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Background: Attitudes and impressions toward the tobacco industry and tobacco products among the general public are important determinants for curbing the menace of the tobacco epidemic. Accordingly, this study aimed to assess the knowledge and perceptions about the tobacco industry and tobacco products and analyze attitudes towards social denormalization (SD) of tobacco use and tobacco industry denormalization (TID) among the rural population of Bihar, India. Methods: This community-based cross-sectional survey was conducted on 421 adults aged 18 to 65 years who were selected using multistage systematic random sampling in a rural area of Bihar State in India from January to March 2022. Results were presented as proportions and the factors associated with support for TID and SD were identified using the chi-square test and binary logistic regression. Findings: Out of 421 participants, 342 (81.2%) did not consider smokeless tobacco to be very dangerous. Nearly half (192, 45.6%) of the individuals believed that tobacco companies never tell the truth about the ill effects of tobacco use on health. Maximum, 345 (89.5%) also believed that the tobacco industry is responsible for adverse health effects of tobacco use and that the government should sue them. The prevalence of favorable attitudes toward TID and SD was found to be 55.1% [95% CI: 50.3% - 59.8%] and 38.2% [95% CI: 33.7% - 42.9%], respectively. Conclusion: One out of every two and one out of every three individuals showed favorable attitudes toward TID and SD, respectively. There is a need to inform and educate the public on the ill effects of tobacco and the deceptive strategies used by the tobacco industry to help them choose health over tobacco. [ABSTRACT FROM AUTHOR]

Introduction and aim. Anemia remains a leading contributor to years lived with disability (YLDs), being responsible for 50.3 million (5.82%) YLDs worldwide and 19.3 million (12.03%) YLDs in India, respectively. Results of the National Family Health Survey 2019-2021 (NFHS-5) suggest a high burden of anemia in India among women of reproductive age and children aged 6-59 months at the national level (57%, 67.1%), and in the state of Bihar, India (63.5%, 69.4%). Iron deficiency is the leading cause, accounting for more than half the cases. Anemia bodes harmful implications for both the mother and child, with long-lasting consequences for the latter. Anemia control programs have yielded little benefit despite efforts stretching over five decades. This narrative review aims to highlight the burden of anemia and the probable factors behind it among under-5 children and women of reproductive age in the Indian state of Bihar. Material and methods. The paper is a narrative review. The following databases were used to search and select literature: PubMed, Web of Science, Scopus, and Google Scholar. In addition, the websites of relevant government departments and national health programs were searched for pertinent material. Analysis of the literature. A multitude of reasons seem to be behind the unabated high prevalence in Bihar: low socioeconomic status, gender disparities, traditional customs and practices, food insecurity, lack of diverse diets, poor consumption, and no adherence to iron and folic acid (IFA) supplements, groundwater contamination with arsenic and fluoride, and supply chain mismanagement, all playing roles of varying degree. Conclusion. An all-encompassing approach and not merely the provision of IFA supplements are necessary to unravel the intricate web of factors that lead to anemia. [ABSTRACT FROM AUTHOR]

Background: Community-based screening is one of the key preventive strategies to tackle the ever-rising burden of non-communicable diseases (NCDs) under the National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS). Objective: The current study was aimed to build capacity among frontline health workers (FHWs) in screening for cardiovascular diseases (CVDs) under NPCDCS in the selected districts of Bihar state. Methodology: This was an implementation study with follow-up components, conducted among 75 FHWs [14 auxiliary nurse midwives (ANMs) and 61 accredited social health activists (ASHAs)] from 15 primary healthcare facilities across four districts of Bihar state from October 2019 to September 2021. The selected FHWs were initially trained on NPCDCS for a day, including pre- and post-training knowledge assessment. Then, supportive supervision (SS) visits using a predesigned questionnaire were done. Results: The pre- and post-training mean knowledge scores of the FHWs were 12.9 and 22.1, respectively, with an overall effect size of 2.5. During SS visits, only 20.0% of the visited primary healthcare facilities had all the required logistics to conduct weekly NCD screening clinics for CVDs. Considering different measurements and operative skill proficiencies of FHWs, waist circumference skills (41.7% for ANMs and 50.8% for ASHAs), followed by blood pressure (BP) (41.7%) and random blood sugar (RBS) measurement (25.0%), were found to be the most deficient skills (among ANMs). Moreover, the quality of initial and follow-up home visits was found to be satisfactory for only 54.1% of the ASHAs. The reported barriers of NCD screening were reported to be non-cooperation, unawareness among community dwellers, lack of knowledge and skill of FHWs, logistic constraints and delayed honorarium credit. Conclusion: One-day training on NCDs for FHWs was quite effective. However, for translating all the desired skills for CVD screening into action, periodic training needs assessment, and SS of FHWs might be fruitful. [ABSTRACT FROM AUTHOR]

Introduction: Nutritional supplements modify immune response and protect against viral infections. Health related behaviour of medical and nursing students governs their attitude towards counselling patients. This study assessed the differences in the Knowledge, Attitude, and Practice (KAP) between undergraduate medical and nursing students regarding the role of nutraceuticals in Coronavirus Disease-2019 (COVID-19). Aim: To assess the differences in the KAP between undergraduate medical and nursing students regarding the role of nutraceuticals in COVID-19. Materials and Methods: An analytical cross-sectional study was conducted in a tertiary care teaching hospital, Patna, Bihar, India in September 2020. A questionnaire was administered to assess the KAP of 265 medical and 150 nursing undergraduates regarding nutraceuticals. The total knowledge score varied between 0 and 12. The score of the attitude was based on 5 points Likert scale. The data was collected through self-administered google forms. Chi-square test and Fisher's exact test was used to compare the difference in categorical data. Results: There were total 273 (65.8%) participants with good knowledge and only 47 (11.3%) with positive attitude. About 68.7% medical students and 82.7% nursing students felt that regular intake of nutraceuticals has a positive role in protecting against COVID-19 (p=0.007). Out of 415, 264 participants (63.6%) had used nutraceuticals. About 156 (58.9%) medical students and 103 (68.7%) nursing students felt that the safety of nutraceuticals is a grave concern. Two-fifth of the participants (202, 48.7%) had consumed a dietary supplement to maintain good health. Conclusion: Although the knowledge score was good, but positive attitude was lacking. Thus, Health Care Personnels (HCP)s should be trained regarding proper usage and recommendations of nutraceuticals. [ABSTRACT FROM AUTHOR]

Introduction: There is a risk of chronic hepatitis B virus (HBV) infection to the newborn through perinatal transmission from a hepatitis B surface antigen (HBsAg) positive mother that can later cause liver cirrhosis or hepatocellular carcinoma. This study was undertaken in a primary health center (PHC) in the Patna district to determine the prevalence of HBV among pregnant women and assess their knowledge across different characteristics. Methodology: A cross-sectional study was done among 275 pregnant women attending the PHC for the first time, using consecutive sampling. The study duration was 12 months. Socioeconomic, obstetric, risk history, and levels of knowledge about hepatitis B were collected followed by rapid diagnostic test (RDT) for serum HBsAg. Univariate analysis was used to compare the knowledge levels across different background characteristics. The significance was set at P < 0.05. Results: Hepatitis B-positive pregnant women were 0.4%. Out of the 275 participants, only 43 had heard about hepatitis B. The mean knowledge score was 0.65 (±1.73) with 1.45% having adequate knowledge. The knowledge score was significant across education (P 0.040), category (P 0.022), hepatitis B immunization status (P 0.003), and risk factor (P 0.039). Conclusion: Knowledge was higher in the literate women belonging to the general category and higher social class, who received hepatitis B vaccination. However, the overall level of knowledge among the pregnant women was very poor, so they should be targeted for quality health education. Additionally, identifying the afflicted pregnant women through point-of-contact diagnosis will aid in community prevention of chronic hepatitis B. [ABSTRACT FROM AUTHOR]

Introduction: The effectiveness of immunisation depends on its timely administration. With delay, the duration of susceptibility of child and chances of disease outbreak is increased. In developing countries, it is further aggravated by poor socioeconomic status and inadequate health care facility. No data for timeliness of vaccination available of Bihar. Aim: To study the timeliness of vaccination, drop-out rates and the association of timeliness of vaccination with demographic characteristics of household. Materials and Methods: A cross-sectional study was conducted in the month of January and February, 2019, on 12- 23 months old children in 59 low-performing blocks of Bihar. Cluster-random sampling was done for selection of villages and house order was calculated for selection of children. Data collection was done using mobile-based application. Timeliness and median age at vaccination was calculated and association was calculated using chi-square. Results: Although, vaccination coverage was high, only 20% were vaccinated timely. Timely vaccination was maximum for Bacillus-Calmette Guerin (BCG); 75% and Measles Containing Vaccine (MCV); 86% and low for first dose of Penta (35%). Timely vaccination was associated with male gender, urban setting, birth at health care facility and low birth order. The study reports 5.8% drop-out rate for BCG-MCV series. Conclusion: Along with vaccination coverage, its timeliness should also be improved. Strengthening of health care facility must be ensured to improve timeliness. [ABSTRACT FROM AUTHOR]

Introduction: Immunization is one of the most cost-effective measures in public health to date, preventing at an approximately 2 to 3 million fatalities in young children every year. As per recent World Health Organisation (WHO) bulletin, these lifesaving vaccines have been successfully averted around 20 million premature deaths and 500 million disease cases. Inspite of this progress the routine vaccine coverage is slow to rise as challenges still live for the underserved, inaccessible and vulnerable children. It is therefore essential to evaluate the coverage of immunization at periodic intervals and to take the required measures to enhance the vaccination status in the State Bihar. Aims and Objective: This study aims to find out the vaccination coverage in different Blocks of study area. Material and Methods: The study was community based cross sectional study which was conducted between January to March 2019 in the selected villages of 59 low performing blocks of Bihar. The study subjects were all the children aged 12-23 month old from selected low performing blocks of the Bihar. Results-Corrected FIC of the study was 90.85%. Close to nine percent (8.8%) children thou have started vaccination could not able to complete it. Rest of the beneficiaries are completely left out. The most common reason for incomplete immunization was unavailability of child on the day of vaccination followed by sickness of the child. Conclusion: The overall Immunization coverage of Bihar is less than the National Immunization coverage as per NFHS-4. This study shows higher rate of immunization as far as Corrected Immunization Coverage is concerned. [ABSTRACT FROM AUTHOR]

Introduction: Avoidable sickness, disabilities and death among under 5 children are prevented by routine immunization against some specific diseases. The percentage fully immunized children was 69.9% in Bihar, India, and was almost same in rural area. Immunization coverage is also associated with various socio-demographic factors. The aim of this study is to assess the immunization coverage among children in rural areas of Bhojpur district and identify socio-demographic factors associated with it. Methods: A cross-sectional study was conducted in rural areas of Bhojpur district during January to May 2015. 2 stage cluster sampling was done. 36 villages were selected randomly as primary selection units and within each village, 10 children of age 12-36 months were selected from the sampling frame of all eligible children in selected village. A pre-designed, pre-tested checklist was used by the trained investigators during their visits. Results: A total of 360 children of age 12-36 months were included in the study, of which 65% of children were fully immunized, 33.9% were partially immunized, and 1.1% were not immunized at all. Mother's education (AOR 2.28 (1.28-4.05), P value = 0.005), place of birth (AOR 29.04 (10.75-78.43), P value = 0.0001) and availability of immunization card (AOR 120.04 (15.82-916.47), P value = 0.001) were significantly associated with immunization status. Conclusion: Immunisation coverage in this area was lower. Socio-demographic factors like mother's literacy, place of birth and availability of immunization cards were significantly associated with full immunization of children. It is needed to focus on health related education among parents regarding immunizing services. [ABSTRACT FROM AUTHOR]