A comprehensive review of dengue with a focus on emerging solutions for precision and timely detection.

Dengue is a global health problem, caused by the dengue virus (DENV), which belongs to the Flaviviridae family of viruses. The transmission of DENV occurs through vectors, Ae. aegypti and Ae. Albopictus mosquitoes, to the human host, classifying it as a vector-borne disease. The disease incidence is increasing at an alarming rate and needs to be tackled to reduce the morbidity and mortality caused by the disease. Environmental and clinical surveillance, detection of the virus, and diagnostics are critical tools to address this issue. In this comprehensive review, we explore various diagnostic techniques and the associated challenges within the context of dengue. While we briefly touch upon dengue's epidemiology, serotypes, and pathogenesis, our primary emphasis remains on diagnostics. We delve into the intricacies of these diagnostic methods, considering both the challenges they entail and the potential they hold in terms of accuracy and accessibility. It's important to note that the review does not extensively cover clinical aspects or regional variations of the disease.

Validating saliva as a biological sample for cost-effective, rapid and routine screening for SARS-CoV-2.

PURPOSE: Compared to nasopharyngeal/oropharyngeal swabs (N/OPS-VTM), non-invasive saliva samples have enormous potential for scalability and routine population screening of SARS-CoV-2. In this study, we investigate the efficacy of saliva samples relative to N/OPS-VTM for use as a direct source for RT-PCR based SARS-CoV-2 detection. METHODS: We collected paired nasopharyngeal/oropharyngeal swabs and saliva samples from suspected positive SARS-CoV-2 patients and tested using RT-PCR. We used generalized linear models to investigate factors that explain result agreement. Further, we used simulations to evaluate the effectiveness of saliva-based screening in restricting the spread of infection in a large campus such as an educational institution. RESULTS: We observed a 75.4% agreement between saliva and N/OPS-VTM, that increased drastically to 83% in samples stored for less than three days. Such samples processed within two days of collection showed 74.5% test sensitivity. Our simulations suggest that a test with 75% sensitivity, but high daily capacity can be very effective in limiting the size of infection clusters in a workspace. Guided by these results, we successfully implemented a saliva-based screening in the Bangalore Life Sciences Cluster (BLiSC) campus. CONCLUSION: These results suggest that saliva may be a viable alternate source for SARS-CoV-2 surveillance if samples are processed immediately. Although saliva shows slightly lower sensitivity levels when compared to N/OPS-VTM, saliva collection is logistically advantageous. We strongly recommend the implementation of saliva-based screening strategies for large workplaces and in schools, as well as for population-level screening and routine surveillance as we learn to live with the SARS-CoV-2 virus.

Effectiveness of a Culturally Responsive mHealth Gaming Application to Improve Diabetes Health Literacy in India: A Randomized Controlled Trial.

The purpose of this study was to determine the effectiveness of a culturally responsive interactive gaming mHealth educational application designed to improve diabetes health literacy among an underserved urban population in India when compared with a traditional approach of verbal education. In addition, relationships between participant sociodemographic variables and participant knowledge were assessed. A randomized controlled trial was conducted using a two-arm parallel, single-blinded intervention and control group design. The parallel groups were the mHealth Education group serving as the intervention group and the Verbal Education group serving as the control group. The mHealth application was as effective in improving diabetes health literacy as verbal education. Results for the difference in posttest and pretest score between the two groups indicated there was no statistically significant difference between groups ( P = .9306). However, there was a significant improvement in the difference in posttest and pretest scores for each group ( P < .0001), indicating that the culturally responsive type 2 diabetes educational content was effective in improving type 2 diabetes health literacy among both groups. This study answers a call by the World Health Organization that advocates for evidence-based mHealth interventions that offer unique opportunities for cost-effective informatics service delivery in low- and middle-income countries.

Seroprevalence of SARS CoV-2 among children after the second surge (June 2021) in a rural district of South India: Findings and lessons from a population-based survey.

Objective: To determine the seroprevalence of SARS COV 2 among children in the Bangalore Rural district. Methods: We conducted a cross-sectional study after the second surge of COVID-19 from 14 June to 13 July 2021 and recruited 412 children through house to house visits from four villages in a rural district. We administered a questionnaire to collect demographics and details of COVID-19 infection and used the ABCHEK Antibody Card test (NuLifecare,India) which is an ICMR approved test for detecting antibodies (IgG & IgM) by immunochromatography using the finger prick method. We used Statistical Package for the Social Sciences version 20.0 for analysis. Results: Our participants had an age group ranging from 11 months to 18 years. There was an almost equal distribution of boys (48.3%) and girls (51.7%). We estimated seroprevalence of 45.9% (95% CI: 41-50.8) among children. Seroprevalence was significantly associated with a history of symptoms suggestive of COVID-19 in the past, the seropositive status of the parents, and any other family members being tested positive. Age and gender of the child, education and occupation of the parents were not associated with the seropositivity status of the child. Conclusion: Seroprevalence of COVID-19 among children corresponds to adult seroprevalence during the same time interval. This knowledge can be of practical application where adult prevalence is documented. Unvaccinated children in low-resource settings need special attention with respect to monitoring for new mutations as well as managing endemic needs.

The Effect of Epidural Analgesia on the Maternal and Fetal Outcomes in Mothers Undergoing Induction of Labour.

Introduction: Elective labour induction is associated with more pain, intrapartum interventions, cesarean deliveries, as compared with spontaneous labour, necessitating the use of labour analgesia. Epidural analgesia is one popular method for control of pain. This study was to determine the effect of epidural analgesia on the maternal and fetal outcomes in women undergoing induction of labour, as adequate data in this specific population is relatively sparse. Materials and Methods: This was a cross-sectional study conducted over a period of 18 months which included mothers with singleton term gestation with cephalic presentation admitted for induction of labour. Result: A sample of 238 mothers were included in the study. Among the study population, 52.7% opted for epidural analgesia. The pain score was less than 3/10 (VAS) in 81% of mothers who opted for epidural analgesia. The cesarean section rate was 20.5% and 34.3% in the epidural and non-epidural groups, respectively. After adjusting the confounding factors, there was a positive effect noted in the caesarean section rate among the epidural group, which was lesser than the non-epidural group. However, a higher instrumental delivery rate (18.8% vs. 10.5%, p-value < 0.05) was noted in the epidural group. There was no significant difference in the duration of labour and fetal outcome in the two groups. Conclusion: Epidural analgesia providing good pain relief in the majority of the mothers was reinforced. In our study, epidural analgesia was associated with a reduction of caesarean section rate after adjusting the confounding factor. Epidural analgesia did not affect the duration of labour, cesarean section rate and fetal outcome independently, however, it was associated with increased risk of instrumental delivery. The outcomes mainly depend on the confounding factors. Therefore, mothers can be provided with an evidence-based information regarding the effect of epidural analgesia in induced labour and help those seeking epidural analgesia to make an informed choice. Supplementary Information: The online version contains supplementary material available at 10.1007/s13224-022-01622-1.

COVID-19 symptoms are reduced by targeted hydration of the nose, larynx and trachea.

Dehydration of the upper airways increases risks of respiratory diseases from COVID-19 to asthma and COPD. We find in human volunteer studies involving 464 human subjects in Germany, the US, and India that respiratory droplet generation increases by up to 4 orders of magnitude in dehydration-associated states of advanced age (n = 357), elevated BMI-age (n = 148), strenuous exercise (n = 20) and SARS-CoV-2 infection (n = 87), and falls with hydration of the nose, larynx and trachea by calcium-rich hypertonic salts. We also find in a protocol of exercise-induced airway dehydration that hydration of the airways by calcium-rich salts increases oxygenation relative to a non-treatment control (P < 0.05). In a random control study of COVID-19 positive subjects (n = 40), thrice-a-day delivery of the calcium-rich hypertonic salts (active) suppressed respiratory droplet generation by 51% ± 11% and increased oxygen saturation over three days of treatment by 48.08% ± 9.61% (P < 0.001), while no changes were observed in the nasal-saline control group. Self-reported symptoms significantly declined in the active group and did not decline in the control group. Hydration of the upper airways appears promising as a non-drug approach for reducing risks of respiratory diseases such as COVID-19.

Seroprevalence of COVID-19 infection among vaccine naïve population after the second surge (June 2020) in a rural district of South India: A community-based cross-sectional study.

OBJECTIVE: To determine the seroprevalence of the SARS Cov 2 infection among vaccine naive population in a rural district of South India post-second surge. METHODOLOGY: We conducted a cross-sectional study in the five villages of a randomly chosen sub-district in the Bangalore rural district. We did house to house surveys and recruited 831 vaccine naive adults in July 2021. We tested samples for the presence of antibodies (including IgG & IgM) to SARS CoV-2 using the Roche Elecsys SARS-CoV-2 -S assay that quantifies antibodies against the receptor-binding domain (RBD) of the spike (S) protein. RESULTS: We estimated an overall prevalence of 62.7% (95% CI: 59.3-66.0) and an age-and gender-adjusted seroprevalence of 44.9% (95% CI: 42.5-47.4). When adjusted for test performance, the seroprevalence was 74.64% (95% CI: 70.66-78.47). The case-to-undetected-infected ratio (CIR) was 1: 8.65 (95% CI 1:8.1-1:9.1), and the Infection Fatality Rate (IFR) was 16.27 per 100,00 infections as of 13 July 2021. A history of at least one symptom suggestive of COVID-19 or a positive COVID-19 test of self or a family member in the past were significantly associated with seropositivity. CONCLUSION: We report a high seroprevalence of COVID-19 infection despite the advantages of low population density and well-ventilated landscapes in rural areas. CIR and IFR were higher than the previous serosurvey conducted in the same population during the first surge. The thought of achieving herd immunity comes with relief. However, it's vital to put efforts into building population health and rural health infrastructure to avert future health catastrophes.

Are hospitals epicentres of COVID19 transmission? Findings of serial serosurveys among healthcare workers from a tertiary hospital in South India.

We conducted a serial cross-sectional study and used blood bank donors serosurvey and the ICMR serosurvey reports for comparison. Seroprevalence was 0% among HCWs (n-211) and blood bank donors (n-210) during the first phase while ICMR serosurvey reported 0.5% among general population in the district at the same time. In phase 2, we estimated a seroprevalence of 9.2% as compared to 18.8% among general population. Seroprevalence among HCWs was comparable to that of the general population during both phases. We postulate that good infection control policies and practice can provide safe working environment without additional risk to HCWs.

Quality of wheelchair services as perceived by users in rural Bangalore district, India: a cross-sectional survey.

BACKGROUND AND AIM: This study investigated the current state of wheelchair services in Bangalore Rural district, as provided by Bangalore Baptist Hospital, and identified areas for improvement. METHOD: a cross-sectional survey was held among 50 wheelchair users. Data was collected on demographics, satisfaction, wheelchair skills and level of disability using QUEST, WST-Q and CHART-SF questionnaires. RESULT: Overall satisfaction can be described as more or less satisfied, scoring 3.8 out of 5. Wheelchair users were less satisfied with the services compared to the wheelchair itself. The skills a wheelchair users had were strongly correlated with satisfaction scores (p < 0.01). Differences in satisfaction between genders were observed and related to multiple factors. CONCLUSION: Wheelchairs should be easy to use with support services being easily accessible. A wheelchair should be delivered together with a training program to provide the user with the skills to operate and maintain the wheelchair. There are gender-wise differences in satisfaction towards wheelchair services that influence satisfaction.Implications for rehabilitationTraining of wheelchair skills should be part of the delivery process as this positively impacts satisfaction of wheelchair users and increases their independent mobility.Requirements towards a wheelchair and its support service are gender specific. Recognizing and acting upon the differing needs between male and female wheelchair users should be an integral part of a wheelchair provision service.Wheelchair users should take part in the development and implementation of novel technologies, policies and service delivery schemes as their need is not always answered. This could lead to a reduced uptake, or even failure, of innovations in (wheelchair) services.The financial situation of a wheelchair user is a factor that influences satisfaction. Therefore, empowering and/or enabling wheelchair users to take part in activities that earns them an income should be part of a wheelchair service.

Cross Cultural Team Collaboration: Integrating Cultural Humility in mHealth Development and Research.

The World Health Organization called for mobile health initiatives to improve population health outcomes, particularly in limited-resource settings. The aim of our study was to reflect upon approaches embedded in cultural humility and recognize areas where improvement was needed in the social innovation collaborative development of an mHealth app to improve hypertension health literacy in India. A qualitative descriptive case study approach was employed to elicit concepts of cultural humility and areas for improvement derived from communications between project stakeholders. Overarching themes included fostering coalescence and strengthening partnerships in addition to multiple subthemes. Enveloping cultural humility in multidisciplinary, interprofessional and cross-cultural healthcare projects and processes is imperative for the development and implementation of successful culturally congruent health initiatives. Team fostering of coalescence and recognizing challenges and adapting to mitigate challenges can strengthen partnerships, a desired consequence of cultural humility.

Seroprevalence of COVID-19 infection in a rural district of South India: A population-based seroepidemiological study.

OBJECTIVES: We aimed to estimate the seroprevalence of COVID-19 in a rural district of South India, six months after the index case. METHODOLOGY: We conducted a cross-sectional study of 509 adults aged more than 18 years. From all the four subdistricts, two grampanchayats (administrative cluster of 5-8 villages) were randomly selected followed by one village through convenience. The participants were invited for the study to the community-based study kiosk set up in all the eight villages through village health committees. We collected socio-demographic characteristics and symptoms using a mobile application-based questionnaire, and we tested samples for the presence of IgG antibodies for SARS CoV-2 using an electro chemiluminescent immunoassay. We calculated age-gender adjusted and test performance adjusted seroprevalence. RESULTS: The age-and gender-adjusted seroprevalence was 8.5% (95% CI 6.9%- 10.8%). The unadjusted seroprevalence among participants with hypertension and diabetes was 16.3% (95% CI:9.2-25.8) and 10.7% (95% CI: 5.5-18.3) respectively. When we adjusted for the test performance, the seroprevalence was 6.1% (95% CI 4.02-8.17). The study estimated 7 (95% CI 1:4.5-1:9) undetected infected individuals for every RT-PCR confirmed case. Infection Fatality Rate (IFR) was calculated as 12.38 per 10000 infections as on 22 October 2020. History of self-reported symptoms and education were significantly associated with positive status (p < 0.05). CONCLUSION: A significant proportion of the rural population in a district of south India remains susceptible to COVID-19. A higher proportion of susceptible, relatively higher IFR and a poor tertiary healthcare network stress the importance of sustaining the public health measures and promoting early access to the vaccine are crucial to preserving the health of this population. Low population density, good housing, adequate ventilation, limited urbanisation combined with public, private and local health leadership are critical components of curbing future respiratory pandemics.

High seroprevalence of COVID-19 infection in a large slum in South India; what does it tell us about managing a pandemic and beyond?

People living in urban slums or informal settlements are among the most vulnerable communities, highly susceptible to coronavirus disease 2019 (COVID-19) infection and vulnerable to the consequences of the measures taken to control the spread of the virus. Fear and stigma related to infection, mistrust between officials and the population, the often-asymptomatic nature of the disease is likely to lead to under-reporting. We conducted a cross-sectional study to determine the seroprevalence of COVID-19 infection in a large slum in South India 3 months after the index case and recruited 499 adults (age >18 years). The majority (74.3%) were females and about one-third of the population reported comorbidities. The overall seroprevalence of IgG antibody for COVID-19 was 57.9% (95% CI 53.4-62.3). Age, education, occupation and the presence of reported comorbidities were not associated with seroprevalence (P-value >0.05). Case-to-undetected-infections ratio was 1:195 and infection fatality rate was calculated as 2.94 per 10 000 infections. We estimated seroprevalence of COVID-19 was very high in our study population. The focus in this slum should shift from infection prevention to managing the indirect consequences of the pandemic. We recommend seroprevalence studies in such settings before vaccination to identify the vulnerability of COVID-19 infection to optimise the use of insufficient resources. It is a wake-up call to societies and nations, to dedicate paramount attention to slums into recovery and beyond - to build, restore and maintain health equity for the 'Health and wellbeing of all'.

Mobile Health to Improve Hypertension and Diabetes Health Literacy Among Asian Indian Migrants to Hong Kong.

The use of mobile technologies to improve health outcomes or mobile health is rapidly evolving, and culturally relevant resources are needed to address health disparities among vulnerable populations. Noncommunicable disease health disparities among Asian Indian migrants to Hong Kong are prevalent. A mobile health application designed to improve hypertension and type 2 diabetes mellitus health literacy was tested using a mixed-methods design to determine its impact on improving health literacy among this subpopulation. Quantitative findings indicated the mobile health application was effective in improving health literacy. Qualitative findings revealed participant perceptions about the application explored its informative nature, usability and likability of application components, and its ability to initiate intentionality for a healthier lifestyle among users. This feedback was valuable to ensure future modifications that will promote the application's scalability and sustainability.

Challenges, experience and coping of health professionals in delivering healthcare in an urban slum in India during the first 40 days of COVID-19 crisis: a mixed method study.

OBJECTIVES: To describe the initial dilemmas, mental stress, adaptive measures implemented and how the healthcare team collectively coped while providing healthcare services in a large slum in India, during the COVID-19 pandemic. SETTING: Community Health Division, Bangalore Baptist Hospital, Bangalore. STUDY DESIGN: We used mixed methods research with a quantitative (QUAN) paradigm nested in the primary qualitative (QUAL) design. QUAL methods included ethnography research methods, in-depth interviews and focus group discussions. PARTICIPANTS: A healthcare team of doctors, nurses, paramedical and support staff. Out of 87 staff, 42 participated in the QUAL methods and 64 participated in the QUAN survey. RESULTS: Being cognizant of the extreme vulnerability of the slums, the health team struggled with conflicting thoughts of self-preservation and their moral obligation to the marginalised section of society. Majority (75%) of the staff experienced fear at some point in time. Distracting themselves with hobbies (20.3%) and spending more time with family (39.1%) were cited as a means of emotional regulation by the participants in the QUAN survey. In the QUAL interviews, fear of death, the guilt of disease transmission to their loved ones, anxiety about probable violence and stigma in the slums and exhaustion emerged as the major themes causing stress among healthcare professionals. With positive cognitive reappraisal, the health team collectively designed and implemented adaptive interventions to ensure continuity of care. They dealt with the new demands by positive reframing, peer support, distancing, information seeking, response efficacy, self-efficacy, existential goal pursuit, value adherence and religious coping. CONCLUSION: The novel threat of the COVID-19 pandemic threw insurmountable challenges potentiating disastrous consequences; slums becoming a threat to themselves, threat to the health providers and a threat for all. Perhaps, a lesson we could learn from this pandemic is to incorporate 'slum health' within universal healthcare.

The Effect of Vitamin D Supplementation on Improving Glycaemic Control in Diabetic Vitamin D-Deficient Pregnant Women: A Single-Blinded Randomized Control Trial.

INTRODUCTION: Gestational diabetes mellitus is one of the most common conditions complicating pregnancy. Vitamin D deficiency is closely associated with gestational diabetes mellitus. OBJECTIVES: To study the effect of vitamin D supplementation on diabetic pregnant women with vitamin D deficiency. METHODS: This randomized controlled study was conducted with 100 diabetic pregnant women. They were randomized into group A and group B. Group A were screened for vitamin D deficiency once diagnosed with GDM of which 40 were found to be deficient and allotted to group D (n = 40) and were supplemented with 60,000 units of vitamin D3 per month. Group B were given routine antenatal care and were screened for vitamin D deficiency when they were admitted for delivery, and 39 of them were found to have vitamin D deficiency and were studied as control group C (n = 39). Ten women in both the groups had normal levels of vitamin D, and one of them was excluded from the study as she had molar pregnancy. The vitamin D supplemented group D and the control group C were matched for age and parity at the baseline. RESULTS: There was a significant increase in the mean insulin and metformin requirements in both the supplemented and control groups. Vitamin D supplementation did not improve the glycaemic control in diabetic pregnant women. CONCLUSION: Vitamin D supplementation did not decrease insulin resistance or improve the glycaemic control in diabetic pregnant women with vitamin D deficiency.

Paternal involvement in feeding and its association with nutritional status of children in an urban slum in a low-resource setting: A cross-sectional study.

OBJECTIVES: In India, childhood malnutrition continues to be a major public health problem, especially in slums. Research mostly focuses on the role of the mother in child feeding, as she spends significantly more time with children. However, the role of fathers, their parenting skills, and child-feeding practices may also affect child development and eating behavior, independent of maternal factors. To our knowledge, there is limited research on the role of the father in child undernutrition, especially in the Indian context. Thus, the aim of this study was to address this knowledge gap and to explore paternal child-feeding patterns, their involvement in feeding, and its association with malnutrition in the slums. METHODS: This community-based, cross-sectional study was conducted in an urban slum in Bangalore. The study included 210 father-child dyads. The Caregiver's Feeding Styles Questionnaire was used to assess paternal involvement in parenting and feeding. Anthropometry measurements were taken using standardized methods. Nutritional status was classified according to the growth standards of the World Health Organization. Logistic regression was used to test the association between paternal parenting style and malnutrition. RESULTS: We recruited 116 boys and 94 girls and their fathers. The mean age of the children was 15.94 mo (SD 4.85). One-fourth of the fathers were illiterate and most of the families belonged to the middle class. Almost half of the fathers fed their children once a day (57.1%) and engaged them during feeding by telling stories (47.1%). The most common paternal feeding style was uninvolved (36%) followed by authoritative (29.5%). Prevalence of undernutrition, stunting, and wasting was 44.3%, 42.8%, and 9.5%, respectively. Religion, type of family, and per capita income were independently associated with uninvolved feeding style. There was no association between paternal child-feeding style malnutrition (P > 0.05) CONCLUSION: The present study explored the dimensions of paternal involvement in child feeding in a slum setting and its effect on child nutrition. A good proportion of fathers were actively involved in child feeding and neither involvement nor paternal feeding styles were associated with the nutritional status of children.

Health issues in a Bangalore slum: findings from a household survey using a mobile screening toolkit in Devarajeevanahalli.

BACKGROUND: Slums are home to nearly one billion people in the world and are expanding at an exponential rate. Devarjeevanahalli is a large notified slum in Bangalore, South India which is characterised by poverty, overcrowding, hazardous living environment and social complexities. The poor living conditions not only affect the health of the people living there but also poses distinctive challenges to conducting health surveys. The purpose of this paper is to report the findings of a household survey that was done to study the health condition of people living in a slum. METHODS: A community-based cross-sectional survey was designed to determine the prevalence of health conditions using a mobile screening toolkit-THULSI (Toolkit for Healthy Urban Life in Slums Initiative). Devarjeevanahalli slum was chosen purposively as it is fairly representative of any slum in a big city in India. Sample size was calculated as 1100 households and demographic parameters at the household level and parameters related to priority health conditions (hypertension, diabetes mellitus, anaemia and malnutrition) at the individual level were studied. Six zones within the slum were purposively selected and all the contiguous households were selected. The last of the six zones was partially surveyed as the desired sample size was achieved. RESULTS: A total of 1186 households were surveyed and 3693 people were screened. More than three fourth (70.4%) of the population were below poverty line. Only one third had a regular job and the average daily income was 5.3$ and 2.6$ in men and women respectively. The prevalence of hypertension (35.5%), diabetes (16.6%) and anaemia (70.9%) was high in the screened slum population. Most of the people (56.5% of hypertensives and 34.4% diabetics) were screened for the first time. Almost half of the children under the age of five years were stunted. CONCLUSIONS: Poor income security and huge burden of health issues were reported among adults and children in the household health screening in a large notified slum in South India. Most people were unaware of their disease condition prior to the screening. Relatively simple technological solutions enabled the local health team to screen the slum population despite many challenges.

Prevalence of complaints of arm, neck, and shoulders among computer professionals in Bangalore: A cross-sectional study.

INTRODUCTION: Complaints of arm, neck, and shoulders (CANS) is a common problem among patients whose work involves computer use, but often ignored most importantly by the physicians partly due to not being able to appreciate the importance of taking a careful detailed occupational history of exposure to a repetitive activity involving upper arms. Upper extremity musculoskeletal disorders constitute a major portion of occupation-related illness with annual costs related to treatment and absenteeism from work ranging between $45 and 54 billion in the United States. MATERIALS AND METHODS: A cross-sectional study was done to assess the factors contributing to CANS among computer professionals in Bangalore. We screened 206 professionals and 181 were administered Maastricht Upper Extremity Questionnaire (MUEQ). Chi-square and logistic regression were used. RESULTS: Prevalence of CANS in the study group was 58.6%. Neck complaints topped the list followed by shoulder, wrist, hand, elbow, upper arm, and lower arm complaints in the descending order. Women had overall higher prevalence and significantly higher prevalence of upper limb complaints than men. Inadequate space, maintaining good posture, and repetition of same tasks have emerged as an independent factors associated with CANS. CONCLUSION: CANS is highly prevalent among computer professionals working in small and medium-sized companies. Provision of adequate workspace and ergonomic designs of workstations are the modifiable risk factors which can be addressed by the employers to reduce the morbidity associated with CANS. Employees could correct postures and improve work habits.

Identification of priority health conditions for field-based screening in urban slums in Bangalore, India.

BACKGROUND: Urban slums are characterised by unique challenging living conditions, which increase their inhabitants' vulnerability to specific health conditions. The identification and prioritization of the key health issues occurring in these settings is essential for the development of programmes that aim to enhance the health of local slum communities effectively. As such, the present study sought to identify and prioritise the key health issues occurring in urban slums, with a focus on the perceptions of health professionals and community workers, in the rapidly growing city of Bangalore, India. METHODS: The study followed a two-phased mixed methods design. During Phase I of the study, a total of 60 health conditions belonging to four major categories: - 1) non-communicable diseases; 2) infectious diseases; 3) maternal and women's reproductive health; and 4) child health - were identified through a systematic literature review and semi-structured interviews conducted with health professionals and other relevant stakeholders with experience working with urban slum communities in Bangalore. In Phase II, the health issues were prioritised based on four criteria through a consensus workshop conducted in Bangalore. RESULTS: The top health issues prioritized during the workshop were: diabetes and hypertension (non-communicable diseases category), dengue fever (infectious diseases category), malnutrition and anaemia (child health, and maternal and women's reproductive health categories). Diarrhoea was also selected as a top priority in children. These health issues were in line with national and international reports that listed them as top causes of mortality and major contributors to the burden of diseases in India. CONCLUSIONS: The results of this study will be used to inform the development of technologies and the design of interventions to improve the health outcomes of local communities. Identification of priority health issues in the slums of other regions of India, and in other low and lower middle-income countries, is recommended.