Abstract Introduction: Suicide is a major global health concern, claiming approximately 800,000 lives annually, predominantly in low- and middle-income countries. In Sub-Saharan Africa, research on suicidal behavior remains limited, hindered by stigma, inadequate mental health infrastructure and data scarcity. This study examines the prevalence and predictors of suicidal ideation and attempts across four African countries (Algeria, Eswatini, Malawi and Zambia) to guide culturally sensitive prevention strategies. Methods: This cross-sectional study analysed secondary data from WHO STEPS surveys (2014–2019). The study employed a multi-stage cluster sampling and standardised assessment to evaluate suicidal behavior among individuals aged 15 years and older. A total of 14,374 participants were assessed for ideation and 16,041 for attempts. Multi-variable logistic regression and spatial mapping were used to identify risk factors and geographic trends. Results: Findings revealed a 6.34% prevalence of suicidal ideation and a 5.69% prevalence of suicide attempts, with higher rates among females and youths aged 15–34 years. Males were significantly less likely to report suicidal thoughts than females (adjusted odds ratio [AOR] = 0.61; 95% confidence interval [CI]: 0.52–0.72; P < 0.001). After adjustment, men were approximately 39% less likely to attempt suicide than women (AOR = 0.61, 95% CI: 0.52–0.72; P < 0.001). Key risk factors included gender, country of residence (Eswatini, Malawi or Zambia), hypertension, high salt intake and alcohol use. Alcohol consumption was notably linked to a two-fold increase in both ideation and attempts. Variables such as education, marital status and urban residence showed minimal influence after adjustment. Conclusion: This study underscores the urgent need to integrate mental health services into primary care systems, enhance public awareness and reduce stigma surrounding suicide. Expanding access to affordable, culturally appropriate mental health resources is critical to addressing the high burden of suicidal behavior in Sub-Saharan Africa.
Abstract Background: Post-partum depression (PPD) is a major contributor to maternal morbidity but remains under-recognised in India, and evidence from Uttarakhand is sparse. This study estimated the prevalence of PPD among mothers in Dehradun and identified associated socio-demographic, obstetric and psychosocial determinants. Methods: A community-based cross-sectional study was undertaken (August 2024–January 2025) in the catchment areas of rural and urban health-training centres in Dehradun. Mothers aged ≥18 years with infants aged 2–24 months were recruited by household visits using convenience sampling. Data were collected through structured interviews including the Edinburgh Post-natal Depression Scale (EPDS), Multidimensional Scale of Perceived Social Support and Iowa Infant Feeding Attitude Scale. Chi-square tests and multivariable logistic regression assessed associations. Results: Among 230 participants, the prevalence of probable PPD (EPDS ≥10) was 10.9%. Lower-middle socioeconomic status (INR: 9865–16,435) (adjusted odds ratio [AOR] 0.04; 95% confidence interval [CI]: 0.01–0.72) and higher perceived family support (AOR: 0.21; 95% CI: 0.06–0.72) were protective. Conclusions: PPD prevalence in Dehradun was below national estimates. Family-centred support and routine PPD screening in primary care may strengthen maternal mental health.
Abstract Introduction: Falls are a major geriatric syndrome contributing to morbidity, disability and mortality, particularly in rapidly againg low- and middle-income settings such as Kerala, India. Methodology: A community-based cross-sectional study was conducted amongst 1000 adults aged ≥60 years in Thrissur Taluk using the proportionate stratified random sampling. History of falls in the last 5 years was assessed using the CDC STEADI 2019 tool and gait and balance were evaluated using the Timed Up and Go test. Factors associated with falls were examined. The manuscript was prepared in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results: Nearly half of the participants (48.4%) reported at least one fall in the previous 5 years. Falls were significantly associated with increasing age, living arrangement, lower income, impaired functional status, depressive symptoms, sensory loss in the feet, etc. Conclusions: The high prevalence of falls amongst older adults in this study highlights the need for routine fall-risk screening and multi-component preventive interventions integrated into primary health care to reduce fall-related burden and support healthy ageing.
Abstract Background: Older adults in long-term care (LTC) facilities are at high risk for fragility fractures due to bone loss, impaired mobility, cognitive decline and polypharmacy. Such fractures increase morbidity, mortality and healthcare costs. Objective: This prospective study evaluated the effectiveness of a multifaceted intervention programme for fracture prevention amongst older adults in LTC. Methods: A prospective, 24-month interventional study (January 2022–December 2023) was conducted in 10 LTC homes across three districts with 520 residents aged ≥65 years. Outcomes were compared with a matched historical control cohort drawn from the same LTC facilities during 2020–2022, using identical inclusion criteria and outcome definitions. The intervention included Vitamin D and calcium supplementation, structured exercise, medication review, fall prevention strategies and environmental modifications. Fracture incidence, fall rates and functional status were compared to a historical control. Results: Hip and non-hip fractures decreased by 36% and 28%, respectively. Vitamin D supplementation improved serum 25(OH) D levels ( P < 0.01). Exercise enhanced balance and strength ( P < 0.05). Psychotropic use declined by 18% following polypharmacy review. Fall rates dropped by 31%. Conclusion: A comprehensive, multidisciplinary intervention significantly reduced fracture risk in LTC residents, supporting its broader implementation to improve musculoskeletal health and safety in geriatric care.
Introduction: Early bystander cardiopulmonary resuscitation (CPR) is crucial in improving survival from out-of-hospital cardiac arrest. Adolescents, due to their physical capability and cognitive maturity, can serve as a potential bystander CPR provider. This study aims to evaluate the effect of a hands-on CPR training program on knowledge and skills among high school students in Agra city, India. Materials and Methods: A non-randomised quasi-experimental pre–post study was conducted among 416 students of classes 9th and 10th. Data was collected using a 20-item Knowledge questionnaire and a 15-step CPR skill checklist before and after a structured hands-on CPR program comprising 1 h of teaching session and a full day of hands-on skill training using mannequins. Data was analysed using Microsoft Excel and Jamovi, with a paired t-test applied for comparisons. The manuscript was prepared in accordance with the TREND guidelines. Results: The mean knowledge and skill score improved significantly from 6.77 ± 2.62 to 14.77 ± 2.34 (P < 0.001) and from 2.72 ± 1.64 to 11.15 ± 1.27 (P < 0.001), respectively. Most participants (98%) expressed willingness to attend future CPR programs. Conclusion: An improvement is observed in the knowledge and skills of class 9th and 10th students regarding CPR post-training, demonstrating the effectiveness of the intervention.
