Nationwide surveys of awareness of tuberculosis in India uncover a gender gap in tuberculosis awareness
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ABSTRACT:
SUBMITTER: Thimmanahalli Sobagaiah R
PROVIDER: S-EPMC11343850 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:The spatial delays of pulmonary tuberculosis (PTB) have been less explored. In this study, a total of 151,799 notified PTB cases were included, with median patient and diagnostic delays of 15 [interquartile range (IOR), 4-35] and 2 (IOR, 0-8) days, respectively. The spatial autocorrelation analysis and spatial-temporal scan statistics were used to determine the clusters, indicating that the regions in the southwestern and northeastern parts of Zhejiang Province exhibited high rates of long-term patient delay (LPD, delay ≥ 15 days) and long-term diagnostic delay (LDD, delay ≥ 2 days). Besides, the Mantel test indicated a moderately positive correlation between public awareness of suspicious symptoms and the LPD rate in 2018 (Mantel's r = 0.4, P < 0.05). These findings suggest that PTB delays can reveal deficiencies in public health education and the healthcare system. Also, it is essential to explore methods to shift PTB knowledge towards real changes in attitude and behavior to minimize patient delay. Addressing these issues will be crucial for improving public health outcomes related to PTB in Zhejiang Province.
| S-EPMC11347602 | biostudies-literature
Project description:OBJECTIVES:We report hospitalisation trends for different age groups across the states of India and for various disease groups, compare the hospitalisation trends among the older (aged 60 years or more) and the younger (aged under 60 years) population and quantify the factors that contribute to the change in hospitalisation rates of the older population over two decades. DESIGN:Serial cross-sectional study. SETTING:Nationally representative sample, India. DATA SOURCES:Three consecutive National Sample Surveys (NSS) on healthcare utilisation in 1995-1996, 2004 and 2014. PARTICIPANTS:Six hundred and thirty-three thousand four hundred and five individuals in NSS 1995-1996, 385 055 in NSS 2004 and 335 499 in NSS 2014. METHODS:Descriptive statistics, multivariable analyses and a regression decomposition technique were used to attain the study objectives. RESULT:The annual hospitalisation rate per 1000 increased from 16.6 to 37.0 in India from 1995-1996 to 2014. The hospitalisation rate was about half in the less developed than the more developed states in 2014 (26.1 vs 48.6 per 1000). Poor people used more public than private hospitals; this differential was higher in the more developed (40.7% vs 22.9%) than the less developed (54.3% vs 40.1%) states in 2014. When compared with the younger population, the older population had a 3.6 times higher hospitalisation rate (109.9 vs 30.7) and a greater proportion of hospitalisation for non-communicable diseases (80.5% vs 56.7%) in 2014. Among the older population, hospitalisation rates were comparatively lower for females, poor and rural residents. Propensity change contributed to 86.5% of the increase in hospitalisation among the older population and compositional change contributed 9.3%. CONCLUSION:The older population in India has a much higher hospitalisation rate and has continuing greater socioeconomic differentials in hospitalisation rates. Specific policy focus on the requirements of the older population for hospital care in India is needed in light of the anticipated increase in their proportion in the population.
| S-EPMC5770834 | biostudies-literature
Project description:BackgroundPre-exposure prophylaxis (PrEP) is a safe and effective HIV prevention strategy. However, in countries such as India where PrEP is driven by the private healthcare system and there is no centralized reporting, it is unknown which populations benefit from PrEP and which populations are being left behind.ObjectivesWe examined and characterized PrEP use and awareness among the sexual and gender minorities using smartphones in India and found measures of association of PrEP use.DesignThis is a cross-sectional study design.MethodsWe used Grindr-a widely used geosocial mobile application-to conduct a national cross-sectional survey in India, including respondents who were 18 years or older and reported sex with men (those who identified as cis-gender females were excluded). We examined overall PrEP awareness and PrEP use, then calculated adjusted prevalence odds ratio and 95% confidence intervals to understand PrEP use correlation with socio-behavioral factors.ResultsOut of the total of 3116 eligible participants, 30.3% (N = 947) were aware of PrEP and 3.1% (N = 97) reported current PrEP use. Our multivariate regression model found that there was a statistically significant association of PrEP use with higher income, being employed, preferred language as English for survey, relationship status as single, and use of party drugs. At the same time, there was a statistically significant association of PrEP awareness with age group, having higher education as a graduate or above, higher income, use of party drugs, and multiple sexual partners.ConclusionWe found overall low awareness and low PrEP use in our cross-sectional sample. PrEP use and awareness were higher among those who belonged to higher-income groups. Including PrEP in existing programmatic interventions by government and NGOs may contribute to PrEP scale-up, which is urgent to stop the HIV epidemic in India.
| S-EPMC11580082 | biostudies-literature
Project description:This study estimates the contribution of gendered social norms in explaining the gender gap in productivity of unorganised manufacturing firms. Restrictions on mobility and burden of household work mean that female firm-owners primarily operate from their household premises. Using data from unorganised firms operating in the manufacturing sector in India, this paper finds gender gap in firm productivity. The Blinder-Oaxaca decomposition at mean show that despite controlling for size of the firm, assets and other conventional factors, the location of a female proprietary firm within the household premises of the owner explains 19% of the observed gender gap in productivity. The RIF decomposition results show that at the different quartiles, this contribution varies from 19 to 36% of the composition effect. The evidence suggests that the persistence of the gender gap in firm productivity is associated with the persistence of gendered social norms. Supplementary Information The online version contains supplementary material available at 10.1007/s11187-022-00637-2. Plain English Summary Almost 95% of female owned firms in the unorganised manufacturing sector in India operate from within the household premises, due to prevalent gendered social norms. These norms put the responsibility of unpaid household work solely on women and impose mobility restrictions. This paper examines whether restrictive social norms contribute towards the gender gap in firm productivity. I find that that the location of these firms within the household restricts them from expanding, as well as contribute to prevalent the gender gap in productivity and incomes generated from proprietary firms operating in the unorganised manufacturing sector. Newer policies supporting women’s mobility and paid work that supplement conventional policies to improve entrepreneurship are required. However, as social norms involve coordinated actions and fear of sanction in case of noncompliance, these policies would work effectively if they are targeted towards both genders and entire neighbourhoods. Supplementary Information The online version contains supplementary material available at 10.1007/s11187-022-00637-2.
| S-EPMC9116277 | biostudies-literature
Project description:Men have higher death rates than women, but women do worse with regard to physical strength, disability, and other health outcomes, the so called male-female health-survival paradox. The paradox is likely to be due to multiple causes that include biological, behavioral, and social differences between the sexes. Despite decades of research on the male-female health-survival paradox, we still do not fully recognize whether behavioral factors explain most of the gender gap or whether biological and social differences contribute more substantially to the explanation of the sex differences in health and mortality. Little work has been done to investigate the magnitude of sex differences in healthy life expectancy and unhealthy life expectancy, as well as to examine the contribution of mortality and disability levels to the sex gap in health expectancy. The five selected works presented at the Réseau Espérance de Vie en Santé (REVES) Meeting 2009 in Copenhagen, and published in this issue, provide new insights into sex differences in health expectancy. The papers examine sex differences in health expectancy indicators in the EU countries, as well as trends in health expectancy in Hong Kong and in the US. They go beyond description of sex differences in health expectancy and assess the contributions of mortality and disability to gender differences in healthy life years and unhealthy life years, investigate temporal changes in sex differential health expectancy, as well as analyze contributions of time and age dimensions to the gender gap. They also show that there is still work to be done to indentify and quantify mechanisms underlying sex differences in longevity, health, and aging.
| S-EPMC5547325 | biostudies-other
Project description:We examine the gender gap in faculty promotion at the University of Geneva. After building a new measure of research quality that has no gender bias (i.e. men and women have, on average, the same level of research quality after we control for disciplines), we find that conditional on research quality, discipline and place where the PhD was obtained, women are 11 percent less likely to get promoted. The gender gap is almost three times larger for promotion from assistant to associate professor, suggesting that the mechanism at play is stronger for junior faculty. The gender gap is explained by the fact that an equal increase in research quality leads to a smaller increase in women's probability of promotion.
| S-EPMC11548758 | biostudies-literature
Project description:Whole genome microarray expression profiling was employed to identify differential gene expression profiles characteristic of tuberculosis patients in the South-Indian cohort. Whole blood samples were extracted from tuberculosis patients at the time of diagnosis and from healthy controls. The experiment served to validate computational predictions from a meta-analysis study of host transcriptional profiles in tuberculosis.
2016-05-24 | GSE81746 | GEO
Project description:A significant rural-urban disparity in unsafe child stool disposal practices exists in India, yet existing research falls short in identifying the contributing factors to this gap. This study addresses the research gap by contextualizing the rural-urban divide in unsafe child stool disposal using data from the fifth round of the National Family Health Survey (NFHS-5, 2019-21). In particular, the study examines the prevalence and predictors of unsafe disposal practices, exploring associated contributing factors to this gap. The study involves a sample of 78,074 women aged 15-49 with a living child under 2 years, without any missing data related to the study interest. Employing descriptive statistics, the Pearson chi-square test, multilevel logistic regression, and the Fairlie decomposition model, the research aims to fulfill its objectives. The rural-urban gap in unsafe child stool disposal practices among the study participants was 22.3 percentage points (pp), with a more pronounced gap among the Scheduled Tribes (ST). Notably, the gap was particularly wide in Madhya Pradesh (33.9 pp), Telangana (27.5 pp), Gujarat (26.1 pp), and Rajasthan (25.8 pp). Predictors such as mother's education, mass media exposure, household wealth quintile, and sanitation facilities proved significant irrespective of residence. However, religion, social group, and water facility on household premises emerged as significant factors in rural areas only. The study identified that 67% of the explained gap in unsafe child stool disposal practices was attributed to the rural-urban difference in household wealth. Other noteworthy contributors were 'household sanitation facility' (21.3%), 'mother's education level' (3.9%), and 'water facility on household premises' (3.9%). These findings underscore the need for population and area-specific policy interventions, especially for individuals from socio-economically disadvantaged backgrounds, those with lower education levels, and limited exposure to mass media, particularly in states with a high prevalence of unsafe disposal practices. Such interventions are crucial to mitigating the existing rural-urban gap in unsafe child stool disposal practices.
| S-EPMC10950857 | biostudies-literature
Project description:Equity in healthcare has been a long-term guiding principle of health policy in India. We estimate the change in horizontal inequities in healthcare use over two decades comparing the older population (60 years or more) with the younger population (under 60 years). We used data from the nationwide healthcare surveys conducted in India by the National Sample Survey Organization in 1995-96 and 2014 with sample sizes 633 405 and 335 499, respectively. Bivariate and multivariate logit regression analyses were used to study the socioeconomic differentials in self-reported morbidity (SRM), outpatient care and untreated morbidity. Deviations in the degree to which healthcare was distributed according to need were measured by horizontal inequity index (HI). In each consumption quintile the older population had four times higher SRM and outpatient care rate than the younger population in 2014. In 1995-96, the pro-rich inequity in outpatient care was higher for the older (HI: 0.085; 95% CI: 0.066, 0.103) than the younger population (0.039; 0.034, 0.043), but by 2014 this inequity became similar. Untreated morbidity was concentrated among the poor; more so for the older (-0.320; -0.391, -0.249) than the younger (-0.176; -0.211, -0.141) population in 2014. The use of public facilities increased most in the poorest and poor quintiles; the increase was higher for the older than the younger population in the poorest (1.19 times) and poor (1.71 times) quintiles. The use of public facilities was disproportionately higher for the poor in 2014 than in 1995-96 for the older (-0.189; -0.234, -0.145 vs - 0.065; -0.129, -0.001) and the younger (-0.145; -0.175, -0.115 vs - 0.056; -0.086, -0.026) population. The older population has much higher morbidity and is often more disadvantaged in obtaining treatment. Health policy in India should pay special attention to equity in access to healthcare for the older population.
| S-EPMC5886081 | biostudies-literature
Project description:Postelection surveys regularly overestimate voter turnout by 10 points or more. This article provides the first comprehensive documentation of the turnout gap in three major ongoing surveys (the General Social Survey, Current Population Survey, and American National Election Studies), evaluates explanations for it, interprets its significance, and suggests means to continue evaluating and improving survey measurements of turnout. Accuracy was greater in face-to-face than telephone interviews, consistent with the notion that the former mode engages more respondent effort with less social desirability bias. Accuracy was greater when respondents were asked about the most recent election, consistent with the hypothesis that forgetting creates errors. Question wordings designed to minimize source confusion and social desirability bias improved accuracy. Rates of reported turnout were lower with proxy reports than with self-reports, which may suggest greater accuracy of proxy reports. People who do not vote are less likely to participate in surveys than voters are.
| S-EPMC11244654 | biostudies-literature