Journal of the Epidemiology Foundation of India
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.
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
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).
Copyright (c) 2025 Journal of the Epidemiology Foundation of India
Monitoring Blood Utilization for Transfusion Services in a Tertiary Care Teaching Hospital: Evidence-Based Analysis
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.
Nutritional Status, Glycemic Response and Dietary Compliance of Newly Diagnosed Versus long term Patients with type II diabetes
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.
Antibiotic Prescription Patterns for Respiratory Infections in Urban Outpatient Settings in India: A Multicenter, Retrospective, EMR-Based Study Using WHO AWaRe Classification
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.
Circadian Rhythm-Aligned Antioxidant Delivery: A Non-Invasive Strategy to Combat Oxidative Stress in Indian Adults
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.
Sibling “Diluan” Physicians Wonder Whether Diluting Milk Before Personal Use Could Dilute Lactation Stress On Mother Cows
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.
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
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.
Enhancing Medical nutrition therapy adherence among GDM mothers: Need for digital solutions and Support systems
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)
Infection Prevention and Control Practices at a Tertiary Care Centre in New Delhi
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.
Zoo-WIN” – Winning over Zoonosis: A Digital Leap Towards Zoonosis prevention in India
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.
Exploring the landscape of Vector-Borne Diseases and Their Vectors in India's Endemic states: Bird’s eye view
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.
Advancing Dengue Prevention: Vaccine Development and Current Trials
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.
Rising Incidence of Stomach Cancer in Arunachal Pradesh: Examining the Role of Traditional Smoked Meat Consumption
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.
Towards One Nation, One Health System: A Pragmatic Approach to Integrative Medicine
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.
A review of infectious disease training programs for healthcare professionals in India: Identifying gaps and the way forward
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.
Boundaries Divided, Diseases Unbound: Zoonotic Threats Crossing Borders
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.
“Listening to Lives”: Patient Voices and the Challenge of Hypertension Control in Rural and Hilly India
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.
Home Care Nursing for Elderly in India: Addressing the Needs and Challenges of a Rapidly Aging Society
India is experiencing demographic changes, with the aged population projected to rise from 153 million to 347 million by 2050. This unprecedented phase calls for urgent attention to geriatric home care, especially with the growing prevalence of chronic diseases and dependence on untrained informal caregivers. A trained workforce with expertise in psychological support, preventive and rehabilitative care, digital literacy, and communication is urgently needed. From a demand perspective, systemic constraints inhibit quality care, including limited training, inadequate financial support, social stigma, and caregiver burnout. Frameworks like NITI Aayog's Senior Care Reforms and WHO's Integrated Care for Older People (ICOPE) offer pragmatic strategies focusing on holistic person-centred care, digital enablement, and caregiver support. This piece identifies critical gaps in competencies and advocates for a professional geriatric home care curriculum aligned with national and global priorities. Integrating these measures with supportive policies, financial incentives, and infrastructure will improve accessibility and caregiver retention. Strengthening the geriatric care platform requires collaboration among policymakers, providers, and educators to ensure equitable, compassionate care for India’s aging population while empowering caregivers to deliver sustained support.
From Harm to Health Equity: Advancing Policy Action Against Conversion Therapy in India
Background: Conversion therapy is a pseudoscientific and unethical practice aimed at altering an individual’s sexual orientation or gender identity. Despite the National Medical Commission’s (NMC) 2021 ban on medical professionals performing it, the practice persists in India through religious leaders, unlicensed practitioners and family members, continuing to inflict significant psychological and physical harm. Aims & Objectives: This article examines the public health consequences of conversion therapy in India, evaluates its divergence from global health standards and the United Nations Sustainable Development Goals (SDGs) and proposes a holistic national response to safeguard LGBTQIA+ rights and wellbeing. Methodology: We conducted a narrative review of peer-reviewed literature, legal documents, policy papers and guidelines from WHO, UN agencies and the Government of India. The review focused on ethical, health and human rights perspectives alongside existing policy gaps. Results: Conversion therapy perpetuates stigma, worsens mental health outcomes and undermines India’s commitments to SDG 3 (health), SDG 5 (gender equality) and SDG 10 (reduced inequalities). Current regulatory efforts remain fragmented, excludes religious leaders, unlicensed practitioners and family-led coercion. Conclusion: A comprehensive national policy is urgently needed. Strengthening legal protections, inclusive education and public health interventions is essential to dismantle conversion therapy and protect LGBTQIA+ individuals in India.
The JN.1 Variant of SARS-CoV-2: Public Health Alert or Controlled Threat?
The recent global rise in cases associated with the JN.1 variant of SARS-CoV-2, a sub lineage of the Omicron variant, calls for urgent scholarly and public health attention. Identified initially in late 2023, JN.1 has rapidly gained prevalence and, by early 2024, became the most dominant circulating strain globally, according to the Centres for Disease Control and Prevention (CDC) (1). As of mid-December 2023, JN.1 was detected in 41 countries, constituting over 27% of global sequences submitted to GISAID (2). Its increasing dominance can be attributed to mutations that confer heightened transmissibility and partial immune evasion. Despite this, available evidence suggests that JN.1 does not lead to more severe disease outcomes compared to its predecessors (1,3).
Nutrition Transition- A Study of Millet Consumption Pattern Across Three Generations of Indian Families
Introduction: Millets, traditional grains of India, are gaining renewed attention due to their nutritional benefits and climate resilience. This study aims to assess the millet consumption patterns among three generations in 200 families living together in Chandigarh to understand dietary shifts and strategies for millet revival in modern diets. Methodology: The study was conducted on 200 families (600 respondents) residing together in Chandigarh (U.T.), India, Data was collected using a purposive sampling method and an interview-based questionnaire. The questionnaire explored millet consumption frequency, preferred cooking methods, reasons for consumption, and awareness of millets' nutritive value. Results: 41% of grandparents, 16% of parents, and 6% of children consumed millets for over 5 years. A significant association (χ2 = 341.365, p = 0.0001) indicates older generations have a longer history of millet consumption. Traditional eating practices influenced consumption across groups (35.5% grandparents, 37.5% parents, 42.0% children). Grandparents and parents predominantly consumed millets as chapatis, while children preferred millet-based cookies and cakes. Awareness of millet nutrition was high (96.5% grandparents, 94.5% parents). Declining intake was attributed to alternative grains (91.5% grandparents, 83.0% parents, 64.0% children). Conclusion: Despite strong awareness, millet consumption has declined across generations, particularly among youth, highlighting the need for innovative dietary integration to improve health and nutritional security.
Tribal Health: A Comprehensive Review of Challenges, Interventions, and Future Directions
Tribal populations worldwide face numerous health challenges due to factors such as socio-economic disparity, geographic isolation, cultural differences, and limited access to healthcare. This article explores the health status of tribal communities, focusing on the prevalence of infectious and non-communicable diseases, barriers to healthcare access, and the role of traditional medicine. The review also highlights the impact of government health interventions, the significance of cultural competence in healthcare, and potential strategies for improving health outcomes in tribal populations. The findings emphasize the need for culturally sensitive healthcare delivery, sustainable policy interventions, and innovative solutions such as telemedicine and mobile health.
Epidemiology, Clinical Features, and Molecular Characteristics of Human Metapneumovirus (HMPV): A Meta-Analysis
Human Metapneumovirus (HMPV) was first described in 2001 in the Netherlands and has become an important pathogen in the Pneumoviridae family, causing significant paediatric and adult respiratory infections worldwide. This review synthesizes the clinical manifestations, genetic diversity, epidemiology, and pathogenesis of the virus based on findings of more than two decades' worth of research. HMPV is not only highly infectious, but it carries a burden in the form of its tendency to result in severe respiratory disease in children, the elderly, and the immunocompromised, often causing lengthy hospitalizations and remarkable expenditures in healthcare. Unlike RSV, HMPV has defined age-related infection patterns and a unique genetic architecture, with the G glycoprotein that is highly variable making subclassification and antigenicity dependent upon this variation. Current subtypes (such as A2b1) demonstrate the scourge of the virus’s adaptability and thus raise obstacles to its vaccine development. HMPV pathogenetically infects ciliated epithelial cells, disrupting mucociliary function, producing robust inflammatory responses, and worsening disease severity. Advanced molecular diagnostics and therapeutic approaches have nonetheless been accompanied by little progress in developing specific antiviral treatments or vaccines, a need underscored by the urgency of such focused research and public health interventions. Finally, these findings are integrated to achieve a complete picture of HMPV and to progress future research and clinical approaches regarding this important respiratory pathogen.
Antigenic Variation and Host-Pathogen Interactions
Seroprevalence and Risk Factors for Hepatitis B and C infection among pregnant women attending a government hospital in Delhi
Background: Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infection during pregnancy is associated with perinatal transmission contributing to the pool of HBV and HCV infection. Pregnant women with chronic hepatitis B and positive Hepatitis B virus E antigen (HBeAg) have a 90% likelihood of transmitting the hepatitis B virus to their newborns. Vertical (mother-to-child) transmission is the leading cause of HCV infection in children. Though there is much data on the overall prevalence of HBV and HCV infection among the general population, only a few studies are focusing on the seroprevalence of HBV and HCV among pregnant women. Methodology: A cross-sectional, descriptive study conducted in Delhi. A total of 422 pregnant women attending the antenatal clinic for the first time were interviewed for risk factors for transmission and then tested for HBsAg and anti-HCV using rapid diagnostic test kit. Results: The seroprevalence for HBsAg and anti-HCV among the participants was 2.1% and 0.2%, respectively. Risk factor assessment revealed a significant association with the history of blood or blood product transfusion. Conclusion: Prevalence rates for HBsAg are higher than those reported in some previous studies and the national average. More in-depth research studies are needed to identify potential risk factors significantly contributing to the disease burden for the targeted approach to eliminate infection.
Challenges in the Use of the Montreal Cognitive Assessment (MoCA) in Primary Health Care Settings in India
Background: With a rapidly ageing population, dementia rates are rising globally, posing challenges to individual health and healthcare systems. Early dementia detection is crucial for effective intervention and improved patient quality of life. The Montreal Cognitive Assessment (MoCA) is a commonly used cognitive screening tool with high sensitivity and specificity. However, implementing MoCA in primary healthcare (PHC) settings in India is met with significant challenges. Methods: This qualitative study explored the barriers healthcare professionals face in using MoCA within PHC settings in Karnataka, India. Twelve healthcare providers, including physicians and nurses, participated in semi-structured interviews. Data were analyzed using thematic analysis, yielding insights into the experiences and perspectives of PHC professionals regarding MoCA use. Results: Five major themes emerged: (1) insufficient training and knowledge about administering MoCA, (2) time constraints in busy clinical environments, (3) cultural and linguistic relevance of the assessment tool, (4) limited resources and accessibility in PHC settings, and (5) lack of integration with other health services. These barriers hindered effective cognitive screening, potentially leading to delayed diagnosis and intervention for cognitive impairment. Innovation: This study uniquely highlights the systemic barriers to implementing MoCA in India's PHC settings and proposes culturally relevant adaptations to the tool. The findings emphasize the importance of integrating cognitive screening within existing healthcare workflows, supported by tailored training programs and resource allocation strategies. These insights provide a foundation for creating context-specific cognitive screening tools and methodologies, advancing early detection of dementia in low-resource settings. Discussion and Conclusions: This study underscores the need for systemic changes to improve MoCA’s usability in PHC, including enhanced training, adaptation of the tool for acultural relevance, improved resources, and integrated care models. Addressing these barriers may enhance the early detection and management of cognitive disorders, fostering a more holistic approach to patient care in India’s PHC settings.
Cognitive Screening; Primary Health Care
Demographic Pattern of Pancreatitis Patients in India – A Hospital-based Study
Background: Pancreatitis, an inflammatory disease of the pancreas, is emerging as a significant health concern globally, with an increasing incidence in India. Historically, the disease was first identified in India in 1937, and since then, research efforts have expanded, focusing on regional patterns and causative factors. Methodology: This hospital-based study analyzes the demographic and clinical characteristics of 2,050 patients diagnosed with pancreatitis between January 1997 and November 2024, treated at leading hospitals across India. Key parameters, including age, gender, region, dietary habits, and lifestyle patterns, were evaluated to identify demographic trends and risk factors associated with the disease. Result: The study revealed a predominantly male population (83%) with an average age of 24 years and a significant proportion (75%) of adult patients aged 19–45 years. Similarly, only 33.6% of patients reported alcohol consumption, and tobacco use was documented in 18.4% of cases. Furthermore, genetic predisposition was observed in 8.8% of patients, while gallstone-related pancreatitis accounted for 5% of cases. Conclusion: The findings indicate the need for broader epidemiological studies to understand the regional and lifestyle factors contributing to the rising incidences of pancreatitis in India.
Body Mass Index, Blood Pressure, and Hypertension Risk: A Regression Analysis Among Adolescents in a North Indian City
Teens who are overweight have a higher likelihood of becoming obese adults as they get older, which increases their risk of developing a variety of ailments. Growing the amount of physical activity among adolescents between the ages of 11 and 17 requires immediate attention, based on global trends for teens who participate in insufficient physical activity. The objective of the study was to test the relationship between BMI and blood pressure, as well as to provide recommendations for preventing adolescent hypertension. This cross sectional study was conducted among 800 students between the ages of 12 and 14 years. It was found that the population's average BMI was 18.89± 3.9 kg/m2. BMI and blood pressure were shown to be significantly correlated. For the systolic and diastolic blood pressure of teenagers in the study, a significant logistic regression was obtained (R2 = 0.130, p 0.00), and (R2= 0.047, p 0.00), respectively. This is essential for early prevention due to the increase in non-communicable diseases, which can be achieved through IEC activities and raised awareness by children
Post-Introduction Evaluation (PIE) of Covid-19 Vaccination in Delhi: Application of WHO Framework
The present study was undertaken for the Post-Introduction Evaluation (PIE) of COVID-19 vaccination across different levels of healthcare system in Delhi. It was conducted in accordance with the guideline provided in the WHO PIE tool to assess the COVID-19 vaccine introduction and document strength and weaknesses. The study found that The detailed operational plans were available at state, district and health facility levels. Both electronic and paper-based reporting and recording mechanism were deployed for COVID-19 vaccination. There was neither stock out nor expiry reported for COVID-19 vaccine. There was an AEFI committee functional with availability of a system and written protocol for monitoring and reporting of AEFIs of COVID-19 vaccine
More than Just Leafy Greens: Expanding the ICMR-NIN Guidelines for a Healthier, Productive Future
The 2024 ICMR-NIN Dietary Guidelines for Indians offer a comprehensive framework to address the dual burden of malnutrition India faces. These guidelines emphasise balanced diets, physical activity, and the consumption of diverse, nutrient-rich foods across all life stages, aligning with global nutrition trends and sustainability goals. This commentary explores the guidelines’ role in fostering improved health outcomes essential for leveraging India’s demographic dividend and promoting a healthier, more productive population. It further suggests expanding the guidelines to include specific recommendations on food safety, mental health, plant-based and sustainable eating, digital nutrition tools, and fortified foods. Integrating these aspects could make the guidelines more relevant, equipping individuals and policymakers with actionable strategies to address India’s evolving public health challenges. Our role in implementing these guidelines is crucial, as it will enhance the nation’s potential for economic growth through a healthier and more resilient workforce.