COVID vaccine hesitancy among the tribal population and its determinants: A community-based study at berhampore block of Murshidabad District, West Bengal

Background

On January 16, 2021, India rolled out the COVID vaccination drive. A successful and effective vaccination campaign requires much more than the availability of a safe and effective vaccine. This includes identifying vulnerable populations with lower vaccine confidence and identifying the drivers of vaccine hesitancy.

Objective

This study aims to find out vaccine hesitancy among the tribal population regarding COVID-19 vaccination.

Methods

It was an observational descriptive cross-sectional study, conducted at Manindranagar and Hatinagar gram panchayat of Berhampore Block of Murshidabad district, West Bengal, from June 2021-November 2021, among tribal people aged >18 years. A total of 198 tribal people were selected by applying the probability proportional to size sampling method. Participants were interviewed using predesigned, pretested, and semi-structured schedules. Potential predictors of hesitancy were investigated using the multivariate logistic regression model.

Results

Vaccine hesitancy was present among 36.9% of the study participants. Fear of side effects (78.1%) was the most common reason of vaccine hesitancy. Only 30.8% of them received at least one dose of vaccine. Vaccine hesitancy was associated with decreased family income in the last 1 year (adjusted odds ratio [AOR] = 8.23), knowledge regarding vaccine (AOR = 0.41), adherence to COVID-appropriate behavior (AOR = 0.45), and trust on the local health-care worker (AOR = 0.32).

Conclusion

Vaccine hesitancy among the tribal population is driven by a lack of knowledge and awareness. Their economic status, attitudes toward the health system, and accessibility factors may also play a major role in vaccine hesitancy. Extensive information, education, and communication activity, more involvement of health-care workers in the awareness campaign, and establishment of vaccination centers in tribal villages may be helpful.

Assessment of knowledge, attitude, and practice about biomedical waste management among healthcare workers during COVID-19 pandemic in a health district of West Bengal

Background

Efforts to combat Coronavirus disease (COVID-19) pandemic have significantly increased the quantity of bio-medical waste (BMW) generation.

Objectives

A cross-sectional study was performed to assess the knowledge, practice, and attitude and factors affecting knowledge on BMW management among Health Care Workers (HCWs) when taking care of patients with COVID-19.

Methods

This cross-sectional study was conducted among 384 HCWs, actively involved in caring of COVID-19 patients in Healthcare settings of North 24 Parganas Health District, West Bengal. Data were collected using a structured self-administered questionnaire (through Google Forms) and an observational checklist after selection criteria and having consent. The Questionnaire included four sections like the sociodemographic information, knowledge related to BMW management, observational questionnaire assessing the practice of HCWs on BMW management and rating scale related to attitudes towards BMW management.

Results

166 HCWs (43.2%) had an excellent knowledge with overall mean score 13.5 ± 3.6. A high mean score (14.4 ± 3.2) was obtained by doctors followed by nurses (13.6 ± 3.8). Regarding practice, the majority of HCWs (52.8%) followed the color-coding of BMW and 49.5% followed policies in separating the wastes according to hazard. Doctors (91%) and nurses (81%) had more favorable attitude than others. There was a statistically significant association found among knowledge level and educational qualification (P = 0.0001), gender (P = 0.001), and work experience (P = 0.05) and work area (P = 0.05).

Conclusion

Emphasis should be given to aware and train all HCWs regarding proper BMW management during this pandemic to prevent infection transmission.

Study on intimate partner violence against rural tribal women of reproductive age group in siliguri subdivision of Darjeeling District, West Bengal

Background

Since the early 1990s, several milestone international declarations have recognized violence against women as a violation of human rights. Intimate partner violence (IPV), often used synonymously with domestic abuse or domestic violence against women, is a big burden to our society which manifests itself in many forms and it has its existence in every corner of the world irrespective of all the boundaries.

Objectives

The objective of this study was to find out the prevalence of IPV against reproductive age group tribal women in Siliguri subdivision of Darjeeling district.

Methodology

A cross-sectional study was carried out among 360 tribal women aged between 15 and 49 years residing at selected villages across Siliguri subdivision. Data regarding IPV were collected using the Indian Family Violence and Control Scale questionnaire. The data were analyzed using SPSS version 20 and multi-variable logistic regression was done to find out factors associated with domestic violence.

Results

The study revealed that 70.3% of women had experienced domestic violence in any form in their lifetime. Logistic regression revealed that IPV was significantly associated with: age between 30 and 49 years, education above primary school, unskilled occupation, ₹ 2500 and above per-capita monthly income, and participants who are separated/broken up. Among the factors related to the male partner, literacy above primary school level was associated with experience to domestic violence.

Conclusion

Domestic violence in all its manifestations was found to be present in the study population. The report may offer policymakers fresh perspectives on how to allocate funds for the complete elimination of domestic violence against women.

Nano-crush technique in narrow angle (<70˚) bifurcation - bench test, computed tomographic reconstruction, fluid dynamics, and clinical outcomes

BACKGROUND

Bifurcation stenting techniques are still refining and under testing. Nano-crush is a novel technique which allow minimum protrusion of side branch struts at the ostium. To demonstrate the efficacy of Nano-crush technique in narrow-angle bifurcation (<70˚) using bench test model, 3D reconstruction of the stent structure, computational fluid dynamics study and a clinical follow-up.

METHODS

This was a retrospective observational single-centre study which included 40 patients who underwent angioplasty using Nano-crush technique for de-novo complex coronary bifurcation lesions with narrow bifurcation angle(<70˚) between April-2016 to March-2019. The in-vitro bench test and computational fluid dynamics analysis were performed using a bifurcation model designed. The clinical primary endpoint was major adverse cardiac events (MACE), defined as a composite of cardiac death, myocardial infarction, and target lesion revascularization (TLR) at one-year angiographic follow-up.

RESULTS

The reconstructed results of in-vitro bench test showed minimum length of stent struts moving away from the rounded side branch ostium. The mean age of patients was 62.8 ± 7.98 years (32 male) and presented 100% procedural success. The mean bifurcation angle was 47.3˚ ± 9.2˚. The MACE was reported in 4 (10%) patients which included 1 (2.5%) death and 3 (7.5%) TLR at the mean follow-up of 35.54 ± 12.31 months. No significant correlation between occurrence of MACE and gender, age, comorbidities and bifurcation angle was reported.

CONCLUSIONS

The Nano-crush technique demonstrated least metal load around carina and abnormal flow dynamics in narrow angle (<70˚) bifurcation lesions and also reported favorable long-term clinical outcomes.

Determinants of out-of-pocket and catastrophic health expenditure in rural population: A community-based study in a block of Purba Barddhaman, West Bengal

Background

In India, health expenditure accounts for <5% of the Gross domestic product and the level of out-of-pocket (OOP) spending is 69.5% of total health expenditures. OOP expenditure (OOPE) has a negative impact on equity and can increase the risk of vulnerable groups slipping into poverty.

Objectives

The study aimed to estimate the OOPE on health and catastrophic health expenditure (CHE) and their sociodemographic determinants in a rural area of Purba Barddhaman.

Methods

A community-based cross-sectional study was conducted between July 2018 and February 2019 in Bhatar Block of Purba Bardhaman district, West Bengal. Required sample of 235 households, selected randomly were primary study units. One respondent from each household was interviewed with a predesigned, pretested schedule for sociodemographic and health-care expenditure-related variables. Mann-Whitney U test/Kruskal Wallis H test and multivariable logistic regression was applied.

Results

The median OOP health expenditure was Rs. 3870 (inter quartile range: 2156-4952). Of 235 families, 38 (16.2%) had CHE over a period of 1 year. The significant correlates for CHE were type of village according to the presence of public health-care facility (adjusted odds ratio [AOR] = 4.748; 95% confidence interval [CI]: 1.886-11.956), presence of health insurance (AOR = 11.124; 95% CI: 3.690-33.535) and gender of the head of the family (AOR = 18.176; 95% CI: 3.353-98.534). Concentration curve suggested a higher concentration of CHE among poor households.

Conclusion

CHE is substantially high in the area. The efforts are required to make the services available as close to the households as possible and to increase awareness about health facilities.

Assessment of stress & related albuminuria in caregivers of severe mentally ill persons

BACKGROUND & OBJECTIVES

The family caregivers of patients with chronic diseases are known to undergo psychiatric stress leading to oxidative damage to glomerular membrane of kidney resulting in proteinuria. This study was aimed to compare current anxiety, depression levels and urinary albumin:creatinine ratio between primary caregivers of chronic mental patients and matched controls, and also whether the urinary albumin : creatinine ratio is correlated with stress factors (state and trait anxiety level, depression and caregiver burden) amongst caregivers.

METHODS

The present cross-sectional study included 131 subjects (93 primary caregivers of patients with major mental illness as cases and 38 normal controls). They completed the Burden Assessment Schedule of SCARF, State Trait Anxiety Inventory and Beck's Depression Inventory. A spot urine sample was tested for urinary albumin : creatinine ratio from all study subjects.

RESULTS

Mean values of current State and Trait anxiety, depression, urinary albumin:creatinine ratio were significantly higher in caregivers than controls (P < 0.001). Urinary albumin : creatinine ratio was significantly correlated (P < 0.001) with State and Trait anxiety level, depression as well as caregiver burden.

INTERPRETATION & CONCLUSIONS

The study demonstrated depression , anxiety and albuminuria amongst primary caregivers of patients with mental illness. Increase in the caregivers' burden, depression and anxiety resulted in an increase in the urinary albumin: creatinine ratio. This indicates that psychological stress is one of the determinants of albumin excretion rate in otherwise healthy subjects.

Assessment of factors influencing adherence to anti-retroviral therapy for human immunodeficiency virus positive mothers and their infected children

BACKGROUND AND OBJECTIVES

Mothers and children are biologically related and dependent. They should be considered as a single unit which is very important regarding adherence to anti-retroviral therapy (ART). Very high levels of adherence are required for effective ART. We therefore carried out this study to examine the adherence levels and different factors associated with adherence among human immunodeficiency virus (HIV)-positive mothers and their HIV-positive children receiving ART.

DESIGN AND SETTING

A hospital-based cross-sectional study.

MATERIALS AND METHODS

Ninety-four HIV-positive mothers and their 94 HIV-positive children under ART attending the ART center of a tertiary care hospital were recruited in this study. Consenting mothers were asked to complete the "Case Study Form" containing socio-demographic and care-giving details. Mothers were also asked to complete the Beck's depression inventory, State trait anxiety inventory, and Ways of coping inventory. Adherence was assessed using pill count. Criteria for good and poor adherence were defined. Current CD4 counts were retrieved from the hospital record.

RESULTS

Fifty-six percent of respondent mothers and 65.8% of respondent children showed good adherence to ART. Different factors were associated with poor adherence in both mothers and their children.

CONCLUSION

Adherence of HIV-positive mothers and their HIV-positive children to ART is influenced by multiple factors and identification of these factors is necessary to get complete adherence to ART. There is statistically significant relationship between maternal and pediatric adherence to ART.