Journal of the Epidemiology Foundation of India
type: channel
description: Journal of the Epidemiology Foundation of India is an official publication of the Epidemiology Foundation of India (EFI). The journal is published in English on quarterly basis and follows double blinded peer review process. Moreover, Journal allows free access (Open Access) to its contents and authors may archive published articles.
publisher: Epidemiology Foundation of India
language: en
publication name: Journal of the Epidemiology Foundation of India
issn: 3048-8559
items: Beyond Functionality: The Multidimensional Impact of Assistive Technology on Individuals, Families, and Societies
items: Making a case for Provision of Assistive technology through healthcare system: Using Evidence to Decision (EtD) Framework Approach
items: Addressing Inequity in Assistive Products Through Healthcare Systems in India: A Review
items: Developing a New Assistive Technology: Parameters, Standards and Compliance Frameworks
items: Strengthening Ecosystem for Assistive Technology
items: Integrating Oral and Maxillofacial Prostheses into India’s RPwD Act, 2016 : A Policy Perspective
items: VISION RESTORATION IN DEGENERATIVE RETINAL DISEASES USING STEM CELLS
items: Emerging Technologies Transforming Vision Rehabilitation and Eye Care Accessibility
items: Global Policy and Frameworks for Assistive Technology in Eye Care
items: Comprehensive Rehabilitation and Assistive Device Intervention in an Untreated Quadrilateral Limb Deformity
items: AI-Driven Horizons; Transforming Assistive Technology for Inclusive Healthcare: An opinion Article
items: Challenges and Barriers in Assistive Technology and the Scale for Their Assessment: A Global and Indian Perspective
items: User-Centered Ergonomics in Orthotic Design: A Perspective on Assistive Technology
items: Impact of exercise on epithelial injury of gastrointestinal membrane associated with levels of circulating I-FABP - A systematic review and meta-analysis of randomized control trial
items: Monitoring Blood Utilization for Transfusion Services in a Tertiary Care Teaching Hospital: Evidence-Based Analysis
items: Nutritional Status, Glycemic Response and Dietary Compliance of Newly Diagnosed Versus long term Patients with type II diabetes
items: Antibiotic Prescription Patterns for Respiratory Infections in Urban Outpatient Settings in India: A Multicenter, Retrospective, EMR-Based Study Using WHO AWaRe Classification
items: Sibling “Diluan” Physicians Wonder Whether Diluting Milk Before Personal Use Could Dilute Lactation Stress On Mother Cows
items: A Pilot study on "Assessment of Knowledge and Attitude of disposing the used napkin of HIV infected women visiting in HIV specific Clinic in King George's Medical University, Lucknow
items: Circadian Rhythm-Aligned Antioxidant Delivery: A Non-Invasive Strategy to Combat Oxidative Stress in Indian Adults
items: Enhancing Medical nutrition therapy adherence among GDM mothers: Need for digital solutions and Support systems
items: Infection Prevention and Control Practices at a Tertiary Care Centre in New Delhi
items: Zoo-WIN” – Winning over Zoonosis: A Digital Leap Towards Zoonosis prevention in India
items: Exploring the landscape of Vector-Borne Diseases and Their Vectors in India's Endemic states: Bird’s eye view
items: Advancing Dengue Prevention: Vaccine Development and Current Trials
items: Rising Incidence of Stomach Cancer in Arunachal Pradesh: Examining the Role of Traditional Smoked Meat Consumption
items: Towards One Nation, One Health System: A Pragmatic Approach to Integrative Medicine
items: A review of infectious disease training programs for healthcare professionals in India: Identifying gaps and the way forward
items: Boundaries Divided, Diseases Unbound: Zoonotic Threats Crossing Borders
items: “Listening to Lives”: Patient Voices and the Challenge of Hypertension Control in Rural and Hilly India

Beyond Functionality: The Multidimensional Impact of Assistive Technology on Individuals, Families, and Societies
type: item
description: .
subject: Original Article
  topic: section
creator: Ravinder Singh
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-12-31
publication date: 2025-12-31
doi: 10.56450/

Making a case for Provision of Assistive technology through healthcare system: Using Evidence to Decision (EtD) Framework Approach
type: item
description: .
subject: Editorial
  topic: section
creator: Ashoo Grover
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-12-31
publication date: 2025-12-31
doi: 10.56450/

Addressing Inequity in Assistive Products Through Healthcare Systems in India: A Review
type: item
description: Abstracts Background: Assistive technologies (AT) are crucial for enhancing individuality, productivity, and quality of life for persons with functional impairments. Despite their proven profits, significant inequities persist in access to assistive products, particularly in low-and middle-income countries like India. Objective: This review scrutinizes the current landscape of assistive technologies establishment in India, evaluates economic and social returns on investment, and categorizes strategies to address inequities through healthcare system integration. Results: Evidence demonstrates substantial returns on investment for assistive products, with wheelchairs increasing economic productivity by 20-40%, spectacles showing benefit-cost ratios of 5:1, and hearing aids yielding ninefold returns per dollar invested. India has established institutional mechanisms including the National Centre for Assistive Health Technology (NCAHT) and the National List of Essential Assistive Products (NLEAP) to address access gaps. However, challenges remain in policy implementation, funding mechanisms, manufacturing capacity, and last-mile delivery. Conclusion: A multi-pronged approach combining strong policy frameworks, increased public funding, indigenous manufacturing, capacity building, and community engagement is essential to achieve equitable access to assistive technologies through India's healthcare system. Integration of AT into Universal Health Coverage represents a strategic pathway toward achieving Sustainable Development Goals 3 and 10. Keywords: Assistive technology, Inequity in Assistive technology, healthcare equity, Functional impairment
subject: Review Article
  topic: section
creator: Dr. Ravinder Singh
creator: Dr Suman Badhal
creator: Dr. Ashoo Grover
creator: Mr. Arvind Vashist
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-12-31
publication date: 2025-12-31
doi: 10.56450/

Developing a New Assistive Technology: Parameters, Standards and Compliance Frameworks
type: item
description: Background: Assistive Technology (AT) development in India lacks a unified compliance and regulatory framework. Objective: To provide a framework that guides innovators in developing ATs aligned with regulatory, ethical, and quality standards. Methods: A comprehensive synthesis of national (ICMR, CDSCO, BIS, MoHFW, MeitY, MoSJE) and international (ISO, IEC, FDA, WHO, CE) standards was undertaken to frame a multi-tier compliance pathway. Results: A structured compliance process integrating user-centric design, safety testing, ethical, clinical validation, and digital interoperability was developed. Conclusion: The proposed framework enables developers to design, test, and commercialize ATs safely, ensuring compliance, accessibility, and sustainability across India’s regulatory ecosystem.
subject: Short Article
  topic: section
subject: Assistive Technology, Compliance Framework, Standards, Accessibility
  topic: keywords
creator: Hitesh K Sharma
creator: Ashoo Grover
creator: Ravinder Singh
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-12-31
publication date: 2025-12-31
doi: 10.56450/

Strengthening Ecosystem for Assistive Technology
type: item
description: This report reflects on some of the initiatives undertaken by the International Committee of the Red Cross (ICRC) to contribute to strengthen the ecosystem of assistive technology (AT) by promoting innovation, building partnerships, and prioritizing user-centered design. The ICRC focused on strengthening national rehabilitation systems, involving end-users in product development, and fostering an environment for sustainable provision of AT.
subject: Report
  topic: section
creator: Charu Sharma
creator: Zeon De Wet
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-12-31
publication date: 2025-12-31
doi: 10.56450/

Integrating Oral and Maxillofacial Prostheses into India’s RPwD Act, 2016 : A Policy Perspective
type: item
description: The Rights of Persons with Disabilities (RPwD) Act, 2016, led to a pivotal moment in India, which initiated the journey towards disability inclusion. This further led to the establishment of a society where all individuals with disabilities, regardless of their abilities, participate fully and with dignity. However, within this broad and inclusive vision lies a silent gap - oral and maxillofacial related disability, rehabilitation for which is still not explicitly recognized as an essential assistive service. For people living with craniofacial defects, prostheses like dentures, obturators, speech aids, and facial prosthetics are often out of reach. These devices are far more than just medical interventions; they restore the ability to speak, eat, and express oneself, restoring not just physical health but also confidence, a sense of belonging, and self-worth. This paper aims to highlight how the formal recognition of Oral and Maxillofacial (OMF) Prostheses could transform India's assistive technology system. These prostheses do much more than just restore function; they help people regain confidence, communicate, and reconnect socially. Backed by growing evidence of their physical, emotional, and social value, this paper calls for a policy change that incorporates OMFP as an essential component of AT, to be included in government-supported rehabilitation programs and promote teamwork among dental professionals, rehabilitation experts, and policymakers. Aligning India's approach with the vision of the RPwD Act (2016) and the WHO's Global Cooperation on Assistive Technology (GATE) initiative would mark a major step toward making oral and maxillofacial rehabilitation not just a legal right, but a lived reality for everyone.
subject: Perspective
  topic: section
subject: Oral and Maxillofacial prostheses
  topic: keywords
subject: Rights of Persons with Disabilities Act (RPwD Act)
  topic: keywords
subject: Assistive technology
  topic: keywords
subject: Disability Policy
  topic: keywords
subject: Health Policy
  topic: keywords
creator: MANU SHARMA
creator: Ravinder Singh
creator: Sandeep Singh
creator: Salaj Rana
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-12-31
publication date: 2025-12-31
doi: 10.56450/

VISION RESTORATION IN DEGENERATIVE RETINAL DISEASES USING STEM CELLS
type: item
description: Degenerative retinal diseases, such as age-related macular degeneration, retinitis pigmentosa, diabetic retinopathy, and glaucoma, are significant causes of irreversible visual loss worldwide. Current treatments are mostly palliative, treating the secondary obstacle rather than reversing degenerated retinal cells. Stem-cell–based interventions are shifting the treatment landscape for retinal degeneration by targeting multiple biological pathways—replacing lost cells, protecting surviving neurons, regulating immune activity, and supporting new vessel growth. This review brings together current laboratory and clinical findings on four major cell sources: embryonic stem cells, induced pluripotent stem cells, mesenchymal stromal cells, and retinal progenitor cells. Early trials, especially in age-related macular degeneration and retinitis pigmentosa, report good safety outcomes and small but measurable gains in visual function, with transplanted cells surviving in the host retina. However, the major translational hurdles are regulation of the immune response, heterogeneity of long-term integration, surgical complexity, and manufacturing scalability. Advances in engineered delivery systems, immune-evasive pluripotent cells, and biomarker-based patient selection are driving the field toward sustainable therapy. Together, stem cell therapy holds great promise in addressing the unmet needs of degenerative retinal diseases; however, well-designed multicenter trials with well-defined endpoints are essential for determining efficacy and ensuring safe and regulated use in clinical practice.
subject: Review Article
  topic: section
subject: Stem cell therapy; Retinal degeneration; Age-related macular degeneration; Retinitis pigmentosa; Diabetic retinopathy; Glaucoma; Retinal pigment epithelium; Vision restoration
  topic: keywords
creator: Harini Viswanathan
creator: Ishita Goyal
creator: Salaj Rana
creator: Sandeep Singh
creator: Ravinder Singh
creator: Suraj Singh Senjam
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-12-31
publication date: 2025-12-31
doi: 10.56450/

Emerging Technologies Transforming Vision Rehabilitation and Eye Care Accessibility
type: item
description: This chapter explores the transformative potential of emerging technologies in vision rehabilitation and eye care accessibility, examining artificial intelligence applications, augmented and virtual reality systems, smartphone-based assistive platforms, 3D printing innovations, and tele-assistive solutions. Through systematic analysis of recent literature spanning 2018-2024, this chapter evaluates the current state of AI-powered wearables, computer vision applications for navigation and object recognition, immersive technologies for therapeutic intervention, and personalized manufacturing approaches. The analysis reveals significant promise in prototype development and research applications, while identifying persistent challenges in commercial translation, affordability, and equitable access, particularly in low- and middle-income countries. The chapter concludes with critical examination of ethical considerations, digital divide implications, and policy recommendations for ensuring that technological advances contribute to rather than exacerbate existing inequities in vision care access.
subject: Original Article
  topic: section
subject: assistive technology
  topic: keywords
subject: innovation
  topic: keywords
creator: KRITIKA CHOPRA
creator: SANGEETA ABROL
creator: Nishi Satish
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-12-31
publication date: 2025-12-31
doi: 10.56450/

Global Policy and Frameworks for Assistive Technology in Eye Care
type: item
description: This chapter examines the global policy landscape for assistive technology (AT) in eye care, analyzing frameworks established by the World Health Organization (WHO) and their implementation across diverse healthcare systems. Drawing from recent literature spanning 2018-2024, this analysis explores the WHO Global Report on Assistive Technology (2022), the Global Cooperation on Assistive Technology (GATE) initiative, and their integration with Vision 2020 and the Integrated People-Centered Eye Care (IPEC) framework. The chapter critically examines policy challenges including accessibility, affordability, and equity gaps across low- and middle-income countries (LMICs), regulatory frameworks for emerging digital technologies, and implementation models ranging from community-based delivery to tele-rehabilitation services. Through comparative analysis of case studies from India, The Gambia, and European contexts, this chapter identifies key barriers to AT access and proposes evidence-based policy recommendations for achieving universal health coverage goals in vision care.
subject: Original Article
  topic: section
subject: assistive technology
  topic: keywords
subject: eyecare
  topic: keywords
subject: Global policies
  topic: keywords
creator: KRITIKA CHOPRA
creator: sangeeta Abrol
creator: NISHI SATISH
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-12-31
publication date: 2025-12-31
doi: 10.56450/

Comprehensive Rehabilitation and Assistive Device Intervention in an Untreated Quadrilateral Limb Deformity
type: item
description: Limb reduction refers to the shortening or total absence of a limb or specific segment of a limb. A 14-year-old boy was presented with deformities of all four limbs. For enhancing the functional independence Multidisciplinary team advised him well fitted orthosis for better wait bearing and ambulation. Occupational therapy for adaptive training for improving his ability to do activities of daily living and to prevent overuse injuries. Counselling was given regarding the importance of having UDID and its benefits. He was introduced to assistive devises and mobile based learning in order to facilitate the academic participation. Congenital limb deficiencies are often neglected and mostly remains outside of the reach of the rehabilitation. Providing a proper rehabilitation will help them to come into the mainstreams of society and will improve their quality of life. Key words: Limb deficiencies, Physical medicine and rehabilitation, Assistive devices, Orthosis.
subject: Report
  topic: section
creator: Dr. Suman Badhal
creator: Dr. Sanam M P
creator: Dr. Ganesh Yadav
creator: Mrs. Poonam Dhanda
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-12-31
publication date: 2025-12-31
doi: 10.56450/

AI-Driven Horizons; Transforming Assistive Technology for Inclusive Healthcare: An opinion Article
type: item
description: Abstract Background: Assistive technology (AT) has grown from a specialized field into a major source of mainstream innovation, while also benefiting from rapid advances in everyday consumer technology. Artificial Intelligence (AI) refers to computer systems capable of tasks requiring human intelligence, such as speech recognition, visual processing, and object identification. Forms of AI relevant to AT include generative AI, transfer learning, human-in-the-loop AI, and embodied AI. AI is integral in developing adaptive aid, autonomous wheelchairs, guidance systems, facial recognition tools, and smart home platforms, facilitating communication, mobility, and independence. Objective: This opinion article examines the role of artificial intelligence in assistive technology, exploring how AI-driven innovations can optimize health outcomes for individuals with functional impairments by enhancing accuracy, personalization, and scalability of assistive solutions, while addressing inherent limitations and challenges specific to AI applications in this field. Key Points: AI-powered AT systems offer extraordinary accuracy, personalization, and scalability through machine learning algorithms, speech recognition, smart prosthetics, and autonomous guidance systems. However, these systems face challenges including data bias, limited generalizability, privacy concerns, and short real-world evaluation. Despite these challenges, AI continues to transform assistive healthcare by enabling more adaptive, responsive, and user-centered technologies that promote greater autonomy and quality of life for people with disabilities. Continued advancements and rigorous real-world testing are imperative to address these limitations and fully realize AI’s potential in assistive technology.​​Additionally, the validation of these systems through more extensive and long-term real-world testing is crucial to ensure consistent safety and effectiveness. Current AT development remains in its infancy, w…
subject: Opinion
  topic: section
creator: Dr Suman Badhal
creator: Dr. Ravinder Singh
creator: Arvind Vashist
creator: Kajal Hans
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-12-31
publication date: 2025-12-31
doi: 10.56450/

Challenges and Barriers in Assistive Technology and the Scale for Their Assessment: A Global and Indian Perspective
type: item
description: Assistive Technology (AT) plays a critical role in enabling independence, participation, and rehabilitation for persons with disabilities. However, current access rates remain critically low, with only 5-10% of individuals in low- and middle-income countries (LMICs) receiving the assistive products they need. This paper examines the multidimensional challenges and barriers hindering access of AT globally and in India, including policy gaps, economic constraints, service delivery limitations, and social stigma. Furthermore, it reviews existing assessment scales and frameworks such as WHO-GReAT, QUEST, PIADS, and the ATLAS framework that can systematically evaluate these barriers. The findings underscore the urgent need for comprehensive AT policies, standardized assessment tools, and inclusive implementation strategies to realize assistive technology as a fundamental right rather than a privilege and charity. Keywords: Assistive Technology; Barriers in Assistive Technology; Health Equity; Assessment in Assistive Technology
subject: Review Article
  topic: section
creator: Dr Suman Badhal
creator: Arvind Vashist
creator: Dr. Ravinder Singh
creator: Tushar
creator: Kajal Hans
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-12-31
publication date: 2025-12-31
doi: 10.56450/

User-Centered Ergonomics in Orthotic Design: A Perspective on Assistive Technology
type: item
description: Orthosis as an integral and important part of Assistive Technology play a crucial role in enhancing mobility, stability, and functional independence for individuals with physical impairments. The design and biomechanical application of these orthotic devices must align with user-centric ergonomic principles to ensure maximum efficiency, comfort and user compliance. This paper highlights the fundamental ergonomic considerations in orthotic designs including biomechanical alignment, load distribution, energy conservation and human factors like cosmesis, ease of donning and doffing, safety and adaptability. Emphasis is placed on how ergonomically guided orthotic interventions can prevent secondary musculoskeletal problems, reduce rehabilitation time, and contribute to long-term adherence. By addressing the interaction between the human body and orthotic device, this paper underscores how ergonomics contributes to functional outcomes, quality of life and long-term adherence in rehabilitation. By aligning engineering design with human factors, the application of ergonomic principles in orthotic design bridges the gap between technology and patient-centered care.
subject: Review Article
  topic: section
creator: PRAVEEN KUMAR SHUKLA
creator: Dr. Suman Badhal
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-12-31
publication date: 2025-12-31
doi: 10.56450/

Impact of exercise on epithelial injury of gastrointestinal membrane associated with levels of circulating I-FABP - A systematic review and meta-analysis of randomized control trial
type: item
description: Aim: Intense exercise promotes intestinal injury in the gastrointestinal tract of humans and a substantial upsurge in intestinal permeability indicating gut barrier dysfunction. Design: Systematic review and meta-analysis Objective: The goal line for this systematic review and meta-analysis was to investigate the consequence of a strenuous workout session on Intestinal epithelial cells (IECs) injury of gastrointestinal membrane and permeability in healthy persons. Methods: Through May 2023, PubMed, EMBASE, Scopus, and Web of Science were searched. Studies were included evaluating intestinal Fatty Acid Binding Protein (I-FABP) of gut permeability and gut cell injury following a solitary strenuous workout. Results: 18 studies showed a mean difference of 488.36 [ 95% CI 280.35; 696.37] in I-FABP post-exercise using a random effects model. The studies were heterogeneous, with a 95% prediction interval of − 427.52 to 1404.24. I-FABP, as a measure of gut injury, had a significant and moderate impact magnitude in disturbing the epithelial lining of the intestinal membrane. Conclusion: This project's decisions establish that a sole strenuous exercise session elevates gut permeability and damage to healthy contributors. The study has been registered with PROSPERO (CRD42023387126).
subject: Original Article
  topic: section
subject: Intestinal Fatty Acid-Binding Protein
  topic: keywords
subject: Biological Markers
  topic: keywords
subject: Exercise Intensity
  topic: keywords
subject: Epithelial cells
  topic: keywords
subject: Intestinal Permeability
  topic: keywords
subject: Gastrointestinal Mucosa Injury
  topic: keywords
creator: Nahid Rehman
creator: Mohd Ashif Khan
creator: Muhammad Aaqib Shamim
creator: Anjana Pandey
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-06-30
publication date: 2025-06-30
starting page: 145
ending page: 157
doi: 10.56450/JEFI.2025.v3i02.007

Monitoring Blood Utilization for Transfusion Services in a Tertiary Care Teaching Hospital: Evidence-Based Analysis
type: item
description: Background: Blood transfusion services have to provide adequate, timely, safe blood and its components. With the aim of maximizing the use of this vital medical resource, there has been a significant evolution in the processes of clinical transference of blood and its components. Objective: To analyze the utility of whole blood and specific components, appropriateness and health outcomes related to use of these products. Methods: Pooled data from various inpatient departments in a tertiary care hospital during the period 2021–2024, which included six separate phases in all, five retrospective phases (Phase-1 to Phase-5) and one prospective phase (Phase-6), each phase with a duration of six months. Results: Revealed that female patients utilized 51.79% and male patients utilized about 48.21% of the total of 1504 blood transfused samples which included whole blood and separated components. Among all VI phases, the most utilised component was PRBC 67.75%, the moderately used component was FFP 10.70%, the low-used components were Whole blood and Platelets 5.38%, and the least utilized components were RDP 3.92%. Conclusion: All findings revealed that the utilization of the Whole Blood and Components was appropriate based on the diagnosis with indications and resulted in positive health outcomes among the patients.
subject: Original Article
  topic: section
subject: Blood
  topic: keywords
subject: PRBC
  topic: keywords
subject: FFP
  topic: keywords
subject: Platelets
  topic: keywords
subject: RDP
  topic: keywords
subject: SDP
  topic: keywords
subject: Whole Blood
  topic: keywords
creator: Ugandar R E
creator: Suresh R
creator: Lakshmi D
creator: Nandini K
creator: Phaneendra P
creator: Preethi P
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-06-30
publication date: 2025-06-30
starting page: 167
ending page: 179
doi: 10.56450/JEFI.2025.v3i02.010

Nutritional Status, Glycemic Response and Dietary Compliance of Newly Diagnosed Versus long term Patients with type II diabetes
type: item
description: Type II Diabetes Mellitus is a growing public health concern in India, with dietary habits, body composition, and long-term glycemic control playing a crucial role in disease management. To assess the nutritional profile, glycated hemoglobin, and dietary compliance of Type II Diabetics, with newly diagnosed (N = 79) and long-term (N = 71) patients. Data was collected for anthropometry, 24-hour dietary recall, HbA1c and dietary compliance. BMI in the newly diagnosed group was 26 + 4 kg/m2) and for the long term group it was 27 + 3 kg/m2 (p=0.081) with significant differences across BMI categories in the two groups (p=0.04). The recommendation for energy and protein intake was met by the newly diagnosed group, while the long-term group's energy and protein intake met 93.9% and 88.6% adequacy, respectively. HbA1c values were better in newly diagnosed subjects (p = 0.07), but dietary compliance scores were higher in the long-term group. The correlation between HbA1c and dietary compliance was very weak and not correlated. In conclusion, nutritional status of both the groups was similar, newly diagnosed diabetics demonstrated better nutrient adequacy and glycemic control, whereas long-term diabetics showed greater dietary compliance, underscoring different challenges across disease stages.
subject: Original Article
  topic: section
subject: Type II Diabetes
  topic: keywords
subject: Nutritional Status
  topic: keywords
subject: HBA1C
  topic: keywords
subject: Glycemic Response
  topic: keywords
subject: Dietary Compliance
  topic: keywords
creator: Vanshika Sachdeva
creator: Ankita Gupta
creator: Namrata Singh
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-06-30
publication date: 2025-06-30
starting page: 130
ending page: 136
doi: 10.56450/JEFI.2025.v3i02.005

Antibiotic Prescription Patterns for Respiratory Infections in Urban Outpatient Settings in India: A Multicenter, Retrospective, EMR-Based Study Using WHO AWaRe Classification
type: item
description: Introduction: The emergence of antimicrobial resistance represents an escalating worldwide challenge, with developing nations like India experiencing heightened vulnerability due to substantial prevalence of communicable diseases coupled with widespread inappropriate antimicrobial utilization. Despite the growing adoption of electronic medical record (EMR) systems, their potential for AMR surveillance remains underutilized. Methods: In this multicenter, retrospective observational study, we analyzed anonymized EMR data from 183,608 outpatient prescriptions for respiratory system infections in seven major metropolitan cities in India, collected between January 2021 and December 2023. Results: Antimicrobials agents were utilized in 59,779 (32%) cases, with a significant majority (85%) classified under the WHO AWaRe “Watch” category. Azithromycin (28.09%), cefpodoxime proxetil (19.07%), and cefixime (13.61%) represented the most prescribed agents, while acute upper respiratory infections comprised (40.6%) of diagnoses linked to antimicrobial prescribing. Conclusion: These observations emphasize the critical requirement for strengthened antimicrobial stewardship through strict compliance to WHO AWaRe recommendations to limit the broad-spectrum antimicrobial overutilization and mitigate AMR. Comprehensive antibiotic policies, regionally tailored strategies, and enhanced EMR-based surveillance are critical to fostering rational antibiotic use and reducing AMR rates in India.
subject: Original Article
  topic: section
subject: Antibiotic Stewardship
  topic: keywords
subject: Respiratory Tract Infections
  topic: keywords
subject: WHO AWaRe Classification
  topic: keywords
subject: Antimicrobial Resistance
  topic: keywords
subject: India
  topic: keywords
subject: EMR
  topic: keywords
subject: Real World Data
  topic: keywords
subject: Eka Care
  topic: keywords
creator: Arunkumar Ramaraj
creator: Sanjana SN
creator: Neelesh Kapoor
creator: Raghunandan Gupta
creator: Vishwesh Jainkuniya
creator: Sankalp Gulati
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-06-30
publication date: 2025-06-30
starting page: 137
ending page: 144
doi: 10.56450/JEFI.2025.v3i02.006

Sibling “Diluan” Physicians Wonder Whether Diluting Milk Before Personal Use Could Dilute Lactation Stress On Mother Cows
type: item
description: The question is all about lactation stress on Mother Cows induced by milk production needs to fulfill milk consumption needs of modern humans. Maybe home “adulteration” of milk with water before personal use could evolve facultative vegans to embrace “diluan” philosophy for maybe reducing if not eliminating lactation stress on Mother Cows while relishing consumption of milk in personally diluted forms.
subject: Opinion
  topic: section
creator: Divya Gupta
creator: Deepak Gupta
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-06-30
publication date: 2025-06-30
starting page: 209
ending page: 211
doi: 10.56450/JEFI.2025.v3i02.017

A Pilot study on "Assessment of Knowledge and Attitude of disposing the used napkin of HIV infected women visiting in HIV specific Clinic in King George's Medical University, Lucknow
type: item
description: Background: Human immunodeficiency virus (HIV) continues to be a major global health concern according to the World Health Organization (WHO).Rapid population growth, extensive urbanization, and cultural diversity all contribute to this problem in the nation. Menstrual hygiene products, especially disposable sanitary napkins, are a major waste management concern. Aims & Objectives: This study aimed to assess the knowledge, attitudes, and practices of HIV-infected women regarding the disposal of used sanitary napkins, with a focus on their awareness of health and environmental risks and the influence of education on hygienic practices. Methodology-We conducted a cross-sectional study among 61 females. We used a pre-tested self-administered questionnaire to assess HIV-infected women's knowledge and attitude towards disposing of used napkins. Results: The results show that there was a strong link between education and knowing that bad hygiene during menstruation can lead to infections (p=0.0001), between education and practicing good hygiene (p=0.0026), between education and using menstrual products (p=0.000), and between education and how often changing menstrual products (p=0.0009). Conclusion: Addressing menstrual hygiene through education, healthcare, and sanitation reduces health risks and environmental harm. Proper disposal of biomedical waste, including HIV-contaminated materials, vital for preventing infections and ensuring sustainability.
subject: Original Article
  topic: section
subject: HIV Infections
  topic: keywords
subject: Women’s Health
  topic: keywords
subject: Menstrual Hygiene Products
  topic: keywords
subject: Sanitary Napkins
  topic: keywords
subject: Refuse Disposal
  topic: keywords
subject: Health Knowledge
  topic: keywords
subject: Attitudes
  topic: keywords
subject: Practice
  topic: keywords
subject: Environmental Health
  topic: keywords
subject: Biomedical Waste
  topic: keywords
subject: Infection Control
  topic: keywords
creator: Rajeev Misra
creator: Sandeep Tiwari
creator: Akanksha Mishra
creator: Prachi Milani
creator: Divyanshi Singh
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-06-30
publication date: 2025-06-30
starting page: 158
ending page: 163
doi: 10.56450/JEFI.2025.v3i02.008

Circadian Rhythm-Aligned Antioxidant Delivery: A Non-Invasive Strategy to Combat Oxidative Stress in Indian Adults
type: item
description: Introduction: Oxidative stress contributes to chronic diseases like diabetes, cardiovascular ailments, and neurodegenerative conditions, which are common among Indian adults. Aligning antioxidant administration with biological circadian rhythms may offer a promising, non-invasive intervention strategy (1,2). Methodology: This cross-sectional observational study was conducted between January and June 2024 and enrolled 1,000 Indian adults aged 30–60 years from urban and rural areas. Participants were randomized into two groups: Group A received Vitamin C and E at circadian-optimized timings, while Group B received them at fixed standard times. Oxidative stress biomarkers were assessed via salivary assays. Statistical analysis was performed in May 2024 using SPSS (p<0.05 considered significant). Results: Group A showed significantly reduced levels of malondialdehyde (1.85 ± 0.23 µmol/L) compared to Group B (2.32 ± 0.27 µmol/L, p<0.001), and higher total antioxidant capacity (1.67 ± 0.14 vs. 1.42 ± 0.15 mmol/L, p<0.001). Discussion: Chronotherapy-based antioxidant delivery was found effective in reducing oxidative stress markers. This supports its potential as a cost-effective, personalized intervention for lifestyle-related conditions.
subject: Original Article
  topic: section
subject: Circadian Rhythm
  topic: keywords
subject: Antioxidants
  topic: keywords
subject: Oxidative Stress
  topic: keywords
subject: Non-Invasive Therapy
  topic: keywords
subject: Indian Adults
  topic: keywords
creator: Dinesh Reddy Sagam
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-06-30
publication date: 2025-06-30
starting page: 164
ending page: 166
doi: 10.56450/JEFI.2025.v3i02.009

Enhancing Medical nutrition therapy adherence among GDM mothers: Need for digital solutions and Support systems
type: item
description: Gestational diabetes mellitus (GDM) is characterized by impaired glucose tolerance that is first detected during pregnancy.(1) Every year, 4 million pregnancies in India are complicated by GDM.(2)The prevalence of GDM in India has rose from 0.53% in 2015-16 to 0.80% in 2019-20. Although the prevalence of GDM is relatively low, its impact on the health of both the mother and her child remains significant and should not be overlooked. (3) Hence, it is critical to combat GDM from the start and protect future generations from the risk of diabetes and other diseases. To address the rising prevalence of gestational diabetes mellitus, the government of India published national guidelines for the diagnosis and management of GDM in 2014.(1)
subject: Opinion
  topic: section
subject: GDM
  topic: keywords
subject: Nutrition
  topic: keywords
subject: Medical
  topic: keywords
creator: Vanessa Ravel
creator: Vishali Baskaran
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-06-30
publication date: 2025-06-30
starting page: 212
ending page: 214
doi: 10.56450/JEFI.2025.v3i02.018

Infection Prevention and Control Practices at a Tertiary Care Centre in New Delhi
type: item
description: Background: Infection prevention and control is a domain of public health that is universally applicable to healthcare professionals as well as patients, at every healthcare interaction. It is the most credible approach to prevent the transmission of infections and associated hazards. HAI is a significant problem, but prevention strategies are effective and cheap, with training programs being easy to plan and implement in almost every variety of clinical setting, yielding an encouraging cost-benefit ratio, thus pointing to the vitality of KAP amongst HCWs. Objective: To assess the knowledge, attitude and practices of healthcare workers regarding infection prevention and control towards minimizing the risk of healthcare associated infections. Methodology: A cross-sectional, descriptive study conducted from November 2023 to October 2024 at a tertiary care hospital in New Delhi. The study population consisted of all healthcare workers (resident doctors and nurses) working in the Neonatology Department. A semi-structured, self-administered questionnaire was used to assess the KAP of the HCWs. Result: The majority of HCWs demonstrated good to excellent knowledge scores, excellent attitude scores and excellent practice scores. Only a minor proportion had average or below average knowledge score, with nursing staff demonstrating lower overall performance than resident doctors. A significant association was observed between years of experience and knowledge (p= 0.046) and between position held and knowledge (p=0.009), but not with attitude and practice. Significant barriers to IPC included lack of time and insufficient supplies. Empirical treatment was the main rationale behind antibiotic prescription. Conclusion: Most HCWs had satisfactory scores, with the overall KAP scores being highest for senior residents, followed by junior residents and nurses. Lack of time was the primary barrier to IPC.
subject: Original Article
  topic: section
subject: Public Health
  topic: keywords
subject: Tertiary Care Centers
  topic: keywords
subject: Health Knowledge
  topic: keywords
subject: Neonatology
  topic: keywords
subject: Health Personnel
  topic: keywords
subject: Nursing Staff
  topic: keywords
subject: Cross Infection
  topic: keywords
creator: Kriti Chauhan
creator: Rajesh Kumar
creator: Sherin Raj T.P
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-06-30
publication date: 2025-06-30
starting page: 113
ending page: 119
doi: 10.56450/JEFI.2025.v3i02.003

Zoo-WIN” – Winning over Zoonosis: A Digital Leap Towards Zoonosis prevention in India
type: item
description: Zoo-WIN is a pioneering digital platform launched by the Government of India to address the critical public health threats of rabies and snakebite envenomation. Developed by NCDC with UNDP support, It facilitates real-time monitoring of anti-rabies vaccine (ARV) and anti-snake venom (ASV) inventory, promoting fair and timely distribution, particularly in areas with limited healthcare access. Aligned with NAPRE and NAPSE, Zoo-WIN strengthens surveillance, supports data-driven planning, empowers primary care facilities, and fosters One Health collaboration. Its transformative potential lies in bridging urban-rural disparities, enhancing public awareness, and optimizing response to zoonotic threats. Zoo-WIN marks a significant leap in digital health innovation for zoonosis prevention in India.
subject: Short Article
  topic: section
subject: Rabies Vaccines
  topic: keywords
subject: Rabies
  topic: keywords
subject: Antivenins
  topic: keywords
subject: Public Health
  topic: keywords
subject: Digital Health
  topic: keywords
subject: Snake Bites
  topic: keywords
subject: One Health
  topic: keywords
subject: Zoonoses
  topic: keywords
subject: Government
  topic: keywords
subject: Health Services Accessibility
  topic: keywords
creator: Krishna Jasani
creator: Krupal Joshi
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-06-30
publication date: 2025-06-30
starting page: 180
ending page: 182
doi: 10.56450/JEFI.2025.v3i02.011

Exploring the landscape of Vector-Borne Diseases and Their Vectors in India's Endemic states: Bird’s eye view
type: item
description: Vector-borne diseases (VBDs) persist as a significant public health concern across the globe. Various arthropod vectors play pivotal roles in the transmission of diverse VBDs worldwide, notably mosquitoes, sandflies, blackflies, lice, ticks and tsetse flies. Among all, mosquitoes act as major vectors causing mosquito-borne diseases (MBDs). Mosquitoes predominantly serve as vectors for neglected tropical diseases, transmitting numerous pathogens due to their large number, attributed to the conducive tropical climatic conditions. Understanding the dynamics of vectors (mosquitoes) is imperative for effectively controlling and eliminating mosquito-borne diseases (MBDs). Extensive research conducted across India indicates commendable efforts towards comprehending the nature, prevalence, and breeding patterns of vectors, subsequently implementing measures to curb their proliferation. Endemic Indian states Jharkhand, Odisha, West Bengal, and Chhattisgarh are characterized by substantial forested areas and rugged terrain and emerged as focal points for mosquito-borne diseases (MBDs), including malaria, dengue, filaria, chikungunya, etc. Several studies emphasised how important it is to comprehend the presence and distribution of vectors to mitigate infections and eliminate them within the designated time limit. Earlier studies conducted in these endemic states of India give an idea of the presence of different vector species and their subspecies. This review is an attempt to offer important new information about MBDs, their status, and the vector prevalence in Jharkhand and other endemic areas of India. The review emphasizes the critical need for unified and collaborative efforts to tackle these diseases, both at the regional and national levels, by integrating various disciplines and strategies.
subject: Review Article
  topic: section
subject: Vector
  topic: keywords
subject: MBD
  topic: keywords
subject: Anopheles
  topic: keywords
subject: Dengue
  topic: keywords
subject: Malaria
  topic: keywords
subject: Endemic States
  topic: keywords
subject: Jharkhand
  topic: keywords
subject: Disease Burden
  topic: keywords
creator: Mithun Kumar
creator: Swati Sinha
creator: Piyoosh Kumar Singh
creator: Praveen Kumar Tripathi
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-06-30
publication date: 2025-06-30
starting page: 101
ending page: 112
doi: 10.56450/JEFI.2025.v3i02.002

Advancing Dengue Prevention: Vaccine Development and Current Trials
type: item
description: Dengue fever remains one of the most significant mosquito-borne viral diseases, affecting nearly 390 million individuals annually, with 96 million symptomatic cases. In the absence of targeted antiviral therapy and the limitations of existing vector control strategies, vaccine development has emerged as the primary strategy for long-term dengue prevention. This manuscript reviews the global necessity for a dengue vaccine, discusses challenges related to immunological responses and antibody-dependent enhancement (ADE), and evaluates current vaccine candidates and ongoing clinical trials. Recent progress with licensed vaccines, such as Dengvaxia and Qdenga, is analyzed, along with promising developments from the NIH and Butantan Institute. Emerging platforms, including mRNA-based vaccines, have also been addressed.
subject: Commentary
  topic: section
subject: Dengue, Vaccine
  topic: keywords
subject: Clinical Trials
  topic: keywords
subject: Dengvaxia
  topic: keywords
subject: Qdenga
  topic: keywords
subject: Mrna
  topic: keywords
subject: Tetravalent Vaccine
  topic: keywords
subject: Antibody-Dependent Enhancement
  topic: keywords
creator: Nandita Sharma
creator: Mahendra Singh
creator: Pradeep Aggarwal
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-06-30
publication date: 2025-06-30
starting page: 200
ending page: 202
doi: 10.56450/JEFI.2025.v3i02.015

Rising Incidence of Stomach Cancer in Arunachal Pradesh: Examining the Role of Traditional Smoked Meat Consumption
type: item
description: Background: Stomach cancer in Arunachal Pradesh is a growing concern, constituting 23.2% of male and 14.6% of female cancer cases in West Arunachal, with high rates in Pasighat. Objective: This study explores the association between stomach cancer and dietary habits, focusing on the high traditional consumption of smoked meat, Helicobacter pylori infection, and alcohol intake. Method: Data from the Population-Based Cancer Registry and a literature review were analyzed. Results: Key risk factors include high traditional consumption of smoked meat, Helicobacter pylori, and alcohol intake. Conclusion: Public health interventions, dietary changes, and screening programs are needed.
subject: Short Article
  topic: section
subject: Stomach cancer
  topic: keywords
subject: smoked meat
  topic: keywords
subject: Helicobacter pylori
  topic: keywords
subject: dietary habits
  topic: keywords
creator: Kamta Beyong
creator: Pradeep Aggarwal
creator: Anubhuti Joshi
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-06-30
publication date: 2025-06-30
starting page: 188
ending page: 190
doi: 10.56450/JEFI.2025.v3i02.013

Towards One Nation, One Health System: A Pragmatic Approach to Integrative Medicine
type: item
description: India has long been a land of medical pluralism, where multiple healing traditions have coexisted for centuries—ranging from Indigenous systems like Ayurveda, Siddha, and Unani to later imports like homoeopathy from Europe and, of course, modern Western medicine or allopathy. Against this backdrop, in late 2021 and early 2022, reports emerged that the Government of India, under the leadership of Prime Minister Narendra Modi, is contemplating a major overhaul of the country's healthcare landscape under the banner of a "One Nation, One Health System" policy by the year 2030. According to preliminary information, this policy would integrate modern allopathy with traditional systems such as homoeopathy and Ayurveda in medical practice, Education, and research.
subject: Commentary
  topic: section
creator: K Madan Gopal
creator: Suneela Garg
creator: K S Uplabdh Gopal
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-06-30
publication date: 2025-06-30
starting page: 191
ending page: 199
doi: 10.56450/JEFI.2025.v3i02.014

A review of infectious disease training programs for healthcare professionals in India: Identifying gaps and the way forward
type: item
description: Infectious diseases pose a significant public health burden in India, necessitating a well-trained workforce equipped to manage both clinical and community-level challenges. In this study, a review of the existing short-term infectious disease courses in India was done, excluding postgraduate programs. Thirteen courses were identified, with ten exclusively targeting clinicians. Most are delivered online, last between 4 and 52 weeks, and range in cost from INR 12,000 to 1,25,200. None of the programs focused on public health competencies such as disease surveillance or outbreak investigations. The findings highlight a critical gap in skill-based training for public health professionals.
subject: Short Article
  topic: section
subject: Capacity Building
  topic: keywords
subject: Communicable Diseases
  topic: keywords
subject: Public Health
  topic: keywords
creator: Sirshendu Chaudhuri
creator: Anil Kaul
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-06-30
publication date: 2025-06-30
starting page: 183
ending page: 187
doi: 10.56450/JEFI.2025.v3i02.012

Boundaries Divided, Diseases Unbound: Zoonotic Threats Crossing Borders
type: item
description: Countries are often delineated by borders, establishing distinct geographical and political demarcations; however, pathogens exist beyond such constraints. They traverse these artificial separations, disseminating across continents and nations with no regard for the boundaries represented on cartographic representations. This occurrence underscores the interdependence of global health, highlighting that a virus or pathogen can seamlessly transition from one nation to another, impacting populations irrespective of their national affiliations. One may have encountered an unparalleled crisis manifested in the zoonotic disease referred to as COVID-19, which has exerted a profoundly detrimental influence on public health worldwide. Notwithstanding progress in global health initiatives, the international community continues to contend with a spectrum of zoonotic infections.
subject: Letter to Editor
  topic: section
creator: Neeraj Ranakoti
creator: Priyanka Naithani
creator: Diksha Silswal
creator: Mahendra Singh
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-06-30
publication date: 2025-06-30
starting page: 226
ending page: 228
doi: 10.56450/JEFI.2025.v3i02.022

“Listening to Lives”: Patient Voices and the Challenge of Hypertension Control in Rural and Hilly India
type: item
description: Hypertension remains a leading cause of morbidity and mortality in India, with particularly low awareness, treatment, and control rates in rural and hilly regions. Despite the availability of screening and treatment under national programs, significant challenges persist. This article emphasizes the value of integrating patient voices into hypertension prevention and control strategies. Through real patient narratives from the hilly districts of Uttarakhand, we explore how perceptions, stigma, and systemic gaps impact patient behavior. These stories highlight the importance of culturally responsive and patient-centered approaches in addressing chronic disease management in underserved populations.
subject: Perspective
  topic: section
subject: Hypertension
  topic: keywords
subject: Rural population
  topic: keywords
subject: Health behavior
  topic: keywords
subject: Non communicable disease
  topic: keywords
subject: Health services accessibility
  topic: keywords
subject: Social stigma
  topic: keywords
subject: Primary health care
  topic: keywords
creator: Madhuri Garbyal
creator: Arshdeep Singh
creator: Om Prakash Bera
creator: Pradeep Aggarwal
rights: Copyright (c) 2025 Journal of the Epidemiology Foundation of India
date: 2025-06-30
publication date: 2025-06-30
starting page: 220
ending page: 223
doi: 10.56450/JEFI.2025.v3i02.020