National Journal of Community Medicine <p align="Justify">The National Journal of Community Medicine is a monthly published peer-reviewed open-access journal. It has a wide circulation amongst the health professionals, researchers, teaching faculties, and postgraduates in the specialty of Community Medicine and public health. The main objective of the journal is to promote wider dissemination of the research conducted by researchers in the fields of public health and community medicine.</p> en-US <p>The authors retain the copyright of their article, with first publication rights granted to Medsci Publications.</p> (Dr. Prakash Patel) (Chirag Patel, Editorial Support Team) Fri, 01 Mar 2024 04:46:41 +0000 OJS 60 Feasibility of using WHO's e-mhGAP-IG Mobile Application for Child and Adolescent Mental/Behavioral Disorders and Substance Use in Indian Setting: Protocol paper <p><strong>Background: </strong>The treatment gap for people with common mental disorders is large, estimated to be 75–95% in India; the reasons are multi-factorial. It was found that 89% of the primary health centers are not providing mental health care services. Technology like the electronic-mental Health Global Action Program-Intervention Guide (e-mhGAP-IG) is necessary to fill this gap, which in turn helps to attain one of the aims of National Mental Health Program-1982. Hence, the study is planned to understand the feasibility and adaptability of WHO’s e-mhGAP-IG by the primary health workers in the delivery of mental health care for child and adolescent mental/behavioral disorders (CMH) and substance use disorders (SUB).</p> <p><strong>Methods: </strong>It is an open-label randomized control trial planned to conduct at primary healthcare centers, Chittoor district. Primary health care staff working at PHCs/Sub-centers having one year experience, and being able to handle smart phones will be included in the study. Data will be collected using a self-structured case report form (CRF) and analyzed by applying per protocol analysis using JAMOVI software. The cost of intervention and the impact on disease outcomes will be taken concurrently to estimate the cost-effectiveness of the intervention.</p> <p><strong>Trial registration:</strong> CTRI/2023/04/051899 dated 24/04/2023 under the clinical trials registry-India</p> <p><strong>Protocol version:</strong> 1.0 dated 24/04/2023</p> Kiranmayi Koni, Jayanthi Tarugu, Sirshendu Chaudhuri, Muthuvenkatachalam Srinivasan, Krishna AM Copyright (c) 2024 Kiranmayi Koni, Jayanthi Tarugu, Sirshendu Chaudhuri, Muthuvenkatachalam Srinivasan, Krishna AM Fri, 01 Mar 2024 00:00:00 +0000 Role of Medical Education in Pandemic Preparedness <p>Every pandemic that has been reported to date has impacted different domains of human life and civilization. The training imparted to medical students during their medical education is expected to enhance their competence and deal with the potential challenges that every pandemic places on human mankind. Medical education is expected to influence our pandemic preparedness in a multiple number of ways and it becomes our responsibility to expose medical students to different aspects during their training period in an incremental manner. Considering the wide extent to which pandemics can account for the loss of lives, human suffering, impairment of different sectors, and the potential that medical education can bridge the existing gap, there is an immense need to integrate topics pertaining to the pandemic and their preparedness in the medical curriculum. In conclusion, there is an immense need to ensure pandemic preparedness in medical education to produce resilient and adaptable health professionals. The need of the hour is to adopt a curriculum that has components of pandemic-related topics in a structured and systematic manner. This calls for the need to adopt a flexible curriculum and expose students to a structured training program, and effective communication skills.</p> Saurabh R Shrivastava, Prateek S Shrivastava, Ahishek Joshi Copyright (c) 2023 Saurabh R Shrivastava, Prateek S Shrivastava, Ahishek Joshi Fri, 01 Mar 2024 00:00:00 +0000 Swot Analysis of Village Food Safety Cadres in The Safe Food Village Program in Gorontalo, Indonesia <p>Village Food Safety Cadres must possess a high level of proficiency in the field of food safety. The purpose of this study was to assess the efficacy of Village Food Safety Cadres in the Safe Food Village Program in Gorontalo, with the aim of promoting the engagement of these cadres. This was done to facilitate the formulation of recommendations aimed at optimizing the performance of cadres in future endeavors.</p> <p>This study uses qualitative descriptive methods. The study findings indicate that there are multiple barriers to establishing active village food safety cadres in Gorontalo. These obstacles include a lack of experience, skills, and knowledge among local food safety cadres, as well as their own self-concept. Additionally, the appointment of cadres is not voluntary but rather done by the Village Head, which hinders the formation of a strong self-concept as a cadre. Furthermore, socio-cultural characteristics, particularly language issues, pose challenges as some cadres are highly proficient in local languages, making it difficult to comprehend materials in Indonesian. The communities that needed to be supported were composed of individuals with varied educational backgrounds, thus requiring the adaptation of counselling methods to cater to their specific needs.</p> <p>To effectively train and meet the necessary qualifications of active cadres, it is essential to create media platforms for spreading food safety information that incorporate local knowledge. This can be achieved by utilizing local languages that cater to the different demographic characteristics of the communities being nurtured. Furthermore, it is imperative to make dedicated endeavors to enhance the knowledge of cadres on food safety, thereby fostering a positive self-perception.</p> Musyafar T Masaliha, Wiwie Heryani, Andriani Misdar, Yuniarty Ikram Copyright (c) 2024 Musyafar T Masaliha, Wiwie Heryani, Andriani Misdar, Yuniarty Ikram Fri, 01 Mar 2024 00:00:00 +0000 Empowering Health: A Comprehensive Concept Analysis of Breast Self-Examination for Proactive Breast Health Management <p>The review paper discusses the concept of breast self-examination (BSE), a vital screening method for early detection and diagnosis of breast cancer. It uses the Walker and Avant analysis method to develop an operational definition, identify critical attributes, antecedents, consequences, and empirical referents of BSE. BSE is crucial for early detection and survival rates, especially in developing countries. It is a cheap and accessible technique for detecting abnormal cells in normal breast tissue, making it useful in underdeveloped countries with limited resources. Defining attributes of BSE include breast awareness, breast examination for lumps and changes, a screening measure for detecting breast cancer, recommended timing after the menstrual period, primary prevention of breast cancer, self-awareness aiding in early detection, and cost-effectiveness in resource-poor countries. The paper also discusses antecedents and consequences of BSE, including knowledge and perception about BSE, personal and family history of breast cancer, health literacy campaigns, education level, increasing age, obesity, and reproductive factors. Conclusions of BSE include the practice of BSE and early detection of breast cancer, motivation towards screening, self-awareness, physical activity, and self-efficacy. The paper provides empirical referents for measuring and assessing BSE, such as structured questionnaires, scales based on health belief models, knowledge tests, and health action process approaches.</p> Sumaira Naz; Sureeporn Thanasilp, Wasinee Wisesrith Copyright (c) 2024 Sumaira Naz, Sureeporn Thanasilp, Wasinee Wisesrith Fri, 01 Mar 2024 00:00:00 +0000 Analysing The Role of Lifestyle Factors on Hypertension Among Rural Indonesian Adults: A Case-Control Study <p><strong>Background: </strong>Hypertension is a degenerative disease, arising from unhealthy lifestyle and becoming a world health problem. It is estimated that 46% of adults with hypertension are unaware of their condition, hence it is called the “silent killer”. This study aims to Lifestyle Risk Factors of Hypertension Incidence upon Productive Age.</p> <p><strong>Methodology: </strong>The type of research used was analytical observational with case control design the samples in this study were 152 (76 cases and 76 controls). The sampling technique in this research was probability sampling using systematic random sampling. Data were processed using Stata version 14 program. The analysis performed was chi-square test and logistic regression test.</p> <p><strong>Results: </strong>The results showed exposure to cigarette smoke (OR= 3.398; 95%CI=1.540-7.683), alcohol consumption (OR= 4.277; 95%CI=1.608-12.606), sleep patterns (OR= 2.628; 95%CI=1.299-5.337), physical activity (OR= 1.75; 95%CI=0.824-3.746), stressful state (OR= 1.793; 95%CI=0.897-3.590;), and coffee consumption (OR= 1.258; 95%CI=0.613- 2.587;). In multivariate analysis, the most risk factor for hypertension was alcohol consumption (OR=4.948; 95%CI=1.841-13.302; ρ-value =0.002).</p> <p><strong>Conclusions: </strong>Risk factors for hypertension included exposure to cigarette smoke, alcohol consumption and sleep patterns and the most risk factor for hypertension was alcohol consumption. It is highly suggested that relevant stake holders to determine programs and policies in order to prevent and treat hypertension more effectively.</p> Nurbaiti, Nur Nasry Noor, A Arsunan Arsin, Andi Zulkifli, Arifin Seweng, Suryani Tawali Copyright (c) 2024 Nurbaiti, Nur Nasry Noor, A Arsunan Arsin, Andi Zulkifli, Arifin Seweng, Suryani Tawali Fri, 01 Mar 2024 00:00:00 +0000 Diagnostic Accuracy of The TrueNat MTB/RIF Assay And Comparison With The Reference Standards To Detect Pulmonary Tuberculosis And Rifampicin Resistance in Sputum Samples From Patients Attending A Tertiary Care Hospital in Bhubaneswar, India <p><strong>Background:</strong> A rapid and accurate diagnostic tool is necessary for correct diagnosis and treatment of TB. This study evaluated and compared the sensitivity, specificity and concordance of TrueNAT MTB/RIF assay with smear microscopy, Xpert MTB/RIF and MGIT culture.</p> <p><strong>Methods:</strong> In all, 4500 patients (1500 each of patients with Diabetes, elderly and HIV-positive patients) attending the Chest and TB department of Capital Hospital, Bhubaneswar were screened. 392 sputum samples were collected from presumptive TB patients. Standard diagnostic procedures (Smear Microscopy, Xpert MTB/RIF, TrueNAT MTB tests and MGIT culture) were performed.</p> <p><strong>Results:</strong> This diagnostic efficiency of rapid molecular TrueNAT MTB/RIF assays have similar properties as Xpert MTB/RIF and may be used for the diagnosis of TB and Rifampicin resistance. Among participants, the TrueNAT MTB shows the sensitivity of 80%, 100% and 78.26% while the specificity was 97.9%, 95.83% and 100%. The concordance rates between all tests were calculated and the TrueNAT MTB showed good agreement with the culture method among study participants (κ = 0.793, 0.554, and 0.862, respectively).</p> <p><strong>Conclusion:</strong> The TrueNAT assays are sensitive for diagnosis of TB patients with faster turnabout time from testing to treatment and economical.</p> Braja Barik, Shritam Das, Khusbu Singh, Sudatta Chandan, Subrat Kumar Swain, Prasanti Nayak, Omkar Abadesh Mishra, Tahziba Hussain, Dasarathi Das, Sanghamitra Pati Copyright (c) 2024 Braja Barik, Shritam Das, Khusbu Singh, Sudatta Chandan, Subrat Kumar Swain, Prasanti Nayak, Omkar Abadesh Mishra, Tahziba Hussain, Dasarathi Das, Sanghamitra Pati Fri, 01 Mar 2024 00:00:00 +0000 Unmet Supportive Care Needs of Women with Gynecological Cancer in Manipur, North East India <p><strong>Background;</strong> Gynecological cancer significantly affects femininity, sexuality, fertility, physical and psychosocial relationships leading to impaired quality of life. There is a dearth of literature that identifies the unmet psychosocial supportive care needs of gynecological cancer patients in North East, India especially in Manipur. The study aims to explore the unmet supportive care needs of women with gynecological cancers and to determine correlates with demographic variables.</p> <p><strong>Methodology: </strong>A cross-sectional study using the “Supportive Care Needs Survey questionnaire (SCNS SF-34) in conjunction with demographic data was done on 72 participants recruited through purposive sampling. Ethical clearance was obtained. Data was analyzed with SPSS version 26.</p> <p><strong>Results:</strong> Physical and daily living were the domains with the highest unmet supportive needs. The top five items with highest unmet needs were lack of energy, feelings of sadness, not being able to do things they used to do, pain, feeling unwell and feeling depressed. Age, education, occupation, income, type of cancer, and comorbidities showed a significant difference in sexual and psychological unmet needs (p=&lt;0.05).</p> <p><strong>Conclusion:</strong> Gynecological cancer patients reveal substantial unmet psychosocial needs, emphasizing the importance of early screening for targeted interventions that can enhance their quality of life.</p> Thungchanbeni, Anu Gauba, Raj Kumar Lenin Singh Copyright (c) 2024 Thungchanbeni, Anu Gauba, Raj Kumar Lenin Singh Fri, 01 Mar 2024 00:00:00 +0000 Patterns of Neoplasm Among the Tribal and Non-Tribal Communities in Wayanad District of Kerala, India: A Hospital Based Cross-Sectional Study <p><strong>Background:</strong> The burden of neoplasms coupled with the inaccessibility to health services has always been a public health concern among the tribal population. The objective of the study was to determine the patterns of neoplasm and its associated factors among the tribal and non-tribal communities attending a primary care hospital in Wayanad, Kerala.</p> <p><strong>Methodology:</strong> A record based cross-sectional study was conducted in a primary care hospital in Wayanad, Kerala. Data of patients who attended the hospital from January 2016 to December 2021 were collected from the procedure registry. The independent predictors of the community were identified using regression model (p value &lt;0.05 was significant).</p> <p><strong>Results:</strong> Among the 650 study participants, majority (85.3%) were females. The mean (±SD) age was 41.62 ± 15.26 years. Only 8.5% of the study participants had malignant lesions. Multivariable analysis revealed that the pre-malignant and malignant lesions were more among the tribals [AOR (95% CI) =3.31 (1.46-7.52)] with a female preponderance [AOR (95% CI) =1.99 (1.17-3.40)]. The other independent predictors of the community were neoplasms of gastrointestinal system [AOR (95% CI) =2.90 (1.04-8.04)] and age less than 20 years [AOR (95% CI) =2.42 (1.06-5.54)].</p> <p><strong>Conclusion: </strong>An increasing trend of malignancy and pre-malignancy is seen among the tribal communities.</p> Neeraj Vinod Mohandas, Neethu George, Sanjeev Vasudevan, Avani Dinesh, Vinod Mohandas, Karthikeyan Kulothungan, Rock Britto Dharmaraj, Tamilarasan Muniyapillai, Abishek Jeevagan Copyright (c) 2024 Neeraj Vinod Mohandas, Neethu George, Sanjeev Vasudevan, Avani Dinesh, Vinod Mohandas, Karthikeyan Kulothungan, Rock Britto Dharmaraj, Tamilarasan Muniyapillai, Abishek Jeevagan Fri, 01 Mar 2024 00:00:00 +0000 COVID-19 Vaccine Breakthrough Infections Among Healthcare Workers in A Tertiary Care Hospital in Coastal Karnataka, India – A Prospective Cohort Study <p><strong>Background:</strong> The COVID-19 pandemic resulted in significant mortality and morbidity globally. The introduction of various COVID-19 vaccines at record time generated hope among people and doubts and apprehension regarding their safety. The study was done to estimate the incidence of COVID-19 vaccine breakthrough infections among Health Care Workers working in a tertiary care hospital and evaluate the outcome of these infections.</p> <p><strong>Methods:</strong> A prospective Cohort study was conducted among 6342 healthcare workers in a tertiary care hospital having received at least one dose of any COVID-19 vaccine. They were followed up for COVID-19 vaccine breakthrough infection for one year by epidemiological investigations. Data on COVID-19-positive healthcare workers was obtained through personal interviews and case records.</p> <p><strong>Results:</strong> 490 (7.9%) developed COVID-19 vaccine breakthrough infection during the study period. The majority of them (96.7%) were asymptomatic, and 16 (3.3%) of them developed complications needing hospitalization with 2 deaths. A statistically significant association was found in sex, healthcare worker categories, co-morbidities, and Blood groups.</p> <p><strong>Conclusion:</strong> COVID-19 vaccination among healthcare workers reduces the incidence, severity, and complications of COVID-19 vaccine breakthrough infections. The risk of acquiring COVID-19 vaccine breakthrough infections was higher among males, partially vaccinated individuals, people with co-morbidities, and those involved in the regular care of COVID-19 patients. COVID-19-appropriate behaviour and receiving all the primary doses of vaccine will be instrumental in COVID-19 control.</p> Nanjesh Kumar S, Amit Kumar Rao, Lavannya Mary Thayil Copyright (c) 2024 Nanjesh Kumar S, Amit Kumar Rao, Lavannya Mary Thayil Fri, 01 Mar 2024 00:00:00 +0000 Scenario of Newborn Care Practices in Private Healthcare Setting in India: An Insights From NFHS-5 Survey <p><strong>Background</strong>: The private sector contributes significantly to health care service delivery in India. Study shows the prevalence of newborn care practices like early initiation of breastfeeding, kangaroo mother care, and hepatitis B birth dose practices in private sector hospitals across India.</p> <p><strong>Methods</strong>: We conducted a basic analysis of unit-level data from the NFHS-5 survey; to understand the newborn care practices in private hospitals in India.</p> <p><strong>Result</strong>: The place of the delivery has a significant impact on newborn care practices like kangaroo mother care, early breastfeeding within an hour of birth, and hepatitis-B vaccination at birth. The private sector accounts for 20.73 percent of deliveries wherein, 39.56 percent of private sector hospitals follow EIBF practice. Pre-lacteals were provided to 14.95 percent of the children within the first three days after birth. The better practice of kangaroo mother care was seen in the public sector. The prevalence of the hepatitis B vaccine at birth is very low with 3.25 percent in India.</p> Jimeet Soni, Tapasvi Puwar, Bhavna Puwar Copyright (c) 2024 Jimeet Soni, Tapasvi Puwar, Bhavna Puwar Fri, 01 Mar 2024 00:00:00 +0000 The Relationship Between Burnout, Stress, And Resilience Among Vietnamese Health Care Workers <p><strong>Introduction</strong>: The COVID-19 pandemic has also caused significant damage in Vietnam, necessitating medical personnel to work tirelessly at different medical establishments to combat the epidemic. Healthcare professionals in Vietnam may experience stress and burnout, leading to adverse effects on their resilience, job performance, health, and overall quality of life.</p> <p><strong>Methodology</strong>: We carried out a cross-sectional investigation involving 147 healthcare professionals from various medical establishments in Ho Chi Minh City, Vietnam. The purpose was to evaluate the levels of stress, burnout, and resilience among these individuals.</p> <p><strong>Results</strong>: The study discovered that resilience acts as a mediator in the association between stress and burnout. Additionally, it revealed that gender traits have an impact on the interplay between stress and mental resilience. The study additionally discovered inequalities in stress, burnout, resilience, and social support based on demographic and professional factors.</p> <p><strong>Conclusion</strong>: Our study has enhanced our comprehension of mental health concerns among healthcare workers and facilitated the identification of a complex pattern that takes into account detrimental factors, protective factors, and existing support systems in mental healthcare, thus offering comprehensive and insightful perspectives for future research.</p> Vu Hoang Anh Nguyen, Yen Thi Hoai Phan, Thien Nguyen Toan Vuong, Ngoc-Anh Truong, Tin Duc Le, Xuan Thanh Kieu Nguyen, Vinh-Long Tran-Chi Copyright (c) 2024 Vu Hoang Anh Nguyen, Yen Thi Hoai Phan, Thien Nguyen Toan Vuong, Ngoc-Anh Truong, Tin Duc Le, Xuan Thanh Kieu Nguyen, Vinh-Long Tran-Chi Fri, 01 Mar 2024 00:00:00 +0000 Overcoming The Challenges of Big C In India Shambhavi Ghotankar, Khushal Patel, Pratiksha Yadav, Sanjay Juvekar Copyright (c) 2024 Shambhavi Ghotankar, Khushal Patel, Pratiksha Yadav, Sanjay Juvekar Fri, 01 Mar 2024 00:00:00 +0000