Bridging the gap in full immunisation coverage with parental awareness and attitudes: a community-based cross-sectional analysis on routine childhood vaccinations in Perambalur district of Tamil Nadu, South India.

Objectives: To determine the independent predictors of full immunisation coverage (FIC) among children aged 12-23 months along with the parental awareness and attitudes (of children aged ≤23 months) regarding routine childhood vaccinations in Perambalur district of Tamil Nadu, South India.

Design: A community-based cross-sectional analysis.

Setting: Perambalur district situated in the central region of Tamil Nadu state, South India.

Healthcare service utilisation among adults with coronary artery disease in rural Aluva, South India: a community-based cross-sectional study.

Objectives: To assess the pattern and determinants of healthcare service utilisation among adults with coronary artery disease (CAD) in a rural setting in Kerala, India.

Design: A community-based cross-sectional analysis conducted within a study cohort.

Setting: The study was conducted from January 2022 to March 2022 within the ENDIRA Cohort (Epidemiology of Non-communicable Diseases In Rural Areas) in the rural part of Aluva municipality of Ernakulam district, Kerala, India, which comprises five adjacent panchayats with a population of approximately 100, 000 individuals.

Hypertension control in Kerala, India: A prescription-based study at primary and secondary level health care institutions.

Objective: We undertook a prescription-based study to identify the provider and institution-level factors related to achieving guideline-recommended control of hypertension and diabetes mellitus in Kerala, India.

Methods: This cross-sectional study in primary and secondary care hospitals in Kerala included both public and private institutions. One practitioner was selected from each institution.

Pattern of contraceptive use, determinants and fertility intentions among tribal women in Kerala, India: a cross-sectional study.

Objectives: To assess the pattern of contraceptive use and its determinants, knowledge regarding contraceptives including oral contraceptive pills and fertility intentions among tribal women in the reproductive age group.

Design: Community-based cross-sectional study.

Setting: Community development blocks in a predominantly tribal district of Wayanad in Kerala, India.

Uncontrolled Blood Pressure and Associated Factors Among Persons With Diabetes: A Community Based Study From Kerala, India.

Unlabelled: The coexistence of raised blood pressure (BP) in people with type 2 diabetes mellitus (T2DM) is a major contributor to the development and progression of both macrovascular and microvascular complications. The aim of our study was to determine the prevalence of uncontrolled BP and its associated factors in persons with T2DM in a district in Kerala.

Methods: The study was conducted in Ernakulam district in Kerala, and a total of 3,092 individuals with T2DM were enrolled after obtaining consent.

Motivators and Barriers for Physical Activity among Health-Care Professionals: A Qualitative Study.

Background: Physical inactivity is one of the critical risk factors for lifestyle-related diseases. In Kerala, the life expectancy of doctors who are considered the gatekeepers of health was found to be 13 years lower than the general population.

Objective: The objective was to identify the motivators and barriers for physical activity among doctors and nurses belonging to public and private health-care sectors in Ernakulam district.

Prevalence of anemia and its association with dietary pattern among elderly population of urban slums in Kochi.

Background: Anemia is common among the elderly and it is the reason behind their poor survival. Anemia among the elderly is consistently disregarded, which can even incite cardiovascular complexities. The risk of physical decline for the elderly with iron insufficiency is twofold than that of others in the same age.

Quality of medical prescriptions in diabetes and hypertension management in Kerala and its associated factors.

Background: Kerala is facing challenges in the secondary prevention efforts of non-communicable diseases (NCDs). In spite of being the top performer in health parameters among Indian states, the burden of NCDs, especially diabetes mellitus (diabetes) and hypertension, is higher in Kerala. This research endeavours to identify the role of quality of medical prescriptions in secondary prevention of diabetes and hypertension and suggest corrective measures.

Prevalence and Determinants of Somatization and Anxiety among Adult Women in an Urban Population in Kerala.

Background: Common mental disorders (CMDs) such as somatization and anxiety are prevalent in general practice. These are twice more common in women.

Objectives: The objective of this study is to estimate the prevalence and determinants of somatization and anxiety among adult women in an urban population of Kochi.

Impediments to Optimal Health-care Utilization of a Particularly Vulnerable Tribal Group in Wayanad: A Qualitative Study.

Introduction: The pathways and mechanisms through which constraints that impede optimal utilization of the government health-care service provisions translate into health inequities among Particularly Vulnerable Tribal Groups seem to be an area that warrants research.

Objective: The objective is to explore and understand the mechanisms/pathways through which various factors result in health care inequity among the Kattunayakan tribe in Wayanad.

Materials And Methods: Designed as a qualitative case study, using observations and interviews with mothers, community members, and frontline health-care personnel, the study was conducted in a Kattunayakan hamlet in Wayanad.

Comparison of Health-care Utilization Pattern and its Correlates among the Tribal and NonTribal Population of Kerala.

Background: The isolation from mainstream development activities, together with poverty and inaccessibility to health facilities made the tribal communities specifically vulnerable to various health problems.

Objectives: This study aimed to compare the utilization of antenatal care, immunization, and supplementary nutrition services by tribal and nontribal mothers and its correlates in the selected districts.

Materials And Methods: The study was a comparative cross-sectional study.

Prevalence and Factors of Urinary Incontinence among Postmenopausal Women Attending the Obstetrics and Gynecology Outpatient Service in a Tertiary Health Care Center in Kochi, Kerala.

Introduction: Urinary incontinence has an immense impact on the social and mental health, and the quality of life of a person. Women neither come forward seeking medical consultation nor do they discuss about their incontinence openly, and the condition remains underestimated in the society. Hence, this study was undertaken to assess the type of urinary incontinence in postmenopausal women visiting obstetrics and gynecology (OBG) outpatient in a tertiary health care sector and to determine the risk factors of urinary incontinence.

Incidence and outcomes of dengue in a cohort of pregnant women from an endemic region of India: obesity could be a potential risk for adverse outcomes.

Background: The primary objectives of the study were to determine the incidence of dengue and outcomes associated with dengue among pregnant women.

Methods: A prospective cohort study was done among 1579 antenatal women in an endemic region in India. Dengue immunoglobulin G (IgG) was tested in 490 women at baseline.

Association of estimated sleep duration and naps with mortality and cardiovascular events: a study of 116 632 people from 21 countries.

Aims: To investigate the association of estimated total daily sleep duration and daytime nap duration with deaths and major cardiovascular events.

Methods And Results: We estimated the durations of total daily sleep and daytime naps based on the amount of time in bed and self-reported napping time and examined the associations between them and the composite outcome of deaths and major cardiovascular events in 116 632 participants from seven regions. After a median follow-up of 7.

Availability and affordability of essential medicines for diabetes across high-income, middle-income, and low-income countries: a prospective epidemiological study.

Background: Data are scarce on the availability and affordability of essential medicines for diabetes. Our aim was to examine the availability and affordability of metformin, sulfonylureas, and insulin across multiple regions of the world and explore the effect of these on medicine use.

Methods: In the Prospective Urban Rural Epidemiology (PURE) study, participants aged 35-70 years (n=156 625) were recruited from 110 803 households, in 604 communities and 22 countries; availability (presence of any dose of medication in the pharmacy on the day of audit) and medicine cost data were collected from pharmacies with the Environmental Profile of a Community's Health audit tool.

Reliability and validity of PHQ-9 when administered by health workers for depression screening among women in primary care.

Background: Depression is twice more prevalent among women but remains unidentified in primary care.

Objective: We aimed to estimate the reliability and validity of PHQ-9, when administered by health workers, a cadre of public health staff, posted in primary health centres. We translated PHQ-9 to Malayalam, a language spoken by 30 million people in Kerala, India.

Effectiveness of community-based depression intervention programme (ComDIP) to manage women with depression in primary care- randomised control trial.

Background: In low and middle income countries where mental health resources are limited, community based depression intervention models, which can be implemented through the existing health system, are extremely relevant.

Objective: To test the effectiveness of Community based Depression Intervention Programme (ComDIP), newly developed by us, to reduce severity of depression in women, compared to the treatment as usual (TAU).

Methods: An RCT (Trial registration Number: CTRI/2011/08/001978, Clinical Trials Registry -India) was conducted in a primary care setting in Trivandrum, Kerala, South India.

Tobacco control environment: cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries.

Objectives: This study examines in a cross-sectional study 'the tobacco control environment' including tobacco policy implementation and its association with quit ratio.

Setting: 545 communities from 17 high-income, upper-middle, low-middle and low-income countries (HIC, UMIC, LMIC, LIC) involved in the Environmental Profile of a Community's Health (EPOCH) study from 2009 to 2014.

Participants: Community audits and surveys of adults (35-70 years, n=12 953).

Effects of bidi smoking on all-cause mortality and cardiorespiratory outcomes in men from south Asia: an observational community-based substudy of the Prospective Urban Rural Epidemiology Study (PURE).

Background: Bidis are minimally regulated, inexpensive, hand-rolled tobacco products smoked in south Asia. We examined the effects of bidi smoking on baseline respiratory impairment, and prospectively collected data for all-cause mortality and cardiorespiratory events in men from this region.

Methods: This substudy of the international, community-based Prospective Urban Rural Epidemiology (PURE) study was done in seven centres in India, Pakistan, and Bangladesh.

Availability, affordability, and consumption of fruits and vegetables in 18 countries across income levels: findings from the Prospective Urban Rural Epidemiology (PURE) study.

Background: Several international guidelines recommend the consumption of two servings of fruits and three servings of vegetables per day, but their intake is thought to be low worldwide. We aimed to determine the extent to which such low intake is related to availability and affordability.

Methods: We assessed fruit and vegetable consumption using data from country-specific, validated semi-quantitative food frequency questionnaires in the Prospective Urban Rural Epidemiology (PURE) study, which enrolled participants from communities in 18 countries between Jan 1, 2003, and Dec 31, 2013.

The environmental profile of a community's health: a cross-sectional study on tobacco marketing in 16 countries.

Objective: To examine and compare tobacco marketing in 16 countries while the Framework Convention on Tobacco Control requires parties to implement a comprehensive ban on such marketing.

Methods: Between 2009 and 2012, a kilometre-long walk was completed by trained investigators in 462 communities across 16 countries to collect data on tobacco marketing. We interviewed community members about their exposure to traditional and non-traditional marketing in the previous six months.