Strengthening breast cancer screening program through health education of women and capacity building of primary healthcare providers

BackgroundGlobally and in India, breast cancer is a prevalent malignancy. India saw 178,361 new cases and 90,000 deaths in 2020. Timely detection is vital, highlighting the importance of Breast Self-Examination (BSE), especially in low-income settings. Strengthening BSE in awareness and screening efforts is urgent. Despite awareness, practical application lags due to women’s reluctance. Effective execution demands partnerships, a multi-sectoral strategy, and training grassroots workers.ObjectiveTo address these challenges, the present study aims to strengthen the breast cancer screening program using BSE strategy and adopting a referral mechanism for the diagnosis and treatment of suspect cases.MethodsA community-based study occurred in specific districts of Rajasthan (2017–2022), enhancing breast cancer screening for women aged 30–65. It involved healthcare providers and local women, utilizing tools like the MT-DM-GP6620 Breast Inspection Model, educational booklets, and semi-structured schedules. The strategy encompassed knowledge assessment, capacity building for healthcare providers, BSE training, increasing women’s breast cancer awareness, suspect case referrals, and phone-based follow-up.ResultsOur study encompassed 157,225 women aged 30–65 in Jodhpur, Jalore, and Pali districts. Initial breast self-examination (BSE) awareness was below 1%. BSE training reached 218,978 women using booklets and demonstrations, with 72% aged 30–65 and the rest 15–30. Follow-ups reinforced BSE, leading to 745 identified suspect breast cancer cases, mostly due to painless lumps (332 cases). Capacity-building workshops involving 824 medical and paramedical staff strengthened early breast cancer detection in Jodhpur and Jalore, in collaboration with the district health department.ConclusionThe study model’s success suggests its applicability in other Rajasthan districts, Indian states, and global breast cancer prevention programs. While positive outcomes were evident, challenges related to culture, cost, and benefits warrant consideration. The approach prioritized early detection through community engagement, reducing patient and government burdens. Community involvement and healthcare engagement were pivotal, with breast self-examination proving effective for enhancing awareness and early detection. Promoting BSE education can significantly enhance breast cancer awareness and early detection

Protocol of systematic reviews on implementation research on cardiovascular diseases, diabetes mellitus and mental ailments in India [version 2; peer review: 2 approved]

Introduction The burden of non-communicable diseases (NCDs) is a major public health concern across the world. Various initiatives have tried to address these with varying degrees of success. Objective The objective is to assess and collate existing evidence in implementation research done in India on three broad domains of NCDs namely, cardiovascular diseases (CVD), diabetes mellitus (DM), and mental health (MH) in India. Materials and methods Three systematic review protocols have been drafted to explore and collate extant evidence of implementation research on cardiovascular diseases, diabetes mellitus, and mental health in India, in accordance with the PRISMA-P statement. Academic databases including PubMed, Embase and Science Direct will be searched. Search strategies will be formulated in iterative processes and in accordance with the formats that are specific to the databases that will be searched. In addition, grey literature and non-academic databases will also be explored. Data extracted from the selected studies will be analysed and a narrative summary of the selected articles, using the SWiM (Synthesis without meta-analysis) guidelines will be produced. Intended Outcomes The outputs of these systematic reviews could help in a better understanding of implementation research gaps and also how to address them. Apart from giving insights into how healthcare initiatives for CVDs, diabetes and mental health could be implemented in a better way, the study could also advocate the need to build and consolidate capacity for implementation research in the country

Model rural health research unit's NS1-based serosurveillance recommends for vector control in rural villages of Jaipur district, Rajasthan, India

Background: Infectious diseases are important public health issues in India. Rajasthan state reported 20,749 numbers of dengue fever (DF) cases in 2021, which was 10.73% of the country's total dengue cases. Aims and objectives: The aim of the study was to diagnose fever cases in the nearby villages of Model Rural Health Research Unit (MRHRU) through the use of its diagnostic facility and to mitigate the diseases using appropriate control methods. MATERIALS AND METHODS: This is a community health center (CHC)-based serosurveillance study. The study subjects were the patients who reported at the Outpatient Department of the CHCs Bhanpur Kalan and Jamwa Ramgarh of Jaipur district in Rajasthan with clinical suspicion of DF. The study was conducted for 6 months from July to December. The serum samples received from CHC Bhanpur Kalan and Jamwa Ramgarh were tested for the detection of dengue antibodies against NS1 antigen at MRHRU. Results: A total of 148 blood samples were received from CHC and were diagnosed with dengue NS1 at MRHRU. Out of 148 serum samples, 79 were male and 69 were female. Among the 148 samples subjected to the NS1 dengue enzyme-linked immunosorbent assay test, 33.1% were found to be positive for dengue, 63.5% were negative, and 3.37% were equivocal. Out of the 113 samples of Jamwa Ramgarh, 31.8% were found to be NS1 positive and 2.65% were equivocal, wherein 35 serum samples of Amber block were tested for diagnosis of NS1 test, and out of them, 37.14% were NS1 positive and 5.71% were equivocal. Conclusion: The number of dengue cases was observed to be higher, and control measure was taken to stop the spreading of the disease. Early and proper diagnosis of dengue cases is helpful in the treatment and control of disease. MRHRU facility was found to be effective in the containment of the disease

Implementation research on diabetes in India: A systematic review

Background: There is a wide range of effective interventions for the prevention of diabetes, but few of these approaches have been extensively utilized in real-world settings. The objective of this systematic review was to assess and collate existing evidence in implementation research (IR) on prevention, control and treatment of Diabetes Mellitus (DM) in India. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses - Protocol (PRISMA-P) guidelines were used to create the protocol for the systematic review. Articles published in the previous 20 years (2001–2020) and published in English language were included in the study. Electronic databases such as MEDLINE (through PubMed gateway), EMBASE, and Science Direct; search engines like Google scholar and ProQuest were systematically searched using separate search protocols for each database. Retrieved articles were screened for titles and abstracts and assessed by two independent reviewers. Using standard checklists, the articles also underwent a risk of bias assessment, and a narrative summary was written using SWiM guidelines. Results: Sixteen studies were included in the review, which included three implementation studies related to screening of diabetes, three studies on the management of diabetes, three studies related to lifestyle interventions, one on behavioral intervention, two on electronic support system-based interventions, and the remaining four studies explored IR in other areas of diabetes. The key attributes of implementation research such as acceptability, feasibility, adoption, economic evaluation measures like cost-effectiveness, operational issues like barriers, and facilitating factors were addressed by most of the studies, in varying extents. Conclusion: Implementation research on diabetes mellitus in India is very limited which underscores the importance of creating awareness about the need of IR and building capacity and skills for conducting IR among various stakeholders