Indian journal of public health最新文献

Background: The first case of measles outbreak in Pune was reported on November 14, 2022; since then, there were a total of 266 cases from Pune Municipal Corporation (PMC).

Objectives: The objective is to find out risk factors associated with measles during an outbreak in Pune city.

Material and methods: This was a 1:1 unmatched case-control study conducted from February 2023 to September 2023 in PMC. Cases were immunoglobulin M-positive laboratory-confirmed measles cases and a control was any child who did not have any rash in the study period and not living in the same household with a case. Face-to-face interview of cases and controls were carried out by visiting houses to obtain information on sociodemographic characteristics and immunization history, including Vitamin A supplementation. The sample size was 200.

Results: There was a statistically significant difference among the mean age of cases (53.18 ± 18.08) and controls (30.08 ± 18.08). Father's and mother's education, immunization, and Vitamin A supplementation were also significant. Those who had not received any dose of measles-rubella (MR) vaccine had a higher chance of having infection with an odds ratio of 3.093 (95% confidence interval [CI]: 2.37-4.037) and those who were partially immunized with 1 dose of MR showed odds ratio of 2.027 (95% CI: 1.328-3.096) for having measles infection. COVID-19 lockdown was the reason given by majority (29.3%) for unimmunized of the measles vaccine.

Conclusions: In this study, the main cause of this measles outbreak was under immunization. It is important to maintain high levels of under 5 immunization even during emergencies to prevent future measles outbreaks.

Background: Cancer patients experience deterioration in their functional status and it is regarded as an important cancer patient outcome metric.

Objectives: (1) To assess the functional status of cancer patients of West Tripura District using the Eastern Cooperative Oncology Group (ECOG) Scale. (2) To study the sociodemographic factors associated with functional status of cancer patients. (3) To study the disease-related factors associated with functional status of cancer patients.

Materials and methods: This was a community-based cross-sectional study conducted among 180 randomly selected cancer patients (≥18 years of age) in West Tripura District. The functional status was assessed using ECOG performance status scale.

Results: The study highlighted that majority of the participants were in the age group of 55-64 years (40.0%), had squamous cell carcinoma (59.40%), and TNM Stage II of cancer (34%). Bivariate analysis showed that age, religion, caste, body mass index, blood pressure, site of cancer, pathological type of cancer, and TNM staging were significantly associated with functional status of cancer patients ( P < 0.05). Multiple logistic regression showed factors such as religion, caste, site of cancer, pathological type of cancer, and TNM staging of cancer patients significantly affected the functional status in cancer patients ( P < 0.05).

Conclusion: The current study highlighted that majority of the cancer patients had poor functional status with site, type, and TNM staging of the cancer significantly affecting the functional status. Hence, targeted interventions with palliative care should be more focused on certain types and advanced stages of the disease to enhance functional performance and health outcomes.

Background: Brucellosis, a zoonotic disease, is responsible for multitude of health issues and economic burden in community and is widely studied in high-risk population. The prevalence of disease or exposure to the organism causing brucellosis in a specific community has not been studied widely.

Objectives: This study was conducted to measure community-based seroprevalence of human brucellosis in livestock-rearing villages in three districts of central Gujarat.

Materials and methods: We collected a total of 2561 blood samples of individuals from households of 93 villages. Multistage random sampling techniques were used for sample collection during the study period of 2021-2023. Serum samples were tested for immunoglobulin (Ig) G and IgM by the Novatech enzyme-linked immunosorbent assay Brucella kit.

Results: District-wise seropositivity ranged from 18.35% to 26.81%, and overall, 579 (22.60%) samples were found to be positive for IgG, IgM, or both antibodies to Brucella spp .

Conclusion: The seroprevalence of human brucellosis is high in the community of livestock-rearing villages and requires to be studied in more detail.

Background: Obesity and chronic inflammation increase metabolic disease risk.

Objectives: This study investigated associations between inflammation, body composition, and dietary patterns in Indian physicians.

Materials and methods: In this cross-sectional study, 550 government doctors aged 25-60 years in Gujarat, India, were recruited through multistage random sampling. Anthropometry, bioelectrical impedance analysis, and food frequency questionnaire data were collected. Dietary Inflammatory Index (DII) scores were calculated.

Results: High obesity prevalence was observed, with 48% classified as obese by body fat percentage (BF%) despite normal body mass index (BMI). Significant positive correlations were found between DII scores and BF% ( r = 0.57, P < 0.001) and BMI ( r = 0.27, P < 0.001). DII scores were negatively correlated with skeletal muscle percent ( r = -0.45, P < 0.001). Higher body fat raised the odds of elevated DII by 1.121 (95% confidence interval [CI] 1.05-1.22, P < 0.001), while higher muscle percent lowered DII odds by 0.910 (95% CI 0.85-0.964, P < 0.001).

Conclusions: Excess adiposity correlated with higher dietary inflammation among Indian physicians, contrasting with lower inflammation linked to greater muscle mass. Evaluating inflammation alongside body composition provides insights beyond BMI alone.

Background: The Ayushman Bharat-Health and Wellness Centers (HWCs) program envisages collective action for health through the formation of facility-level committees- Jan Arogya Samitis (JAS), at the HWCs.

Objectives: The study aimed to appraise the constitution and functioning of the JAS, identify the enablers and barriers in carrying out its functions, and explore the perceived level of decentralization among elected and nonelected community members in Punjab state of India.

Materials and methods: A sequential mixed methods study was conducted in a block of Punjab. The first phase consisted of quantitative assessment of the constitution and functioning of JAS, which was followed by in-depth interviews with the JAS members to understand the enablers and barriers for the functioning of the committee. The final phase comprised interviews with the elected local body representatives and community members to understand their perceived extent of decision space, capacities, and accountability for a series of healthcare functions.

Results: It was noted that JAS performed the functions of leading health promotional activities and enabling quality service delivery. However, the committees played a passive role in supporting village-level committees, monitoring services, and facilitating social accountability, majorly due to awareness gaps. The perceived extent of decision space, capacity, and accountability was found to be low to moderate with significantly higher decision space and accountability reported by elected representatives, in comparison to service recipients.

Conclusion: The study emphasizes the need of consistent support for strengthening local health governance through the structured capacity-building program for all the members of health committees and regular supportive supervision.

Background: Auxiliary nurse midwife (ANM) health workers are pivotal in providing preventive and promotive healthcare services, including vaccinations, disease screening, antenatal checkups, and health education at the primary healthcare level. Their tireless efforts in strengthening primary healthcare and combating recent pandemics are evident.

Objectives: This study aimed to assess the extent, associated factors, and reasons for burnout in a district of West Bengal.

Materials and methods: This mixed methods research (explanatory-sequential approach: Quan-Qual) was conducted from May 2022 to January 2023, involving randomly selected 226 ANMs from 13 rural blocks (cross-sectional design). ANMs with maximum burnout were purposively selected for the qualitative follow-up. A self-administered, modified Copenhagen Burnout Inventory questionnaire captured three domains of burnout. Responses from an open-ended free-listing guide identified reasons for burnout. Adjusted multinomial logistic regression analysis determined factors associated with burnout. Findings were integrated and presented in a joint display.

Results: Out of 214 complete responses, 44.9% reported burnout, over single (20.1%), double (18.7%), and triple (6.1%) domains, namely personal (32.2%), work-related (28.5%), and patient-related (14.9%) burnouts. Chronic morbidity, lack of physical activity, and recent negative incidents were associated with higher burnouts, whereas <5 km home to work-site distance and more support from supervisor were protective factors. Qualitative exploration revealed logistics problems, workload, distance, lack of support, etc., as reasons for burnout. After data triangulation, burnouts were identified with individual, interpersonal, community, and institutional level socioecological attributes.

Conclusion: Almost 45% ANM suffered burnout. Addressing the interrelated factors at different socioecological levels could enhance productivity and job satisfaction, fostering a positive work environment.

Background: Escherichiacoli are the reservoirs of antimicrobial resistance (AMR) genes. Shiga toxin-producing E. coli of animal origin can cause severe life-threatening infections in man.

Objectives: The present study investigated the susceptibility of poultry-origin E. coli isolates to Clinical and Laboratory Standard Institute (CLSI)-recommended antibiotics and their Shiga toxin profiles.

Materials and methods: A total of 141 samples comprising cloacal swabs and water and litter samples were investigated. Antimicrobial susceptibility profiles of the recovered isolates were determined for 15 antibiotics as recommended by CLSI. Shiga toxin-encoding genes (Shiga toxin 1 [ stx1 ] and Shiga toxin 2 [ stx2 ]) and plasmid-mediated AMR determinants were ascertained by the polymerase chain reaction.

Results: E. coli isolation rates were 90.1% with a higher incidence in organized (93.8%) compared to backyard rearing systems (87%). AMR (21.3%) was limited to only three antibiotic classes, i.e., penicillins (9.4%), fluoroquinolones (11.0%), and phenicols (0.8%). All the isolates were susceptible to aminoglycosides, carbapenems, monobactams, and polymyxins with the absence of multidrug resistance. The incidence of resistant E. coli was significantly higher in organized rearing systems (30.0%) compared to backyard units (13.4%). All penicillin-resistant isolates were positive for bla SHV and two isolates co-expressed bla OXA-1 with bla SHV . 21.4% of fluoroquinolone-resistant isolates were positive for plasmid-mediated aac(6')-Ib resistance. 96.3% of resistant isolates carried isolates stx2 and none had stx1 .

Conclusion: Low AMR incidence was recorded in E. coli isolates of poultry origin for CLSI-recommended old and newer classes of antibiotics. Higher levels of stx2 detections in antimicrobial-resistant E. coli isolates pose a significant public health threat.

Background: Gestational diabetes mellitus (GDM) is defined as "Any degree of glucose intolerance with onset or first detection during pregnancy." Counseling motivates to follow the lifestyle modifications, especially related to dietary changes and physical activity.

Objective: To determine the effect of dietary and physical activity counselling on blood glucose level.

Materials and methods: One hundred and eighty-eight pregnant women diagnosed with GDM were divided into two groups. Women in Group 1 received an individualized diet plan and one-to-one counseling regarding the diet and physical activity and reminder phone calls, while women in Group 2 received usual antenatal care with a diet plan for management of GDM and no reminder phone calls were done.

Results: The pregnant women with GDM in the two groups were not significantly different in terms of sociodemographic variables such as age, religion, education, socioeconomic status, occupation, type of family, and family history of diabetes mellitus.

Conclusion: The study concluded that counseling women about GDM and individualized diet plan helps women with GDM to achieve glycemic control.