Association Of Socio-Demographic Determinants with Economic Burden Among Road Traffic Accident Victims: A Longitudinal Study

Background: RTA are the sixth leading cause of death in India with a greater share of hospitalization, disabili-ties, deaths and socio-economic losses. The study was conducted to assess the socio-demographic determi-nants associated with households’ economic burden among RTA victims. Methods: A longitudinal study was conducted for 2 years in Puducherry employing simple random sampling to include 169 accident victims. Baseline data was collected with a semi-structured questionnaire on socio-demographic details, direct and indirect costs towards road traffic injuries. Follow up was at 6th and 12thmonth from the day of accident. Data entry and analysis were performed using Epi-data. Written informed consent from each participant was sought. Ethical clearance received. Results: Mean age of the accident victims was 36.2 (11.4) years. The median (IQR) for direct, indirect and to-tal expenses were INR 1500 (1000-22100), 18000 (2400-46500) and 3000 (1037-47125) respectively. Asso-ciation between the median (IQR) indirect expenses and marital status as well as socio-economic status of vic-tims were found to be statistically significant. Conclusion: Accident victims and their family faced financial burden, as a large proportion of victims were from productive age group belonging to lower- and middle-class income group

Association between vaccination status and COVID-19-related health outcomes among community-dwelling COVID-19 patients in Nara, Japan

BACKGROUND@#Many previous studies have reported COVID-19 vaccine effectiveness, but there are few studies in Japan. This community-based, retrospective observational study investigated the association between vaccination status and COVID-19-related health outcomes in COVID-19 patients by SARS-CoV-2 variant type.@*METHODS@#The study participants were 24,314 COVID-19 patients aged 12 or older whose diagnoses were reported to the Nara Prefecture Chuwa Public Health Center from April 2021 to March 2022, during periods when the alpha, delta, and omicron variants of COVID-19 were predominant. The outcome variables were severe health consequences (SHC) (i.e., ICU admission and COVID-19-related death), hospitalization, and extension of recovery period. The explanatory variable was vaccination status at least 14 days prior to infection. Covariates included gender, age, population size, the number of risk factors for aggravation, and the number of symptoms at diagnosis. The generalized estimating equations of the multivariable Poisson regression models were used to estimate the adjusted incidence proportion (AIP) and 95% confidence interval (CI) for each health outcome. We performed stratified analyses by SARS-CoV-2 variant type, but the association between vaccination status and COVID-19-related health outcomes was stratified only for the delta and omicron variants due to the small number of vaccinated patients during the alpha variant.@*RESULTS@#Of the 24,314 participants, 255 (1.0%) had SHC; of the 24,059 participants without SHC, 2,102 (8.7%) were hospitalized; and of the 19,603 participants without SHC, hospitalization, and missing data on recovery period, 2,960 (15.1%) had extension of recovery period. Multivariable Poisson regression models showed that regardless of SARS-CoV-2 variant type or health outcome, those who received two or more vaccine doses had significantly lower risk of health outcomes than those who did not receive the vaccine, and there was a dose-response relationship in which the AIP for health outcomes decreased with an increased number of vaccinations.@*CONCLUSION@#A higher number of vaccinations were associated with lower risk of COVID-19-related health outcomes, not only in the delta variant but also in the omicron variant. Our findings suggest that increasing the number of COVID-19 vaccine doses can prevent severe disease and lead to early recovery of patients not requiring hospitalization.

Postpartum Depression and its Clinico-Social Correlates – A Community-Based Study in Aligarh

Context: Postpartum depression (PPD) is onset of depressive symptoms in postpartum period from 2 weeks to 1 year. It causes maternal morbidity and long?term negative effects on growth and development of infant and child. It is often unreported and underdiagnosed. Aims: (1) To estimate the prevalence of PPD,(2) To determine socio?demographic, clinical, and obstetric correlates of the same. Settings and Design: A cross-sectional study was done in urban and rural areas of District Aligarh. Methods: A total of 304 females between 6 weeks and 6 months’ postpartum period giving consent were included in this study. Sociodemographic, obstetric, and clinico-social factors were recorded using predesigned, pretested questionnaire. Edinburgh Postnatal Depression Scale (EPDS) score ?10 was used to screen for PPD and International Classification of Disease (ICD?10) criteria for confirmation. Statistical Analysis Used: Correlates of PPD were determined using logistic regression analysis. Results: The prevalence of PPD was 9.5% using EPDS and was confirmed by ICD?10 criteria. History of abortion (adjusted odds ratio [AOR]: 6.0, 95% Confidence Interval [CI] 2.2–16.5), poor relationship with in?laws(AOR: 5.1; 95% CI 1.3–20.5), marital conflict (AOR: 13.3; 95% CI 2.2–77.6), and substance abuse in husband (AOR: 3.1; 95% CI 1.1–9.0) were found to be significant correlates for PPD. Conclusions: About one in every 10 postpartum females suffered from depression but did not seek health care for the same. Women facing social pathologies such as substance abuse in husband, marital conflict, and poor relationship with in?laws are more at risk of PPD. Screening for PPD should be included in the maternal and child health care programs to ensure early diagnosis and treatment.

Association between serum trace elements and dyslipidemia： a community-based cross-sectional study / 上海预防医学

Objective:To investigate the association between serum trace elements and dyslipidemia in Pudong New Area. Methods:A community-based cross-sectional study was carried out. A stratified， cluster sampling approach was used for sampling. In total 1 814 community residents aged above 35 years old were recruited in Pudong New Area， Shanghai. A face-to-face investigation was conducted and blood samples were collected. Serum levels of 16 trace elements， including boron， vanadium， chromium， manganese， iron， cobalt， nickel， copper， zinc， arsenic， selenium， strontium， molybdenum， tin， antimony， and barium were measured by inductively coupled plasma mass spectrometry （ICP-MS）. The relationship between serum trace elements and dyslipidemia was analyzed with single and multiple Logistic regression models. Results:Prevalence of dyslipidemia is higher among participants of more than 45 years old with high BMI， hypertension or diabetes．Serum iron leveled the highest， followed by copper， zinc， selenium， strontium， boron and other trace elements. After adjusting for potential confounders， the odds ratios of dyslipidemia associated with the highest quartile of trace elements concentrations were 1.41 （95%CI： 1.12-1.78）， 0.77 （95%CI： 0.61-0.96）， 1.65 （95%CI： 1.31-2.09）， 1.27 （95%CI： 1.02-1.58）， and 1.32 （95%CI： 1.06-1.66） for chromium， cobalt， zinc， arsenic， and tin， respectively， compared with that associated with the other three quartiles. Conclusion:Some serum trace elements are potentially associated with dyslipidemia in community residents.

A community based study of scenario of glaucoma in Aligarh, India

Background: Glaucoma is the leading cause of irreversible blindness worldwide and is second only to cataracts as the most common cause of blindness overall. In the developing world, the prevalence of glaucoma is expected to rise even more dramatically as the population of adults has doubled within a span of few decades. So this study was done with an objective of finding out the prevalence of glaucoma among adults aged 40 years and above in the field practice area of the Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh.Methods: A cross-sectional study was carried out for the duration of one year. A total of 680 persons were interviewed and examined by a trained ophthalmologist for detailed eye examination including visual acuity, refraction and slit-lamp bio-microscopy, intraocular pressure (IOP) by Keeler Pulsair non-contact tonometer confirm by applanation tonometry, gonioscopy, and dilated fundus examination after ruling out the risk of angle closure. Anderson criteria were used to diagnose glaucomatous visual field defect.Results: In our study population, the IOP of the majority of population lied in 11-15 mm Hg with a mean IOP of 13.42±4.09 mmHg. In regard to optic disc examination, a cup to disc ratio of >0.6 was found in 35 eyes. According to the predefined criteria, a total of 31 subjects were diagnosed as glaucoma in either one or both eyes. The overall prevalence of glaucoma was found to be 4.6% (31/680), with the prevalence of primary open angle glaucoma, primary angle closure glaucoma, normotensive glaucoma and secondary glaucoma as 1.3%, 1.2%, 1.2% and 0.9% respectively.Conclusions: The prevalence of glaucoma is quite high in an elder population of Aligarh. This should warrant more intensive activities, focusing not only on early diagnosis and management of glaucoma but also include strengthening preventive ophthalmic care.

A community based cross-sectional study on the health system responsiveness in the urban field practicing area of tertiary health care centre, Hyderabad

Background: According to WHO, responsiveness is an important goal of the health system, in addition to the two predominant goals of improving health and fairness of financing. Responsiveness includes non-medical aspects of health care. As the progress to universal health coverage is gaining pace, the present study has attempted to study the domains of responsiveness in the government and private health services and health care providers.Methods: A community based cross-sectional study for a period of 3 months in the households of the urban field practising area. Sampling technique was simple random sampling. Assuming the prevalence of 50% and allowable error of 5%, 400 households were surveyed. KISH table method was used at household level. Study tool was World Health Survey responsiveness module questionnaire for the eight responsiveness domains-prompt attention, dignity, communication, autonomy, confidentiality, choice, quality of basic facilities and social support (for inpatients).Results: The mean age (yrs) of the study subjects is 46.078±13.998. 68.25% (273) were males.31.75% (127) were females. 46.25% (185) were using government services and 53.75% (215) were using private services. The mean waiting time (min) in the public health facilities was 135.2±111.2 which was more than private facilities, 62.4±40.8.Conclusions: All the responsiveness domains (except confidentiality) were found to be positively associated (p<0.05) with the government health services. Proportion of people rating the responsiveness domains from most important to the least important showed prompt attention (52%) and dignity (30%) as the most important domains.

Prevalence and Alternative Treatment of Head-Lice Infestation in Rural Thailand: A Community-Based Study

Head-lice infestation, pediculosis capitis, remains a public-health burden in many countries. The widely used first-line pediculicides and alternative treatments are often too costly for use in poor socio-economic settings. Ivermectin has been considered an alternate treatment for field practice. This study was composed of 2 parts, a cross-sectional survey and an intervention study. The main objectives were to determine the prevalence and potential factors associated with head-lice infestation, and to evaluate the effectiveness and safety of oral ivermectin administration. A community-based cross-sectional survey was conducted among 890 villagers in rural areas along Thai-Myanmar border. Females with infestations were eligible for the intervention study, and 181 participated in the intervention study. A post-treatment survey was conducted to assess acceptance of ivermectin as a treatment choice. Data analysis used descriptive statistics and a generalized-estimation-equation model adjusted for cluster effect. The study revealed the prevalence of head-lice infestation was 50% among females and only 3% among males. Age stratification showed a high prevalence among females aged <20 years, and among 50% of female school-children. The prevalence was persistent among those with a history of infestation. The major risk factors were residing in a setting with other infected cases, and sharing a hair comb. The study also confirmed that ivermectin was safe and effective for field-based practice. It was considered a preferable treatment option. In conclusion, behavior-change communication should be implemented to reduce the observed high prevalence of head-lice infestation. Ivermectin may be an alternative choice for head-lice treatment, especially in remote areas.

Incidence of congenital anomalies in a rural population of Jammu - A prospective study

Background: Congenital anomalies (CAs) are a major cause of stillbirths and neonatal mortality in India. Its magnitude and pattern reportedly vary over time and across geographical locations. Objectives: The objective of the study is to estimate the incidence of CAs in community development block RS Pura of District Jammu. Methods: The present study is a community-based prospective study. The field workers were trained with the help of “Birth Defect Surveillance” Atlas issued by WHO and ICBDMS (International Clearinghouse for Birth Defects Monitoring Systems) 2014. Pregnant women (registered or unregistered) with all health institutions in RS Pura Block on or after April 1, 2014, were followed till September 2015 for the ascertainment of CAs. All CAs detected during antenatal period (by ultrasonography), after delivery and abortion at any site were counted as events and classified by organ system according to the 10th version of the WHO International Classification of Diseases-10. Results: A total of 1670 mothers were followed till their pregnancy outcome was recorded. Among 1600 live births recorded, 54 babies had CAs resulting in the incidence rate of 33.7/1000 live births. The incidence rate was comparatively higher among women aged <20 years (71.4/1000 live births) and with Para 4 (43.5/1000 live births) as compared to other women. Digestive system was the most common system involved (35%) followed by the Central nervous system (26.6%). The U-shaped pattern in the incidence of CAs with regards to parity and maternal age was observed. Conclusion: The study demonstrated that the CAs continue to occur in Jammu at a similar magnitude as reported from other parts of the country.

Ownership of Bed Nets and Use by Children below 5 Years in Sagamu Local Government Area of Ogun State, Nigeria.

Aim: To document the level of ITNs ownership and utilization for children within the Sagamu Local Government Area in Ogun State three years after the commencement of major distribution exercise of this simple tool. Study Design: A descriptive cross -sectional community based study. Place and Duration of Study: Sagamu Local Government area in Nigeria. May 2009. Methodology: Study involved one hundred and thirty one (131) children within the Local Government with fever or a 2 day history of fever prior to the day of the meeting following a 3 day community campaign. They were enrolled into the study using a systematic random sampling method. Pretested semi-structured questionnaire was administered by research assistants/investigators to obtain data on ownership of ITNs by the caregiver and their utilization by the index child. Factors that may affect ownership and utilization were also documented. Frequency tables were generated for all the categorical variables and association between them tested using the chi-square test and logistic regression. Level of significance was set at p value <0.05. Result: The mean age of the study population was 47.3±50.6 months for the children and 28.8±5.9 years for the mothers. Among the 128 respondents, ITNs ownership was 9.2%, utilization was 4.6%. House-types and mothers’ occupation were positive predictors of use (r=0.97). There was a strong positive correlation between mother’s educational level and ownership (r=0.96). Ownership was however limited by a combination of lack of awareness and knowledge of access point as well as cost. Conclusion: While improving the awareness of the populace through radio jingles and social marketing as well as use of private health facilities as access points will aid in better ownership of ITNs, subsidizing the cost of ITNs rather than making it out rightly free may ensure better utilization.

Knowledge of Hypertension and other Risk Factors for Heart Disease among Yoruba Rural Southwestern Nigerian Population.

Background and Objectives: There is paucity of reliable information on knowledge about hypertension and cardiovascular disease (CVD) risk factors in rural southwestern Nigeria. This study assessed the level of awareness, basic knowledge and management of hypertension and CV risk factors among people living in rural south western Nigeria. Methods: A population based cross-sectional survey was conducted in Egbeda local government area of Oyo State, Nigeria. A structured questionnaire was used to interview 2000 subjects in order to assess knowledge of various aspects of modifiable CV risk factors. Results: The commonest source of medical information was the family/friend/opinion leaders of trusted groups in 1198(59.9%), the media (including radio, public enlightenment programmes, and newspapers) in 492(24.6%), and the doctor/nurse/health worker in 183(9.1%) of the respondents. The overall knowledge of CVD and its risk factors was poor. About 56% of the respondents could not identify a single risk factor. Of those who were able to, only a few could correctly identify the relationship between CV risk factors and CVD with some misconceptions. . We found that subjects who had more years of formal education, a positive family history of CVD, and self reported history of diabetes mellitus were more likely to have a good level of knowledge of hypertension and other CV risks when adjusted for age, gender and marital status. Conclusion: Our study confirms a limited knowledge and misconceptions of CVD and its risk factors in this population. Early detection and preventive practices were significantly lacking due to these gaps in Knowledge. There is an urgent need to design and implement culturally appropriate public awareness, health educational and health promotional programmes about CV risk factors and CVD for this community which can be adapted for other rural population in the country.

Diabetes Mellitus Among Tuberculosis Patients in A Rural Population of Jammu - A Community Based Observational Study.

To determine the existence of diabetes mellitus in patients with tuberculosis and to study the effect of coexistent diabetes mellitus on tuberculosis outcome under programmatic conditions. Out of 280 tuberculosis cases registered, 183(65.3%) were males & 97 (34.6%) were females. Approximately two third (58%) of the patients were in the age group of 31 - 60 years. Majority of the patients (61.7%) belonged to lower and lower middle socio-economic class. 69% of the registered patients were sputum positive. Sputum positivity was found to be higher among males. 23 patients (8.2%) were found to be diabetic comprising of 15 males and 8 females. The outcome of tuberculosis did not differ significantly in patients having coexistent diabetes mellitus.8.2% of the tuberculosis patients had coexistent diabetes mellitus.The effect of coexistent diabetes mellitus on tuberculosis outcome under programmatic conditions was not found to be significant.

Awareness and perception of mothers about functioning and different services of ICDS in two districts of West Bengal.

Integrated Child Development Services, a national programme of the Government of India has health, nutrition, and pre-school education components of services. To ascertain awareness, perception of mothers about functioning and different services of ICDS a cross-sectional community based study was conducted between June to September 2007 in Howrah and Purulia districts of West Bengal. A total of 1235 mothers were included as study subjects. As per opinion of the mothers 73% AWCs opened regularly, behaviour of the AWWs was friendly (71.6%) and 63% mothers opined that ICDS is beneficial to their children. 84.2% mothers were aware of any ICDS services. Quantity and quality of supplementary food was acceptable to 88% and 72.7% mothers respectively. 79.2% and 87.5% mothers did not receive any advice on child feeding and growth chart. Making beneficiaries aware about services by targeted interventions will ensure better utilization of ICDS.