Journal of Preventive Medicine and Public Health

Original Articles

Prevalence and Severity of Depression Among Patients With Anemia Attending a Rural Outpatient Clinic in Faridabad, India: A Cross-sectional Study: Prince , Urvashi , Rajat Sharma, Jubair Shamsi, Satya Vir Singh; J Prev Med Public Health. 2025;58(6):629-634. Published online August 9, 2025; DOI: https://doi.org/10.3961/jpmph.25.363

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Abstract Summary PDF: Objectives
This study was performed to determine the prevalence and severity of depression among patients previously diagnosed with anemia and to explore associated clinical and socio-demographic factors.
Methods
This cross-sectional study was conducted from October 2024 to February 2025, among 300 patients with anemia attending the outpatient clinic at the Rural Health Training Centre, Amrita School of Medicine, Faridabad, Haryana. Data on socio-demographic and clinical variables were collected using a structured questionnaire. Depression was evaluated using the Patient Health Questionnaire-9 (PHQ-9). Associations of anemia severity with depression presence and severity were analyzed using the chi-square test, logistic regression, and ordinal logistic regression, with adjustment for potential confounders.
Results
The prevalence of depression (PHQ-9 score>9) among patients with anemia was 31.3%. Severe anemia was significantly associated with higher odds of depression (adjusted odds ratio [aOR], 3.02; 95% confidence interval [CI], 1.13 to 8.07; p=0.027) and more severe depression (aOR, 2.87; 95% CI, 1.14 to 7.27; p=0.026). Symptoms such as weakness (aOR, 3.57) and shortness of breath (aOR, 2.71) were also significantly associated with depression. Moderate anemia displayed a non-significant trend.
Conclusions
Severe anemia is independently associated with both the presence and severity of depression. Routine mental health screening should be integrated into anemia management protocols, especially in rural healthcare settings.; Summary

Key Message
Anemia is a common problem in India, whereas there is a growing awareness about mental health issues like depression. This study was conducted at a Rural Health Training Centre in India, to estimate the prevalence and severity of depression among patients with anemia. The prevalence of anemia was found to be 31.3% (PHQ-9 score > 9), and severe anemia was associated with higher odds of depression and more severe depression. Our study indicated a need of routine mental health screening in patients with anemia.

COVID-19 Vaccine Acceptance and Hesitancy: Perceptions in Kerala, the Indian State With the Highest Literacy: Dhanya Muralidharan, Arun Paul, Suhaila Panangadanakath, Sreelakshmi T. Nandakumar, Shana S. Poothotill, Rahila A. MoiduKunhi, Zainul Ameen; J Prev Med Public Health. 2025;58(5):527-537. Published online June 13, 2025; DOI: https://doi.org/10.3961/jpmph.25.137

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Abstract Summary PDF Supplementary Material

Objectives
Public acceptance of a vaccine determines whether pandemic control is successful. Most studies assessing coronavirus disease 2019 (COVID-19) vaccine acceptance were conducted before the vaccine became publicly available, whereas the actual intent to be vaccinated often differs once the vaccine is accessible. Therefore, this study investigated COVID-19 vaccine acceptance, hesitancy, and associated determinants among the general population of Kerala, India, after the vaccine became available.
Methods
A cross-sectional descriptive online survey was conducted using a structured and validated questionnaire in both English and Malayalam. It collected information on contextual influences, individual perceptions, group influences, COVID-19 vaccine-specific factors, and attitudes toward COVID-19 vaccination.
Results
Of the 1078 participants, 85.0% (n=916) accepted the COVID-19 vaccine, while 15.0% (n=162) were hesitant. Factors predicting vaccine hesitancy included male sex, younger age, lower educational attainment (school level), lower income, being unmarried, and not having children. Key determinants of vaccine hesitancy identified were concerns regarding vaccine safety and effectiveness, lack of trust in the government, insufficient information provided through the vaccination program, disbelief in vaccination’s protective role against COVID-19, and perception of the vaccination process as complicated and inconvenient.
Conclusions
Vaccine-hesitant individuals do not perceive COVID-19 vaccination as a social responsibility to their community. Digitization of the vaccination process may not be suitable for all segments of society, indicating that additional support for persons from lower socioeconomic statuses may be necessary to enhance acceptance. The newly identified areas of concern can guide government and healthcare workers, both nationally and globally, in effectively addressing and mitigating vaccine hesitancy.

Summary

Key Message
Real intent to vaccinate varies following availability of newly introduced vaccines. Most studies assessing determinants of COVID-19 vaccine acceptance and hesitancy were performed prior to vaccine availability in India. None have assessed the degree of acceptance after vaccine was available for the general public above 18 years. The study findings provide more valid and meaningful understanding of determinants of vaccine hesitancy, emphasizing the need for identifying and educating hesitant individuals, highlighting need for greater involvement of health care workers. Newer focus areas identified will aid Government and Health care workers nationally and globally in preventing a rise in vaccine hesitancy.

Citations

Citations to this article as recorded by

Underreporting of Adverse Events Following COVID-19 Vaccination Among Healthcare Professionals in Poland: Potential Implications for Vaccine Hesitancy
Jakub Grabowski, Anna Niebrzydowska, Aleksandra Brzozowska, Przemysław Waszak, Paweł Zagożdżon, Shan Ali, Tomasz Brancewicz, Monika Wolff, Aleksandra Macul-Sanewska, Leszek Bidzan
Tropical Medicine and Infectious Disease.2025; 10(11): 320. CrossRef

Prevalence, Sources, and Correlates of Second-hand Smoke Exposure Among Non-smoking Pregnant Women in India: Farheen Ahmed, Nilesh Gawde, Sulabha Parasuraman; J Prev Med Public Health. 2025;58(2):136-145. Published online December 4, 2024; DOI: https://doi.org/10.3961/jpmph.24.278

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Abstract Summary PDF: Objectives
Second-hand tobacco smoke (SHS) is a risk factor for adverse health outcomes, particularly among pregnant women. This study aimed to address the research gap concerning the prevalence and correlates of SHS exposure at home and in public settings among non-smoking pregnant women in India.
Methods
The dataset from the Global Adult Tobacco Survey (2016-17), India, was utilised to evaluate the prevalence of SHS exposure in pregnant women both at home and in public spaces. Multivariable logistic regression analysis was employed to identify the determinants of SHS exposure among this population.
Results
The prevalence of SHS exposure at home was 36.9%, while exposure outside the home was 26.5%. Among non-smoking pregnant women, 10.0% were exposed to SHS on public transport. The risk of SHS exposure at home was significantly higher in the North (adjusted odds ratio [aOR], 5.33; 95% confidence interval [CI], 2.45 to 11.60), Central (aOR, 4.46; 95% CI, 1.98 to 10.02), and Northeast (aOR, 4.18; 95% CI, 1.78 to 9.81) regions compared to the South. Pregnant women aged 25-34 (aOR, 0.61; 95% CI, 0.39 to 0.93) and those aged 35 and above (aOR, 0.48; 95% CI, 0.27 to 0.86), as well as those with secondary (aOR, 0.50; 95% CI, 0.30 to 0.85) or higher education (aOR, 0.30; 95% CI, 0.15 to 0.58), had lower odds of SHS exposure at home. For SHS exposure outside the home, the North region (aOR, 2.53; 95% CI, 1.19 to 5.36), employment status (aOR, 1.99; 95% CI, 1.13 to 3.47), and belonging to scheduled tribes (aOR, 3.20; 95% CI, 1.25 to 8.21) were associated with higher odds.
Conclusions
The prevalence of SHS exposure among pregnant non-smoking women was notably high both at home and in external environments.; Summary

Key Message
Our secondary analysis of GATS-2 India data (2016-17) showed that the prevalence of Second-hand Tobacco smoke (SHS) exposure at home was high (36.9%) among non-smoking pregnant women in India. Among pregnant women, younger age, lower education levels, and residing in the country's North, Central, and Northeast regions were significantly associated with higher odds of SHS exposure at home. Overall, about a quarter (26.5%) of pregnant women reported SHS exposure outside their home. Tribal women, employed ones, and those residing in the North region were at higher risk of SHS exposure outside their homes during their pregnancies.

Understanding the Perspectives of Paediatric Physicians on Physiotherapy in Paediatric Rehabilitation in Chennai, India: A Qualitative Approach: Vadivelan Kanniappan, Abishek Jayapal Rajeswari, Pearlyn Esther Padma Lawrence, Subash Sundar; J Prev Med Public Health. 2024;57(2):157-166. Published online January 21, 2024; DOI: https://doi.org/10.3961/jpmph.23.426

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Abstract Summary PDF Supplementary Material

Objectives
Children with disabilities may exhibit a multitude of symptoms, and treatment requires a multidisciplinary approach for a satisfactory outcome. Lack of awareness among physicians, lack of referral, and lack of inter-sectoral coordination have hindered paediatric practice in Tamil Nadu, a state in India with a striking childhood disability rate that warrants a timely interdisciplinary approach. However, the perspectives of paediatricians on paediatric physiotherapy are unknown. The aim of the study was to investigate the perspectives of practicing paediatric physicians in Chennai on the role of physiotherapy in paediatrics.
Methods
For an in-depth exploration, qualitative semi-structured interviews were conducted in person with 10 paediatricians. Audio from the sessions was recorded and transcribed, and data saturation was achieved through iterative analysis.
Results
A grounded theory analysis of the results yielded 5 domains under which the perspectives and expectations of the physicians were described, along with the barriers experienced by patients’ parents as explained by their paediatrician. The responses highlighted deficits in awareness, structural support, accessibility and direct communication between physicians and physiotherapists.
Conclusions
Paediatric physicians have different opinions, and some ignorance persists concerning paediatric physiotherapy. This study warrants a proper structure of the paediatric rehabilitation unit and regular interdisciplinary meetings and focus group discussions to increase access for parents and improve patient outcomes.

Summary

Key Message
The paper investigates the views of pediatricians in Chennai, Tamil Nadu, India, about pediatric physiotherapy. It finds themes including the value of a multidisciplinary approach, the function of experienced physiotherapists, and parental access restrictions via qualitative interviews with ten doctors. To maximize patient outcomes, recommendations include raising awareness, strengthening multidisciplinary cooperation, and creating centralized pediatric rehabilitation centers.

Citations

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Knowledge and awareness of developmental delays, the role of physiotherapy in gross motor delays, and effective lifting and carrying techniques among parents of children with developmental delays – An observational study
Sachin Chaudhary, Megha Rao, Neha Sachin Chaudhary, Sarika Shrivastav, Sakshi Uttamchandani, Snehal Samal
Physiotherapy - The Journal of Indian Association of Physiotherapists.2025; 19(2): 147. CrossRef
“This is Something Else, It is Not Like Physical Therapy in the Clinic”: Perspectives of Stakeholders About School-Based Physical Therapy
Nilly Waiserberg, Paula Feder-Bubis
Physical & Occupational Therapy In Pediatrics.2025; : 1. CrossRef
Impact of model physiotherapy centres in reducing the burden among the caregivers of children with neurodevelopmental disorders in the rural area of Tamil Nadu: a study protocol
Vadivelan Kanniappan, Prakash Muthuperumal, P. Venkataraman, T. S. Veeragoudhaman, Balaji Chinnasami, Manikumar Muthiah, Abishek Jayapal Rajeswari, Manju Bashini Manoharan, Shrisruthi Suresh, Ashok Natesan
Journal of Health, Population and Nutrition.2024;[Epub] CrossRef

Effects of Antiretroviral Therapy on the Survival of Human Immunodeficiency Virus-positive Adult Patients in Andhra Pradesh, India: A Retrospective Cohort Study, 2007-2013: Ram Bajpai, Himanshu Chaturvedi, Lakshmanan Jayaseelan, Pauline Harvey, Nicole Seguy, Laxmikant Chavan, Pinnamaneni Raj, Arvind Pandey; J Prev Med Public Health. 2016;49(6):394-405. Published online October 28, 2016; DOI: https://doi.org/10.3961/jpmph.16.073

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Abstract PDF

Objectives
The survival outcomes of antiretroviral treatment (ART) programs have not been systematically evaluated at the state level in India. This retrospective study assessed the survival rates and factors associated with survival among adult human immunodeficiency virus (HIV)-infected patients in Andhra Pradesh, India.
Methods
The present study used data from 139 679 HIV patients aged ≥15 years on ART who were registered from 2007 to 2011 and were followed up through December 2013. The primary end point was death of the patient. Mortality densities (per 1000 person-years) were calculated. Kaplan-Meier and Cox-regression models were used to estimate survival and explore the factors associated with survival.
Results
The overall median follow-up time was 16.0 months (2.0 months for the deceased and 14.0 months for those lost to follow-up). Approximately 13.2% of those newly initiated on ART died during follow-up. Of those deaths, 56% occurred in the first three months. The crude mortality rate was 80.9 per 1000 person-years at risk. The CD4 count (adjusted hazard ratio [aHR],4.88; 95% confidence interval [CI], 4.36 to 5.46 for <100 cells/mm³ vs. >350 cells/mm³), functional status (aHR, 3.05; 95% CI, 2.82 to 3.30 for bedridden vs. normal), and body weight (aHR, 3.69; 95% CI, 3.42 to 3.97 for <45 kg vs. >60 kg) were strongly associated with the survival of HIV patients.
Conclusions
The study findings revealed that high mortality was observed within the first three months of ART initiation. Patients with poor baseline clinical characteristics had a higher risk of mortality. Expanded testing and counseling should be encouraged, with the goal of ensuring early enrollment into the program followed by the initiation of ART in HIV-infected patients.

Summary

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Highly active antiretroviral therapy is necessary but not sufficient. A systematic review and meta-analysis of mortality incidence rates and predictors among HIV-infected adults receiving treatment in Ethiopia, a surrogate study for resource-poor settings
Beshada Zerfu Woldegeorgis, Yordanos Sisay Asgedom, Aklilu Habte, Gizachew Ambaw Kassie, Abebe Sorsa Badacho
BMC Public Health.2024;[Epub] CrossRef
Association Between Body Mass Index Variation and Early Mortality Among 834 Ethiopian Adults Living with HIV on ART: A Joint Modelling Approach
Animut Alebel, David Sibbritt, Pammla Petrucka, Daniel Demant
Infectious Diseases and Therapy.2023; 12(1): 227. CrossRef
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Ramón E. R. González, Pedro Hugo de Figueirêdo, Sergio Galvao Coutinho
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Rate and Predictors of Mortality Among Adults on Antiretroviral Therapy at Debre Markos Referral Hospital, North West Ethiopia
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Predictors of Mortality Among Adult HIV-Infected Patients Taking Antiretroviral Therapy (ART) in Harari Hospitals, Ethiopia
Abdi Birhanu, Tariku Dingeta, Moti Tolera
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Medical Journal Armed Forces India.2020; 76(3): 284. CrossRef
How varying CD4 criteria for treatment initiation was associated with mortality of HIV-patients? A retrospective analysis of electronic health records from Andhra Pradesh, India
Ram Bajpai, Himanshu K Chaturvedi, Josip Car
Journal of Global Health.2020;[Epub] CrossRef
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Rimke Bijker, Sasisopin Kiertiburanakul, Nagalingeswaran Kumarasamy, Sanjay Pujari, Ly P Sun, Oon T Ng, Man P Lee, Jun Y Choi, Kinh V Nguyen, Yu J Chan, Tuti P Merati, Do D Cuong, Jeremy Ross, Awachana Jiamsakul
Antiviral Therapy.2020; 25(3): 131. CrossRef
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Zaw Zaw Aung, Yu Mon Saw, Thu Nandar Saw, Nwe Oo, Hnin Nwe Ni Aye, Sithu Aung, Htun Nyunt Oo, Su Myat Cho, Moe Khaing, Tetsuyoshi Kariya, Eiko Yamamoto, Nobuyuki Hamajima
International Journal of Infectious Diseases.2019; 80: 10. CrossRef

Food Security in Households of People Living With Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome: A Cross-sectional Study in a Subdivision of Darjeeling District, West Bengal: Pallabi Dasgupta, Sharmistha Bhattacherjee, Dilip Kumar Das; J Prev Med Public Health. 2016;49(4):240-248. Published online July 19, 2016; DOI: https://doi.org/10.3961/jpmph.16.023

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Abstract PDF

Objectives
Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) adversely impacts food security in households of people living with HIV/AIDS (PLWHA). Little research has focused on food insecurity among PLWHA in India. The purpose of this study was to identify the prevalence of and factors relating to food security in households of PLWHA in the Siliguri subdivision of Darjeeling, West Bengal, India.
Methods
A cross-sectional community-based study was carried out among 173 PLWHA residing in Siliguri and registered at the Anti-retroviral Therapy Centre of North Bengal Medical College & Hospital. Data was collected at the household level with interviews of PLWHA using a food security survey instrument. We analyzed the associations using logistic regression.
Results
The prevalence of household food security among the participants was 50.9% (88/173). Five years or more of schooling, higher socioeconomic class and males were found to be significantly associated with a higher likelihood of food security. A later stage of the disease and the presence of other family members with HIV/AIDS were significantly associated with a lower likelihood of food security. The major coping strategies to deal with food insecurity in the acute phase HIV infection included borrowing money (56.1%), followed by spousal support, loans from microfinance institutions, banks, or money lenders, borrowing food, or selling agricultural products.
Conclusions
The present study revealed that only about half of households with PLWHA were food secure. Prior interventions relating to periods of food and economic crisis as well as strategies for sustaining food security and economic status are needed in this area.

Summary

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