All India Institute of Hygiene and Public Health

Introduction: Thalassemia is a severe chronic anaemia. Caregivers face many stresses to provide the best possible medical care for their children. They develop a variety of coping mechanism. Objectives: To determine coping mechanism among caregivers of thalassemia patients and its associated factors; To explore challenges faced by caregivers of thalassemia patients. Methods: Institutional based observational study with convergent parallel mixed method study design was conducted in tertiary care hospital at OPD of Haematology Department in Kolkata, India. Total of 130 caregivers were selected through systematic random sampling for the quantitative strand who were interviewed using pre-tested questionnaire and the Coping Health Inventory for Parents-45 (CHIP). Additionally, seven in-depth interviews were conducted for the qualitative strand. Data were analysed using MS Excel 2019, SPSS v25, and QDA Miner Lite v3.0.2 with coding and thematic analysis after data saturation. Results: Among the caregivers 55 (42.3%) and 75 (57.7%) were mothers and fathers respectively with median age of 34 years. The median total score of the CHIP was 75, where 49% caregivers had adequate and 51% had inadequate coping skills. There was significant association between inadequate coping with poor social support (p=0.045) and frequent blood transfusion interval (p=0.020). The qualitative strand of this mixed-methods study identified five major themes-health problems, self-negligence, financial issues, familial issues and spiritual beliefs. Conclusion: Nearly half of the caregivers exhibited inadequate coping due to poor social support and shorter intervals between blood transfusions. Comprehensive support systems are crucial to improve their coping and overall quality of life.

Background Leprosy-related foot ulceration remains a significant cause of disability despite the decline in global disease prevalence. Self-care practices are essential for preventing foot complications, particularly in resource-limited settings. Aim To assess foot care practices among leprosy-affected persons with foot disabilities and to explore the barriers to proper foot care among the study participants with unsatisfactory foot care practices Methods A community-based cross-sectional mixed-method study with an explanatory sequential design was conducted in a Leprosy Colony of Bankura, West Bengal from December 2023 to August 2024. For the quantitative strand, 104 leprosy-affected adults with Grade 1 and Grade 2 foot disabilities were interviewed using a predesigned, pretested semi-structured questionnaire. In-depth interviews were conducted among seven individual with unsatisfactory foot care practices, for the qualitative strand. Results The median foot care practice score was 5.5 (4, 7), with 84.6% of participants having unsatisfactory practices. Women (p?0.001), widowed/never married status (p?0.004), and Grade 1 foot disability (p?0.034) were significantly associated with unsatisfactory foot care. Qualitative exploration revealed three major barrier themes: cognitive (knowledge deficits, misconceptions, low perceived disease severity), socio-economic (lack of caregivers, insufficient income, forced long-distance walking), and product-related (gender-inappropriate footwear design, poor fit, limited durability). Limitations Conducting this study in a single leprosy colony and non-probabilistic sampling method may limit generalisability and self-reported data may subject to response bias. Conclusions Multiple interconnected factors influence foot care practices among leprosy-affected individuals. Interventions should address gender-specific barriers, enhance risk perception among those with milder disabilities, and improve the design, fit, and quality of protective footwear to reduce disability burden.

ABSTRACTObjectives:Despite receiving opioid substitution therapy (OST), injectable drug consumption is not uncommon among the injecting drug users (IDUs) that increases the risk of contracting HIV. The current study was aimed at exploring the injection related and sex related high-risk behaviour among IDUs, choices of injectable opioids consumed and treatment adherence.Materials and Methods:An observational study was conducted among 168 IDUs attending the OST centre. Structured questionnaire included sociodemographic characteristics, high-risk behaviour as well as injectable opioids consumption. Descriptive statistics were used to summarize the data.Results:Nearly 30% of the IDUs were engaged in injecting practice while on OST. Of 143 male IDUs, 5.6% of the clients had had sex with commercial sex worker, whereas 3.5% of them had multiple partners. Four of 143 men were MSM, whereas 32 IDUs had sex without condom in the preceding 1 year. Regarding treatment adherence, 62.9% IDUs were very regular. As far as the retention rate was concerned, the findings were promising, i.e. 77.8% at the end of 3 months and 70.7% at the end of 6 months. Buprenorphine was the commonest opioid consumed by the IDUs before attending the OST centres while heroine used to be drug of choice when they first started injecting.Conclusion:The study revealed high-risk behaviour of IDUs attending an OST centre. The study provided useful information about the choices of opioids injected by the IDUs. The findings of the study might be of help in designing appropriate strategies for the improvement of treatment adherence among IDUs.

Background: Beedi workers are frequently exposed to various health hazards due to ergonomically poor working conditions and lack of safety standards, exacerbating worker risks. The current study aimed to determine major morbidities and their determinants affecting beedi workers of Murshidabad district, thereby laying a way forward to uplift their health and wellbeing. Methods: A community based cross sectional study was conducted among 420 beedi workers from March to August 2021 in Murshidabad district of West Bengal. Multistage sampling was used to randomly select one village and one municipality of the district. A predesigned pretested questionnaire was used to conduct face-to-face interviews. Data were entered using Microsoft Excel and subsequently analysed in SPSS v20. Results: Major morbidities among beedi workers were musculoskeletal followed by respiratory and ophthalmological conditions. Multivariate analysis revealed age, marital status, educational level, duration as a beedi worker (in years) and working posture were significant determinants of musculoskeletal morbidity, whereas age, duration as a beedi worker (in years) and number of beedi rolled per day were found to be significantly associated with respiratory morbidities. Similarly, age, education, duration as a beedi worker (in years), number of beedis rolled per day and place of work were found to be significant predictors of ophthalmological morbidities among beedi workers through multivariate analysis. Conclusions: The occupational environment should be uplifted along with legislation to recognise this occupation as a part of organised sector. Furthermore, stricter authoritative actions are needed to regulate the current workload and improve the health status of beedi workers.

Sleep is very important for carrying out normal bodily functions. Lack of sleep or insomnia is a worry in the modern society. Many infections are now known to hamper proper sleep via a number of mechanisms like bacteriocin molecules released, and cytokines liberated. Some infections may also increase the duration and intensity of sleep. Insomnia in various infections can be mediated via the microbes directly or their metabolic products. However, deep sleep is also a protective response of the body against various infections. These mechanisms should be explored more and more, and new strategies can also be tested to induce sleep in patients suffering from infections and concomitant insomnia. The molecules released from the microbes which can affect or alter sleep can be used to treat sleep disorders in the form of novel nutraceutical molecules.

The family adoption program has been inculcated in the undergraduate medical curriculum vide the March 2022 directives to ensure community-based hands-on experience from the beginning and increase the availability and accessibility of doctors or medical professionals in the rural areas and is currently in a nascent phase of implementation across the various medical colleges in India. To assess the challenges faced while implementing the new initiative of family adoption over three and a half years and possible solutions offered by the faculties of Community Medicine of various colleges of West Bengal based on their hands-on experience. A cross-sectional qualitative study was carried out among the Community Medicine faculty representatives from 24 medical colleges in West Bengal. After due informed consent, they were interviewed by a panel of senior faculty members based on a semi-structured questionnaire. A qualitative thematic content analysis was carried out to identify the major themes involved. The four themes emerging were sustainability of adopted families, human resources and other Logistics issues, logbook proto-type, and building on previous successful implementation of family visits. Various modifications were mentioned by different respondents. Despite the different deterring issues noted, solutions by the implementers themselves that can have far-reaching implications were identified. A successful implementation of FAP can make a difference in public health, and develop Indian Medical Graduates competent to serve the community at their best.

Background: Every chronic illness involves specific physical, social, and psychological care. Patients must comprehend their diagnosis (sense) and gain control over the ailment (grip on the disease). The sense of grip on disease (SoGoD) of a person living with chronic disease can be explored using narrative interviews which are lengthy, and often subjective. Thus, there is a need for an objective quantitative tool to assess SoGoD status. Oour objective was to develop a quantitative tool for the assessment of a sense of grip on disease based on the SoGoD model. Methods: This institution-based tool development study was conducted among 120 PL-HIV visiting the ART center of a tertiary care hospital in Kolkata in 2023. Based on the deductive approach and literature review, a five-construct SoGoD tool was made, subsequently validated by three domain experts, pre-tested, and revised. Revised version used for data collection. Confirmatory factor analysis and reliability analysis were performed for the tool validation. Results: A 15-item tool well mounted on five theoretical constructs of SoGoD was confirmed. Each item responded to a five-point Likert scale of one to five, considering the imposed weight, the global SoGoD score ranges from 3 to 15. A higher score indicates a higher sense of grip. The cut-off value was found to be seven. The tool was internally consistent with Cronbach’s alpha of 0.883. Conclusions: Sense of grip on disease is a relatively simple, easy-to-apply tool but the cut-off needs to be contextualized based on setting and population.

Abstract Background: Promoting preventive measures of cancer among people should be based on a psychosocial model and be tailored to attitude which is a difficult variable to measure. Objectives: The objective of this study was to develop and validate a questionnaire to evaluate the attitude of urban adults toward the prevention of cancer. Methods: This observational study with cross-sectional design was done in the field practice area of a tertiary care hospital, Kolkata. Four hundred and fifteen respondents were interviewed. The content validity, construct validity, and reliability were performed, followed by exploratory and confirmatory factor analysis to identify the factors. Results: Items were generated by literature review. Kaiser–Meyer–Olkin (KMO) value suggests that the model was reasonably fit (KMO > 0.8). The final attitude questionnaire contained 19 items. The factorial analysis revealed four domains such as perceived severity, perceived susceptibility, perceived barrier, and perceived benefit that explain the 58% estimated variance. Overall reliability was measured by Cronbach’s alpha (0.716) and McDonald’s omega (0.709). Conclusion: The results show that the questionnaire is relatively valid and reliable to assess the attitude of urban adults toward cancer prevention. Understanding the attitude of people with respect to cancer prevention will help develop more effective cancer-preventive programs.

Introduction: Tobacco kills half of its users and globally every year around 8 million deaths are attributable to tobacco use. All forms of tobacco are harmful and there is no safe level of exposure to tobacco but cigarette smoking is the most common and notorious since it kills not only its users but also the innocent passive bystanders. Objectives: The study was conducted to determine the prevalence of cigarette use, minimum length of cigarette (nicotine portion) to quench the craving, level of nicotine dependence along with their stage of change (in behaviour to quit tobacco use) and also to find out its determinants among males above 15 years residing in the urban field practicing area of a Public Health Institute. Materials and methods: A community based observational, cross-sectional study was conducted in a slum of West Bengal. Data was collected as per a pre-designed and pre-tested schedule adapted from GATS India Questionnaire. Males above 15 years of age residing in the study area were interviewed during house-to-house visit. Results: A total of 352 study participants were interviewed. 38.4% of study participants consumes cigarettes on a regular basis. Study participants with a positive family history of tobacco use are 2.1 times (95% CI: 1.3, 3.4) more probable to use cigarettes. Half of the population are in stage of precontemplation and 43.7% of them are having high level of nicotine dependency. 66.7% of them do not need to consume the full length of a cigarette to quench their craving. Those with younger age of initiation (OR 5.35 95%CI:2.5,11.2) and consume full length of cigarette (OR 2.72, 95% CI: 1.3,5.7) are having more probability of high nicotine dependency than their counterparts. Odds of willingness to quit is significantly more among those who don’t require full length of a cigarette even when adjusted with various covariates found significant in univariate regression. Conclusion: Length of the cigarettes (nicotine portion) may be reduced to at least half the size of present standard length to not only decrease the nicotine dependence but also to encourage quitting behaviour among the users.