Indian journal of public health最新文献

Background: Pregnancy is a vital phase that significantly impacts both maternal health and birth outcomes. Quality of life (QoL) during pregnancy is a critical aspect of maternal health, influencing health outcomes of mothers and infants. It can be affected by multiple factors such as physical, emotional and psychological health, and social and financial aspects. All these factors must be considered while providing comprehensive care.

Objectives: The objectives of this study were to assess and compare the QoL scores of pregnant women in experimental and control groups after a 10-week follow-up period and investigate the correlation between posttest QoL scores and birth outcomes in pregnant women.

Materials and methods: A randomized controlled trial was carried out involving 184 pregnant women (92 experimental and 92 control) attending antenatal Outpatient Department, assessed for their QoL. Experimental group received multicomponent nursing interventions with routine care whereas control group received routine care.

Results: Data were analyzed using the SPSS software version 26. Result revealed that experimental group's PCS and Mental Component Summary scores improved significantly after 10 weeks, from 62.75-77.40 to 80.85-90.56, respectively while the control group's scores declined. In addition, experimental group experienced better birth outcomes, with fewer preterm deliveries (1 vs. 11), lower cesarean sections (16 vs. 30), higher birth weights, and improved APGAR scores. QoL tends to decline as pregnancy progresses; however, the interventions helped to improve it resulting in better birth outcomes.

Conclusion: The QoL can be enhanced by continuous monitoring, motivation, and extra support along with routine care which will reduce maternal as well as neonatal morbidity and mortality.

Background: Kyasanur forest disease (KFD) is a tick borne zoonotic viral infection endemic to southern India. Despite preventive strategies, including vaccination, an outbreak occurred in March 2023 in Caranzol village, Sattari sub district, North Goa.

Objectives: This study aimed to describe the outbreak by time, place, and person and to explore contributing factors.

Materials and methods: An unmatched case-control study (1:4 ratio) was conducted from February to April 2023 after a village wide active case search among 484 residents. Presumptive and confirmed cases were identified using RT PCR/immunoglobulin M enzyme linked immunosorbent assay. Data on demographics, exposure history, and preventive practices were collected through structured interviews. Attack rates were calculated, and risk factors were assessed through logistic regression. Tick surveillance and verification of monkey mortality were also undertaken.

Results: Thirteen presumptive cases were identified; five were laboratory confirmed. The epidemic curve showed onset in early March with decline by the 5th week. The attack rate was 3.1%, highest among females (4.6%) and those aged 45-59 years (5.1%). Common symptoms included fever, weakness, myalgia, and headache. Forest visits without protective clothing, lack of repellent use, and poor postexposure hygiene were significantly associated with illness. Six cases reported prior vaccination, received 5 years earlier. Tick pools tested negative for KFD virus, and no monkey deaths were recorded.

Conclusion: The outbreak underscores the need for strengthened surveillance, public awareness, and intersectoral collaboration between health, animal husbandry, and forest departments. Emphasis on personal protective measures and reassessment of KFD vaccine efficacy and booster requirements is recommended.

Summary: We investigated a cluster of acute gastroenteritis reported from a college in Kerala on December 1, 2021. We defined a suspect case as an occurrence of vomiting or at least three episodes of loose stools within 24 h. We identified 113 suspected case patients; 63 (55.8%) were boys, and 110 (97.3%) were hostel inmates. All five stool samples and three out of eight water samples we collected tested positive for norovirus. We conducted a retrospective cohort and did univariate and multivariable binomial regression to calculate the adjusted risk ratio (aRR). Norovirus infection risk was higher among those who had a symptomatic roommate (aRR - 4.69; 95% confidence interval [CI]: 3.05-7.22) and who drank water from the jar (aRR - 1.41; 95% CI: 1.08-1.86) and filter in boys' canteen (aRR - 1.40; 95% CI: 1.04-1.89) and filter in Boys' hostel (aRR - 2.02; 95% CI: 1.63-2.49). We recommended changing water filters and frequent handwashing with soap.

Background: In September-October 2021, Palakkad district, Kerala, faced an H3N2 influenza outbreak among medical and paramedical students.

Objectives: We described the outbreak and determined the agent, source, and risk factors.

Materials and methods: To investigate the outbreak, we conducted an active case search using an online questionnaire. We defined a case as fever with any of the associated symptoms of cough, running nose, headache, sore throat, tiredness, or breathlessness. We described cases by time, place, person, and attack rates (ARs), and adjusted risk ratios (aRRs) were calculated.

Results: Among 780 students, 607 responded, with 122 cases of H3N2 (20.1%). Higher ARs were observed among females (23%), MBBS students (24%), and ladies' hostel inmates (22%). We conducted a retrospective cohort study among all the students to determine the risk factors. Univariate analysis identified MBBS students, residing in the ladies' hostel, improper mask use and having close contact at a common place as risk factors for being a case. Multivariable analysis confirmed improper mask use (aRR-2.2 [95% confidence interval (CI):1.4-2.7]) and residing in ladies' hostels (aRR-2.6 [95%CI: 1.6-4.4]) as significant risk factors, supported by environmental factors like poor ventilation.

Conclusion: The outbreak was caused by the H3N2 influenza virus. Residing in the ladies' hostel, poor compliance with mask-wearing and close contact during gatherings were identified as risk factors for the outbreak. We recommended proper mask use among students as well as isolation of cases. Swift public health action contained the outbreak by November 2, 2021.

Background: India ranks first among fatal road traffic accidents (RTAs) and accounts for one-tenth of global RTAs. North Goa district in Goa reported a higher burden of fatal RTAs than the national average.

Objectives: To estimate the burden of fatal RTAs and describe them by human, vehicle, and environmental characteristics.

Materials and methods: A cross-sectional analysis of four-years (2017-2020) data obtained from the Traffic Authority of Goa was conducted, and the characteristics were classified using the Haddon's Matrix. The mortality rate and case fatality ratio (CFR) were calculated.

Results: Overall, 6412 RTAs (487 deaths) were reported in North Goa, with an average mortality rate of 17.7, decreasing from 25.7 (2017) to 15.4 (2020), highest in Pernem subdistrict (23.8). The average mortality rate across four years was higher among individuals aged 25-34 years (22.6) and males (32.5). The overall CFR was 76, with an increase from 76 (2017) to 82 (2020). The highest average CFR was in Pernem subdistrict (150) and on state highways (80). A higher CFR was noted during peak tourism months (82) than during rainy months (63). The highest CFR was found on Sundays (89) and during midnight to early morning hours (87). Among fatalities, 60% were riders, 60% had two-wheeler as the impacting vehicle, 90% involved overspeeding, 30% involved a head-on collision, 50% wore helmet (two-wheelers), and 70% wore seat belts (four-wheelers).

Conclusion: Lower mortality but higher case fatality was reported in North Goa in 2020 during the COVID-19 pandemic lockdown. Various precrash and crash factors influencing fatality among RTAs were identified, which needs evaluation to mitigate fatal RTAs in the district.

Background: Retaining and attracting healthcare professionals is crucial for hospital managers, as many professionals leave due to workplace hazards, excessive workload, and poor working conditions. This exodus leads to a loss of human capital, decreased patient trust, and financial difficulties for hospitals.

Objectives: This study aims to design and explain an employer branding model for hospitals in Tehran City to attract and retain healthcare professionals.

Materials and methods: This study used a mixed-method approach. Qualitative data were collected through in-depth interviews with 15 healthcare management and human resource management experts. Quantitative data were collected from 367 healthcare professionals using a researcher-made questionnaire. Data were analyzed using grounded theory methodology.

Results: The study developed a paradigm model with six causal factors impacting a hospital's ability to attract and retain healthcare professionals: A strong mission statement, effective human resource management, internal marketing, evaluation of the hospital's reputation as an employer, financial stability, and industry competitiveness.

Conclusion: Implementing these strategies can result in motivated and long-term employees who become brand ambassadors for the hospital and contribute to a stronger brand compared to competitors. This model provides a framework for hospitals in developing countries to improve their employer branding and address healthcare professional retention challenges.

Summary: This qualitative study investigates how local Islamic belief systems shape the lived experiences of stigma, disclosure, and treatment seeking among people living with human immunodeficiency virus (PLHIV) in Kashmir. Drawing on in-depth interviews with 15 PLHIV and four Muslim religious scholars at a major antiretroviral therapy center, and analyzed using interpretative phenomenological analysis, the study reveals that religious values deeply inform individuals' emotional struggles and choices around care. The findings call for culturally grounded, faith-sensitive public health strategies that not only address medical needs but also engage with the moral and spiritual realities of those living with human immunodeficiency virus in conservative contexts.

Summary: A disproportionate focus on fertility and reproductive function within health programs and policies in India obscures the health needs of quarter-to-midlife women. This paper aims to foreground this obfuscation of women in quarter-to-midlife and the implications of this neglect. Addressing health needs in this cohort is critical, not only due to biosocial vulnerabilities including anemia, early menopause, noncommunicable diseases, and mental health, but also because they represent the most active age group in both paid and unpaid work. Women's quarter-to-midlife health thus has implications for livelihood, wellbeing, and empowerment.

Summary: The jigsaw technique involves splitting the topic into smaller bits and dividing the class into small groups to work on small problems, leading to a final collaborative learning outcome. 40 MBBS students participated in the jigsaw after a thorough briefing and meticulous planning by the mentors for the topic Nutrition. A pre- and postsession test depicted statistically significant improvement of 20.7% in the scores. The use of jigsaw as a teaching learning method was noted to increase the students' overall interest in the topic and lead to a better understanding among the learners. The faculty, too, found it very engaging.