COVID-19 pandemic and transgender migrant women in India: Socio-economic vulnerability and vaccine hesitancy.

In India, transgender women, often referred to as hijra or kinnar, remain a marginalized group and encounter interpersonal and structural barriers that subject them to social exclusion, discrimination, lack of access to education and health care, and fewer job opportunities compared with the general population. During the COVID-19 pandemic these disparities were heightened and the livelihood of transgender migrant women were severely hit and disrupted, causing further financial and physical hardship. The present study aims to explore the socio-economic vulnerability faced by these women during the pandemic and the factors that contribute to vaccine hesitancy in order to assist government officials and policy makers in the formulation of more inclusive policies for transgender people. Results indicate that the pandemic has adversely impacted their livelihood as most of them depend on sex work and begging. In order to fulfil their daily needs during the lockdown, they have borrowed loans from multiple sources with a higher interest rates and remain in debt. On vaccination status, only seven out of 43 transgender migrant women have taken one vaccine dose, and the rest are not willing to visit vaccine centres because of societal stigma and discrimination including from healthcare personnel. The study reported that these migrant women suffered intensified social stigma, verbal hostility and transphobia attitudes from healthcare professionals whihc caused panic, fear, anxiety and depression among them, and thus they evade these spaces for further consultation or to obtain any other services. Many of them have decided not to take the COVID-19 vaccine in order to stay away from hostility. Further, the lack of trust in medical professionals is also one of the principal concerns leading to vaccine hesitancy among transgender migrant women. Thus a systemic inclusive healthcare services policy is required to address the factors that may influence the vaccine acceptance among transgender women in India.

Oral Health Status and Treatment Needs of 12-year-old School Children among Urban and Rural Areas of Raichur Taluk, Karnataka, India.

INTRODUCTION: Oral health is an integral part of general health. Oral health status has a direct impact on general health, and conversely, general health influences oral health. OBJECTIVES: The objectives of the study were to assess oral health status and treatment needs of 12-year-old school children among urban and rural areas of Raichur Taluk, Karnataka, India. MATERIALS AND METHODS: A cross-sectional study was conducted on 1240 school children in the age group of 12 years from urban (620) and rural (620) areas of Raichur Taluk, Karnataka, India. Oral health status was assessed using the World Oral Health assessment form 1997. RESULTS: The prevalence of caries in urban and rural areas of school children was 63.5% and 64.5%, respectively. The mean decayed teeth, missing teeth, filled teeth, and decay, missing, filled teeth of school children in Raichur Taluk were 1.15 ± 1.20, 0.0, 0.03 ± 0.23, and 1.19 ± 1.21, respectively. CONCLUSION: This study highlights the need for preventive and curative oral health services and should be made integral to other health programs. Oral health promotion strategies need to be implemented to improve the oral health of primary school children. Health education should be given regarding the prevention of dental caries by maintaining good oral hygiene.

Prevalence of violence against indigenous women victims of human trafficking and its implications on physical injuries and disabilities in Monterrey city, Mexico.

Human trafficking victims suffer different kinds of physical abuse and torture that cause severe physical injuries. During 2016-17 a total of 68 indigenous labor and sex-trafficking women victims were surveyed in Monterrey city, Mexico to explore the prevalence of violence against them and its implications on physical injuries and disabilities. We found that women reported different types of injuries and long term disabilities. Considering the level of violence and occupational hazards faced by victims, we suggest there is an urgent need to create instruments in the Mexican national human trafficking program to address the unmet health needs of the victims.

Prevalence of Periodontitis and Soft Tissue Lesions among Human Immunodeficiency Virus-positive Patients on Antiretroviral Therapy in Raichur Taluk, Karnataka, India.

INTRODUCTION: In countries where human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is widespread and highly active antiretroviral therapy (HAART) medications are too expensive, or patients are failing HAART, oral disease management and risk remain an important issue. AIM: The aim of the study was to evaluate the prevalence of oral mucosal lesions and periodontitis among the HIV-positive adult patients and assess the association of these lesions with age, sex, duration of HIV, time on ART, dietary habits, and oral hygiene habits. MATERIALS AND METHODS: Sample size was 170. Demographic data of the patients along with community periodontal index (CPI) and loss of attachment (LA) were recorded. Oral soft tissue lesions, such as ulcerations, sores, erosions, and fissures were also recorded. The study was carried out in Raichur Taluk, Karnataka, India. Convenience sampling design was followed. Statistical Package for the Social Sciences (SPSS) version 20.0 (Chicago, USA) was used for data analysis. Chi-square test was carried out; p < 0.05 was considered to be statistically significant. RESULTS: There was no association between the oral mucosal conditions and the age and the adverse habits, such as tobacco and alcohol, CD4 count, and the time duration of HIV and ART among these patients. A higher percentage of people with 4 to 5 mm of pockets was seen with those who cleaned their teeth with a finger, which was statistically significant. CLINICAL SIGNIFICANCE: The present study highlights the poor condition of the oral health of these patients and their unmet dental needs.

Stigma and Discrimination faced by HIV-infected Adults on Antiretroviral Therapy for more than 1 Year in Raichur Taluk, Karnataka, India.

AIM: The aim of this study was to evaluate the stress and discrimination faced by human immunodeficiency virus (HIV)-affected adult patients on antiretroviral therapy (ART) for more than 1 year. MATERIALS AND METHODS: A cross-sectional study was carried out among 170 adults on ART, reporting to the ART center of the District Civil Hospital, for more than 1 year in Raichur Taluk, Karnataka, India. Convenience sampling technique was followed. Descriptive statistics was performed (Chi-square test) using Statistical Package for the Social Sciences version 16.0. RESULTS: A total of 156 (91.8%) patients' families had knowledge about their seropositive status. Seventeen (10.9%) HIV-positive patients reported of change in the attitude of their family members. The main reasons for not revealing the HIV status were the internalized stigma and fear of rejection. Women faced greater discrimination from family, friends, and neighbors than men. CONCLUSION: It is necessary to not undermine the effect of rejection due to HIV. It is the only infection that has so many associated social and psychological norms which we need to tend at the earnest. Till date, there is an existence of condescendence toward treatment approach. CLINICAL SIGNIFICANCE: The presence of stigma and the fear of being discriminated could be a major hurdle in the rehabilitation of these patients into the mainstream society. Furthermore, it serves as an existing challenge to ascertain these individuals to achieve overall health.

Oral Health Status and Treatment Needs among Pregnant Women of Raichur District, India: A Population Based Cross-Sectional Study.

Background and Objectives. Pregnancy can be a risk factor for dental diseases as oral tissues are liable to changes due to hormonal variations. The aim of the study was to assess the oral health status and treatment needs among pregnant women of Raichur district, Karnataka, India. Methods. Cross-sectional data was collected from 300 primigravidae from all the 5 taluks of Raichur district visiting the respective community health centre at taluk headquarters. A specially designed questionnaire was used to assess the demographic variables and oral hygiene practices. A clinical examination was done according to WHO (World Health Organization) criteria 1997 and recorded using WHO Oral Health Assessment Form. Results. The mean age of the pregnant women in the study was 21.8 (2.12) years. The prevalence of caries and periodontal diseases was 62.7% and 95%, respectively. The mean DT, MT, FT, and DMFT were 2.06 (2.5), 0.03 (0.17), 0.04 (0.27), and 2.13 (2.54), respectively. The mean OHI-S was 2.87 (1.27). Chi-square test showed that CPI scores increased with the trimester of pregnancy. Conclusion. The present study demonstrates poor oral hygiene and high prevalence of periodontal diseases, as well as a large proportion of unmet dental treatment needs among pregnant women of Raichur district, India.

Changing Trends in oral cancer - a global scenario.

Oral cancer is one of the highly prevalent cancers worldwide and a leading cause of mortality in certain regions like South-Central Asia. It is a major public health problem. Late diagnosis, high mortality rates and morbidity are characteristics of the disease worldwide. For control of oral cancer an idea of the coverage of the same in the various regions is necessary. The estimated incidence, mortality and 5-year survival due to lip, oral cavity cancer in world is 3, 00, 373(2.1%), 1, 45, 328(1.8%) and 7, 02, 149(2.2%) respectively according to data of GLOBOCAN 2012. A changing trend in incidence and prevalence of oral cancer has been observed with more women and youngsters being affected by oral cancer.