National Journal of Community Medicine

The Silent Crisis: Malnutrition in Uttarakhand's Children

Tue, 01 Jul 2025 00:00:00 +0000

Children comprise a major part of the population in many countries and are considered the future. A child is structured and designed right from birth by parents, school, society and environment into what they become. So, the foundation laid down in the young age plays an important role in the overall development of a child. A child’s development is influenced by various factor and one of the major issues is nutrition. Childhood nutrition is very important, and one cannot ignore the fact of adequate and appropriate nutrition for a child especially during the growing up days. Malnutrition is a major menace in many developing and underdeveloped countries, which places the children at risk to develop various other ailments. World Health Organization and Government of India have been trying to eliminate the peril of malnutrition by implementing various programs at various levels. In spite of the massive interventional programs at all levels the mortality rate of children dying because of malnutrition is still at alarming levels. The need to educate the masses at grass root levels is important and efficient screening is the need of the hour. For successfully eradicating malnutrition from our country, we all need to join in hands and pledge to make sure that our children are not deprived of proper nutrition, especially during the preschool age.

Design and Evaluation of a Data-Driven Youth Well-Being Dashboard: A Pre-Post Mixed-Methods Study in Indian Colleges

Tue, 01 Jul 2025 00:00:00 +0000

Background: Well-being is a state similar to health that incorporates a sense of meaning in an individual's life. This study introduces the Youth Well-Being Dashboard, a digital platform for enhancing well-being for individuals aged 18-24.

Methodology: Over six months, a pre-post mixed-methods study was conducted with 200 college students (n=100 intervention; n=100 control) in Uttarakhand and Uttar Pradesh. The intervention group used a dashboard delivering personalized, real-time feedback across five domains; controls received static PDFs. Outcomes were measured using validated tools (DASS-21, GPAQ, FANTA, Ryff’s Scale, GSE) and the System Usability Scale (SUS).

Results: The intervention group experienced a 30% reduction in anxiety, a 25% increase in physical activity, and an 18% improvement in dietary diversity all statistically significant (p<0.01). Notably, improved well-being strongly correlated with higher academic performance (r=0.41) and greater social engagement (r=0.36). User satisfaction was high (SUS: 82/100), and operational costs were low (₹420/user/month), demonstrating both effectiveness and scalability.

Conclusions: A personalized digital dashboard significantly improves youth well-being and related outcomes, offering a scalable, cost-effective solution for integration into educational and public health programs in India.

Knowledge, Attitude, And Practice in Diabetic Kidney Disease Prevention and Its Associated Factor Among Type 2 Diabetes Mellitus Patients in Northeast Peninsular Malaysia

Tue, 01 Jul 2025 00:00:00 +0000

Introduction: Diabetic kidney disease (DKD) is a major complication among Type 2 Diabetes Mellitus (T2DM) patients. Understanding their knowledge, attitude, and practice (KAP) of DKD prevention is crucial for guiding effective interventions. This study aimed to assess the level of KAP in DKD prevention and identify the factors associated with poor KAP among T2DM patients in Northeast Peninsular Malaysia.

Methods: A cross-sectional study was conducted among 600 T2DM patients from government health clinics in Kelantan, Malaysia. Data were collected using a validated questionnaire, and logistic regression analyses identified factors associated with poor KAP, considering socio-demographic and clinical characteristics.

Results: Findings showed 77.0% had poor knowledge, 58.2% poor attitude, and 37.7% poor practice. Poor knowledge was associated with single/divorced marital status, lower education, and diabetic complications, while unemployed participants had lower odds of poor knowledge. Poor attitude was linked to poor knowledge, lower education, and unemployment, while poor practice was associated with non-Malay ethnicity, lower education, and poor attitude.

Conclusion: Targeted educational interventions are needed, focusing on vulnerable groups with lower education and specific socio-demographic factors to enhance DKD prevention and improve T2DM patient outcomes.

Practices and Determinants of Household Solid Waste Management: A Cross-Sectional Study in Urban Karnataka, South India

Abhiharshan SB, Samudyatha UC — Tue, 01 Jul 2025 00:00:00 +0000

Introduction: Scientific and sustainable household solid waste management is crucial in achieving SDG 12 (responsible consumption) and SDG 3 (good health). Poor waste practices can harm both the environment and people's health. Objective: To assess the solid waste management practices and its association with sociodemographic profile of households in a selected urban locality of Kolar, in South India.

Methods: A cross-sectional study was conducted from April to June 2023, covering 318 consecutively sampled urban households, using a validated semi-structured questionnaire to collect data.

Results: The majority (28.6%) of households were from the lower middle socioeconomic class. Food and kitchen waste, plastics, and paper waste were the most common types of waste generated. Sanitary napkins/pads were disposed of with plastic waste without segregation. Closed containers were used for wet waste storage in 64.8% of households. Households with children under 5 years were more likely to use closed containers (OR: 2.04, 95% CI: 1.18-3.50). Sanitary disposal of waste was practiced by 64.4% of households, with higher odds in households located along main roads.

Conclusion: This study found high waste segregation rates but poor sanitary waste management so this recommends a multi-faceted approach to improve waste management. Urban governance should adopt a circular waste management approach to improve accountability and resource efficiency.

Traffic Noise Levels and Hearing Impairment Among Shop Keepers in a Metropolitan City – An Embedded Mixed-Method Study

Kirubakaran S , Manoj Kumar K , Arun Murugan — Tue, 01 Jul 2025 00:00:00 +0000

Context: Traffic noise and its impact on shop keepers is studied less. Use of mobile application for assessing noise levels and hearing impairment might provide solution in resource poor settings. Aims: Assess hearing impairment in shop keepers of traffic busy roads. Measure the noise exposure and monitor the community noise level in that locality. Find association between noise exposure and level of hearing impairment.

Methods and Material: The study design was embedded mixed method design. It had 1) quantitative phase - hearing impairment among shop keepers, noise level measurements and photographs of study locations were taken, 2) qualitative phase - narrative analysis of the photographs.

Results: Among participants, mean hearWHO score was 49.71 ± 10.95 and 34 had hearing impairment. It is found people who work for more than 10 years had a higher chance of developing hearing loss than those who worked less than 5 years. Weekly averages of noise values exceeded permissible limits in all locations. Narrative analysis suggested increased vehicle density in all locations.

Conclusions: Traffic noise levels are higher than permissible limits mainly contributed by vehicles with potential risk for causing hearing impairment on long term exposure.

Quality of Life Among Old Age Homes Residents in Gujarat, India: Evidence from a Sequential Explanatory Mixed Method Study

Mamta Roshan Patel, Uday Shankar Singh — Tue, 01 Jul 2025 00:00:00 +0000

Introduction: The concept of old age homes is developing in India. For many elderlies, moving into old age homes becomes their only viable choice. Objectives: To assess the quality of life of the elderly living in old age homes and to explore stakeholders' perspectives on running these facilities.

Methods: It was a sequential explanatory mixed methods study design consisting of a quantitative (Survey) followed by a qualitative phase. In the first phase, residents of old age homes were selected using a purposive sampling method. To evaluate their quality of life, an Old People Quality of Life questionnaire was used. In the second phase, six key informant interviews were conducted to explore their perspectives. Quantitative data was analyzed using bivariate and multiple regression techniques, while qualitative data was analyzed using content analysis.

Results: The standardized mean score of quality of life of 102 elderlies was 70.3(10.3), with the lowest score for the social domain 56.2(13.5). Multiple regression analysis showed that quality of life was significantly influenced by education level, duration of stay and source of income. There was lack of recreational activities.

Conclusion: Residents who were getting pension experienced a better QOL. Lowest score in social domain explained by qualitative finding.

Comparison of Thyroid Function in Lead Poisoned Patients and Healthy Individuals in North India

Tue, 01 Jul 2025 00:00:00 +0000

Background: Lead remains a pervasive environmental toxicant in India, with emerging evidence linking it to endocrine disruption. Its potential effect on thyroid function remains unclear, with inconsistent findings across studies. This study aimed to evaluate the association between blood lead concentration (BLC) and thyroid hormone levels in a North Indian population.

Methods: This retrospective study included 237 patients from Punjab who underwent simultaneous testing for BLC and thyroid hormones between January 2022 and December 2023. Patients were grouped by BLC (<10, 10–25, >25 µg/dL), and those with known thyroid disease or on thyroid-altering medications were excluded. BLC and thyroid hormones (fT3, fT4, TSH) were measured using validated instruments (LeadCare II, Roche Elecsys).

Results: Group 3 (BLC >25 µg/dL) had significantly higher fT4 levels (19.26 ± 4.95 pmol/L) and lower TSH levels (2.19 ± 1.77 µIU/L) compared to Group 1 (fT4: 16.26 ± 6.65 pmol/L; TSH: 3.60 ± 4.59 µIU/L; p <0.05). No statistically significant differences were observed in fT3 values between the groups (p = 0.513). Regression analysis showed a positive association between BLC and fT4 and a negative association with TSH. These findings suggest a trend toward subclinical hyperthyroid features in individuals with elevated lead levels.

Conclusion: Elevated BLC is associated with altered thyroid function, notably increased fT4 and decreased TSH concentrations, even in the absence of overt thyroid disease. These results support lead’s role as a potential endocrine disruptor, with possible involvement of oxidative stress and neuroendocrine pathways.

Prevalence of Eating Disorders and Their Association with Psychosocial Wellbeing Among Adults in an Urban Area of Tamil Nadu, India

Tue, 01 Jul 2025 00:00:00 +0000

Background: Eating disorders are caused by the dynamic interaction of biological, psychological and sociocultural factors that affect physical and psychological well-being of humans. It leads to abnormal behavior in eating habits and excessive concern with body appearance and shape.

Methodology: A cross-sectional study was conducted among 350 people in urban field practice area of tertiary care hospital, Chengalpattu district by simple random sampling. Data was collected using standard questionnaires and analysed using SPSS v25. Analytical tests like Chi-square and odds ratios were used to find association between the presence of eating disorders following which enter method of logistic regression was done.

Results: Out of 350 participants prevalence of eating disorder was found to be 81(23.1%). Gender (AOR-6.15, 95%CI- 2.31-16.34), Occupations (AOR-2.49, 95%CI-1.13-5.48), Diet (AOR-6.06, 95%CI-2.01-18.30), family history of mental health problems (AOR-4.71, 95%CI-1.42-15.54), BMI and poor wellbeing (AOR-2.82, 95%CI-1.32-6.01) were statistically significant.

Conclusion: The risk of eating disorders was high among the female participants. Exercise, Body image perception, and family history of mental health problems are also associated with eating disorder. These findings show the need for targeted awareness programs and mental health interventions, particularly among high-risk groups such as females and individuals with poor well-being, to effectively address and prevent eating disorders.

Factors Predicting Treatment Adherence Among Patients with Hypertension: A Systematic Review and Meta-Analysis

Thandar Win, Sureeporn Thanaslip, Rapin Polsook — Tue, 01 Jul 2025 00:00:00 +0000

Background: Through the increased prevalence of hypertension, the notch of following the prescribed anti-hypertensive treatment among these populations is very inadequate, and the unsatisfactory disease control rate. This study systematically reviewed and identified their characteristics of the predicting factors on it and their magnitude.

Methodology: By the Joanna Briggs Institute (JBI) methodology, the included articles were critically appraised and assessed their certainty of evidence with the GRADE guidelines. Four databases (Google Scholar, ScienceDirect, PubMed, and WILEY online) and the keywords of treatment adherence” OR “compliance” AND “determinants” OR "factors" OR "predictors" OR “influences” AND "hypertension" OR “high blood pressure” were applied. The integrated effect sizes (z), 95% confidence intervals (CIs), and I² index were reported.

Findings: Descriptive correlational and longitudinal designs were included in total 20 studies. The significant predictors were demographic, intrapersonal, interpersonal, condition-related, and health system-related ones. Patients’ self-efficacy, perception, co-morbidity and social support produced the most significant effects. Additionally, various adherence levels to treatment were reported as low to acceptable.

Conclusion: The hypertension society should strengthen their adherence practices by clear instructions and guidance, especially for multimorbid ones, by improving their self-efficacy and perception on their disease, building social support and virtuous patient-provider communication.

Childhood Vaccination Among Arab Parents: A Meta-Analysis of Knowledge, Attitudes, and Practices

Sakina Al-Jadd, Mohammed Merzah — Tue, 01 Jul 2025 00:00:00 +0000

Background: Childhood vaccination is crucial for preventing infectious diseases, yet parental concerns and hesitations persist. Understanding and assessing parental knowledge, attitudes, and practices (KAP) regarding vaccines is essential, as these factors influence confidence in vaccination and adherence to immunization schedules.

Methods: This meta-analysis synthesized evidence on Arab parents' KAP toward childhood vaccination, based on a systematic review of eligible studies and pooled analysis using a random-effects model.

Results: Fifteen studies were included: 14 reported knowledge scores (9,035 participants), 13 reported attitudes (8,523 participants), and 7 reported practices (5,106 participants). The pooled estimates were 0.73 for good knowledge (95% CI: 0.62–0.81), 0.83 for positive attitudes (95% CI: 0.74–0.89), and 0.77 for good practices (95% CI: 0.64–0.86), all with high heterogeneity (I² >97%). Meta-regression showed persistent variability (I² = 92.7%, 99.2%, 98.7%), with no significant link between KAP scores and the proportion of mothers.

Conclusion: This meta-analysis highlights a strong association between good parental knowledge and positive attitudes, which translate into favorable vaccination practices. However, high heterogeneity across studies due to differences in design, populations, and cultural context limits the generalizability of findings. These findings underscore the need for targeted educational interventions to enhance parental vaccine awareness and uptake.

Resurgence of Mumps in India: A Call to Reintroduce MMR into the Immunization Program

Lalithambigai Chellamuthu, Anlin Jenisha — Tue, 01 Jul 2025 00:00:00 +0000

The recent rise in mumps outbreaks across several Indian states exposes a critical gap in the national immunization framework specifically, the absence of mumps vaccination in the Universal Immunization Programme (UIP). As mumps is currently excluded from the India's Universal Immunization Program and only the MR vaccine is administered, millions of children remain susceptible to this vaccine-preventable disease. In accordance with World Health Organization (WHO) and Indian Academy of Paediatrics (IAP) guidelines, this communication urges policymakers to reintroduce the MMR vaccine into India’s Universal Immunization Programme (UIP).

Online Drug Purchasing in India: Community Pharmacists Perceptions and Attitudes

Subodh S Satheesh, Viswanatham Sai Lakshmi, Sigma Surbhi, Shreyas PR — Tue, 01 Jul 2025 00:00:00 +0000

Background: In India, online pharmacies have gained significant popularity and are reshaping the way in which pharmaceutical services are provided. With community pharmacist serving as an integral part of public health, promoting the safe and effective use of medicines, this study aimed to evaluate their perceptions of online pharmacies.

Methods: A cross-sectional study was conducted in Bangalore, Karnataka India. An electronic survey was developed and distributed to pharmacists across Bangalore through email and the collected data was analyzed using descriptive statistics.

Results: A total of 122 pharmacists participated in the study, and more than half of the participants agreed that they purchase medicines from online pharmacies, with approximately 19% doing it frequently and 52% making occasional purchases for their personal or family use. Half of the respondents (50.81%) believe that online pharmacies can be a source of counterfeit and substandard medicines and raised their concern over their safety. Participants suggested mandatory (47.54%) prescription verification, stringent regulatory measures, and accreditation processes for online pharmacies.

Conclusion: Online pharmacies have the potential to further expand access to medications but must be introduced into the healthcare system in a balanced approach that does not compromise either patient safety or the traditional roles of pharmacies.