Health Protection and Research Organisation

This paper presents a semi-analytical solution for one-dimensional advection-diffusion equation coupled with a linear partial differential equation with constant coefficients. The mathematical model describes a grain-fumigant-air system during fumigation processes, where fumigant gas transports through a storage silo. The coupled system considers both diffusion and advection mechanisms with constant velocity and diffusivity parameters. The solution methodology employs the Laplace transformation technique to convert the partial differential equations into ordinary differential equations in the Laplace domain. The Stehfest numerical algorithm is subsequently applied to invert the Laplace transforms and obtain the time-domain solution. Numerical computations are performed using MATLAB software to simulate the fumigant concentration distributions. Graphical results illustrate the fumigant gas concentration in air versus vertical height within the silo for different time intervals. Additional plots demonstrate the fumigant concentration absorbed by grain particles over time. The analysis examines effects of varying initial gas concentration and flow velocity on the transport process. Results indicate that higher initial concentrations and increased velocities accelerate the fumigation process, requiring less time to fill the silo completely. The proposed solution provides a mathematical framework for optimizing fumigation parameters in agricultural storage applications.

This study aimed to investigate the prevalence and associated factors of anaemia and its association with the academic performance of schoolchildren in Kandahar, Afghanistan. This was a cross-sectional analytical study. This was a school-based study conducted among 1866 schoolchildren aged 6-14 years in Kandahar city from September to December 2023. Haemoglobin concentration was measured using a portable HemoCue Hb 301 analyser, while the WHO age-adjusted cut-off for haemoglobin was used to classify anaemia. Data were analysed by using descriptive statistics, the χ² test and multivariate logistic regression. In this study, the mean age of the children was 9.1 years, 61.1% (1138/1866) were boys, 83.6% (1560/1866) had illiterate mothers, and 81.3% (1517/1866) belonged to poor families. Prevalence of anaemia among schoolchildren was 64.1% (1196/1866), while 20.8% (388/1866), 41.7% (778/1866), and 1.6% (30/1866) were suffering from mild, moderate and severe anaemia, respectively. Main associated factors of anaemia were being male (adjusted OR (AOR) 1.4, 95% CI 1.1 to 1.7, p=0.003), unemployed father (AOR 1.5, 95% CI 1.1 to 2.2, p=0.020), poor family (AOR 2.3, 95% CI 1.8 to 2.9, p<0.001), large family (AOR 1.2, 95% CI 1.0 to 1.6, p=0.048), history of intestinal helminths (AOR 1.3, 95% CI 1.0 to 1.6, p=0.017) and decreased meat consumption (AOR 2.0, 95% CI 1.6 to 2.5, p<0.001). Children with anaemia had significantly lower academic performance. Prevalence of anaemia was very high and is a severe public health problem in schoolchildren of Kandahar. Based on the known consequences of anaemia on academic performance, the education and health authorities of Afghanistan should take serious steps to alleviate this problem. Periodic iron supplementation and deworming, as well as daily iron-rich mid-day meal programmes, should be started for both boys and girls in schools.

Background: We aimed to evaluate Health-related quality of life (HRQoL) and its major influencing factors among patients with Type 2 diabetes mellitus (T2DM). Methods: A hospital-based, cross-sectional study was undertaken in 2025 at Wazir Mohammad Akbar Khan National Hospital, Kabul. The study included 298 adults with confirmed T2DM, selected through non-probability convenience sampling. Information on sociodemographic characteristics and clinical profiles was gathered via structured interviews and medical file reviews. HRQoL was evaluated using the Short Form-36 (SF-36) questionnaire, which assesses eight health domains and provides composite physical (PCS) and mental (MCS) scores. Statistical analysis was conducted using SPSS version 20, with results summarized descriptively. Results: The study population had a mean age of 53.6 years (SD ±12.4), and just over half were male. HRQoL scores indicated substantial overall impairment, with physical health domains showing the greatest deficits. Limitations in physical roles and reduced physical functioning emerged as the most affected areas. Physical composite scores were consistently lower than mental composite scores, reflecting a heavier physical disease burden. Lower HRQoL was more common among women, older individuals, patients with a longer history of diabetes, and those reporting persistent pain or emotional difficulties. Increasing age and prolonged disease duration were associated with a gradual deterioration in quality of life. Conclusion: Adults living with T2DM in Kabul experience pronounced reductions in HRQoL, driven predominantly by physical health limitations. These findings underscore the need for integrated care approaches that prioritize functional ability, pain control, and mental health support, particularly for high-risk groups such as women, elderly patients, and individuals with long-standing diabetes.

Rotavirus vaccine clinical trials and post-licensure evaluations found malnourished children may have lower protection against rotavirus diarrhea hospitalizations than well-nourished children. On a population level, rotavirus vaccines are less protective in high child mortality settings. We analyzed rotavirus vaccine effectiveness (VE) among malnourished and well-nourished children categorized using four anthropometric malnutrition indicators, birthweight, and reported malnutrition from medium to high child mortality countries in the Multi-National Subpopulations Study to Evaluate Rotavirus Vaccines (MNSSTER-V) dataset. We calculated child-level z-scores for weight-for-age, length-for-age, weight-for-length, and mid-upper arm circumference (MUAC), and the site-level proportion implausible z-scores. Sites with published VE estimates by nutritional status or those with <3% implausible values were included in the final analysis. Z-scores <-2 were considered moderate-to-severe malnutrition and <-3 were considered severe malnutrition. We calculated complete series rotavirus VE in each malnourished and well-nourished group using an unconditional adjusted logistic regression model, where VE = (1 - odds ratio of vaccination among cases and controls) × 100, where cases and controls were children who tested rotavirus positive and negative, respectively. Complete series VE was more protective among children without stunting (normal length-for-age) (59%; 95% confidence interval [CI]: 49-67) compared to children with moderate-to-severe stunting (42%; 95% CI: 19-58) and severe stunting (31%; 95%CI: -14 to 58). Adjusted VE point estimates were similar among malnourished and well-nourished children using the other anthropometric and birthweight indicators. Our findings clearly show that chronic malnutrition negatively impacted rotavirus VE. Efforts to address and prevent malnutrition generally may further reduce the burden of rotavirus morbidity and mortality.

Speaking is the productive and critical skill of language. It is one of the big goals of college and university students to be a fluent speaker of English while after graduation 60-65 % of the learners doesn't achieve. It's also called the output of language. It is important to mention and we believe that language cannot be learned only through input. There is a vital role of output. Therefore, this paper conducted on challenges hindering English public speaking among undergraduate EFL learners at Nangarhar University. The study used quantitative research design. In addition, this study used close-end questions for collecting data. There were 50 participants of ELD students from different level freshmen, sophomore, junior, and senior classes. Finally, the participants revealed the key challenges while they speak in public such as, limited time and practice, psychological and cultural factors, linguistic influences, and social norms or in another words, the study shows that the mix of linguistic, psychological, and cultural factors affects learners public speaking performance.

IntroductionTo ensure that humanitarian action is disability-inclusive, evidence is needed to understand how different strategies to support children living with disabilities and their families can work in these settings. Evidence from other contexts suggests support groups can improve caregiver quality of life (QOL). This study reports an evaluation of the ‘Mighty Children’ programme a participatory educational support group programme for caregivers of children living with disability in Kabul province, Afghanistan.MethodsWe conducted a mixed-methods realist-informed before-and-after study to measure change in caregiver-reported QOL and explore how and for whom the programme worked, and in what contexts. Female caregivers of children with any disability were recruited through clinics in urban Kabul (n=3) and rural Paghman district (n=3). We collected quantitative data on QOL pre/post programme using the Paediatric Quality of Life Inventory Family Impact Module (PedsQL-FIM). Qualitative data were collected through facilitator and participant focus groups postprogramme.Results118 caregivers participated in two cohorts (November 2020, February 2021). Caregivers expressed a significant increase in QOL from baseline to programme completion (t(125)=−10.7, p≤0.0001). Participation in cohort 2 was associated with the greatest PedsQL-FIM change.Qualitative data revealed positive changes postprogramme in five key areas: caregiver mindset, parenting practices, disability-inclusive behaviours, psychological well-being and child functioning. These changes were seen as both outcomes and mechanisms influencing the primary outcome of QOL. Mechanisms that mediated these changes included increased knowledge of disability and the core acceptance and commitment therapy components of mindfulness and acceptance.ConclusionThe Mighty Children caregiver support programme for children living with disability in Afghanistan was associated with improved caregiver QOL. Further studies are warranted to explore pathways to scale, sustainability and potential application in other settings.

A lack of high-quality provider education hinders the delivery of standard-of-care delirium detection and prevention practices in the intensive care unit (ICU). To fill this gap, we developed and validated an e-learning ICU Delirium Playbook consisting of eight videos and a 44-question knowledge assessment quiz. Given the increasing Spanish-speaking population worldwide, we translated and cross-culturally adapted the playbook from English into Spanish. To translate and culturally adapt the ICU Delirium Playbook into Spanish, the second most common native language worldwide. The translation and cross-cultural adaptation process included double forward and back translations and harmonization by a 14-person interdisciplinary team of ICU nurses and physicians, delirium experts, methodologists, medical interpreters, and bilingual professionals representing many Spanish-speaking global regions. After a preeducation quiz, a nurse focus group completed the playbook videos and posteducation quiz, followed by a semistructured interview. The ICU Delirium Playbook: Spanish Version maintained conceptual equivalence to the English version. Focus group participants posted mean (standard deviation) pre- and post-playbook scores of 63% (10%) and 78% (12%), with a 15% (11%) pre-post improvement (P = 0.01). Participants reported improved perceived competency in performing the Confusion Assessment Method for the ICU and provided positive feedback regarding the playbook. After translation and cultural adaptation, the ICU Delirium Playbook: Spanish Version yielded significant knowledge assessment improvements and positive feedback. The Spanish playbook is now available for public dissemination.

Background: Despite millions of COVID-19 infections worldwide since the beginning of the pandemic, relatively few confirmed cases of COVID-19 reinfection have been reported. In Afghanistan, COVID-19 undetected cases are more than detected cases. This study aims to describe the burden of COVID-19 reinfection cases in Afghanistan, along with the epidemiological and demographical patterns. Methods: A descriptive study of national-wide secondary data on COVID-19 reinfection cases was carried out from January to June 2022. Data were extracted from the District Health Information Software 2 (DHIS2) and managed and analyzed using Microsoft Excel and Epi Info V.7.2.1. Results: In 2022, 79 reinfection cases of COVID-19 were reported, with males being more affected than females. The mean age of re-infected patients was 39, with most from Wardak province. Most cases occurred within six months after the primary infection. Cough was more prevalent among reinfected cases. Only 26 patients had taken two doses of the vaccine, while 44 (55.70%) had not received it. Out of all cases, 44 (55.70%) were recovered and 5 (6.85%) died. Conclusion: The COVID-19 reinfection rate is very low in Afghanistan, which was common in males since other cases might be unreported. Coughing was more common among reinfection patients. Relying on the results, vaccination and awareness-raising may play a protective role in reinfection; hence, enhancement of vaccination and taking preventive measures are recommended to prevent further reinfection.