Indian Journal of Community Medicine最新文献

Millets are a group of small, drought-resistant grains that have been grown for more than thousands of years. They are highly nutritious, rich in essential vitamins and minerals, and have gained attention in recent years due to their potential to address global food security and environmental challenges. This review article provides an overview of millets, their nutritional benefits, environmental advantages, and their role in promoting sustainable agriculture and processing of millets. The article also discusses the various types of millets, their cultivation, and their potential to improve human health and combat malnutrition.

Introduction: The study aimed to examine anemia prevalence and risk factors in employed women at a medical center compared to unemployed women from a charity center, with anemia defined as hemoglobin <120 g/L and iron deficiency as serum ferritin <30 ng/mL or serum iron <10 mcg/dL.

Material and methods: This cross-sectional study included 651 employed, non-pregnant randomly selected women aged 20-67 years. Participants completed questionnaires on sociodemographic, nutritional, and obstetrical characteristics. Blood indicators such as hemoglobin, serum ferritin, iron, and TIBC were measured.

Results: Out of 651 participants, 395 (60.7%) had anemia/IDA (Hb <120 g/L, ferritin <30 ng/mL, or iron <10mcg/dL), comprising 308 (47.3%) having IDA and 215 (33%) having anemia. Younger age (<40 years) and menorrhagia were individually associated with 1.84- and 2.79- times increased risk of developing anemia in the studied population, respectively. A higher number of shifts and lack of vegetable consumption were found to be significantly prevalent in the anemic group. The prevalence of anemia/IDA among hospital staff and referred women was 60.7% and 43.1%, respectively.

Conclusions: The study emphasized the influence of employment on the prevalence of anemia/IDA among hospital staff compared to unemployed women.

Background: Antiretroviral therapy (ART) has transformed the life of PLHIV with a longer life expectancy. The rising coexistence of non-communicable diseases (NCD)s especially type 2 diabetes mellitus (DM) and hypertension (HTN) among PLHIV (people living with HIV) is much more complicated and demanding for the health system, patients, and their families. To document the current status of type 2 DM and HTN among known diabetic/hypertensive PLHIV attending ART center, tertiary care hospital of South Gujarat.

Materials and methods: A mixed method study (cross-sectional survey followed by qualitative in-depth interview) was conducted among 184 PLHIV on ART with history of Type 2 DM and/or Hypertension who were registered and availing services from ART center, tertiary care hospital. Convenient sampling technique was used. All the participants were interviewed using pre-designed, semi-structured questionnaire, during their routine visits. In -depth interview (IDI) has been conducted to explore the delivery of NCD services at ART Centre.

Results: Out of 184 PLHIV on ART, the most common co-morbidities were Type 2 DM (46.2%), HTN (39.13%), and 14.67% had both. Among total 184 participants, 64.1% were males and 35.9% were females. Only 22.3% of participants were availing treatment services for the above at tertiary care hospital. The study results showed a range of findings involving ART adherence, BMI, RBS, and BP measurements were included. IDI results described the NCD service delivery at ART Center.

Conclusions: Study results suggest that the services received by PLHIV with NCD require an overhauling. Routine monitoring and strengthening of existing services should be focused to upgrade the quality and continuum of the care provided to PLHIV with NCD.

Background: Chronic respiratory diseases are becoming a more prominent cause of morbidity and mortality worldwide. Street sweepers are commonly found in low- and middle-income countries. This job involves outdoor work that exposes workers to various health hazards and air pollution, particularly affecting respiratory health. There is still limited research focusing specifically on street sweepers. The study aims to examine the prevalence of chronic respiratory symptoms and the associated factors in street sweepers in Bangkok, Thailand.

Materials and methods: We undertook a cross-sectional survey between February and April 2023. A multi-stage sampling technique was employed, stratifying the sample according to district locations within Bangkok, Thailand. Data were collected through a questionnaire assessing demographic characteristics, occupational and environmental factors, and respiratory symptoms using a modified version of the Medical Research Council questionnaire. Data analysis included bivariate analysis and multiple logistic regression.

Results: The response rate was 98.0% (n = 341). The prevalence of chronic respiratory symptoms among street sweepers in Bangkok, Thailand, with at least one respiratory symptom was reported by 33.7% of the participants, specifically cough (22%), phlegm (20.2%), dyspnea (17.6%), and wheeze (7.0%). The average age of the sample group was 43.2 years, with a majority being female (85.9%). Among the participants, 88.3% were non-smokers, while 37.2% reported exposure to secondhand smoke. All participants reported the use of respiratory protective equipment, with face masks used at 78.9%. 7.3% of the participants lived near sources of pollution, and 12.0% were involved in household pollution activities. An average annual air quality index in the workplace area was categorized as 'good' at 57.8%. Multiple logistic regression analysis revealed significant associations of chronic respiratory symptoms with the following factors: exposure to secondhand smoke [odds ratio (OR) =2.3, 95% confidence interval (CI) 1.3-4.2] and household activities (OR = 3.0, 95% CI 1.3-6.6).

Conclusion: Exposure to secondhand smoke and indoor air pollutants in household environments are significant factors associated with the symptoms. Raising awareness about secondhand smoke hazards in household and environmental settings and promoting self-care practices related to various activities with potential exposure to indoor air pollution is crucial.

Background: Vitamin B₁₂ deficiency is widely prevalent in all age groups which is of major concern. However, there is no valid Food Frequency Questionnaire (FFQ) for dietary vitamin B₁₂ estimation. Hence, we aimed to develop and validate an FFQ for the estimation of dietary intake of Vitamin B₁₂.

Materials and methods: Commonly consumed B₁₂-rich food items were selected from literature and filtered using a market survey. For concordant and discriminant validation, B₁₂ and homocysteine levels were estimated. To establish convergent validity, the Cobalamin Intake in North Indians by Food Frequency Questionnaire (COIN-FFQ) and 72-hour dietary recall (72HrDR) were both administered to the same subjects. The COIN-FFQ was readministered after initial administration for test-retest reliability. Internal consistency of the FFQ was then tested using Cronbach's alpha.

Results: We enrolled 115 adults with a mean age and weight of 31.9 ± 8.7 years and 66.0 ± 11.8 kg, respectively. In total, 19.1% were vegetarian. The dietary B₁₂ using COIN-FFQ (n = 60; mean = 4.3 ± 1.8 µg/d) was significantly correlated (r = 0.255; P = 0.049) with serum levels (mean = 120.1 ± 62.6 pmol/L) establishing concordant validity. A significant difference was noted between the dietary, serum B₁₂, and homocysteine levels of vegetarians versus nonvegetarians establishing discriminant validity (mean diff 1.4 (0.5-2.4), P = 0.004; Z-statistic -2.182, P value 0.029, and Z-statistic -2.438; P value 0.015), respectively. FFQ was strongly correlated with 72HrDR and test-retest FFQ (n = 27; r = 0.814, P < 0.001 and r = 0.869, P < 0.001, respectively) establishing convergent validity and test-retest reliability. The internal consistency with Cronbach's alpha was in the acceptable range, 0.631 (n = 115).

Conclusion: The newly developed COIN-FFQ is valid and reliable in estimating dietary B₁₂ intake.

Background: In India, current maternal mortality ratio is 97/100,000 livebirths, and still more efforts are needed to achieve Sustainable Development Goal 3, target 1 of 70/100,000 livebirths. Women die because of complications during and following pregnancy and childbirth. Skilled care during and immediately after delivery has been identified as one of the key strategies in reducing maternal mortality. Birth preparedness and complication readiness (BPCR) has been implemented as a comprehensive strategy to fill this gap. BPCR is one of the key interventions to reduce the maternal mortality.

Materials and methods: This was a community-based before and after interventional study (quasi-experimental study) and was conducted in two randomly selected primary health centers of South West district of Delhi.

Results: A total of 152 community health workers (CHWs) took part in the study. About one fourth (22.03%) had knowledge regarding water breakage without labor, which increased to 85.53% after training and was statistically significant (P < 0.0001). Mean knowledge score preintervention was 4.35 (1.82), whereas the postintervention mean knowledge score was 8.98 (0.99) and was statistically significant (P < 0.0001).

Conclusion: Though awareness of CHWs on some aspects of the BPCR components was good before the training program, marked improvement was seen in most of the domains after the training session.

Background: India is a vast and diverse country with existing variations in the frequency and distribution of cancers across its various parts. In regions lacking population-based cancer registries (PBCRs) in a vast country like India, hospital-based cancer registry (HBCR) data become an important source of information on the trends and patterns of a region. To determine the numerical trends of cases of the top ten cancer sites reporting to HBCR of a tertiary care cancer center in Bihar from 2014 to 2021.

Materials and methods: The details of all histopathologically confirmed cancer cases registered in the HBCR department of radiation oncology, State Cancer Institute, Indira Gandhi Institute of Medical Sciences, Patna, India between January 2014 and December 2021 were included in this retrospective observational study. All these cases were grouped site-wise and listed in descending order of the total number of cases reported in each group. Cross-tabulation with age and sex distribution was done. The frequency distribution of the top ten leading cancers for every consecutive calendar year was plotted in line diagrams for time trend analysis. Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp.). was used for analysis. Annual percent change (APC) was determined for the number of cases of all ten cancer sites using joinpoint regression analysis (Joinpoint Regression Software, Version 4.0.4-May 2013; Statistical Methodology and Applications Branch, Surveillance Research Program of the US National Cancer Institute; Bethesda, MD, USA).

Results: Out of 32,057 total cancer cases registered between Jan 2014 and Dec 2021, 21,848 patients (68.2%) cases constituted the top ten cancers. The top ten cancers among both sexes were cancer gallbladder (n = 4204, 13.1%), head and neck (n = 3395, 10.6%), breast (n = 3392, 10.6%), lung (n = 2069, 6.5%), cervix (n = 2039, 6.4%), hematolymphoid (n = 1930, 6.0%), liver (n = 1572, 4.9%), stomach (n = 1116, 3.5%), ovary (n = 1103, 3.4%), and colon-rectum (n = 1028, 3.2%). Except for cervical and hematolymphoid cancers, the rest all showed a rising trend over consecutive years.

Conclusion: Cancer of the gallbladder continues to be among the most common cancers in the region. Focused research in all aspects of this deadly disease is needed. Strengthening of prevention and screening programs for common cancers and upliftment of the existing infrastructure for diagnosis and treatment of cancer in the region are necessitated.

Background: Soil-transmitted helminth infections (STHs) in pregnancy have been linked to maternal anemia, low birth weight, and adverse perinatal outcomes. STH includes Ascaris lumbricoides, hookworm, and Trichuris trichiura. However, conflicting evidence exists regarding these effects. Hence, we aimed to assess the association of STH infections with perinatal outcomes.

Methods and materials: A community-based cohort study was conducted among pregnant women in primary care settings in Puducherry, South India, during December 2019 to April 2021. Stool samples were collected for STH screening and confirmed using polymerase chain reaction. Information on perinatal outcomes and hemoglobin levels were extracted from case records. The association of pre-term birth, low birth weight, anemia, and miscarriages with STH infection was analyzed using the Chi-square test.

Results: Among the 650 women enrolled, 58 (8.9%) had one of the STH infections. At the time of recruitment, 336 (52.0%) women had anemia. Twenty-four women (3.7%) had miscarriages, 14 (2.2%) had pre-term birth, and 65 (10.4%) had low-birth-weight (LBW) babies. All 14 pre-term babies had LBW, and out of 65 LBW, 40 were in mothers with anemia. Incidence of LBW, pre-term deliveries, and anemia were higher in women with STH than in those without STH (LBW: 12.3% vs 10.2%, P = 0.62; pre-term: 3.5% vs 2.1%, P = 0.5; and anemia: 54.4% vs 51.85, P = 0.7).

Conclusion: Though the incidence of anemia, LBW, and pre-term delivery was higher in women with STH infections compared to those without STH, we did not find any significant association between the presence of STH infections and perinatal outcomes.