Indian Journal of Community Medicine最新文献

[This retracts the article on p. S96 in vol. 49.].

Rashtriya Bal Swasthya Karyakram (RBSK) was established in 2013 to screen and manage birth defects, deficiencies, diseases, and developmental delays, including disabilities in Indian children, with the assistance of certified mobile health teams and grassroots workers nationwide. This study assessed the prevalence of 2Ds and adolescent health conditions per the RBSK and examined links between biosocial factors and health issues among school-aged children and adolescents in East Singhbhum, Jharkhand. A sample of 210 students, 105 from government and 105 from private schools, was surveyed. Data were collected using a predesigned, semi-structured questionnaire that included biosocial details, the RBSK screening tool for ages 6-18 years, and an adolescent-specific questionnaire. The results of the study showed that the prevalence of diseases and deficiencies was 39.5% and 32.0%, respectively, in school-going children aged 10-18 years. The prevalence of anemia, vitamin-A deficiency, vitamin-D deficiency, goiter, and edema was 28.1%, 3.8%, 2.9%, 3.3%, and 1.4%, respectively in the study population. The prevalence of convulsive disorders, Otitis Media, dental conditions, skin conditions, and asthma was 3.8%, 4.3%, 11.0%, 7.6%, and 5.2%, respectively. In addition, 106 (50.5%) children out of the 210 screened were found to be underweight. Enhanced awareness sessions in the community could contribute to a deeper understanding of these health issues, potentially reducing the prevalence of 2Ds and adolescent health issues and moving toward achieving Sustainable Development Goals (SDGs) faster.

The present study was done to assess influence of Accredited Social Health Activist's (ASHA) knowledge, performance of health centers, satisfaction of other Community Health Workers (CHWs), and beneficiaries on motivation level of ASHAs in rural areas of northern India. In a study district, stratified random sampling was done to select high-performing (HP) and low-performing (LP) health centers. A total of 24 (12: PHCs and 12: SCs), 12 HP and LP each, were selected. From each SC, ASHAs, co-workers, and beneficiaries (pregnant, postnatal, and eligible couple women) were interviewed. The mean level of satisfaction was observed to be high among beneficiaries (71.4 vs. 64.3; P = 0.023) and AWWs (76.1 vs. 65.4; P = 0.003) of HP-PHCs except among MPHW-Fs, where it was high in LP-PHCs for (92.3 vs. 86.9; P = 0.003). Multilevel linear modeling showed that with one unit increase in knowledge, the level of motivation significantly increases by 0.22 (P = 0.03) units, with insignificant effects of HP and LP categorization. It was found that the baseline knowledge is a significant predictor for motivation among ASHAs irrespective of level of performance of PHCs.

Excessive screen time has a significant negative impact on physical activity, growth, and psychological development and leads to a sedentary lifestyle, risk of noncommunicable diseases, and poor dietary behavior among children. This study was conducted to describe the pattern of physical activity, restraint time, sleep time, and screen time among preschool children. This cross-sectional study was conducted among children aged 0-5 years. We recorded a detailed history, including daily average screen time and physical activity, restraint time, sleep time, and anthropometric measurements. These measurements were compared with the World Health Organization recommendation for the respective age groups. Statistical data was analyzed using Chi-square test and Student's "t" test. A total of 102 children (9 infants, 47 toddlers, and 46 preschool children) with a mean age of 34.3 (standard deviation [SD] 15.9) months participated in the study. Overall physical activity, restraint time, and sleep were inadequate in 12.7%, 5.9%, and 18.6%, respectively. Excess screen time was seen in 57.8% of children, with 55.5% infants, 59.5% toddlers, and 56.5% preschool children. There was a significant change in screen time with junk food consumption (P = 0.03) and daily caloric intake (P = 0.04), but there was no change in the screen time relation with anthropometric variables. To conclude inadequate physical activity and excessive screen time are prevalent among infants, toddlers, and preschool children from Northeast India. The study's findings provide insight into the importance of balancing screen time and physical activity to ensure the well-being and development of young children.

Background: The Test and Treat Policy (2017) of antiretroviral therapy (ART) was launched in India to achieve treatment goals more effectively than previous strategies. The study aimed to establish association of sociodemographic and clinical characteristics with immunological response to ART among patients living with HIV/AIDS (PLHIV) initiated on ART under the Test and Treat policy.

Material and methods: It was a longitudinal study conducted in a tertiary care hospital of South Gujarat, India, where data were collected from 318 PLHIV newly initiated on ART in 2018-19 regarding baseline and subsequent clinical (CD4 count, adherence, opportunistic infections, side effects) profiles. Association of these variables with CD4 count changes overtime was examined using repeated measures correlation and mixed models analysis.

Results: Participants (63.2%) had a baseline CD4 count of less than 350 cells/cu.mm. Repeated measures correlation with adherence and rise in CD4 was significant in participants with baseline CD4 of 301-500 cells/cu.mm (ρ = 0.280, P = 0.005) and those with above 500 cells/cu.mm (ρ =0.224, P = 0.03). The mixed model consisting of time, category of baseline CD4, and gender was the best fitting model. CD4 increased by an average of 48 cells/mm3 (95% CI: 27-70 cell/cu.mm, P = 0.00) between 6 and 18 months of ART. Baseline CD4 was a predictor in determining rise in CD4.

Conclusion: Lower baseline CD4 was not associated with significant rise despite early ART initiation. Significantly higher CD4 rise was seen in females. The majority of PLHIV were symptomatic with low baseline CD4. This opens the avenue for strengthening HIV/STI testing services for early detection and bidirectional screening.

Background: India accounts for more than one fifth of all maternal deaths from causes related to pregnancy and child birth worldwide. Information about reasons for delivering at home is important for health planning to design appropriate maternity services. The present study aimed to find out various reasons for home delivery among mothers in Gujarat.

Materials and methods: A community-based, cross-sectional study was conducted in rural and urban areas of Vadodara district during April 2017 to July 2017. Mothers delivered at home were interviewed by using semistructured questionnaires through house-to-house visits. Self-reported reasons for home deliveries by mothers were found out. The study findings were presented using descriptive statistics, and association was found with Chi-square test. P-value ≤ 0.05 was considered statistically significant.

Results: The common reasons cited for home deliveries include "all happened suddenly" (50.9%), "delay in transportation" (13.1%), and "no escorts available" (11.6%). The rest of other reasons contributed to 24.4% of home deliveries. On comparison of reasons for home deliveries between urban and rural areas, "all happened suddenly" was found more in urban (66.7%) than in rural (38.4%) areas (P = 0.0002). Other factors contributing to home delivery included "no escorts available," seen only among rural mothers (20.5%, P = 0.02).

Conclusion: This study highlighted important reasons for home deliveries such as "all happened suddenly," "delay in transportation," "no escorts available." So, it is recommended that appropriate maternity services should be designed and emergency ambulance services should be strengthened.

Background: Optimal infant and young child feeding (IYCF) practices are crucial for children's health and survival, protecting against diarrhea and acute respiratory tract infection (ARTI). Despite strong evidence, breastfeeding and complementary feeding rates remain low. This study aimed to assess IYCF practices among mothers and identify associated morbidities in children.

Materials and methods: A cross-sectional study was conducted among 400 mothers of children aged 0-24 months at the Gulbarga Institute of Medical Sciences, using convenience sampling over 2 months (October-November 2023). Data were collected via a pretested semi-structured questionnaire based on WHO IYCF indicators and analyzed using SPSS software version 20.

Results: The study found that 57.75% of mothers initiated breastfeeding within the first hour of delivery, and 49% practiced exclusive breastfeeding for infants aged 0-6 months. However, only 28.6% met minimum dietary diversity (MDD), 13.2% met minimum meal frequency, and 13.2% achieved a minimum acceptable diet. Exclusive breastfeeding was significantly associated with lower incidence of diarrhea (P ≤ 0.0001) and ARTIs (P < 0.0001). Bottle feeding was linked to higher rates of diarrhea (P = 0.002) and ARTIs (P = 0.04). Diarrhea was also significantly associated with inadequate dietary diversity (P = 0.02) and sweetened beverage intake (P = 0.0002).

Conclusion: The findings highlight the link between inadequate feeding practices and increased risk of diarrhea and respiratory infections. Immediate interventions, including health worker training and community nutrition programs, are essential to enhance maternal knowledge and improve infant feeding practices, ultimately reducing childhood illnesses.