Job satisfaction among medical officers working in Delhi.

Background: Satisfied human resource is an essential asset for high productivity, efficiency, and quality of care in a healthcare organization. Job satisfaction among healthcare professionals assumes further significance for the purpose of maximization of human resource potential in the context of the shortage of manpower in the health sector in India. Objectives: The objective of the study was to assess the job satisfaction among medical officers (MOs) working in Delhi and to study the factors influencing the satisfaction level amongst them. Material and Methods: It was a cross-sectional study conducted amongst selected MOs (by convenience) in all the districts of Delhi. A structured, self-administered questionnaire was used to collect data from the participants. Results: A total of 115 MOs completed the questionnaire. There were 61 (53%) female doctors and 54 (47%) male doctors. The mean age of the study participants was 38.28 ± 7.37 years. The experience of the study group ranged between 1 and 28 years (9.59 ± 6.47 years). Of the total, 59.1% of participants were found to be satisfied with their job. The most common reason given for satisfaction with job was the timing of their job that suits them. The reason given for not being satisfied with job was salary not at par with work pressure. A significantly higher proportion of male participants considered "lack of accommodation" (P < 0.03) and "frequent detailment" (P < 0.031) are big problems faced in their jobs as compared with the female participants. Only 37 (32.2%) participants felt that the MO is able to give enough time to patients for clinical assessment in Out Patient Department. Conclusions: Although majority (59%) of the study group was satisfied with their job, there were numerous problems faced by the doctors at their workplace. Low pay was one of the important reasons cited for being dissatisfied. There is an urgent need to address all the factors affecting job satisfaction through proper planning and implementing relevant human resource policies for improvement in the work environment at public health institutions.

Vaccination With Routine Childhood Vaccines and Severity of COVID-19 Among Children in Delhi.

OBJECTIVE: To study the association between routine childhood vaccination and the severity of COVID-19 among children. METHODS: A cross-sectional study was undertaken among 141 children (aged ≤15 years), tested positive for SARS-CoV-2 infection. RESULTS: COVID-19 severity (combined moderate and severe) was significantly more in males (14.5%) than females (3.8%), and in those who did not receive first and second dose of MR vaccine (57.1%, and 40%, respectively) than who received (6.3%, and 6.1%, respectively). Disease severity was more in partially immunized children (16.7%) as compared to fully immunized children (7.0%). CONCLUSION: Children who did not receive both doses of MR vaccine had a severe infection when compared to those who were vaccinated.

Occupational Health Hazards of Rickshaw Pullers in Lower Middle Income Country, India.

Background: Rickshaw pullers work in unorganized sector. Ignorance, poverty, and strenuous physical exertion make them vulnerable to ill health and disease. Objectives: To assess the magnitude and pattern of morbidity, associated sociodemographic factors, and health-seeking behavior of the participants. Materials and Methods: A cross-sectional study was conducted on 305 participants. Predesigned, pretested questionnaire was used for data collection. Statistical Package for the Social Sciences (SPSS) 16 version was used for data analysis. Results: About 61% of the participants had morbidity in their lifetime and 49.5% fell sick in the last 15 days. Substance abuse in any form was reported by 73.1%. Grade-1 hypertension was reported in 28.2% and 7.5% was having grade-2 hypertension. Age, monthly income, substance abuse, and availing of health services were significantly associated with the development of health problems. Conclusion: Need to devise interventions that will focus on health awareness and early health-seeking behavior among the participants.

Seroprevalence of antibodies to SARS-CoV-2 and predictors of seropositivity among employees of a teaching hospital in New Delhi, India.

OBJECTIVE: Healthcare workers (HCWs) are at a high risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) due to the increased likelihood of clinical exposure during patient management. The study objective was to determine the seroprevalence of antibodies to SARS-CoV-2 and its predictors among hospital employees. METHODS: The cross-sectional study was conducted at a teaching hospital from August 2020 to September 2020 among 1,401 employees, including 1,217 HCWs, in New Delhi, India. The serum samples were examined for immunoglobulin G (IgG) antibodies to SARS-CoV-2 using the COVID Kavach-Anti-SARS-CoV-2 IgG Antibody Detection enzyme-linked immunosorbent assay kit. Data were collected electronically using the EpiCollect mobile platform. A p < 0.05 was considered to indicate statistical significance. RESULTS: A total of 169 participants (12.1%) had detectable IgG antibodies to SARS-CoV-2. The highest seropositivity rate was observed in the administrative staff (20.1%), while it was lowest among medical doctors (5.5%, p < 0.001). Male sex and ever having lived in a containment zone were independently associated with past infection with SARS-CoV-2. CONCLUSION: The seroprevalence of SARS-CoV-2 infection in health workers may be lower than in the general population in New Delhi. However, nonpharmaceutical interventions were not associated with a reduction in the risk of acquisition of SARS-CoV-2.

A Cross-Sectional Study of Prevalence of Depression, Anxiety and Stress among Professional Cab Drivers in New Delhi.

BACKGROUND: The profession of drivers is one of the occupational groups exposed to very poor working conditions. This study aimed to establish the prevalence of depression, anxiety and stress among cab drivers. MATERIALS AND METHODS: This cross-sectional study included 134 cab drivers. Their mental health status was assessed with the help of a screening tool - Depression Anxiety Stress Scale (DASS-21). Their demographic details, working conditions, lifestyle factors and use of habit-forming substances were also assessed with the help of a semi-structured questionnaire. RESULTS: It was revealed that all cab drivers were male and between 20 to 64 years of age. Eighty two (62%) drivers said they are sometimes irritated at work, 29 (21.5%) said they feel irritated daily and rest 23 (17.2%) said that they were never irritated at work. When screened for depression, anxiety and stress, it was found out that 81 (60.5%) were suffering from depression, 63 (47%) from anxiety and 49 (36.5%) had variable degree of stress. CONCLUSION: Cab drivers are at high risk of acquiring mental health diseases, yet the mental health of this large workforce is ignored.

Sexual assault and associated factors among the cases reported in a tertiary care hospital of Delhi.

Background: Sexual assault is said to be an under-reported and under-researched crime worldwide. The high number of cases of sexual assault reported in India is the tip of the iceberg. We did this study to understand various factors associated with this crime. Methods: We did a retrospective analysis of 312 forensic examination reports of alleged sexual offenders, available from a tertiary care hospital of Delhi from January 2014 to December 2016. Results: Of the 312 victims of sexual assault, 62.9% were adults and 37.1% minors. The time of assault was mentioned in only 73 cases. Among these, about two-thirds of cases (60.3%) occurred during daytime. Among the 213 cases where the reporting time of the crime was mentioned, only 35.7% of cases were reported within 24 hours of the crime. Around 92% offenders were known to the victims. Conclusion: More than one-third of sexual assaults were against minors and in a majority of instances the alleged offenders were known to the victims. A major delay in reporting the crime was observed when the victim was known to the perpetrator.

Assessment of knowledge, attitude, and practices toward prevention of hepatitis B infection among medical students in a high-risk setting of a newly established medical institution.

BACKGROUND: India is in the intermediate hepatitis B virus endemicity zone with hepatitis B surface antigen prevalence among the general population ranges from 2% to 8%. Among health-care workers, seroprevalence is two to four times higher than that of the general population. AIM: The aim of the study was done to assess the knowledge, attitude, and practices (KAPs) of medical students regarding hepatitis B. MATERIALS AND METHODS: This is a cross-sectional study that was conducted from March to April 2018. Students were invited to the department on specified dates for awareness and immunization against hepatitis B. Their KAP was assessed with the help of a self-administered questionnaire. RESULTS: With a response rate of 81.3%, a total of 161 students participated in the study out of 198. Out of the 161 study participants, only 13 (8%) students had received a completed course of hepatitis B vaccination in the past, 30 (18.7%) students had a history of inability to complete the three doses of hepatitis B vaccination, and the rest 118 (73.3%) students were never immunized against hepatitis B. The knowledge about the risk of acquiring the disease at the hospital or high-risk setting was present in less than half of the students. The average knowledge score was 10.63 out of 16 and average healthy practice score was 2.94 out of 4. On applying Pearson correlation test, it was found that there was a positive correlation of knowledge and practices of the students (P = 0.012), implying that better knowledge of the disease has a positive effect on the practices exercised by an individual. CONCLUSION: Newly enrolled students and other individuals attached to a high-risk setting such as a medical institution should be screened for immunization status during initial medical examination as the number of unimmunized persons, especially against hepatitis B is high.

Malaria and dengue: Knowledge, attitude, practice, and effect of sensitization workshop among school teachers as health educators.

BACKGROUND AND OBJECTIVES: Outbreaks of vector-borne diseases (VBDs) such as dengue and malaria can overwhelm health systems in resource-poor countries. Teachers can act as excellent educators by playing a key role of delivering important health education messages to school children and targeting an important health determinant - the health behavior. This study was done to assess the knowledge, attitude, and practice (KAP) of school teachers regarding VBDs and the effect of a sensitization workshop on the same. MATERIALS AND METHODS: This is a cross-sectional study done on 212 school teachers to know their KAP regarding dengue and malaria. They were also exposed to an intervention workshop after the pretest, and the gain in knowledge scores was compared. RESULTS: The mean age of respondents was 38.5 years and 57.5% of them were females. Participants had fairly good knowledge about dengue and malaria. More than 90% participants knew that mosquito bite is responsible for dengue and malaria. Around 75% of respondents were also aware of the symptoms of these diseases. The number of participants having a low, medium, and high pretest knowledge score (<50%, 50%-74%, and ≥75%, respectively) was 6.6%, 42.5%, and 50.9%, respectively. A significant improvement was seen in the knowledge score after the intervention workshop (χ2 = 23.6, P < 0.001). CONCLUSION: Key success for mosquito-borne diseases control depends not only on services provided by Health Authority but also on knowledge, awareness, preventive practices, and early care-seeking behavior of the community. There is a need to know and improve existing knowledge and practice regarding mosquito-borne diseases and its control in community, especially with the collaboration of school teachers as health educators.

Knowledge assessment regarding poliomyelitis among the caregivers of children who received oral polio vaccine reveals lack of awareness of the vaccine vial monitor (VVM): Implications extending beyond polio eradication.

Vaccine vial monitor (VVM) is now commonly used for vaccines that are included in the National Immunization Schedule in India. It helps to indicate the viability of the vaccine and of the proper functioning of the cold chain. This is useful as it prevents health personnel from administering damaged vaccine. Studies have shown a lack of awareness of health workers regarding the use and interpretation of a VVM. The current study, undertaken among the caregivers of children who were immunized, showed that this lack of information about the VVM also exists among the caregivers. This deficiency in knowledge, both in the health workers and the caregivers, can affect the health of the child and needs urgent attention.

Prevalence of induced abortions and contraceptive use among married women in an urban slum of Delhi, India.

OBJECTIVE: To document abortion practices and contraceptive use among women of reproductive age in an urban slum of Delhi. METHODS: Data were collected as part of a cross-sectional study conducted in an urban resettlement colony in the North East District of Delhi between November 2010 and December 2011. Systematic random sampling was used to enroll 200 married women aged 15-49 years from each of the four blocks of the colony. Participants were interviewed and data were entered into a pretested semi-structured questionnaire. RESULTS: Among 802 participants, 284 (35.4%) reported at least one spontaneous or induced abortion, and 196 (24.4%) reported induced abortions. Unsupervised medical termination was reported by 78 (27.5%) of the 284 women. Overall, only 207 (25.8%) women practiced any type of contraception. The predominant decision maker regarding contraception was the husband for 95 (45.9%) women and the mother-in-law for 78 (37.7%). CONCLUSION: There is a need for focused community-based education to address specific issues, particularly regarding the dangers of unsafe abortion and choosing a method of contraception in consultation with a healthcare practitioner.

Prevalence of reproductive tract infections and their determinants in married women residing in an urban slum of North-East Delhi, India.

BACKGROUND: Reproductive tract infections (RTIs) have adverse implications on the health of the women. Community-based studies in India have shown a high prevalence of RTIs but here is a lack of sizeable literature from urban slums and resettlement areas. AIMS AND OBJECTIVES: The objective was to document the prevalence and determinants of RTIs in married women (15-49 years) residing in an urban slum in Delhi, India. MATERIALS AND METHODS: The study was conducted in an urban resettlement colony of Gokulpuri in the North-East district of Delhi. Systematic random sampling method was adopted to choose the study subjects, that is, married and non-pregnant women in the reproductive age group (15-49 years) residing in the study area. Data were collected using a pretested semi-structured questionnaire, through the house to house visits. The diagnosis of RTIs was made as per the World Health Organization syndromic approach. Data were analyzed in SPSS version 16 (Chicago, IL, USA). RESULTS: A total of 802 women were interviewed. The mean age of study subjects was 30.79 ± 7 years. A total of 352 (43.9%) women currently had symptoms of RTIs. The most frequently reported symptoms included abdominal pain (68.2%), back pain (69.6%), and vaginal discharge (59.3%). Older women (≥25 years) (odds ratio [OR] 2.2, 95% confidence interval [CI]; 1.4-3.5), those belonging to the lower socioeconomic status (OR 2.1, 95% CI; 1.5-2.9), those using cloth during menses (OR 2.6, 95% CI; 1.6-4.3), those having more than three pregnancies (OR 1.8, 95% CI; 1.2-2.6) and those using an intrauterine contraceptive device (OR 11.8, 95% CI; 4.3-32.0) had higher odds of having RTIs. CONCLUSIONS: A high case load was found based on the syndromic approach. Generating community awareness, ensuring proper menstrual hygiene, and improving the socioeconomic status would help in reducing the cases of RTI.

A Community-based Cervical Cancer Screening Program among Women of Delhi using Camp Approach.

BACKGROUND: Cervical cancer is the commonest malignancy among women in developing countries. Cytological screening (Pap smear) have been claimed to reduce incidence and mortality of carcinoma cervix significantly for which sensitization of women is required through community-based approach. OBJECTIVES: To find out number of cervical cancer cases among patients reporting to a general health care camp through screening program and study the prevalence of perceived morbidity and its confirmation. SETTINGS: Cross-sectional study among women attending cancer awareness camps. MATERIALS AND METHODS: A total of 435 women attending cancer awareness camps were screened for carcinoma cervix. The findings of history and clinical examination were recorded. Pap smears of all the symptomatic patients were collected and cytological diagnosis was confirmed by a pathologist. RESULTS AND CONCLUSIONS: The perceived gynecological morbidity was observed to be 59.8%. The smear of the women who were suspected of carcinoma on clinical examination was confirmed to be the cases of carcinoma-in-situ (7.8%) and high-grade neoplasia (2.9%) on laboratory investigations. The findings of the study highlight the utility and need of cancer cervix screening among the women at regular intervals through camp approach in the community.

Evaluation of a health education intervention on knowledge and attitudes of food handlers working in a medical college in Delhi, India.

The present study assessed change in knowledge, attitudes, and self-reported hand-washing practices of 136 food handlers 3 months after providing them health education using posters and interactive sessions using a flip chart. There was a significant change in the proportion of study participants who named food borne or waterborne diseases, including gastroenteritis (79.4% to 91.9%), worm infestation (39.0% to 55.9%), cholera (16.2% to 42.7%), and typhoid (9.6% to 28.7%). Significant increase in knowledge about hand hygiene measures, namely, washing hands before handling food (23.5% to 65.4%) and keeping nails cut and clean (8.1% to 57.4%), was observed. Baseline self-reported hand-washing practices revealed low figures for washing hands after micturition (82.4%) and smoking (52.8%) and consistent use of soap at the workplace (24.3%) and after micturition (14.0%), which improved after health education but not to the desired extent. Findings highlight the importance of providing health education in food and personal hygiene to food handlers and incorporating the same in existing guidelines for food establishments laid down by civic agencies in Delhi and elsewhere.

Awareness status about HIV/AIDS among Indian railway's employees and their family members.

A house to house survey was conducted in December 2005 in the Railway Colony of Shamli, located in the state of Uttar Pradesh, India using a semistructured questionnaire to study the awareness level regarding HIV/AIDS among Indian Railway's employees and their family members. Information regarding demographic characteristics and knowledge about various aspects of HIV/AIDS was recorded by a trained staff nurse of the local Railway Medical Unit from at least one person, aged 15 years to 59 years, from each household. Among 293 individuals interviewed, majority were males (61.8%), aged > 30 years (56.6%) and literate (85.3%). Majority were aware about existence of HIV infection in India (92.5%), AIDS is a fatal disease (92.8%) and laboratory tests are available for detecting HIV infection (89.4%). Although most of them knew the correct routes of HIV transmission viz. sexual (91.50%), parentral (90.8%), perinatal route (86.3%) and blood transfusion (86.0%), misconceptions such as transmission through shaking hands (89.1%), hugging (88.4%), sharing utensils (82.6%), mosquito bite (74.1%) and using public toilets (73.4%) were also observed. Most of them were also aware about preventive measures. Knowledge about various aspects was observed to be significantly higher among females, among individuals aged <45 years and literate individuals. The findings highlight the need of intensified health education focusing on removal of misconceptions and further improvement in awareness level of the study population.

Profile of food handlers working in food service establishments located within the premises of a medical college in Delhi, India.

OBJECTIVES: To find out: (1) the socio-demographic and professional characteristics of food handlers working in food service establishments located in the campus of a medical college in New Delhi, (2) the prevalence of morbid conditions among them and their health-care-seeking behaviour and immunization status. STUDY DESIGN: Cross-sectional study METHODS: A total of 151 food handlers working in 18 food service establishments were interviewed regarding their socio-demographic and professional characteristics, history of substance use, disease if any and health care sought for it, immunization status and pre-placement and in-service medical examination. They were also subjected to clinical examination. Stool examination was done for 129 study subjects. RESULTS: The majority were less than 40 years of age (60.3%), male (97.4%), Hindu (95.3%), literate (80.1%) and had the habit of substance use (75.5%). Most of them (94.7%) had one or more morbid conditions, important ones being dental caries (50.3%), worm infestation (41.1%) and injuries/burns on hands (39.7%). The health seeking behaviour, immunization status in relation to enteric group of fevers and tetanus and pre-placement and in-service medical examination were observed to be unsatisfactory. CONCLUSION: The findings of the study highlight the need of creating awareness among food handlers about various measures of maintaining food hygiene and ensuring their good health through pre-placement and inservice medical examination.

Perception of risk and potential occupational exposure to HIV/AIDS among medical interns in Delhi.

A cross sectional study was conducted among 129 medical interns of Maulana Azad Medical College, New Delhi for assessing the perceived levels of risk of acquiring HIV infection in the health care settings among medical interns, reasons for the same and their exposure to situations having potential of HIV transmission. Majority of the interns (68.3%) perceived themselves to be at a very high/high risk of acquiring HIV infection during their medical career. The common reasons for perceived risk of acquiring HIV infection were getting injuries due to needle pricks/cuts during surgical procedures (32.4%), frequent exposure to the blood/ secretions of patients (28.5%) and insufficient availability of gloves (17.6%). Some (23.2%) were of the opinion that students in future might lose interest in the medical profession due to increasing risk of HIV infection and few (3.1%) were even considering to leave the medical profession for the same reason. Majority of the interns (72.9%) had experienced needle pricks and more than half (53.7%) of them even had had blood splashes in their eyes/ nose/ mouth during surgical procedures. The findings of the study call for efforts for bringing a reduction in the risk perception of the interns through awareness campaigns and reorientation trainings, ensuring availability of gloves and other items necessary for observing universal work precautions and proper disposal of potentially contaminated articles.

Study of hand hygiene and enteroparasite infestation among food handlers working in a medical college of North India.

The present study was conducted to assess: 1) Prevalence of enteroparasite infestation among food handlers working in food service establishments located in the campus of a medical college, 2) Presence of enteric organisms on their hands and nails and their hand washing practices. A total of 151 food handlers were interviewed regarding their socio-demographic and professional characteristics. Their hand washing practices were also observed. Stool examination for enteroparasites and stool culture for Salmonella & Shigella and culture of nail clippings / nail bed swabs for detecting presence of enteric organisms were also carried out. Prevalence of enteroparasite infestation was observed to be 41.1%. None of the stool samples was observed to be positive for Salmonella or Shigella. Enteric organisms were isolated from nail clippings/nail bed swab samples of 76 (73.1%) study subjects. Hand washing practices were observed to be poor with low use of soap. Findings highlight importance of periodic stool examination and deworming of food handlers and need to educate them about importance of maintaining hand hygiene with a focus on improving their hand washing practices.