Background:
Health-seeking behaviour is defined as ‘any activity undertaken by individuals who perceive themselves to have a health problem or to be ill for the purpose of finding an appropriate ...remedy. The severity of the disease among elderly is influenced by one important factor which is health seeking behaviour. To regain their lost health status the elderly must seek the treatment. The way people conceptualize the cause of their health problem and their perception of symptoms plays an important role in seeking healthcare. Health seeking behaviour is influenced by few factors like illiteracy, misconception, income, family composition, social isolation and dependency.
Objective:
To assess the healthcare seeking behaviour among the geriatric population residing in the field practise area of a Medical College in South East Delhi.
Methodology:
Community-based cross-sectional study conducted in South East Delhi. • The sample size was calculated as 350 considering a relative error of 3% at 95% level of significance and 10% non-response rate. Stratified random sampling with probability proportional to size was applied to the population registered at UHTC & RHTC area of a medical college in southeast Delhi. Households were selected by systematic random sampling. Persons aged > 60 years from the households were selected for the study. A self-designed, pre-tested, validated, structured questionnaire was used to collect the data.
Results
In our study it was found that the majority of the participants take treatment when they fall sick ie 99.5%. Of those who take treatment 54% go forconsultation whereas 48% take over the counter medication and 33% do home remedies. Out of the 54% who consult, 78.7% visit Private health facility and 21.3% visit Public health facility. Out of the 78.7% who visit private health facility 65.9% visit Non registered medical practitioner and 7.1% don’t even know whether their doctor is registered or not. Majority of the participants ie 86% preferred health facility within 1kms of their house & it was also a major reason for choosing a health facility for consultation. 98% of the participants visit only in case of illness. 52% were accompanied by their children or daughter in law and 26% visited alone.
Conclusion:
The participants favoured more private than public healthcare institutions. Nearby medical facilities were favoured, and non-registered medical professionals comprised the majority of them. Almost all senior people received therapy of some kind rather than dismissing it as an issue unique to ageing.
Background:
Antenatal care provides preventive health care, through which women can learn from skilled health personnel. Women who don’t consume Iron Folic Acid Supplements as prescribed would ...experience iron and folic acid (IFA) deficiency anemia. Iron deficiency has negative effects on mothers and newborns while folic acid deficiency in pregnancy causes pre-eclampsia, preterm delivery, neural tube defects, fetal malformation, type 2 diabetes, and obesity in the newborn. Comprehensive antenatal care is early registration of pregnancy (within 12 weeks), at least four ANC visits at a health facility, two doses of tetanus toxoid, and at least 100 days of IFAS consumption.
Objectives:
1-To assess pregnancy outcomes associated with antenatal care service utilization in participants aged 18-49 years residing in the field practice areas of a Medical College in South-East Delhi. 2-To determine the barriers and enablers affecting the utilization of antenatal care services in the given population.
Methodology:
It is a community-based cross-sectional study conducted in South-East Delhi. The sample size was calculated as 300 considering a 5% absolute error for a 95% confidence interval and 10% non-response rate. Out of 300, the current data of 200 participants will be depicted here. Stratified systematic random sampling with the Probability Proportional to Size technique was applied to the population registered at RHTC & UHTC. Households were selected by systematic random sampling. Pregnant women aged between 18-49 years were selected from the household. A self-designed, pre-tested, validated structured questionnaire was used.
Results:
Out of the total number of participants, 66.0% had knowledge regarding early registration of pregnancy. 80.0 % had permission to attend a health facility, 70.5 % had an accompanying person, 62.5 % of participants had been residing more than 6 km away from the health facility. 58.0 % of participants could meet the expenses of health care services. Out of all newborns, 90.0 % had normal birth weights, 10% had low birth weights, 81.0% participants had NVDs, and 19% were caesarean sections.
Conclusion:
Enablers are knowledge regarding early registration, presence of accompanying person. Permission for health visits, expenses for health care services & distance to health facility were barriers.
Healthcare workers (HCW) are most vulnerable to contracting COVID-19 infection. Understanding the extent of human-to-human transmission of the COVID-19 infection among HCWs is critical in managing ...this infection and for policy making. We did this study to estimate new infection by seroconversion among HCWs in recent contact with COVID-19 and predict the risk factors for infection.
A cohort study was conducted at a tertiary care COVID-19 hospital in New Delhi during the first and second waves of the COVID-19 pandemic. All HCWs working in the hospital during the study period who came in recent contact with the patients were our study population. The data was collected by a detailed face-to-face interview, serological assessment for anti- COVID-19 antibodies at baseline and end line, and daily symptoms. Potential risk factors for seroprevalence and seroconversion were analyzed by logistic regression keeping the significance at p<0.05.
A total of 192 HCWs were recruited in this study, out of which 119 (62.0%) were seropositive. Almost all were wearing Personal protective equipment (PPE) and following Infection prevention and control (IPC) measures during their recent contact with a COVID-19 patient. Seroconversion was observed among 36.7% of HCWs, while 64.0% had a serial rise in the titer of antibodies during the follow-up period. Seropositivity was negatively associated with being a doctor (odds ratio OR 0.35, 95% Confidence Interval CI 0.18-0.71), having COVID-19 symptoms (OR 0.21, 95% CI 0.05-0.82), having comorbidities (OR 0.14, 95% CI 0.03-0.67), and received IPC training (OR 0.25, 95% CI 0.07-0.86), while positively associated with partial (OR 3.30, 95% CI 1.26-8.69), as well as complete vaccination for COVID-19 (OR 2.43, 95% CI 1.12-5.27). Seroconversion was positively associated with doctor as a profession (OR 13.04, 95% CI 3.39-50.25) and with partially (OR 4.35, 95% CI 1.07-17.65), as well as fully vaccinated for COVID-19 (OR 6.08, 95% CI 1.73-21.4). No significant association was observed between adherence to any IPC measures and PPE adopted by the HCW during the recent contact with COVID-19 patients and seroconversion.
Almost all the HCW practiced IPC measures in these settings. High seropositivity and seroconversion are most likely due to concurrent vaccination against COVID-19 rather than recent exposure to COVID-19 patients. Further studies using anti-N antibodies serology may help us find the reason for the seropositivity and seroconversion among HCWs.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The transmission of respiratory pathogens, including SARS-CoV-2, is often facilitated through household contact. To better understand the transmission rate of COVID-19 among households and factors ...that affect viral clearance and seroconversion, a case-ascertained community-based prospective study was conducted between December 2020 and June 2021 on the urban population of the national capital region of India. The study collected nasopharyngeal swabs for SARS-CoV-2 RT-PCR on the 1st, 7th, 14th, and 28th day, and blood samples for antibody detection on the 1st, 14th, and 28th day from household contacts (HCs) of laboratory-confirmed COVID-19 cases. The study monitored the demographic data, symptoms, and outcomes of 417 participants, including 99 index cases and 318 contacts, for a period of 28 days. The results of the study showed that SARS-CoV-2 was easily spread within households, with a secondary infection rate of 44.3 %. In fact, almost 70 % of the contacts got infected within 1–2 days of identification of the index case, while 34 % remained asymptomatic. Sero-conversion was found in 35.6 % of the participants while 22.9 % did not produce antibodies after 28 days of infection. The study also revealed that females, spouses, older members, and primary care providers were at higher risk of getting infected in a home setting. However, approximately one-third of individuals in the younger age group managed to avoid infection. The study demonstrated that most infected individuals became RT-PCR negative within two weeks, although viral clearance was delayed in older patients and those with lower cycle threshold values in RT-PCR.
Introduction: With the availability of antiretroviral therapy (ART) and subsequent change in the HIV/AIDS disease dynamic to a chronic manageable disease, adherence studies have received increasing ...attention. However, there is a paucity of studies that have considered World Health Organization (WHO) dimensions of adherence to ART. Therefore, this study was conducted with the objectives of determining the prevalence of adherence and the association of various factors across five WHO dimensions to adherence. Methods: A cross-sectional study was carried out at the ART Centre, Aligarh. A total of 440 adult patients, taking treatment from the ART Centre, Aligarh were selected. A self-reported instrument of missing pills was used to measure adherence. Various factors across five WHO dimensions were studied. Results: Prevalence of adherence in our study was 81.3%. Among the five dimensions of adherence, distance from home (odds ratio OR 0.980; 95% confidence interval CI 0.964-0.997) among socioeconomic determinants, frequent adherence counseling (OR 8.737; 95% CI 4.076-18.727) among health system-related, drug regimen (OR 2.202; 95% CI 1.023-4.738) and absence of side effects (OR 3.293; 95% CI 1.473-7.365) among therapy related, absence of substance abuse (OR 2.747; 95% CI 1.209-6.243), and perceived change in health status (OR 4.196; 95% CI 1.613-10.915) among patient-related dimension were found to be significantly associated with adherence to ART, while clinical condition dimension did not play a significant role. Conclusion: The ART adherence rate is still below satisfactory levels for long-term viral load suppression. WHO multidimensional approach - which was found to be quite relevant in our study setting - could be applied to effectively solve the adherence problem in our country.
BACKGROUND: Tobacco use remains a significant global health challenge, contributing to 8 million annual deaths and potentially reaching 1 billion deaths in the 21 st century. Despite taking efforts ...like India’s National Tobacco Control Program, the country faces a persistent 39% tobacco use prevalence, particularly in low-income communities like those from Madanpur Khadar, Delhi. This study explores the effectiveness of behavior modification therapy in addressing this challenge. MATERIALS AND METHODS: In a community-based trial, 400 adult tobacco users from Madanpur Khadar were enrolled and randomization and allocation concealment were done (CTRI no.: CTRI/2021/06/034298). Participants were randomly assigned to intervention and control groups during the study period of 18 months. Data on sociodemographic characteristics, smoking behaviors, and motivation levels were collected. The intervention included behavior modification therapy, while the control group received brief advice. Motivation levels were assessed using the contemplation ladder, and carbon monoxide levels were measured with piCO + Smokerlyzer. The study adhered to ethical considerations and obtained approval from Jamia Hamdard’s Institutional Ethical Committee. RESULTS: Sociodemographic characteristics revealed a predominantly male (88%) population, aged above 30 years (68.5%), with lower middle class representation (51%). The intervention group exhibited a 7% smoking cessation rate, which is significantly higher than the control group (1%). piCO+ Smokerlyzer confirmed a 41.7% reduction in carbon monoxide levels among participants in the intervention group. High motivation levels correlated with successful quitting, with a 6.5 times higher odds ratio for highly motivated individuals compared to low or moderately motivated ones. CONCLUSIONS: The study highlights the cost-effective impact of behavior modification therapy in promoting tobacco cessation, particularly in resource-constrained settings. The significant association between motivation levels and quitting underscores the importance of tailored interventions in public health initiatives aimed at reducing tobacco use.
Tuberculosis Preventive Treatment (TPT) is a powerful tool for preventing the TB infection from developing into active TB disease, and has recently been expanded to all household contacts of TB cases ...in India. This study employs a mixed-methods approach to conduct a situational analysis of the initial phase of TPT implementation among household contacts of pulmonary TB patients in three districts of Delhi, India. It was completed using a checklist based assessments, care cascade data, and qualitative analysis. Our observations indicated that organizational structure and planning were established, but implementation of TPT was suboptimal with issues in drug availability and procurement, budget, human resources, and training. Awareness and motivation, and shorter regimen, telephonic assessment, and collaboration with NGOs emerged as enablers. Apprehension about taking TPT, erratic drug supply, long duration of treatment, side effects, overburden, large population, INH resistance, data entry issues, and private provider reluctance emerged as barriers. The study revealed potential solutions for optimizing TPT implementation. It is evident that, while progress has been made in TPT implementation, there is room for improvement and refinement across various domains.
We read the paper on disease-specifc out-of-pocket expenditure (OOPE), catastrophic health expenditure and impoverishment efects in India with great interest 1. The paper confrms the pervasive ...presence of catastrophic expenditures across diferent diseases as well as types of healthcare, adding layers to the mounting evidence on healthcare expenditure in low-income and middle-income countries. The paper refects the concern of the National Health Policy 2017 2, and rightly identifes the two policy implications: (i) increasing access to health insurance and price regulations in the private sector and (ii) stringent implementation of health system fnancing policies. Given the disease-specifc differences in access and provisioning of care, we now draw attention towards three additional policy-related issues of signifcance.
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