Open Access Public Health and Health Administration Review

Pakistan’s Combating Wild Poliovirus (WPV): Efforts and Lessons Learned

Dr. Bahadar Shah — 2025-06-30

Pakistan stands at a critical juncture in the history of public health. As one of only two remaining countries endemic for wild poliovirus (WPV), alongside Afghanistan, the nation carries a significant burden—and an even greater responsibility—in the global quest for eradication. The fight against polio in Pakistan is a complex tapestry woven with threads of remarkable resilience, innovative strategies, hard-won successes, and persistent, daunting challenges. From a public health perspective, understanding this landscape is paramount, not just for Pakistan but for the health security of the world. Despite decades of effort, WPV transmission stubbornly lingers, primarily in specific high-risk zones of Khyber Pakhtunkhwa (KP) and parts of Balochistan and Sindh. The year 2023 saw only 6 reported WPV1 cases – a significant reduction from peaks exceeding 300 annually, demonstrating progress. However, the continued detection of the virus in environmental samples from major cities like Karachi, Peshawar, Quetta, and Bannu underscores the silent circulation and the ever-present risk of resurgence. Key reservoirs remain in areas characterized by insecurity, population mobility, low routine immunization coverage, and persistent community refusals. Pakistan has come too far and invested too much to falter now. The recent low case numbers are encouraging but fragile. The virus exploits any gap with ruthless efficiency. The strategies are proven; the successes demonstrate what is possible. The end of polio in Pakistan is within sight. Achieving it will be one of public health's greatest triumphs, a testament to human perseverance and collaboration. It is not just an option; it is an ethical and practical imperative for the health of Pakistan's children and the world. The time for the final, decisive push is now.

An Empirical Study of the Prevalence of Free-living Protozoans from the River Indus, Sindh, Pakistan

Dr. Asma Kanwal — 2025-06-30

Protozoa are unicellular eukaryotic organisms that exist in biomes, both land and water. Out of about 200,000 currently known species of protists, over 199,000 (or about 99 %) are autotrophs or heterotrophs that occupy free-living niches, while the rest, only 1%, are obligate symbionts that live inside or on a definite host organism. The research aimed to conduct an empirical study of the prevalence of free-living protozoans from the River Indus, Sindh, Pakistan. In the case of a research study on the water quality of rivers in Hyderabad, Sindh, Pakistan, the polypropylene water bottles and plastic zip-lock bags were used to fill the samples of river water in the River Indus. To ensure the understanding of measurements of dissolved oxygen, free CO₂, phosphate, nitrate, and biological oxygen demand, water samples were put through several standard analytical processes. Results indicate that Amoeba proteus exists at high levels in every season, particularly in winter and summer. The Paramecium was most abundant during the summer. In contrast, the number of Tintinnopsis became moderate all year, but they increased a bit during the monsoon. The winter and summer months saw the lowest numbers for Oxytricha, possibly because it isn’t as adaptable to its surroundings. This virus remains stable most of the year, except for a small increase in the summer. These results highlight the usefulness of protozoan surveillance as a bioindicator in measuring the level of water quality, as well as give credence to the notion that there should always be periodic surveillance and analysis in determining policies guiding the preservation efforts.

Using AI to Integrate Multiple Omics to Predict the Mechanisms of Rare Diseases

Mukarram Sharif — 2025-07-09

Rare diseases, which affect less than 1 in 2,000 people, are difficult to diagnose and treat due to their complex pathophysiology and genetic variation. Recent advances in artificial intelligence (AI) and multi-omics technologies, including proteomics, metabolomics, and genomics, may help us better understand the molecular mechanisms underlying these diseases. This study was aimed to explore how AI integrates multi-omics data to identify biomarkers, forecast treatment targets for rare diseases, and uncover disease-causing pathways. It highlights how AI may help with data complexity, enable personalized care, and enhance predictive modeling. Despite progress, problems like consistency, model interpretability, and data scarcity persist. By integrating recent research, this paper proposes future directions to accelerate clinical translation and highlights AI-driven multi-omics as a groundbreaking approach to understanding the mechanisms underlying uncommon diseases.

Ecological and Morphological Studies of Indian Peafowl (Pavo Cristatus) of Khar Centre, Khar Division at Khirthar National Park, Sindh, Pakistan

Mohsin Ali Brohi — 2025-07-10

In Pakistan, the blue peafowl is found in Narowal and Tharparkar, and is breeding in the natural habitat of Khar Centre, Kirthar National Park, which is the only national park in Sindh. The present research on Ecological and Morphological study is carried out in an 8 km radius of Khar Centre, Kirthar National Park, from July 2021 to June 2022. The estimated population of Indian peafowls was recorded as 250. Among them, about 30%. subadult 36% and 34% peachicks, male, female ratio is 34% to 66%. Thirty specimens of Indian peafowls were collected to measure their body parameters. Average body length from beak to cloaca was measured as 64cm and 52.8cm for adult males and females, respectively. While for sub-adults, males and females, it was 49.2cm and 44cm, respectively. While for peachicks, it was 38.4 cm and 29.6 cm, respectively. Average beak length was measured as 2.96 cm to 1.5 cm in adult, subadult, and peahen. Tail length varied from 146.8 cm to 29.2 cm in different categories. Wingspan length varied from 156 cm to 54 cm, while crest length varied from 8.2 cm to 4 cm in adults and in peahens, respectively. The temperature varies from 10°C to 45°C in the area. The water used by the Indian peafowl (Pavo cristatus) has a pH. Salinity, conductivity, and TDS are (pH: 8.60±0.59), (salinity: 60±0.28 ppt), (conductivity: 1609.33±300.57 μs/cm), and (TDS: 790.67±147.64 mg/l). In this study, the estimated population of Indian peafowl (Pavo cristatus) was observed as 31 individuals/km. The results indicate that the Khar Centre in Kirthar National Park is a suitable place for the breeding and conservation of Indian peafowl. This study is the first of its kind in Khar Centre, Kirthar National Park, Sindh.

Evaluation of Response Variation of Some Species of Mosquitoes to Various Plant Extracts

Sobia Rani — 2025-07-17

This study aimed to discover the cheapest and non-toxic method to reduce the mosquito population at the larval stage. Several plant extracts were reported as biologically active against insects and pests. For a Larvicidal activity of some plant extracts, leaves of Eucalyptus Lanceolatus, Olea Ferruginea, Melia Azedarach, & Pinus Roxburghii were evaluated against the third and fourth instar larvae of Culex quinquefasciatus and Aedes aegypti by preparing various concentrations of aqueous extract of leaves from selected plants. The concentration of these plants had an ethanolic extraction on Culex quinquefasciatus and Aedes aegypti was 500ppm, 1000ppm, 2000ppm, 3000ppm, 4000ppm, and 5000ppm concentration extract, after 24 hours, ten larvae (III and IV instar stage) were placed in each polyethylene plastic container with test solutions (100ml) at a room temperature of 25 to 30 °C. It has been observed that after 24 hours the percentage of mortality rate against 5000ppm, 4000ppm, 3000ppm, 2000ppm 1000ppm and 500ppm ethanolic extract concentration were recorded for Pinus Roxburghii extract against Culex quinquefasciatus were found the best, it was observed for Larvicidal activity after 24 hours for 5000ppm is 100%, and for 4000ppm the Larvicidal activity were also noted as 100%, Among all the tested plant extracts, the Pinus Roxburghii extract against Culex quinquefasciatus for 5000ppm and 4000ppm were also found the best as the mortality rate is 100% as well as the Eucalyptus Lanceolatus extract against Aedes aegypti were also found the best as the Larvicidal activity has been observed after 24 hours for 5000ppm is 100%, and for 4000ppm, the Larvicidal activity were also recorded as 100%, The mortality depends on time of exposure, plant species and chemical composition.

Epidemiological Analysis of Theileriosis in Goats and Its Effect on Hematological Parameters in Southern Districts of Khyber Pakhtunkhwa, Pakistan

Asjad Umair Shah — 2025-07-19

Theileriosis is among the emerging issues of the wild ungulates, especially in the tropical and sub-tropical parts of the globe. The study carried out was aimed at looking into the goats having the presence of Theleria infection by identifying the presence of the infection with the use of the microscope and to see the disease impact on the hematological points. 300 blood samples from asymptomatic goats were to be taken using a convenient sampling technique at random. The simple microscopic examination was done in the Clinical Medicine and Parasitology laboratory on all the blood samples. This has seen the percentage of positive outcomes being found 34 % in the three hundred total samples. The highest prevalence was recorded in female goats (55.88%) than male (44.1%) and statistically significant (p<.04) / non-significant (P< .002) difference was observed Area wise study was also observed where the highest prevalence was recorded in the District of Karak (25.49%), followed by Bannu (20.58%), Lakki Marwat (16.66%), DIKhan (13.72%), while the lowest prevalence was recorded in the District of Tank (11.76%). Statistically, a significant (p<.04) / (P< .002) non-significant difference was observed, where the p value (p<.0000). The alterations in hematological parameters were also observed, where the highest increase was observed in the District Karak (KC) 26/103×100. while the number of DIKhan (DIK) 11/103×100 was seriously decreased.

Global Strategies for Combating Antimicrobial Resistance through the One Health Approach: A Mini Review

Haleema Sadia — 2025-07-27

The introduction of antibiotics revolutionized medicine by significantly reducing the burden of bacterial infections. However, antimicrobial resistance (AMR) has emerged as a major global health and economic challenge. AMR arises primarily from the misuse and overuse of antimicrobials in human health, agriculture, and animal husbandry. It leads to treatment failures, prolonged illnesses, and increased mortality. The One Health approach, which integrates human, animal, and environmental health, provides a comprehensive framework for addressing AMR. The extensive use of critically important antimicrobials such as fluoroquinolones, cephalosporins, colistin, tetracyclines, and macrolides in food-producing animals is a key driver of resistance. Prudent antimicrobial use, infection prevention, and enhanced hygiene are vital in human healthcare. In animal agriculture, reducing prophylactic and growth-promoting antimicrobial use is essential. Surveillance systems help track resistance trends across sectors. Internationally, the WHO-led Global Action Plan (GAP), supported by the FAO and WOAH, emphasizes antimicrobial stewardship, resistance surveillance, and policy harmonization. At the national level, countries implement National Action Plans (NAPs) that promote public awareness, antimicrobial regulation, and research into alternatives. Tackling AMR requires a coordinated multisectoral response. The One Health approach embedded in both national and global strategies is crucial for preserving the efficacy of antimicrobials and safeguarding health across species and environments.

Genomic Analysis of Cephalosporin Resistance in Salmonella: A One Health Perspective on the Transmission of Resistance Genes between Animals, Humans, and the Environment in Punjab, Pakistan

Mahnoor — 2025-07-27

Antimicrobial resistance (AMR) in Salmonella, particularly to third-generation cephalosporins, is a rising public health threat, especially in developing regions with dense human-animal-environment interactions. This study evaluates cephalosporin resistance in Salmonella through a One Health lens in Punjab, Pakistan, using whole-genome sequencing (WGS) to uncover resistance mechanisms and transmission dynamics. Phenotypic resistance was determined through antimicrobial susceptibility testing, while genotypic resistance was characterized using WGS. Phylogenetic analysis and multilocus sequence typing (MLST) were used to map potential transmission routes. Salmonella was isolated from 33.4% of samples, with the highest prevalence in poultry (42%). Cephalosporin resistance was phenotypically observed in 52.7% of isolates, with 72.7% being ESBL-producers. WGS revealed the presence of CTX-M-15 (58%), TEM-1 (29.5%), and CMY-2 (20.5%) among resistant strains. Significant SNP-based phylogenetic relatedness was observed between human, animal, and environmental isolates, indicating active cross-sector transmission. Notably, poultry and wastewater sources were major transmission hubs. This study presents robust genomic evidence that cephalosporin-resistant Salmonella is circulating across animal, human, and environmental sectors in Punjab, Pakistan, with poultry acting as a key reservoir. The detection of widespread resistance genes such as CTX-M-15, TEM-1, and CMY-2, along with evidence of mobile genetic elements (e.g., IncFII, IncI2 plasmids), underscores the critical role of horizontal gene transfer in resistance propagation. The strong genetic relatedness between isolates from live bird markets, hospitals, and wastewater suggests ongoing transmission across the One Health spectrum.