National Journal of Community Medicine

Social Support, Spiritual Well-Being, and Quality of Life Among MSM and Transgender Women Living with HIV in Rural Thailand

Anongluk Vongtree — 2025-02-01

Background: HIV/AIDS continues to be a significant public health challenge in Thailand, affecting not only the physical health but also the overall quality of life (QOL) of those living with the virus. Understanding the factors influencing QOL is crucial for developing effective interventions and support systems. This study examined the QOL among men who have sex with men (MSM) and transgender women (TGW) living with HIV in Thailand and identify factors that are associated with their QOL.

Methods: A cross-sectional quantitative design with secondary analysis was employed. Standardized measures were used to assess social support, spiritual well-being (SWB), and QOL. Data were analyzed using descriptive statistics and Pearson’s correlation coefficient.

Results: Social support was found to be at a moderate level, while SWB was high. Overall QOL was moderate. QOL scores were significantly higher among those with a bachelor’s degree, those earning 20,001-30,000 baht monthly, and those who had disclosed their HIV status (p<0.05). Significant positive correlations were observed between QOL and both social support (r=0.459, p<0.05) and SWB (r=0.501, p<0.05).

Conclusion: The findings revealed that moderate level of overall social support and high level of overall SWB significantly influence QOL among MSM and TGW. These findings provide a foundation for developing targeted nursing interventions that focus on social support and SWB to improve QOL among MSM and TGW.

Impact of Perinatal Death Auditing: Outcomes of An Interventional Study on Perinatal Death Auditing in Two Districts of Karnataka State, India

Harsha Kumar HN — 2025-02-01

Background: Perinatal death auditing is useful to identify preventable perinatal deaths and avoidable/preventable factors. Objectives: To know the impact of perinatal death audit like 1). Documentation of Care Provided 2) Changes in Infrastructure and Facilities 3). Number of perinatal deaths 4) Any other impact.

Methodology: Perinatal death auditing project implemented in two districts of Karnataka state. As a Part of Intervention, Expert Panel audited the perinatal deaths and provided feedback to the hospitals where these deaths occurred. The feedback included issues identified and suggestion for prevention. Trained Medical-Social Workers conducted evaluation surveys in post-interventional period at 6^th monthly intervals. They collected the filled tools from the hospitals and handed over the written feedback of the expert panel to these hospitals. It was anticipated that the process of feedback would initiate some changes in infrastructure, facilities, documentation and number of perinatal deaths.

Results: Number of reported perinatal deaths decreased in Koppal District (from 325 to 301) as compared with Dakshina Kannada (from 223 to 221). Improvements in: 1]. Documentation of care provided 2] Assertion of preventability by the doctors 3] Infrastructure &facilities were observed in backward district of Koppal as compared to developed district of Dakshina Kannada.

Conclusion: Perinatal Death Auditing reduces the number of perinatal deaths apart from improving documentation, assertion of preventability by doctors, infrastructure & facilities.

The Impact of Inter-Generational Relationships on Depressive Symptoms in Elderly Parents in Rural Jammu, India

Richa Mahajan — 2025-02-01

Background: Given the paucity of literature in the Jammu region on intergenerational relationships that contribute to a connected society promoting empathy and family support, this study was undertaken to evaluate its effect on depressive symptoms in older parents. The aim of this study was to examine patterns of intergenerational relationships between aging parents and their adult children.

Setting and design: A cross-sectional study conducted in Darsopur village in R S Pura block, Jammu district.

Methods and Material: This cross-sectional study was conducted on 350 male and female adults living in Darsopur village in RS Pura block of Jammu district. Study participants were selected using two-stage simple random sampling. Results were determined by ANOVA and binary logistic regression using IBM SPSS Statistics for Windows, version 20.0.

Results: The mean score with standard deviation for the Geriatric Depression Score was 3.97 ± 3.78, indicating a lower level of depressive symptoms. Binary logistic regression analysis revealed that consensual normative solidarity was inversely associated with depression.

Conclusions: The present research results showed a higher mean score of solidarity between parents and their children, which can be attributed to the fact that the study was conducted in rural India.

Family-Centered Approaches to Pediatric Tuberculosis and Nutritional Challenges in North Aceh: A Qualitative Study

Mardiati — 2025-02-01

Background: Pediatric tuberculosis (TB) remains a major global health issue, particularly in low- and middle-income countries. In areas such as Aceh, the nutritional needs of pediatric TB patients are frequently neglected, with treatment primarily addressing the causes of infection and insufficient family involvement. This study aimed to analyze the nutritional problems related to pediatric TB in North Aceh Regency, Aceh Province, Indonesia.

Methodology: This qualitative study employed phenomenological analysis through in-depth face-to-face interviews with pediatric patients, their guardians, healthcare professionals, and hospital administrative staff at Cut Meutia General Hospital, North Aceh, from July to September 2024. Conducted in Indonesian, the interviews were audio-recorded with consent and analyzed using thematic analysis.

Results: This study examined 28 pediatric TB patients, equally divided by sex, with a mean age of 2.6 years. Most were normally nourished, and nearly half had pulmonary TB, primarily contracted from household contact. This study identified five key themes: increasing TB incidence, pediatric TB treatment challenges, nutritional concerns, inadequate sanitation, and strategies to address treatment and nutritional issues in children with TB.

Conclusions: The proposed interventions include increasing TB awareness, promoting BCG vaccination, considering socioeconomic factors, enhancing treatment adherence, and integrating nutritional support into management strategies.

Effect of mHealth Communication on Modifiable Risk Factors of Non-Communicable Diseases in An Adult Rural Population of District Gautam Buddha Nagar, Uttar Pradesh

Ankita Makhija — 2025-02-01

Introduction: Non-communicable diseases (NCDs) are responsible for 74% of all deaths globally. Burden of NCDs can be reduced by decreasing the modifiable risk factors associated with these diseases through behavioural change which can be done by the use of mHealth communication. Objectives: To assess the effect of mHealth communication on modifiable risk factors in an adult rural population of District Gautam Buddha Nagar, Uttar Pradesh.

Methodology: A Community-based Interventional study was conducted among 480 adult subjects in the rural area of District Gautam Buddha Nagar, Uttar Pradesh. Baseline information on sociodemographic variables, behavioural risk factors (STEP 1), anthropometric and physiological risk factors (STEP 2), and biochemical risk factors (STEP 3) of NCDs was collected. mHealth intervention in the form of telephone calls and text messages was carried out for reduction of NCD risk factors following which post-intervention data of the risk factors was collected.

Results: After mHealth intervention, significant reduction in tobacco use, alcohol use, unhealthy diet, physical inactivity, BMI, waist hip ratio, blood pressure, fasting blood sugar, total cholesterol, total triglyceride and low-density lipoproteins was observed in intervention group with respect to control group.

Conclusion: Effect of mHealth communication contributed significantly to decrease majority of the modifiable risk factors of NCDs.

Study on Drug Usage, Storage and Wastage among Households in Chengalpattu, Tamil Nadu, India - A Cross-Sectional Study

Nancy L — 2025-02-01

Background: Improper drug storage is immensely prevalent in households. A significant number of families do not follow prescribed practices for maintaining the safety and efficacy of medications. Increased rates of unintentional poisoning, decreased drug efficacy, and the emergence of antibiotic resistance are just a few adverse consequences that might result from such negligence.

Methodology: A total of 213 households were selected using multi-stage random sampling techniques. A pretested structured questionnaire on drug storage, usage, wastage in the households was used and detailed interview was conducted with the participants.

Results: Majority of the participants 56.3% (120) belonged to the age group of 30- 40 years, most of the participants are graduates 39.4% (83). The prevalence of self-medication was 30.5%. Safe storage conditions with appropriate packing were used by 81.5% (167) of people. About 69.9% (149) has good knowledge on correct dosage of medications.91.2% (187) of households discard unused medications in the garbage. Commonly stored medicine was analgesics and antipyretics 21.6% (86). In this study Increasing age, Education and Family with senior citizens above 60 years have a strong association with storage condition of medicines at home.

Conclusions: This study shows 96.3% prevalence of in-home storage medication practices. Ensuring the efficacy, safety, and cost-effectiveness of medications requires proper management from storage to use and waste prevention.

Effectiveness of Breast Cancer Awareness Month (BCAM) Before and After the COVID-19 Pandemic: Google Trends Analysis

Majed Ramadan — 2025-02-01

Background: Breast cancer awareness month (BCAM) strategy has been established in Saudi Arabia to promote national knowledge about Breast Cancer, as the Saudi Cancer Registry annual reports reported that breast cancer has ranked first among other cancerous diseases in women. Early detection and the treatment in the early stages of the disease will increase the survival rate of breast cancer patients. Many detection techniques have been used for breast cancer. The objectives of this study are to investigate the popular pattern in seeking screening information of breast cancer in Saudi Arabia using Google Trends.

Methods: Data from January 2012 to December 2022 were analyzed for "breast cancer" and "Mammogram" searches. A difference-in-differences design compared pre- and post-COVID-19 search volumes. Ethical approval was obtained, and statistical analysis was conducted using SAS.

Results: Over a decade, interest in breast cancer and mammograms in Saudi Arabia increased steadily. However, during the COVID-19 pandemic, there was a significant decline in both searches. Breast cancer searches decreased notably post-pandemic (p = 0.007), while mammogram searches declined but not significantly (p = 0.31). Regional disparities in search volumes were observed.

Conclusion: Several awareness campaigns especially in the country sides are essential to help increase public awareness and interest.

Household Food Insecurity and the Factors Influencing Growth and Nutrition Among Under-5 Children in Hubballi, India: A Case-Control Study

Anjana R Joshi — 2025-02-01

Background: Household Food Insecurity is one of the key determinants of chronic undernutrition in Indian children. Other factors include maternal factors, feeding practices, socio- sociocultural and environmental factors. The study was conducted to compare household food insecurity and other factors among undernourished and normal children aged < 5 years.

Methodology: A community-based case-control study was conducted among PEM cases and normal controls in Hubballi using a pretested, semi-structured, validated questionnaire. Food insecurity was assessed using the standard USFAID household food insecurity scale. Height-for-age, weight-for-age, and weight-for-height Z scores were calculated using WHO Anthro PC.

Results: Food Insecurity was found in 42% of the cases and 30% of the controls with 10% of the cases having severe food insecurity. There was a significant difference in the mean scores of household food insecurity among cases and controls. Food insecurity, low birth weight, illness, weaning initiation < 6 months of age, children without deworming, and the children who did not attend the under-5 clinic had higher odds of being malnourished.

Conclusion: Household food insecurity is one of the important preventable risk factors for malnutrition. Creating awareness and proper utilization of health services has a positive impact on the child’s growth and development.

Development and Validation of a Food Frequency Questionnaire for Dietary Antioxidant Intake among Prediabetic Individuals in the South Indian Population

Sowmya R — 2025-02-01

Background: Prediabetes is a growing global public health concern, with dietary factors playing a major role in its progression to type 2 diabetes. Antioxidants can mitigate oxidative stress, a major contributor to prediabetes. This study developed a Food Frequency Questionnaire (FFQ) to assess the intake of key antioxidants, including vitamin C and E, selenium and zinc among prediabetic population in Chennai, India.

Methodology: The food list was based on the Indian Food Composition Table (2017), and the portion sizes and frequencies were derived through a focus group discussion with registered dietitians and physicians. The FFQ intake data were compared with the mean of two 24-hour dietary recall (DR) using Pearson correlation analysis.

Results: Strong correlations were observed for vitamin C (r=0.909) and vitamin E(r=0.915), and moderate correlations were observed for selenium (r = 0.696), and zinc (r = 0.706), with significant results (p < 0.001 for vitamin C, E, selenium, and p = 0.036 for zinc).

Conclusion: The results indicated good agreement between the FFQ and DR, validating the developed FFQ as a reliable tool for estimating antioxidant intake in prediabetic individuals. This tool is useful for monitoring antioxidant intake in both clinical and public health settings.

Factors Affecting Maternal Behavior in Achieving Complete Basic Immunization for Toddlers Aged 12–23 in Banggai Laut Regency, Indonesia

Amrin Madolan — 2025-02-01

Background: Complete Basic Immunization (CBI) is essential to prevent vaccine-preventable diseases (VPDs). However, the coverage of complete basic immunization in Banggai Laut Regency remains low at 67.9%, compared to the national target of 90%. Several factors, including maternal knowledge, attitudes, accessibility to healthcare facilities, healthcare workers' roles, family support, and maternal occupation, are believed to influence maternal behavior in immunization provision. This study aimed to analyze factors affecting maternal behavior in achieving complete basic immunization for toddlers aged 12–23 months in Banggai Laut Regency.

Methodology: This cross-sectional analytical survey involved 321 mothers selected through cluster random sampling. Data were collected using structured questionnaires and analyzed using Chi-Square tests and logistic regression.

Results: Significant associations were found between complete basic immunization and good knowledge (p<0.000; OR=3.2), positive attitudes (p<0.000; OR=2.8), availability of healthcare facilities (p<0.000; OR=3.4), proximity to healthcare services (p<0.000; OR=3.7), supportive roles of healthcare workers (p<0.000; OR=2.9), and strong spousal support (p<0.000; OR=2.5). Maternal occupation showed no significant effect (p=0.379).

Conclusions: Knowledge, attitude, availability of healthcare facilities, distance to healthcare facilities, spousal support, and the role of healthcare workers are key factors in improving the coverage of complete basic immunization. Interventions targeting these factors are essential to achieving national immunization targets in Banggai Laut Regency.

Promoting Inclusivity in Blood Donation: Public Health

Saurabh R Shrivastava — 2025-02-01

The practice of blood donation supports community unity, as it brings all individuals on a common platform where they help each other and the health system in the mission to save human lives. Regardless of the wide scope and merits of blood donation in saving lives and improving health, it is a fact that many patients who are in need do not receive safe blood timely. As the existing pool of donors cannot meet the requirements of everyone, it is the need of the hour to appeal to and encourage a diverse group of blood donors to support the healthcare delivery system. Acknowledging the need to have a diverse pool of donors, we must promote inclusivity in blood donation and this will require a combination of multiple strategies. In conclusion, the availability of a diverse blood donor base makes it extremely useful for patients from different backgrounds by making the entire process compatible and safe. Many barriers have been identified that could limit the inclusivity in blood donation, and this will require a comprehensive approach to ensure that all communities are equally represented in the donor pool, ultimately leading to a more diverse and adequate blood supply.

Prevalence of Non-Communicable Diseases Among Elderly in India: A Scoping Review

Patlolla Sriram Yadav — 2025-02-01

Background: Non-communicable diseases (NCDs) are a growing concern for India's aging population. This scoping review aimed to identify and summarize the prevalence of NCDs among elderly people in India.

Methods: A systematic search of PubMed and Google Scholar identified 37 studies published in English between 2013 and 2023 that met the inclusion criteria. Two independent reviewers screened and selected studies, and data was extracted and analyzed using a standardized form. The PRISMA framework was employed to visualize the study selection process.

Results: Hypertension was the most prevalent NCD (˃50% in studies), followed by diabetes (<50% in studies, but with high new case detection). Depression was particularly prevalent among urban females (over 50%). Obesity and overweight were widespread, with women being more likely to be overweight and men to have central obesity. Significant gender disparities existed in hypertension, depression, diabetes, and visual impairments.

Conclusion: This review highlights the significant NCD burden among elderly Indians, particularly hypertension and diabetes, underscoring the need for targeted health interventions. Addressing modifiable risk factors with gender-sensitive approaches is essential. Further research is needed on the intersection of aging and NCDs in India to improve the quality of life for elderly individuals.

Prevalence of Anxiety Disorders Among Adolescents: A Cross-Sectional Study in An Urban Area of Delhi, India

Febida BPK — 2025-02-01

Background: Adolescence is a critical period and anxiety disorders affect one in seven adolescents globally, yet data on this in the Indian population remain limited. This research aimed to study the prevalence and types of anxiety disorders among adolescents in an urban area of Delhi.

Methods: In this cross-sectional study involving 300 adolescents, participants were selected using systematic random sampling. Data was collected using a pretested semi-structured questionnaire after ethical approval was obtained.

Results: The majority were 10-14 years of age (52.7%), with a mean age of 14.35±2.80. The prevalence of anxiety disorders was 35.3%, with social anxiety (14%) being the most common. Prevalence was higher in females and in the 15-19 years age group.

Conclusion: This study reveals a significant burden of anxiety disorders (35.3%) among urban adolescents in Delhi, with social anxiety being the most prevalent type.

Unveiling Genital Tuberculosis: India’s hidden Infertility Epidemic

Yashvanthan VR — 2025-02-01

Genital tuberculosis (GTB) is a significant yet underrecognized cause of infertility, particularly in high-burden countries like India. It often presents asymptomatically or mimics other reproductive disorders, leading to delayed diagnosis and treatment. GTB primarily affects women of reproductive age but can also impact men, contributing to infertility through various pathophysiological mechanisms. Despite its prevalence, GTB remains a hidden epidemic due to limited awareness, diagnostic challenges, and systemic healthcare gaps. This narrative review explores the epidemiology, pathophysiology, clinical presentation, and impact of GTB on infertility in India. It also highlights diagnostic and management challenges while proposing strategies to address this critical public health issue.

GTB contributes to 15-20% of infertility cases in India, with the highest burden among women aged 20-40 years. Hematogenous spread of Mycobacterium tuberculosis leads to chronic inflammation, fibrosis, and scarring of reproductive organs, resulting in irreversible damage. Traditional methods like microscopy and culture are inadequate for GTB detection. Advanced techniques, though more accurate, remain inaccessible to many due to cost and resource constraints. While antitubercular therapy (ATT) can control infection, restoring fertility often requires surgical intervention or assisted reproductive technologies, which are financially prohibitive for most patients. GTB is a silent epidemic with profound implications for reproductive health and social well-being in India. Addressing GTB requires enhanced awareness, integration of infertility screening into TB programs, improved access to advanced diagnostics and treatments, and targeted public health policies. Bridging these gaps can mitigate the burden of infertility and improve quality of life for affected individuals.

Management of Vitamin D Deficiency Among the Under-Five Children Residing in Coastal Areas of Karnataka: A Study Protocol

Mamatha Shivananda Pai — 2025-02-01

Introduction: Vitamin D deficiency has become the new normalcy due to rapid transition of lifestyles among the people globally. Vitamin D is synthesized in the body due to exposure of skin to sunlight. Correction of vitamin D deficiency poses a major demand due to its action on bone and muscle health. The objective of this study is to assess the effectiveness of sun exposure and Vitamin D supplement and Vitamin D supplements alone on serum vitamin D levels among the under-fives.

Methods: This protocol is a randomized controlled study planned to be carried out among the under-five children with vitamin D deficiency. Children will be randomised into two groups (Group 1 -Vitamin D supplementation only) and (Group 2 - vitamin D supplementation +sun exposure). Both the group will receive intervention for 12 weeks and Serum Vitamin D levels will be tested after 12 weeks. Descriptive and inferential statistics will be used to present the findings of the study.

Conclusion: Identification and treatment of Vitamin D deficiency is vital in children`s bone health. This protocol will provide direction and guidance to optimize utilization of treatments to improve vitamin D deficiency among under five children.