Objectives:Coronavirus disease 2019(COVID-19)pandemic has been associated with a great level of psychological distresses in people around the world.This study aims to assess the prevalence of depression,anxiety and stress among COVID-19 patients and identify the associated factors,in Herat Province of Afghanistan.Methods:This cross-sectional study was conducted on 459 hospitalized patients between May and September 2021.Data was collected with a structured questionnaire on depression,anxiety and stress scale,which was the validated Dari-version.Chi-square test was adopted to analyze the associations of the prevalence of the mental disorders and the factors.Results:The mean age of participants was 38.05;51.9％(238/459)were male and 84.1％(386/459)were married.Median scores for depression,anxiety and stress were 5.0,8.0,and 10.0,respectively.Gender,general health condition,nutritional status,COVID-19 clinical manifestation and concurrent comorbidities(except diabetes and hypertension)were significantly associated with mental disorders;while association between marital status and these psychological disorders was not significant.Moreover,a significant difference was observed in the level of anxiety between healthcare workers and other respondents.Conclusion:This is the first study to report the high prevalence of depression,anxiety and stress among CO VID-19 patients in Herat,which indicates the negative effect of mental health for COVID-19 patients globally and highlights the need for urgent and appropriate interventions to improve mental health of people during the pandemic.

Background:The prevalence of pediatric mental illnesses has been increasing in recent years,with a great potential to impact on individual's functionality and adaptation in adulthood.Objective:This study aims to assess emotional and behavioral problems among schoolchildren in Herat City of Afghanistan.Methods:This cross-sectional study was conducted on schoolchildren(grade 5-10),between September and November 2021.Sociodemographic data was collected using a paper-based 14-item structured questionnaire.Data on emotional and behavioral problems was collected using the Strengths and Difficulties Questionnaire(SDQ)based on teachers'and children's report.Statistical analyses were performed in IBM SPSS Statistics(version 27).Results:A total of 418 students,including 190(45.5％)males and 228(54.5％)females with a mean age of 14.1±1.7(11-＜18)years were included in the study.The prevalence of students'self-reported total difficulties and prosocial problem were 5.7％and 1.2％,respectively.An insignificant difference was observed between mean total difficulties scores between students'self-reported and teachers'reported SDQ.Gender,grade,concern about shortage of food,and concern about losing house were significantly predicting students'self-reported total difficulties scores.Conclusion:This is the first study to report the prevalence of emotional and behavioral problems among schoolchildren in Herat City,Afghanistan.This,together with relevant global literature,highlight the need to address pediatric mental health,and provide services aimed at preventing,and treating children with these prob-lems around the world.

Objective:Afghanistan has witnessed a long-lasting 4-decade armed conflict,which together with high levels of poverty and interpersonal violence,resulted in high incidence and prevalence of mental disorders in general population,including children and adolescents.Until mid-2018,there was neither mental health care facility nor a child psychiatrist in Afghanistan.Here,we report the establishment of the first children and adolescents'mental health center(CAMHC)in Herat province of Afghanistan. Methods:In July 2018,CAMHC was initiated at Mental Health Training Center-Herat.CAMHC was initially planned by the International Assistance Mission(IAM)and Herat Public Health Directorate;and financially sup-ported by the Tearfund UK,the United Methodist Committee on Relief and Tearfund Australia.The target pop-ulation of CAMHC was children and adolescents in Herat and neighboring provinces,healthcare professionals,staff of government and non-governmental organizations,school teachers and community leaders. Results:A group of eight mental health professionals were trained and made the interdisciplinary board for di-agnosis and management of mental disorders in children and adolescents.During the initial three-year period,2 448 patients,including 1 264(51.6％)boys and 1 184(48.4％)girls,presented with mental disorders to CAMHC.Diagnosis and management of mental disorders were performed according to standard international protocols.Eighteen awareness-raising seminars were held;2 000 leaflets,10 000 posters,and 30 000 brochures were pre-pared and distributed;and two short video clips were produced and broadcast via IAM website,social media and local TV channels.A database was developed to house for project data,assessment of outcomes and reporting to stakeholders. Conclusion:Establishment of CAMHC resulted in significant achievements in diagnosis and management of men-tal disorders among children and adolescents,healthcare staff capacity building,and awareness-raising about mental disorders.Data obtained in CAMHC offers government,mental health professionals and the community the opportunity of improving mental health in the region.

Objective:Breast cancer is the most common cancer in women,causing significant mortality in the world,which contributed 11.7％ to the overall cancer-related mortality in Afghanistan.In 2018,3062 new breast cancer cases were reported accounting for 29.7％ of all cancers in women in the country.However,a comprehensive diagnostic and therapeutic system is lacking in Afghanistan.In this paper,we reported the implementation of a project aiming to establish a comprehensive breast cancer center in Herat province of Afghanistan.Methods:From July 2017,a two-year-program initiated at Kimia Hospital in Herat.This first free diagnostic and therapeutic breast cancer project planned by the Afghanistan Surgeons Society-West and the Verein für Afghanistan-F(o)rderung e.V.,as well supported by three international foundations.The target populations of this project were women presenting with breast problems at Kimia Hospital in Herat and healthcare staff involved in breast cancer diagnosis and management.Results:A group of six medical personnel chosen to represent the breast cancer core team for breast cancer diagnosis and management were trained in India.These caregivers established the breast cancer service and tumor board.During a period of 20 months,a total of 632 women with breast problems presented to Kimia Hospital of whom 44 (7.0％) were diagnosed with breast cancer.Diagnosis was established by a physical exam-ination,ultrasonography,mammography,biopsy and histopathology.Treatment included surgery,radiotherapy and chemotherapy.Twelve seminars for 512 healthcare workers,1000 brochures and a movie were prepared for awareness-raising actions.For continuation of this project,potential resource providers were identified.A database was developed to record project findings.Conclusion:Implementation of this comprehensive breast cancer project resulted in significant achievements in healthcare staff capacity building,diagnosis and management of breast cancer patients in Herat province.Data obtained in this project offer Afghan govemment,public health authorities,and the community the opportunity of improving diagnosis and treatment of breast cancer in Afghanistan.