Browsing by Author "Pati, Sanghamitra"
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Item Development, validation & pilot testing of a questionnaire to assess healthcare seeking behaviour, healthcare service utilization & out-of-pocket expenditure of Particularly Vulnerable Tribal Groups of Odisha, India(Wolters Kluwer – Medknow, 2023-05) Ghosal, Jyoti; Dutta, Ambarish; Kshatri, Jaya Singh; Das, Arundhuti; Kanungo, Srikanta; Singh, Aalapti; Kerketta, Sushmita; Ghosal, Shishirendu; Kaur, Harpreet; Bal, Madhusmita; Ranjit, Manoranjan; Satpathy, Sudhir Kumar; Pati, SanghamitraBackground & objectives: Assessing healthcare seeking behaviour (HSB), healthcare utilization and related out-of-pocket expenditures of Particularly Vulnerable Tribal Groups (PVTGs) of India through a prism of the health system may help to achieve equitable health outcomes. Therefore, this comprehensive study was envisaged to examine these issues among PVTGs of Odisha, India. However, there exists no validated questionnaire to measure these variables among PVTGs. Therefore, a study questionnaire was developed for this purpose and validated. Methods: Questionnaire was constructed in four phases: questionnaire development, validity assessment, pilot testing and reliability assessment. Nine domain experts face validated questionnaire in two rounds, followed by a single round of quantitative content validity. Next, the questionnaire was pretested in three rounds using cognitive interviews and pilot-tested among 335 and 100 eligible individuals for the two sections healthcare seeking behaviour (HSB-Q) and maternal and child healthcare service utilization (MCHSU-Q). Internal consistency reliability was assessed for de novo HSB-Q. Results: On two rounds of expert-driven face validity, 55 items were eliminated from 200 items. Questionnaire showed moderate to high content validity (item-level content validity index range: 0.78 to 1, scale-level content validity index/universal agreement: 0.73; scale-level content validity index/average: 0.96 and multirater kappa statistics range: 0.6 to 1). During the pre-test, items were altered until saturation was achieved. Pilot testing helped to refine interview modalities. The Cronbach alpha and McDonald’s omega assessing internal consistency of HSB-Q were 0.8 and 0.85, respectively. Interpretation & conclusions: The questionnaire was found to be valid and reliable to explore healthcare seeking behaviour, maternal and child healthcare utilization and related out-of-pocket expenditure incurred by PVTGs of Odisha, India.Item An ethnographic approach to understand cultural perspectives of tribes on branding practice for sick children in Odisha, India(Wolters Kluwer – Medknow, 2022-08) Jena, Shubharanjan; Sahoo, Krushna Chandra; Modak, Biswajit; Epari, Venkatarao; Satpathy, Sudhir Kumar; Kaur, Harpreet; Pati, SanghamitraBackground & objectives: Traditional beliefs on child healthcare at time lead to potentially harmful practices like branding. However, there is a gap in people’s perceptions, attitudes and beliefs about branding practice. Therefore, the present study was undertaken to document the cultural motivation, ability and opportunity for branding practice in a tribal district of Odisha, India. Methods: Initially, such practices were observed in the tribal community for three months. Then, 18 in-depth interviews were conducted - ten among women having under-five children, and eight among traditional healers. Six focus group discussions were conducted with community health workers as well. The responses were digitally recorded, transcribed and translated and were further used for thematic framework analysis. Results: The primary determinants of branding practice were cultural beliefs compounded with low-health literacy, proximity to conventional care and influence of family and friends. The key driver for branding practices was traditional cultural beliefs on child healthcare decisions and health-seeking behaviours. Opportunities in the health system – availability and quality of health services – frequently drive them to seek healthcare from the system structure and routine health communication improves their ability to make better healthcare decisions. Interpretation & conclusions: Culture significantly affects the conceptualisation of illness and care-seeking pathways in a society. The indigenous community used to consult local traditional healers for their health concerns. While the government has made efforts to increase community health literacy through various platforms and multiple stakeholders’ engagements, the doorstep availability of modern care and health promotion interventions remains critical for meeting the health needs of the indigenous community.Item The prevalence of tuberculosis infection in India: A systematic review and meta-analysis(Wolters Kluwer – Medknow, 2023-03) Chauhan, Arohi; Parmar, Malik; Dash, Girish Chandra; Solanki, Hardik; Chauhan, Sandeep; Sharma, Jessica; Sahoo, Krushna Chandra; Mahapatra, Pranab; Rao, Raghuram; Kumar, Ravinder; Rade, Kirankumar; Pati, SanghamitraBackground & objectives: The National Prevalence Survey of India (2019-2021) estimated 31 per cent tuberculosis infection (TBI) burden among individuals above 15 years of age. However, so far little is known about the TBI burden among the different risk groups in India. Thus, this systematic review and meta-analysis, aimed to estimate the prevalence of TBI in India based on geographies, sociodemographic profile, and risk groups. Methods: To identify the prevalence of TBI in India, data sources such as MEDLINE, EMBASE, CINAHL, and Scopus were searched for articles reporting data between 2013-2022, irrespective of the language and study setting. TBI data were extracted from 77 publications and pooled prevalence was estimated from the 15 community-based cohort studies. Articles were reviewed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and were sourced using a predefined search strategy from different databases. Results: Out of 10,521 records, 77 studies (46 cross-sectional and 31 cohort studies) were included. The pooled TBI prevalence for India based on the community-based cohort studies was estimated as 41 per cent [95% confidence interval (CI) 29.5-52.6%] irrespective of the risk of acquiring it, while the estimation was 36 per cent (95% CI 28-45%) prevalence observed among the general population excluding high-risk groups. Regions with high active TB burden were found to have a high TBI prevalence such as Delhi and Tamil Nadu. An increasing trend of TBI was observed with increasing age in India. Interpretation & conclusions: This review demonstrated a high prevalence of TBI in India. The burden of TBI was commensurate with active TB prevalence suggesting possible conversion of TBI to active TB. A high burden was recorded among people residing in the northern and southern regions of the country. Such local epidemiologic variation need to be considered to reprioritize and implement-tailored strategies for managing TBI in India.Item Profile of Pediatric Scrub Typhus in Odisha, India(Indian Academy of Pediatrics, 2019-04) Bhagirathi, Dwibedi; Pati, Sanghamitra; Manoranjan, RanjitObjective: To investigate the distribution and clinical profile of scrub typhus infection amongchildren with acute febrile illness in Odisha. Methods: Children (<15 y) presenting with acutefever (>5 days) in 4 agro-climatic zones from June to November 2017 were evaluated.Patients were screened for malaria, leptospira, dengue, typhoid and scrub typhus. Scrubtyphus was confirmed by IgM ELISA and PCR. Results: Out of413 casesexamined, 48.7%were positive for scrub typhus, and 5.5% of them developed systemic complications. Escharwas found in 17.9% of cases. Five days treatment of Doxycycline and/or Azithromycin wasclinically effective against scrub typhus. Conclusion: Our study highlights that scrub typhusis one of the causes of high morbidity in children during rainy months in Odisha.Item A scoping review of community-based geriatric assessment and screening tools used in South Asia(The Indian Academy of Geriatrics, 2022-01) Panigraghi, Sucharita; Bhoi, Trilochan; Pati, Sanghamitra; Kshatri, Jaya, SinghBackground: Home-based comprehensive assessment and integrated care of the older people could be a key to relieve the pressure on the already overburdened health system. This review summarizes evidence on validated community-based geriatric assessment tools in South Asia. Methods: Guided by Arksey and O扢alley抯 five?stage scoping review framework, a total of 46 studies were included in the scoping review after searching from electronic databases and reference lists using the predefined eligibility criteria. Data were extracted on the main characteristics of included studies, identified instruments, and their psychometric properties of the tools. This review was reported in accordance with preferred reporting items for systematic reviews and meta-analyses-ScR guidelines. Results: Among the 46 included studies, 10 reported on instruments for medical assessment, 12 on tools for psychological conditions, 13 on tools for functional issues, 2 on social well-being, and 9 on tools with multiple domains of health. Most studies included participants from both gender and different social classes. Majority used measurements that were both self-reported or measured by the investigator, whereas only two instruments were designed to be used by clinicians. In the existing geriatric health assessment tools, environmental domain was neglected completely, and not a single tool considered in this review covered all 5 domains which influence regular life of the elderly. Conclusion: There are no validated tools available that can be used for comprehensive geriatric assessment in South Asia. There is a need to develop and validate culturally sensitive tools that can be used for assessing all the geriatric health domains.Item Seropositivity of Chlamydia trachomatis & Toxoplasma gondii among male partners of infertile couples in Odisha, India: A facility based exploratory study(Wolters Kluwer – Medknow, 2022-11) Naik, Kaushik V.; Mishra, Aparajita; Panda, Sailendra; Sinha, Abhinav; Padhi, Maya; Pati, Sanghamitra; Sahoo, Prakash KumarChlamydia trachomatis (CT) is the most common curable sexually transmitted non-viral infection, which can cause urethritis, prostatitis, orchitis and epididymitis among males. Toxoplasma gondii, a protozoan causes toxoplasmosis among humans. These infections may lead to decreased fertility. Hence, this study was aimed to estimate the seropositivity of CT and T. gondii infection among the male partners of infertile couples in Odisha, India. In this facility-based cross-sectional study, first void urine, seminal fluid and blood sample were collected from 153 males attending infertility clinics including 74 healthy controls. Urine and seminal fluid were tested through polymerase chain reaction (PCR), and enzyme-linked immunosorbent assay was used to detect immunoglobulin (Ig) G, IgA and IgM anti-Chlamydia and IgM anti-Toxoplasma antibodies through serum. The prevalence of CT was 1.26 per cent (95% CI: 0.03-6.85) as estimated from semen samples using PCR. We detected anti-Chlamydia antibodies IgM-four per cent [95% confidence interval (CI): 0.83-11.24]; IgA-28.16 per cent (95% CI: 18.13-40.09) and IgG-12.5 per cent (95% CI: 5.87-22.4) among participants. Anti-Toxoplasma antibodies IgM were observed in 27.63 per cent (95% CI: 17.98-39.08) of participants. None of the control samples were found positive. Overall seropositivity of CT and Toxoplasma infections is comparable, which suggests that greater attention is required for screening these infections at clinics, especially among infertile couples.Item A systematic review of community-based studies on mental health issues among tribal populations in India(Wolters Kluwer – Medknow, 2022-08) Verma, Priyanka; Sahoo, Krushna Chandra; Mahapatra, Pranab; Kaur, Harpreet; Pati, SanghamitraBackground & objectives: Globally, mental disorders are rising with increasing urbanization. India has the world’s second-largest tribal population and it is critical to appreciate the mental health problems in this population. However, the extent of mental health issues among tribal populations is unknown. Against this background, we systematically reviewed community-based studies on mental health issues among tribal populations in India. Methods: Online databases PubMed, Embase, ProQuest databases and Google Scholar were searched and articles published between January 1990 and May 2021 including primary community-based quantitative observational studies focused exclusively on tribal population were retrieved. PRISMA guidelines were followed and this review was registered on PROSPERO (CRD42020178099). Results: A total of 935 articles were identified, of which 63 were selected for full-text review, and finally, 11 studies were included. Seven studies examined alcohol use disorder with a pooled prevalence of 40 per cent. Two studies reported on suicidal attempts. A few studies mentioned anxiety, depression and other mental health conditions. Interpretation & conclusions: This systematic review established that a few community-based primary studies were conducted on mental health issues among tribal populations over the last three decades. Among these, fewer studies focused exclusively on tribal communities. The studies differed in their study design and the tools used. The findings of these investigations highlighted a limited range of mental health issues, primarily alcoholism, anxiety, depression and suicide.Item Teaching of public health ethics in India: a mapping exercise.(2014-07) Pati, Sanghamitra; Sharma, Anjali; Zodpey, SanjayPublic health ethics has been receiving increasing attention in recent years. Frequently, public health practitioners have to confront complex decisions, with numerous and often conflicting ethical implications. The objective of this study was to obtain information on the teaching of public health ethics in India by making a detailed examination of the public health and community medicine curricula. The specific areas of interest included the content and structure of the courses and electives available to students. The results of this study indicate that ethics courses are yet to find their rightful place in the teaching of public health in India. The curricula vary across institutes in terms of the time and content devoted to the teaching of public health ethics. It is suggested that public health programmes in India develop and incorporate ethics courses so as to keep pace with the emerging challenges in the field. An interdisciplinary consortium should preferably be formed at the national level to take up this academic endeavour.