Perception and Acceptance of the Newly Introduced COVID-19 Precaution (THIRD) Vaccination Dose among Health Workers at an Indian Medical College.

INTRODUCTION: India has run a nationwide vaccination campaign against COVID-19, which has recently introduced a precaution (third) dose for health workers. This study assessed the perception and attitude of health workers toward the Indian vaccination campaign against COVID-19, with an emphasis on this major change. MATERIALS AND METHODS: A printed questionnaire was distributed among health-care workers at the Medical College of West Bengal. The completed forms were analyzed. RESULTS: Most of the participants were doctors (83.7%). Although all had received two doses of vaccine before, 44.4% were unwilling to be vaccinated with the third dose in the present scenario. The majority (63.8%) of the patients were concerned about side effects. The emergence of new COVID strains (65.6%) was viewed as a threat to the effectiveness of the vaccines. Participants with higher age, comorbidities, and those with the perception that the third dose was being introduced appropriately and would be effective against newer strains of the vaccine tended to be more willing to get vaccinated with the precaution dose compared to their counterparts. CONCLUSION: A dilemma regarding the acceptance of precaution doses was noted among health workers. This warrants the availability of more comprehensive information to increase acceptance of these vaccines.

Socio-cultural and financial issues against breast cancer screening behaviour among eligible Indian women: evidence for action.

PURPOSE: Breast cancer, a common malignancy in Indian women, is preventable and curable upon early diagnosis. Screening is the best control strategy against breast cancer, but its uptake is low in India despite dedicated strategies and programmes. We explored the impact of socio-cultural and financial issues on the uptake of breast cancer screening behaviour among Indian women. METHODS: Breast cancer screening-uptake and relevant social, cultural, and financial data obtained from the National Family Health Survey (NFHS) round 5 were used for analysis. We studied 399,039 eligible females to assess their breast cancer screening behavior and determine the impact of socio-cultural and financial issues on such behavior using multivariable logistic regression. RESULTS: Most participants were 30-34-year-old (27.8%), educated to the secondary level (38.0%), and 81.5% had bank accounts. A third (35.0%) had health insurance, and anaemia was the most common comorbidity (56.1%). Less than 1.0% had undergone breast cancer screening. Higher age, education, urban residence, employment, less privileged social class, and access to the Internet and mass media were predictors of positive screening-uptake behavior (p < 0.05). Mothers of larger number of children, tobacco- and alcohol-users, the richer and having health insurance had negative uptake behavior (p < 0.05). CONCLUSION: A clear impact of socio-cultural and financial factors on breast cancer screening behavior is evident among Indian women. Therefore, apart from the ongoing health system strengthening efforts, our findings call for targeted interventions against prevailing misconceptions and taboos along with economic and social empowerment of women for the holistic success of India's cancer screening strategy.

Morbidity pattern and health-care seeking among women domestic workers: Perspective from an Indian metropolis.

Background: Domestic work being unrecognized as a formal form of occupation in India, workers are often deprived of basic social security, including access to proper health care. Self-negligence coupled with societal neglect makes them vulnerable to injury and a variety of illnesses. Objectives: We aimed to study the morbidity pattern of women domestic workers residing in a slum area of Kolkata, West Bengal, India. Materials and Methods: An observational descriptive cross-sectional study was carried out by interviewing and clinically examining 106 randomly selected women domestic workers. Results: The majority (82.08%) had health complaints: heart burn being most common (40.57%). Musculoskeletal and dermatological issues were common. Anemia (31.25%) was a common prediagnosed morbidity. Pallor (33.96%) and dental caries (31.13%) were common; 50.94% reported workplace injury. Of those having complaints, 77.36% sought health care, 59.43% of whom relied on health facilities. Lack of time (54.05%), felt need (35.14%) and money (21.62%) affected adequate care seeking. Participants with cardiorespiratory complaints tended to visit health facilities significantly more (P < 0.05). Conclusion: Health vulnerabilities and neglectful behavior among domestic workers are evident, making the need to sensitize them about their health risks and ways to overcome such issues very vital. Awareness should also be generated about government health schemes to encourage timely health checkup and necessary intervention.

Face mask use and disposal behaviour of frontline young doctors during the COVID-19 pandemic: a two-year study.

INTRODUCTION: The COVID-19 pandemic has severely affected India in spite of an ongoing vaccination campaign. The doctors are at greater risk of COVID-19 and face masks are a protective measure against this threat. We assessed the use and disposal of face masks among postgraduate trainees (PGTs) working on the COVID-19 frontline in an Indian medical college. METHODOLOGY: Data was collected from all PGTs who agreed to participate during the first, second and third wave of the pandemic in India. A pre-tested questionnaire to assess and compare face mask use and disposal behaviour across the three phases was used. RESULTS: All participants used face masks regularly; a significant uptrend in N-95 mask users and double mask users was observed as the pandemic progressed. Use of face shields peaked during the second wave. Most participants preferred keeping the mask on always at work and avoided donning and doffing of masks in between usage. Many of them practiced 'extended use' of face masks and nearly a third re-used a mask for ≥ 6 days, which is against the standard recommendations; however, such behavior among participants showed a downward trend. Proper disposal practices were not followed by many participants, leaving scope for environmental contamination. CONCLUSIONS: There is an imminent need to make the young frontline doctors aware regarding appropriate mask usage and disposal for better preparedness before any health exigencies of the future.

How Covid-19 Affected the Work Prospects and Healthcare-Seeking of Women Domestic Workers in Kolkata City, India? A Longitudinal Study.

Background: Self-negligence, societal neglect, and lack of access to adequate health care make domestic workers vulnerable to ill-health. COVID-19 has adversely affected the work prospects of people across social classes and their health care-seeking opportunities as well. We studied the impact of COVID-19 pandemic on work prospects and health care-seeking behavior of a vulnerable section of the society - the women domestic workers. Methods: A longitudinal analysis on 292 randomly selected women domestic workers residing in slums of "Kalikapur" locality of Kolkata city, West Bengal (India). Data were collected using a predesigned and pretested schedule twice: in early-2020 (before severe impact of COVID-19) and mid-2020 (during the pandemic ravaging India). Paired t-test and McNemar's test were used to check for significant changes. Result: Of all the participants, 57.2% lost jobs partially while 2.7% were completely jobless in mid-2020; the average daily work-hour decreased by 25.7%. Their average monthly pay significantly reduced (P < 0.05); mean family income in mid-2020 was lesser as well, compared to earlier (P < 0.05). Compared to early-2020, 15.8% more participants were sole bread-winners for their families during COVID-19. Number of participants visiting health practitioners significantly reduced (P < 0.05) in mid-2020. Rise in over-the-counter medicine use (P < 0.05) and increased tendency to ignore symptoms (P < 0.05) during COVID-19 was noted. Conclusion: The COVID-19 pandemic has affected work prospects and health care-seeking behavior of women domestic workers negatively. Most of them faced wage reduction, many becoming sole-earners for their families. This necessitates continued formulation and implementation of strategies ensuring social benefits including healthcare. Awareness about affordable healthcare and ill-effects of bad practices like self-medication should also be built.

Factors predicting proper handwashing practice amidst the COVID-19 pandemic in India: a field-based cross-sectional study.

Proper handwashing is one of the effective ways to prevent many communicable diseases, including COVID-19. We explored the handwashing practices in a rural Indian population before the probable third wave of the COVID-19 pandemic. A data collection schedule was administered to eligible adult members of a rural community, selected by multi-stage sampling, to assess their pattern and practice of handwashing. All 176 respondents washed their hands after defecation, 82.4 and 80.7% washed hands after urination and before taking food, respectively, while 68.2% of respondents washed hands after coming back from outdoors. Among those who handwashed, 82.9% used soap water after defecation; 46.2, 45.8 and 50.8% washed hands with soap water after urination, before taking food and after visiting outdoors, respectively. Only a quarter (24.4%) of all the participants used soap water for handwashing consistently after defecation, after urination, before taking food and after coming home. The more educated, those coming from higher socioeconomic stratum and working from home, were more likely to report proper handwashing practice. Handwashing, as recommended by health agencies, for restraining COVID-19 infection, was not noticed in the majority of the participants. Better awareness of handwashing is recommended to help restrain COVID-19 in the Indian population.

Evaluation of the rashtriya bal swasthya karyakram (RBSK): A national children healthcare program in a health district of West Bengal, India.

Background: The Rashtriya Bal Swasthya Karyakram (RBSK) was launched in 2013 to screen and manage birth defects, deficiencies, diseases, and developmental delays including disabilities in Indian children, with the help of designated mobile health teams and grassroot workers across the country. Objectives: Performance of the RBSK program in three selected blocks of a health district of a large Indian state (West Bengal) was assessed. Methods: The performance assessment was based on input, process, and output performances, using checklists based on RBSK operational guidelines. Results: While some essential evaluation tools were available in required numbers at the block level, many were unavailable. There were deficiencies in the number of health staff appointed. Although most screening camps were conducted as per microplan, some were not. Anthropometric measurements were not done in some camps; Information, Education, and Communication (IEC) materials were not used adequately. Issues with fund management were also noted. The intervention rate at higher centers (District Early Intervention Centre) was low with regard to the children referred for management. Involvement of grassroot workers such as ASHA was also found to be lacking. Conclusion: Frequent orientation training of medical officers and staff is needed along with the efforts to strengthen the referral system and the patient tracking system. Sensitizing the children and their guardians regarding the importance of the relevant health issues is also needed with the help of the proper implementation of IEC services.

Public Perception About Pandemic Situation and Preparedness Towards a Probable Lockdown in an Affected Indian State Amidst the Second Wave of the Covid-19 Pandemic.

OBJECTIVE: The COVID-19 second wave badly affected India. This study assessed public preparedness and attitude towards a new lockdown in the state of West Bengal (WB) along with perception about the COVID pandemic situation. METHODS: An anonymous questionnaire was administered to all willing adult attendees of a COVID vaccination centre in Kolkata, capital city of WB. Logistic regression was applied to find the relationship between attitude towards lockdown and other selected independent variables. RESULTS: Of the 839 persons analyzed, 72.0% were non-health workers; and 55.4% thought that available vaccines reduce COVID-19 risk. Among them, 54.4% wanted stricter guidelines imposed. For preparedness, 42.6% and 28.8% said they would stock additional food and medicines respectively. On multiple logistic regression, being female, having elderly family members, perceiving the second wave as worse, and favouring stricter restrictions, all had odds of favourable attitude towards the new, proposed lockdown. CONCLUSIONS: A new lockdown was favoured by the majority. However, a well-planned and phased approach for this is needed in the light of many concerns about the previous lockdown. Mental health issues, financial security, medical help at hand, and ease of travel to workplaces are important issues that need to be addressed in case of future lockdown(s).

Pattern and practice of self medication among adults in an urban community of West Bengal.

Introduction: Self-medication is the obtainment and consumption of drugs without a physician's advice, in any stage of disease management. Indiscriminate practice of self-medication, which is common in developing countries like India, often leads to dangerous unwarranted adverse effects, ultimately increasing cost burden due to health care. The aim of this study was to assess self-medication practice and its reasons among study participants. Methods: Eligible residents of the urban field practice area of a Kolkata-based medical college were interviewed using a predesigned and pretested data collection schedule. Results: Among 170 participants, 98 (57.7%) were found to have practiced self-medication; 39.8% of them were aged between 28 and 37 years, the majority being females (57.1%). Lack of felt need to visit a registered medical practitioner was the most common reason (34.7%) cited behind practicing self-medication. All (100.0%) self-medicating participants checked expiry date before use; pain suppressing medications were the most commonly used (46.9%). Pharmacies were the commonest source of knowledge for medicinal use (64.3%). The less educated tended to self-medicate more than those with a higher level of education (P < 0.05). Conclusion: The study found the majority of its respondents to be practicing self-medication. Stringent implementation of law and increasing community awareness regarding the ill effects of self-medication is therefore necessary.

Realistic personal exposure assessment of air pollutants and health outcomes - A cross-sectional study among Kolkata slum dwellers.

Background: Rapid, unplanned, and unsustainable patterns of urban development can result in many emerging environmental and health hazards. One of the important public health problems of urban environment is regular exposure to dust and pollutants and consequence of such exposure in the form of changes in the pulmonary function. Being the immediate environment, indoor pollution poses a higher risk to human health than the ambient environment. Realistic personal exposure assessment gives the actual idea about the exposure status. Objectives: This study determined the household principal environmental exposures (Dust, SO2, NO2, and total volatile organic compound) among urban slum dwellers and assessment of the respiratory function to determine any possible relationship between those exposures and outcomes. The study also described the knowledge, attitude, and practice of these urban slum people regarding air pollution and its effect. Methods: A cross-sectional study was carried out among 442 urban slum people residing in the slums of the Kolkata Municipal area. Household environmental exposures were collected by standardized methods and outcome was observed by conducting a pulmonary function test. Finally, knowledge, attitude, and practice regarding air pollution were carried out with the help of a questionnaire-based survey. Results and Discussion: Almost all the pollutants exposure was associated with impairment of lung function. Younger age and female gender were statistically associated protective factors for the development of any lung disease. Those who had an overall good awareness regarding the means and effects of air pollution were found to be protected from developing lung disease. Using exhaust ventilation, relocation to inner side of slums, using personal protective measures, and adequate pollution awareness can help the slum citizens to overcome the problem.

Awareness Regarding Eye Donation and Effects of COVID-19 on Its Perception: A Community-Based Cross-Sectional Study From India.

OBJECTIVES: This study aimed to assess awareness toward eye donation and the effects of COVID-19 on perceptions about eye donation in an urban community of West Bengal, India. MATERIALS AND METHODS: Eligible adults residing in the area under study were chosen by simple random sampling and interviewed using a predesigned and pretested data collection schedule to assess awareness and perception. Based on their total awareness score, the participants were classified as having good awareness or poor awareness toward eye donation. RESULTS: Among 423 participants, 52.0% were male, 34.0% were 18 to 30 years old, 38.3% were educated up to secondary level, and 85.6% had eye disease in their family. Of total participants, 70.2% had heard about eye donation, with 59.9% of this group having knowledge of eye donation only after death and 57.9% having knowledge that donation must occur within 6 hours of death. In addition, 52.9% were aware about donation from home, 30.6% said only the cornea is transplantable, and 52.2% knew it can be preserved. Participants with higher education, higher socioeconomic status, and outside of the house occupational engagement had significantly higher chance of good eye donation awareness. Of total participants, 32.0% said that COVID-19 could be transmitted through eye donation, with 58.2% of participants opining that the pandemic was not a suitable time to consider donation of eyes. CONCLUSIONS: COVID-19 has had a negative impact on eye donation perceptions. Although most of our participants had heard about eye donation, their awareness regarding important aspects about eye donation were still lacking, thus calling for a more focused action plan and implementation of the same.

Perception and Willingness towards Eye Donation in an urban community of West Bengal.

INTRODUCTION: Corneal blindness, though treatable, contributes largely to the burden of blindness. With 1.2 million existing cases of corneal blindness in India, the demand for cornea collection is increasing. 69349 corneas were collected in 2018-19 but it is much less than what is needed. Faulty perceptions and unwillingness are two major hurdles against a scenario favourable towards eye donation. The objectives of the study was to assess the perception and willingness towards eye donation and the socio-demographic variables that affect such perception and willingness, in an urban community of West Bengal. MATERIALS AND METHODS: In this cross-sectional study conducted among adult residents of the urban field practice area of Medical College Kolkata, data was collected from randomly selected eligible members, one each from all the available families by interviewing them using a validated pre tested schedule. RESULTS: Eighty nine (52.3%) among 170 interviewed participants had Secondary level education or higher, 49.4% had outdoor engagement. 128 participants reported ocular morbidity in the family but only 126 had heard about eye donation. 98 (77.8%) of these 126, had favourable perception towards eye donation. Among these 98 participants, 40 were willing to pledge for eye donation. Higher education and outdoor engagement significantly predicted favourable perception, while willingness significantly increased with participants belonging to higher socio-economic class and with higher education. CONCLUSIONS: Compared to favourable perception, willingness of pledging eyes was lesser due to various false notions. Proper education through usage of means of mass communication and stress upon school education is needed to address these hurdles.