Background: Isoniazid preventive therapy (IPT) has been shown to reduce the risk of tuberculosis (TB) among people living with HIV (PLHIV). In 2017, India began a nationwide roll-out of IPT, but there is a lack of evidence on the implementation and the challenges. Objectives: Among PLHIV newly initiated on antiretroviral therapy (ART) from January 2017 to June 2018, to: (i) assess the proportion who started and completed IPT and (ii) explore reasons for non-initiation and non-completion from health-care providers' and patients' perspectives. Methods: An explanatory mixed-methods study was conducted in two selected districts of Karnataka, South India. A quantitative phase (cohort analysis of routinely collected program data) was followed by a qualitative phase involving thematic analysis of in-depth interviews with providers (n = 22) and patients (n = 8). Results: Of the 4020 included PLHIV, 3780 (94%) were eligible for IPT, of whom, 1496 (40%, 95% CI: 38%-41%) were initiated on IPT. Among those initiated, 423 (28.3%) were still on IPT at the time of analysis. Among 1073 patients with declared IPT outcomes 870 (81%, 95% CI: 79%-83%) had completed the six-month course of IPT. The main reason for IPT non-initiation and non-completion was frequent drug stock-outs. This required health-care providers to restrict IPT initiation in selected patient subgroups and earmark six-monthly courses for each patient to ensure that, once started, treatment was not interrupted. The other reasons for non-completion were adverse drug effects and loss to follow-up.
Conclusion:The combined picture of 'low IPT initiation and high completion' seen in our study mirrors findings from other countries. Drug stock-out was the key challenge, which obliged health-care providers to prioritize 'IPT completion' over 'IPT initiation'. There is an urgent need to improve the procurement and supply chain management of isoniazid.
Background:
Delhi, the capital of India, has suffered many outbreaks of dengue in recent past and despite the obvious magnitude of problem, very scarce evidence exists that documents the knowledge, awareness and practices of the people regarding dengue.
Aim:
To assess the knowledge and practices related to control of dengue fever and to assess the differences in knowledge and practices based on sex and literacy.
Materials and Methods:
A cross-sectional study was conducted among persons visiting a tertiary care hospital in New Delhi. A systematic sampling procedure was adopted and a pretested questionnaire was used.
Results:
A total of 215 individuals were interviewed. Majority of the respondents (96.3%) had heard about dengue. The important sources of information were television (54.9%) and newspaper/magazines (51.7%). Around 89% of the study participants considered dengue as “serious problem”. Nearly 86% participants were aware of the spread of dengue by mosquitoes while 73% were aware of one of the correct breeding sites of
Aedes
mosquito. Mosquito mats/liquidators were used by 61% of respondents, coils by 56% and repellant creams by 22%.
Conclusion:
The awareness regarding dengue and mosquito control measures was satisfactory to an extent. Programs should focus that this knowledge gets translated into practice.
Acute respiratory infections (ARIs) are the leading cause of death among children less than 5 years in India. Emergence of newer pathogenic organisms, reemergence of disease previously controlled, wide spread antibiotic resistance, and suboptimal immunization coverage even after many innovative efforts are major factors responsible for high incidence of ARI. Drastic reduction in the burden of ARI by low-cost interventions such as hand washing, breast feeding, availability of rapid and feasible array of diagnostics, and introduction of pentavalent vaccine under National Immunization Schedule which are ongoing are necessary for reduction of ARI.
a b s t r a c tBackground: Diabetes mellitus and hypertension (HT) are common diseases in adulthood, pre-disposing to many cardiovascular complications, posing a major public health challenge. Few studies have reported increased prevalence of cardiovascular disease risk factors and type 2 diabetes in policemen. Hence, this study aims to assess the prevalence of cardiovascular risk factors such as diabetes, HT, smoking, alcohol intake, and obesity among policemen. Materials and methods: A cross-sectional study was carried out in 2008e2009 among 256 policemen in Puducherry, South India. Policemen were selected by simple random sampling. Socio-demographic details and some of the risk factors such as alcohol intake and smoking history were obtained using a pretested, structured questionnaire. Presence of stress was measured using the professional life stress score questionnaire. Blood pressure, waist circumference, and hip circumference were measured by standard methods. Fasting blood sugar was estimated using a glucometer. Serum cholesterol was also measured. Lipid profile was measured for a randomly chosen subgroup of 50 participants. Results: Mean age of study participants was 40.9 years (SD AE 10.9). Out of the study subjects, 23% (n ¼ 60) were known diabetic and 16.8% (n ¼ 43) were known hypertensive. Prevalence of diabetes among study participants was 33.6% (CI: 27.8%e39.6%). Prevalence of HT among study participants was 30.5% (CI: 24.9%e36.5%). Seventy percent (n ¼ 178) had at least moderate range of stress in their life related to their profession and 4% (n ¼ 11) had stress as a "problem" in their life. Conclusions: Burden of cardiovascular risk factors such as diabetes and HT was high among police personnel of Puducherry.
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