Indian journal of public health最新文献

Background: Injection drug use is a global issue with almost one-fifth of them being human immunodeficiency virus (HIV) positive.

Objectives: The present study is aimed at finding out the burden of HIV infection and associated factors among injecting drug users (IDUs) between 18 and 25 years of age of Tripura and to compare with the registered prevalence of infection among them.

Materials and methods: A cross-sectional study was conducted among 80 young IDUs in West and Dhalai district of Tripura. Respondent driven sampling was done identifying hotspots with the help of targeted intervention-NGOs, to interview the respondents.

Results: Most of the respondents were male (92.5% and 85% respectively from West and Dhalai district) and between 22 and 23 years age. The self-reported seroprevalence of HIV among IDUs was 53.8% (in comparison to 38% among Tripura State AIDS Control Society (TSACS) registered seroprevalence) in West district and 57.9% (in comparison to 50.6%) in Dhalai district. Most of them (81% and 91%, respectively) are currently on antiretroviral therapy and socioeconomic status of IDUs from Dhalai district was found to be significant predictor of HIV infection among them.

Conclusion: Self-reported prevalence of HIV among IDUs in both the study districts was higher than TSACS reported HIV prevalence among IDUs in the same districts. Socioeconomic status was a significant predictor of HIV infection among the IDUs with scope for improvement among practice related to regular use of condoms during sexual intercourse.

Background: The state of maternal nutrition, denoted by the maternal anthropometric parameters (MAPs), plays a pivotal role in determining the birth outcomes.

Objectives: This study was conducted to determine whether MAPs could predict selected birth outcomes.

Materials and methods: A cross-sectional study was conducted among randomly selected 333 pregnant mothers admitted for delivery after 28 weeks of period of amenorrhea at a tertiary care maternity hospital in Sri Lanka. Pregnant mothers who were having multiple pregnancies, awaiting elective cesarean section due to past section, registered for booking visits after 12 weeks of gestation, and had pre-existing disease conditions that might affect anthropometric parameters were excluded from the sample. Information on MAPs and birth outcomes were extracted from medical records. Data were analysed using ordinal logistic regression.

Results: Mean ± standard deviation of pre-pregnancy weight (PPW), maternal height (MH), pregnancy weight gain (PWG), and pre-pregnancy body mass index (BMI) were 55.1 ± 12.8 kg, 154.7 ± 5.7 cm, 9.6 ± 4.1 kg, and 22.9 ± 4.9 kg/m 2 , respectively. Nearly half of the mothers had unsatisfactory prepregnancy BMI, while 68.5% of mothers had unsatisfactory PWG. Low birth weight was reported in 24.6%, while 18.3% and 12.1% had prematurity and APGAR scores less than nine at birth, respectively. Higher PPW and PWG predicted better birth weight. Satisfactory PWG was predictive of maturity at birth. Both a satisfactory PPW and MH emerged as predictors of a good APGAR score at birth.

Conclusions: PPW, PWG, and MH can significantly predict selected birth outcomes in singleton pregnancies. These predictions will be useful for the provision of better perinatal care through early identification of high-risk newborns.

Background: Private practitioners play a key role in addressing the healthcare needs of a large proportion of the Indian population. While several studies have explored drug prescribing practices in India, a gap exists in understanding the drug prescribing patterns of private practitioners.

Objectives: This study described the drug prescribing patterns of private practitioners using World Health Organization (WHO) prescribing indicators, with a focus on estimating the proportion of antibiotics prescribed based on AWaRe (ACCESS, WATCH, and RESERVE) classification.

Materials and methods: The study used a cross-sectional descriptive design. The prescriptions of private practitioners were collected from customers at 20 pharmacies in Puducherry, South India from September to November 2023.

Results: A total of 600 prescriptions were included in the analysis. About one-third (33.7%) of prescriptions collected were for individuals aged 31-45 years, whereas least (6.3%) were for those <18 years. The antibiotic prescription rate was 38.8%, exceeding WHO standards (20%-26.8%), with 61.4% falling in the WATCH category, below the WHO target of ≥60% ACCESS category. Polypharmacy was observed, averaging 3.6 drugs per prescription, exceeding the WHO standards (1.6-1.8 drugs). Generic name prescription was only 0.2%, deviating from the WHO's 100% standard. Injections were prescribed in only 3.5% of prescriptions, below the WHO standards (13.4%-24.1%). Furthermore, only 52.8% of prescribed drugs were on the National Essential Medicine List (NEML) of India, 2022, below the WHO's 100% NEML prescription standards.

Conclusion: This study has highlighted the practice of polypharmacy, higher preference for branded drugs and antibiotics, and a lesser utilization of NEML-listed medications by the private practitioners in Puducherry.

Background: The incidence of mortality and cumulative risk of developing cancer has been consistently high in the northeastern Region of India. Cancer is among the leading causes of death in Mizoram.

Objectives: This survey is an approach to implement a baseline monitoring system to drive us in understanding the linkage between exposures to risk factors, other noncommunicable diseases, and cancer incidence.

Materials and methods: A cross-sectional study was conducted among 2880 households from 60 primary sampling units who were selected using a multistage cluster sampling technique. The data were collected using household level interview, adult interview, cancer patient interview, and health facility interview.

Results: Nearly half of the respondents had a clustering of >3 cancer risk factors. The prevalence of current tobacco use (smoked or smokeless) was as high as 77.1%. Over 80% of the respondents consumed fermented products. Nearly half of the respondents were prehypertensive. 35.9% of the respondents were overweight. Nearly 41.3% of the respondents had central obesity. Around 42.8% of the respondents were aware of cancer screening. Less than 25% of the surveyed primary health cares provided cancer screening services.

Conclusion: The high prevalence of cancer risk factors underscores the urgent need for comprehensive and sustained efforts toward prevention, education, and intervention. The challenges posed by a poor health system for cancer prevention are grave and demand urgent attention from all stakeholders involved in health-care delivery.

Background: Government of Himachal Pradesh imposed smoke ban in 2009 with convincing decline in smoking prevalence among young adults. Thereafter, government wanted to assess the impact of smoke ban considering its effective implementation.

Objectives: The objectives of this study were to assess reduction in acute myocardial infraction (AMI) and stroke hospital admissions in two districts (Shimla and Kangra) of Himachal Pradesh after smoke ban on July 1, 2009.

Materials and methods: A secondary data-based retrospective study using Poisson regression-based interrupted time series (ITS) modeling was carried out from January 2007 to December 2011. Monthly AMI and stroke hospital admission data were collected from January 2007 to December 2011 from two tertiary care hospitals. In district Kangra, admission data for study period 2007 (January to November) were not available, so ITS analysis was done from 2008 to 2011 for the said district. Risk ratio was calculated as exp (regression estimate) with a 95.0% confidence interval (CI) to assess effect.

Results: In both districts, smoke ban showed no effect (Shimla: 1.03; 95% CI: 0.85-1.25, Kangra: 0.97; 95% CI: 0.74-1.28) in terms of AMI admissions, even across gender and age groups. In Kangra district, smoke ban showed a protective effect on stroke admissions but with wide confidence intervals (0.21; 95% CI: 0.07-0.59). However, in Shimla district, it showed significant positive effect on an increase in stroke admissions (1.06; 95.0% CI: 1.03-1.75).

Conclusions: Smoke ban showed no impact on AMI and stroke monthly hospital admissions in both districts, except in Kangra for stroke.

Summary: Poor glycemic control is associated with an increased risk of diabetes-related complications, attributable to a wide range of factors. The aim of this study was to determine the prevalence and predictors of poor glycemic control among patients with type 2 diabetes in southern Afghanistan. We conducted a cross-sectional study among diabetes patients randomly recruited from four hospitals in southern Afghanistan during their follow-up visits between August and October 2024. Out of 406 patients, 74.9% (95% confidence interval [CI]: 70.3%-79.1%) had poor glycemic control. Physical inactivity (adjusted odds ratio [AOR] =1.89, 95% CI: 1.04-3.41), irregular monitoring of blood glucose levels (AOR = 8.80, 95% CI: 4.49-17.2), nonadherence to antidiabetic medications (AOR = 2.69, 95% CI: 1.41-5.13), and presence of depression symptoms (AOR = 2.20, 95% CI: 1.25-3.86) were significant predictors of poor glycemic control. The findings highlight an urgent need for targeted health policies and clinical interventions to address the high prevalence of poor glycemic control in Afghanistan.

Background: Persons with substance use disorders (SUDs) who do not recognize their substance use as problematic are less likely to perceive needing treatment and less motivated to seek help. The factors that contribute to cognizance among persons with SUDs are poorly understood. The identification of factors of cognizance and using this to tailor motivational enhancement strategies may be beneficial toward minimum relapse and prolonged drug-free existence.

Objectives: To identify the social and clinical factors which are at play with cognizance of SUD among subjects attending opioid substitution clinic.

Materials and methods: A cross-sectional study of subjects registered more than 3 months who attended opioid substitution therapy were included with a sample size of 62. Pretested questionnaire was used to elicit the information from consenting eligible persons. A translated validated version of Scale of Change Readiness and Treatment Eagerness Scale in Bengali was applied scoring subjects with high or low recognition of SUD.

Results: On regression modeling, predictors which had positive odds of having good cognizance were subjects with family support (adjusted odds ratio [AOR]: 9.4, confidence interval [CI]: 1.77-81.9) and those subjects who were continuing the present spell of therapy for less than a year (AOR 4.03, CI 1.1-19.7). Subjects who were declared clean at least once in their life time had a less chance of being cognizant of their problems. (AOR 0.13 CI 0.03-0.55). Model had an accuracy of 74% and area under the curve as 0.8.

Conclusion: Identifying the factors associated with increased or decreased cognizance can be used while counseling or predicting follow-up treatment for SUD subjects.

Background: In India, oral cancer ranks as the third most common cancer in men and the fourth in women, largely due to the prevalent use of tobacco. Data on oral cancer screening among tobacco users in India are limited.

Objectives: This study aimed to determine the prevalence of oral cancer screening among tobacco users and to identify factors associated with it.

Materials and methods: This study analyzed data from the National Family Health Survey (NFHS-5), using stratified multistage clustering sampling to ensure national representativeness. The data analysis included estimating weighted proportions to account for the cluster sample design.

Results: The NFHS-5 data include information on oral cavity examinations for oral cancer for 97,000 men and 707,119 women. Among these individuals, 41,669 (40.59%) men and 45,568 (6.44%) women were identified as tobacco users. Among tobacco users, screening rates were low, at 1.07% for men and 0.53% for women, with even lower rates among those using smokeless tobacco. Significant differences in screening rates were observed across different tobacco products and demographic groups. Factors such as gender, age, socioeconomic status, education level, and recent healthcare visits significantly influenced screening rates. Screening rates were highest among individuals in Andhra Pradesh, with 6.28% for men and 5.38% for women, showing significant differences in screening outcomes based on attempts to quit tobacco use and visits to healthcare providers.

Conclusion: The study finds low oral cancer screening rates among tobacco users. Efforts should prioritize overcoming barriers to screening and customizing interventions to enhance screening rates in India.