Indian journal of public health最新文献

Background: A study was conducted to examine variations in latent tuberculosis infection (LTBI) risk factors among household contacts (HHCs) of tuberculosis (TB) patients.

Objectives: The objective of this study was to assess LTBI prevalence among first-degree relatives (FDRs) and spouses of TB patients and identify associated risk factors.

Materials and methods: A cohort study at JIPMER under Regional Prospective Observational Research for TB India included HHCs of newly diagnosed pulmonary TB patients. Prevalence ratios with 95% confidence intervals (CIs) were calculated using generalized linear modeling.

Results: Among 1318 HHCs of 548 TB patients, the mean ages were 45.2 (13.7) and 29.5 (16.1) years, respectively. LTBI prevalence was 58.1%, with 0.5% progressing to active TB. Spouses had a higher LTBI prevalence (64.2%) than FDR (55.8%), with a significantly elevated risk (PRR: 1.42, 95% CI: 1.11-1.83). Older age (40-59 and ≥60 years), bed-sharing, female gender, prolonged exposure, undernutrition, overweight/obesity, and alcohol use were linked to higher LTBI prevalence. Female spouses spent more time caring for index cases than male spouses.

Conclusion: Spouses had a higher LTBI prevalence than FDR. Screening programs should prioritize female spouses, undernourished individuals, overweight/obese individuals, and alcohol users to reduce TB transmission.

Background: Double fortified salt (DFS) is an innovative new fortified food product that provides humans with small but critical amounts of iodine and iron through their diet.

Objectives: The present study involved assessing the effectiveness of DFS in improving the status of iron biomarkers and hemoglobin (Hb) concentration among adolescent girls in Chandauli district, Uttar Pradesh.

Materials and methods: A double-blind, randomized controlled trial was conducted in 26 villages of the Chandauli district among 602 adolescent girls (15-19 years). Venous blood samples were collected from anemic adolescent girls, followed by a baseline survey. One group received DFS along with nutrition education, whereas the other group received iodized salt and nutrition education. An end line survey was conducted to compare the outcomes. The Wilcoxon signed-rank test was employed to evaluate the differences in median values of biochemical parameters, and a regression test was used to assess the association of DFS with the change in serum iron levels from baseline to end line.

Results: The Hb levels among girls increased by 1.7 g% from baseline to end line ( P < 0.001), and serum iron levels rose by 8.4 µg/dL ( P < 0.001). After adjusting for covariates and confounders, the DFS was positively associated with a greater increase in serum iron levels compared to iodized salt ( P < 0.05).

Conclusion: The present study identified an easy and economical solution to mitigate iron deficiency without causing side effects such as toxicity or stomach upset as with iron tablets. DFS is shown to be an effective public health strategy for enhancing the nutritional status and overall health among adolescent girls.

Background: Menstruation is very significant process in women's life and maintenance of proper hygiene during this time is quintessential to her health. However in low- and middle-income countries like India, this does not get due importance to the point that many misconceptions and taboos are attached to it, which in turn leads to worsening of overall health and wellbeing of women.

Objectives: This study aimed at assessing the awareness and practice toward different aspects of menstrual hygiene management (MHM) and to find out the determinants of its practice among school-going girls in Kolkata, West Bengal.

Materials and methods: An observational descriptive study with cross-sectional design was conducted among 155 adolescent girls of classes IX to XII from two girls' schools in Kolkata, West Bengal over a period of 2 months. A predesigned, pretested self-administered questionnaire and 36-item Menstrual Practice Needs scale (MPNS) were self-administered anonymously.

Results: Out of 155, 69.7% admitted to have no idea on menstruation before their menarche. Although 78.1% were found to have an idea on ideal type of material but score in MPNS-36 among 108 (67.5%) of participants indicates "improper" MHM. Regression analysis showed significant association with parental education, frequency of changing soaking materials, disposal of them and maintenance of genital hygiene.

Conclusion: Menstrual health education as part of life skill education in school may bring about menstrual well-being of adolescent girls.

Background: India faces unique challenges in tobacco control, with 266.8 million adults using tobacco. Despite these challenges, the country has made progress with the National Tobacco Control Program (NTCP). Effective execution of these policies is crucial to combat the growing tobacco epidemic.

Objectives: This study aims to establish consensus on national and subnational NTCP priorities using a modified Delphi technique.

Materials and methods: A three-stage modified Delphi process involved 21 experts from government, nongovernmental organizations, and academia. In the first stage, experts identified key tobacco control priorities. In the second stage, they rated these priorities on a Likert scale (0-4), and the top 10 were determined using a weighted mean. The final stage included an in-depth discussion and ranking of these top priorities by the expert panel.

Results: In the initial round, experts proposed 20 national and 17 subnational priorities, which were then rated and ranked to achieve consensus on the top 10 for each level. The top three national priorities identified were amending the National Tobacco Control Legislation (COTPA), monitoring NTCP implementation, and protecting health policy from tobacco industry interference. The top three subnational priorities were: enforcing COTPA and the e-cigarette ban (PECA), engaging civil society in tobacco control efforts, and promoting tobacco-free schools and villages.

Conclusion: While national policies and legislation are vital for strengthening the overall tobacco control framework, effective implementation and enforcement at both national and subnational levels are essential for curbing the tobacco menace in India.

Background: Hypertension and tobacco use are significant public health concerns with detrimental effects during pregnancy.

Objectives: This study was conducted to assess the association between tobacco use and hypertension among women of prime childbearing age (20-34 years) in India using a representative survey, the National Family Health Survey (NFHS)-5.

Methods: Secondary data from the NFHS-5 conducted between June 2019 and April 2021 were utilized. Multivariable logistic regression was performed to analyze the association between tobacco use and hypertension, adjusting for sociodemographic factors, illness, physical characteristics, and state-wise data.

Results: Tobacco users had a significantly higher prevalence of hypertension (8.8%) compared to nonusers (6.57%). Women using tobacco were 1.16 times more likely to have hypertension than nonusers (95% confidence interval: 1.05-1.28).

Conclusion: The study highlights the increased risk of hypertension among tobacco-using women of childbearing age in India. Comprehensive interventions addressing both tobacco control and hypertension management are urgently needed.

Background: The nutritional status of children in South Asian regions is already under threat from rising global temperatures and more unpredictable rainfall and humidity patterns. Child undernutrition based on mid-upper arm circumference has been a major concern for Nepal as it is the highest among children in the world.

Objective: The objective of our study is to determine the climate change and socioeconomic determinants of undernutrition in children under 3 years.

Methods: This study explored the sample of 538 children ranging in age from 3 to <36 months using a binary logistic regression model to determine the climate change and socioeconomic factors associated with child undernutrition.

Results: Our study estimated approximately 24% of children are undernourished. Our analysis in the adjusted multivariable logistic regression model found that children born between 65% and 75% humidity were 3.48 times more likely to be undernutrition as compared to the humidity level at <65% (adjusted odds ratio = 3.48; 95% confidence interval [CI]: 1.08-11.18). The bivariate analysis found that children born at a temperature higher than 30°C were four times more likely to suffer from undernutrition (odds ratio = 4.00; 95% CI: 1.19-13.44). The study revealed that children who had low childbirth weight were eight times more at risk of being undernutrition.

Conclusions: Our study revealed that temperature, precipitation, climate hazard, occupation of the mother, and health facility distance were common climate change and socioeconomic risk factors of child undernutrition in Nepal.

Background: End TB Strategy seeks to eliminate catastrophic costs for TB-affected households.

Objectives: The study was done to address the knowledge gap with regards to catastrophic & out of pocket expenses (OOPE) incurred by TB patients and to identify its determinants.

Materials and methods: A cross-sectional study was carried out at 2 randomly selected Tuberculosis Units in Lucknow district. Three hundred and seventy one drug sensitive TB patients were interviewed using a semi structured schedule to assess direct, indirect & coping cost and its determinants over the course of treatment. Chi square and Mann Whitney U test was applied to measure association of categorical and continuous data variable respectively, with incurring catastrophic cost. Multivariate regression analysis was used to identify predictors for catastrophic cost .

Results: About 18% of patients had catastrophic expenses, with a median of INR 28,670 (INR 6000-215,375) and a total median OOPE of INR 10,150 (INR 0-215,375). A higher proportion of households with TB patients aged 15-59 years, female, non-Hindu, rural inhabitants, and educational levels below high school experienced catastrophic and OOPE. Multivariate regression analysis revealed "Recurrent TB episodes," "place of first consultation," and "socioeconomic class-SEC" as significant predictors. TB patients with recurrent TB, First consultation at a private facility and belonging to lower SEC were more likely to incur catastrophic expenses.

Conclusions: Strengthening early case detection and enrollment of TB patients under National TB Elimination Programme in vulnerable population and addressing determinants like recurrent TB through tailored IEC can cut down on catastrophic and OOPE.

Background: An Increased burden of noncommunicable diseases and their association with sleep problems exists.

Objective: The objective of this study was to estimate the prevalence of sleep problems in India.

Materials and methods: A meta-analysis of the studies conducted on Indian data was planned using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. To assess the methodological quality, a 10-point Joanna Briggs Institute (JBI) checklist for prevalence studies was used.

Results: Pooled estimates of 100 eligible studies showed the prevalence was 25.7% for insomnia (95% confidence interval [CI]: 16.3%-38.0%, I2 = 99.4%), for obstructive sleep apnea (OSA), 37.4% (95% CI: 27.8%-48.2%, I2 = 98.3%), and for restless leg syndrome (RLS) was10.6% (95% CI: 7% to 15.9%, I2 = 97.3%). An increased prevalence was seen in patients with diabetes, heart disease, and other conditions. JBI checklist scores ranged from 4 to 9, with a median score of 7. Subgroup analysis showed that both patients and the general population had sleep disorders; prevalence of insomnia 32.3% (95% CI: 18.6%-49.9%, I2 = 99.4%) and 15.1% (95% CI: 8.0%-26.6%, I2 = 99.1%), OSA 48.1% (95% CI: 36.1%-60.3%, I2 = 97.4%) and 14.6% (95% CI: 9.2-22.5%, I2 = 97.4%), and RLS 13.1% (95% CI: 8.7%-19.3%, I2 = 91.9%) and 6.6% (95% CI: 2.4%-16.4%, I2 = 99.1%) in patients and general population, respectively. Excessive daytime sleepiness was a common symptom. Different methodologies and diverse population groups were studied, thus increased heterogeneity was seen.

Conclusion: Increased prevalence of sleep problems existed in noncommunicable diseases and the general population. A need to recognize the allostatic load of sleep problems in noncommunicable diseases is highlighted.

Background: Southern India has one of the highest prevalence of consanguineous marriages in Asia. Limited research has been conducted to understand the reasons behind this in the rural areas of South India, despite the potential risks associated with consanguinity.

Objectives: The present community-based mixed-methods study was conducted in selected villages of Telangana, with an aim to determine the prevalence and pattern of consanguineous marriages and also to find out why the population native to this region prefer such marriages.

Materials and methods: Two hundred and fifty-two married couples aged 18-75 years, native to this region, were interviewed by doing house to house survey, for achieving the aim, and focused group discussions were conducted, to find out why people of this region prefer or oppose consanguineous marriages, to understand their "mind-set," influencing consanguinity.

Results: The present study found a prevalence of 36.51% consanguinity in this region, with an inbreeding coefficient of 0.014028. The wife's education level is the only sociodemographic factor significantly affecting the prevalence of consanguineous marriages, while factors such as age, socioeconomic status, time spent in the region, religion, employment, husband's education, family structure, and age at first birth show no impact. The continuation of consanguineous marriages in this region is driven by social factors such as marital security and cultural practices, along with economic factors such as inheritance and dowry.

Conclusion: Consanguinity is highly prevalent in this region, and there is an urgent need community-based campaigns to raise the awareness of the general population regarding its negative effects.