Factors affecting quality of life in hepatitis B patients in Herat, Afghanistan: A case-control study.

Hepatitis B virus is a global health concern with a high death rate in Afghanistan. Limited data exist on the disease's impact on quality of life in low-resource settings. This case-control study aims to identify potential risk factors and assess the quality of life among hepatitis B patients in Herat, Afghanistan, with a focus on sex differences. Understanding these factors can inform prevention, care, and sex-specific interventions. A cross-sectional study conducted at Herat Regional Hospital examined hepatitis B patients above 18 years old, between October 2020 and February 2021. The control group consisted of age and sex-matched individuals without a history of hepatitis B. Data were collected through a structured questionnaire covering socio-demographic characteristics, signs and symptoms of hepatitis B, and the SF-36 questionnaire for measuring the quality of life of study participants. Statistical analysis was performed using multivariate General Linear Models, and logistic regression. We identified several potential risk factors for hepatitis B infection, including male sex, younger age groups, tobacco use, lower education levels, rural residence, family history, weak social networks, specific family structures and underlying chronic diseases (p < .05). The study found that hepatitis B cases had significantly lower mean scores across all SF-36 components, indicating an overall reduced quality of life (p < .05). These differences were more pronounced in males, although females had lower scores in most components. Role limitations due to physical and emotional health were particularly affected. These findings highlight the urgent need for targeted interventions, sex-specific strategies, improved healthcare access and comprehensive policies. These findings can inform prevention efforts to improve the overall quality of life of people with hepatitis B in Afghanistan.

Exploring Sex Differences in Risk Factors and Quality of Life Among Tuberculosis Patients in Herat, Afghanistan: A Case-Control Study.

Objectives: Tuberculosis (TB) is a significant public health concern in Afghanistan, with a high burden of disease in the western province of Herat. This study explored the risk factors of TB and TB's impact on the quality of life of patients in Herat. Methods: A total of 422 TB patients and 514 controls were recruited at Herat Regional Hospital and relevant TB laboratories between October 2020 and February 2021. Data was collected through interviews using a structured questionnaire and the SF-36 questionnaire. Descriptive statistics, chi-square tests, Multivariate General Linear Model, and logistic regression analysis were used to analyze the data. Results: The results showed that male sex (p = 0.023), chronic disease (p = 0.038), lower education levels (p < 0.001), and worse health status (p < 0.001) were significantly associated with higher odds of TB infection. The study also found that TB patients had significantly lower quality of life scores in almost all components (p < 0.05). Conclusion: This study provides important insights into the specific ways in which TB affects the wellbeing of patients in Afghanistan. The findings highlight the importance of addressing the psychological and social dimensions of TB.

Cancer prevalence, incidence, and mortality rates in Afghanistan in 2020: A review study.

BACKGROUND: Afghanistan is in an epidemiological transition, as cancer is the second leading cause of mortality due to non-communicable diseases. This study is the first to provide a comprehensive perspective on the overall cancer situation in Afghanistan by discussing the top five most common cancers, their incidence variations, risk factors, and preventive measures. The limited number of cancer studies conducted in Afghanistan highlights the importance of the present review. RECENT FINDINGS: This article provides an overview of cancer burden in Afghanistan in 2020. It utilizes IARC-generated GLOBOCAN 2020 data for one, three, and five-year prevalence rates, the estimated number of new cancer cases, and mortality rates by age group in Afghanistan. According to GLOBOCAN, the top five common cancers in both sexes in Afghanistan were breast (n = 3173, 14.3%), stomach (n = 2913, 7.8%), lung (n = 1470, 6.6%), cervix uteri (n = 1200, 5.4%), and colorectum (n = 1084, 4.9%). CONCLUSION: This study provides a brief overview of the general cancer situation in Afghanistan, and a more in-depth analysis of the five common cancers identified. Effective therapies, awareness, and prevention initiatives targeting lifestyle, immunization, early diagnosis, and environmental risk factors are essential for addressing the impact of population growth and aging on cancer incidence in Afghanistan. Further research and extensive studies are needed to better understand cancer burden in the country.

Exploring the Relationship between Drug Addiction and Quality of Life in Herat, Afghanistan: A Cross-sectional Study.

Background: Addiction is a global public health problem, with over 36 million people suffering from drug-use disorders. Afghanistan, the world's leading opium producer, has high rates of drug use owing to the easy access to drugs in this country. This study aimed to investigate drug users' quality of life in Herat, Afghanistan, and identify the factors affecting it. Methods: This cross-sectional study examined health-related quality of life at six rehabilitation camps in Herat, Afghanistan, from March to July 2019, using the short form-36 questionnaire (SF-36). Data collected through interviews were analyzed using SPSS software (version 25). Findings: A total of 240 participants from six rehabilitation camps in Herat, Afghanistan participated in this study. The majority of participants (80%) rated their overall health as "good" or "very good". Men had higher average scores for mental health and vitality than women and those aged 30-39 had the highest quality of life. Statistically significant differences were found in bodily pain (P=0.038), vitality (P=0.042), and social functioning (P=0.046) among users of different types of drugs. Opium abusers had the highest scores for the physical and mental components, followed by heroin, methamphetamine, hashish, and crack abusers. Conclusion: This study explored the relationship between drug addiction and quality of life in Herat, Afghanistan. The findings showed that young adults were more vulnerable to drug use and male addicts and opium users had the highest quality of life. This study can inform the development of effective rehabilitation programs but more research is needed for addiction treatment strategies.

Risk Factors Related to Esophageal Cancer, a Case-Control Study in Herat Province of Afghanistan.

BACKGROUND: The Herat province of Afghanistan is located on the Asian Esophageal Cancer Belt (AECB), a wide area in Central and Eastern Asia where very high rates of esophageal cancer (EC) have been observed. Several risk factors have been reported in the AECB Region by previous studies. Considering lack of information in Afghanistan on this issue, a study was conducted to determine the major risk factors related to EC in order to guide protective measures. METHODS: A population-based case-control study was performed from July 2015 to August 2016 among 657 EC patients in the Herat Province and 180 histopathological confirmed cases and 189 controls were interviewed. A structured questionnaire was used and face-to-face interviews were conducted. RESULTS: Low body mass index (BMI), low socio-economic status, family history of EC, consumption of dark tea, very hot beverage and qulurtoroosh were found to be statistically significant for EC and esophageal squamous cell carcinoma (ESCC) in univariate analyses. According to multivariate analyses, sex (OR=2.268; 95% CI=1.238-4.153), very hot beverages (OR=2.253; 95% CI=1.271- 3.996), qulurtoroosh (OR=5.679; 95% CI=1.787-18.815), dark tea (OR=2.757; 95% CI=1.531-4.967), high previous BMI (OR=0.215; 95% CI=0.117-0.431) and low socio-economic status (OR=1.783; 95% CI=1.007-3.177) were associated with ESCC. Being male was found to increase the risk of ESCC with OR=2.268 (95% CI=1.238-4.153). CONCLUSION: Consuming very hot beverages dark tea and a local food, qulurtoroosh, were found as important risk factors for EC. Our findings warrant further studies and necessitate the implementation of protective measures for EC which is one of the leading cancers in the region.

Epidemiology of Drug Use in Herat - Afghanistan.

Background: Drug addiction is one of the alarming public health and social problems in Afghanistan and around the world. Addiction denotes the habitual use or the physical or mental dependence on narcotic drugs or psychotropic substances. Methods: Drug addicts who were admitted to six public addicts' rehabilitation centers in Herat, Afghanistan between March and July 2019 were recruited for this descriptive study. A total of 299 drug addicts were included in this study. A 77-item questionnaire containing three subscales: 39 items for personal information, 32 items for drug use, and 6 items for dependence and treatment subscale were validated and used for data collection. IBM SPSS Statistics for Windows v.22.0 was used for data analyses. Findings: The median age of the participants was 30 years. Of all participants, 79.1% were male, 56.6% were illiterate, and 1.7% were university graduates. In this study, 44.8% of the participants used heroin, 20.7% used opium and 15.4% used methamphetamine. Almost half of the participants (49.5%) declared that at least one member of their families was a drug user. Of the 299 drug users included in this study, 64.9% stated that at least one person close to them (except family members) used drugs. Over two-thirds of the participants (78.4%) had easy access to drugs, 26.8% had broken laws for money/drugs at least once. Conclusion: This study revealed that male illiterate teenagers living in low-economic nuclear families were more vulnerable to drug use in Herat, Afghanistan. The most common reasons for drug use were curiosity, peer influence, and seeking pleasure.

The Short Form Health Survey (SF-36): translation and validation study in Afghanistan.

BACKGROUND: Quality of life is defined as the subjective perception of one's own well-being within a sociocultural context. SF-36 is commonly used to check the health status of the general population in many countries. AIMS: To validate the Persian (Dari) version of the Short Form Health Survey (SF-36) in Herat. METHODS: The Persian (Dari) version of SF-36 was culturally adapted. A total of 1259 healthy individuals aged ≥ 18 years participated in the study between November 2016 and April 2017. Construct validity of SF-36 was evaluated through exploratory factor analysis. The extraction was performed by principal component analysis from the polychoric correlation matrix estimated by a 2-step method with varimax rotation. Internal consistency and test-retest reliability were assessed by Cronbach's α SPSS version 23.0 and R version 3.1.3 were used in the analysis. RESULTS: The last version of SF-36 including 27 items in 8 factors explained 86.48% of the variance. The Kaiser-Meyer-Olkin value was 0.391 and Bartlett's test showed statistical significance (P < 0.001). Confirmatory factor analysis revealed that the final model demonstrated good fit statistics (P < 0.001), root mean square error of approximation=0.056, goodness-of-fit index=0.963, and adjusted goodness-of-fit index=0.953). Cronbach's α for the 8 subscales was 0.753-0.933. All subscales of SF-36 had good internal consistency reliability and good test-retest reliability. CONCLUSIONS: We showed that our Dari version of SF-36 is suitable to evaluate quality of life in adults in Herat City. This scale will be useful for health researchers in the future.

Waterpipe Smoking among Herat University Students: Prevalence, Attitudes, and Associated Factors.

BACKGROUND: Waterpipe tobacco smoking (WTS) is an ancient type of smoking that has become a global phenomenon. This study aimed to identify the prevalence of waterpipe smoking and its relation to socio-demographic characteristics in Herat University students in western Afghanistan. METHODS: In this cross-sectional study, a structured self-administered questionnaire containing 53 items in 3 subscales was distributed between July and December 2018, to examine the use of waterpipe among Herat University students. Data were evaluated in SPSS. Chi-square test was used to observe differences between categorical variables. All important variables were separately evaluated for men and women in logistic regression models. A P-value less than 0.05 was considered statistically significant. FINDINGS: The prevalence of ever waterpipe use in male and female students was 54.1% and 81.8%, respectively. Parents' higher education and family economic status were associated with higher rates of ever waterpipe use in both sexes. On the other hand, marital status and parents' employment were not associated with waterpipe use. Ever waterpipe use was associated with having smoking friends or family members in both sexes. Male and female waterpipe users believed that cigarette smoke had more nicotine than waterpipe. While more male waterpipe users believed that cigarette was more addictive than waterpipe, more female users believed otherwise. CONCLUSION: The prevalence of ever waterpipe use is higher in male students at Herat University. Having a smoking friend and family member positively influences waterpipe use among both sexes. Most users believed that waterpipe smoking was less hazardous than cigarette smoking.