Evidence of Knowledge, Attitude, and Practice Regarding Human Papilloma Virus Vaccination at the Community Level in India: A Systematic Review and Meta-analysis.

BACKGROUND: Effective vaccines for the prevention of cervical cancers are available in India. The existing knowledge and attitude regarding the Human Papillomavirus (HPV) vaccine varies widely among available studies. Our study aimed to estimate pooled prevalence related to knowledge, attitude, and practice of HPV vaccination in India. METHODOLOGY: We conducted systematic searches in PUBMED, EMBASE, CINHAL, PROQUEST, and Cochrane Library databases using database-specific search strategies. The random effects model was used for estimating the pooled proportion of knowledge, attitude, and practice. The outlier studies were identified using the Baujat test. Egger's regression test and funnel plots were used to identify publication bias. RESULTS: Database-specific search strategies yielded 2,377 records from five databases. We identified 48 studies for full-text retrieval after screening titles and abstracts. Finally, 27 studies were included in the meta-analysis. The pooled prevalence of knowledge regarding HPV vaccines in India was 0.22 (CI;0.14-0.31, I2 =99.5%). The pooled prevalence of positive attitudes towards the uptake of HPV vaccines in India was 0.45 (CI;0.33-0.57, I2 =100%). The pooled prevalence of coverage of HPV vaccines in India was 0.04 (CI;0.02-0.07, I2 =96%). Significant publication bias was present for the studies' reported knowledge and coverage. CONCLUSION: The knowledge, attitude, and coverage of the HPV vaccine were low in India. It suggests effective strategies to improve knowledge and attitudes towards HPV vaccination in India.

Intimate partner violence in India: Need for renewed corollary during COVID-19 pandemic.

Intimate partner violence (IPV) is considered any type of behavior involving the premeditated use of physical, emotional, or sexual force between two people in an intimate relationship. The prevalence of health-seeking attitude towards IPV in India is very low among victims affected by it. The chances of facing violence or even in their maternal life were substantially high among women having lesser education or without any financial empowerment. Data have been quite supportive whenever elevated odds of risk of experiencing controlling behavior from their spouses were concerned. Safety strategies for violence programming could increase monitoring and evaluation efforts to reduce violence. Women with vulnerabilities like being marginalized, least resourced, and disabled are likely to suffer violence in an intimate relationship. Primary care physicians have a definitive role and involvement of other stakeholders like ward members and self-help groups to mitigate such occurrences.

Perception of undergraduate medical students toward stressors and de-stressors during COVID-19 pandemic: Online cross-sectional survey from a medical institute in Eastern India.

Introduction: COVID-19 has affected the quality of life of all age groups. Medical education during the pandemic shifted to online mode due to lockdown restrictions. The stress felt by medical students during the pandemic has been studied less. The current study aimed to assessed the stressors and de-stressors for undergraduate medical students during the COVID-19 pandemic. Materials and methods: A cross-sectional online survey was conducted for the undergraduate medical students of a tertiary care institute of eastern India. A total of 307 medical students were included in the study by convenient and snowball sampling. A self-designed semi-structural questionnaire was created as a Google form and circulated among the students between September and October 2020. A combination of purposive and snowball sampling was adopted. Responses regarding stressors and de-stressors were recorded on a Likert scale. Data analysis was performed using Statistical Package for Social Sciences (SPSS) version 22. Categorical variables were presented as percentages and descriptive statistics were performed. Results: A total of 307 students responded and 64.5% of them were men and 35.5% were women. 47.6% of the students experienced stress due to changes brought about by COVID-19. Risk of parents getting infection (63.2%), fear of not easily returning home (53.1%), lack of clinical exposure (52.7%), and financial impact (47.9%) were the major stressors perceived by the students. Connecting with family and friends through social media (47.5%), gaming (45.0%), online streaming platform (51.2%), spending time with family members (54.4%) were the coping strategies adopted by these students. Conclusion: Higher level of psychological stress perceived by the undergraduate students needs psychological intervention. Academic revamp and adaptation of coping strategies are required for the medical under-graduates.

Learning innovation in community medicine teaching: A-Z of job responsibilities of anganwadi worker, accredited social health activist, and auxiliary nurse midwife.

The interaction between medical students and frontline healthcare workers is one of the crucial components of community medicine. The interaction of medical students with frontline healthcare workers provides multiple opportunities. Medical students like to understand their job responsibilities and their involvement in implementing the various national health programs at the community level. Innovation is required to train our medical students better and enhance their learning. A learning and teaching innovation was developed by us to provide insight into the various roles and involvement of frontline healthcare workers in the community. One innovation is the A-Z activity calendar of frontline healthcare workers in teaching and learning in medical education.

Hospital-Based Contact Tracing of Patients With COVID-19 and Health Care Workers During the COVID-19 Pandemic in Eastern India: Cross-sectional Study.

BACKGROUND: The contact tracing and subsequent quarantining of health care workers (HCWs) are essential to minimizing the further transmission of SARS-CoV-2 infection and mitigating the shortage of HCWs during the COVID-19 pandemic situation. OBJECTIVE: This study aimed to assess the yield of contact tracing for COVID-19 cases and the risk stratification of HCWs who are exposed to these cases. METHODS: This was an analysis of routine data that were collected for the contact tracing of COVID-19 cases at the All India Institute of Medical Sciences, Bhubaneswar, in Odisha, India. Data from March 19 to August 31, 2020, were considered for this study. COVID-19 cases were admitted patients, outpatients, or HCWs in the hospital. HCWs who were exposed to COVID-19 cases were categorized, per the risk stratification guidelines, as high-risk contacts or low-risk contacts. RESULTS: During contact tracing, 3411 HCWs were identified as those who were exposed to 360 COVID-19 cases. Of these 360 cases, 269 (74.7%) were either admitted patients or outpatients, and 91 (25.3%) were HCWs. After the risk stratification of the 3411 HCWs, 890 (26.1%) were categorized as high-risk contacts, and 2521 (73.9%) were categorized as low-risk contacts. The COVID-19 test positivity rates of high-risk contacts and low-risk contacts were 3.8% (34/890) and 1.9% (48/2521), respectively. The average number of high-risk contacts was significantly higher when the COVID-19 case was an admitted patient (number of contacts: mean 6.6) rather than when the COVID-19 case was an HCW (number of contacts: mean 4.0) or outpatient (number of contacts: mean 0.2; P=.009). Similarly, the average number of high-risk contacts was higher when the COVID-19 case was admitted in a non-COVID-19 area (number of contacts: mean 15.8) rather than when such cases were admitted in a COVID-19 area (number of contacts: mean 0.27; P<.001). There was a significant decline in the mean number of high-risk contacts over the study period (P=.003). CONCLUSIONS: Contact tracing and risk stratification were effective and helped to reduce the number of HCWs requiring quarantine. There was also a decline in the number of high-risk contacts during the study period. This indicates the role of the implementation of hospital-based, COVID-19-related infection control strategies. The contact tracing and risk stratification approaches that were designed in this study can also be implemented in other health care settings.

Empowering primary healthcare institutions against COVID-19 pandemic: A health system-based approach.

Primary health care institutions (PHCIs) are an essential foundation for the national response to COVID-19 disease in India. With the soaring number of confirmed cases, the health system is currently under unprecedented stress. In this scenario, there is a pressing need for empowering PHCIs in COVID-19 preparedness and response. The World Health Organization's (WHO) "Health system building block" approach is a classic model, which can work as a road map for the national health system in the process of empowering PHCIs against COVID-19 as well as other upcoming global and regional public health emergencies.