Indian journal of public health最新文献

Background: Sexually transmitted infections (STIs) pose a global public health threat, with over 30 pathogens known to spread sexually. In 2020, the World Health Organization reported 374 million new cases, with varied prevalence in India, especially among at-risk groups.

Objectives: The objective of the study was to assess the prevalence of syphilis, chlamydia, and gonorrhea among the general population and blood donors in Madhya Pradesh.

Materials and methods: Study findings adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two reviewers independently searched databases-PubMed, Scopus, Google Scholar, and ShodhGanga-along with manually checking references of included articles and systematic reviews. A standardized checklist guided data extraction. The risk of bias was assessed using the appraisal tool for cross-sectional studies tool for cross-sectional studies. Quantitative results were presented in a Forest plot via MetaXL software, using a random-effects meta-analysis model to estimate the pooled prevalence of syphilis among the general population and blood donors in Madhya Pradesh.

Results: A review was conducted on 2943 articles to assess their eligibility. Seventeen studies met the inclusion criteria. The pooled prevalence of syphilis in seven studies involving the general population was found to be 0.4%, with a 95% confidence interval (CI) ranging from 0.1% to 0.7%. Studies on blood donors have a combined prevalence of 0.32% (95% CI, 0.25%-0.39%, n = 8 studies) in Madhya Pradesh.

Conclusion: This review highlights STIs as an ongoing public health issue in Madhya Pradesh and underscores the need for surveillance to detect emerging patterns and address specific STIs effectively.

Background: Sexually transmitted infections (STIs) are a major global public health concern and are linked with human immunodeficiency virus in many ways. There is little evidence of the pooled prevalence of STIs across both states (Andhra Pradesh and Odisha).

Objectives: Hence, we aim to estimate the prevalence of STIs in Andhra Pradesh and Odisha.

Materials and methods: The protocol was registered in PROSPERO. A comprehensive search was done in PubMed, EBSCO, Cochrane Library, and Google Scholar. Studies were selected based on inclusion and exclusion criteria. Quality appraisal was done using the Joanna Briggs Institute tool. We used a standardized data extraction form to collect information from eligible studies. We did a random-effects meta-analysis to obtain the pooled prevalence of STI in Andhra Pradesh and Odisha. We stratified meta-analyses by states, microorganisms, and study setting.

Results: We identified 1152 studies, of which 23 studies were included in the systematic review and 22 studies were included for meta-analysis. The pooled prevalence of Syphilis in Andhra Pradesh and Odisha was 0.01 (95% confidence interval [CI] 0.01-0.02) and 0.00 (95% CI 0.00-0.00), respectively. The pooled prevalence of Chlamydia and N. Gonorrhea in Andhra Pradesh among the general population was 0.01 (95% CI 0.00-0.03) and 0.05 (95% CI 0.01-0.24), respectively. The prevalence of Syphilis and Chlamydia among high-risk group populations in Andhra Pradesh was high in comparison with the general population.

Conclusion: Understanding the prevalence of STIs in Andhra Pradesh and Odisha among the general population and high-risk group populations will strengthen the epidemiological data tracking and help in the effective management and control of STIs.

Background: Obesity is associated with cognitive impairments that hinder effective adherence to treatment protocols, exacerbating the condition's complexity and management challenges. Addressing these cognitive deficits through targeted interventions is crucial for improving treatment outcomes and sustainable weight management.

Objectives: The study aims to develop and validate a cognitive retraining module to address these deficits and improve treatment adherence.

Materials and methods: The study was carried out at the Department of Medicine in a Tertiary Care Hospital in North India. The developmental phase comprised four sequential steps as outlined by Fraser and Glinsky: (a) conducting a needs analysis, (b) creating program materials, (c) validating and enhancing program components through effectiveness tests, and (d) disseminating the developed module. The study involved 22 participants, including 12 experts from diverse fields such as psychology, medicine, psychiatry, and human nutrition, and 10 individuals with obesity having significant cognitive deficits. The validation process consisted of two steps: (i) assessing the content validity of the session-wise module with subject matter experts and (ii) conducting pilot testing to evaluate acceptability and feasibility among the targeted population.

Results: The module consists of six sessions, targeting seven cognitive domains: (i) abstraction, (ii) visuospatial, (iii) working memory, (iv) attention, (v) language, (vi) delayed recall, and (vii) executive functioning. Each session lasts for around 40-45 min.

Conclusion: The module is a standardized, feasible, and effective intervention for treating cognitive deficits among obese patients. This research introduces a 6-session cognitive retraining module addressing various cognitive domains to enhance weight management among obese adults.

Summary: The wastewater surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may provide information on the potential transmission of COVID-19 infection when mass clinical testing declines. In the present study, a total of 1110 wastewater samples were collected from Hisar, Haryana (India), from August 2022 to June 2023. The SARS-CoV-2 detection in the wastewater correlated with clinical cases of COVID-19 in Hisar, suggesting that wastewater-based epidemiology can potentially complement classical testing of COVID-19 and may serve as an early warning system to prevent potential disease transmission and consequential outbreaks.

Summary: Human papillomavirus (HPV) appears to play an important role in the development of penile cancer. Research indicates geographical variations in HPV prevalence in penile cancer. Identifying the specific HPV genotypes involved in penile cancer is crucial for the development of targeted screening and vaccination initiatives. Hence, this study was conducted to determine the prevalence of HPV genotypes in penile carcinoma and to correlate that with certain histopathological, clinical, and radiological parameters. Biopsy samples from 27 penile carcinoma cases were subjected to real-time multiplex polymerase chain reaction. HPV prevalence was 74.1%, with multiple subtypes detected in 75% of patients. HPV 16 was the predominant genotype (75%). Other genotypes were detected as coinfection. This study revealed a high burden of HPV in penile carcinoma in Assam, with exposure to multiple sexual partners as a significant risk factor. Vaccination against High-risk-HPV should be given importance to reduce the overall burden of HPV-related malignancies.

Summary: The global impact of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has raised concerns regarding the potential risk of respiratory viruses in children. Although respiratory syncytial virus (RSV) and SARS-CoV-2 exhibit similar clinical manifestations, the detection of RSV has decreased. Therefore, we aimed to evaluate the role of RSV in pediatric cases that tested negative for SARS-CoV-2. A total of 106 cases, aged 4 days-18 years, from October 1, 2021, to March 31, 2022, were tested for RSV-A using polymerase chain reaction (PCR). Samples were tested for RSV-A using conventional PCR. RSV-A was detected in 34% of cases with the highest prevalence (25.5%) in school-going children aged 6-12 years. This reinforces the significance of RSV-A as a prevalent viral pathogen among young children. These results highlight the importance of preventive measures and/or efficient antiviral medication to lower the illness load in young infants.

Background: Tuberculosis (TB) is one of the major causes of mortality among children globally. Considering the vulnerability of children, India's National TB Elimination Program (NTEP) recommends screening of all household contacts aged <6 years for TB and initiates 6-month isoniazid preventive therapy (IPT).

Objectives: The objective of the study was to assess the child contact management (CCM) in terms of screening and initiation of IPT under NTEP.

Materials and methods: This record-based study has included 192 child contacts and 108 pulmonary TB cases registered from January 2019 to December 2020 from two randomly selected TB units, one each from rural and urban area. The data were obtained from TB treatment registers and TB treatment cards from the district TB office.

Results: Most of the children were in the age group of 2-4 years, belonging to rural area and below poverty line families. Although screening of the child contacts was good (97.9%), IPT was initiated in only 49.4% of the screened children. Initiation of IPT was found to be low among males, relatively younger children, and rural population. Lower rates of initiation of IPT were also noted among the children with male index cases, those who are aged ≥45 years, and also among households with more than one child contact. Poor initiation rates were found among the children for whom the index cases presented with any of the comorbidity and addiction.

Conclusion: CCM under NTEP is repeatedly emphasized for decades together. Although the percentage of screening was good (97.9%), the initiation of IPT was found, nearly only half of the children which emphasizes the need for the effective strategies and tools to improve the same under the program.

Background: High-performance liquid chromatography (HPLC) using whole blood (WB) samples is considered gold standard for screening and diagnosis of sickle cell, beta-thalassemia, and other hemoglobinopathies. Collection of WB and temperature-controlled logistics to a laboratory limits the use of HPLC in population screening hemoglobinopathies, especially in remote, tribal regions, having limited resources for venous blood sample collection and transport.

Objectives: Use of dried blood spot (DBS) sample for HPLC analysis (DBS-HPLC), as an alternative to WB can ease the process of sample collection, decrease the time and resources utilized, and save substantial time and cost on the hemoglobinopathy screening program operations for all age groups.

Materials and methods: We compared the results from HPLC analysis of hemoglobin (Hb) variants on DBS (DBS-HPLC) stored and transported at ambient temperatures to laboratory at 3, 5, 11, and 24 days post collection, to results from fresh WB analyzed on the same day by HPLC.

Results: The results showed accurate identification and quantitation of fetal hemoglobin, HbA, HbS, HbA2, HbE, and HbD by DBS-HPLC even after 3 weeks of storage and transport at ambient temperature, with accurate interpretation of all major hemoglobinopathies, i.e., homozygous, and heterozygous cases of sickle cell, beta-thalassemia, HbE, HbD, and compound heterozygous cases of these variants, when compared to the conventional WB HPLC results.

Conclusion: DBS sample collection combined with HPLC analysis offers a cost-effective, operationally efficient, and accurate method for unified, integrated, and comprehensive population screening test for hemoglobinopathies in resource poor, remote and geographically vast regions in India.

Summary: The One Health Poultry Hub conducted multiple work packages on poultry intensification and risk, including a study on Campylobacter and nontyphoidal Salmonella infections among retail chicken shop workers in India. Here, we highlight the experience of administering questionnaires and collecting stool and blood samples from these workers and chickens in multiple cities in Tamil Nadu state. The significant challenges noted were as follows: (i) selecting and locating shops, (ii) obtaining consent and collecting samples, and (iii) timely transport of samples to the laboratory. Similar challenges may be faced in One Health studies in poultry and other animal health sectors in low-resource settings.