Department of Community Medicine

Study to Assess Factors Influencing Initiation, Adherence, and Completion of Tuberculosis Preventive Therapy Among Household Contacts of Pulmonary Tuberculosis Patients in Vijayapura District

Fri, 01 Jan 2021 00:00:00 GMT

Study to Assess Factors Influencing Initiation, Adherence, and Completion of Tuberculosis Preventive Therapy Among Household Contacts of Pulmonary Tuberculosis Patients in Vijayapura District Shanoon Sharaf, Ali Background: India has the highest burden of Tuberculosis (TB) infection globally, nearly 35-40 crores of which an estimated 26 lakh are likely to develop active TB. Although early diagnosis and treatment of active TB remains a top priority in India, preventing TB by detecting and treating TB Infection (TBI) is an important step towards ending TB. Tuberculosis preventive treatment (TPT) is one of the key interventions recommended by the World Health Organization (WHO). The risk of developing TB disease is reduced by 60% after receiving TPT. In July 2021, NTEP issued new guidelines recommending TPT for all House-Hold Contacts (HHCs) of Bacteriologically confirmed pulmonary TB cases. There is very little literature on the initiation and completion rates of TPT. Knowledge about the current scenario and programmatic challenges would help in future improvision of the programme. Objective: 1. To estimate the Proportion of HHCs (Household Contacts) of Bacteriologically confirmed Pulmonary TB who initiate and complete the TPT in Vijayapura district. 2. To explore the Factors influencing Adherence and Non-Adherence to TPT treatment. 3. To understand operational difficulties for non-initiation and non-completion of TPT by interviewing concerned health care providers and informing programme and policymakers. Methodology: This Cross-sectional study was conducted in a high burden district in Northern Karnataka by Interview Technique using a pre-tested semi-structured questionnaire. All HHCs of Bacteriologically confirmed Pulmonary TB cases registered from June 2022 to December 2022, who were eligible for TPT were enrolled in the study. The HHCs were interviewed From March 2023 to July 2023. Out of 10 TB units, five units were selected using a simple random sampling method. TB patients were selected from these 5 TB units using the probability proportional to size sampling method to achieve the sample size. HHCs of those TB patients were interviewed after agreeing to participate in the study. Results & Conclusion: Total 565 HHCs interviewed in 119 households with average HH size of 5. 81% pf households were holding BPL card, 59% overcrowded and 78% Hindu by religion. We found that 22% of the HHCs/study participants told they were not screened for TB (even not for clinical symptoms) to start TPT and 21% of the study participants were not initiated on TPT, and 50% of those initiated did not complete the full course of TPT. The reasons for non-initiation were as follows: 56% lacked awareness about TPT, 32% told they were not approached by any healthcare provider regarding TPT, 6% were Unwilling, and another 6% had medical conditions that prevented them from being prescribed TPT. The most common reason for not completing the full course of TPT as told by 48% was it was not necessary to take complete TPT. Other reasons mentioned were: Unavailability of medicines (6%), not receiving drugs after 3 months (12%), discontinuation due to adverse effects (15%), and some medical conditions and migration (9%). The study highlights the prevalent social factors and stigma associated with the TB disease, with a 55% non-response rate when approached for study participation. To address these factors and improve TPT outcomes, the study recommends several strategic interventions like introduction of shorter TPT regimens to enhance adherence, improved training for Health Care Personnels to ensure effective TPT delivery, addressing programmatic issues like ensuring steady drug supply, establishment of IGRA testing facilities, expanding health insurance coverage, and intensifying targeted IEC activities to reduce stigma and foster a stronger acceptance of TPT within communities.

To Assess the Knowledge, Attitude, And Beliefs Towards the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community Among Students of Various Professional Backgrounds in Vijayapura

Fri, 01 Jan 2021 00:00:00 GMT

To Assess the Knowledge, Attitude, And Beliefs Towards the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community Among Students of Various Professional Backgrounds in Vijayapura Kavimalar, T Introduction: In the 21st century, social attitudes toward gender, sexuality, and identity are evolving. However, despite constitutional provisions for equality, discrimination against the LGBTQIA+ community persists in various forms across Indian society. The discourse surrounding LGBT+ rights and acceptance is dynamic, reflecting ongoing debates and discussions about equality, human rights, and social justice. The current study focuses on understanding heterosexual perceptions of homosexuality and cultural attitudes toward the LGBTQIA+ community, aiming to address the limited research on this sensitive topic in India, particularly in Northern Karnataka. By understanding these perspectives, the study seeks to contribute to fostering a more supportive and accepting environment for LGBTQIA+ individuals. Objectives • To study the knowledge, attitude, and beliefs of students toward the LGBT community. • Compare and Correlate the Knowledge, attitudes, and beliefs of students with respect to social-demographic variables and their professional background. Materials & Methodology: This is a cross-sectional study conducted in the colleges of Vijayapura among students aged above 18 years. All participants who met the inclusion criteria were included in the study. In-person interviews were conducted using semi-structured questionnaires to collect socio-demographic data and information on cultural practices. Additionally, Riddles and CSUN scales were utilized to assess the knowledge, attitudes, and beliefs (KAB) of the respondents regarding the LGBTI community. Statistical Analysis: The data was entered into an Excel spreadsheet and then analyzed using SPSS version 26. Descriptive statistics such as frequencies, percentages, and diagrams were employed to analyze the data. The chi-square test was utilized to examine the statistical associations between the knowledge, attitudes, and beliefs (KAB) and other independent variables. Results: Out of 984 study participants, a notable proportion showed poor knowledge (36.4%), exhibited poor attitudes (3.5%), and held poor beliefs (35.9%). Conversely, positive outcomes were observed across various domains, with 24.6% exhibiting good knowledge, 59.7% showing good attitudes, and 36.0% holding good beliefs. The study revealed that good knowledge often aligns with positive beliefs in 42.7% of cases. Negative attitudes correlate with poor beliefs in 4.8% of instances, while positive attitudes frequently coincide with good beliefs in 88.1% of RespondentsConclusion: Our study underscores the necessity of incorporating LGBT-related topics into college curricula and providing training for educators and staff. These steps are crucial for fostering inclusivity and support for LGBT individuals within educational institutions. Additionally, launching targeted educational campaigns is essential for increasing understanding and acceptance of sexual orientation and gender identity diversity.

Epidemiological profile of Tuberculosis patients in Vijayapura, North Karnataka: A hospital-based study.

Fri, 01 Jan 2021 00:00:00 GMT

Epidemiological profile of Tuberculosis patients in Vijayapura, North Karnataka: A hospital-based study. Fyroose, Eariyaden BACKGROUND Tuberculosis (TB) remains a significant global health challenge, despite advancements in its treatment. TB, a respiratory illness transmitted through the air, continues to impact millions worldwide, with 10.6 million cases reported in 2022, marking an increase from previous years. The disease perpetuates economic hardship and poverty, affecting individuals, families, and communities. In India, the National Tuberculosis Elimination Program (NTEP) reported a record high of 24.2 lakh cases in 2022, with substantial improvements in TB surveillance and case-finding strategies. The relationship between TB and malnutrition is bidirectional, with each exacerbating the other. Addressing the social determinants of TB through coordinated, multi-sectoral approaches is crucial for effective TB control. However, there is limited information on the socio-epidemiological factors influencing TB in regions like northern Karnataka. This study focuses on examining these factors in patients with drug-sensitive and drug-resistant TB in the Vijayapura district. AIM AND OBJECTIVES OF THE STUDY 1. To assess the sociodemographic details, previous treatment history and clinical characteristics of T.B patients. 2. To understand the health-seeking behaviour and nutritional status of T.B. patients. 3. To evaluate comorbidities among T.B patients. METHODOLOGY This cross-sectional study was conducted from January to December 2023 at BLDE (Deemed to be University) Shri B. M. Patil Medical College Hospital & Research Centre, Vijayapura, anagricultural district with a high TB burden. The study population included TB patients aged over 18 years who were treated at the hospital. Using convenient sampling, 180 patients were interviewed face-to-face with semi-structured questionnaires and underwent anthropometric measurements. Ethical clearance was obtained, and informed consent was assured. Inclusion criteria encompassed all diagnosed TB cases admitted during the study period, while exclusion criteria included non-consenting, critically ill patients, and pregnant or lactating women. RESULTS The study population comprised 63% males and 37% females, with a higher representation of young to middle-aged adults (37.2% aged 21-40). About 25.6% were uneducated, and socioeconomically, most participants were from middle or lower-middle-class backgrounds. Farmers (22.8%) and daily laborers (20.6%) were the predominant occupations, and 46.7% belonged to nuclear families. Among the 180 participants, 88.3% were newly diagnosed with TB, and 11.7% had a previous TB diagnosis. The majority (87.8%) had no history of contact with TB cases, and 58.9% had been vaccinated with BCG. Extrapulmonary TB was present in 51.1% of cases. HIV prevalence was low (1.1%), and 16.1% had diabetes. Most participants were non-smokers (74%) and non-alcoholics (75.6%).Housing conditions varied, with half living in pucca houses and 28.9% experiencing overcrowding. The majority (90%) were diagnosed through sputum examination. Hygiene practices showed 66.7% used facemasks, and 57.8% had correct cough etiquette knowledge. Nutritionally, 53.9% were underweight, while 31.7% had a normal weight. Pulmonary TB was more common among smokers and alcoholics, while extrapulmonary TB was more prevalent among non-smokers and non-alcoholics. Diabetic patients had a higher prevalence of pulmonary TB (72.4%). Educational status influenced the choice of initial consultation, with higher-educated individuals preferring private hospitals. Previous TB diagnosis and treatment completion status also impacted thechoice of healthcare facilities. There was a significant association between BMI and TB type, with underweight individuals more likely to have pulmonary TB. CONCLUSION This cross-sectional study at BLDE (Deemed to be University) Shri B. M. Patil Medical College Hospital & Research Centre, Vijayapura, analyzed socio-demographic factors and healthcare-seeking behaviors among 180 TB patients. Significant associations were found between smoking, alcohol consumption, diabetes, BMI, and TB types. Educational status influenced healthcare-seeking behavior, with more educated individuals preferring private facilities. Previous TB diagnoses affected current treatment choices. These findings highlight the need for tailored health interventions to improve TB treatment adherence and healthcare accessibility, especially in high-prevalence areas

Psycho-Social and Economic Burden on People with Physical Disabilities and Their Caregivers of Vijayapura District

Fri, 01 Jan 2021 00:00:00 GMT

Psycho-Social and Economic Burden on People with Physical Disabilities and Their Caregivers of Vijayapura District Bhoomika., N Introduction The International Classification of Functioning, Disability, and Health (ICF) defines disability as impairments, activity limitations, or participation restrictions due to interactions between a health condition and environmental and personal factors. Disabilities, which can be cognitive, physical, mental, sensory, emotional, or developmental, affect approximately 10% of the global population, or 650 million people, with 26.8 million individuals in India according to the 2011 Census. Disabilities significantly impact psychological, social, and economic dimensions, often leading to marginalization and affecting both individuals with disabilities and their families. Caregivers play a crucial role but often face emotional and financial challenges, particularly in developing countries with inadequate healthcare services. This study aims to evaluate the quality of life of individuals with disabilities and caregivers in the Vijayapura district. - Objectives: 1. To explore the psychological stress on the physically disabled persons and their caregivers (>18 years) using Perceived Stress Scale (PSS) questionnaire. 2. To assess the social burden on the Caregivers of physically disabled persons using the Caregiver Burden Inventory (CBI). 3. To assess the Economic burden on family & caregivers of physically disabled persons by using the Financial Impact Scale (FIS). - Materials and Methodology: A cross-sectional study was conducted at the DDR Centre of BLDE (DU) Shri B M Patil Medical College, Hospital & Research Centre, Vijayapura, Karnataka, focusing on physically disabled individuals and their caregivers. Ethical clearance was obtained from the Institutional Ethical Committee before commencing the study. Participants were interviewed using a pretested semi structured questionnaire to gather socio-demographic information. The Perceived Stress Scale (PSS) was employed to evaluate psychological stress among physically disabled individuals, the Caregiver Burden Inventory (CBI) was used to assess the social burden on caregivers, and the Financial Impact Scale (FIS) was utilized to measure the economic burden on families and caregivers of the physically disabled individuals. - Statistical Analysis: The data were compiled into an Excel spreadsheet and analyzed using SPSS version 20. Descriptive statistics such as frequencies, percentages, and diagrams were utilized for analysis. The statistical association between depression and other independent variables was assessed using chi-square tests and logistic regression analysis. Results: Out of 400 participants, 40.3% experienced high levels of stress, while 51.5% reported moderate stress levels according to the PSS scale. On the CBI scale, 56% indicated a greater need for respite and services, and 73.8% agreed that caregiving strained their family and social life based on the FIS scale. Binary logistic regression showed significant associations between caregivers’ burden and several independent variables like low income and lower educational level (p<0.001). - Conclusion: Improving the quality of life for physically disabled individuals and their caregivers to alleviate their stress and burden is crucial. Effective communication techniques and regular counselling are needed to identify subtle signs of distress and prompt timely help.