Gestational diabetes: How risky are the mothers of rural Bengal, India

Early detection of gestational diabetes in antenatal mothers can improve both pregnancy and fetal outcome. A descriptive, cross-sectional study was conducted to find out the magnitude of gestational diabetes by selective screening using “American Diabetes Association (ADA) risk approach strategy” and distribution of risk factors of gestational diabetes among the mothers attending the antenatal clinic of Singur Rural Hospital. Pregnant women with gestational age between 24-28 weeks were interviewed using a predesigned schedule adapted from American Diabetes Association and WHO guidelines and their clinical and obstetrical examination was done. Mothers identified with at least 1 risk factor were advised for screening by Glucose Challenge test (GCT). Those with a positive result were confirmed by Glucose Tolerance Test. Out of 625 antenatal mothers, majority i.e. 60.32% of the mothers were exposed to low risk for developing gestational diabetes. Among 248 (39.68%) mothers who had at least one risk factor, 20.56% were GCT positive amounting to 8.16% of the total population. 11.69% of the mothers with positive risk factors were GTT positive amounting to 56.86% of GCT positive mothers. This accounted for 4.64% of the total study population. Thus this method of preliminary screening for risk factors of gestational diabetes undertaken in all antenatal mothers followed by confirmatory testing in those found to be risk factor positive can provide a feasible alternative in increasing the yield for detection of gestational diabetes articularly in a low resource setting

Work-related stressors and coping strategies during COVID-19 pandemic: A qualitative study on reflections of frontline health care workers from India

Background: Frontline healthcare workers, a vital workforce in developing countries is often out of mainstream vision and their challenges and coping behaviors under stressful conditions remain unclear to stakeholders. This study was undertaken with the objective to explore the challenges faced by community surveillance workers and their coping strategies during COVID-19 pandemic. Methods: A qualitative descriptive study with constructivism paradigm was undertaken for a period of one year by conducting eight focus group discussions and eight in-depth interviews among the health workers undertaking COVID-19 surveillance selected purposively from eight wards within three Boroughs of a Municipal Corporation using interview guide. Thematic analysis was used to compare and contrast the codes to generate themes inductively under two constructs. Results: The first construct, factors influencing work related stress was categorized into four themes related to- work environment, community’s response towards pandemic surveillance, organizational support and personal factors. Main predisposing factors of work place stress were risk of self-infection, concern for family safety, inadequate training, shortage of manpower and protective equipment etc. While a strong commitment towards work, assistance from local community influencers, administrative appreciation and supportive supervision were protective factors against stress. Second construct on coping strategies was categorized into managing stress by problem-focused strategies like adapting with experience, gathering information and sharing experiences, adopting self-care practices; while emotion-based coping strategies included denial, venting out, or turning to religion etc. Conclusion: Community surveillance workers faced considerable and variable stress during pandemics due to various underlying work stressors, managed innovatively, using self-coping strategies

Hospital-based perinatal outcomes and complications in teenage pregnancy in India

Teenage pregnancy is a worldwide problem bearing serious social and medical implications relating to maternal and child health. A cross-sectional observational study was undertaken to compare the different sociodemographic characteristics and perinatal outcomes of teenage primigravida mothers with those of adult primigravida mothers in a tertiary-care hospital in eastern India. A sample of 350 each in cases and comparison group comprised the study subjects. Data were collected through interviews and by observa-tions using a pretested and predesigned schedule. Results revealed that the teenage mothers had a higher proportion ( 27. 7%) of preterm deliveries compared to 13. 1% in the adult mothers and had low-birth-weight babies ( 38. 9% vs 30. 4% respectively). Stillbirth rate was also significantly higher in teenage deliveries ( 5. 1% vs 0. 9% respectively). The teenage mothers developed more adverse perinatal complications, such as preterm births, stillbirths, neonatal deaths, and delivered low-birthweight babies, when compared with those of the adult primigravida mothers. Teenage pregnancy is still a rampant and important public-health problem in India with unfavourable perinatal outcomes and needs to be tackled on a priority basis

Role of predictors in acceptance of post-exposure prophylaxis with single-dose rifampicin among contacts of leprosy in rural area of Bankura: An explanatory mixed-method study

Background: India achieved the elimination of leprosy two decades ago although its sustenance continues to be threatened by ongoing active transmission in few remaining pockets. There is a paucity of data regarding the acceptance of single-dose rifampicin (SDR) prophylaxis among healthy contacts. Aims and Objectives: The aims and objectives of the study are to assess the factors influencing the acceptability of SDR among contacts. Materials and Methods: A community-based, sequential, explanatory mixed-method study was conducted over 6 months from September 2022 to February 2023 among 168 contacts of leprosy patients from two blocks in Bankura district, West Bengal. Quantitative analysis was done for SDR acceptance and its predictors among contacts using the Chi-square test, Mann–Whitney U test, and Logistic regression. This was followed by qualitative assessment using focus group discussions and in-depth interviews among contacts to explain the findings through a thematic approach. Results: Household contacts (aOR=13.72, 95% CI=2.09–90.19), increasing knowledge score of contacts (aOR=3.18, 95% CI=1.88–5.38), counseling by health workers (aOR=11.98, 95% CI=2.20–65.15), trust in health workers (aOR=152.96, 95% CI=13.17–1776.09), and not taking other medicines for comorbidity (aOR=35.82, 95% CI=2.94–436.02) were associated with increased SDR uptake among leprosy contacts. Barriers and facilitators of post-exposure prophylaxis (PEP)-SDR were categorized as contact, health workers, and program-related factors. Conclusion: SDR acceptability among contacts was 77.4%. Facilitators of SDR-PEP were awareness of side-effects, follow-up, prompt support by health workers, IEC, belief in National programs, etc. Lack of knowledge of PEP-SDR and contraindications, ineffective counseling by health workers, stigma of the disease, the increased workload of health workers, etc., were the barriers to SDR-PEP implementation

Hospital-based perinatal outcomes and complications in teenage pregnancy in India

Teenage pregnancy is a worldwide problem bearing serious social and medical implications relating to maternal and child health. A cross-sectional observational study was undertaken to compare the different sociodemographic characteristics and perinatal outcomes of teenage primigravida mothers with those of adult primigravida mothers in a tertiary-care hospital in eastern India. A sample of 350 each in cases and comparison group comprised the study subjects. Data were collected through interviews and by observa-tions using a pretested and predesigned schedule. Results revealed that the teenage mothers had a higher proportion ( 27. 7%) of preterm deliveries compared to 13. 1% in the adult mothers and had low-birth-weight babies ( 38. 9% vs 30. 4% respectively). Stillbirth rate was also significantly higher in teenage deliveries ( 5. 1% vs 0. 9% respectively). The teenage mothers developed more adverse perinatal complications, such as preterm births, stillbirths, neonatal deaths, and delivered low-birthweight babies, when compared with those of the adult primigravida mothers. Teenage pregnancy is still a rampant and important public-health problem in India with unfavourable perinatal outcomes and needs to be tackled on a priority basis