Publications by authors named "Yamini Marimuthu"

13 Publications

  • Page 1 of 1

Perceptions of Frontline Workers, Female Health Workers, and School Teachers in Menstrual Hygiene Promotion among Adolescent Girls of Delhi, India: A Qualitative Study.

Indian J Community Med 2021 Apr-Jun;46(2):201-205. Epub 2021 May 29.

Department of Community Medicine, Maulana Azad Medical College, New Delhi, India.

Background: Government schemes for the promotion of Menstrual Hygiene Management (MHM) among adolescent girls in India are underpinned by crucial implementation efforts from the frontline health workers, community health workers, and school teachers.

Aim: The aim of the study is to identify the perspectives on menstrual health and hygiene management with regard to government schemes for sanitary pad distribution to adolescent girls among the frontline workers and the government school teachers located in urban resettlement colonies in Delhi.

Methods: In-depth interviews were conducted with 30 accredited social health activisits, 30 Anganwadi Workers (AWW), and 30 auxiliary nurse midwives (ANMs) and five focus group discussions among 28 government school teachers from the middle, high, and secondary standard.

Results: Most participants recognized the phenomenon of menstruation-related problems in adolescent girls and were aware of some of the common sociocultural, religious, and hygiene-related menstrual restrictions prevalent in their communities. All the participants believed that the pad distribution scheme was highly beneficial. However, in spite of inclusion of menstrual health promotion in the school curriculum, teachers often lacked self-efficacy in discussing challenges and health concerns related to MHM with their students.

Conclusions: Despite their potential as community resources for adolescent girls, FHWs, ANMs, and school teachers often fail to impart crucial menstrual hygiene information and skills-building needed toward achieving effective, safe, and optimal MHM.
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http://dx.doi.org/10.4103/ijcm.IJCM_137_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8281854PMC
May 2021

Perceived Stress and Its Determinants among Postmenopausal Women in Urban Puducherry.

J Midlife Health 2021 Jan-Mar;12(1):33-38. Epub 2021 Apr 17.

Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Background: Menopause characterized by a gradual decline in ovarian hormones takes its toll on the women both physically and mentally. These health problems can negatively impact the mental status. Hence, the current study was done to determine the level of stress and its associated factors among postmenopausal women in urban Puducherry, India.

Materials And Methods: A facility-based cross-sectional study was done among 219 postmenopausal women attending the outpatient department in urban primary health center during May 2017-June 2017. Information regarding sociodemographic profile was collected using pretested semi-structured questionnaire and Cohen's Perceived Stress Scale was used to assess the stress level. We calculated adjusted prevalence ratios (aPRs) to identify the determinants of stress.

Results: Among 219 participants, 46.6% were in the age group of 60-74 years; 32.9% had primary to secondary level of education; 56.2% were unemployed; 42.5% belonged to lower socioeconomic class; and 32.9% had both diabetes mellitus and hypertension. The prevalence of stress among the postmenopausal women was 26.0% (95% confidence interval: 20.7-32.2). Postmenopausal woman with higher education (aPR - 2.18), belonging to nuclear family (aPR - 1.93), lesser parity (aPR - 1.18), and current alcohol/tobacco users (aPR-2.32) were found to have a significant association with stress among the study participants.

Conclusion: The current study showed that more than one-fourth of the postmenopausal women had high to very high level of stress. Education, religion, parity, and substance abuse were the significant determinants of stress. However, further longitudinal research needs to be done to determine whether the factors informed in the current study are truly associated with stress and develop interventions accordingly.
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http://dx.doi.org/10.4103/jmh.JMH_127_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8189331PMC
April 2021

Development and Validation of a Menstruation-Related Activity Restriction Questionnaire among Adolescent Girls in Urban Resettlement Colonies of Delhi.

Indian J Community Med 2021 Jan-Mar;46(1):57-61. Epub 2021 Mar 1.

Department of Community Medicine, Maulana Azad Medical College, New Delhi, India.

Introduction: Menstruation, a physiological phenomenon, till date is associated with myths, taboos, and malpractices. These interfere with the emotional, physical, and mental health of adolescent girls. This study attempts to draft a validated questionnaire to measure menstruation-related activity restriction.

Objective: The objective was to study activities restricted during menstruation among adolescent girls residing in urban resettlement colonies of Delhi and to develop and validate a questionnaire for menstruation-related activity restriction.

Materials And Methods: A community-based cross-sectional study was conducted among adolescent girls residing in urban resettlement colonies of Delhi during 2019. A multistage random sampling technique was used to select 1100 girls across four districts of Delhi. A 15-item questionnaire was developed by an expert committee and validated with principal component analysis (PCA).

Results: In total, 1100 adolescent girls were included in the study whose mean age was 15.8 (±2.1) years. School/college/work was missed due to menstruation in 60% of the adolescent girls, 66% were not comfortable during menstruation, and 92% were restricted from entering religious places. In exploratory factor analysis using PCA, 6 principal components were identified which had eigenvalues more than 1.

Conclusion: Religious restrictions during menstruation (94%) were highly prevalent among adolescent girls, followed by restriction of routine activity (69%) and work/academically related activity (60%). Construct validity has identified a six-factor structure for the menstruation-related activity restriction questionnaire. This was identified as a valid and internally consistent tool to assess activities restricted during menstruation among Indian adolescent girls.
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http://dx.doi.org/10.4103/ijcm.IJCM_183_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117893PMC
March 2021

Clinical profile and risk factors for mortality among COVID-19 inpatients at a tertiary care centre in Bengaluru, India.

Monaldi Arch Chest Dis 2021 May 17;91(3). Epub 2021 May 17.

ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru.

COVID-19 is an emerging viral disease affecting more than 200 countries worldwide and it present with varied clinical profile throughout the world. Without effective drugs to cure COVID-19, early identification and control of risk factors are important measures to combat COVID-19.  This study was conducted to determine the clinical profile and risk factors associated with mortality among COVID-19 patients in a tertiary care hospital in South India. This record-based longitudinal study was conducted by reviewing the case records of COVID-19 patients admitted for treatment from June 2020 to September 2020 in a tertiary care centre in South India. The clinical details, discharge/death details, were collected and entered in MS Excel. Potential risk factors for COVID-19 mortality were analysed using univariate binomial logistic regression, generalized linear models (GLM) with Poisson distribution. Survival curves were made using the Kaplan-Meier method. Log-rank test was used to test the equality of survivor functions between the groups. Out of 854 COVID-19 patients, 56.6% were men and the mean (standard deviation) age was 45.3(17.2) years. The median survival time was significantly lesser in male COVID-19 patients (16 days) as compared to female patients (20 days). Increasing age, male gender, patients presenting with symptoms of fever, cough, breathlessness, smoking, alcohol consumption, comorbidities were significantly associated with mortality among COVID-19 patients. Patients with older age, male gender, breathlessness, fever, cough, smoking and alcohol and comorbidities need careful observation and early intervention.  Public health campaigns aimed at reducing the prevalence of risk factors like diabetes, hypertension, smoking and alcohol use are also needed.
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http://dx.doi.org/10.4081/monaldi.2021.1724DOI Listing
May 2021

Attitude towards mobile learning among resident doctors involved in undergraduate medical education at a government medical college in Delhi, India.

J Educ Health Promot 2020 26;9:321. Epub 2020 Nov 26.

Department of Community Medicine, Maulana Azad Medical College, New Delhi, India.

Background: There is growing recognition of the role of mobile learning (M-learning) for undergraduate (UG) academic education and teaching purposes, but teacher attitudes toward it can be variable.

Objective: To determine the attitudes toward the incorporation of M-learning methods for UG medical education among resident doctors at a government medical college in Delhi, India.

Methods: A cross-sectional study was conducted for 3-months duration (2019) among 60 final year junior and senior resident doctors. The participants were selected from all the preclinical and paraclinical department, and one clinical department selected randomly based on the probability proportion to size method. The data was collected using self-administered instruments including the modified 20-item M-learning Perception Scale (MLPS).

Results: Social media (36.7%) and instant messaging platforms (85%) were routinely used by the participants for exchanging academic (medical) and health-related information. The mean score for all the MLPS item responses was >3, indicating positive attitudes toward M-Learning. The participants expressed maximum agreement with the views stating M-Learning can "supplement traditional teaching," was "reliable for personal use," and "improves the quality of lessons." The responses of those participants having preexisting familiarity with health information and education portals, and those aware of massive open online courses correlated significantly with higher MLPS scores.

Conclusion: M-learning is visualized as an increasingly relevant teaching and learning medium by early-career resident doctors involved in UG medical education in India.
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http://dx.doi.org/10.4103/jehp.jehp_443_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774636PMC
November 2020

Prevalence of Food Insecurity at Household Level and Its Associated Factors in Rural Puducherry: A Cross-Sectional Study.

Indian J Community Med 2020 Jul-Sep;45(3):303-306. Epub 2020 Sep 1.

Department of Preventive and Social Medicine, JIPMER, Puducherry, India.

Background: Malnutrition is a consequence of food insecurity. Food insecurity in India became a public health problem due to explosive population growth and widening gap between rich and poor. It also has a detrimental effect on factors related to health and social well-being of the family.

Objectives: The study was conducted to determine the prevalence of food insecurity at household level in rural population and factors associated with it.

Subjects And Methods: A community-based cross-sectional study was conducted among the households of rural Puducherry. The adult females in the households were interviewed with a pretested semi-structured questionnaire in which, along with sociodemographic factors, food insecurity was assessed using the Household Food Insecurity Access Scale. Univariate and multivariate logistic regression analysis was done to identify the factors associated with food insecurity.

Results: Out of 299 households that were assessed for food insecurity, 31.7% (95% confidence interval [CI]: 26.6-37.4) had food insecurity. Out of 95 households with food insecurity, 51 (17%), 37 (13%), and 7 (2%) had severe, moderate, and mild food insecurity, respectively. In univariate analysis, the presence of children in the family, using below poverty line ration card, and socioeconomic status were significantly associated with food insecurity. In multivariate analysis, socioeconomic status was significantly associated with food insecurity (rate ratio: 3.59; < 0.001 [95% CI: 1.68-7.67]).

Conclusions: One in three families experienced the food insecurity, and it was more among households with children. It has to be addressed to prevent nutrition-related disorders in community, particularly in children.
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http://dx.doi.org/10.4103/ijcm.IJCM_233_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745822PMC
September 2020

Willingness to quit alcohol use and its associated factors among male outpatients attending urban primary health centers in Delhi.

J Educ Health Promot 2020 28;9:252. Epub 2020 Sep 28.

Department of Preventive and Social Medicine, JIPMER, Puducherry, India.

Context: Harmful use of alcohol has led to 1.7 million deaths from noncommunicable diseases and 1 million injury deaths including road traffic accidents, self-harm, and interpersonal violence. The opportunistic screening can be used to screen for substance abuse in outpatient department (OPD) attendees of primary health-care (PHC) settings in India.

Aims: This study was conducted to determine the prevalence of willingness to quit alcohol use among alcohol users and factors associated with it.

Subjects And Methods: A facility-based cross-sectional study was conducted in urban PHCs and willingness to quit alcohol was assessed among the alcohol users. Alcohol Use Disorder Identification Test (AUDIT) scale was used to assess the alcohol use disorder score. Data were entered using Epidata version 3.1 and analyzed using STATA version 14.

Results: It is found that two-third of the male OPD patients are using alcohol and 59% of the alcohol users were willing to quit alcohol. Education (adjusted prevalence rate ratio [aPR] = 1.9; 95% confidence interval [CI]: 1.2-2.9), occupation (aPR = 1.4; 95% CI: 1.1-1.8), higher AUDIT scores (aPR = 2.7; 95% CI: 2.2-3.5), frequency of alcohol use (aPR = 1.6; 95% CI: 1.2-2.0), and positive family history of alcohol-related illness times (aPR = 1.6; 95% CI: 1.3-2.0) were significantly associated with willingness to quit alcohol.

Conclusion: Two-third of the male OPD patients are using alcohol and 59% of the alcohol users were willing to quit alcohol. Education, occupation, higher AUDIT scores, frequency of alcohol use, and positive family history of alcohol-related illness were significantly associated with willingness to quit alcohol.
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http://dx.doi.org/10.4103/jehp.jehp_486_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7657403PMC
September 2020

Unintentional Injuries Among Under-five Children in a Rural Area in Delhi.

Indian Pediatr 2021 Jun 29;58(6):560-563. Epub 2020 Aug 29.

Department of Pediatrics, Lok Nayak Hospital and Maulana Azad Medical College, New Delhi.

Objective: To determine the prevalence of unintentional injuries and its associated factors among under-five children in Rural Delhi.

Methods: This community based cross-sectional study was conducted in Pooth Khurd village of Delhi during 2018 among under-five children and their care givers. Primary caregivers of the child in the randomly selected households were interviewed using a semi-structured pretested questionnaire. Data related to unintentional injuries in past 12 months and its associated factors were collected.

Results: Unintentional injuries were prevalent in 29.3% (95% CI: 25.8-32.9) of the 650 under-five children included. Male children had 1.4 times increased prevalence of injuries (aPR=1.4, 95% CI: 1.1-1.7). As the age increases from 2 years to 5 years the prevalence of injuries increased constantly from 29% to 50%. The prevalence of unintentional injuries was significantly higher among children of working mothers (aPR=1.7, 95% CI: 1.4-2.1), family with more than 3 children (aPR=1.6, 95% CI:1.1-2.4), household without a separate kitchen (aPR=1.6, 95% CI:1.2-2.2) and household with inadequate lighting (aPR=1.8, 95% CI:1.4-2.3).

Conclusions: The factors significantly associated with unintentional injuries were male gender, higher age of the children, maternal occupation, increased number of children in the family, not having a separate kitchen and inadequate lighting.
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June 2021

COVID-19 and tuberculosis: A mathematical model based forecasting in Delhi, India.

Indian J Tuberc 2020 Apr 12;67(2):177-181. Epub 2020 May 12.

New Delhi Tuberculosis Centre, New Delhi, 110002, India.

Background: There is emerging evidence that patients with Latent Tuberculosis Infection(LTBI) and Tuberculosis(TB) disease have an increased risk of the SARS-CoV-2 infection and predisposition towards developing severe COVID-19 pneumonia. In this study we attempted to estimate the number of TB patients infected with SARS-CoV-2 and have severe disease during the COVID-19 epidemic in Delhi, India.

Methods: Susceptible-Exposed-Infectious-Recovered (SEIR) model was used to estimate the number of COVID-19 cases in Delhi. Assuming the prevalence of TB in Delhi to be 0.55%, 53% of SARS-CoV2 infected TB cases to present with severe disease we estimated the number of SARS-CoV2 infected TB cases and the number of severe patients. The modelling used estimated R for two scenarios, without any intervention and with public health interventions.

Results: We observed that the peak of SARS-CoV-2-TB co-infected patients would occur on the 94th day in absence of public health interventions and on 138th day in presence of interventions. There could be 20,880 SARS-CoV-2 infected TB cases on peak day of epidemic when interventions are implemented and 27,968 cases in the absence of intervention. Among them, there could be 14,823 patients with severe disease when no interventions are implemented and 11,066 patients with severe disease in the presence of intervention.

Conclusion: The importance of primary prevention measures needs to be emphasized especially in TB patients. The TB treatment centres and hospitals needs to be prepared for early diagnosis and management of severe COVID-19 in TB patients.
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http://dx.doi.org/10.1016/j.ijtb.2020.05.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7214306PMC
April 2020

Seroconversion Rate and Diagnostic Accuracy of Serological Tests for Coronavirus 2019.

Clin Infect Dis 2020 12;71(11):3016

Department of Community Medicine, Maulana Azad Medical College, New Delhi, India.

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http://dx.doi.org/10.1093/cid/ciaa676DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7314238PMC
December 2020

Level of neighborhood environmental factors related to noncommunicable diseases in selected wards of urban Puducherry, South India.

J Educ Health Promot 2019 15;8:34. Epub 2019 Feb 15.

Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Background: Noncommunicable diseases (NCDs) are the leading causes of mortality worldwide. Environmental factors play an important role in development of risk factors. Hence, the study was done to assess the neighborhood environmental factors related to NCDs in urban area.

Methodology: This community-based cross-sectional study was carried out among three selected wards of urban Puducherry. All shops/establishments related to the risk of NCDs within the study area were study units. Information regarding tobacco, alcohol, diet, and physical activity-related establishments was assessed using pretested semi-structured pro forma. Shops/establishments were labeled either as "favorable" (prevents the risk of NCDs) or "unfavorable" (increases the risk of NCDs).

Results: Among 655 establishments, 372 (56.8%) belonged to favorable and 283 (43.2%) to unfavorable category, respectively. Tobacco-related establishments amount to 15.1% (95% confidence interval: 12.6-18.1) of the total establishments. Among these tobacco establishments, almost one-third were selling tobacco to minor and located within 100 m of school. Fruits and vegetable markets contributed to 21.8% of the total establishments. About 22% of the establishments were fast-food outlets. Public health sports facilities were only 6.8% of the total establishments.

Conclusion: The current study reported almost equal distribution of favorable and unfavorable establishments. However, among unfavorable establishments, tobacco establishments raised concern as one-third of those were selling tobacco to minors. Healthy diet and physical activity related establishments were also found to be less. Hence, corrective measures are to be implemented which will reduce the burden of behavioral risk factors.
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http://dx.doi.org/10.4103/jehp.jehp_130_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6432806PMC
February 2019

Role of Social Support and Spouse Abuse in Low Birth Weight: A Case-control Study from Puducherry, India.

Indian J Community Med 2019 Jan-Mar;44(1):12-16

Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Background: Low birth weight (LBW) is a major cause of neonatal morbidity and mortality. In addition to medical/clinical risk factors, various socio-demographic factors also have an impact on birth weight.

Objective: The objective of the study is to determine the association of antenatal social support and spouse abuse during pregnancy with LBW in Urban areas of Puducherry.

Materials And Methods: A community-based case-control study was conducted in Puducherry. Mothers of 100 LBW infants and normal birth weight infants in 2016 were studied. Functional Social Support Questionnaire and Index of Spouse Abuse scales were used. Conditional logistic regression for matched pair studies was done for multivariate analysis.

Results: Mean (± standard deviation) age and education of the study participants was 25.6 (±3.5) and 8.28 (±3.6) years, respectively. The proportion of girl child was 59% and 43% among cases and controls, respectively. Mothers with higher perceived social support (odds ratio [OR] = 0.5; 95% confidence interval [CI]: 0.4-0.7) had lesser odds of LBW. The odds of LBW was 3.6 (adjusted OR [aOR] = 3.6; 95% CI: 1.3-9.9) times and 6.9 (aOR = 6.9; 95% CI: 1.5-31.9) times greater among mothers who experienced nonphysical abuse and had pregnancy-induced hypertension respectively and it was statistically significant after adjusting for child's gender, social support, and parity.

Conclusions: The presence of nonphysical abuse during the antenatal period increased the risk of LBW. The awareness should be created in the community to prevent maternal exposure to abuse.
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http://dx.doi.org/10.4103/ijcm.IJCM_114_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437797PMC
April 2019

Prevalence and associated factors for social phobia among school-going adolescents in a rural area of Puducherry, South India.

Int J Adolesc Med Health 2018 Nov 6;33(1). Epub 2018 Nov 6.

Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Background: The World Health Organisation has reported that mental disorders are one of the leading causes of disability worldwide. Social phobia is one such mental disorder that can have significant impact on the livelihood of adults if not detected at an early stage. There have been very few studies done on social phobia among adolescents in South India. Hence, this study was done to determine the prevalence of social phobia and factors associated with it among the school-going adolescents in rural Puducherry.

Methodology: A community-based cross-sectional study was conducted among 1018 school going adolescents from December 2017 to January 2018 in rural Puducherry. Information on socio-demographic characteristics was collected by a pre-tested semi-structured questionnaire and social phobia was assessed using the validated Social Phobia Inventory (SPIN) questionnaire.

Results: Among 1018 participants, 738 (72.5%) belonged to early adolescence (10-13 years); 520 (51.1%) were boys; 557 (54.7%) were studying in a middle class; 931 (91.5%) were Hindus; 978 (96.1%) had siblings.The prevalence of social phobia among adolescents was found to be 22.9% (95% CI: 20.4-25.5%). The prevalence of mild social phobia was 18% [95% confidence interval (CI): 15.7-20.4%], moderate social phobia was 4% (95% CI: 2.9-5.4%), severe social phobia was 0.7% (95% CI: 0.3-1.3%) and very severe social phobia was 0.2% (95% CI: 0.03-0.64%). Higher age, female gender, lack of counselling services and specialist visits at school were found to be determinants of social phobia.

Conclusion: The current study showed that one in every five adolescents was at risk of developing social phobia. Health education for students, teachers and family members needs to be given to make them aware of the importance of social phobia.
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http://dx.doi.org/10.1515/ijamh-2018-0037DOI Listing
November 2018
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