Provinces Of Afghanistan Research Articles

Status of insecticide resistance in high-risk malaria provinces in Afghanistan.

BackgroundInsecticide resistance seriously threatens the efficacy of vector control interventions in malaria endemic countries. In Afghanistan, the status of insecticide resistance is largely unknown while distribution of long-lasting insecticidal nets has intensified in recent years. The main objective of this study was thus to measure the level of resistance to four classes of insecticides in provinces with medium to high risk of malaria transmission.MethodsAdult female mosquitoes were reared from larvae successively collected in the provinces of Nangarhar, Kunar, Badakhshan, Ghazni and Laghman from August to October 2014. WHO insecticide susceptibility tests were performed with DDT (4 %), malathion (5 %), bendiocarb (0.1 %), permethrin (0.75 %) and deltamethrin (0.05 %). In addition, the presence of kdr mutations was investigated in deltamethrin resistant and susceptible Anopheles stephensi mosquitoes collected in the eastern provinces of Nangarhar and Kunar.ResultsAnalyses of mortality rates revealed emerging resistance against all four classes of insecticides in the provinces located east and south of the Hindu Kush mountain range. Resistance is observed in both An. stephensi and Anopheles culicifacies, the two dominant malaria vectors in these provinces. Anopheles superpictus in the northern province of Badakhshan shows a different pattern of susceptibility with suspected resistance observed only for deltamethrin and bendiocarb. Genotype analysis of knock down resistance (kdr) mutations at the voltage-gated channel gene from An. stephensi mosquitoes shows the presence of the known resistant alleles L1014S and L1014F. However, a significant fraction of deltamethrin-resistant mosquitoes were homozygous for the 1014L wild type allele indicating that other mechanisms must be considered to account for the observed pyrethroid resistance.ConclusionsThis study confirms the importance of monitoring insecticide resistance for the development of an integrated vector management in Afghanistan. The validation of the kdr genotyping PCR assay applied to An. stephensi collected in Afghanistan paves the way for further studies into the mechanisms of insecticide resistance of malaria vectors in this region.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1149-1) contains supplementary material, which is available to authorized users.

Phylogenetic structure of Leishmania tropica in the new endemic focus Birjand in East Iran in comparison to other Iranian endemic regions

Iran has been identified being among the countries with the highest number of cutaneous leishmaniasis (CL) cases. South Khorasan province in East Iran is an emerging focus of CL. Species identification of sixty clinical samples by ITS1 PCR-RFLP presented evidence for the dominance of Leishmania tropica (90%) in this region. Analysis of the ITS1 sequence of 19 L. tropica isolates revealed seven closely related sequence types. In addition, ITS1 sequences available in GenBank from other Iranian regions were compiled for comparison with the studied isolates. Iranian L. tropica was distributed in two main clusters. All East Iranian sequence types were grouped with strains from foci from Southeast and Central regions in cluster A, showing highly similar sequences. The highest similarity was observed between most L. tropica from East and all isolates from Southeast regions and from Savojbolagh county in Central Iran. Southwest L. tropica was shown to be paraphyletic as the isolates were distributed in both clusters A and B. All Northeastern L. tropica were part of cluster B, however they showed significant heterogeneity and were distributed in different subclusters. Distribution of L. tropica populations was to some extent congruent with genetic lineages of Phlebotomus sergenti in Iran and may be an evidence for parasite-vector co-evolution. Southeast-East L. tropica was also similar to strains from Herat province in Afghanistan at the East border of Iran. This is the first comprehensive study on population structure of L. tropica in Iran that provides a guideline for appropriate sampling for further molecular based epidemiological studies.

Bypassing Primary Care Facilities for Childbirth: Findings from a Multilevel Analysis of Skilled Birth Attendance Determinants in Afghanistan.

The objective of this study was to assess the association between health facility characteristics and other individual/household factors with a woman's likelihood of skilled birth attendance in north-central Afghanistan. Data from a 2010 household survey of 6879 households in 9 provinces of Afghanistan were linked to routine facility data. Hierarchical logistic regression models were used to assess determinants of skilled birth attendance. Women who reported having at least one antenatal visit with a skilled provider were 5.6 times more likely to give birth with a skilled attendant than those who did not. The odds of skilled birth attendance were 84% higher for literate women than those without literacy skills and 79% higher among women in the upper 2 wealth quintiles than women in the poorest quintile. This study did not show any direct linkages between facility characteristics and skilled birth attendance but provided insights into why studies assuming that women seek care at the nearest primary care facility may lead to misinterpretation of care-seeking patterns. Findings reveal a 36 percentage point gap between women who receive skilled antenatal care and those who received skilled birth care. Nearly 60% of women with a skilled attendant at their most recent birth bypassed the nearest primary care facility to give birth at a more distant primary care facility, hospital, or private clinic. Distance and transport barriers were reported as the most common reasons for home birth. Assumptions that women who give birth with a skilled attendant do so at the closest health facility may mask the importance of supply-side determinants of skilled birth attendance. More research based on actual utilization patterns, not assumed catchment areas, is needed to truly understand the factors influencing care-seeking decisions in both emergency and nonemergency situations and to adapt strategies to reduce preventable mortality and morbidity in Afghanistan.

Current Agricultural Conditions and Constraints in Paktya Province of Afghanistan

Current Agricultural Conditions and Constraints in Paktya Province of Afghanistan

Development of a land suitability model for saffron (Crocus sativus L.) cultivation in Khost Province of Afghanistan using GIS and AHP techniques

ABSTRACTIn this study, we have attempted to develop a land suitability model for saffron, an agronomic crop, which is economically viable, environmentally bearable and socially equitable at Khost Province of Afghanistan. The objective was to determine different land suitability classes for saffron cultivation using Analytical Hierarchy Process (AHP) and Geographic Information System (GIS). A decision tree was developed encompassing the physical, economic and social criteria. We used the secondary data (meteorological, remote sensing) from available sources and also substantial primary data generated from soil survey, interviews and experts’ opinion. A total of 30 physical and socio-economic factors were included in the analysis. The final land suitability result showed that out of the total land area of Khost Province, 1.5, 4.5, 8.6 and 85.4% areas were highly suitable, moderately suitable, marginally suitable and not suitable, respectively. This modelling approach can be applied to determine the suitability of land for other crops covering a wider geographical region of Afghanistan.

Neither security nor development? Czech and Hungarian identities and interests in the provincial reconstruction teams in Afghanistan

This article builds on the securitisation and post-development literature and it scrutinises the Czech and Hungarian legitimising discourses of the two countries’ respective Provincial Reconstruction Teams (PRTs) in the Logar and Baghlan provinces of Afghanistan from 2007 to 2013. In spite of the hybrid civil–military character of the PRTs, their security–development nexus was absent and they were respectively securitised and “developmentalised” only indirectly and to a varying extent. The PRTs were mostly justified by the Czech Republic's NATO membership as an identity issue and they were justified as a Hungarian national interest and as both an obligation and an opportunity. Rather than merely importing NATO's arguments as suggested by the previous literature, the depoliticisation and positive connotation of the intervention in Afghanistan was constructed by the domestic NATO-related identities and interests in the Czech Republic and Hungary.

Dental caries, fluorosis, and oral health behavior of children from Herat, Afghanistan.

Decades of conflict, poverty, and dysfunctional public services have affected people's health in Afghanistan. To estimate treatment needs and guide health initiatives, epidemiologic data are required. Such data are currently unavailable for dental health. The present study assessed caries experience, fluorosis, and oral health behavior in children from Afghanistan. We performed a two-stage, school-based cross-sectional study in Herat province in Afghanistan. A total of 1059 children, 369 children aged 6-7, 300 aged 12, and 390 aged 15years, were sampled. Caries was assessed according to ICDAS, and oral hygiene, dietary habits, and parental economic and educational status evaluated. Prevalence of fluorosis was assessed, and fluoride concentrations in drinking water and in used toothpastes were measured. Mean (SD) number of decayed, missing, or filled teeth was dmft=4.88 (3.11), DMFT=2.57 (2.16), and DMFT=4.04 (3.03) in 6-/7-, 12-, and 15-year-olds, respectively. The majority of lesions in 6-year-olds were cavitated, while 12- and 15-year-olds showed more non- or microcavitated lesions. Most lesions, especially in young children, were untreated. Mean (range) water fluoride concentration was 0.37 (0.19-0.67)ppm. Fluoride concentrations in evaluated toothpastes did not meet internationally recommended levels. The majority of children showed no or minimal fluorosis. Having fluorosis, infrequently consuming sweets, or having a father with high education was associated with low caries experience (dmfs/DMFS<10), with OR (95% CI) being 0.64 (0.47/0.90), 0.65 (0.44-0.95), and 0.64 (0.47/0.90), respectively. Examined Afghan children had high unmet dental treatment needs and caries experience. Sufficient access to restorative treatment and prevention measures is urgently required.

Afghanistan after NATO Withdrawal

Abstract The conclusion of a conflict, called by some American analysts as “America’s Longest War”, after the withdrawal of the majority of NATO military forces, requires a careful analysis of the conditions and security environment that ISAF mission, International Security Afghan Forces, leaves as legacy to the Afghan military forces. The transfer of authority towards a strong government, recognized by most Afghan provinces, and benefiting from the support of national military forces able to cope with terrorist and insurgent threats on its own, are the minimum and necessary conditions leading the country towards a stable and secure environment and towards a sustainable development. Given these realities, any approach on the consequences of the transition towards self-sustainable governance becomes interesting and timely for any military political study. These are the prospects that we propose in our paper.

Blurred Lines? Provincial Reconstruction Teams and NGO Insecurity in Afghanistan, 2010–2011

Members of nongovernmental organizations (NGOs) have been critical of the Provincial Reconstruction Team (PRT) initiative in Afghanistan since its inception, claiming that the mixture of military and humanitarian operations has resulted in ‘blurred lines’ that inhibit insurgents from identifying who is and is not a combatant. Certain organizations have hypothesized that aid workers are more likely to come under attack as a result of this mixture. Although this claim has surfaced in multiple outlets over the years, there was a lack of empirical evidence to support it. This study tests this hypothesis using a panel-corrected standard error regression model of all 34 Afghan provinces in 2010 and 2011. Preliminary results show that NGOs were likely to encounter a greater number of security incidents in provinces with PRTs; however, further analysis reveals this was only the case in provinces with teams not led by the US. This calls into question the validity of a general ‘blurred lines’ explanation for decreased aid worker security.

Book Reviews

Nejat Anbarci of Deakin University reviews “The Economics of Conflict: Theory and Empirical Evidence”, by Karl Wärneryd. The Econlit abstract of this book begins: “Nine papers, originally presented at a CESifo Summer Institute workshop in San Servolo in July 2011, present a rational-choice perspective on conflict using methodological approaches that range from the game theoretic to the experimental. Papers discuss the strategic aspects of fighting in alliances; fiscal equalization and political conflict; natural resources, social conflict, and the poverty trap; power structure and the stability of regimes; the probability of military rule in Africa, 1970 to 2007; sociopolitical conflict and economic performance in Bolivia; occupational choices and insurgency in Afghanistan's provinces; social unrest in the wake of IMF structural adjustment programs; and social preferences of excombatants—survey and experimental evidence from postwar Tajikistan. Wärneryd is Associate Professor of Economics at the Stockholm School of Economics.”

Pollution Problem in River Kabul: Accumulation Estimates of Heavy Metals in Native Fish Species.

The contamination of aquatic systems with heavy metals is affecting the fish population and hence results in a decline of productivity rate. River Kabul is a transcountry river originating at Paghman province in Afghanistan and inters in Khyber Pakhtunkhwa province of Pakistan and it is the major source of irrigation and more than 54 fish species have been reported in the river. Present study aimed at the estimation of heavy metals load in the fish living in River Kabul. Heavy metals including chromium, nickel, copper, zinc, cadmium, and lead were determined through atomic absorption spectrophotometer after tissue digestion by adopting standard procedures. Concentrations of these metals were recorded in muscles and liver of five native fish species, namely, Wallago attu, Aorichthys seenghala, Cyprinus carpio, Labeo dyocheilus, and Ompok bimaculatus. The concentrations of chromium, nickel, copper, zinc, and lead were higher in both of the tissues, whereas the concentration of cadmium was comparatively low. However, the concentration of metals was exceeding the RDA (Recommended Dietary Allowance of USA) limits. Hence, continuous fish consumption may create health problems for the consumers. The results of the present study are alarming and suggest implementing environmental laws and initiation of a biomonitoring program of the river.

Factors affecting the goat producers choice of market place and marketing efficiency in Afghanistan

This paper aims to assess the efficiency in marketing goats and to identify the factors influencing the choice of market location for goat producers’ in Baghlan and Nangarhar provinces of Afghanistan. Goat producers (280) were randomly selected in equal proportions for rainfed and irrigated systems from 28 villages in 4 districts in Baghlan and Nangarhar provinces. Shepherd index of marketing efficiency and binary logit model were used to assess the marketing efficiency and to analyze the goat producers’ choice of market respectively. The study indicated that market efficiency was higher in Nangarhar than in Baghlan markets due to lower marketing margins. There is considerable potential for improving the marketing efficiency through capacity building of goat producers in production as well as marketing. Anticipated price per kg live weight of goat, breed, week day, age of goats and production system are influencing goat producers’ choice of market location. The study enables the goat producers to plan their goat sales in district markets to fetch high revenue.

Corruption and clientelism in the lower levels of the Afghan police

Some scholars argue that the Afghan police are regularly engaged in bribery and drug-related corruption. Prevalent corruption in the Afghan police has demonstrably resulted in greater support for the Taliban which is a threat to security. This suggests that a robust anti-corruption strategy is needed to restore legitimacy in the Afghan state and police and to counter the insurgency. This article initially provides a discussion of police corruption in Afghanistan that reveals four interrelated explanations: (1) structural causes of corruption, patronage and nepotism, (2) low pay, (3) state capture, and (4) ethnic favouritism. The research methodology included 70 semi-structured interviews with elites conducted by the author in Kabul during May–June 2010 and 100 surveys conducted with patrolmen and lieutenants in various Afghan provinces during January–March 2012. The article finds that it can prove counterproductive to post poorly paid policemen in distant provinces in order to challenge patronage relations as it tends to exacerbate survival-based corruption. Moreover, improved pay reform could help reduce survival-based corruption in the Afghan police but systemic corruption, clientelism and state capture will remain if it is not implemented alongside other wider structural initiatives.

Prevalence of drug and alcohol use in urban Afghanistan: epidemiological data from the Afghanistan National Urban Drug Use Study (ANUDUS).

Previous attempts to assess the prevalence of drug use in Afghanistan have focused on subgroups that are not generalisable. In the Afghanistan National Urban Drug Use Study, we assessed risk factors and drug use in Afghanistan through self-report questionnaires that we validated with laboratory test confirmation using analysis of hair, urine, and saliva. The study took place between July 13, 2010, to April 25, 2012, in 11 Afghan provinces. 2187 randomly selected households completed a survey, representing 19 025 household members. We completed surveys with the female head of the household about past and current drug use among members of their household. We also obtained hair, urine, and saliva samples from 5236 people in these households and tested them for metabolites of 13 drugs. Of 2170 households with biological samples tested, 247 (11·4%) tested positive for any drug. Overall, opioids were the most prevalent drug in the biological samples (5·6%), although prescription drugs (prescription pain pills, sedatives, and tranquilliser) were the most commonly reported in the past 30 days in the questionnaires (7·6%). Of individuals testing positive for at least one substance, opioids accounted for more than 50% of substance use in women and children, but only a third of substances in men, who predominantly tested positive for cannabinoids. After controlling for age with direct standardisation, individual prevalence of substance use (from laboratory tests) was 7·2% (95% CI 6·1-8·3) in men and 3·1% (2·5-3·7) in women-with a national prevalence of 5·1% (4·4-5·8) and a prevalence of 5·0% (4·1-5·8) in Kabul. Concordance between laboratory test results and self-reports was high. These data suggest the female head of household to be a knowledgeable informant for household substance use. They also might provide insight into new avenues for targeted behavioural interventions and prevention messages.

English

This study was conducted to reveal the perceptions of history, geography and social studies teachers giving the social studies lesson at primary schools in Turkey and Afghanistan towards the social studies lesson. The working group of the study involves history, geography and social studies teachers rendering service in Tokat and Kayseri provinces of Turkey and Cevizcan and Sar-ı Pul provinces of Afghanistan in the school year of 2012 to 2013. In the study conducted &nbsp;using the qualitative research methodology, purposeful sampling selection was used in determining the participants, semi-structured interview form in collecting the data and descriptive analysis method in analyzing the acquired data. It could be asserted that social studies teachers that graduated from the departments of history and geography and are teaching social studies in our country still adopt the single-discipline approach and keep away from the interdisciplinary approach, which is the nature of social studies. It is concluded that social studies teachers rendering service in Afghanistan are unable to adopt the nature of social studies due to the fact that the units in books are prepared as single-discipline. Key words: Social studies, teacher, geography teacher, social studies teacher, Turkey, Afghanistan.

Numerous, Capable, and Well-Funded Rebels: Insurgent Military Effectiveness and Deadly Attacks in Afghanistan

Why do some of Afghanistan's provinces experience more deadly attacks on counterinsurgents than others? We argue that provinces with more militarily effective insurgents will be deadlier for the forces of the counterinsurgency. We posit that insurgent military effectiveness is an interactive function of the rebel group's size, the quality of its recruits, and the group's operational budget. More militarily effective insurgents should, in turn, produce more deadly violence against Coalition forces. We model this relationship at the provincial level in Afghanistan using negative binomial regressions. Ultimately, we find that in provinces where the insurgency is more militarily effective, deadly attacks against counterinsurgent forces occur more often. Based on this finding, we conclude with directions for future research and policy recommendations for both the current operations in Afghanistan and for future counterinsurgency campaigns.

Does task shifting in tuberculosis microscopy services to non-certified technicians in Afghanistan affect quality?

Tuberculosis microscopy centres in 30 provinces in Afghanistan. To compare the quality of sputum smear examinations in microscopy centres with microscopists who are fully certified as laboratory technicians with those performed in centres with technicians who do not have such certification (high school graduates). Cross-sectional record review of sputum smear microscopy slides examined by technicians and cross-checked by trained assessors as part of routine external quality assurance between July and September 2009. Of 129 non-certified technicians, 118 (91%) were stationed in rural health centres compared with 217/257 (84%) certified technicians. From 386 microscopy centres, 7313 slides were cross-checked. Of 257 microscopy centres with certified technicians, 42 (16%) had at least one slide with a major error compared to 23 (18%) of 129 microscopy centres staffed with non-certified technicians. The difference was not statistically significant (OR 1.11, 95%CI 0.64-1.94). The number of slides showing major errors was also similar between the centres with both certified and non-certified technicians. This study confirms the deployment of non-certified microscopy technicians to peripheral health centres throughout the country and that their performance with sputum smear microscopy is similar to that of certified technicians with 3 years of training.

A population survey of the glucose-6-phosphate dehydrogenase (G6PD) 563C>T (Mediterranean) mutation in Afghanistan.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common inherited enzyme defect and an important problem in areas with Plasmodium vivax infection because of the risk of haemolysis following administration of primaquine to treat the liver forms of the parasite. We undertook a genotypic survey of 713 male individuals across nine provinces of Afghanistan in which malaria is found, four in the north and five in the east. RFLP typing at nucleotide position 563 detected 40 individuals with the Mediterranean mutation 563C>T, an overall prevalence of 5.6%. This varied according to self-reported ethnicity, with prevalence in the Pashtun/Pashai group of 33/369 (8.9%) compared to 7/344 individuals in the rest of the population (2.0%; p<0.001, Chi-squared test). Multivariate analysis of ethnicity and geographical location indicated an adjusted odds ratio of 3.50 (95% CI 1.36–9.02) for the Pashtun/Pashai group, while location showed only a trend towards higher prevalence in eastern provinces (adjusted odds ratio = 1.73, 0.73–4.13). Testing of known polymorphic markers (1311C>T in exon 11, and C93T in intron XI) in a subset of 82 individuals wild-type at C563 revealed a mixture of 3 haplotypes in the background population and was consistent with data from the 1000 Genomes Project and published studies. By comparison individuals with G6PD deficiency showed a highly skewed haplotype distribution, with 95% showing the CT haplotype, a finding consistent with relatively recent appearance and positive selection of the Mediterranean variant in Afghanistan. Overall, the data confirm that the Mediterranean variant of G6PD is common in many ethnic groups in Afghanistan, indicating that screening for G6PD deficiency is required in all individuals before radical treatment of P. vivax with primaquine.

Evolution and circulation of type-2 vaccine-derived polioviruses in Nad Ali district of Southern Afghanistan during June 2009-February 2011.

Oral polio vaccine has been used successfully as a powerful tool to control the spread of wild polioviruses throughout the world; however, during replication in under immunized children, some vaccine viruses revert and acquire the neurovirulent phenotypic properties. In this study, we describe the evolution and circulation of Vaccine-Derived Polioviruses (VDPVs) in Helmand province of Afghanistan. We investigated 2646 AFP cases of Afghan children from June 2009–February 2011 and isolated 103 (04%) vaccine viruses, 45(1.7%) wild type polioviruses and six (0.22%) type 2 circulating vaccine-derived polioviruses (cVDPVs). These cVDPVs showed 97.7%–98.2% nucleotide and 98%–98.7% amino acid homology in VP1 region on comparison with Sabin type 2 reference strain. All these cVDPVs had two signature mutations of neurovirulent phenotypes and 12 additional mutations in P1 capsid region that might also have contributed to increase neurovirulence and replication. Phylogenetic analysis revealed that all these viruses were closely related and originated from previously reported Sabin like 2 virus from Pakistan which did not conform to the standard definition of VDPVs at that time. It was also observed that initial OPV dose was administered approximately 9 months prior to the collection of first stool specimen of index case. Our findings support that suboptimal surveillance and low routine immunization coverage have contributed to the emergence and spread of these viruses in Afghanistan. We therefore recommend high quality immunization campaigns not only in affected district Nad Ali but also in the bordering areas between Pakistan and Afghanistan to prevent the spread of cVDPVs.

The Network-Society Phenomenon in the Lithuanian-Led PRT in Afghanistan

This article analyses the implementation of NATO`s comprehensive approach in the Lithuanian-led Provincial Reconstruction Team (PRT) in the Ghor province in Afghanistan. The ambiguity of this approach – its meaning varies greatly accordingly to the specific organization or country implementing it – encourages discovery of the “Lithuanian” model of comprehensive approach. In order to achieve this goal, the network-society theory of sociologist Manuel Castells is chosen as the theoretical background of the analysis. By expanding this theory to the military domain and by conducting a quantitative, expert-interviews based analysis of the Lithuanian-led PRT, the level of “comprehensiveness” entrenched in the activities of the Lithuanian civil-military team is revealed.