Indian journal of public health最新文献

Background: The cardiovascular disease (CVD) risk prediction charts, updated by the World Health Organization for 21 regions in 2019. These charts-lab and non-lab versions-estimate a person's overall CVD risk; the non-lab version is intended for low-resource environments.

Objectives: Using the "non-lab" and "lab" versions of the WHO CVD risk prediction charts, we sought to estimate the burden of ten-year risk of a fatal or non-fatal CVD event in a tertiary care hospital of Puducherry and to assess the agreement between them.

Materials and methods: We included 255 doctors working in a tertiary care hospital in Puducherry. Age, gender, systolic blood pressure, and smoking status are all factors used in both charts. Moreover, a lab chart requires a person's total cholesterol and diabetes mellitus status, whereas a non-lab chart requires a person's body mass index. Proportions (95% confidence intervals) were used to portray the population at various CVD risk levels. Using Cohen's Kappa, the degree of agreement between the lab and non-lab charts was assessed (k).

Results: The majority of the study participants had <5% risk of CVD, and none had a risk of >20% in both the charts, which shows the better health-seeking behaviour of doctors. A good level of agreement was shown by the 95.2% (95%CI = 91.7 - 97.4 ) concordance in the risk categorization between the two charts (k = 0.934).

Conclusion: When data are available and there is strong agreement between non-lab and lab-based charts, it is practical to apply WHO-updated CVD risk prediction charts.

Summary: Acute respiratory infection (ARI) represents a pervasive global health concern, contributing to significant morbidity and mortality. Our findings reveal a notably high prevalence of ARI in Ladakh. Employing a cross-sectional design, the total number of households surveyed was 401, among them, the total population was 2107; males, 1153, and females, 954. The highest incidence rate of 160.26/1000 persons was observed in the age group below 14 years, followed by those above 59 years (47.76), while the age group of 14-59 exhibited the lowest incidence rate at 21.23. To explore the factors contributing to ARI in Ladakh, we employed binary logistic regression modeling. Our analysis highlights significant associations between ARI incidence and various socioeconomic and environmental determinants. Notably, primary occupation, family type, kitchen ventilation, domestic fuel consumption, crowding, and smoking behaviors within families were found to be statistically significant determinants of ARI among the sample population of Ladakh.

Background: Of the 43 mpox cases reported by the WHO in South East Asia between January 2022 and March 2023, 24 (56%) were from India.

Objectives: We describe the clinical and epidemiological profile of cases identified through India's hospital case-based surveillance.

Materials and methods: We identified mpox cases as a positive result for mpox virus polymerase-chain-reaction assay, reported through surveillance from July 1, 2022 to January 7, 2023. Cases and clinicians were interviewed, and data were abstracted from the medical records. We conducted contact tracing among family, close social networks, and healthcare personnel staff for the first 17 cases. We collected the data on sociodemographics, clinical findings, and behavior, and described data using summary statistics.

Results: We identified 24 laboratory-confirmed cases (42% females, median age 30 years, range 22-38), including one death (case fatality rate 4.2%). We collected clinical and behavioural data from 21 of 24 cases. All had rashes with vesicles and genital lesions; 7 (33%) reported genital lesions as the first symptom; and 3 (13%) reported complications. Among the 21 cases, all were sexually active, none self-identified as men having sex with men (MSM), and 6 (29%) reported multiple sex partners. We identified 51 contacts of the first 17 reported cases, none reported symptoms suggestive of mpox.

Conclusion: The clinical and behavioral characteristics of mpox cases in India are consistent with the global 2022 outbreak, with the exception that no cases in India reported MSM. Most were sexually active young adult economic migrants and developed genital lesions.

Background: Hepatitis C virus (HCV) antibody prevalence in Punjab, India (0.56%) is higher than the national average (0.32%), but primary drivers of local transmission are unclear.

Objectives: The objective of this study was to identify behavioral and demographic predictors of screening positive for HCV in Punjab.

Materials and methods: Interviews assessing exposure to potential HCV risk factors were administered cross-sectionally to persons screening for HCV across 10 treatment facilities. Risk ratios (RRs) were calculated using generalized estimating equation models accounting for clustering by health facility.

Results: One thousand seven hundred and sixty-three patients tested anti-HCV positive; 595 were negative. 57.7% of respondents were male; the median age was 40 years. 13.8% reported injecting drugs. Males were more likely to test positive than females (RR: 1.14, 95% confidence interval [CI]: 1.07-1.21). Unmarried men were at higher risk of anti-HCV positivity compared with married men (RR: 1.16, 95% CI: 1.08-1.24), but unmarried women were at lower risk (RR: 0.65, 95% CI: 0.43-0.98). The strongest risk factors were history of injecting drugs (RR: 1.37, 95% CI: 1.24-1.51), incarceration (RR: 1.22, 95% CI: 1.12-1.33), acupuncture use (RR: 1.20, 95% CI: 1.09-1.33), having household member(s) with a history of incarceration (RR: 1.17, 95% CI: 1.08-1.26), and tattoos (RR: 1.16, 95% CI: 1.09-1.24). Additional risk factors among men included receiving injections in a public hospital or from unregistered medical practitioners and among women included a history of childbirth.

Conclusion: Injecting drugs was most strongly associated with anti-HCV positivity in this population. Greater attention to HCV prevention is needed, with a focus on people-centered harm reduction programs, behavioral change interventions, and increasing safety in potential transmission settings.

Summary: The study has used a nonparametric method to estimate the technical efficiency of health-care sector in the substate level of Assam. The study is based on secondary data for the year 2018-2019. The average constant return to scale technical efficiency score is 0.81, while the average efficiency scores in variable return to scale technical efficiency and scale efficiency (SE) are 0.88 and 0.92 respectively. Moreover, seven (26%) districts are technically efficient. The major cause of inefficiency is the poor management of health-care sector. Four (15%) districts Chirang, Dima Hasao, Baksa, and Udalguri have achieved least efficiency score, while five (19%) districts Kamrup (Rural), Sivasagar, Dibrugarh, Lakhimpur, and Goalpara have the highest potentiality to achieve efficiency level. The study is static in nature. However, it will help the health policymakers to improve management and size of operation of health sector in the state.

Summary: This study analyzes data from India's National Family Health Survey to assess the prevalence of anemia among children aged 6-59 months. Over the past decade, the prevalence increased from 59% to 67%, remaining a significant public health concern. Gujarat has highest rates, and Kerala has lowest among major states in India. The Western region tops in prevalence (75.70%), whereas the Northeast has the lowest (56.20%). Factors such as lower maternal education, poverty, religion, rural residence, poor child nutrition, low birth weight, and stunting contribute to higher odds of anemia. Improved socioeconomic conditions and maternal nutrition are recommended for risk reduction.

Background: Thalassemia is an inherited blood disorder characterized by abnormal production of hemoglobin. The prevalence of thalassemia in India varies depending on the region and population. The study used a pre- and postcounseling cross-sectional design, which involves measuring outcomes before and after the intervention (genetic counseling).

Objectives: Three hundred and eighty-five respondents were screened as thalassemia carriers, between a pool of 2985 participants to depict the quantitative prevalence of thalassemia. Two separate qualitative cross-sectional studies were conducted and compared to validate genetic counseling. The aims of the study are to contribute to the understanding of thalassemia carrier frequency and to improve the education and awareness of college students regarding thalassemia.

Materials and methods: Two different questionnaires were used with the same knowledge, attitude, and practice parameters, one before and one after counseling. A two-sample t-test and an analysis of variance (ANOVA) F-test were used to compare the changes in knowledge, attitude, and practice.

Results: Using paired samples t-test to compare the pre- and postcounseling outcome showed significant (P < 0.001) elevation in terms of knowledge, attitude, social beliefs, social discomfort, and practice as a thalassemia carrier. Further, ANOVA F-test demonstrates the relationship between demography and the difference in parametric score of the pre- and postcounseling outcome.

Conclusion: By improving knowledge and attitudes, counseling can help individuals to better understand their condition and the importance of adhering to treatment recommendations. This can lead to improved health outcomes and a better quality of life for affected individuals.