Effectiveness of Using AI-Driven Hotspot Mapping for Active Case Finding of Tuberculosis in Southwestern Nigeria.

Background: Nigeria is among the top five countries that have the highest gap between people reported as diagnosed and estimated to have developed tuberculosis (TB). To bridge this gap, there is a need for innovative approaches to identify geographical areas at high risk of TB transmission and targeted active case finding (ACF) interventions. Leveraging community-level data together with granular sociodemographic contextual information can unmask local hotspots that could be otherwise missed. This work evaluated whether this approach helps to reach communities with higher numbers of undiagnosed TB. Methodology: A retrospective analysis of the data generated from an ACF intervention program in four southwestern states in Nigeria was conducted. Wards (the smallest administrative level in Nigeria) were further subdivided into smaller population clusters. ACF sites and their respective TB screening outputs were mapped to these population clusters. This data were then combined with open-source high-resolution contextual data to train a Bayesian inference model. The model predicted TB positivity rates on the community level (population cluster level), and these were visualised on a customised geoportal for use by the local teams to identify communities at high risk of TB transmission and plan ACF interventions. The TB positivity yield (proportion) observed at model-predicted hotspots was compared with the yield obtained at other sites identified based on aggregated notification data. Results: The yield in population clusters that were predicted to have high TB positivity rates by the model was at least 1.75 times higher (p-value < 0.001) than the yield in other locations in all four states. Conclusions: The community-level Bayesian predictive model has the potential to guide ACF implementers to high-TB-positivity areas for finding undiagnosed TB in the communities, thus improving the efficiency of interventions.

Applicability of Data Mining and Predictive Analysis for Tobacco Cessation: An Exploratory Study.

Objectives: Predictive analysis can be used to evaluate the enormous data generated by the healthcare industry to extract information and establish relationships amongst the variables. It uses artificial intelligence to reveal associations not suspected by the healthcare professionals. Tobacco cessation is clearly beneficial; however, many tobacco users respond differently as it is based on multitude of factors. Our objectives were to assess the data mining techniques using the WEKA tool, evaluate its role in predictive analysis, and to predict the quit status of patients using prediction algorithms in tobacco cessation. Materials and Methods: WEKA, a data mining tool, was used to classify the data and evaluate them using 10-fold cross-validations. The various algorithms used in this tool are Naïve Bayes, SMO, Random Forest, J-48, and Decision Stump to further analyze its role in determining the quit status of patients. For this, secondary data of 655 patients from a tobacco cessation clinic were utilized and described using 20 different attributes for prediction of quit status. Results: The Decision Stump and SMO were found to be having the best prediction and accuracy for prediction of the quit status. Out of 20 attributes, previous quitting attempt, type of intervention, and number of years since the habit was initiated were found to be associated with early quitting rate. Conclusion: This study concluded that data mining and predictive analytical models like WEKA tool will not only improve patient outcomes but identify variables or a combination of variables for effective interventions in tobacco cessation.

Effectiveness of dental health education on oral hygiene among hearing impaired adolescents in India: A randomized control trial.

AIM: To assess the effectiveness of two different methods of dental health education (DHE) for improving oral hygiene among hearing impaired adolescents in school aged 11-20 years. METHODOLOGY AND RESULTS: A randomized double blind controlled parallel time series trial was done among 178 hearing impaired adolescents. Considering existing literature, the required sample size was found to be 82 per group, at 95% confidence interval, design effect = 1, type I error = 5%, power of study = 80%, and 20% attrition rate. Two out of five schools were randomly selected. Different methods of DHE were used, schools were coded as School A (DHE using sign language by the investigator) and School B (DHE by conventional visual method, using only posters). The mean reduction in Simplified Oral Hygiene Index (OHI-S), Plaque Index (PI), and Gingival Index (GI) scores was 1.13 ± 0.81, 0.66 ± 0.31, and 0.58 ± 0.32, respectively, in school A. The mean reductions seen in school B was 0.52 ± 0.89 in OHI-S, 0.44 ± 0.44 in PI, and 0.34 ± 0.32 in GI index (P-value < 0.05). CONCLUSION: Basic training of dental professionals in sign language is both effective and feasible, and brings about greater improvement in oral hygiene status and gingival health as compared to the conventional methods of health education.

Compliance Assessment of Cigarette and Other Tobacco Products Act in Public Places in Delhi Government Hospitals

Objective: Tobacco-free policies in hospital campus reduce exposure to tobacco smoke; change the demeanour of the professionals, patients and people visiting hospitals towards tobacco use. Section-4, 5 and 6 of COTPA (Cigarettes and Other Tobacco Products Act) necessitates the need for implementation of the prohibition on smoking in public places. Against this background, the present work was designed to evaluate the status of compliance Section 4, 5 and 6 of COTPA in Delhi Government hospitals Methods: A cross-sectional observational study was conducted within Government hospitals. Multistage random sampling was used to select 18 hospitals out of 39 hospitals from 5 zones. Standard assessment Proforma developed by John Hopkins School of Public Health for assessing compliance to Tobacco-Free Law was used and modified to address certain aspects of Section-4, 5 and 6 of COTPA. Hospital campuses were assessed by dividing them into zones like hospital buildings, office buildings, public places outside the hospital and residential areas. Result: Signs of active tobacco use observed in 40.6% of hospital buildings, 35.3% in office buildings, and 75.4% in public places outside the buildings. 'No smoking signage was not as per the COTPA guidelines in 21.4% of the hospitals and 72% were not tobacco free outdoors in these positions. Conclusion: The study highlighted a lower compliance rate than expected which raises questions on law enforcement concerning tobacco. Hence necessary measures have to be used up for sustained awareness campaigns, backed by enforcement drives. Periodic compliance surveys will strengthen the implementation of tobacco free legislation in health care institutions.

Hookah products and online retail marketing strategies in India: A content analysis.

INTRODUCTION: Hookah smoking is becoming increasingly popular among the youth. Evidence shows that exposure to marketing of the unhealthy products through social media platforms may impact adolescent health behaviors. The aim of the study was to perform a content analysis of online portals selling hookah products. MATERIALS AND METHODS: A content analysis of online retail market was conducted on Google India using three keywords hookah, hookah products, and shisha. Retail websites popular in India that were selling hookah products were randomly selected and explored. A total of 15 themes were developed and used to describe various promotional strategies for hookah products. RESULTS: In all, 41 (19.2%) products claimed to be tobacco/nicotine-free and only 14 products (6.5%) displayed age/health-specific warnings. About 86% of products were available at discounted rates; glamorizing words for describing products in form of superior, premium, and legendary were found on 189 (88.3%) products. Phrases such as "ultimate way to celebrate," "perfect excuse to chill with your friends," and "now enjoy the world of smoking without any doubt of harm" are commonly used to promote hookah products. CONCLUSION: Easy availability of newer forms of smoking at online markets could play a role in promoting the use of hookah among the youth. Most products are being sold without any warnings and there is no means to control the selling of the products to minors. There is a need to raise the issue of hookah products in the same tune as done for other forms of tobacco.