Prevalence of postpartum depression & anxiety among women in rural India: Risk factors & psychosocial correlates.

BACKGROUND OBJECTIVES: Postpartum depression and anxiety (PPD/A) impact a woman's physical and psychological wellbeing. In the absence of corroboratory evidence from the community setting in India, the present study was undertaken to examine the prevalence, psychosocial correlates and risk factors for PPD/A in the rural community of India. METHODS: This cross-sectional study included 680 women during the postpartum period from a rural community in northern India. Screening for PPD/A was done using Edinburg Postnatal Depression Scale and State and Trait Anxiety Inventory. Diagnostic assessment of screened-positive women was done using Mini-International Neuropsychiatric Interview (MINI). The psychosocial evaluation was done on parameters including women's social support, bonding with the child, functionality, parental stress, interpersonal violence and marital satisfaction. RESULTS: The overall prevalence of PPD/A/both in community women was 5.6 per cent, with a specific prevalence of 2.2 per cent for PPD, 0.74 per cent for PPA and 2.8 per cent for both disorders. Comparative analysis indicated that women with PPD/A/both experienced significantly higher levels of parenting stress, poor lifestyle (prior two weeks), less support from their partner, parents-in-law and parents, less marital satisfaction, high intimate partner violence, poor bonding with infants and higher infant-focussed anxiety. On multivariable logistic regression analysis, higher education, marital satisfaction, support from partners and in-laws were associated with reducing the risk of PPD/A/both. INTERPRETATION CONCLUSIONS: Rural Indian women experience PPD/A/both which causes stress and impacts their functionality, bonding with the infant and relationship with their spouse and parents. Higher education, marital satisfaction and higher support from partners and in-laws reduce the risk of developing PPD/A/both.

Test concordance and diagnostic accuracy of three serological assays for detection of anti-SARS-CoV-2 antibody: result from a population-based sero-epidemiological study in Delhi.

BACKGROUND: Several methodological tests are available to detect SARS-CoV-2 antibody. Tests are mostly used in the aid of diagnosis or for serological assessment. No tests are fully confirmatory and have variable level of diagnostic ability. We aimed at assessing agreement with three serological tests: quantitative anti receptor binding domain ELISA (Q-RBD), qualitative ELISA (WANTAI SARS-CoV-2 Ab) and qualitative chemiluminescence assay (CLIA). METHODS: This study was a part of a large population based sero-epidemiological cohort study. Participants aged 1 year or older were included from 25 randomly selected clusters each in Delhi urban (urban resettlement colony of South Delhi district) and Delhi rural (villages in Faridabad district, Haryana). Three type of tests were applied to all the baseline blood samples. Result of the three tests were evaluated by estimating the total agreement and kappa value. RESULTS: Total 3491 blood samples collected from March to September, 2021, out of which 1700 (48.7%) from urban and 1791 (51.3%) from rural. Overall 44.1% of participants were male. The proportion of sero-positivity were 78.1%, 75.2% and 31.8% by Wantai, QRBD and CLIA tests respectively. The total agreement between Wantai and QRBD was 94.5%, 53.1% between Wantai and CLIA, and 56.8% between QRBD and CLIA. The kappa value between these three tests were 0.84 (95% CI 0.80-0.87), 0.22 (95% CI 0.19-0.24) and 0.26 (95% CI 0.23-0.28). CONCLUSIONS: There was strong concordance between Wantai and QRBD test. Agreement between CLIA with other two tests was low. Wantai and QRBD tests measuring the antibody to same S protein can be used with high agreement based on the relevant scenario.

New Delhi, India: Perceptions & apprehensions: A qualitative studyOral HIV self-testing among men who have sex with men in.

Background & objectives: The overall adult prevalence of HIV in India was estimated to be 0.22 per cent in 2019. The HIV prevalence among men who have sex with men (MSM), a high-risk group for HIV, was estimated to be 4.3 per cent, which is 16 times higher than the national average. In Delhi, the estimated prevalence among MSM was 1.8 per cent. Despite free HIV testing services being made available by the National AIDS Control Programme for more than two decades, many MSM were not aware about their HIV status. Therefore, newer testing strategies are needed. Oral HIV self-testing (HIVST) has proved to be one such promising innovation. At present, there are no programme guidelines on HIVST and oral HIVST kit is not available in India. The aim of this study was to understand the perceived advantages and disadvantages of introduction of oral HIVST strategy among MSM. Methods: MSM who were registered with the selected non-governmental organizations working as targeted intervention sites in Delhi, India, were recruited for focus group discussions (FGDs) between January and May 2021. For the purpose of this study, MSM were defined as males who had anal/oral sex with male/hijra partner in the past one month. A total of six FGDs were conducted using a prepared FGD guide. The FGD guide included questions on problems faced during conventional HIV testing, participants' awareness, acceptability and perceptions of oral HIVST. The data were manually coded and entered in NVivo release 1.5 and themes were identified. Results: A total of 67 respondents participated in the FGDs. A total of 28.4 per cent MSM were beggars at traffic lights, 12 per cent were sex workers and 11.9 per cent were bar/event dancers. Nearly half (50.7%) of the participants had undergone HIV testing less than twice in the preceding one year. None of the MSM were aware about oral HIVST. Perceived advantages of oral HIVST were ease of use, confidentiality and the non-invasive pain-free procedure. Perceived concerns included lack of post-test counselling, linkage to care, poor mental health outcomes and forced testing. Interpretation & conclusions: Most MSM had positive perceptions about oral HIVST. Therefore, it is likely that the introduction of oral HIVST may result in higher uptake of HIV testing among MSM.

Non-participation of female sex workers in HIV sentinel surveillance 2017 in the central zone, and its effect on observed HIV prevalence rate.

BACKGROUND: During HIV sentinel surveillance (HSS) 2017 round, the sampling strategy to recruit female sex workers (FSWs) was changed from consecutive to random sampling. This may affect the participation and HIV positivity rates among FSWs. OBJECTIVE: The objective of this study is to estimate the nonparticipation rates among FSWs and its effect on the observed HIV prevalence rate during HSS-2017. METHODS: The data were collected from FSW sentinel sites located in the states of Delhi, Jharkhand, Uttar Pradesh, and Uttarakhand (Central Zone). The HIV positivity rate among FSWs who participated in HSS-2017 was compared with the HIV positivity rate of those who did not participate. HIV status of the participants was obtained from HSS-2017 data. The master list of participating targeted intervention sites was accessed to obtain the last known HIV status of the eligible nonparticipants. RESULTS: Nonparticipation rate of FSWs from the central zone during HSS2017 was 10.8%. The HIV positivity rate among nonparticipant FSW was four times and six times higher in Delhi and UP, respectively. CONCLUSION: Selective nonparticipation of eligible FSWs might have led to the underestimation of the HIV positivity rate in the central zone during the HSS-2017 round.

Site preparedness and quality of HIV sentinel surveillance at antenatal care clinic sites in India, 2019.

BACKGROUND: Quality of HIV sentinel surveillance (HSS) depends on preparedness of the site and adherence to the standard operating procedures (SOPs) for HSS. A designated sentinel site is considered prepared for the round of sentinel surveillance based on the availability of infrastructure, human resource, and consumables. OBJECTIVES: The study objectives were to describe the site level preparedness and adherence to SOP of antenatal care clinic (ANC) sites during the 16th round of HSS in India. METHODS: This was a cross-sectional study based on the findings of the supervisory visits conducted by public health specialists in ANC sites during the 16th round of HSS from January to March 2019. Semi-structured checklists were used to assess site-preparedness and adherence to the SOP for HSS. All supervisors were expected to upload the filled pro forma to the HSS management information system (MIS). We present here a descriptive analysis of the uploaded visit reports. RESULTS: Of 870 HSS sites, 783 (90%) were visited, and 479 (61.2%) reports were uploaded to MIS. Preround HSS training was not attended by one-fifth (22.6%) of the site in-charges; 35.8% of them had never received any HSS training. SOP was followed at most (94%) of the sites. The most frequently reported problem at the sites was inadequate or delayed availability of consumables. CONCLUSION: The overall quality of site-level preparedness at antenatal clinic sites in India was good. Attention needs to be given to timely and adequate availability of consumables at sentinel sites along with proper administrative support and preround training of site in-charges.

Maternal health care access among migrant women labourers in the selected brick kilns of district Faridabad, Haryana: mixed method study on equity and access.

BACKGROUND: Socio-economic inequity leads to health inequity. Inequity is closely intertwined with internal migration. This study was planned with the objective of documenting the maternal health care utilization among women labourers working in brick kilns situated in an area of Haryana, north India. METHODS: A community based mixed method study was done in select brick kilns of Faridabad district in north India. A mixed method study was done to assess maternal health care utilization in a sample of 500 women in the reproductive age group. Focus group discussions were also carried out. Descriptive analysis was done. Qualitative data was analysed using the thematic framework approach. RESULTS: The mean age of the women was 30 (SD 0.3) years. Mean number of pregnancies per woman was 3.1 (SD 1.7). Only 22.9% ever had institutional delivery. About one third of women had ever received cash benefit under Janani SurakshaYojana (JSY) or had ever used free ambulance services. Seven major themes emerged from the qualitative analysis. Important themes include-Gaps in knowledge regarding local health system; Sub-standard private health care delivered at brick kilns prevent migrants from accessing the basic public health services; Misconceptions and mistrust about public health system influenced maternal health care utilization; Barriers to avail universal health coverage: location of brick kilns, time, apathy of public health system, partial health insurance cover. CONCLUSIONS: A typical migrant woman labourer in the brick kiln was an illiterate, had migrated from poor states, belonged to a socially disadvantaged community and worked long hours, and had been doing so for many years. This study has identified migrant women working in brick kilns as a vulnerable population subgroup in terms of maternal health utilization. To achieve universal health care it is important to understand the needs of all population subgroups and make concerted efforts at the health system level.

Assessment of implementation status of Cigarettes and Other Tobacco Products Act (COTPA) and its awareness among residents in a block of Haryana.

BACKGROUND: Legislative route is one of the known method to control behaviour of population. Cigarette and Other Tobacco Products Act is one of the laws enacted to control the use of tobacco in India lunched in the year 2003. OBJECTIVE: The objective of this study was to find compliance of COTPA among tobacco stores and to find the knowledge of people regarding COTPA. METHODS: All selected communities were studied by community audit. All stores selling tobacco products were assessed for its compliance to COTPA. Thirty participants from selected communities with in the age range of 18- 65 years were selected and interviewed for knowledge regarding COTPA. RESULTS: A total of 218 stores were found to be selling tobacco. None of the stores were fully compliant to all COTPA clauses. Stores in rural areas were found to be more non-complaint than urban areas. 41% of stores were selling tobacco to minors, 10% were within 100 yards of schools.8% of schools have tobacco advertisement on façade and 24% displayed tobacco products openly. Around half of the participants (n-552) had heard about COTPA whereas only 4% were aware of all 4 provisions of COTPA. CONCLUSION: Although more than a decade passed since the law was enacted poor compliance and knowledge was found among participants.

Population-based estimate of urinary stones from Ballabgarh, northern India.

BACKGROUND: Stones in the urinary tract are a common condition but there is paucity of data on their population-based estimates in India. We describe our findings of the burden of urinary stones during a cross-sectional study with another primary goal. METHODS: We conducted the study at Ballabgarh Health and Demographic Surveillance System, Haryana, among residents aged 18 years or above. We used simple random sampling to enrol participants. Self-reported history of urinary stones was elicited through an interview schedule. Results of the descriptive analysis were described as proportions with 95% confidence intervals (CI) or as mean wherever applicable. Bivariate analysis was done using t-test and chi-square test as applicable. RESULTS: The response rate for our study was 86.6%; lifetime prevalence (95% CI) of urinary stones was 7.9% (5.7, 10.8). In a majority of participants, urinary stones were diagnosed at an age of 20-40 years (55.9%), mostly by an ultrasonography examination (94.1%). CONCLUSIONS: A high burden of urinary stones is indicated in the working-age population in northern India at the community level. Untreated urinary stones can lead to an acute emergency (colic) or may have long-term adverse consequences, e.g. hydronephrosis, which have implications for the healthcare delivery system.

Vitamin D status of adult females residing in Ballabgarh health and demographic surveillance system: A community-based study.

BACKGROUND: Vitamin D deficiency (VDD) is widespread, yet it is the most underdiagnosed and undertreated nutritional deficiency in the world. The prevalence of VDD is estimated to affect over 1 billion people worldwide. OBJECTIVES: The present study was conducted to estimate the prevalence of VDD among adult females aged 20-60 years residing in a rural community of North India, and to find its association with various sociobehavioral risk factors. METHODS: The present study is an analytical cross-sectional study conducted among females aged 20-60 years in rural Ballabgarh. Four hundred women were randomly selected from one of the villages of the Health and Demographic Surveillance System. Semi-structured, pretested interview schedule was administered to the study participants. Fasting venous blood sample was collected for the measurement of plasma sugar level and Vitamin D (25-hydroxyvitamin D). RESULTS: The prevalence of VDD was 90.8% (95% confidence interval [CI] - 87.5-93.3), while that of Vitamin D insufficiency was 8.9% (95% CI - 6.4-12.2). On logistic regression analysis, 24 h calorie intake, protein intake, and prediabetes status of the participants were significantly associated with VDD. CONCLUSION: Very high prevalence of VDD was observed among the females (20-60 years) residing in rural Ballabgarh.

Epidemiological Study of Patients of Road Traffic Injuries Attending Emergency Department of a Trauma Center in New Delhi.

BACKGROUND AND AIMS: There is paucity of data regarding some of the lesser known contextual and epidemiological factors with respect to road traffic injuries (RTIs). The objective was to study the epidemiological profile of RTI victims attending an emergency department of a tertiary care trauma center. METHODS: The present study was a hospital-based cross-sectional study conducted in the emergency department of a tertiary care trauma center in New Delhi. All patients of RTI attending the emergency department during the designated data collection days were included in the study. Patients brought dead were excluded from the study. A semi-structured interview schedule was developed for collecting data on various domains such as sociodemographic characteristics, vehicle-related factors, accident site-related factors, personal protection measures, contextual factors, and prehospital care-related factors. RESULTS: A total of 984 patients and informants were approached and finally data of 900 participants were analyzed after excluding those who refused participation and those for whom incomplete data were available. Out of 900 RTI victims, 756 were male (84.0%) and 144 (16.0%) were female. Mean age of the victims was 32.7 years. Most of the victims, i.e., 377 out of 900 (41.9%) were occupants rather than drivers. Majority of victim's vehicle meeting accidents were motorized two-wheelers (53.4%), and majority of the colliding vehicle was a four-wheeler (39.3*). Helmet use was found to be low (63.3%), but seat belt use was particularly low (32.4%). Most accidents (28%) happened between midnight and 6 A.M. More than half of the victims were in a hurry on the day of the accident. An ambulance was used to transport the victims in only 14.6% cases. CONCLUSION: In road traffic accidents some lesser known epidemiological data were generated that may be useful in defining preventive measures.

Prevalence of nonalcoholic fatty liver disease in an adult population in a rural community of Haryana, India.

BACKGROUND: Though nonalcoholic fatty liver disease (NAFLD) is increasingly becoming prevalent in the Indian population, knowledge regarding the burden and risk factors of NAFLD is limited, more so from rural areas. This study was thus conducted to estimate the prevalence of NAFLD among adults in a rural community of Haryana, India and to measure the association of diet, physical activity, and other selected risk factors with NAFLD. MATERIALS AND METHODS: The present study was conducted in a rural community of Haryana, India among resident adults ≥35 years of age. Eight out of 28 villages were selected by probability proportion to size sampling. The number of eligible and consenting participants randomly selected from each village was 27. Out of 216 participants thus recruited, 184 participants reported for undergoing ultrasonography (USG) of the liver, anthropometry, blood pressure recording, and blood sample collection. Finally, 176 participants were analyzed. RESULTS: Prevalence of NAFLD was 30.7%. There was no significant difference in the calorie intake and average total physical activity between participants with and without NAFLD. On multivariate analysis, hypertension [adjusted odds ratio (OR): 2.3, 95% confidence interval (CI): 1.1-5.0, P 0.03] and an increased waist circumference (adjusted OR: 4.9, 95% CI: 1.5-7.0, P < 0.001) were independently associated with NAFLD. A normal high-density lipoprotein (HDL) level was protective against NAFLD (adjusted OR: 0.4, 95% CI: 0.2-0.8, P 0.001). CONCLUSIONS: The high prevalence of NAFLD is already a public health problem, even in the rural parts of India. Urgent public health interventions are required to prevent its development by controlling the cardiometabolic risk factors associated with it.

Epidemiology of acute respiratory infections in children - preliminary results of a cohort in a rural north Indian community.

BACKGROUND: Despite acute respiratory infections being a major cause of death among children in developing countries including India, there is a lack of community-based studies that document its burden and aetiology. METHODS: A dynamic cohort of children aged 0-10 years was established in four villages in a north Indian state of Haryana from August 2012 onwards. Trained health workers conducted weekly home visits to screen children for acute respiratory infection (ARI) defined as one of the following: cough, sore throat, nasal congestion, earache/discharge, or breathing difficulty. Nurses clinically assessed these children to grade disease severity based on standard age-specific guidelines into acute upper or lower respiratory infection (AURI or ALRI) and collected nasal/throat swabs for pathogen testing. RESULTS: Our first year results show that ARI incidence in 0-10 years of age was 5.9 (5.8-6.0) per child-year with minimal gender difference, the ALRI incidence in the under-five age group was higher among boys (0.43; 0.39-0.49) as compared to girls (0.31; 0.26-0.35) per child year. Boys had 2.4 times higher ARI-related hospitalization rate as compared to girls. CONCLUSION: ARI impose a significant burden on the children of this cohort. This study platform aims to provide better evidence for prevention and control of pneumonia in developing countries.

Decadal transition of adult mortality pattern at Ballabgarh HDSS: evidence from verbal autopsy data.

BACKGROUND: Mortality levels and patterns are significant indicators of population health, and are of importance to prioritize the goals of health systems and efficient resource allocation. We ascertained the decadal transition of mortality pattern in adult population aged 15 years and above during the years 2002-2011. METHODS: All adult deaths aged 15 years and above during the years 2002 to 2011 were included in the study. Cause of death was ascertained by verbal autopsy tool for adults which is a validated questionnaire developed at Ballabgarh Health and Demographic Surveillance System (HDSS). Cause and age specific mortality, and mean age at death was determined for individual years. RESULTS: A total of 4,276 deaths (≥15 years) occurred in the Ballabgarh HDSS during the years 2002 to 2011. Of these, 96.8 % deaths were investigated using verbal autopsy tool. Of total deaths investigated, 60.6 % were males. Cardiovascular diseases (19.6 %) were the leading cause of death, followed by respiratory diseases (16.5 %). In the age group of 15-59 years, the most common cause of mortality was external causes of mortality (28.9 %). Most common cause of death was senility (20.8 %) in females, whereas cardiovascular diseases were commonest cause (19.6 %) in males. Road traffic injuries contributed 6.7 % deaths in males compared to 1.5 % in females. Over the years, the proportions of mortality due to cardiovascular diseases had increased (12.6 % to 18.8 %). Mortality proportions had decreased for infectious diseases (12.1 % to 9.5 %) and respiratory diseases (24.7 % to 10.9 %). Mortality due to neoplasms remained nearly stagnant (6.6 % to 6.4 %). Mean age at death due to cardiovascular diseases and neoplasm had increased from 57 years (95 % CI: 52.2-62.9) to 62 years (95 % CI: 59.2-65.4) and 58 years (95 % CI: 53.1-63.2) to 62 years (95 % CI: 57.0-66.7), respectively, during the decade. Mean age at death had decreased for road traffic injuries and infectious diseases from 41 years (95 % CI: 31.7-50.8) to 39 years (95 % CI: 34-43.4) and 53 years (95 % CI: 48.3-58.6) to 50 years (95 % CI: 44.1-55.8), respectively over the years. CONCLUSION: Mortality surveillance using verbal autopsy tool revealed a transition in cause specific deaths from respiratory diseases to cardiovascular diseases over the decade. The apparent epidemiological transition in the community demands reorientation of healthcare priorities.

Induced abortion in villages of Ballabgarh HDSS: rates, trends, causes and determinants.

BACKGROUND: Induced abortion has been legal in India on a broad range of medical and social grounds since 1980s. Often, induced abortion is resorted to as a means for contraception, and has a potential to be misused for sex selective feticide. We assessed the rates, trends, causes and determinants of induced abortions from 2008-12 in a rural community of northern India. METHODS: Present study is a secondary data analysis of pregnancy outcomes at Ballabgarh Health and Demographic Surveillance System from 2008-12. The data was retrieved from the Health and Management Information System maintained at Ballabgarh. Cause of abortion was self-reported by the women who underwent abortion. RESULTS: Of the 11,102 pregnancies, 1,226 (11%) culminated as abortions of which 425 (3.8%) were induced abortions. Spontaneous abortion rate (7.2%) was twice that of induced abortion rate (3.8%). Both abortion rates had an increasing trend during the course of the study period. Self-reported reasons for opting for induced abortions were bleeding per vaginum (23%), unwanted pregnancy (16%), and unviable fetus diagnosed by ultrasonography (11%). Eight percent of the induced abortions were due to the female sex of the fetus. About 11% of the abortions were performed beyond 20 weeks of gestation which was the upper legal permissible gestational age for performing induced abortions in India. About 10% of the abortions were performed by unqualified practitioners. Caste, wealth index, birth order and size of the village population were the factors that were significantly associated with induced abortion. CONCLUSIONS: Though the abortion rate was low, the proportionate contribution of induced abortion was more than what could be expected. Unsafe and sex selective abortion, though illegal, was prevalent. Upper caste and higher socio-economic status families were more likely to opt for induced abortion.

Prevalence and determinants of sexually transmitted infections (STIs) among male migrant factory workers in Haryana, North India.

BACKGROUND: Male migrant workers display high risk sexual behavior and have been shown to have higher prevalence of sexually transmitted infections (STIs), which make them more vulnerable to HIV infection. We aimed to estimate the prevalence of self-reported STIs and delineate their determinants among male migrant factory workers in Faridabad, Haryana. MATERIALS AND METHODS: Male workers in two selected factories, who were aged ≥18 years, were born outside Haryana (destination), and who had migrated to Haryana after the age of 15 years were eligible. Socio-demographic information, HIV/AIDS knowledge and behavior, and self-reported STI symptoms in the last 1 year were ascertained by face-to-face interview. Determinants of STIs were identified by regression analysis. RESULTS: Totally 755 eligible workers participated. Mean ± SD age was 31.4 ± 8.2 years and migration duration was 9.5 ± 6.7 years. At least one STI symptom was reported by 41.7% of the participants (burning micturition- 35%, inguinal bubos-5.2%, genital ulcers- 2.6%, urethral pus discharge- 1.3%). Factors associated with STIs were higher age at migration, lower HIV/AIDS knowledge, paid sex in the last year, non-use of condoms during the last non-spousal sex, and unfavorable intention to use condom. CONCLUSION: Prevalence of self-reported STIs among these migrant men was high. Targeted Interventions among migrant workers need to be strengthened for control and prevention of STIs.

Perception and Practices Regarding Stubble Burning in Rural Community of Haryana.

Background: Agricultural emissions pose significant health risks, especially in countries like India with abundant agricultural waste. This study focuses on understanding stubble burning perceptions and practices in rural National Capital Region to inform targeted interventions for sustainable farming practices and improved public health. Methods and Material: This community-based cross-sectional study was conducted among the randomly selected households of rural Ballabgarh, Haryana. A pre-tested, semi-structured questionnaire was used to obtain information on perception and practices on stubble burning. Data were collected in Epicollect 5 and analyzed in STATA 14. Results: Of the 2000 households approached, 1813 responded with a response rate of 90.7%. Around 53% of the study participants believed that vehicular pollution is the main reason for air pollution, and 90% of them were unaware of the Government schemes related to stop stubble burning and with respect to the practices of stubble disposal. Around 70% of the participants mentioned that respiratory illness is the most severe effect of air pollution. Conclusion: The public was mostly unaware of the government's efforts to reduce stubble burning. Health promotion initiatives must be carried out to raise community knowledge about the programs available to combat stubble burning, therefore decreasing air pollution and its health implications.

Effectiveness of targeted intervention program under the national AIDS control program among Hijra and transgender population: Evidence from Integrated Biological and Behavioral Surveillance, 2014-15.

INTRODUCTION: The hijra and transgender (H/TG) population in India is vulnerable to HIV/AIDS. India had instituted a targeted intervention (TI) program to reduce this vulnerability. We aimed to measure the effectiveness of the TI program for H/TG. MATERIALS AND METHODS: The National Integrated Behavioral and Biological Survey (IBBS) was carried out in 2014-15. H/TG data from IBBS was analyzed. Bivariate and multivariate logistic regression were used to calculate the unadjusted and adjusted odds ratios with 95% confidence interval. Condom use during the last sexual intercourse, and the consistent condom use in the last one month were considered as indicators of program effectiveness. The Propensity Score Matching (PSM) method was used to assess the effectiveness. RESULTS: We found that the participants who had received condoms from peer educator/outreach worker were 1.74 and 1.40 times more likely to use condoms in the last sexual intercourse (aOR: 1.74, CI: 1.35 - 2.26) and consistent condom use in the last one month (aOR: 1.40, CI: 1.12 - 1.74) respectively compared to the participants who did not receive the condom. The matched-samples estimate (i.e., average treatment effect on treated) for the condom use during the last sexual intercourse increased by 13.0%, i.e., 0.13 (CI; 0.08 - 0.18) and consistent condom use in the last one month increased by 5.0%, i.e., 0.05 (CI; 0.00 - 0.10) among those who had received condoms from the peer educator/outreach worker compared with those who had not received condom, respectively. CONCLUSIONS: The TI program intervention for H/TG was effective in reducing HIV risk behavior as evidenced by increase in use of condom during last sexual intercourse, and consistent condom use in the last one month.

Long-Term Kinetics of SARS-CoV-2 Neutralizing and Anti-Receptor Binding Domain Antibodies among Laboratory-Confirmed COVID-19 Cases in Delhi National Capital Region, India: A Prospective, One-Year Follow-Up Study.

Background: This study was conducted with the objective of measuring the neutralizing and anti-receptor binding domain antibody levels against SARS-CoV-2 among laboratory-confirmed COVID-19 cases and exploring its long-term kinetics over a period of 1 year. Methods: One hundred laboratory-confirmed COVID-19 cases were recruited. Serum samples of the participants were collected within three months from the date of the positive COVID-19 report. The participants were prospectively followed up every three months for symptoms and the collection of blood samples for three additional rounds. The presence of anti-SARS-CoV-2 antibodies (IgA, IgG, and IgM antibodies), anti-receptor binding domain antibodies (anti-RBD), and neutralizing antibodies were measured. Findings: Median plaque reduction neutralization test (PRNT) titers showed a rising trend in the first three rounds of follow-up. The quantitative anti-receptor binding domain ELISA (QRBD) values showed a declining trend in the initial three rounds. However, both the PRNT titers and QRBD values showed significantly higher values for the fourth round of follow-up. Total antibody (WANTAI) levels showed an increasing trend in the initial three rounds (statistically significant). Interpretation: Neutralizing antibodies showed an increasing trend. The anti-receptor binding domain antibodies showed a decreasing trend. Neutralizing antibodies and anti-RBD antibodies persisted in the majority.

Prevalence of metabolic syndrome and its selected determinants among urban adult women in South Delhi, India.

AIMS: Metabolic syndrome is a clustering of cardiovascular risk factors. Asian Indians, particularly women, have been reported to be at higher risk of developing metabolic syndrome. We aimed to estimate the prevalence of metabolic syndrome and its selected known determinants among adult Asian Indian women of lower socioeconomic status. METHODS: We conducted a cross-sectional study over a period of 1 year from January 2008 to December 2008 in South Delhi, which included 300 women (>20 years) recruited through multistage systematic random sampling. Blood pressure and anthropometric measurements were taken. Biochemical tests were performed on blood samples collected after overnight fasting. Metabolic syndrome was defined using updated National Cholesterol Education Program/Adult Treatment Panel-III (NCEP/ATP-III) guidelines with modified waist circumference for Indians and International Diabetes Federation (IDF) criteria. RESULTS: The overall prevalence of metabolic syndrome was 29.6% (95% CI 23.8 to 36.0) and 20.4% (95% CI 15.3 to 26.1) using NCEP/ATP-III and IDF criteria, respectively. The risk of metabolic syndrome increased with age and calorie intake. Most (203 (90%)) of the study participants were involved in physical activity with a low metabolic equivalent (MET) score but one-fifth (19.5%) had a calorie intake recommended for women involved in vigorous activity. CONCLUSIONS: The high prevalence of metabolic syndrome among women of lower socioeconomic status is a cause of concern, and calls for an effective public health response.