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Background: India achieved the elimination of leprosy two decades ago although its sustenance continues to be threatened by ongoing active transmission in few remaining pockets. There is a paucity of data regarding the acceptance of single-dose rifampicin (SDR) prophylaxis among healthy contacts. Aims and Objectives: The aims and objectives of the study are to assess the factors influencing the acceptability of SDR among contacts. Materials and Methods: A community-based, sequential, explanatory mixedmethod study was conducted over 6 months from September 2022 to February 2023 among 168 contacts of leprosy patients from two blocks in Bankura district, West Bengal. Quantitative analysis was done for SDR acceptance and its predictors among contacts using the Chi-square test, Mann–Whitney U test, and Logistic regression. This was followed by qualitative assessment using focus group discussions and in-depth interviews among contacts to explain the findings through a thematic approach. Results: Household contacts (aOR=13.72, 95% CI=2.09–90.19), increasing knowledge score of contacts (aOR=3.18, 95% CI=1.88–5.38), counseling by health workers (aOR=11.98, 95% CI=2.20–65.15), trust in health workers (aOR=152.96, 95% CI=13.17–1776.09), and not taking other medicines for comorbidity (aOR=35.82, 95% CI=2.94–436.02) were associated with increased SDR uptake among leprosy contacts. Barriers and facilitators of post-exposure prophylaxis (PEP)-SDR were categorized as contact, health workers, and program-related factors. Conclusion: SDR acceptability among contacts was 77.4%. Facilitators of SDR-PEP were awareness of side-effects, follow-up, prompt support by health workers, IEC, belief in National programs, etc. Lack of knowledge of PEP-SDR and contraindications, ineffective counseling by health workers, stigma of the disease, the increased workload of health workers, etc., were the barriers to SDR-PEP implementation. [ABSTRACT FROM AUTHOR]

Background: Sepsis is a common cause of morbidity and mortality among geriatrics. Aims and Objectives: The objective of study was to find the clinicomicrobiological profile of elderly inpatients (=60 years) with sepsis and to evaluate the diagnostic accuracy of urine albumin to creatinine ratio (ACR) or microalbuminuria in predicting mortality. Materials and Methods: A prospective observational study was conducted among 50 geriatric patients admitted with sepsis in the ward or intensive therapy unit under medicine department of a tertiary care center for a period of 1 year. Baseline clinicomicrobiological profile was noted. Urine ACR values were measured at admission, day 4, and day 7 and geriatrics were followed up for 28 days to see the outcome. Receiver operator characteristic curve analysis was performed to evaluate the area under the curve for microalbuminuria on the 3 days and to determine the optimum cut-off points to predict mortality. Results: The mortality rate within 28 days was 64%. Urine microalbuminuria on day 1, day 4, and day 7 of admission was significantly higher among the non-survivors compared to survivors (P=0.001, P=0.001, and P=0.006, respectively). Microalbuminuria levels (in mcg/mg) of 143.0, 60.05, and 42.6 on day 1, 4, and 7 of admission, respectively, can be used as the cut-off to predict the death of geriatric sepsis inpatients with overall diagnostic accuracy of 83.0%, 83.4% and 86.1%, respectively, sensitivity as 93.75%, 87.50%, and 100.0%, respectively, and specificity as 44.44%, 72.22%, and 72.22%, respectively. Conclusion: Microalbuminuria can be a potential biomarker to predict death among geriatric septic inpatients, which can further help in improving the treatment strategy. [ABSTRACT FROM AUTHOR]

Background: Lifestyle modifications and medication compliance are key strategies. Objectives: To evaluate the effect of community-based care delivered by trained primary healthcare providers in management of hypertension. Materials and Methods: A longitudinal study was conducted between two groups of newly diagnosed hypertensive patients to evaluate the impact of an educational intervention. Six blocks in a district were chosen with pairwise matching. All primary healthcare providers of one block in each pair were randomized to receive the intervention and the other was controlled. Next screening for risk factors, detection of hypertension, counseling, and follow-up care were provided. The patients within the control group received usual care as per clinician's discretion. A total of 227 patients in the "study" group and 230 patients in the "control" group were recruited from 12 subcenters selected randomly. Data analysis was done by Χ² test, t test, and GLM analysis using SPSS 16. Results: Patients in the intervention blocks demonstrated a statistically significant mean reduction in SBP of 16.14 ± 0.82 and DBP by 11.65 ± 0.53 compared to 9.83 ± 1.02 and 7.68 ± 0.66, respectively, in the control blocks after adjusting for age, sex, and baseline blood pressure at one-year follow-up. Regarding lifestyle-related cardiovascular risk factors, statistically significant differences were found in favor of the intervention group. Conclusion: The study supports and reinforces the utilization of trained primary healthcare providers under the NPCDCS program in screening and promoting blood pressure control by preventive services to hypertensive patients in the community. [ABSTRACT FROM AUTHOR]

Background: Primary health-care providers can play a crucial role in the prevention and early detection of non-communicable diseases. Knowledge, attitude, and practice (KAP) survey of primary health-care providers is needed to assess their gaps in knowledge, and identify barriers for effective implementation of the national program. However, such KAP instruments are lacking. Objective: The aim of this study is to develop, validate and assess the reliability of a questionnaire to determine the KAPs of primary health-care providers about hypertension and associated comorbidities Materials and Methods: This study was conducted in the following steps: item construction and psychometric testing, by validity and reliability analysis. Results: The final KAP questionnaire comprised 25 knowledge items, 12 attitude items, and 8 practice items. Exploratory factor analysis using principal axis factoring with varimax rotation revealed four dimensions in the attitude section explaining 35.93% and two dimensions in practice sections explaining 65.96% of the total variance. Cronbach's alpha coefficient for attitude and practice session measured 0.65 and 0.85, respectively. A Kuder Richardson value of 0.70 was obtained for the knowledge section. ICC coefficients were 0.56 (P < 0.00) for knowledge, 0.77 (P < 0.00) for attitude and 0.88 (P < 0.00) for practice sections indicating moderate-to-good correlations. Overall, the instrument developed had acceptable validity and reliability. Conclusion: Overall, the instrument developed had acceptable validity and reliability to assess the perceptions and practices of primary healthcare providers about prevention and control of hypertension and associated comorbidities in the community. [ABSTRACT FROM AUTHOR]

Background:Visual impairment resulting from infectious diseases has declined by public health efforts but cataract and refractive errors still continue as major causes of blindness. Moreover, ageing & life style diseases also contribute to large number of blindness. Objective: This study was undertaken to assess the ocular morbidity pattern and the risk factors among rural population of West Bengal. Material & Methods: A community based, descriptive, observational study was conducted in Hariharpur PHC. One subcentre was chosen purposively and three villages under the subcentre were chosen randomly. The study population comprised of all persons residing in those villages for at least one year. Door to door visit was conducted for screening of eye problems and then detailed examination was carried out in the PHC by ophthalmic assistant. Subjects requiring specialist consultation were referred. Results: Difficulty with vision was the commonest complain followed by watering, burning and itching sensation, pain and redness. Refractive errors (myopia & hypermetropia) were the commonest morbidity among all age groups followed by cataract and allergic conjunctivitis. Cataract was found to be significantly associated with diabetes and hypertension (P=0.001) and allergic conjunctivitis was associated significantly with hypertension (P=0.007). Interestingly quite a high proportion of the patients with visual complaints could be detected and managed at the PHC level . So simple screening for eye disorders and utilization of trained ophthalmic assistants can enable early detection of eye conditions, prompt treatment and early referral. [ABSTRACT FROM AUTHOR]