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   2016| July-September  | Volume 1 | Issue 2  
    Online since October 12, 2016

 
 
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ORIGINAL ARTICLES
A community-based study on knowledge of diabetes mellitus among adults in a rural population of Kerala
Beteena Kurian, Mariya Amin Qurieshi, Rajini Ganesh, Kamalamma Leelamoni
July-September 2016, 1(2):59-64
DOI:10.4103/2468-8827.191925  
Background: Worldwide India leads in diabetes mellitus and within India Kerala tops the list. Keeping in view increasing the burden of diabetes mellitus in Kerala, it is highly important to know about the awareness of the disease among the general population to chalk out culturally appropriate and need oriented educational strategies. Objective: The objective of this study is to assess the knowledge of diabetes mellitus in a rural populace of Kerala. Materials and Methods: A descriptive cross-sectional study was undertaken in a rural Panchayat of District Ernakulam of Kerala wherein 343 adults were randomly interviewed from six randomly selected wards. The interview schedule had 23 items on knowledge which was assessed in four domains including general awareness of diabetes mellitus, its risk factors, complications, and lifestyle modifications. Each item was given a score. Maximum possible score was 23. Knowledge score of <9 was considered as poor, 9-17 as average and above 17 was taken as good. Data were analyzed using SPSS version 11. Descriptive analysis was done for sociodemographic variables, and t-test and ANOVA were used to ascertain the level of significance of predictors of awareness. Results and Conclusion: Mean age of the participants was 47.7 ± 15.74 years with more than half (55.7%) having completed their high school education. Mean knowledge score was 15.6. Being diabetic, having completed high school education and with family history of diabetes had significantly better knowledge score (P < 0.05). Educating the community on risk factors is the key strategy for the prevention of diabetes and delaying the onset of disease among high-risk individuals.
  7,772 332 -
REVIEW ARTICLES
Overview of national strategies on noncommunicable disease and adolescent health in South-East Asia Region countries
JS Thakur, Neena Raina, Priya Karna, Preeti Singh, Gursimer Jeet, Nidhi Jaswal
July-September 2016, 1(2):76-86
DOI:10.4103/2468-8827.191989  
Research shows that risk factors for noncommunicable diseases (NCDs) are associated with behaviors that either begin or are reinforced during adolescence. Yet, focus on this age group in national NCDs policies globally or regionally in South-East Asia Region (SEAR) has not been adequately addressed. This overview of strategies to prevent NCDs among adolescents in SEAR countries provides a benchmark against which policy response can be assessed and strengthened. We reviewed all publically available documented strategies issued by governments in the 11 SEAR member countries of the World Health Organization on NCDs, published between January 1, 2002, and December 31, 2015. NCDs are currently a policy priority in many of the countries with school-based campaigns on healthy lifestyles; alcohol and tobacco-free environment and public ban on advertisements glamorizing unhealthy food among others. However, major challenges such as lack of specific focus on adolescents, lack of recognition of all major risk factors in national policies/programs, weak surveillance, unavailability of age disintegrated data, inefficient program management, low community awareness, and absence of multistakeholder policies persist. Of the countries reviewed, only 54.5% (6/11) proposed a policy that addressed all four of the main NCD risk factors - alcohol and tobacco use, physical inactivity, and obesity. This review demonstrates the disconnection between NCDs, adolescent health, and national policies.
  2,800 97 -
ORIGINAL ARTICLES
Input of stakeholders on reducing depressive symptoms and improving diabetes outcomes in India: Formative work for the INtegrated DEPrEssioN and Diabetes TreatmENT study
Deepa Rao, Lauren Lipira, Shuba Kumar, Rani Mohanraj, Subramani Poongothai, Nikhil Tandon, GR Sridhar, Wayne Katon, KM Venkat Narayan, Lydia Chwastiak, Viswanathan Mohan, Mohammed K Ali
July-September 2016, 1(2):65-75
DOI:10.4103/2468-8827.191979  
Context: Depression and diabetes are highly comorbid, adversely affecting treatment adherence, and resulting in poor outcomes. To improve treatment and outcomes for people dually affected by diabetes and depression in India, we aimed to develop and test an integrated care model. Aims: In the formative phase of this INtegrated DEPrEssioN and Diabetes TreatmENT (INDEPENDENT) study, we sought stakeholder perspectives to inform culturally-sensitive adaptations of the intervention. Settings and Design: At our Delhi, Chennai, and Visakhapatnam sites, we conducted focus groups for patients with diabetes and depression and interviewed health-care workers, family members, and patients. Subjects and Methods: Key informants were asked about experiences with diabetes and depression and for feedback on intervention materials. Analysis: Qualitative data were analyzed using a grounded theory approach. Results: Three major themes emerged that have bearing on adaptation of the proposed intervention: importance of family assistance, concerns regarding patient/family understanding of diabetes, and feedback regarding the proposed intervention (e.g., adequate time needed for implementation; training program, and intervention should address stigma). Conclusions: Based on our findings, the following components would add value when incorporated into the intervention: (1) engaging families in the treatment process, (2) clear/simple written information, (3) clear nonjargon verbal explanations, and (4) coaching to help patients cope with stigma.
  1,966 43 2
EDITORIAL
Sustainable surveillance systems for noncommunicable diseases in developing countries: A bridge too far or a realizable dream?
Anand Krishnan
July-September 2016, 1(2):53-54
DOI:10.4103/2468-8827.191919  
  1,824 62 1
ORIGINAL ARTICLES
Dietary salt intake estimation by routine healthcare workers in an urban slum of Chandigarh: A feasibility study
Sudip Bhattacharya, JS Thakur
July-September 2016, 1(2):55-58
DOI:10.4103/2468-8827.191918  
Context: Hypertension is an important modifiable risk factor for cardiovascular disease (CVD). From numerous studies, it was observed that excess dietary salt is responsible for 17-30% of high blood pressure and increases the risk of blood pressure-related CVD events in normotensives also. Employing the most appropriate method is important to assess the baseline consumption as well as to evaluate the impact of potential salt reduction initiatives. Aim and Objective: The aim and objective of this study is to collect salt data at population level by health workers, with a standard questionnaire, as they regularly visit household level for other national programs. Methods: A cross-sectional study was conducted in an urban slum of Chandigarh for salt data collection using the WHO STEPS instrument version 3.1. Sample size of 255 was calculated by Epi Info software. However, we have taken 300 participants for our study. Six health staff from Urban Health Training Centre, Indira Colony, Department of Community Medicine, PGIMER, Chandigarh, were involved. They were trained regarding filling the questionnaire. Investigator then re-interviewed 20% of the respondents interviewed by health workers, and a comparison of agreement was done. Results: The range of agreement was observed to be 55-90%, and percentage agreement varies between 63% and 83%, except in 3 questions which could be considered reasonable for initiating public health interventions. Conclusion: From this study, we can conclude that even in resource-poor settings, it is possible to collect salt data by proper training of health workers, and thus, we can initiate evidence-based salt reduction interventions in the community.
  1,705 61 -
PUBLIC HEALTH INNOVATION
m-STEPS: Developing and implementing a smart innovative android tool for noncommunicable disease risk factor (STEPS) survey in India
JS Thakur, Gursimer Jeet, Jaya Prasad Tripathy
July-September 2016, 1(2):91-93
DOI:10.4103/2468-8827.192018  
  1,561 93 -
REVIEW ARTICLES
Cancer-associated thrombosis in some African populations: A growing concern
Hannah E Omunakwe, Theresa U Nwagha
July-September 2016, 1(2):87-90
DOI:10.4103/2468-8827.192017  
The burden of cancer is gradually increasing in developing countries in Africa. This has accounted for significant rates of morbidity and mortality. The development of thrombosis in cancer patients impacts significantly on the outcome of care. Cancer-associated thrombosis may occur due to the stage of cancer, its organ site, treatment modality among other reasons. Some reports of studies of the management of patients with deep venous thrombosis (DVT) from African centers have identified malignancy as a significant risk factor for DVT. However, there are no reported studies in cancer patient groups to evaluate the prevalence, risk factors, and efficacy of prophylactic measures in Africa. This review focuses on the epidemiology, pathophysiology, risk indicators, and reports of thrombosis affecting cancer patients in Africa. The aim is to increase awareness and draw the attention of clinicians and oncologist in cancer management in Africa to the need for a robust multicenter research, establishing evidence-based interventions, and guidelines for improved patient outcome.
  1,535 26 -