Indian journal of public health最新文献

Summary: Supervisory monitoring visits play a vital role in strengthening surveillance systems in India's healthcare sector, particularly in sexually transmitted infection/RTI programs under the National AIDS Control Organization. This article focuses on the Apex Regional STD Centre at Vardhman Mahavir Medical College, Safdarjung Hospital, highlighting the impact of these visits on program implementation, data accuracy, and equitable healthcare services. Key recommendations include improving personnel training, optimizing supply chain management, and refining procurement processes. By empowering healthcare staff and ensuring robust operational procedures, supervisory visits contribute to enhanced health outcomes and the overall success of public health initiatives.

Summary: Cervical cancer is a leading cause of cancer-related morbidity and mortality in women living with human immunodeficiency virus (WLHIV) worldwide. However, there is no nationwide public health policy in India that aims to prevent cervical cancer among WLHIV. Thus, the integration of cervical cancer preventive services within existing HIV care programs is essential. This study proposes a framework for healthcare providers and policymakers to enhance the integration of cervical cancer screening services within existing HIV care programs in India. This aims to improve access to early detection and treatment of cervical cancer among WLHIV, ultimately reducing morbidity and mortality.

Background: There is a notable gap persisting in the existing body of evidence regarding the prevalence of sexually transmitted infections (STIs) in the general population in India.

Objectives: The primary aim of this review is to provide a comprehensive assessment and quantification of the burden of STIs within the state of Rajasthan.

Materials and methods: The study findings conformed to the criteria outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two reviewers independently conducted an extensive search across multiple databases, which included PubMed, Scopus, Google Scholar, and Shodhganga, along with cross-referencing and manual searches. A standardized data extraction checklist was used to extract the data from the included studies. An appraisal tool for cross-sectional studies was used to assess the risk of bias. A random-effects meta-analysis model was utilized to estimate the pooled prevalence of syphilis among the blood donor population and the general population in Rajasthan.

Results: A total of 2575 articles were screened, and 20 studies met the inclusion criteria. The burden of STI in the general population ranges from 2.2% to 9.09% (gonorrhea, n = 2 studies) and 16% (chlamydia, n = 1 study). Of these, 14 studies in blood donors revealed a pooled prevalence of syphilis as 0.04% (95% confidence interval [CI], 0.03%-0.05%). Similarly, in the general population, the pooled prevalence was found to be 0.05% (95% CI, 0.04-0.06).

Conclusion: STIs are an important public health concern with a considerable burden in the population. This review underscores the significance of conducting STI surveillance to identify emerging trends to address specific STIs effectively. In addition, there was a gap in evidence reporting the prevalence of STIs other than syphilis.

Background: Female sex workers (FSWs) constitute a significant portion of high-risk groups (HRGs) in the districts of West Bengal, as indicated by HRG size mapping exercises.

Objectives: This study aimed to evaluate the knowledge of HIV/AIDS and condom usage practices among FSWs in clusters selected from districts in West Bengal for behavioural surveillance surveys (BSS)-lite.

Materials and methods: BSS-lite was implemented in designated districts of West Bengal and interviews with 399 brothel and street-based FSWs from January to March 2020 were conducted utilizing computer-assisted personal interview or audio-computer assisted self-interview. Data analysis was performed using SPSS, version 17. Chi-square testing was employed to examine the association between HIV/AIDS knowledge and sociodemographic factors, service utilization, and condom usage behaviors.

Results: The mean age of FSW respondents was 31 years (standard deviation 7.9) with a majority being illiterate (48.4%). Approximately 50.5% of FSWs were separated or divorced, and for 87.2% of respondents, sex work constituted their primary occupation. The percentage of comprehensive knowledge was 12.8%. There was a significant association ( P < 0.01) between condom use in the last sex act with frequency of condom use with commercial partner and condom use with regular partner.

Conclusion: Enhanced interventions are warranted to address the knowledge gap concerning HIV transmission and condom use practices among FSWs, particularly with respect to regular partners.

Summary: Sexually transmitted infections are a major public health concern in India, particularly affecting high-risk groups, women and adolescents. The apex regional sexually transmitted disease center plays a key role in surveillance, offering testing, treatment, and data collection to guide national strategies. However, challenges such as stigma, limited healthcare access, underreporting, and resource constraints hinder effective control. India's large population and the prevalence of asymptomatic cases further complicate the issue. Key strategies for improvement include public awareness, expedited partner therapy, better healthcare access, and digital health solutions, with a focus on high-risk populations and stronger healthcare infrastructure.

Background: Human immunodeficiency virus (HIV) and hepatitis are common viral infections. Given sexual, blood, and perinatal transmission routes, HIV and hepatitis can be expected to be transmitted in similar at-risk populations. Roughly 10%-20% of HIV-infected patients are expected to have hepatitis B virus (HBV) coinfection.

Materials and methods: This paper uses the data of 17 th round of HIV Sentinel Surveillance 2021 conducted in 5 prisons of Assam, Manipur, Mizoram, and Tripura. The 17 th round of HSS was implemented at 53 surveillance sites in prisons during 2020-21. Almost every district in the country has a HIV surveillance site for one or more of the risk groups. Five prison surveillance sites were included in this study from the state of Assam, Manipur, Mizoram, and Tripura.

Results: In this study, the seroprevalence of HIV monoinfection among 1996 prison inmates was 1.5% (31), HBV monoinfection was 1.25% (25), Hepatitis C virus (HCV) monoinfection was 10.77% (215), HIV and HBV coinfection was 0.15% (3), HIV and HCV coinfection was 4.71% (94), HBV and HCV coinfection was 0.35(7) and HIV, and HBV and HCV coinfection was 0.25% (5).

Conclusions: The HIV coinfection with HBV or HCV is high and a significant health threat in the prison inmates of Northeast India. Data suggest a high prevalence of HCV coinfection compared to HBV, despite the fact both viruses have common routes of transmission.

Background: Periodic monitoring of HIV prevalence among antenatal care (ANC) attendees and exploring the factors influencing its transmission is essential to get updated information on the HIV epidemic.

Objectives: The objective of this study was to analyze HIV prevalence trends among ANC attendees in Western India from 2008 to 2021 and identify factors associated with HIV positivity in this population.

Materials and methods: This secondary analysis utilized surveillance data from seven consecutive rounds of HIV sentinel surveillance among ANC attendees in Western India. Trends in HIV prevalence were calculated using the Mantel-Haenszel linear-by-linear χ 2 association test, and logistic regression was used to examine the factors associated with HIV positivity. Statistical analysis was done on IBM Corp. Released 2016. IBM SPSS Statistics for Windows, Version 24.0. (Armonk, NY: IBM Corp.).

Results: HIV prevalence for ANC attendees was 0.4% in 2008 which significantly declined to 0.2% in 2021. Women with spouse/partner residing alone in another place/town (odds ratio [OR]: 1.78, 95% confidence interval [CI]: 1.42-2.23), spouse involved in local transport/truck driver/helper (OR: 1.89, 95% CI: 1.54-2.30), and spouse employed in hotel industry (OR: 1.71, 95% CI: 1.41-2.08) were the factors associated with HIV positivity. In the adolescent age group, the second gravida showed a significant increase in HIV prevalence from 0.0% in 2008 to 0.9% in 2021.

Conclusion: The declining trend of HIV prevalence among ANC attendees in Western India highlights the effective program implementation. However, the identified factors associated with HIV positivity provide critical insights for focused preventive interventions.

Background: Prisoners are considered a high-risk group for HIV, and global data suggest a higher HIV prevalence among prisoners. HIV Sentinel Surveillance (HSS) was initiated as a biennial activity among prisoners in India in 2019 to monitor HIV prevalence levels and trends in Indian prisons.

Objectives: The aim is to estimate the prevalence of HIV and syphilis and to assess the associated HIV risk behaviors among prisoners in South India.

Materials and methods: HSS was a cross-sectional study design conducted in 12 central prisons across six southern states with a sample size of 400 for 3 months in 2019. Male prisoners aged 18 years and above were recruited through simple random sampling. Sociodemographic and behavioral data were collected, and HIV and syphilis testing was done.

Results: A total of 4717 prisoners were included, and overall HIV prevalence was 1.1%, with higher prevalence in Telangana (3%) and Andhra Pradesh (1.9%). Marital status ever had sex in their lifetime, and syphilis positivity was significantly associated with higher HIV prevalence. More than 50% of the prisoners were never tested for HIV. About 1% ( n = 45) were injecting drug users, 81.5% had a regular female partner, and only 15% reported condom usage during their last sex.

Conclusion: Higher HIV prevalence than the general population was observed. A significant proportion of the prisoners exhibited HIV risk behaviors and a major gap in availing of HIV testing and treatment services exists. The findings emphasize the urgent need to intensify HIV testing and IEC to facilitate impactful behavioral change communication.

Background: HIV Sentinel Surveillance (HSS) among pregnant women aged 15-49 serves as a key indicator for estimating HIV infection rates in the general population. Primigravida mothers represent the broader female demographic for assessing new HIV infections and determining HIV incidence among the female general population, as HIV transmission is predominantly through heterosexual routes in India.

Objectives: This study aims to estimate the levels and trends of new infections among pregnant women in seven South Indian states and to understand the associated HIV risk factors.

Materials and methods: HSS data from pregnant women attending ANC across seven South Indian states in 2015, 2017, 2019, and 2021 were analyzed. Based on inclusion criteria, a total of 182,066 records were analyzed. Multivariate logistic regression was used to determine the correlation between sociodemographic factors and the occurrence of new HIV cases.

Results: A total of 470 (0.26%) new HIV infections were reported among all primigravida mothers, of which 74% ( n = 346) were aged between 15 and 24 years. Overall, the incidence among young primigravida mothers declined from 0.32% in 2015 to 0.20% in 2021. Age, education, and the occupation of the spouses were associated with the odds of new HIV infections Compared to 2019, the number of new HIV infections increased substantially in 2021 in the states of Andhra Pradesh, Karnataka, and Tamil Nadu, notably in 15-24-year age group.

Conclusions: There is a need to investigate the transmission patterns of new infections in the general population, taking into account the varying trends among different states.