Background: The WHO Global Tuberculosis Programme works towards the goal of a world free of TB, with zero deaths, disease and suffering due to the disease. Tuberculosis (TB) is a preventable and usually curable disease. Yet in 2022, TB was the worlds second leading cause of death from a single infectious agent, after coronavirus disease (COVID-19). The reported global number of people newly diagnosed with TB was 7.5 million in 2022; this is the highest number since WHO began global TB monitoring in 1995. Around 87% of new TB cases occurred in the 30 high TB burden countries, with more than two-thirds of the global total in Bangladesh, China, Democratic Republic of the Congo, India, Indonesia, Nigeria, Pakistan and the Philippines. Objective: To study the epidemiological profile of tuberculosis cases in an urban slum of Mumbai. Methodology: A retrospective record-based analysis of secondary data on tuberculosis (pulmonary and extrapulmonary) reported on the NIKSHAY portal between January to December 2022 at an urban health training center in an urban slum in Mumbai. Results: The total number of drug sensitive TB cases reported in 2022 was 519. Males constituted 42% and females 58%. The most common age group affected was 20-29 years. Pulmonary cases comprised 66.9% of the cases. The total number of Drug resistant TB cases reported were 75, 53 were pulmonary & 22 were extrapulmonary. Conclusion: In contrast to Male predominance (52.26%) of cases in Maharashtra, the urban slum had 42% males affected. India grapples with multiple challenges in combatting tuberculosis (TB), marked by a high disease burden, diagnostic delays, drug resistance, and socioeconomic barriers. While significant strides have been made through programs like the National Tuberculosis Elimination Program, the path to eradication demands continued efforts.

Background: There is a paucity of research to explore the common age of initiation of each food group item and its perceptions. Objective: To assess the age of initiation of complementary food items, understand its perceptions and determine IYCF indicators. Methodology: An explanatory mixed-method study was conducted in the urban slums of Mumbai. A total of 93 Health care workers (HCWs) working in different areas and 24 mothers were interviewed with the pretested questionnaire. Later 5 and 6 FGDs with mothers and AWs respectively were done. The data was analyzed with the point of integration for the mixed- method approach Results: In 68.9% and 52.7% of the HCWs areas, commonly started cereals at 6 to 8 months are rice and ragi. Vitamin A-rich vegetables, green leafy vegetables, and other vegetables are usually started at 9 to 11 months (32.2%), after 12 months (32.9%), and after 19 months (35.4%) respectively. Banana is a common fruit initiated at 6 months onwards. Intake of chicken and egg are started at 9 months onwards in 31% and 42% of areas respectively. Pulses and beans consumption is initiated at 6 to 8 months and after 12 months in 42% and 33% of areas respectively. Cow’s milk is started in 78.9% of the areas. Milk products intake starts at 12 to 19 months onwards. Biscuits are started at 6 months (39.1%). The Minimum Meal Frequency, Minimum dietary diversity and Zero vegetable consumption are 56%, 28% and 22% respectively Mothers self-efficacy, Family members’ and neighbour’s influences, Child’s responses to feeding, and Family food habits are factors that decide food items at a particular age. Conclusion: Dietary diversity at 6 to 8 months is very poor. Mothers’ self-efficacy plays a key role in improving dietary diversity at an early age.

Background: Anaemia is prevalent globally, notably in marginalized adolescent girls. NFHS-5 reports 59.1% anaemia in Indian adolescent girls. Tribal communities face unique health challenges due to their sociocultural dynamics. The national program for anaemia addresses this, but its implementation in contexts like tribal areas is unexplored. This study integrates quantitative and qualitative data for a thorough understanding of anaemia and its control in tribal settings. Objectives: 1. To estimate the prevalence of anaemia in tribal adolescent girls 2. To explore the awareness of anaemia in tribal adolescent girls 3. To understand the challenges in the implementation of an anaemia control program in a tribal setting Methodology: This 6-month mixed methods study assessed anaemia prevalence among adolescent girls in tribal schools. Using complete enumeration, a 200-sample size was determined, with obtained informed consent and assent. Adolescent girls were administered a questionnaire in their local language to collect information on their socio-demographic status and anaemia-related habits like diet and handwashing among others. Haemoglobin levels were measured using a digital haemoglobinometer. Focus Group Discussions with willing girls explored their understanding of anaemia, its causes and complications. Forced field analysis for ASHA and Anganwadi workers and certain Key Informant Interviews were conducted. Data was collected until saturation. Ethical approval with confidentiality was ensured. Results: The prevalence of anaemia was 70%, indicating a severe public health concern. Among these, 57.1% had mild, 34.3% had moderate, and 8.6% had severe anaemia. Anaemia in girls was statistically associated with specific food groups and habits. Low awareness of anaemia and operational issues in the control program were also identified. Conclusion: To enhance adolescent awareness of anaemia, efforts to improve their understanding of the condition and its impact are necessary. This research is vital for informing policymakers and health practitioners in refining interventions for this specific demographic in Maharashtra.

Background: Compliance to antihypertensive therapy reduces the risk of complications. It is important to understand the factors affecting compliance in patients so that the goal of successful treatment is not jeopardized. Objectives: To determine the proportion of participants' compliant to treatment and various factors associated with compliance of antihypertensive treatment. Settings and Design: A cross-sectional study of 330 hypertensive patients on treatment attending the outpatient department of a tertiary care hospital in Mumbai. Subjects and Methods: It was conducted over 8 weeks using a validated, pretested questionnaire including information on the individual's sociodemographic profile, compliance to antihypertensive therapy and lifestyle advice assessed using a 4-point Likert scale. Statistical Analysis: Data were entered into MS Excel 2007 and analyzed using SPSS 20. Results: Participants' mean age was 55.2 ± 12.6 years. 39.4% were compliant to their treatment. Common reasons for frequently skipping the dose – forgetfulness (41.2%) and discontinued the medication when feeling well (30.3%). Factors positively associated with compliance were gender and illiteracy. The proportion of noncompliance among smokers and alcoholics was statistically significant. Conclusion: Forgetfulness and subjective feeling of wellness were the prevalent reasons for noncompliance. Controlling habits such as smoking and alcohol may prove as key factors for compliance.

Background: Zinc Supplementation adopted as part of Indian National Programme for management of diarrhoea since 2006. The backbones of the programme are peripheral health workers. Objective: To quantify the effect of training workshop on knowledge and attitude for ‘zinc and its role in management of diarrhoea’ among the study population. Methodology: A prospective interventional study conducted amongst peripheral health workers of tribal PHC in thane district. Two day’s workshop session were conducted with the help of power point presentation, role play, Flip charts, pamphlets and Zinc tablet demonstration. A predesigned and pretested questionnaire was used to collect the pre-workshop baseline data and post-workshop data which were collected after one month. The results were analyzed statistically using SPSS 15 version and Microsoft Excel. Results: Baseline survey showed that 66% of the subjects had knowledge of diarrhoea, 92% knew about ORS and 97.7% were unaware about Zinc. Post- intervention, 42% showed complete and 50% partial gain in knowledge about Zinc’s role in diarrhoea, 8% showed no gain in knowledge. 94.3% felt it as an appropriate supplement for diarrhoea management while 87.5% were ready to use it. Conclusion: Lack of awareness and training were the main reason to not to use or delay in use of zinc supplement during diarrhoea. A positive impact was observed on change in knowledge & attitude for use of zinc tablets in diarrhea.

Context: Rabies is a zoonotic disease of major public health importance. Post exposure prophylaxis including immediate wound washing, rabies immunoglobulin & vaccination is essential to prevent rabies deaths. Non-scientific pre-treatment practice of dog bite wound gives rise to false sense of security against rabies. Hence, the need to ascertain the epidemiological factors associated among dog bite cases in order to plan and enhance management strategies. Objectives: To study prevailing pre-treatment practices and some epidemiological factors associated with dog bite among study population. Method: A cross-sectional study was carried out by interviewing 357 subjects who received anti-rabies immunization injection at outpatient department of tertiary care hospital in Mumbai by filling the structured, pretested performa. Chi-square test was used for statistical analysis with the help of SPSS software. Results: Dog bite was most common among males (73.94%) and majority (57.70%) were observed in the age group of 16-45 years. Maximum cases were of Grade-III (61.6%) bite with common site was lower limbs (82.9%) and 58.26% belonged to poor socioeconomic class. Immediate pre-treatment of wound was practiced by 173(48.45%) subjects before visiting health care personnel, while 184 (52.54%) had not used any method. 86 (24.08%) had washed the wound with soap, water &/or disinfectant. Majority 87(24.3%) applied local remedies like Lime 33(37.93%) followed by Turmeric 21 (24.13%) and Chilly powder (16.09%). Conclusion: Though rabies is preventable, people are not aware about right pre-treatment practices and there is a need to increase the public awareness in this context and to control stray dog population.

Background: In an attempt to make primary health care services available, especially, to the poorest and most vulnerable segments of rural & tribal society, JSY forms a crucial component of the NRHM. JSY is a safe motherhood intervention initiated to reduce maternal and neo-natal mortality and increasing institutional deliveries in them. Objective: 1) To assess awareness about Janani Suraksha Yojana (JSY) among ANC registered women. 2) To establish association of socio-demographic factors with awareness about Janani Suraksha Yojana (JSY). Methods: A cross sectional study was conducted in Primary Health Centre, Khardi of Thane district of Maharashtra during the period of Oct. 2010. A total of 110 ANC registered women were interviewed using pre-designed questionnaire. Results were analyzed by using SPSS version-15. Chi-square test was applied and p < 0.05 was considered as statistically significant. Results: More than half of the women (52.7%) were aware about this governmental scheme & only 17.24% of them were able to answer the correct name of the scheme. They obtained this knowledge mainly from the ANMs (58.6%), AWWs (22.4%) and ASHAs (17.2%). About 54.5% women had the knowledge about the components of JSY. Poor socioeconomic class, backward caste (SC/ST) & skilled/unskilled type of occupation were found to be significantly associated with the presence of knowledge about JSY. Conclusion: As the awareness and knowledge in our study group was less compared to other studies, there is a need to intensify the efforts to increase awareness and knowledge about JSY.

Background: Nurses forms an important health care delivering force in tertiary care hospitals.Positive working environment in hospital has enhancing effect on work efficiency and quality of care provided by nurses. Aim: The aim was to find out perception of nurses on working environment and related problem of tertiarycare hospital in Mumbai. Objectives: To know the perception of nurse on problems related to work load, patient related problems and problems due to lack of resources. Materials and Methods: A work site cross-sectional descriptive study was conducted amongst 202 consented nurses of tertiary care hospital in Mumbai. Data was collected by personal interview. Predesigned semi-structured standardized interview schedule consisting of questions related to Sociodemographic factors, work load, patient related problems and to lack of resources included. Results:In this study 104/202(51.5%) subjects always perceived work load was too much. 84/202 (41.6 %) subjects had to always compromise quality of work because of work load.47/202 (23.3%) subjects always face difficulty in dealing with serious patient33/202 (16.3%) always face difficulty when patient do not recover for long time.136/202(67.3%) subjects always feel that the staff was inadequate to accomplish work properly.97/202 (48.0%) subjects always feel that equipments and supplies were never adequate. Conclusions: Components of working environment in the present tertiary care hospital play a majorrole interfering with work efficiency of nurses and patient care. Proper training and management support needed to make service successful perceived by nurses.

Background: Reproductive tract infections (RTIs) represent a major public health problem in developing countries. Integrating RTIs/STIs management and early detection of cervical dysplasia in broader reproductive health services can improve women’s health. The objectives of the study were 1. To study the association of socio-demographic & reproductive factors among self-reported symptomatic women for reproductive tract infections. 2. To carry out clinical examination & feasible tests like PH, gram staining, VDRL for reproductive tract infections. 3. To study Pap smear among study subjects. Methods: A cross sectional study community based study was carried out in villages under ‘Parol’ Primary Health Centre of Thane district, Maharashtra, India. A total of 415 married women in reproductive age group were interviewed and examined. Pre-structured, pre-designed questionnaire was used. Clinical examination & feasible laboratory tests were done. Results were analyzed with the help of Microsoft Excel & SPSS 15. Results: A total of 415 women were interviewed, of them 263(63.4%) had one or more symptoms of reproductive tract infections. On examination, 69(35%) had cervicitis and 30(15.2%) pelvic inflammatory disease, 39(19.8%) bacterial vaginosis and candidiasis in 61(31%). Cervical erosion was present in 147(74.6%) women. On Pap smear, 20(10.2%) women had ASCUS (Atypical squamous cells of undetermined significance). Only 2(1%) women found HIV positive. No woman was found VDRL reactive. Conclusion: Routine RTI/STI screening and periodic surveys to detect the infection patterns which will helps to control HIV infections in the community is needed in the remote tribal area as the current study shows high prevalence of reproductive tract infection.