Indian journal of public health最新文献

Summary: A cross-sectional, web-based survey was conducted to assess the health-care professionals (HCPs)' perception toward existing medical device postmarket surveillance (PMS) practices in India. A total of 1756 responses (medical practitioners [19.8%], nurses [22.5%], pharmacists [21.4%], and biomedical engineers [13.8%]) were recorded and analyzed. About 71.2% of participants were aware about the ongoing PMS program, 87.5% were aware that medical devices are under regulation in India, and 83.3% were aware about who can report medical device adverse event (MDAE). About 56.3% of participants agreed that they take regular feedback from patients after using high-risk medical device. Majority of participants (69.4%) were aware about tools for reporting MDAE and the online reporting form is the most preferable tool among users. About 76.2% of participants were agreeing that reporting of MDAE is their professional/ethical responsibility. This study reveals that Indian HCPs show a good understanding of PMS practices and a positive perception toward MDAE reporting. However, underreporting still remains a challenge in India.

Summary: Cytomegalovirus (CMV) is known to cause fatal pneumonia in human immunodeficiency virus (HIV) infected children. There is a paucity of literature on pediatric HIV and CMV coinfection in India. We describe six cases of severe pneumonia in infants infected with HIV. Four of these infants also had CMV coinfection, detected by urine polymerase chain reaction. There was a lack of antenatal and postnatal care in all cases. All four infants with CMV coinfection succumbed to severe acute respiratory distress syndrome, whereas the other two survived. In conclusion, a high index of suspicion for CMV should be kept in HIV-infected infants presenting with severe pneumonia, although CMV pneumonia is difficult to diagnose with certainty. The important role of antenatal care for mothers with HIV infection, as well as postnatal care for babies born to HIV-positive mothers, cannot be overstated.

Background: Tuberculosis (TB) management continues to be a challenge globally; weakened immunity plays a significant role in the reactivation of TB. There is limited information on hematological parameters in patients with pulmonary TB and its association with outcome.

Objectives: We present hematological parameters of newly diagnosed sputum-positive pulmonary TB patients enrolled in a randomized, clinical trial that assessed the efficacy and safety of 3 and 4 regimens using moxifloxacin.

Materials and methods: Blood hematological parameters at baseline, comparison of the baseline and end of treatment values, including the monocytes by lymphocytes ratio (M/L), neutrophil lymphocyte ratio (N/L), and platelet lymphocyte ratio (P/L) between the patients with favorable and unfavorable TB treatment outcome, and among different age group and sex presented in this paper.

Results: Among the total 1059 patients, 782 were males, the mean hemoglobin (HB) ± standard deviation (SD) was 11.5 g/dL ± 2.0, the mean white blood cell (WBC) count ± SD was 9800 ± 3009 and the mean platelet count (in lakhs) ± SD was 4.24 ± 1.42 cells/uL. There was an increase from baseline in the mean hemoglobin, eosinophil, and lymphocyte count and a decrease in mean neutrophil, monocyte counts to the end of treatment. There was a decrease in baseline mean total WBC count posttreatment, both in favorable (10,271 cells/uL ± 3007 SD to 6689 cells/uL ± 1837 SD, [P ≤ 0.001]), and unfavorable TB outcome patients.

Conclusion: An increase in HB, and a decrease in WBC count, M/L, N/L, and P/L ratio is possible at the end of TB treatment and future studies to correlate blood hematology parameters with TB treatment outcome.

Background: Food insecurity prevails in people at all phases of their life course and causes remarkable health, social, and financial repercussions. In Sarawak state, Malaysia, information regarding household food insecurity is limited.

Objectives: The objective of this study was to examine the prevalence of household food insecurity, together with its predictors and coping strategies among the Sarawak indigenous communities.

Materials and methods: This cross-sectional study was conducted among 953 Indigenous households (women) located in six districts throughout Sarawak using multistage sampling. Interviewer-administrated questionnaires were used. Simple and multiple logistic regressions were employed to draw inferences.

Results: The prevalence of food insecurity was 42.2%. Large household size (adjusted odds ratio [AOR] =1.57 [1.04-2.45]), hardcore poor (AOR = 12.26 [5.07-29.65]), and absolute poor families (AOR = 3.01 [1.76-5.15]), recipient of financial assistance (AOR = 1.94 [1.27, 2.96]), no savings (AOR = 1.63 [1.08-2.46]), increased resource loss (AOR = 1.004 [1.001-1.008]), and employment of coping strategies (AOR = 3.78 [2.50-5.72]) were significantly related to a higher risk of household food insecurity. High level of perceived social support (AOR = 0.73 [0.58-0.93]), optimism (AOR = 0.91 [0.86-0.96]), and general perceived self-efficacy (AOR = 0.88 [0.85-0.91]) among respondents were protective against household food insecurity.

Conclusion: Nearly half of the Indigenous households faced food insecurity in the current study. The findings suggest that incessant effort by pertinent stakeholders is warranted via diverse strategies to enhance the socioeconomic status and nutrition intervention programs that incorporate components of perceived social support, optimism, and perceived general self-efficacy to mitigate the level of food insecurity among the Sarawak Indigenous communities.

Summary: Cardiovascular diseases (CVDs) are the leading cause of death globally and the prevention and control of these diseases tend to entail longer and larger social and economic commitments on the part of governments. This systematic review (SR) aims to understand the quantum, diversity, and quality of implementation research (IR) done in the field of CVDs in India with a view to maximizing the utility of the efforts made by the government. The evidence was collated on IR on CVDs in India conducted in the past 20 years (2001-2021) using a SR approach. The SR was drafted using Preferred Reporting Items for SRs and Meta-analyses guidelines. Academic databases (PubMed, Embase, and Science Direct) and nonacademic databases (Google Scholar and ProQuest) were chosen, along with repositories of gray literature. Retrieved articles were screened for titles and abstracts and assessed by two independent reviewers. The articles also underwent a concomitant risk of bias assessment utilizing checklists (STARI, STROBE, CONSORT, etc.,) and a narrative summary was drafted using SwiM guidelines. In the final analysis, 10 articles that fitted the inclusion criteria of IR for CVD in India were included, of which seven were directed at IR on hypertension, and three were related to coronary artery disease, myocardial infarction, and stroke. Acceptability, adoption, and feasibility were the only attributes of IR that were explored in these studies.

Background: Despite genetic testing being recommended by international guidelines for the selection of targeted therapy for prostate cancer (PCa), limited data are available on genetic testing for PCa in India.

Objectives: The objective is to understand the current genetic testing practice pattern for PCa in India.

Materials and methods: A panel of 9 experts developed and validated a premeeting online questionnaire comprising 12 objective questions. The questionnaire was circulated from February 2022 to May 2022 among medical oncologists and uro-oncologists across pan-India, followed by response collection over 3 months. Descriptive statistics were used to summarize results and concluding statements were formulated on current genetic testing practice patterns for PCa.

Results: A total of 103 responses were received. Genetic testing was advised by 35.9% of the participants in <5% of patients with PCa. Patients with a family history of PCa (88.3%) were most commonly referred for genetic testing. Nearly half (50.2%) of the participants routinely tested for homologous recombination repair (HRR) genes; 52% used blood and tissue as the most preferred specimen for performing genetic testing and 44.7% followed the testing sequence of tumor tissue followed by blood. Major barriers to genetic testing were affordability and scarcity of genetic counselors, while a major change could be brought by making it cost-effective and improving access to medication.

Conclusions: We observed a lower prescription frequency of genetic testing for the HRR gene across pan-India. Improving the quality and access to genetic testing and the availability of cost-effective-targeted therapies will aid in delivering personalized care to patients with metastatic PCa.

Summary: In Asian cultures, discussing sexual matters with adolescents is often considered taboo and culturally or religiously sensitive. Due to a lack of knowledge and skills, many parents find approaching such a topic with their children challenging, fearing that raising such an issue will bring concerns about encouraging promiscuity. This systematic review aims to assess evidence on Asian parents' perspectives and practices regarding delivering sexuality information to adolescents. It also seeks to identify the factors that facilitate or hinder the effective delivery of such knowledge. The electronic databases EBSCO-CINAHL, Scopus, and Science Direct were searched using keywords and synonyms such as "sexuality information," "sexuality education," "parent-child," "communication," and "Asian." The studies' quality was assessed using the Mixed-Method Assessment Tool. A comprehensive database search identified 1392 potentially relevant literature sources for this review. Following the application of inclusion criteria, a final set of 16 eligible full-text research articles was selected for inclusion in the review. In most quantitative literature, parents were found to have a good level of knowledge, whereas most qualitative studies reported the opposite, indicating inadequate knowledge. Seven studies highlighted the cultural denial of delivering regarding sexuality, whereas six studies emphasized the need for parental support. Negative experiences, including discomfort, shyness, embarrassment, fear of intimidation, and fearful encounters, were reported in the literature. In conclusion, this review aims to pinpoint gaps and challenges in the delivery of sexuality education among Asian parents, offering valuable insights for public health practitioners and policymakers.