Post-traumatic stress disorder among COVID-19 survivors in Manipur: A cross-sectional study.

Background: Post-traumatic stress disorder (PTSD) is a condition which can develop among those experiencing psychological trauma and can cause substantial distress and disruption in one's life during a pandemic. This study aims to assess the prevalence of PTSD among the COVID-19 survivors in Manipur and its predictors. Materials and Methods: This cross-sectional study was conducted among the COVID-19 survivors aged 18 years and above from July to September 2020 in Manipur using a validated instrument-the Post-Traumatic Stress Disorder Checklist-5 (PCL-5) based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for screening PTSD which was administered through phone-based Google Form questionnaire. Descriptive statistics like mean and percentages were used and bivariate and multivariate logistic regression were used for predicting PTSD, taking P < 0.2 and P < 0.05, respectively. Results: Out of the 228 participants screened, 67.5% were identified for PTSD symptoms. Increasing age of the participants (Adjusted Odds Ratio (AOR): 1.1; 95% CI: 1.19-1.13), being employed in the private sector (AOR: 14.55; 95% CI: 1.50-13.73), urban residence (AOR: 2.07; 95% CI: 1.01-4.25), and those referred by a doctor for testing Coronavirus Disease (COVID 19) (AOR: 7.90; 95% CI: 2.82-22.1) were found significantly more likely to have the PTSD symptoms. Conclusion: Nearly three-fourths of the COVID-19 survivors were found to have PTSD symptoms. The active involvement of mental health professionals for psychosocial support and timely counseling along with support from the family and community is needed to avert the deleterious effect of the pandemic on mental health.

Characteristics of substance abusing female sex workers and identifying the changing trends in sex work dynamics in Imphal, Northeast India: A mixed-method study.

BACKGROUND: Substance abuse by female sex workers (FSWs) is particularly prevalent in the Northeastern states in India. It is important to understand how the FSWs actually function in different contexts. OBJECTIVES: The study aimed to describe various characteristics of substance abusing FSWs and to explore the changing trends in sex work dynamics in Imphal, Northeast India. METHODS: This community-based, mixed-method, cross-sectional study was conducted among FSWs in Imphal from May 2017 to August 2019. 288 FSWs were recruited using respondent-driven sampling method and were interviewed using a semistructured questionnaire after obtaining written informed consent. Focus group discussions and in-depth interviews were conducted with participants and key informants. RESULTS: The mean ± standard deviation age of the respondents was 30.9 ± 6.1 years; 53.8% were Christian. Majority (98.3%) of the respondents reported sex work as their only source of income; drug use (41.3%) and poverty and debt (35%) were main reasons for involvement in sex work. The most common place of solicitation was lodge/hotel (72.9%); condom was not used during the last sexual act by 2.1%; and heroin was frequently used before having sex by 52.1% and 9.3% used mobile phones for soliciting clients. "Pimps helped in getting customers but want to avoid paying half to them." "It's easy to contact customers on mobile phone. I have 10-12 regular customers contacting through mobile." CONCLUSIONS: Substances abusing FSWs predominantly uses heroin before sexual act and continue to practice unprotected sex. Newer technology like mobile phones was used for soliciting clients.

Assessment of respectful maternity care during childbirth: Experiences among mothers in Manipur.

BACKGROUND: The relationship between the lack of quality care and adverse maternal outcomes is being highlighted globally. Respectful maternity care includes respect for women autonomy, dignity, feelings, privacy, choices and freedom from ill treatment, coercion, and consideration for personal preferences including option for companionship during the maternity care. OBJECTIVES: This study planned to determine the prevalence and types of disrespect and abuse among mothers during childbirth and its associated factors. METHODS: This was a cross-sectional study conducted among 231 women having children <2 years, who had undergone institutional deliveries and accessing immunization clinics during October to December 2018 using a semi-structured questionnaire adapted from the Person-Centered Maternity Care Scale, a validated instrument which gives a holistic measure of women's experiences during childbirth wherein the questions were grouped under seven domains. RESULTS: : The mean (standard deviation) age of the respondents was 28.9 ± 5.8 years. The prevalence of any form of abuse present was 96.5% with the highest found in "Facility and Environment" Domain (77.5%). Women delivering in public tertiary care facility were significantly more likely to face more abuse in the domains of "Dignity and Respect," "Support and Care," "Facility and Environment," "Predictability and Transparency," as compared to other types of health facilities (P < 0.05). CONCLUSION: : Nearly almost all of the respondents (96.5%) faced some form of abuse in one domain or the other. There is a need for greater action, dialog, research, and advocacy on this important public health issue for promoting dignified maternal health-care services.

Knowledge and attitudes regarding medical ethics among junior medical graduates in a tertiary care hospital, Manipur: A cross-sectional study.

Training in medical ethics has been made mandatory in the undergraduate curriculum (1). The Medical Council of India (MCI) in 2002 released its revised Code of Ethics, a regulatory document on professional conduct, etiquette, and ethics of doctors (2).

Keywords: Medical ethics, knowledge, attitudes,

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Evaluation of vaccination coverage of measles-rubella campaign in Imphal East District, Manipur: A cross-sectional study.

BACKGROUND: In India, the measles-rubella (MR) vaccination campaign was conducted with the purpose of vaccinating all children of 9 months-15 years of age with a single dose of MR vaccine. However, it encountered various challenges which may hamper with the coverage. OBJECTIVES: This study was conducted to evaluate the recently conducted MR campaign in Manipur pertaining to its coverage and factors for not vaccinating. METHODS: The cross-sectional study was conducted in Imphal East district of Manipur during May and June 2018 among 1551 children from two communities. The study tool was adapted from the rapid convenience monitoring tool of the WHO. Descriptive statistics were generated, and multivariable logistic regression analysis was performed with vaccination status as dependent with selected independent variables. RESULTS: Among the study children, 38% were in the age group of 5-10 years, males constituting 51.3%. Only two-third (68.8%) of the children had received the MR vaccine, coverage among Muslim children was 40.4% only, and 6.5% of the respondents reported some forms of adverse events following immunization. Children from the Meitei community were (odds ratio: 14.35, 95% confidence interval: 10.22-20.16) significantly more likely to receive the MR vaccination as compared to children belonging to the Muslim community (P = 0.001). CONCLUSION: Vaccination coverage of only 68.8% highlighted the need for increased sensitization and involvement of local and religious leaders in generating necessary awareness for improved coverage of the campaign.

Knowledge and attitudes of doctors on medical ethics in a teaching hospital, Manipur.

This study aimed to assess the knowledge of and attitudes to, medical ethics among doctors in the Regional Institute of Medical Sciences (RIMS), Imphal, Manipur. It also looked at the association between levels of knowledge and selected variables. A self-administered structured questionnaire was distributed to all doctors working in RIMS, Imphal between September and October 2007. 315 of 440 (71.6%) doctors contacted, responded. 62.2% of respondents (196) were below 35 years of age. 22.5% (71) were faculty members. 98.7% (311) had heard of the Code of Medical Ethics but only 188 (59.7%) had read it, even in part. 69.2% (218) felt that the undergraduate curriculum on medical ethics was not adequate. 10.5% (33) could describe what medical professionalism meant. Knowledge of medical ethics was higher among those who were over 35 years of age, those who graduated before 1999 and those having higher educational qualifications. The doctors in this survey lacked adequate and detailed knowledge on the code of ethics, though most of them had read it once. There is a need to sensitise doctors on medical ethics and professionalism.

Determination of sex-ratio by birth order in an urban community in Manipur.

OBJECTIVE: To determine the sex ratio by birth order and to assess the sex preference of the couples in an urban community. METHODS: A cross sectional study, in an urban community in Manipur, was conducted among the currently married couples. Data on background characteristics of the couple, family pedigree chart (of the offspring) including history of abortion, stillbirth, death of child of the couple, sex preference and Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act [PNDT Act] were collected through a structured interview. Data were analyzed using descriptive and chi-square statistics. RESULTS: There were a total of 1777 births to the 855 couples interviewed. There were 900 females per 1000 males for the 1st birth order but the sex ratio was favorable towards females in the 2nd, 3rd and 4th birth orders. Among both the husbands and wives, being more educated was significantly associated (p<0.05) with preferring lesser number of children, using new technology for sex selection and having heard of the PNDT Act. Majority of those who wanted to use new technology for sex selection (128, 56.6%) preferred to have male child. CONCLUSION: Sex ratio in this community was favorable towards females, though it was less among the first born babies.