Prevalence and Determinants of Substance Use Among Indigenous Tribes in South India: Findings from a Tribal Household Survey.

BACKGROUND: Indigenous populations have higher substance use than non-indigenous populations. Current evidence on indigenous substance use is largely derived from national household surveys, while there are no specifically designed, culturally specific methodological studies available to determine the prevalence of substance abuse among the indigenous tribes. The present study examined the prevalence and predictors of alcohol use, smoking, and betel quid chewing among indigenous tribes in South India. METHOD: We conducted a cross-sectional population-based random survey of 2186 tribal households in the Wayanad District, Kerala. A self-prepared, pilot-tested structured interview schedule was used to collect information on sociodemographic variables and substance use. Multivariate logistic regression models were used to examine the sociodemographic predictors of substance use. RESULTS: The overall prevalence of current alcohol use, current smoking and daily betel quid use was 17.2%, 18.8% and 47.6% respectively. Consistently, male gender (alcohol use OR = 13.55; smoking OR = 3.42; betel quid use OR = 1.65), increasing age (OR = 1.32; OR = 1.01; OR = 1.03), Paniya tribe status (OR = 2.24; OR = 1.39; OR = 5.38) and employment status being working (OR = 2.07; OR = 1.77; OR = 1.26) increased the risk of alcohol use, smoking and betel quid chewing. Furthermore, having 'no formal education' was associated with smoking (OR = 1.35), and betel quid chewing (OR = 3.27). CONCLUSION: Substance use was high among the indigenous tribes. The male gender, increasing age, Paniya tribe and working status significantly influenced alcohol use, smoking and betel quid chewing. The results underscore the need for indigenous specific de-addiction policies and programmes, alongside a consideration of the critical sociodemographic predictors.

Facing COVID-19: Psychological Impacts on Hospital Staff in a Tertiary Care Private Hospital in India.

OBJECTIVE: To investigate the prevalence of depression, anxiety, and insomnia among hospital staff working in a tertiary care private hospital in India during the early period of the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This cross-sectional study was conducted May 5-25, 2020, among 347 hospital staff (nursing and other hospital staff, with the exception of doctors). Depression, anxiety, and insomnia were measured using the 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder Scale, and the Insomnia Severity Index, respectively. RESULTS: Of respondents, 16.4% reported clinically significant depression, 13.8% reported clinically significant anxiety, and 13.3% reported insomnia. Among the nursing staff, 20.9% reported clinically significant depression, 15.9% reported clinically significant anxiety, and 17.0% reported insomnia. There was significantly higher depression (P = .000), anxiety (P = .002), and insomnia (P = .007) among nursing staff compared with other hospital staff in 2-tailed t tests. There was a significantly higher prevalence of insomnia among females (χ2 = 5.85, df = 2, P = .05). CONCLUSIONS: Study results show that more than 1 in 10 hospital staff suffer from mental health conditions, even during the beginning of the pandemic, and there is a need for active psychiatric support for the hospital staff during this pandemic. Depression, anxiety, and insomnia are significantly higher among nurses compared to other hospital staff. The results of this research suggest that comprehensive support measures should be implemented to protect and maintain mental health of hospital staff, especially nurses, while fighting the COVID-19 pandemic.

Factors Associated with Alcohol Misuse among Indigenous Tribal Men in Wayanad: A Qualitative Study.

BACKGROUND: Disproportionate level of alcohol misuse is reported among indigenous people all over the world. A few available studies from India also support higher alcohol misuse among tribal men, but the reason for it is largely unexplored. Thus, we explored the factors associated with alcohol misuse among indigenous tribal men in Wayanad, Kerala. METHODS: Using a qualitative phenomenological method and purposive sampling techniques, we recruited seven tribal men with a history of alcohol misuse and 28 tribal promoters from the identified tribal colonies in Wayanad, Kerala, India. Data collection was done with a combination of focus group discussions and in-depth interviews. Thematic analysis was applied to the data for identifying core themes. RESULTS: We identified the important trajectories of alcohol consumption among tribal men. They initiated alcohol misuse at a younger age due to parental influence, home environment, and peer pressure. Alcohol misuse associated with their traditional rituals and practices, exploitation of landlords, occupational factors, and saving habits. It caused a substantial burden to their spouses and children. CONCLUSION: Alcohol consumption often initiated in their young age was associated with socio-cultural rituals, practices, and exploitation.