatment (p < 0.0001) and tattooing or piercing on any part of the body (p = 0.0028) were assessed as significant risk factors in HBV and HCV transmission. CONCLUSIONS: Presence of 7.0% HBsAg and 17.5% Anti-HCV in a small fragment of the migrant population cannot be overlooked. Lack of awareness among people and negligence of health department could escalate the situation.

Background: As the prevalence of hepatitis B continues to rise in Pakistan, our study focused on educational institutions in the state of Azad Kashmir due to the complete absence of data on this scenario concerning college populations. We aimed to assess the prevalence of hepatitis B and identify associated risk factors among the population of postgraduate colleges in Muzaffarabad city, situated in Pakistan-administered Kashmir. Methods: In this cross-sectional study, rapid immuno-chromatographic tests and real-time quantitative PCR methods were used to identify hepatitis B infection, while serum ALT levels were tested to assess their diagnostic associations with the infection level. The evaluation of risk factors was conducted through interviews using a questionnaire, and the obtained data were subjected to statistical analysis. Results: The study revealed 1.3% of participants positive for HBsAg, 0.6% tested positive for HBV, and 0.1% tested positive for HBeAg. Male participants were found to be more likely to test positive for HBsAg (odds ratio of 4.026, p=0.0074), and participants aged 30 years and above exhibited a higher prevalence (p<0.0001) for hepatitis B. The average ALT level in the HBsAg positive participants was significantly higher (p<0.0001). A significant association between HBsAg positivity and various factors including married status (p=0.0005), doing jobs (p=0.0004), getting cuts at hair salons or parlours (p<0.0001), hospitalization history (p<0.0001), blood transfusion (p<0.0001), and residence in hostels (p=0.0015) was observed. Only 0.4% participants were vaccinated against hepatitis B virus. Conclusions: Our study revealed a significant prevalence of hepatitis B among postgraduate colleges in Muzaffarabad city, emphasizing the need for targeted awareness and prevention efforts. Identifying key risk factors such as blood transfusion, hospitalization, and residence in hostels underscores the importance of tailored initiatives. Considering the low vaccination rate, comprehensive actions, including routine screening, prioritized vaccination campaigns, and the implementation of multi-marker-based testing, are essential to mitigate the impact of hepatitis B.

Background: This longitudinal study was conducted during August to December 2011 in District Faisalabad to analyzeepidemiological pattern of dengue outbreak in the district. Weekly trends of all cases (893) reported through Disease Surveillance Systemfrom week No.33 to 54 were monitored. On the basis of this continuous flow of information, different ongoing vector control measureswere adopted simultaneously in different areas of the district and larval indices were calculated. Methods: The Surveillance data was usedto monitor the trends of the outbreak in terms of time, person and place. Teams of 3102 trained workers were formed to conduct varioussurveillance activities like vector surveillance, fogging, larviciding, and indoor residual sprays. During indoor and outdoor vectorsurveillance, teams also calculated the larval indices for vector control. Results: The rural to urban ratio of cases was 1:3. Maximumcases (215) were reported from Jinnah Town in urban area and (102) cases were reported from Tehsil Sadar among the rural areas. Mostcases of dengue fever were observed during the 40-45 weeks of the year 2011. Mean age was 29±14.7 years for rural and 35±16.5years for urban. Male to Female ratio was 1.2:1 in urban and 1.8:1 in rural areas. Majority of the cases belonged to the age group 21-30.The case fatality rate was 6/1000 cases. The house lndex was 1.03%, the indoor container index was 0.26% and the breateu index wasfound 1.21%. Conclusions: Maximum cases occurred during 44th and 45th weeks. Male were affected more as compare to females.Jinnah Town in urban areas and Tehsil Sadar among the rural areas reported maximum number of cases. The different calculated larvalindices like house index, indoor/outdoor container index and breateu index showed moderate larval growth and hence, the outbreak waswithin control.

An increased prevalence of diagnostically untypable HCV isolates has been reported for the past few years in Pakistan and the efficacy of DAA-based treatment regimens can be significantly affected by HCV genotypes and subtypes. The Current study aimed to evaluate the drug response of diagnostically untypable isolates to existing DAA based treatment regimens in Pakistan. Drug response was evaluated by an observational study including 192 patients infected with an untypable genotype with 101 patients receiving Sofosbuvir-Daclatasvir (SOF-DCV) and 91 receiving Sofosbuvir-Ribavirin (SOF-RBV) for 12 weeks and by monitoring Rapid virologic response (RVR) at 4 weeks of initiating therapy, end of treatment (EOT) response at 12 weeks and sustained virologic response at 12 weeks (SVR12) after EOT. Overall, SVR12 of untypable genotypes against the current treatment regimen was 83.3% (160/192). The untypable genotype responded significantly well to SOF-DCV as compared to SOF-RBV with an SVR12 rate of 91.0% and 74.7% respectively. The proportion of non-responders to SOF-DCV (6.9%) was significantly less as compared to non-responders to SOF-RBV (19.7%). Also, relapse rates were significantly high in the group treated with SOF-RBV (5.4%) as compared to SOF-DCV (1.9%) (p0.05) but did not vary with gender. A Pangenotypic SOF-DCV treatment regimen is found as an effective regimen for these circulating untypable genotypes.