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   2022| July-September  | Volume 66 | Issue 3  
    Online since September 22, 2022

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Psychological impact of the COVID-19 pandemic among adults in India: A longitudinal study
Manjit Sidhu, Malhi Prahbhjot, Neha Pandeya
July-September 2022, 66(3):323-326
DOI:10.4103/ijph.ijph_1034_21  PMID:36149113
A longitudinal follow-up design was used to study the psychological distress and coping among 168 individuals immediately after the national lockdown and after 6 months of the pandemic. Psychological distress was measured using the Depression, Anxiety, and Stress Scale (DASS-21). The coping strategies used were measured by the Brief-COPE, and Intolerance of Uncertainty Scale (IUS-12) was employed to measure response to uncertainty. On follow-up, the prevalence rates for severe/very severe levels of depression, anxiety, and stress had increased substantially from time 1 to time 2. The stepwise multivariate regression analyses revealed that the change in the three DASS-21 scores over time was primarily predicted by intolerance of uncertainty as measured by the IUS-12 and dysfunctional style as assessed by the coping Brief-COPE. There is a need to implement public health policies that promote psychological resilience among high-risk groups.
  4,066 194 -
Large-scale staple food fortification as a complementary strategy to address vitamin and mineral vulnerabilities in India: A critical review
Mona Duggal, B Sesikeran, N Arlappa, Sirimavo Nair, Vedeika Shekhar, Vandana Sabharwal
July-September 2022, 66(3):313-320
DOI:10.4103/ijph.ijph_708_22  PMID:36149111
The slow improvement in micronutrient malnutrition globally and in India warrants a need for scaling-up scientifically proven, cost-effective public health interventions. The present review discusses the potential of staple food fortification as a complementary strategy to tackle micronutrient deficiencies, while addressing the current concerns raised regarding its implementation. The review indicates the below par status of current strategies like dietary diversity and supplementation to address multiple micronutrients deficiencies in India and the need for complementary strategies to tackle this problem. Based on systematic reviews and meta-analysis, global and national evidence has identified staple food fortification as a proven and recognized cost-effective solution to address micronutrient deficiencies. The Government of India has shown a strong leadership to promote this proven intervention. Further, the paper addresses the concern that large-scale staple food fortification (LSFF) may lead to excessive nutrient intakes when delivered together with other interventions, e.g., supplementation, dietary diversity, among the same populations. A key message that emerges from this review is that LSFF is safe with current dietary intake and deficiencies and low coverage of other interventions. Given the current situation of food and nutrition insecurity which the COVID-19 pandemic has further exacerbated, and the critical role that nutrition plays in building immunity, it is even more important that health and nutrition of the population, especially vulnerable age groups, is not only safeguarded but also strengthened. LSFF should be implemented without any further delay to reach the most vulnerable segments of the population to reduce the dietary nutrient gap and prevent micronutrient deficiencies. Effective monitoring and regular dietary surveys will help ensure these interventions are being deployed correctly.
  2,956 264 -
Anemia control program in india needs to be more comprehensive
Priya Y Kulkarni, Jitendra S Bhawalkar, Archana A Jadhav
July-September 2022, 66(3):358-361
DOI:10.4103/ijph.ijph_1918_21  PMID:36149123
Iron-deficiency anemia has continued to remain high in India. It is possibly due to relying on only iron–folic acid (IFA) supplementation through Anemia Control Program (ACP) that is National Iron Plus Initiative (NIPI). Based on the WHO's recommendations, we studied different interventions that can help to increase the effectiveness of NIPI such as Vitamin C supplementation with IFA, low-dose iron (LDI) with intensified health education (IHE), LDI with Vitamin C, and iron-rich food items to increase hemoglobin (Hb%) among adolescent girls through public–private partnership named Rashtriya Kishor Swasthya Karyakram. Increments in Hb after 12 weeks of interventions were compared with that of control groups one with NIPI and the other without any intervention. Highest increment in Hb% was observed in IFA under NIPI plus Vitamin C group, followed by LDI plus IHE group which was comparable to Hb increment in only the NIPI group. It emphasizes the need of making existing NIPI more stringent and comprehensive by integrating effective measures based on up-to-date scientific knowledge.
  2,551 190 -
Evaluation of the rashtriya bal swasthya karyakram (RBSK): A national children healthcare program in a health district of West Bengal, India
Srikanta Chakraborty, Arup Chakraborty, Sukumar Mitra, Shibaji Gupta, Arista Lahiri, Nibedita Banerjee
July-September 2022, 66(3):307-312
DOI:10.4103/ijph.ijph_1690_21  PMID:36149110
Background: The Rashtriya Bal Swasthya Karyakram (RBSK) was launched in 2013 to screen and manage birth defects, deficiencies, diseases, and developmental delays including disabilities in Indian children, with the help of designated mobile health teams and grassroot workers across the country. Objectives: Performance of the RBSK program in three selected blocks of a health district of a large Indian state (West Bengal) was assessed. Methods: The performance assessment was based on input, process, and output performances, using checklists based on RBSK operational guidelines. Results: While some essential evaluation tools were available in required numbers at the block level, many were unavailable. There were deficiencies in the number of health staff appointed. Although most screening camps were conducted as per microplan, some were not. Anthropometric measurements were not done in some camps; Information, Education, and Communication (IEC) materials were not used adequately. Issues with fund management were also noted. The intervention rate at higher centers (District Early Intervention Centre) was low with regard to the children referred for management. Involvement of grassroot workers such as ASHA was also found to be lacking. Conclusion: Frequent orientation training of medical officers and staff is needed along with the efforts to strengthen the referral system and the patient tracking system. Sensitizing the children and their guardians regarding the importance of the relevant health issues is also needed with the help of the proper implementation of IEC services.
  2,108 316 -
Preparedness of healthcare facilities of manipur in the management of noncommunicable diseases: A cross-sectional study
Avantika Gupta, Takhellambam Gitanjali, Soubam Christina, L Janani, M K Mohammed Jamsheer, Brogen Singh Akoijam
July-September 2022, 66(3):245-250
DOI:10.4103/ijph.ijph_29_22  PMID:36149099
Background: India is experiencing a rapid health transition with a rising burden of noncommunicable diseases (NCDs), causing significant morbidity and mortality. Cost-effective interventions for comprehensive NCD management can only be designed after assessing the readiness of various health facilities. Objectives: This study aimed to assess the preparedness of healthcare facilities of Manipur in the management of NCDs and to assess the knowledge of doctors regarding NCDs. Methods: A cross-sectional study was conducted in 21 public healthcare facilities in seven districts of Manipur during October 2021. Readiness of these facilities was assessed through observation and interview of doctors and nurses using a checklist adapted from the WHO Package of Essential NCDs. Knowledge of 153 doctors was also assessed using a self-administered, structured questionnaire. Data were entered in SPSS-26 and expressed using descriptive statistics. Results: General readiness index of primary health centers (PHCs), community health centers (CHCs), district hospitals (DHs), and tertiary care centers (TCCs) was 47%, 66.3%, 73.2%, and 70%, respectively. CHCs were ready in the domains of patient care services (80%), human resources (75%), and advocacy (91.7%). DHs and TCCs were ready in terms of patient care services, human resources, record maintenance, referral system, and advocacy. PHCs were not ready in any of the nine domains. Majority of the doctors (88%) had inadequate knowledge regarding NCDs. Conclusion: PHCs and CHCs were not adequately prepared, but DHs and TCCs were ready to manage NCDs. More than four-fifth of the doctors had inadequate knowledge. Strengthening PHCs and CHCs and training of healthcare workers are needed for integrated NCD management.
  1,722 407 -
A newer mind map for public health journals in India
Pritam Roy, Rajib Dasgupta, Atul Kotwal, Sanjay Chaturvedi
July-September 2022, 66(3):237-238
DOI:10.4103/ijph.ijph_1183_22  PMID:36149097
  1,561 352 -
Burden of COVID-19: DALY and productivity loss for Karnataka, India
Shashank D Shindhe, Suhas Bhat, Surekha B Munoli
July-September 2022, 66(3):239-244
DOI:10.4103/ijph.ijph_959_21  PMID:36149098
Background: COVID-19 is a pandemic that is devastating the world right now quelling over 2.5 million people worldwide. Similarly, in India and its largest southern state Karnataka, the coronavirus is responsible for around 161,000 and 12,449 deaths, respectively. These numbers capture the havoc caused by this novel coronavirus, but fail to discern the complete picture. Objectives: Broadly, this study aimed to study the mortality, morbidity, and the economic issues inflicted by the COVID-19 in the state of Karnataka. Specifically, the study used publically available epidemiological data to study both mortality and morbidity by means of disability-adjusted life years (DALYs). Furthermore, the study aimed at estimating the permanent losses to the state gross domestic product (SGDP) due to the pandemic. Materials and Methods: Publicly available epidemiological data are used from selected sources and DALYs are computed. The permanent loss to the SGDP is estimated using the human capital approach. Results: The total DALYs for Karnataka are computed to be 22,506 of which 22,041 correspond to mortality and remaining correspond to morbidity. Financially, Karnataka lost around 208 years of productive years of lives costing around ₹590 million rupees to the SGDP. Conclusions: It is found that major burden of COVID-19 during study period is due to mortality. Morbidity accounts for around 2% of the total DALYs. Males are the most affected by the mortality and also the morbidity. With respect to loss in productivity, the losses due to premature mortality of COVID-19 amounted to ₹590 million.
  1,382 445 -
Measles surveillance in Kashmir: A mixed methods study
Khalid Bashir, Khurshid Ahmad Wani, Mariya Amin Qurieshi, S Muhammad Salim Khan, Inaamul Haq
July-September 2022, 66(3):251-256
DOI:10.4103/ijph.ijph_1482_21  PMID:36149100
Background: Measles surveillance serves as the means of monitoring program success. The quintessential purpose of measles surveillance is to identify gaps and garner effective public health responses to achieve measles elimination. Objectives: There were two key objectives: (i) to conduct an in-depth review of the existing measles surveillance system in Kashmir and highlight its strengths and weaknesses and (ii) to assess the pattern of measles-containing vaccine (MCV1) coverage and MCV2 coverage among under-5 years children and describe the health-seeking patterns of suspected cases of measles. Methods: The mixed methods study was conducted in the Kashmir valley from March 2018 to March 2019. An explorative qualitative design was followed using individual face-to-face interviews with thirty-two (n = 32) different stakeholders from the state, district, medical block, and primary health center (PHC) levels. To complement the qualitative study, a quantitative survey was done in two districts, Srinagar and Ganderbal, which consist of 5 and 4 medical blocks, respectively. Results: Among the suspected cases of measles, 52% had visited PHCs. Sixty-four suspected cases of measles (64) were immunized with two doses of MCV. None of the clinically suspected cases of measles were further investigated. In the qualitative analysis, five themes were generated viz, “measles surveillance description of Kashmir valley;” “factors affecting measles surveillance, perceptions, and experiences of stakeholders;” “barriers to measles surveillance;” “measles surveillance activities need to be intensified;” and “respondent recommendations for building an effective and sensitive measles surveillance system.” Conclusion: The current measles surveillance system in Kashmir was not effectively functioning; case-based measles surveillance is not being done as per the WHO guidelines. There is a lack of planning, advocacy, awareness, and communication of measles surveillance among the stakeholders. The visible barriers in measles surveillance included lack of training, logistics, incentives, and monitoring by internal and external agencies.
  1,505 250 -
Dengue and scrub typhus co-infection in children: Experience of a teaching hospital in an endemic area
Priya Jose, Nishanth Rajan, Peter Prasanth Kumar Kommu, Lalitha Krishnan
July-September 2022, 66(3):292-294
DOI:10.4103/ijph.ijph_2052_21  PMID:36149107
Background: Dengue fever and scrub typhus are considered an endemic disease in the Indian subcontinent. The epidemiology and clinical presentations are complex and vary each year. Objective: The objective of this study was to estimate the prevalence of coinfection with scrub typhus in children diagnosed with dengue fever. Methods: A retrospective hospital-based, cross-sectional study was done in the Department of Pediatrics of a teaching hospital in Puducherry. All children (0–14 years) who had enzyme-linked immunosorbent assay (ELISA) reported scrub typhus among those diagnosed with dengue fever (NS1Ag or immunoglobulin M ELISA positivity) during 2012–2016. Medical records with incomplete data were excluded from the study. Odds ratio was calculated to find out the association of coinfections. An independent t-test was used to find out the statistical significance. P < 0.05 was considered statistically significant. Results: Atypical features of dengue were present in 250/318 (78.6%) children. Coinfections were seen in 62/318 (19.4%) children. Scrub typhus was the most common (n = 51/62, 82.2%). The chance of scrub typhus in a dengue serology-positive child is significant when the symptoms are atypical or protracted (OR– 2.6, P = 0.033). Conclusion: High index of suspicion should be present in endemic dengue and scrub typhus coinfection.
  1,524 152 -
Is the rule of halves in hypertension valid uniformly across India? A cross-sectional analysis of national family health survey-4 data
Mohd Maroof, Nafis Faizi, Pruthu Thekkur, Sonika Raj, Sonu Goel
July-September 2022, 66(3):269-275
DOI:10.4103/ijph.ijph_2143_21  PMID:36149103
Background: Hypertension is widely prevalent across India. The rule of halves is commonly used to describe the attrition and gaps in the care cascade of hypertension management across detection, availing treatment, and having controlled blood pressure (BP) on treatment. Objectives: Using nationally representative data, we aimed to assess the rule of halves in hypertension management in different states of India and across sociodemographic, health system, and personal factors. Methods: A descriptive analysis of secondary data from the National Family Health Survey-4 was conducted. We included 770,662 individuals (112,122 men and 658,540 nonpregnant women) of 15–49 years of age. The proportion of individuals not aware of hypertension status among those with high BP, known hypertensives not availing of treatment, and uncontrolled BP among those on treatment were expressed as percentage with a 95% confidence interval (CI). Results: Of those with high BP, 48.5% (95% CI: 47.8%–49.3%) were not aware of their hypertensive status. Among known hypertensives, 72% (95% CI: 71.2%–72.8%) had not availed treatment for hypertension. Among those on treatment, 39.8% (95% CI: 38.7%–40.9%) had uncontrolled hypertension. Conclusion: The rule of halves of India shows that the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke has made relatively good progress with the detection of hypertension and achieving BP control among those on treatment. However, with three-fourth of known hypertensives not availing treatment, more dividends from the detection of hypertension efforts could be realized. The program needs to especially focus on ensuring the treatment for those detected with hypertension.
  1,462 206 -
Effect of integrated people-centred eye care (IPEC) model on eye care seeking behaviour of community
Pallavi Shukla, Praveen Vashist, S Senjam Suraj, Vivek Gupta, Noopur Gupta, Amit Bharadwaj
July-September 2022, 66(3):282-286
DOI:10.4103/ijph.ijph_1391_21  PMID:36149105
Background: World report on vision makes integrated people-centered eye care as care model of choice. Integrating eye care with the existing public health system makes services available, accessible, affordable, and sustainable. Being from the community, Accredited Social Health Activists (ASHAs) are better suited to improve people's eye health-seeking behavior. Objectives: This study aims to assess the eye care-seeking behavior of community and to understand their response toward the approach of integrated vision centers (VC) with ASHA involvement. Methods: A cross-sectional descriptive study was conducted in South Delhi district where integrated VC were functional for more than a year. These centers were supervised by medical officer in-charge, under whom ophthalmic assistants, ASHAs, auxiliary nurse midwives, and pharmacist work. ASHAs were trained in community-based primary eye care. The community survey was conducted on eye health-seeking behavior and utilization of VC services. Descriptive statistics were used for data analysis. Results: Out of 1571 study participants, 998 reported any ophthalmic illness in family in the past 6 months as against 1302 who reported nonophthalmic illness in family. The majority (1461, 90%) were aware about integrated VC and half of them (748, 51.2%) visited it. Of them, 64.2% were motivated through ASHAs. ASHAs spread awareness about eye diseases, eye treatment facility, and referred patients from the community. The majority (93%) were happy with the integrated VC and 87.8% were happy with ASHAs. Conclusion: Integrated VC with ASHA engagement could pave the way for universal eye health. Understanding people's needs and engaging community would increase the demand for eye care.
  1,274 144 -
Intrinsic capacity of rural elderly in thar desert using world health organization integrated care for older persons screening tool: A pilot study
Arvind Mathur, Pankaj Bhardwaj, Nitin Kumar Joshi, Yogesh Kumar Jain, Kuldeep Singh
July-September 2022, 66(3):337-340
DOI:10.4103/ijph.ijph_731_22  PMID:36149117
Integrated Care for Older Persons (ICOPE) screening tool helps to address declines in physical and mental capacities in older people. In India, majority of the older population resides in rural areas and there is a paucity of studies that demonstrates the utility of the ICOPE screening tool in India. Thus, a cross-sectional study was conducted to demonstrate the feasibility of using the World Health Organization ICOPE screening tool in a rural population. Comprehensive geriatric assessment of intrinsic capacity revealed cognitive decline in 31.5% (n = 142) participants, diminished mobility 52.1% (n = 235) participants, eye problems in 49.4% (n = 223) participants, and hearing loss in 68.3% (n = 308) participants. Gender difference was statistically significant with mobility limitation (P = 0.005; χ2 = 7.95) and feeling of pain (P = 0.001; χ2 = 15.64), being more in females than males. This tool seems suitable in identifying the intrinsic capacity of the rural elderly.
  1,278 139 -
Prevalence of anemia and its associated factors among children under 5 years of age attending a comprehensive healthcare facility in Kandahar City, Afghanistan
Muhammad Haroon Stanikzai, Sibghatullah Zakir, Niamatullah Ishaq, Bilal Ahmad Rahimi
July-September 2022, 66(3):378-379
DOI:10.4103/ijph.ijph_2202_21  PMID:36149128
  1,279 136 -
Factors Affecting Stunting in Children under 5 Years of Age in Indonesia using Spatial Model
Zurnila Marli Kesuma, Latifah Rahayu Siregar, Edy Fradinata, Aliya Fathinah
July-September 2022, 66(3):264-268
DOI:10.4103/ijph.ijph_1989_21  PMID:36149102
Background: Stunting in children under 5 years of age is a condition where they have a length or height that is less than −2 standard deviations of the growth standard of Indonesian children. Stunting is caused by chronic malnutrition in the first 1000 days of life. The spatial panel data method was developed to solve problems related to spatial objects that are measured periodically by involving elements of area and time. Objectives: The purpose of this study was to determine the best model and factors that influence stunting in children under 5 years of age in Indonesia using spatial panel data. Methods: The data used were from the website of the Central Statistics Agency and the publications of the Ministry of Health of the Republic of Indonesia in 2015–2019. Determination of the selected model is done by comparing the random effect spatial autoregressive model and spatial error model (SEM) random effect based on the value and Akaike information criterion (AIC). SEM random effect produces the largest value and the smallest AIC. Results: The selected spatial panel data model in determining the factors that influence stunting in children under 5 years of age in Indonesia is the SEM random effect based on the largest and AIC compared to other models. Conclusion: Based on the selected model, children under five with malnutrition and poor nutrition, receiving Vitamin A, and the average monthly per capita expenditure on food have a significant effect on the percentage of stunting in children under five in Indonesia.
  1,156 229 -
An observational study on maternal mortality and maternal near miss in a selected facility of West Bengal
Sima Maity, Snehamay Chaudhuri
July-September 2022, 66(3):371-374
DOI:10.4103/ijph.ijph_211_22  PMID:36149126
An observational study was performed at Purba Medinipur District Hospital, West Bengal, from April 1, 2018, to December 31, 2020, with an aim to find out the magnitude of maternal mortality and near miss cases and to assess the utilization of available maternal health care services by the deceased women and near miss cases. Result showed 4.5% women developed potentially life-threatening condition (PLTC) of which 21% women developed LTC. Maternal Near Miss (MNM) ratio was 9.46/1000 live birth and the MNM-to-Maternal Mortality ratio was 8.3:1 and the leading causes of MNM and maternal death were hemorrhage, pregnancy induced hypertension/eclampsia. The utilization of maternal health-care services revealed that there is a scope to increase the service delivery. Study finding indicates that health-care programs need to enhance the existing efforts to improve timely health seeking behavior of women.
  1,140 142 -
Access–Watch ratio based on access, watch, and reserve classification of antibiotics in public health facilities of Tamil Nadu
Isha Sinha, Krishna Kanth, Yuvaraj Krishnamoorthy, Vijayaprasad Gopichandran
July-September 2022, 66(3):352-354
DOI:10.4103/ijph.ijph_274_22  PMID:36149121
The rise in cases of antibiotic resistance can be mainly attributed to the overuse and misuse of antibiotics. To address this issue, the WHO launched Access, Watch, and Reserve (AWaRe) classification of antibiotics in 2017 as a surveillance tool. Many countries have adopted it to monitor and optimize their antibiotic usage. However, implementation of it is yet not seen at a very appreciable level. Through this survey, we tried to explore the prescribing pattern of antibiotics based on the WHO AWaRe classification in selected secondary and tertiary care health facilities of Tamil Nadu. In-patient case sheets were audited in selected departments across 18 health facilities in six districts. Proportionately higher use of the watch group of antibiotics was found in all the districts. A lower access–watch ratio suggests the need for judicious implementation of such tools to safeguard this life-saving good and ensuring its sustainability.
  1,115 113 -
Knowledge and practice pattern of integrated child development services scheme supervisors (AWS) following capacity building and remote supportive supervision
Baidurjya Mahanta, Tulika Goswami Mahanta, Manjit Boruah
July-September 2022, 66(3):300-306
DOI:10.4103/ijph.ijph_725_22  PMID:36149109
Background: Nutritional status of under-5 children in India is not promising and lags far behind the WHO Global Nutrition Targets. Although the Integrated Child Development Services has been continuously delivered through Anganwadi centers since 1975, the burden of malnutrition still persists. Objectives: This study was conducted to estimate the knowledge and practice pattern of Anganwadi supervisors and the effect of capacity building through remote supportive supervision during the COVID-19 pandemic in Assam, India. Methods: A cross-sectional before-after study using a mixed methods approach was used to evaluate the knowledge pattern and service delivery of supervisors from each district of Assam. For qualitative assessment, telephone depth interviews were conducted. Results: Knowledge of supervisors in the beginning was 83.43% which improved by 7.97% at the end of the study. The highest burden of SAM children was in Tinsukia and Barpeta districts. On mapping, most districts with lower burden of SAM had supervisors with higher knowledge levels on Infant and Young Child Feeding practices. Qualitative assessment revealed house-to-house visit for ensuring service delivery and use of online platforms and phone calls for counseling. However, community resistance and lack of transport stood as a main challenge. Conclusion: Supportive supervision done remotely during the pandemic to enhance the performance of health workforce was found effective.
  1,078 145 -
Risk factors predicting early in-hospital mortality among underfive children and need for decentralization of pediatric emergency care services
Aditya Soni, Sumaira Khalil, RM Pandey, Harish Chellani
July-September 2022, 66(3):257-263
DOI:10.4103/ijph.ijph_487_22  PMID:36149101
Background: Lack of pediatric triage and emergency care system in peripheral healthcare centers leads to unnecessary referral of low- and medium-risk patients. This study was conducted to study the risk factors predicting mortality within 48 h of admission in neonates and under-five children referred to the pediatric emergency of a tertiary care hospital in India. Methods: This prospective study was conducted on children (0–5 years) referred to the pediatric emergency who were enrolled and followed up. The outcome was defined as “survival” or “death” at 48 hours. Logistic regression analysis was conducted to assess the predictors of early in-hospital mortality. Results: A total of 246 consecutive pediatric (62 neonates, 52 young infants, and 132 children aged 1–5 years) referral cases were enrolled; mortality within 48 hours was 20%. Lack of pediatric intensive care (odds ratio [OR] 4.07, 95% confidence interval [CI] 2.0, 8.32, P = 0.02), lack of neonatal intensive care (OR 2.10, 95% CI 1.01,4.28, P ≤ 0.001), distance from referral center >20 km (OR 4.61, 95% CI 2.01, 10.58, P = 0.0003), >1 h taken during transport (OR 7.75, 95% CI 2.93, 20.46, P < 0.001), lack of ambulance facility (OR 0.04, 95% CI 0.009, 0.143, P < 0.0001), very sick condition on arrival (OR 210.1, 95% CI 12.1, 3643.41, P = 0.0002), and unstable temperature-oxygenation-perfusion-sugar on arrival were the independent risk factors predicting in early in-hospital mortality. Conclusion: Developing a pediatric triage and monitoring system, tele-pediatric intensive care unit, regionalizing referral-back-referral services with robust interhospital communication, and strengthening pediatric emergency services are the need of the hour to reduce early in-hospital mortality.
  1,050 158 -
Implementation research: The need of the hour
Arun Kumar Sharma, Poonam Singh
July-September 2022, 66(3):321-322
DOI:10.4103/ijph.ijph_1169_22  PMID:36149112
Formative research creates evidence. Evidence-based interventions are implemented in community settings. In the past, evidence-based interventions have failed to get desired outcomes. The tuberculosis control program despite being evidence based did not succeed at the beginning. Similarly, evidence-based treatment of hypertension and diabetes has not yet controlled these diseases. This is where the role of implementation research (IR) starts. IR either as part of evidence-based research or independently should be a part of health programs so that the program shall be able to ensure feasibility, fidelity, penetration, acceptability, sustainability, efficiency, effectiveness, and equity.
  860 162 -
The pressing need for integrated nephrology services in Northeastern India
Arpita Panchal, Shobhana Nayak Rao
July-September 2022, 66(3):375-377
DOI:10.4103/ijph.ijph_246_22  PMID:36149127
Chronic kidney disease (CKD) is a major public health problem with an estimated prevalence ranging from 5% to 13% over South Asian region. CKD care and the need for provision of care for the management of end-stage renal disease are an increasingly growing need in India with rising rates of CKD, especially those attributable to uncertain etiologies in certain regions of India. There is a wide disparity between nephrology care services and availability between geographical regions of the kidney with the representation of nephrologists and nephrology care centers more in the Southern and Western regions than in the rest of the country. The Northeastern region of the country is poorly presented in terms of both availability as well as the accessibility of nephrology care services. Better integration and provision of care are the sole need of the hour.
  934 85 -
Does the mode of delivery affect the health-related quality of life? A comparative analysis
Pallika Singh, SK Rasania
July-September 2022, 66(3):295-299
DOI:10.4103/ijph.ijph_2149_21  PMID:36149108
Background: Health-related quality of life (HRQoL) of postpartum mothers is a multidimensional concept and is relatively neglected in both researches and in practice as most postpartum researches have focused on the physical complications. In line with the global trends, India has witnessed a sharp rise in cesarean section (CS) deliveries and has become a global concern for the health of the mother as well as her quality of life. Objectives: This study was conducted to analyze and compare the HRQoL after normal vaginal delivery and CS in the postpartum women. Methods: It was a community-based cross-sectional study and a predesigned, pretested interview schedule was used in the form of a questionnaire including the Medical Outcomes Study Short Form 36 Health Survey for HRQoL. The study was conducted in a resettlement colony, Kalyanpuri located in Delhi, India with a total population of 25,754 with 4596 eligible couples in 4302 households from November 2018 to March 2020. The study participants comprised of a sample size of 330 post-partum women and the data were collected in the 6th week of post-partum period. Results: In our study, there were statistically significant (P < 0.05) differences with mode of delivery as one of the predictors of HRQoL of postpartum mothers. The study subjects with vaginal delivery had higher mean HRQoL score under all the domains. Conclusion: In CS, reduced physical activity, body pain not only affected the mental health domain score but also significantly impacted the emotional domain. Promoting the use of family planning services is also significant in improving maternal health and should be made a provision of quality of care and strengthening of quality improvement and sustainable quality assurance mechanisms are major problem-solving steps in improving access to healthcare.
  883 130 -
Monkeypox virus - Immune imprinting
Sathish Sankar
July-September 2022, 66(3):384-385
DOI:10.4103/ijph.ijph_848_22  PMID:36149132
  894 116 -
A comparative study on the efficiency of commercial reverse transcriptase–Polymerase chain reaction kits for the detection of severe acute respiratory syndrome coronavirus 2 infections
Gopinath Ramalingam, A Dhanasezhian, Amudhan Murugesan, Gowsalya Saminathan, Lallitha Sivathanu
July-September 2022, 66(3):276-281
DOI:10.4103/ijph.ijph_2042_21  PMID:36149104
Background: Real-time reverse transcriptase–polymerase chain reaction (RT-PCR) kits have been reliably employed for the diagnosis of coronavirus disease 2019 (COVID-19) by the detection of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA since the beginning of the disease outbreak. In consideration of reliable diagnosis, apart from RT-PCR, the isothermal nucleic acid amplification-based point-of-care automated kits have also been tagged as a simpler and rapid alternative to the conventional techniques. Currently, the availability of a better diagnostic method for COVID-19 when compared to RT-PCR is nil. The most important step in the detection of SARS-CoV-2 in a RT-PCR diagnostic laboratory is to identify and employ RT-PCR kits with higher sensitivity as well as specificity. Objectives: This study aimed to study commercially available RT-PCR kits for the detection of SARS-CoV-2 infections. Methods: The performance of seven different RT-PCR kits from different manufacturers used for diagnosis of COVID-19 in Govt Theni Medical College and Hospital, Theni, Tamil Nadu were analysed. Nasopharyngeal and oropharyngeal swabs were collected from patients and subjected to RT-PCR using these kits. Results and Conclusion: The sensitivities and batch effects of the assessed kits were slightly different for different targets, for SARS-CoV-2 detection in nasopharyngeal swab specimens. Examination of COVID-19 kits should be done using currently employed kits in routine diagnosis for better efficiency.
  886 123 -
Factors influencing life satisfaction and discrimination among the elderly in India
Roopani Roopani, Neha Dumka, Atul Kotwal
July-September 2022, 66(3):362-366
DOI:10.4103/ijph.ijph_2152_21  PMID:36149124
India is moving toward a demographic transition which leads to more elderly population than younger. Maximum life satisfaction (LS) and minimum discrimination are necessary to have healthy aging. The secondary data analysis was conducted to assess the perceived LS and discrimination among the elderly based on Longitudinal Aging Study in India (LASI). Data from the LASI-Wave I were used to analyzing to assess the LS and discrimination and factors associated with them. This study reported that the majority of the elderly were satisfied with their life and does not face any kind of discrimination; however, various factors affect them. LS was positively associated with the level of Monthly per capita consumption expenditure quintile, and education, self-rated good health. Furthermore, refraining from alcohol and tobacco positively influence the LS among the elderly. The factors responsible for more LS among the elderly were education, money, social support, and a healthy lifestyle.
  879 126 -
Excess Screen Time and its Associated Factors among Young Men in a Rural Community of North India
Sumit Malhotra, Shashi Kant, Ramashankar Rath, Farhad Ahamed, Ramadass Sathiyamoorthy, Sanjeev Kumar Gupta
July-September 2022, 66(3):327-330
DOI:10.4103/ijph.ijph_2027_21  PMID:36149114
Screen-based media usage among young people is blooming rapidly due to technological and digital revolution. We conducted community-based cross-sectional study to determine the prevalence of excess screen time and its association with sociodemographic and behavioral patterns in a rural block of Haryana, India. A semi-structured interview schedule was administered by trained physicians to ascertain screen time in a typical day and various socioeconomic and behavioral factors among a random sample of 860 young men aged 18–24 years. The prevalence of excess screen time was 61.8% (95% confidence interval [CI] 58.4–65.1). It was significantly associated with education (adjusted odds ratio [AOR] 1.7, 95% CI 1.1–2.6) and occupation (AOR 2.2, 95% CI 1.2–3.9) of the father and their sleep duration of ≤8 h (AOR 1.6, 95% CI 1.2–2.3). Limiting the screen time as per international standards and behavioral interventions are needed for this young population.
  854 124 -
Media reporting of suicide in the bengaluru E-edition of three major indian dailies: An archival study
Sharmitha Krishnamurthy, Kolar S Meena, Santosh K Chaturvedi, Aruna Rose Mary Kapanee, Latha Krishnamurthy, Anish Cherian
July-September 2022, 66(3):348-351
DOI:10.4103/ijph.ijph_372_22  PMID:36149120
India has the world's largest newspaper market, with over 100 million copies sold daily. The media scapegoat, simplify, speculate, and sensationalize suicide-related news instead of signposting people to seek help. Suicide affects individuals, families, and communities and is worthy of responsible reporting. This study examined the quality of newspaper coverage of suicides from January to December 2017 in three popular English dailies in Bengaluru, South India. Three hundred and ninety-five online suicide reports were evaluated for compliance with the 2017 WHO recommendations for responsible suicide reporting by media professionals. The secondary data were obtained from digital newspaper archives and analyzed. A handful of the sampled articles met key recommendations. While reporting on suicide in the Indian media, three critical areas that require the most attention are reducing sensationalism, providing help-seeking information, and educating the public on suicide prevention without perpetuating myths.
  896 81 -
Nurse-led cardiovascular diseases risk assessment and communication using WHO/ISH risk prediction chart in a tertiary care hospital of North India
Ankita Ankita, Kavita Kavita, JS Thakur, Vikas Suri, Pankaj Arora
July-September 2022, 66(3):367-370
DOI:10.4103/ijph.ijph_1539_21  PMID:36149125
Cardiovascular diseases (CVDs) contribute to most of the potentially preventable burden through early risk assessment. Nurse-led CVD risk assessment is an effective strategy to address the human resource crisis for CVD prevention. An interventional study was conducted in medicine wards of a tertiary care hospital in North India to train nurses in CVD risk assessment and its communication. All bedside nurses (n = 30) of selected wards were enrolled and trained in CVD risk assessment and communication using WHO/ISH risk prediction charts. Once fully trained, each nurse enrolled patients (>40 years of age) from their respective wards to assess and communicate CVD risk. To calculate the reliability of risk assessment, investigator simultaneously assessed CVD risk with nurses. The mean age of nurses was 32.07 ± 6.31 years. The results revealed that training significantly increased the knowledge of nursing personnel (P < 0.001). There was perfect inter-rater reliability agreement (Cohen's k = 0.929) between nurses and investigators while assessing CVD risk. Nurses demonstrated good communication skills. The study concluded that nurses can be trained successfully in CVD risk assessment and communication. The study recommends the task shifting of CVD risk assessment to nurses after providing proper training.
  880 95 -
Does health financial resource correlate with physical health infrastructure?
Motika Sinha Rymbai, Darishisha W Thangkhiew
July-September 2022, 66(3):287-291
DOI:10.4103/ijph.ijph_535_22  PMID:36149106
Background: Is building physical health infrastructure (PHI) a priority for state governments within the northeastern states (NES) of India? The decentralization mechanism initiated by the government of India to synergize health care across states seems highly unequal. Certain Indian states such as Kerala, Uttarakhand, and Himachal Pradesh have achieved phenomenal progress in the health-care system through a decentralized mechanism. Objectives: The study attempts to examine the PHI of NES and public health resources. Methods: The study has employed the Euclidian Distant Method (EDM) which fulfills various compulsive and instinctive properties; specifically, normalization, symmetry, monotonicity, proximity, uniformity, and signaling inclusively. This method ranks the states in terms of infrastructure availability and public health resources. Second, the correlation was done to see the relationship between the PHI of NES and public health resources. Results: The results of the EDM show that Arunachal Pradesh ranked the highest in the Index of Public Health Infrastructure, whereas Assam ranked the lowest. The Index of Public Health Resource shows interesting results. Assam has remained at the lowest rank and inconsistency of ranks among the other NES. The correlation between the indices is positive, yet not encouraging. Conclusion: This implies that building up health infrastructure and responding to the demand for health-care infrastructure still stands ignored and rather remained stagnant.
  797 133 -
Is the second jab of an anti-SARS-CoV-2 vaccine reasonable after guillain–Barre syndrome following the first dose?
Josef Finsterer
July-September 2022, 66(3):385-386
DOI:10.4103/ijph.ijph_106_22  PMID:36149133
  820 96 -
Need for mindfulness-based relapse prevention strategies for postpartum smoking relapse prevention
Anita Mary Vadivale, Anuradha Sathiyaseelan
July-September 2022, 66(3):334-336
DOI:10.4103/ijph.ijph_1494_21  PMID:36149116
The health concerns for women are varied from that of men and are of higher concern. To increase this concern, women have recorded higher smoking relapse rates than men were an alarming 60% to 90% of the women who have attempted to quit relapse within their first year. Women who quit during pregnancy are seen to have higher rates of relapse than others. Such postpartum relapse has detrimental effects on the mother as well as the newborn. Mindfulness-based interventions have seen benefits in the areas of substance abuse and relapse prevention. Although research in the area of mindfulness and its benefits on smoking cessation has been limited, literature shows positive outcomes. This brief article examines the need for mindfulness-based relapse prevention strategies for women who are undergoing postpartum smoking relapses so that they could benefit from the same.
  820 82 -
An exploration of pulmonary fitness of construction workers in Delhi NCR in light of the building and other construction workers act, 1996
S Krishnakumar, Shailaja S Thakur, Jesim Pais, Nandita Narayanasamy
July-September 2022, 66(3):355-357
DOI:10.4103/ijph.ijph_2074_21  PMID:36149122
Workers in the construction sector are exposed to high concentrations of particulate matter at their workplace. This increases their susceptibility to various respiratory diseases, particularly chronic obstructive pulmonary disease (COPD) and acute respiratory distress syndrome (ARDS). The study reports comparative pulmonary fitness and hematological parameters of the migrant workers in the construction sector versus other sectors in Delhi. Parameters such as forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), the ratio of FEV1 to FVC, and peak expiratory flow were measured in both groups using a spirometer. We observed significant differences (P < 0.05) in FEV1 and FVC between both groups. The study thus confirms that workers exposed to poor air quality at the construction site are susceptible to respiratory diseases, particularly ARDS. All of this reflects the poor enforcement of the adequate safety measures well enlisted in social legislations such as the Building and Other Construction Workers Act.
  791 87 -
Sociodemographic and environmental factors influencing acute respiratory infections among under-five children of chars (riverine islands) of Tinsukia District, Assam: A community-based cross-sectional study
Ishan Phukan, Rupali Baruah, Sultana Jesmin Ahmed, Tulika Goswami Mahanta, Baidurjya Mahanta, Farhana Shaheen Hussain
July-September 2022, 66(3):344-347
DOI:10.4103/ijph.ijph_1691_21  PMID:36149119
Acute respiratory tract infections (ARIs) are a major cause of morbidity and mortality in under-five children worldwide. Assam has around 2500 river islands (locally called Chars/Chaporis) in the Brahmaputra River with socioeconomically deprived inhabitants lacking access to basic health-care facilities. A community-based cross-sectional study was carried out among 380 under-five children living in the Char areas of Tinsukia District to estimate the prevalence of ARI and determine the associated risk factors. The prevalence of ARI among under-five children was found to be 56.32%. Prevalence was significantly higher among children living in Dibru-Saikhowa island, with families having >2 children, belonging to socioeconomic class 5 (modified BG Prasad scale), having a positive history of smoking or ARI in family members, having homes with attached kitchens or using wood for cooking, inadequate ventilation or overcrowding and residences of katcha ghars.
  756 120 -
Effect of different maternal positions on comfort of antenatal mothers and fetal parameters during nonstress test
Reshmi Siby, MS Vinsi, Rebecca Mathew
July-September 2022, 66(3):341-343
DOI:10.4103/ijph.ijph_1904_21  PMID:36149118
Providing comfort to an antenatal mother is one of the critical components of the nonstress test (NST). An experimental study was conducted on 450 antenatal mothers beyond 34 weeks, who were randomly allocated into three groups – supine, left lateral, and semi-fowler's position, to explore the association of selected maternal positions on NST results and to find the impact of these positions on the comfort level of antenatal mothers. The fetal parameters were assessed by observing and recording biophysiological measurements from the NST and the maternal comfort of different positions by the Verbal Numerical Rating Scale. The data analyzed reveal a significant association between maternal positions and fetal parameters at P < 0.05 level. Antenatal women who were in semi-fowler's position exhibited more comfort and fetal NST reactivity as noted by significant variation in the baseline fetal heart rate, beat-to-beat variability, acceleration, deceleration, and fetal movements.
  732 101 -
Exploring the clinical variables among drug-dependent HIV-Positive patients: Implications for treatment strategies
Rizwana Quraishi, Siddharth Sarkar, Arpit Parmar, Raka Jain, Bimal Kumar Das, Atul Ambekar
July-September 2022, 66(3):331-333
DOI:10.4103/ijph.ijph_1317_21  PMID:36149115
This study explored the profile of HIV positive patients seeking treatment at a tertiary care addiction treatment facility. A retrospective study was done to collet detailed information on clinical characteristics: drug use (type, age of initiation, duration), general medical condition and past treatment history. The study included 138 patients with mean (SD) age 30.2 (8.3) years. Opioid dependence with injecting drug use (IDU) was diagnosed in 97% of the patients. The median age of injecting onset was 24.5 years (IQR 20-31 years). The most frequently injected substances were pheniramine (60.1%) and buprenorphine (59.4%). Past treatment seeking was reported by 57% patients and interestingly they were less likely to present any medical condition (2 =69.611, p < 0.001). Variability in the age of onset of drug use indicates the need for broad based approach to prevent IDU and motivation to seek treatment may lead to better health conditions.
  708 80 -
Occurrence of atypical enteropathogenic Escherichia coli with multidrug-resistant trait in street food of Northeast India
Sayani Roy, Pranab Behari Mazumder, Amitabha Bhattacharjee, Apurba Chakraborty
July-September 2022, 66(3):386-388
DOI:10.4103/ijph.ijph_347_22  PMID:36149134
  702 84 -
Addressing health needs of the highest settlements in the world
Anmol Gupta, Harshvardhan Singh, Amit Sachdeva, Sanjay Kumar, Deepesh Barall, Siddhit Tamba
July-September 2022, 66(3):380-381
DOI:10.4103/ijph.ijph_392_22  PMID:36149129
  614 84 -
Factors to consider in the development of institutional pain management policy
G Shankar Ganesh
July-September 2022, 66(3):383-383
DOI:10.4103/ijph.ijph_948_22  PMID:36149131
  602 79 -
Immunity to diphtheria among medical students of a tertiary Hospital, North Kerala
Pushpa Kizhakkekarammel, Kalpana George, Anitha Puduvail Moorkoth, Geetha Raveendran
July-September 2022, 66(3):381-382
DOI:10.4103/ijph.ijph_327_22  PMID:36149130
  562 79 -