Indian journal of public health最新文献

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.

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.

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.