Public Attitudes Toward Psychiatric Hospitals: A Rural-Urban Comparative Public Survey in Odisha State, India

Background: Integration of psychiatric care with public health services and offering mental health care services to patients from lower socioeconomic status remains a global challenge. Scarcity of funds and professional workforce in psychiatric hospitals contribute to this situation. However, negative attitudes in the population are also a known impediment to patients seeking mental health services. This study aimed to assess the attitudes toward psychiatric hospitals among the urban and rural population in India. Subjects and Methods: The study was carried out amongst the general population in Odisha, India. The total sample (n = 988) includes 496 respondents from an urban-setting, and 492 respondents from rural parts of the district. Participants were selected by using simple random-sampling from the Asian Institute of Public Health (AIPH) data base. A standardized seven-item questionnaire was adopted, with responses indicated on a 5-point Likert-scale. Interviews were fully structured and conducted face-to-face. Results: Level of education (B = -0.192, ss = -0.320, p < 0.000) and urban-rural comparison (B = -0.272, ss = -0.189, p < 0.000) significantly influenced attitudes toward psychiatric hospitals. Gender, age, and religious beliefs did not show any significant effect on attitudes toward psychiatric hospitals. Individuals in rural areas and those with lower education levels showed more negative attitudes toward psychiatric hospitals. Conclusion: Negative attitudes toward psychiatric hospitals from those living in rural areas as well as those with lesser education may be reflective of the lack of availability, accessibility, affordability, and credibility of such mental health services. The Mental Health Care Act in India is a progressive legislation which might improve the situation of the provided services and, consequently, reduce negative attitudes in the years to come

Shigellosis in Sweden: A public health concern

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Mapping Concurrent Wasting and Stunting Among Children Under Five in India: A Multilevel Analysis

Objectives: The study aims to examine the coexisting forms, patterns, and predictors of concurrent wasting and stunting (WaSt) among children under five in India.Methods: We used data from the National Family Health Survey to understand the trend and association of WaSt among children under five-year-old in India. Univariate analysis and cross-tabulations were performed for WaSt cases. The association was determined using multilevel binary logistic regression and multilevel regression, and the results were provided as adjusted odds ratios (aOR) with 95% confidence intervals at the significance level of p &lt; 0.05.Results: The prevalence of WaSt has decreased from 8.7% in 2005–06 to 5.2 percent in 2019–2020. The proportion of WaSt children grew rapidly from 6 to 18 months, peaked at 19 months (8%), then dropped after 24 months. The prevalence of concurrent wasting and stunting is higher among boys compared to girls. Compared to children of different birth orders, those in the higher birth order are 1.2 times more likely to be WaSt cases (aOR = 1.20, 95% CI = 1.09, 1.33). The education of the mother is strongly correlated with WaSt instances, and children of more educated mothers have a 47% lower chance of being WaSt cases (aOR = 0.63, 95% CI = 0.57, 0.71). Children from wealthy families are 52% less likely to be WaSt cases (aOR = 0.48, 95% CI = 0.43, 0.55).Conclusion: This study emphasizes the importance of concurrent wasting and stunting and its relationship with socioeconomic factors among children under five in India

Perception of Availability, Accessibility, and Affordability of COVID-19 Vaccines and Hesitancy: A Cross-Sectional Study in India

Background: The current study aimed to identify the perceptions and issues regarding the affordability, availability, and accessibility of COVID-19 vaccination and determine the extent of vaccine hesitancy among non-vaccinated individuals. Methods: A Prospective cross-sectional study was conducted among 575 individuals for a period of six months. All the relevant information was collected using the peer-validated survey questionnaire. An independent t-test was applied to check the association between variables. Result: Among 575 participants, 80.8% were vaccinated, and 19.2% were non-vaccinated. Among the vaccinated, 35.1% were vaccinated in private centres and 64.9% in public health centres (PHC). In total, 32% had accessibility issues and 24.5% had availability issues. However, responders vaccinated at PHC were having more issues in comparison to other groups which was statistically significant (p &lt; 0.05). Among the 163 privately vaccinated participants, 69.9% found it completely affordable. Another 26.9% and 3.1% found vaccines partly affordable and a little unaffordable. Among the 110 non-vaccinated, 38.1% were found to be vaccine-hesitant. Conclusions: Individuals vaccinated at PHC experienced issues such as long waiting times, unavailability of doses, and registration. Further, a significant level of hesitancy towards COVID-19 vaccines was observed. The safety and efficacy of COVID-19 vaccines contributed to negative attitudes

Socio-environmental determinants of parasitic intestinal infections among children: a cross-sectional study in Nigeria

Background: Intestinal parasitic infections are a major public health problem among school-aged children, especially those residing in rural areas. These infections predispose the children to several other health problems. This study assesses intestinal parasitic infections among school children in a rural area in Nigeria and their socioenvironmental determinants. Methods: This cross-sectional study included 250 primary school-age children from three randomly selected schools in Elemere, a poor rural area in Kwara State, Nigeria. A semi-structured questionnaire was used to record the socio-demographic data, and stool samples were microscopically examined for intestinal parasites. Results: The overall prevalence of intestinal parasites was 23.6% (59/250). Of the infected children, the most common parasite was Ascaris lumbricoides 50.8% (30/59), followed by Giardia lamblia 28.8% (17/59), Entamoeba spp.16.9% (10/59) and Dipylidium caninum in 3.4% (2/59). Rural domicile was associated with parasitic infections (P= 0.036) compared to a semi-urban or urban residence. Compared to younger age groups, children in the higher age groups had 64% (95% confidence interval,0.15–0.90;P= 0.03) lesser parasitic infections. Conclusion: Intestinal parasitic infections are common in school children in the studied area, and may be associated with unclean water sources, poor hygiene, and economic conditions. General health education should emphasize cleanliness, personal hygiene and sanitation to prevent and control parasitic intestinal infections among schoolchildren in these communities

Prevalence of stunting among under-five children in refugee and internally displaced communities: a systematic review and meta-analysis

BackgroundA pooled estimate of stunting prevalence in refugee and internally displaced under-five children can help quantify the problem and focus on the nutritional needs of these marginalized groups. We aimed to assess the pooled prevalence of stunting in refugees and internally displaced under-five children from different parts of the globe.MethodsIn this systematic review and meta-analysis, seven databases (Cochrane, EBSCOHost, EMBASE, ProQuest, PubMed, Scopus, and Web of Science) along with “preprint servers” were searched systematically from the earliest available date to 14 February 2023. Refugee and internally displaced (IDP) under-five children were included, and study quality was assessed using “National Heart, Lung, and Blood Institute (NHLBI)” tools.ResultsA total of 776 abstracts (PubMed = 208, Scopus = 192, Cochrane = 1, Web of Science = 27, Embase = 8, EBSCOHost = 123, ProQuest = 5, Google Scholar = 209, and Preprints = 3) were retrieved, duplicates removed, and screened, among which 30 studies were found eligible for qualitative and quantitative synthesis. The pooled prevalence of stunting was 26% [95% confidence interval (CI): 21–31]. Heterogeneity was high (I2 = 99%, p &lt; 0.01). A subgroup analysis of the type of study subjects revealed a pooled stunting prevalence of 37% (95% CI: 23–53) in internally displaced populations and 22% (95% CI: 18–28) among refugee children. Based on geographical distribution, the stunting was 32% (95% CI: 24–40) in the African region, 34% (95% CI: 24–46) in the South-East Asian region, and 14% (95% CI: 11–19) in Eastern Mediterranean region.ConclusionThe stunting rate is more in the internally displaced population than the refugee population and more in the South-East Asian and African regions. Our recommendation is to conduct further research to evaluate the determinants of undernutrition among under-five children of refugees and internally displaced populations from different regions so that international organizations and responsible stakeholders of that region can take effective remedial actions.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=387156, PROSPERO [CRD42023387156]

Modified coptisine derivatives as an inhibitor against pathogenic Rhizomucor miehei, Mycolicibacterium smegmatis (Black Fungus), Monkeypox, and Marburg virus by molecular docking and molecular dynamics simulation-based drug design approach

During the second phase of SARS-CoV-2, an unknown fungal infection, identified as black fungus, was transmitted to numerous people among the hospitalized COVID-19 patients and increased the death rate. The black fungus is associated with the Mycolicibacterium smegmatis, Mucor lusitanicus, and Rhizomucor miehei microorganisms. At the same time, other pathogenic diseases, such as the Monkeypox virus and Marburg virus, impacted global health. Policymakers are concerned about these pathogens due to their severe pathogenic capabilities and rapid spread. However, no standard therapies are available to manage and treat those conditions. Since the coptisine has significant antimicrobial, antiviral, and antifungal properties; therefore, the current investigation has been designed by modifying coptisine to identify an effective drug molecule against Black fungus, Monkeypox, and Marburg virus. After designing the derivatives of coptisine, they have been optimized to get a stable molecular structure. These ligands were then subjected to molecular docking study against two vital proteins obtained from black fungal pathogens: Rhizomucor miehei (PDB ID: 4WTP) and Mycolicibacterium smegmatis (PDB ID 7D6X), and proteins found in Monkeypox virus (PDB ID: 4QWO) and Marburg virus (PDB ID 4OR8). Following molecular docking, other computational investigations, such as ADMET, QSAR, drug-likeness, quantum calculation and molecular dynamics, were also performed to determine their potentiality as antifungal and antiviral inhibitors. The docking score reported that they have strong affinities against Black fungus, Monkeypox virus, and Marburg virus. Then, the molecular dynamic simulation was conducted to determine their stability and durability in the physiological system with water at 100 ns, which documented that the mentioned drugs were stable over the simulated time. Thus, our in silico investigation provides a preliminary report that coptisine derivatives are safe and potentially effective against Black fungus, Monkeypox virus, and Marburg virus. Hence, coptisine derivatives may be a prospective candidate for developing drugs against Black fungus, Monkeypox and Marburg viruses

Disaster response, confined space medicine and safety systems against railway accidents: 2023 Odisha railway accident from India

Abstract Railways are a major mode of transportation for passengers as well as goods. Across the world, minor and major accidents involving railways causing damage to life and property have been reported. The recent triple train derailment and collision near a small railway station in the state of Odisha, India, on 02.06.2023 is a major calamity. The accident resulted in 292 deaths, and more than 1000 injuries were attributed to the accident. In its comprehensive enquiry report, the Commissioner of Railway Safety found lapses in the signalling mechanism and oversight as the reasons for the accident. Immediate rescue, emergency transport and treatment are essential in reducing the mortality and morbidity of such accidents. The relatively newer domain under pre‐hospital and disaster medicine is confined space medicine, which deals with patients trapped in places with limited access to conventional intervention and reduced ventilation. Confined space medicine employs a multi‐hazard and interprofessional approach to treating individuals who are trapped in a structural collapse. It is also essential to critically evaluate and disseminate the entire disaster response systems that functioned during and after the railway accident to identify the existing system's best practices, bottlenecks, and gaps. The train's speed, lack of track and signal maintenance, absence of safety oversight, driver fatigue and distractions are some major determinants of train accidents, highlighting the need for comprehensive planning and training in rail safety. It is essential to improve the timely implementation of maintenance activities and completion of accident inquiries on time. A comprehensive review of the preparedness, rescue and response must be undertaken at the earliest possible opportunity to prevent and prepare for any such disasters in the future

Sociodemographic Determinants of Knowledge towards Tuberculosis Transmission among Women of 15–49 Years of Age in India

Background. India is one of the countries in the world most heavily impacted by tuberculosis (TB). In 2015, TB was a leading cause of death, killing 1.4 million people worldwide. The aim of the study was to assess the knowledge and associated factors regarding the transmission of TB among women in India. Method. We used publicly available datasets collected as part of the NFHS during 2015–16 in India. Data related to sociodemographic factors and knowledge about the transmission of TB among women (N = 699,686) were extracted using STATA. Multiple logistic regression analyses were used to determine factors associated with the knowledge of TB transmission among women. Results. Among 699,686 women, 88.36% knew about TB, 59.81% recognized that tuberculosis spreads by air through coughing or sneezing, and 78.55% understood that tuberculosis is a curable disease indicating correct knowledge about TB. 70.74% of the women were from rural areas with 59.29% having a secondary or higher level of education and 40.41% living in poverty. Multivariable analysis indicated that the probability of having good knowledge of TB was consistently significant among women with higher education [aOR: 2.502; 95% CI: 2.454–2.551]; women living in rich households (highest wealth quintile) [aOR: 1.590; 95% CI: 1.556–1.625]; and women residing in urban areas [aOR: 1.191; 95% CI: 1.166–1.215] than their rural counterparts. Conclusion. The findings of this study showed that women in India have moderately good knowledge and a correct attitude towards tuberculosis. However, the level of information varies with the various sociodemographic factors such as age group, place of residence, education, wealth index, religion, and caste/tribe bearing a positive causal relationship between the knowledge and TB transmission and hence the resulting attitude