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Background: Sensitization plays a pivotal role in raising awareness about critical youth issues and encouraging them to access support services, contributing to the success of programs like Yuva Spandana, a youth-centric mental health promotion initiative in Karnataka, India. For youth to access support within YSKs, the quality and effectiveness of sensitization programs (SPs) are crucial. A standard quality assessment through indicators for SPs is required to provide recommendations for improvement. To enlist quality indicators and assess the quality of SP conducted under Yuva Spandana (YS) program across Karnataka. Material and Methods: We performed secondary data analysis (utilizing data available within the computerized management information system over 5 years; 2017-2022) and direct/in-person observation of SPs (by the researcher and the core team of YS between June and July 2022 using a specifically developed checklist). Quality indicators were developed using a process of consensus building. Each attribute within the checklist was scored, and a composite mean score and mean percentage scores for quality were calculated. Results: Overall, 33257 SP reports and 31 in-person SPs were assessed. A total of 36 quality indicators (10 quality indicators based on SP reports and 26 based on in-person observation) were developed. The average quality score of report-based SPs was 10.93 (±2.59; range 1-20) and in-person assessment was 63.06 (±6.61; range 50-73). Conclusion: The study emphasizes the importance of addressing all youth issues, including sensitive topics like gender, sex, and sexuality, to ensure a holistic approach to youth mental health. Challenges faced during program execution and the distribution of Information, Education, and Communication (IEC) materials also contribute to program quality. This research offers valuable insights for improving the conduct of SPs, enhancing youth access to services, and guiding future community-based health promotion initiatives. [ABSTRACT FROM AUTHOR]

Background: Stroke is a major public health and clinical challenge that results in significant mortality and disability. Stroke survivors require care and support, particularly during the crucial 3 months post-stroke when 95% of functional neurological recovery occurs. To estimate case-fatality and extent of disability, assess perceived needs, barriers, and unmet needs for care, and ascertain pathways to care post-discharge (at 3 months) among first-ever stroke patients attending a tertiary care neuro-specialty center in India. Material and Methods: A cross-sectional descriptive study was conducted among patients receiving care within [NIMHANS]. Patients with confirmed computed tomography (CT) scans experiencing their first-ever stroke between September 1 and October 31, 2022, were contacted between November 1, 2022, and March 31, 2023. A pre-tested semi-structured questionnaire was used to collect information. Descriptive statistics were performed using STATA version 16. Results: Stroke fatality among study subjects was 13.8%. Almost half (49.09%) had some form of disability, with 40% having moderate to severe disability. The majority perceived the need for follow-up visits (87%) and compliance with stroke medication (84%). Distance and transportation (60%) were cited as the main barriers to care. After discharge, the majority preferred healthcare facilities close to their homes (60%). Conclusions: This study emphasizes the need for stroke survivors to have follow-up and compliance with medication, along with various unmet needs such as de-addiction services, vocational training, and emotional support. A network-based multi-disciplinary approach, along with a comprehensive hub and spoke model of stroke management services, could help address these challenges and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Stroke is a leading cause of death and disability worldwide. In India, it is the fourth leading cause of death and fifth leading cause of disability, posing a major public health concern. National surveys reveal an increasing trend in stroke risk factors such as tobacco use, physical activity, alcohol use, hypertension, and dyslipidemia. However, knowledge regarding the combined effect of these risk factors and their various combinations is limited. Understanding the individual, combined, and synergistic effects of known risk factors, along with new risk factors, is essential to address gaps in stroke epidemiology. This study aims to examine the effect of various risk factors of acute stroke and their association with stroke occurrence and its outcomes (survival, disability and quality of life). Methods: This retrospective-prospective cohort will be conducted in one taluka of Kolara district and two urban wards of Bengaluru with a total population of ~400,000. All stroke-free individuals above 30 years of age ~200,000 individuals in the selected sites will be participants of stroke-free period and all first ever stroke patients in the community will be part of stroke and post-stroke period respectively. The study subjects will be recruited through a complete house-to-house survey at baseline and undergo annual follow-ups during the stroke-free period, with specific assessments at defined time points during the stroke and post-stroke period for a period of one year. Efforts are implemented to minimize loss to follow-up, including community engagement, a helpline number, and hospital-based surveillance. Discussion: This large population-based cohort study addressing stroke epidemiology in the country, is one -of-its-kind, attempting to fill certain critical gaps in the natural history, management, and outcomes of stroke in India. This research has the potential to provide important insights into the effect of novel risk factors of stroke and various combinations of risk factors of stroke. Furthermore, the development of a stroke risk predictability calculator will add value to the existing Indian National Programme for Prevention & Control of Non-Communicable Diseases (NP-NCD) and offers a model for similar countries once developed. [ABSTRACT FROM AUTHOR]

Background: A staggering 85% of the global population resides in low- and middle-income countries (LAMICs). India stands as an exemplary pioneer in the realm of mental health initiatives among LAMICs, having launched its National Mental Health Program in 1982. It is imperative to effectively evaluate mental health systems periodically to cultivate a dynamic learning model sustained through continuous feedback from mental healthcare structures and processes. Materials and Methods: The National Mental Health Survey (NMHS) embarked on the Mental Health Systems Assessment (MHSA) in 12 representative Indian states, following a pilot program that contextually adapted the World Health Organization's Assessment Instrument for Mental Health Systems. The methodology involved data collection from various sources and interviews with key stakeholders, yielding a set of 15 quantitative, 5 morbidity, and 10 qualitative indicators, which were employed to encapsulate the functional status of mental health systems within the surveyed states by using a scorecard framework. Results: The NMHS MHSA for the year 2015--16 unveiled an array of indices, and the resultant scorecard succinctly encapsulated the outcomes of the systems' evaluation across the 12 surveyed states in India. Significantly, the findings revealed considerable interstate disparities, with some states such as Gujarat and Kerala emerging as frontrunners in the evaluation among the surveyed states. Nevertheless, notable gaps were identified in several domains within the assessed mental health systems. Conclusion: MHSA, as conducted within the framework of NMHS, emerges as a dependable, valid, and holistic mechanism for documenting mental health systems in India. However, this process necessitates periodic iterations to serve as critical indicators guiding the national mental health agenda, including policies, programs, and their impact evaluation. [ABSTRACT FROM AUTHOR]

Introduction: Indian National Mental Health Survey reports an alarming prevalence of 20.9% for tobacco dependence in India. Dependence on smoked tobacco can be prevented by thorough knowledge of the risk factors associated with it. Objectives: To estimate the prevalence and identify the factors associated with smoked tobacco dependence among participants attending the life skills training and counselling services programme (LSTCSP) across Karnataka from 2017 to 2022. Materials and Methods: Pretraining data of 3104 participants from training programmes between 2017 and 2022 were utilised. Univariate and multivariable logistic regression analysis was performed based on a conceptual framework with various hypothesised exposure variables and smoked tobacco dependence as outcome. Results: The overall prevalence of smoked tobacco dependence among LSTCSP participants who used smoked tobacco products was 59.4%. Ever use of smokeless tobacco products (Adjusted odds ratio (AOR) =2.05, 95% CI: 1.11–3.78) and screening positive for symptoms of generalised anxiety (AOR = 2.53, 95% CI: 1.32–4.84) significantly increased the odds of smoked tobacco dependence, whereas making decisions collectively in the family (AOR = 0.35, 95% CI: 0.18–0.66) and individuals with increased score for neurotic personality traits (AOR = 0.64, 95% CI: 0.44–0.93) were the factors associated with reduced odds of smoked tobacco dependence. Conclusion: The identified risk factors associated with smoked tobacco dependence are important to develop tobacco control programmes as well as in preventing its onset. With the risk factors for smoked tobacco dependence identified, the results of this study have implications for health promotion and prevention programmes as well as cessation programmes related to smoked tobacco dependence, within India and similar countries. [ABSTRACT FROM AUTHOR]

Introduction: Encephalitis is a major public health problem worldwide that causes huge emotional and economic loss to humanity. Encephalitis, being a serious illness, affects people of all ages. The aim is to describe the sociodemographic, clinical, etiological, and neuroimaging profile among 101 acute encephalitis syndrome (AES) patients visiting a tertiary neuro-specialty care hospital in India. Methods: Record review of medical records of all patients attending neurology emergency and outpatient services at NIMHANS Hospital, diagnosed with AES in 2019, was conducted. Data were collected using standardized data collection forms for all cases in the study. Descriptive analyses (mean and standard deviation for continuous variables and proportions for categorical variables) were conducted. The Chi-square test/Fisher's exact test was used for the comparison of independent groups for categorical variables, and t-test for comparing means for continuous variables. Results: About 42.6% of AES patients had viral etiology, while in 57.4%, etiology was not ascertained. Common presenting symptoms were fever (96%), altered sensorium (64.4%), seizures (70.3%), headache (42.6%), and vomiting (27.7%). Herpes simplex was the most common (21.8%) identified viral encephalitis, followed by chikungunya (5%), arboviruses (chikungunya and dengue) (4%), Japanese encephalitis (4%), rabies (3%), dengue (1%), and varicella virus (1%). About 40% of AES patients showed cerebrospinal fluid pleocytosis (44%), increased protein (39.6%), abnormal computed tomography brain (44.6%), and magnetic resonance imaging abnormalities (41.6%). Conclusion: The study highlights the need to ascertain etiology and importance of evidence-based management of AES patients. A better understanding of opportunities and limitations in the management and implementation of standard laboratory and diagnostic algorithms can favor better diagnosis and management of AES. [ABSTRACT FROM AUTHOR]

Objectives: This paper describes the methodology of developing and implementation of a youth focused life skills training and counselling services programme (LSTCP) and assessment of factors associated with life skills of participants pre-training. Design: Development of all aspects of LSTCP (modules, methods and evaluation) was through a consultative process. Experiential learning based facilitation was decided as the approach for training participants. A quasi-experimental design with pre, post and follow-up assessment post-training was finalised. Data collection was done using specifically developed semi-structured self-administered questionnaire. Results: Multivariable logistic regression with life skills as outcome and various exposure variables was performed. About 2/3rd of participants had high level of life skills (68%). Increased score of extraversion (AOR = 1.57,95% CI = 1.32–1.85), agreeableness (AOR = 1.42,95% CI = 1.16–1.73), conscientiousness (AOR = 1.9,95% CI = 1.55–2.33), physical (AOR = 1.03,95% CI = 1.01–1.04), environmental (AOR = 1.02,95% CI = 1.004–1.03) and social quality of life (AOR = 1.01,95% CI = 1.006–1.02) were associated with high life skills score. Higher score of neuroticism (AOR = 0.66,95% CI = 0.53–0.79) was associated with low life skills score. Conclusion: The results presented provide an opportunity to understand the evolution of factors affecting life skills during the follow-up of this study. This study throws light on development of LSTCP for apparently healthy population in a setting like India and its states. [ABSTRACT FROM AUTHOR]

Background: Suicidality among youth is one of the most challenging public health issues. A thorough understanding of the risk factors that contribute to youth suicidality is necessary. The main aim of the study is to estimate the proportion of suicidality and understand factors associated with suicidality amongst clients attending youth mental health promotion clinics in Karnataka, India. Methods: A retrospective cross-sectional case record analysis was performed utilising data from real-time digitised management information system specifically developed for the programme. All case records of clients aged 15 to 35 years who received mental health promotion (MHP) services between January 2017 and December 2020 across 30 districts of Karnataka were included in this analysis. Multivariate logistic regression analysis was performed with suicidality among clients as outcome. Socio-demographic characteristics, issues reported, feelings/emotions that indicate underlying mental health issue/crisis, being aware of suicidality among friends and family and personal habits (smoking/chewing tobacco and drinking alcohol) were considered potential exposure variables. Findings: Overall proportion of suicidality among youth presenting to youth mental health promotion clinics in Karnataka was 3.5% (357/10,340). Among factors associated with suicidality, the strongest association was found among those clients who reported attempted suicide among friends (AOR 8.94; 95% CI 5.95–13.45), family members (AOR 5.50; 95% CI 3.66–8.29), being anxious (AOR 4.90; 95% CI 3.43–6.99), inability to trust anyone (AOR 4.07; 95% CI 2.75–6.03), had issues of Gender, Sex and Sexuality (AOR 3.16; 95% CI 1.93–5.17) and relationship issues (AOR 2.77; 95% CI 2.05–3.73). Conclusion: The results alert all institutions, organisations and departments that cater to services and development of youth, to be sensitive towards risk factors of suicidality. The study advocates youth mental health promotion clinics to be equipped with measures/interventions to identify and manage such risk factors. This study has implications for Youth mental health promotion in India and other similar South-East Asian countries. [ABSTRACT FROM AUTHOR]

INTRODUCTION Chewing tobacco and smoking among youth leads to poor health outcomes. Understanding the factors associated with chewing tobacco and smoking is thus important for interventions. METHODS A case-record analysis among 10340 youth (aged 15-35 years) attending a unique mental health promotion program, Yuva Spandana, across the state of Karnataka in southern India, was performed to assess prevalence of chewing tobacco and smoking. Multiple logistic regression was applied to determine the factors associated with their use. RESULTS Overall, the prevalence of chewing tobacco and smoking among beneficiaries was 3% and 2.1%, respectively. The risk of tobacco chewing and smoking increased with age and risk was higher among males, married individuals and among all occupational categories, other than students. Adjusted odds ratios of chewing tobacco were found to be highest among business/salaried beneficiaries (AOR=3.48; 95% CI: 2.27-5.34), followed by ever married beneficiaries (AOR=3.41; 95% CI: 1.27-9.17). Adjusted odds ratios of smoking tobacco were highest among males (AOR=12.89; 95% CI: 7.5-22.14), followed by emotional experience of feeling worthless (AOR=4.19; 95% CI: 2.78-6.32), beneficiaries with poor relationship with family members (AOR=3.79; 95% CI: 1.38-10.44), and business/salaried beneficiaries (AOR=2.90; 95% CI: 1.79-4.7). Strength of association of males with smoking was much higher (AOR=12.89; 95% CI: 7.5-22.14) than compared with chewing tobacco (AOR=2.49; 95% CI: 1.89-3.28). CONCLUSIONS Early identification of these factors associated with chewing tobacco and smoking will help in focusing on youth specific health promotion and interventions to improve their overall health and wellbeing. [ABSTRACT FROM AUTHOR]

Abstract Background In the context of AVAHAN, the India AIDS Initiative of the Bill & Melinda Gates Foundation, general population surveys (GPS) were carried out between 2006 and 2008 in Belgaum (northern), Bellary (mid-state) and Mysore (southern) districts of Karnataka state, south India. Data from these three surveys were analysed to understand heterogeneity in HIV risk. Methods Outcome variables were the prevalence of HIV and sexually transmitted infections (STIs). Independent variables included age, district, place of residence, along with socio-demographic, medical and behavioural characteristics. Multivariate logistic regression was undertaken to identify characteristics associated with HIV and differences between districts, incorporating survey statistics to consider weights and cluster effects. Results The participation rate was 79.0% for the interview and 72.5% for providing a blood or urine sample that was tested for HIV. Belgaum had the highest overall HIV (1.43%) and Herpes simplex type-2 (HSV-2) (16.93%) prevalence, and the lowest prevalence of curable STIs. In Belgaum, the HIV epidemic is predominantly rural, and among women. In Bellary, the epidemic is predominantly in urban areas and among men, and HIV prevalence was 1.18%. Mysore had the lowest prevalence of HIV (0.80%) and HSV-2 (10.89%) and the highest prevalence of curable STIs. Higher HIV prevalence among men was associated with increasing age (p25-29years=11.22,95%CI:1.42-88.74, AOR30-34years=13.13,95%CI:1.67-103.19 and AOR35-39years=11.33,95%CI:1.32-96.83), having more than one lifetime sexual partner (AOR=4.61,95%CI:1.26-16.91) and having ever used a condom (AOR=3.32,95%CI:1.38-7.99). Having a dissolved marriage (being widowed/divorced/separated) was the strongest predictor (AOR=10.98,95%CI: 5.35-22.57) of HIV among women. Being a muslim woman was associated with lower HIV prevalence (AOR=0.27,95%CI:0.08-0.87). Conclusion The HIV epidemic in Karnataka shows considerable heterogeneity, and there appears to be an increasing gradient in HIV prevalence from south to north. The sex work structure in the northern districts may explain the higher prevalence of HIV in northern Karnataka. The higher prevalence of HIV and HSV-2 and lower prevalence of curable STIs in Belgaum suggests a later epidemic phase. Similarly, higher prevalence of curable STIs and lower HIV and HSV-2 prevalence in Mysore suggests an early phase epidemic.

(1) Background: To empower and facilitate mental health promotion for nearly 18 million youth, a pioneering state-wide Life Skills Training and Counselling Services Program (LSTCP) was implemented in Karnataka, India. This study assesses the changes in life skills scores, level of life skills and factors associated with increased life skills among participants of the LSTCP. (2) Method: This pre–post study design was conducted on 2669 participants who underwent a six-day structured LSTCP. Changes in mean life skills scores and level of life skill categories pre- and post-LSTCP were assessed. Multivariate logistic regression was performed to assess the factors associated with increases in life skills. (3) Results: The LSTCP resulted in significant changes in life skill scores and level of life skills, indicating the effectiveness of the training. All life skill domains, except empathy and self-awareness, increased post-training. There was a positive shift in the level of life skills. Age (AOR = 1.34, CI = 1.11–1.62), gender (AOR = 1.39, CI = 1.15–1.68), education (AOR = 1.44, CI = 1.05–1.97) and physical (AOR = 1.02, CI = 1.01–1.03) and psychological (AOR = 1.02, CI = 1.01–1.03) quality of life was associated with an increase in life skills among participants. (4) Conclusions: The LSTCP is effective in improving the life skills of participants. The LSTCP modules and processes can be used to further train youth and contribute to mental health promotion in the state. [ABSTRACT FROM AUTHOR]

Context: The need for physicians qualified in the field of occupational safety and health (OSH) is growing with the growth of manufacturing and service sectors where maximum number of work-related morbidity and mortality occur. Aims: This article aims to assess the effectiveness and feasibility of the certificate course in occupational safety and health for training and capacity building of primary care physicians in OSH. Methods and Material: Guideline for reporting evidence-based practice educational interventions and teaching (GREET) was used for describing educational interventions. The outcome was assessed by comparing the mean scores. t test with P < 0.005 was considered a level of significance. Results: The result showed significant improvement in the cumulative pre- and post-test scores after each module. The certificate course is suitable for adult learning as there was no intergroup difference in knowledge after the program. Consistent with the findings, the improvement scores indicate that training has made a difference in the knowledge and learning of the trained physicians. Conclusions: This customized training intervention has high potential for scaling up while optimally addressing the scarcity of trained physicians in the OSH in high population density settings like India where a high number of vulnerable workforces work in the informal economy. [ABSTRACT FROM AUTHOR]

Promoting positive identity and seeking early support for gender, sex and sexuality (GSS) issues among youth is vital. Understanding and addressing factors associated withGSS among them is critical. We assessed four-year case records (January 2017-December 2020) of all first visit youth mental health promotion clinic (YMHPC) clients (15-35 years) for factors associated with GSS issues in Karnataka. Overall, prevalence of GSS issues was 1.8% (189/10,340). Increased risk of GSS issues was observed among clients reporting suicidality (AOR = 4.27, 95% CI = 2.70-6.74) and relationship issues (AOR = 3.63, 95% CI = 2.36-5.57), followed by issues of safety (AOR = 2.56, 95% CI = 1.72-3.81), personality (AOR = 2.48, 95% CI = 1.60-3.85), health and lifestyle (AOR = 2.27, 95% CI = 1.77-4.19), smokers (AOR = 2.30, 95% CI = 1.24-4.27), and those who felt depressed (AOR = 2.10, 95% CI = 1.43-3.09) and worthless (AOR = 2.08, 95% CI = 1.28-3.39). Clients aged 21-25 years (AOR = 1.80,95% CI = 1.27-2.54), male (AOR = 1.72, 95% CI = 1.20-2.46) and who had been married (AOR = 2.32, 95% CI = 1.51-3.57) had a higher risk of GSS issues than those aged 15-20 years and other counterparts, respectively. Clients who drank alcohol (AOR = 0.49, 95% CI = 0.30-0.81) had reduced risk of GSS issues. The findings re-iterate the importance of early recognition of factors (essential precursors) of GSS issues among youth. The study highlights the importance of promoting awareness and improving primordial prevention of possible GSS issues in later life. This study has important implications on youth mental health promotion programs, especially in countries like India. [ABSTRACT FROM AUTHOR]

Background: Heterogeneity of the HIV epidemic across districts of south India is reflected in HIV positivity among antenatal clinic (ANC) attendees. Along with individual factors, contextual factors also need consideration for effective HIV interventions. Thus, identifying district and individual level factors that influence ANC HIV positivity assumes importance to intervene effectively. Methods: Data on HIV sentinel surveillance among the ANC population were obtained from the National AIDS Control Organization (NACO) between years 2004 and 2007. Data from serial cross-sectional studies among female sex workers (FSWs) conducted during this time period in 24 districts were used to generate district level variables corresponding to parameters concerning this high risk population. Other district level data were obtained from various official/governmental agencies. Multilevel logistic regression was used to identify individual and district level factors associated with ANC-HIV positivity. Results: The average ANC-HIV prevalence from 2004 to 2007 in the 24 integrated biological and behavioural assessments (IBBA) districts ranged from 0.25 to 3.25%. HIV positivity was significantly higher among ANC women with age≥25 years [adjusted odds ratio (AOR):1.49; 95% confidence interval (95%CI):1.27 to 1.76] compared to those with age<25 years; illiterate (AOR:1.62; 95%CI:1.03 to 2.54) compared to literate; employed in agriculture (AOR:1.34; 95%CI:1.11 to 1.62) or with occupations like driver/helper/industry/factory workers/hotel staff (AOR:1.59; 95%CI:1.26 to 2.01) compared to unemployed. District level HIV prevalence among FSWs (AOR:1.03; 95%CI:1.0 to 1.05) and percentage women marrying under 18 years were significantly associated with ANC-HIV positivity (AOR:1.02; 95%CI:1.00 to 1.04). Conclusion: Illiteracy of the woman, higher HIV prevalence among FSWs and early marriage were associated with HIV positivity among pregnant women in southern India. In addition to targeted HIV preventive interventions among FSWs, studying and changing the behavior of FSW clients and addressing structural drivers of the epidemic might indirectly help reduce HIV infection among women in southern India. [ABSTRACT FROM AUTHOR]

To assess the population-level impact of “Avahan,” the India AIDS Initiative of the Bill & Melinda Gates Foundation, between 2003 and 2008 in Karnataka state, India.Secondary data analysis using all consistent data collection sites from antenatal clinic (ANC) sentinel surveillance data from 2003 to 2008 in Karnataka.A multilevel logistic regression model considering individual- and district-level variables was developed to compare time trends in HIV prevalence among young ANC women (younger than 25 years of age) between Avahan (18) and non-Avahan (9) districts. District-level random effects were considered for the intercept and time. The impact was assessed using interaction terms between district type (Avahan vs. non-Avahan) and time. The number of cases averted was estimated, comparing predicted ANC HIV prevalence in the presence versus the absence of Avahan. Data from the National Family Health Survey Round 3 (2006) were used to extrapolate these numbers to the general population.HIV prevalence among young ANC women declined from 1.46% (2003) to 0.83% (2008). The HIV prevalence trend was significantly different between Avahan and non-Avahan districts (P = 0.046). Overall, 87,035 cases of HIV infection were estimated to have been averted in the Karnataka general population because of Avahan during the 2003-2008 period (range under varying assumptions: 55,160-150,784).Our results suggest that Avahan has had a significant impact on the HIV epidemic in the general population of Karnataka. These results suggest that targeted interventions similar to Avahan should be implemented and scaled up in all concentrated and mixed HIV epidemics. [ABSTRACT FROM AUTHOR]

In Karnataka, India only one-third of HIV-infected pregnant women received antiretroviral prophylaxis at delivery in 2007 through the state government's prevention of parent-to-child HIV transmission (PPTCT) program. The current qualitative study explored the role of HIV-associated stigma as a barrier to access PPTCT services in the rural northern Karnataka district of Bagalkot using in-depth interviews and focus group discussions with HIV-infected women who had participated in the PPTCT program, male and female family members, and HIV service providers. Participants discussed personal experiences, community perceptions of HIV, and decision-making related to accessing PPTCT services. They described stigma toward HIV-infected individuals from multiple sources: healthcare workers; community members; family; and self. Stigma-related behaviors were based on fears of HIV transmission through personal contact and moral judgment. Experience and/or fears of discrimination led pregnant women to avoid using PPTCT interventions. Government, cultural, and historical factors are described as the roots of much the stigma-related behavior in this setting. Based on these formative data, PPTCT program planners should consider further research and interventions aimed at diminishing institutional and interpersonal HIV-associated stigma experienced by pregnant women. [ABSTRACT FROM AUTHOR]

Background: The National Mental Health Survey was borne out of the felt need for a comprehensive epidemiological survey on mental health to understand the magnitude of psychiatric morbidities in India to aid in mental health policymaking, service planning, and delivery. Kerala was one of the 12 surveyed states, representing southern India., Aims: To estimate the prevalence and pattern of various mental illnesses and substance use disorders in a representative sample from Kerala state., Settings and Design: A household survey using a multi-stage, stratified, random cluster sampling technique, with selection based on probability proportionate to size at each stage., Materials and Methods: The community-based survey was carried out by trained field staff on individuals from systematically selected households from three randomly selected districts of Kerala. The instruments used in the survey included M.I.N.I adult version 6.0, a modified version of the Fagerström Nicotine Dependence Scale and questionnaires to screen for epilepsy, intellectual disability, and autism spectrum disorders., Results: A total of 2479 respondents aged >18 years were interviewed. The lifetime and current prevalence of mental morbidity (excluding tobacco use disorders) was 14.14% and 11.36%, respectively. Neurotic/stress-related disorders and depressive disorders were 5.43% and 2.49%, respectively, while severe mental disorders were prevalent in 0.44% of the sample. The prevalence of high risk for suicide was 2.23%., Conclusions: The survey revealed high rates of common mental illnesses and suicide risk in the state when compared to national estimates., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Journal of Psychiatry.)

Introduction: Tobacco smoke affects the health of non-smokers by exposure to second-hand smoke (SHS). The Indian Cigarettes and Other Tobacco Products (COTPA) Act 2003 Section 4 aims to reduce exposure to SHS. Awareness and compliance to COTPA are key to achieving its intended outcome. We assessed: a) awareness among persons responsible for compliance (PRC) and authorized officers (AO), and b) compliance of public places to COTPA in South Bengaluru, India., Methods: A cross-sectional assessment of public places in South Bengaluru was conducted using time-location sampling. The Johns Hopkins Bloomberg School of Public Health's observational and interview checklist was used to assess compliance of public places to COTPA and awareness of COTPA among PRC/AO, respectively., Results: Among 359 public places, one-third of the public places showed complete (1.9%) or partial compliance (28.1%). The majority (93%) of the PRCs and all AOs were aware of COTPA. However, they lacked information on the different provisions of the Act. Violations like persons smoking (3.9%), visible ashtrays (6%) and cigarette butts (13%) were noted more among eateries compared to other public places. Among those public places supposed to have designated smoking-areas, only 19% complied., Conclusions: This is the first representative survey of awareness and compliance of COTPA in Bengaluru City. Low compliance, coupled with the lack of appropriate awareness among PRCs and AOs about COTPA, demands a comprehensive strategy to enhance awareness. Comprehensive efforts towards making all stakeholders understand the health impacts of smoking, and strict enforcement, might facilitate effective implementation of COTPA., Competing Interests: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported., (© 2017 Banandur P.)