Knowledge, Attitude and Practices regarding tuberculosis among slum pockets of western Mumbai: a cross sectional study

Background: Tuberculosis (TB) is a major public health problem prevailing in the rural and urban areas of India. A study was conducted to assess the Knowledge, Attitude, and Practices regarding tuberculosis among slum pockets of western Mumbai. Material and methods: Cross sectional quantitative study conducted using a pre-validated WHO KAP questionnaire. Random walk technique stratified by daytime was used. Descriptive analysis and inferential statistics (Chi-square test) were used. Result: A total of 140 participants were interviewed. Knowledge received from friends, neighbors reported more (58%) in NCC and squatters colony as compared Ambujwadi (48.6%). People held compassion and desire to help people living with TB (59.3%), but only 1.4% participants had reported actual support to TB patients in need. Stigma of TB (80.0%) is one of the most difficult challenges which attributed to hiding of TB disease status. Almost all respondents agreed that people hide TB status because of “fear that people will avoid them”.BMC corporation hospital (82.9 %) is the first choice of health seeking among the study participants however only 7.9 % of people knew about DOTs. Gender (p<0.005) and educational status (p<0.05) were found significantly associated with the knowledge of TB. Conclusion: Knowledge towards tuberculosis within the population is poor. It suggests that specialized educational programs should be developed for community to promote awareness regarding TB. The findings regarding attitude and stigma indicate need to address “stigma related to TB” by health care facilitators and community people at the time of health education

Protocol for process evaluation of ARTEMIS cluster randomised controlled trial: an intervention for management of depression and suicide among adolescents living in slums in India

Introduction There are around 250 million adolescents (10–19 years) in India. The prevalence of mental health-related morbidity among adolescents in India is approximately 7.3%. Vulnerable subpopulations among adolescents such as those living in slum communities are particularly at risk due to poor living conditions, financial difficulty and limited access to support services. Adolescents’ Resilience and Treatment nEeds for Mental Health in Indian Slums (ARTEMIS) is a cluster randomised controlled trial of an intervention that intends to improve the mental health of adolescents living in slum communities in India. The aim of this paper is to describe the process evaluation protocol for ARTEMIS trial. The process evaluation will help to explain the intervention outcomes and understand how and why the intervention worked or did not work. It will identify contextual factors, intervention barriers and facilitators and the adaptations required for optimising implementation.Methods Case study method will be used and the data will include a mix of quantitative metrics and qualitative data. The UK Medical Research Council’s guidance on evaluating complex interventions, the Reach, Efficacy, Adoption, Implementation and Maintenance Framework and the Affordability, Practicability, Effectiveness and cost-effectiveness, Acceptability, Safety/Side Effects and, Equity criteria will be used to develop a conceptual framework and a priori codes for qualitative data analysis. Quantitative data will be analysed using descriptive statistics. Implementation fidelity will also be measured.Discussion The process evaluation will provide an understanding of outcomes and causal mechanisms that influenced any change in trial outcomes.Ethics and dissemination Ethics Committee of the George Institute for Global Health India (project number 17/2020) and the Research Governance and Integrity Team, Imperial College, London (ICREC reference number: 22IC7718) have provided ethics approval. The Health Ministry’s Screening Committee has approved to the study (ID 2020-9770).Trial registration number CTRI/2022/02/040307

An intervention to reduce stigma and improve management of depression, risk of suicide/self-harm and other significant emotional or medically unexplained complaints among adolescents living in urban slums:protocol for the ARTEMIS project

BACKGROUND: There are around 250 million adolescents in India. Adolescents are vulnerable to common mental disorders with depression and self-harm accounting for a major share of the burden of death and disability in this age group. Around 20% of children and adolescents are diagnosed with/ or live with a disabling mental illness. A national survey has found that suicide is the third leading cause of death among adolescents in India. The authors hypothesise that an intervention involving an anti-stigma campaign co-created by adolescents themselves, and a mobile technology-based electronic decision support system will help reduce stigma, depression, and suicide risk and improve mental health for high-risk adolescents living in urban slums in India. METHODS: The intervention will be implemented as a cluster randomised control trial in 30 slum clusters in each of the cities of Vijayawada and New Delhi in India. Adolescents aged 10 to 19 years will be screened for depression and suicide ideation using the Patient Health Questionnaire (PHQ-9). Two evaluation cohorts will be derived—a high-risk cohort with an elevated PHQ-9 score ≥ 10 and/or a positive response (score ≥ 2) to the suicide risk question on the PHQ-9, and a non-high-risk cohort comprising an equal number of adolescents not at elevated risk based on these scores. DISCUSSION: The key elements that ARTEMIS will focus on are increasing awareness among adolescents and the slum community on these mental health conditions as well as strengthening the skills of existing primary healthcare workers and promoting task sharing. The findings from this study will provide evidence to governments about strategies with potential for addressing the gaps in providing care for adolescents living in urban slums and experiencing depression, other significant emotional or medically unexplained complaints or increased suicide risk/self-harm and should have relevance not only for India but also for other low- and middle-income countries. TRIAL STATUS: Protocol version – V7, 20 Dec 2021 Recruitment start date: tentatively after 15th July 2022 Recruitment end date: tentatively 14th July 2023 (1 year after the trial start date) TRIAL REGISTRATION: The trial has been registered in the Clinical Trial Registry India, which is included in the WHO list of Registries (https://www.who.int/clinical-trials-registry-platform/network/primary-registries) Reference No. CTRI/2022/02/040307. Registered on 18 February 2022. The tentative start date of participant recruitment for the trial will begin after 15th July 2022. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13063-022-06539-8