Rural Western India Research Articles

Determinants of right coronary artery occlusion in patients with inferior wall myocardial infarction: A cross-sectional study from Western India

ABSTRACT Introduction: In acute inferior wall myocardial infarction (IWMI) and occlusion of the right coronary artery (RCA), the most important element is to recognize the culprit artery and the location and size of the infarct, which is essential in the treatment. Adequate knowledge about clinical determinants can aid in prompt and effective management. Materials and Methods: A cross-sectional study was conducted to find determinants of RCA occlusion among 103 subjects with IWMI from rural western India. Results: About 86.4% of subjects were male. Females experienced IWMI at a later age than males (62.4 ± 10.3 vs. 58.6.1 ± 11.8 years). Bradycardia was more prevalent than tachycardia (44.66% vs. 15.53%). Males had a 5.17 times higher odds of having RCA involvement in IWMI. Subjects with deranged lipid profiles had 2.37 times higher odds of involvement of RCA. RCA involvement was significantly associated with bradycardia (P = 0.006, aOR = 15.31, 95% confidence interval [CI] = 2.21–105.7) but not with tachycardia (P = 0.903). Proximal site occlusion was significantly associated (P = 0.027; aOR = 0.103; 95% CI = 0.013–0.772) with bradycardia compared to distal sites. Triple-vessel disease had significantly (P < 0.05) 12.9 times higher odds than single-vessel disease. Total occlusion of RCA was 2.9 times higher than obstructive coronary artery disease. Conclusion: These findings suggest determinants associated with RCA involvement in IWMI, including gender, lipid profile, cardiac rhythm disturbances (particularly bradycardia), and the extent and site of coronary artery occlusion. Incorporating these factors into clinical practice, clinicians can better predict the underlying pathophysiology of IWMI, anticipate its hemodynamic and electrophysiologic consequences, and tailor management strategies accordingly.

Anemia Prevalence and Socioeconomic Status among Adolescent Girls in Rural Western India: A Cross-Sectional Study.

Anemia poses a significant challenge among Indian adolescent girls due to their heightened vulnerability, resulting from increased micronutrient requirements, rapid physical growth, menstrual blood loss, inadequate nutrition, and socioeconomic disparities. This study sought to evaluate the prevalence of anemia, along with socioeconomic and nutritional statuses among adolescent girls attending rural public schools in Pune, India. A sample of 400 girls was selected from 22 villages through Symbiosis International University. Hemoglobin levels were assessed using the HemoCue 201 system, while standardized protocols were employed for height, weight, and BMI-for-age measurements. Socioeconomic status was determined using the Kuppuswamy scale. The findings revealed an overall anemia prevalence of (42.75%), comprising severe (2.5%), moderate (21%) and mild (20.25%) cases. Additionally, a substantial proportion (74.6%) of girls were classified as underweight. Socioeconomic analysis disclosed that 64.25% of families belonged to the lower middle class, and 27% in the upper lower class. Anemia was more prevalent in young adolescent girls (10-14 years) and in the families of adolescents who had low income, were illiterate, unemployed, and belonged to the lower-middle class and upper-lower-class socio-economic status (SES) and did not have a bank account. Anemia was prevalent in adolescent girls and associated with low SES. This study underscores the limitations of relying solely on the distribution of iron and folic acid tablets to combat anemia. A holistic strategy is imperative, encompassing improvements in SES of families (literacy, employment and income), as well as initiatives aimed at enhancing the nutritional status of adolescent girls.

Feasibility and acceptability of the paediatric pulse oximeter in integrated management of neonatal and childhood illnesses (IMNCI) services by public health facilities: A qualitative study in rural Western India.

Pneumonia contributes to about 15% of child deaths globally, with 20% of the overall deaths occurring in India. Although WHO recommends the use of pulse oximeters (PO) in first-level facilities for early detection of child pneumonia in low- and middle-income countries (LMICs), this has not yet been implemented in India. We aimed to assess the feasibility and acceptability of introducing PO in integrated management of neonatal and childhood illnesses (IMNCI) services at primary health centres (PHC) in the rural Pune district. We identified medical officers (MO) and auxiliary nurse midwives (ANM) from six PHCs as study participants due to their involvement in the treatment of children. We developed in-depth interview (IDI) guides for both groups to explore their IMNCI knowledge and attitude towards the program through a qualitative study. We conducted interviews with MOs (n = 6) and ANMs (n = 6) from each PHC. The PO module was added to explore perceptions about its usefulness in diagnosing pneumonia. After baseline assessment, we conducted training sessions on adapted IMNCI services (including PO use) for MOs and ANMs. PO devices were provided at the study PHCs. At baseline, no PO devices were being used at study PHCs; PHC staff demonstrated satisfactory knowledge about paediatric pneumonia management and demanded refresher IMNCI training. They also felt the need to reiterate the PO use for early diagnosis of pneumonia in children and highlighted the challenges encountered in managing pneumonia at PHCs, such as health system-related challenges and parents' attitudes towards care seeking. There was positive acceptance of training and PO started to be used immediately in PHCs. There was increased confidence in using PO at endline. PO use in examining symptomatic children increased from 26 to 85%. Paediatric PO implementation could be integrated successfully at PHC levels; we found pre-implementation training and provision of PO to PHCs to be helpful in achieving this goal. This intervention demonstrated that an algorithm to diagnose pneumonia in children that included PO could improve case management.

Challenges of transforming evidence-based management of osteoarthritis into clinical practice in rural central Western India. Perceptions of an educational program.

Osteoarthritis (OA) is a major threat to public health worldwide and is predicted to increase. Existing interventions to implement clinical practice guidelines (CPGs) seem to be used mainly in the Western world. We conducted a structured educational program on the evidence-based management of OA (BOA) for Indian physical therapists (PT). Our study aimed to describe Indian PTs' knowledge, attitudes and confidence on evidence-based management of OA, and their perceptions of a course on this subject. The 2-day course included didactic parts and practical skills training. Thirty-five PTs participated and answered a questionnaire. Fourteen of them participated in focus group interviews. Questionnaire data are presented as medians and full ranges. Manifest content analysis was used to analyze interview data that are presented as catagories illustrated by interview quotes. The formal ethics permission was granted. 74% of PTs agreed that radiography determines the type of treatment required, and 69% agreed that a prescription for exercise is enough to ensure adherence. PTs agreed (mean 5 on 6-point scale) that exercises increasing pain should be advised against. Confidence in guiding the physical activity was generally high (≥5 on 6-point scales). Five categories reflected participants' perceptions of the course content: Shift in management focus, Need for cultural adaptation, Importance of social support, Development of organization and collaboration, and Feelings of hesitation. Our results indicate that in order to facilitate the implementation of CPGs, PT curricula may consider the inclusion of knowledge on CPGs, focus more on students' own reflections on transforming theory into practice, and incorporate training of basic skills required for implementation of self-management, body awareness, and neuromuscular fitness. If given access and mandates, PTs may play a major role in the early diagnosis and treatment of OA and thus contribute to the prevention of an epidemic of OA in India.

Awareness of refractive error and diabetic retinopathy in the rural population of western India

Purpose: To assess the awareness, knowledge and treatment seeking tendencies about refractive error and diabetic retinopathy in rural western India. Methods: The study was done from July 2019 to September 2019 in 1000 subjects in the rural population in the vicinity of Dhiraj general hospital, Pipariya. Demographic details about age, gender and literacy were collected. A questionnaire based door to door survey was done and their responses were graded and data was analysed. Results: There were 475(47.5%) males and 525(52.5%) females. 590(59%) were between the ages of 20-50 years and 410(41%) were above 50 years of age. 210(21%) were illiterate, 565(56.5%) had received primary education and 225(22.5%) had received secondary education and above. It was observed that there was more awareness, knowledge and treatment seeking tendencies in educated subjects (p<0.01). Younger subjects had more knowledge about refractive error and older age group had more knowledge about diabetic retinopathy. Conclusion: Our study strongly suggests that there is lack of awareness, knowledge and treatment seeking tendencies in the rural population in western India. More effective health education in the form of public health care programmes and mass media awareness might be beneficial.

Reconstructing culture: seasonal labour migration and the cultural geographies of social change in rural western India

ABSTRACT This paper focuses on seasonal labour migration in rural India to examine how migrant returnees sought to reconstitute historical and hierarchical social relations in their home villages. I use qualitative research conducted in Maharashtra state in western India from 2014–15 among landowning farmers, landless returnees, and nonmigrant laborers. I demonstrate that for the returnees, an important element of social and cultural change in their home communities was their ability to upend and replace ‘residual culture,’ based on expectations of continued exploitation and performative hierarchy, with an ‘emergent’ one. I claim that the mechanics of counter-hegemony in rural Maharashtra includes a struggle for vernacular equality to eliminate caste-based practices of humiliation, including labour exploitation. I show that the attempts by returnees to reconstitute social relations in their home communities were undercut by the limits of cultural politics, in its inability to usher in the change that entails the redistribution of resources and substantive political power. This research contributes to theoretically textured scholarship in cultural geography on contestations between elite and subordinate cultures, particularly on the question of efforts to erase unjust historical practices of humiliation and how spatial, social, and economic mobility of the returnees, in part, enables this effort.

Accuracy of Computed Tomography Pretreatment Staging and Post-treatment Recurrence in Head and Neck Cancers in Rural Western India- A Retrospective Observational Study

Introduction: Cancers of head and neck are the most common in developing countries especially, in India. Multi-disciplinary approach and treatment are required in management of head and neck cancers which include surgeries, radiotherapy techniques and chemotherapy regimens. These can complicate the post-treatment imaging field and contribute to difficulties in image interpretation. Knowledge of these expected post- treatment changes, possible complications and the capability to identify early changes of tumour recurrence is an integral part of post-treatment surveillance and effective management. Aim: To evaluate the effectiveness of Multi-Detector Computed Tomography (MDCT) in pre-treatment staging, post-treatment response and recurrence in comparison with Positron Emission- Computed Tomography (PET-CT). Materials and Methods: A retrospective observational study was conducted including 101 patients, undergoing pre- and post-treatment, contrast enhanced CT scan with sections from skull base to base of neck. The pre-treatment imaging of primary tumour was assessed for its Tumour (T) and Node (N) stage with corresponding staging on histopathology. The imaging observations on pre- and post-treatment scans, for outcomes on recurrence, residual disease and cure were considered. Recurrence when suspected on post-treatment CT scan was confirmed with PET-CT or biopsy. The agreement of T and N staging on pre-treatment CT scan with that on histopathology was examined using quadratic weighted kappa. Sensitivity and specificity for detection of post-treatment recurrence on CT scan was determined by measuring true positive rates and true negative rates. Results: An agreement of 0.4 and 0.58 (kappa coefficient) was found between T and N staging on CT and histopathology which suggests fair accuracy of CT in pretreatment staging of head and neck cancers. The CT had a sensitivity and specificity of 88.89% and 100% for detecting recurrence in head and neck cancers in post-treatment neck CT scan in the background of post-treatment imaging changes. Conclusions: MDCT is a good imaging tool in pre-treatment staging of head and neck cancers. It effectively detects recurrence in the background of post-treatment changes. A standard post-treatment evaluation protocol should be followed.

A Bioecological Systems View of School Experiences of High-Ability Students From Rural India

Using Bronfenbrenner’s bioecological systems theory, this study investigated the school experiences of nine high-ability students from three secondary schools in rural Western India. Analyses of semistructured interviews revealed several interconnected systems of influences on the school experiences of participants. Intrapersonal aspects such as positive academic self-perceptions, constant pursuit for academic excellence, and mixed feelings about being formally identified as gifted directly affected school experiences. In the participants’ immediate environment, school aspects such as teacher–student relationships, teaching methods, and curricular content had the most prominent influence on their school experiences. Interactions between family and the school systems had direct and mixed influences on participants’ school experiences. Besides the adversities of rural education, participants emphasized the unique strengths of rural settings in India including the role of extended families, strong rural attachment, and positive relationships with school, teachers, and community that positively contributed to their school experiences. Implications for rural gifted education in India are discussed.

Original Substance use among females –Study from Rural Western India

Background: Substance abuse is a common health problem which affects individual and takes a toll on not only person consuming it rather all members of society related to that person. Aim & Objective: The purpose of study was to determine the prevalence of substance use among females & to know the reasons for same and association of socio-demographic profile and substance use. Settings and Design: Cross-sectional study was conducted among females attending OPD at rural health training centre of a medical college for 6months duration. Total 500 females were interviewed for same by convenience sampling. Methods and Material: After taking informed consent from participants all the information was collected on predesigned and pretested oral questionnaire. Statistical analysis used: Qualitative Data was presented in the form of numbers and percentages. Test of significance such as chi-square was applied. Statistical analysis was done using MedCalc version 19.1 and Epi-info7. Results: Prevalence of substance use was found very high as 74%. Most common form of substance use was tobacco chewing at 77.03%. Abuse was maximum among females educated up to primary level (82.3%). Near about 72.7% were using substance out of curiosity. 84.32% were interested in quitting abuse. Conclusions: Substance use prevalence was very high affecting health of females adversely.

Knowledge of Breastfeeding and Kangaroo Mother Care Practices Among General Practitioners in Rural Western India.

Breastfeeding and Kangaroo Mother Care (KMC) are interventions to reduce neonatal mortality and undernutrition. We investigated the knowledge of allopathic and Ayurvedic, Yoga-naturopathy, Siddha, and Homeopathic (AYUSH) general practitioners in rural western India and identified attributes associated with awareness and knowledge on these topics. This cross-sectional study of general practitioners in the Anand district of Gujarat, India, used an anonymous self-reported survey. Multivariable regression models were used to identify practitioner attributes associated with awareness and knowledge. Among the 158 respondents, a quarter (26.0%) were trained in allopathic medicine and 63.0% had practiced for 5 years or more. The average score of breastfeeding knowledge was 8.0 of 13. Most (79.1%) did not have any awareness of KMC. After adjusting for potential confounders, knowledge of breastfeeding practices among AYUSH practitioners was 4-fold greater than that of allopathic practitioners (incidence rate ratio: 3.9; 95% CI: 3.2-4.6). By contrast, AYUSH practitioners had 80% decreased odds of awareness about KMC compared with allopathic practitioners (odds ratio: 0.2; 95% CI: 0.1-0.3). This study demonstrates distinct knowledge gaps among allopathic and AYUSH general practitioners regarding breastfeeding and KMC. There is a need for tailored continuing medical education among general practitioners to enhance their clinical knowledge of newborn care practices to achieve improvements in neonatal health.

Carbapenem –resistant Enterobacteriaceae : Prevalence and bacteriological profile in a tertiary teaching hospital from rural western India

Introduction: In last few years, Gram-negative bacilli are isolated capable of producing various classes of carbapenemases with ability of hydrolyzing the ?-lactam antimicrobial. Carbapenem Resistant Enterobacteriaceae (CRE) have been reported worldwide. There is a serious threat to public health due to the emergence and rapid spread of CRE. Aims: To find prevalence and bacterial profile of CRE in clinical isolates in indoor patients from a rural tertiary care centre. Materials and Methods: The study was conducted in a tertiary care teaching hospital in Western India, June 2016 to April 2018. The clinical specimens received in microbiology laboratory were processed by the standard method. Bacteria were identified by VITEK 2 compact (Biomerieux) automation system, and antimicrobial susceptibility testing was done with the same system to detect minimum inhibitory concentrations for carbapenem group of antimicrobials. CLSI 2016 guidelines were used to detect CRE. Results: Total 535 Enterobactericaeae clinical isolates were included in the study. Of these, 31.77% (n=170) were CRE. Specimens like urine, pus/ wound swab and endotracheal tube secretion were the major contributors for CRE isolates.82% of CRE were Klebsiella pneumoniae (63%) and E.coli (19%). Conclusions: A high prevalence of 31.77% carbapenem resistance was observed among Enterobacteriaceae isolates. Early detection, isolation and contact precaution of CRE patients will help to prevent rapid dissemination of CRE infection. Keywords: Carbapenem Resistant Enterobacteriaceae, CRE, Carbapenemase, Klebsiella pneumoniae.

The geographies of intermediation: Labor intermediaries, labor migration, and cane harvesting in rural western India

In this paper, I explain the role of labor intermediaries in the weaving of capital–labor relations in capitalist agro-business. I do so by focusing on migration infrastructure or the vertical network of labor intermediaries who facilitate labor recruitment from migrant home villages and migrant labor disciplining on cane fields in rural western India, where the laborers are brought seasonally to harvest sugarcane. I show how the role of labor intermediaries cannot be understood by containing them within the villainous stereotypes associated with brokers. Intermediaries are embedded within the labor geographies of commodity production where capital accumulation requires the downward transferring of the risk of financial loss from capitalist agro-business to intermediaries and laborers. I collected data for this research by conducting interviews and focus-group discussions in the Yavatmal and Kolhapur districts of Maharashtra state in rural western India during summer 2014 and 2015–2016.

Challenges encountered in community-based physiotherapy interventions for urinary incontinence among women in rural areas of Anand District of Gujarat, India.

It is necessary to understand the way women think about their health. There is a "culture of silence" among women regarding urinary incontinence (UI). Physiotherapy is proven effective mode of therapy in case of UI. This study aimed to explore the attitude of the women toward UI, to understand the related sociocultural factors and health-seeking behavior, and to ascertain the challenges encountered in community-based physiotherapy interventions. A qualitative study was conducted among women who refused to participate in a physiotherapy intervention for UI in the rural community of Gujarat, India. Fourteen in-depth key informant interviews were conducted using an interview guide. The responses were noted and compiled into a composite interview script. Interviews were not recorded due to nonavailability of consent. Interviews were reviewed by investigators and content analysis was carried out. Key themes were identified after multiple iterations. Most of the women were unaware of the UI and believed that it may be due to their gender or due to aging. Physiotherapy interventions were disregarded due to various reasons such as shy nature, lack of priority and privacy, dependency, self-neglect, and influence of social and cultural norms. Cultural and social systems were more important determinants of health seeking than health systems themselves particularly when sensitive issue such as UI in women of rural Western India was concerned.

Learning and Leading: Resistance, Subaltern Leadership and the Making of Two Bhil Community Leaders from the Narmada Valley, Western India

This paper studies subaltern agency and the changing nature of leadership in rural western India among the Bhil Scheduled Tribe or Adivasi group in the wake of the anti-dam movement initiated by urban middle-class activists of the Narmada Bachao Andolan (NBA; also Save Narmada Campaign). Drawing on fieldwork data along with oral history, archival research, government records, vernacular records and dailies, it analyzes the politics of displacement and resettlement due to the Sardar Sarovar Dam on the River Narmada as a lived experience of two ordinary Bhil men from the submergence villages in Maharashtra state across three decades from 1985–2016. The NBA-led movement acts as a form of political education for the two Bhils who assume leadership, displacing both traditional Bhil leaders and external activists to guide their community deftly to the resettlement colonies by making claims on the Indian state, and helping to recreate life and livelihood for themselves and their fellow Bhils in the new setting.

Mobile Helpline and Reversible Contraception: Lessons From a Controlled Before-and-After Study in Rural India.

BackgroundResearchers and activists have expressed concerns over the lack of availability and nonuse of reversible, modern, contraceptive methods in India for decades. New attempts to increase access, availability, and acceptance of reversible contraceptives need to be developed, instead of relying solely on female sterilization. Mobile health (mHealth) initiatives may offer one way to serve underprivileged populations who face challenges in sexual and reproductive health (SRH) in countries such as India.ObjectiveThis study aimed to examine the outcome of an mHealth intervention for enhancing knowledge of, and practices related to, reversible contraceptives in rural Western India.MethodsWe implemented a nonrandomized controlled trial (before-and-after study in an intervention area and a control area) in the Indian state of Maharashtra. The intervention in this case was a mobile-based SRH helpline provided by a nongovernmental organization (NGO). Baseline and follow-up surveys were carried out in two government-run primary health center areas, one each in the intervention and control area, and 405 respondents were surveyed in the two rounds. An interview-based structured questionnaire suitable for a low-literacy environment was used to collect data. The effect of the intervention was estimated using logistic regression, adjusted for gender, by calculating robust standard errors to take into account the clustering of individuals by the area (intervention or control). In each regression model, the effect of intervention was estimated by including a term for interaction between the intervention area and the period before and after the intervention. The exponent of the regression coefficient of the interaction term corresponding to the period after the intervention, along with the 95% CI, is reported here. The odds ratio for the control village multiplied by this exponent gives the odds ratio for the intervention village. Calls received in the intervention were recorded and their topics analyzed.ResultsThe current use of reversible contraception (18% increase in intervention area vs 2% increase in control area; 95% CI) has seen changes. The proportion of respondents who had heard of contraception methods from an NGO rose in the intervention area by 23% whereas it decreased in the control area by 1% (95% CI). However, the general level of awareness of reversible contraception, shown by the first contraceptive method that came to respondents’ mind, did not improve. Demand for wider SRH information beyond contraception was high. Men and adolescents, in addition to married women, made use of the helpline.ConclusionsA mobile helpline that one can confidentially approach at a time most convenient to the client can help provide necessary information and support to those who need reversible contraception or other sexual health information. Services that integrate mHealth in a context-sensitive way to other face-to-face health care services add value to SRH services in rural India.

Seasonal masculinities: seasonal labor migration and masculinities in rural western India

In this research article, I study seasonal labor migration in rural western India to understand gender negotiations in the course of labor migration. Based on qualitative research conducted in six villages in rural Maharashtra state in Western India during the early Kharif cropping season in 2014 and during Kharif and Rabi cropping seasons in 2015–16, I examine gendered labor in migrant home communities and at various rural and urban employment destinations, the relationship of labor to the social construction of masculinities, and gender negotiations across space. I show that in their home communities, the politics of resistance of returnee laborers can be understood by examining how returnee men deploy ‘protest masculinities’ to subvert claims on their body and labor by elite men who have historically been in a dominant relationship with the laborers. Yet, these protest masculinities are buttressed by the continued exploitation of women’s labor. I also show the flexibility of masculinities. More broadly, I show that migrant destinations themselves are gendered spaces that are constructed by the active consensual work of women and male migrants and employers alike. Second, seasonal migrants enter migration cycles from rural spaces that are gendered, both in production and social reproduction. I find that rural workplaces are the preferred choice of destination for migrant women; a choice that migrant men find reasonable. This is so because rural destinations are already gendered as spaces conducive for social reproduction and discursively constructed in the same terms as the idealized woman subject.

Screen time usage among preschoolers aged 2-6 in rural Western India: A cross-sectional study.

Aims:We have evaluated screen time usage among preschool-aged (≤6 years) children in rural Western India. In addition, we have evaluated various lifestyle factors and their impact on the screen time of these children.Materials and Methods:English-medium schools in the locality were chosen based on convenience. A self-report survey requesting family information and screen usage information was distributed to the parents. Daily screen time was categorized as a three-category variable. Ordered logistic regression with multivariable regression was performed to examine the association of risk factors with screen time.Results:Average screen time among the 379 (208 males, 171 female) children amounted to 2.7 hours (SD: 1.7), with average daily television screen time of 1.6 hours (SD: 1.1). Most children (87.2%) started screen use by the age of 3. Only 65 (17.2%) participants met AAP recommendation. Households with three devices and smartphone usage by mothers increased the odds of screen time by 60% and two-folds, respectively. Compared to weekdays, children had increased screen time exposure (3.5 vs 2.7 hours, P < 0.001), outdoor activity time (2.3 vs 1.6, P < 0.001), and reading hours (1.2 vs 1.1, P = 0.03) on weekends. No association was observed between screen time and mother's occupation.Conclusions:More than 80% of children exceeded the advised screen time with television and smartphone being the major contributors. This issue has to be dealt with at both individual and societal levels. Increased awareness about the high prevalence of inappropriate use of screen time use within the Indian context is needed to inspire attention and interventions for this emerging public health problem in India.

Age-and-sex stratified prevalence of atrial fibrillation in rural Western India: Results of SMART-India, a population-based screening study

BackgroundEarly detection of Atrial Fibrillation (AF) is a public health priority across the globe because AF-related strokes are preventable. Despite an ongoing stroke epidemic in India, a public health strategy for AF screening and treatment is missing because the epidemiology of AF in India remains poorly defined. MethodsThis population-based study used mobile technology to derive age and sex-stratified AF prevalence by screening 7 participants in each of six age and sex strata (age 40–55, 56–65, 65+, and male and female) from 50 villages (2100 participants). A health worker from each village used a handheld digital electrocardiogram (iECG) device (Kardia) to screen for AF on 3 separate days, and administered a questionnaire. All abnormal (AF or unclassified) iECGs were reviewed by the Indian cardiologist and AF determination confirmed by a US-based cardiac electrophysiologist. ResultsOf the 2100 individuals enrolled, iECGs were collected from 2074 participants (98.8%) and 1947 (92.7%) participants responded to the questionnaire. AF was identified in 33 participants (1.6%), two-thirds on the first iECG. AF prevalence was higher among males (2.3% vs 1.0%, p = 0.03) and in older people (0.6%, 0.9%, 2.1%, 5.6%; p < 0.01). ConclusionsThe prevalence of AF observed in our population-based sample is comparable to rates found in studies from North America and Western Europe and increases similarly with age. AF screening using village health workers in rural India is feasible and presents an opportunity for a strategy to address the stroke epidemic in India through primary prevention.

Healthcare scenario in rural western India: A cross sectional survey

Healthcare scenario in rural western India: A cross sectional survey

Non-compliance With Neonatal Hearing Screening Follow-up in Rural Western India

The reasons of failure to follow-up for the Universal Neonatal Hearing Screening (UNHS) program were delineated. Review of case records for data related to follow-up of neonates who underwent the UNHS between February 2012 - January 2015. 2534 neonates underwent primary screening with Distortion Product Oto-acoustic Emission (DPOAE). 14 (26.9%) were lost to follow-up between the first and second DPOAE screenings. 275 neonates (including high-risk cases) were to undergo confirmatory Brain Evoked Response Audiometry testing out of which 201 (73.4%) came for follow-up. Out of 74 who failed to follow-up (including those lost between first and second DOPAE screenings), unwillingness and non-compliance was the commonest reason. Increasing awareness and counseling of the caretaker are important interventions for ensuring good follow-up in hearing screening programs.