Predicting suicidal behavior among Indian adults using childhood trauma, mental health questionnaires and machine learning cascade ensembles

Among young adults, suicide is India's leading cause of death, accounting for an alarming national suicide rate of around 16%. In recent years, machine learning algorithms have emerged to predict suicidal behavior using various behavioral traits. But to date, the efficacy of machine learning algorithms in predicting suicidal behavior in the Indian context has not been explored in literature. In this study, different machine learning algorithms and ensembles were developed to predict suicide behavior based on childhood trauma, different mental health parameters, and other behavioral factors. The dataset was acquired from 391 individuals from a wellness center in India. Information regarding their childhood trauma, psychological wellness, and other mental health issues was acquired through standardized questionnaires. Results revealed that cascade ensemble learning methods using a support vector machine, decision trees, and random forest were able to classify suicidal behavior with an accuracy of 95.04% using data from childhood trauma and mental health questionnaires. The study highlights the potential of using these machine learning ensembles to identify individuals with suicidal tendencies so that targeted interinterventions could be provided efficiently.Comment: 11 pages, presnted at the 4th International Conference on Frontiers in Computing and Systems (COMSYS 2023), Himachal Pradesh, October 202

Are people at high risk for diabetes visiting health facility for confirmation of diagnosis? A population-based study from rural India.

BACKGROUND: India is witnessing a rising burden of type 2 diabetes mellitus. India's National Programme for Prevention and Control of Diabetes, Cancer, Cardiovascular diseases and Stroke recommends population-based screening and referral to primary health centre for diagnosis confirmation and treatment initiation. However, little is known about uptake of confirmatory tests among screen positives. OBJECTIVE: To estimate the uptake of confirmatory tests and identify the reasons for not undergoing confirmation by those at high risk for developing diabetes. METHODS: We analysed data collected under project UDAY, a comprehensive diabetes and hypertension prevention and management programme, being implemented in rural Andhra Pradesh, India. Under UDAY, population-based screening for diabetes was carried out by project health workers using a diabetes risk score and capillary blood glucose test. Participants at high risk for diabetes were asked to undergo confirmatory tests. On follow-up visit, health workers assessed if the participant had undergone confirmation and ask for reasons if not so. RESULTS: Of the 35,475 eligible adults screened between April 2015 and August 2016, 10,960 (31%) were determined to be at high risk. Among those at high risk, 9670 (88%) were followed up, and of those, only 616 (6%) underwent confirmation. Of those who underwent confirmation, 'lack of symptoms of diabetes warranting visit to health facility' (52%) and 'being at high risk was not necessary enough to visit' (41%) were the most commonly reported reasons for non-confirmation. Inconvenient facility time (4.4%), no nearby facility (3.2%), un-affordability (2.2%) and long waiting time (1.6%) were the common health system-related factors that affected the uptake of the confirmatory test. CONCLUSION: Confirmation of diabetes was abysmally low in the study population. Low uptake of the confirmatory test might be due to low 'risk perception'. The uptake can be increased by improving the population risk perception through individual and/or community-focused risk communication interventions

Divergent Approaches to Health-related Behavior Change: Pampering under NACP vs Persecution under RCH II

ABSTRACT Reproductive and Child Health Program II (RCH II) is essentially the largest program within the gamut of the National Rural Health Mission (NRHM) in India which aims to improve the maternal and child health indicators of the country. The program has evolved through various strategies and witnessed major policy changes that range from training traditional birth attendants (TBAs) to targeting 100% institutional deliveries. The TBAs who were earlier encouraged have almost eclipsed into extinction in the movement toward abolishing the practice of home deliveries. A contrasting scenario is observed in the strategies adopted under the NACP (National AIDS Control Program) like condom promotion and needle exchange which attempt to make the risky behavior safer. Applying the same rationale of NACP to RCH, one can justify the earlier practice of training TBAs and providing them with sterile kits to make home deliveries safer. While different strokes are required to solve different problems a difference in the fundamental ideology of two major National Health Programs has to be justified with solid evidence base. How to cite this article Jeyashree K, Kathirvel S, Singh A. Divergent Approaches to Health-related Behavior Change: Pampering under NACP vs Persecution under RCH II J Postgrad Med Edu Res 2013;47(3):148-149. </jats:sec

Outbreak investigation of acute watery diarrhea in a village of North India: timely action saved lives

Introduction: Outbreaks of acute watery diarrhoea are common in developing countries having poor access to safe drinking water and sanitation. An outbreak of acute watery diarrhoea in a village in North India was investigated with the aim to initiate and recommend necessary actions to control it.&#x0D; Methodology: A house to house survey using a specially designed case record form was conducted covering all the households. Stool samples of some of the affected individuals and twenty water samples during and after the outbreak from various sites were collected for laboratory analysis.&#x0D; Results: Out of 624 inhabitants surveyed, 118 were found to be suffering from acute watery diarrhoea (Overall attack rate of 18.9%) with two suspected deaths following diarrhoea. Males and females were affected equally and the age group of 15–44 years was affected predominantly. A peculiar epidemic curve with single peak was noted. One of the stool samples collected during the outbreak grew Vibrio Cholera O1(Ogawa) and twelve out of the twenty water samples including the samples from both the tube wells had high coliform counts indicating fecal contamination. Chlorine levels in all the water samples were found to be inadequate.&#x0D; Conclusions: Local cultural practices such as indiscriminate defecation in public places, using tullu pumps to extract water from the public supply line, poor engineering design and maintenance of the water supply system having leakages at many sites along with inadequate chlorination of the supply water from the tube wells were the risk factors that could have contributed to this outbreak.</jats:p

Perception of Global Participants of ITEC Nations on Country's Preparedness and Response to COVID-19 Pandemic

BackgroundThe Coronavirus disease 2019 (COVID-19) pandemic has exposed the public health preparedness and response system across the world. The current study was conducted to gauge the perception of public health professionals of Indian Technical and Economic Cooperation (ITEC) countries regarding the preparedness and responses of their countries in mitigating the COVID-19 pandemic.MethodologyThree capacity-building programs, namely “Managing COVID-19 Pandemic–Experience and Best practices of India” were conducted by PGIMER, Chandigarh, for public health professionals from ITEC countries from April to May 2021 in which 97 participants from 13 countries have participated. The tools used in the study were adapted from WHO's COVID-19 Strategic Preparedness and Response (SPRP), Monitoring and Evaluation Framework, interim guidelines for Critical preparedness, readiness and response actions for COVID-19, and a strategic framework for emergency preparedness, and finalized using Delphi technique. The overall preparedness of managing COVID-19 was rated using five-point Likert scale, whereas the overall score for the country in combating the COVID-19 pandemic was assessed using 10 point scale.ResultsWe found that the perception of public health professionals to government response regarding COVID-19 for fostering improvement on COVID-19 situation was “moderate” with respect to transmission and surveillance mechanism, uniform reporting mechanism, and availability of adequate personal protective equipment (PPE) for health workers. However, the participants rated government response as “poor” in the availability of multisectoral national operational plan, human resource capacity, availability of trained rapid response team (RRT), preparedness in prevention and clinical management, training of healthcare workers, communication and community engagement strategies, facilities to test samples of patients, and transparent governance and administration.ConclusionA poor level of preparedness of countries in diverse domains of managing the COVID-19 pandemic was observed. As the global threat of COVID-19 is still looming, great efforts on building a robust preparedness and response system for COVID-19 and similar pandemics are urgently required.</jats:sec

Bi-directional screening for COVID-19, tuberculosis and diabetes in flu, DOTS and NCD clinics in a rural hospital in Northern India

Introduction: To assess the status of bi-directional screening for COVID-19, tuberculosis and diabetes among people attending Non-communicable Disease (NCD), Directly Observed Treatment Short-course (DOTS), and flu clinics of a secondary care hospital in rural northern India. Material and Methods: A cross-sectional, analytical study was conducted among the eligible (aged ≥18 years) population who attended the study clinics in a rural sub-district hospital. In the flu clinic, consecutive patients were assessed for screening for TB (symptom-based) and diabetes (random blood sugar) and status of referral to DOTS and NCD clinics. Similarly, the screening for diabetes and COVID-19, Reverse Transcription-Polymerase Chain Reaction (RT-PCR) in the DOTS clinic, and TB and COVID-19 in the NCD clinic were assessed. The independent association of factors with COVID-19 positivity were assessed by calculating the adjusted prevalence ratios (aPR) at 95% confidence interval (CI). Results: Of the 405 people assessed, 279 (68.9%), 102 (25.2%), and 24 (5.9%) were from flu, NCD, and DOTS clinics, respectively. 26 (25.5%) and 22 (91.7%) of NCD and DOTS clinic patients underwent RT-PCR for COVID-19. TB screening in NCD and flu clinics was done among 4 (3.9%) and 7 (12.5%), respectively. A total of 23 (9.0%) were found positive for COVID-19, and no factors other than the presence of COVID-19 symptoms (aPR: 2.89; 95% CI: 1.33–6.29) had any independent association with COVID-19 positive status. Conclusion: The low screening for TB in NCD and flu clinics indicates the need to strengthen the implementation the TB-DM and TB-COVID-19 bidirectional screening. Similarly, the low screening or testing for COVID-19 in the NCD clinic can be improved by the implementation of systematic screening strategies like TB-DM bidirectional screening