Immunization crisis may develop due to economic crisis during COVID-19 pandemic

COVID-19 pandemic is a global health crisis with 61, 149,391 confirmed cases and 370,478 deaths till 29May, 2020 [1]. This pandemic has shattered many economies with an estimated loss of $5.8 trillion to $8.8 trillion globally. This economic loss can result in reduction in funds to World Health Organization. Unfortunately, United States of America (USA) has announced termination of any further funding to WHO which can lead to another global health crisis[2]. As WHO is a voluntary funding based organization its main donor are America, China, Japan, Germany and United Kingdom. Among these USA is the main donor with a contribution of $115.8million alone followed by China $57.4 million, Japan $41million, Germany $29.1 million and UK $21.9 million [3].  America’s termination of funding can put WHO and child health programs in serious crisis. Among many programs run by WHO one of the most important program is immunization of children. Immunization coverage programs  save 2-3 million livesper year causing decline in measles related deaths, eradication of polio, surveillance of rotavirus, BCG and DTaP vaccination in children[4]. It is estimated that during MillenniumDevelopment Goal (MDG) there is overall decline in child related mortalities due to malaria, measles, diarrhea, AIDS and meningitis [5]. Remarkable results are achieved with measles are diarrhea immunization programs causing a decline in death rate by 73% and 80% respectively. According to a study with current success rate diarrhea related deaths can be virtually eliminated by 2030. Another successful program is “End Polio” program which eradicated polio from world except from Pakistan and Afghanistan [4][6]. This termination of funds to WHO can waste all previous efforts in developing countries. On the other hand despite of all efforts still 19.4 million children did not received prescribed dose of vaccines. Data analysis revealed among these  60% of children belong to 10 developing countries namelyAngola, Brazil, the Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria, Pakistan, the Philippines and Viet Nam [4]. These countries mainly rely on foreign funding and Non-Government Organization (NGOs) for child health care programs.

Outcomes of Turco’S Procedure for Idiopathic Clubfoot Among Children at French Medical Institute for Mothers and Children from January 2011 to July 2016

Background: Clubfoot known as Congenital Talipes Equino Varus Deformity (CTEV) is one of the most common congenital foot deformities. Affect 1-2/1000 live births worldwide. Males are more affected with Club foot compared to female. Idiopathic clubfeet was considered 80% as isolated birth defects and 20% are syndromic or neurogenic. Objective: 1. To estimate the demographic characteristics of patients with clubfoot at FMIC, Kabul, Afghanistan from 2011 to July 2016. 2. To determine the outcomes of Turco’s Procedure for idiopathic clubfoot among children from 2011 to July 2016 at Paediatric Orthopaedic Department of FMIC, Kabul, Afghanistan.Methodology: A descriptive case series study design is used to determine the outcomes of Turco’s Procedure for idiopathic clubfoot among children at Paediatric Orthopaedic Department of French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan during January 2011 to July 2016. Records of 99 participants with 151 feet who had undergone Turco’s procedure were clinically and radiologically assessed and followed for 3 years. Self-developed structured questionnaire was used by applying consecutive sampling technique. Age range of the study participants was from nine months to five years. The descriptive analysis was done, using SPSS Version 22. Mean and standard deviation (SD) were calculated for Quantitative continuous/discrete variables. Frequency and proportions were calculated for categorical variables. T- test for two independent samples and Chi-square test also were run for few variables.Result: Out of 99 participants, 67(67.7%) males and 32(32.3%) females were affected; males were affected twice as often as girls. 52 (52.5%) participants were bilaterally, 26 (26.3%) Right side and 21 (21.2%) were Left side affected. 25 (25.3%) participants had positive family history. Hospital length of stay at hospital was 1.7 days (1 to 7 days). Participant’s feet were assessed clinically and radiologically. The results showed that Turco’s procedure in 79.8% of participants was successful and 20.2% of them had developed some kinds of complications. Family satisfaction rate was 89% found in the study. Conclusion: Clubfoot is one of the most common congenital foot deformities and patients with idiopathic clubfoot can be successfully treated in most of the cases by Turco’s procedure; Outcome of the surgery will be better if patient gets treatment at appropriate age. Overall, an 80% success rate of Turco’s procedure was found in this study