Evaluation of oral health among people with multimorbidity in the marginalized population of Karachi, Pakistan: A multicenter cross-sectional study.

Background: Oral health is linked to physical and mental well-being. Oral disease is common among poor and socioeconomically disadvantaged people in developing and industrialized countries. Objectives: This study assessed the oral health disease burden among people with multimorbidity in marginalized populations. Methods: This cross-sectional study was conducted across 16 locations in the slums of Karachi, Pakistan, to assess oral health disease problems among adults aged 18 to 70 with comorbidity or multimorbidity. The questionnaire covered the socioethnic, demographic, and disease status of people with oral health status. Data analyses were performed using SAS version 9.4. Results: Of the 16 designated slum locations, 870 individuals were considered for oral health screening. Gingivitis was highly prevalent, 29% among slum dwellers with multimorbidity of diabetes, hepatitis, and hypertension. Dandasa was widely used as a tooth-cleansing agent in 35% of the study population. By contrast, 45.4% of people showed unsatisfactory oral hygiene conditions. Pathan ethnicity showed the highest prevalence (i.e., 29.8% of dental problems with disease multimorbidity in 26.8% of Baldia Town residents of Karachi). Of the 870 individuals, the highest frequency of dental problems was found in the age group of 18-38 years (28-42.9%) and among female participants (53.8%). Conclusion: There is an urgent need for the global enhancement of public health programs, specifically focusing on implementing effective strategies to prevent oral illnesses, promote oral health, and address other chronic diseases in basic healthcare settings. Enhancing oral health poses significant difficulties, especially in less developed nations.

Unveiling Barriers to the Modern Contraceptive Uptake in the Urban Slums of Karachi: Perceptions, Attitude, and Accessibility.

Background Modern contraception plays a vital role in family planning and preventing unintended pregnancies. However, its uptake remains limited in many developing countries, including Pakistan. This study aimed to evaluate the barriers to modern contraception and identify strategies to enhance its adoption in the urban slums of Karachi. Methods A multi-site, cross-sectional study was conducted in 38 slum areas of Karachi, Pakistan. Women aged 15-49 years were interviewed using a comprehensive questionnaire. The questionnaire covered socio-ethnic and economic demographics, knowledge and perceptions of modern contraception, accessibility, affordability, attitudes, and usage. Data analysis was performed using the Statistical Package for Social Sciences (SPSS) version 24 (IBM SPSS Statistics, Armonk, NY). Results The majority of the respondents identified as Pathan ethnicity (49%), and the age range was predominantly from 23 to 34 years (45.5%). A high proportion of participants demonstrated satisfactory knowledge of contraceptives (87.6%). However, a significant portion perceived contraception or family planning to be in conflict with religious beliefs (84%). Many women expressed a desire for more children (56%) and had concerns about contraceptive side effects (78%). A notable proportion of women reported that their spouses forbade the use of contraceptives (12%). Among the surveyed population, the most widely used contraceptives were injections among women (15.5%) and condoms among their male partners (12%). Conclusion Despite sufficient knowledge and accessibility, considerable barriers exist in the uptake of modern contraception in the urban slums of Karachi, Pakistan. These barriers include religious conflicts, cultural norms, concerns about side effects, spousal disapproval, and desires for larger families.

Metabolic syndrome and obesity among marginalised school-going adolescents in Karachi, Pakistan: a cross-sectional study.

Background: Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors which increase the likelihood of developing type 2 diabetes and cardiovascular disease. This study aimed to determine the prevalence of MetS among adolescents living in slums aged 11-18 years in Karachi, Pakistan. Methods: Data were collected from 689 adolescents attending five schools in two slum areas of Karachi, Korangi and Baldia, from February 2023 to March 2023. Measurements of weight, height, waist circumference, and blood pressure were obtained from the study participants. Blood samples were collected to assess fasting plasma glucose, High density lipoprotein HDL-cholesterol, and triglyceride levels as per National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). The prevalence of MetS was estimated using five diagnostic criteria, i.e., International Diabetes Federation (IDF-2007), World Health Organization, NCEP-ATP III, de Ferranti et al., and Cruz and Goran. Findings: The study revealed an overall prevalence of MetS among the adolescents in the two slum areas as 16.7%. A higher prevalence of MetS was observed among females (9.1%) and those with lower body mass index BMI (13.6%). The diagnostic criteria proposed by Cruz and Goran were found to be the most sensitive, with a MetS diagnosis rate of 22.93%. The study also identified several significant risk factors associated with MetS, including sedentary lifestyle (7.7%), lack of physical activity (7.5%), increased screen time (1.5%), lower fruit consumption (6.1%), and underweight (7.7%). Among slum-dwelling adolescents, low levels of HDL-cholesterol (33.96 ± 5.21), high triglyceride levels (161.45 ± 63.09), and elevated fasting plasma glucose levels (112.59 ± 28.92) were prevalent components of MetS. Interpretation: This study provides compelling evidence of a high prevalence of MetS among marginalised school-going adolescents in Karachi, Pakistan. The findings underscore the importance of early identification of adolescents at risk of developing MetS (especially those living in slum areas) and the implementation of effective preventive strategies to mitigate the risk of type 2 diabetes and cardiovascular disease in later life. Funding: None.

Anxiety levels among school-going adolescents in peri-urban areas of Karachi, Pakistan.

INTRODUCTION: Mental health problems are pervasive nowadays. Adolescents are often expected to balance academic performance with familial obligations and work to support the family financially if they belong to low-socio-economic areas. These pressures can lead to Anxiety, stress, and even depression. OBJECTIVE: The study's main objective is to assess the association of gender, parenting style, eating habit, and screen timing with the level of Anxiety among school-going adolescents in three peri-urban areas of Karachi, Pakistan. METHODOLOGY: A school-based cross-sectional study was conducted among adolescents of age group 10-19 years using the Generalized Anxiety Disorder-7 (GAD-7) scale in two months in, three populated peri-urban areas of Karachi, Pakistan. Collected Data was analyzed by statistical software SPSS version with 80% response rate. FINDING: In our collected data, 544 students participated; 313 (57%) were female, and 231(42%) were male. Among them 173(33%) participants showed moderate to severe level of anxiety out of which 140(26%) were female and 33(7%) were male. As per our study, strict Parenting style plays a significant role in developing moderate to severe 108(20%) levels of Anxiety, shown among adolescents in the studied population. In addition to this, those who do not take tuition 115 (21%), do not use transport to school 91(16%), spend significant time in games on mobile and computer 101 (18%), and have no involvement in physical activities 172 (31%) show more moderate to severe level anxiety than others factors. A significant multivariate association between level of anxiety with gender, school commute, type of lunch Intake, smoker family member at home, physical activity, video game, tuition and strict parent. CONCLUSION: This study concluded that there are various factors which have great association with anxiety and can affect adolescents' mental health badly. The factors were parental strictness, video game playing, a sedentary lifestyle, and the smoking habits of family members. Children and adolescents must be evaluated as soon as possible while they are still young to prevent mental health issues.

Depression and suicidal ideation among individuals with type-2 diabetes mellitus, a cross-sectional study from an urban slum area of Karachi, Pakistan.

Background: Suicidal thoughts and depression are associated with patients with diabetes, especially patients with low socioeconomic backgrounds and prolonged illness. Objective: We aimed to estimate suicidal thoughts and depression among patients with type 2 diabetes (T2D) in the slums of Karachi. Methods: This cross-sectional study was conducted across 38 locations in the slums of Karachi to understand depression, suicidal thoughts, and other supporting factors of depression associated with T2D. The three-item Oslo Social Support Scale, the Patient Health Questionnaire-9 (PHQ-9) scale, and the Ask Suicide Screening Questions were used to screen the patients. Results: A total of 504 study participants were interviewed, with a response rate of 98%. The prevalence of depression among patients with diabetes was 30.83%, and suicidal ideation was 20.39%. In the final multivariate analysis, being socioeconomically poor, physically disabled, and having poor social support were independent predictors of depression. Conclusion: Diabetes, low socioeconomic level, a lack of social support, and physical disability were all linked to depression. Therefore, trained health providers should conduct an early depression-focused routine screening for patients with diabetes.

Respiratory Diseases' Burden in children and adolescents of marginalized population: A retrospective study in slum area of Karachi, Pakistan.

Background: Worldwide, the burden of respiratory disease has dramatically increased, endangering public health. To our knowledge, there have been no reported cases of respiratory illness among children and adolescents living in the slums of Karachi, Pakistan. This study aimed to assess the burden of respiratory disease in marginalized slum populations and the factors causing such an increase in disease burden. Methods: This study was conducted in 35 slums of Karachi, Pakistan, to determine the prevalence of respiratory disease in children and adolescents. Data on pneumonia, bronchitis, bronchiolitis, tuberculosis, and asthma from August 2019 to July 2022 were analyzed and inferences were drawn. Results: Among the studied diseases, pneumonia was more prevalent among females (39,864, 44.9%), followed by males (19,006, 21.4%). Most of the children (59,988, 67.6%) were aged 1-5 years. In addition, of those diagnosed with pneumonia, 50,348 (56.8%) were from the same age group. Furthermore, bronchiolitis was found among 10,830 (12.2%) children aged 5-9 years. The majority (46,906, 52.9%) of the studied population belonged to the Pathan ethnicity, followed by Sindhi (21,522, 24.2%), and most of them (84,330, 95.1%) were of a lower socioeconomic status. Conclusions: This study found that pneumonia is the most common respiratory disease followed by bronchiolitis in children and adolescents in a marginalized slum population of Karachi, Pakistan. Both pneumonia and bronchiolitis have seasonal variations in their occurrence.