Monika Agarwal

King George's Medical University | CSM · Department of Community Medicine

Millions of people infected by the SARS-CoV2 virus are now dealing with its sequelae, mostly known as ‘Long COVID’. Multiple studies have shown that approximately 10–20% of the survivors of COVID-19 develop symptoms that can be diagnosed as Long COVID. This systematic review and meta-analysis aimed at estimating the system-wise prevalence of Long C...

Background Globally, prevalence of diabetes is 10.5%, and in 2019, approximately 463 million adults were living with diabetes by 2045; this will increase to 700 million (10.9%). India is a diabetic capital of world, prevalence of diabetes in India is 8.3%. Aim This study aimed to assess self-care practices (SCPs) among type 2 diabetes mellitus (T2...

Introduction: Incomplete information in the referral letters may result in a delayed diagnosis, polypharmacy, and wasteful duplication of laboratory testing, which negatively impact patient care. The aim of the present study was to assess the quality (completeness and legibility) of obstetric referral documents sent by health personnel of lower-lev...

Background: Every woman needs to know the facts, and the fact is, when it comes to breast cancer, every woman is at risk. India accounts for 7.2% of global cancer incidence, but in terms of mortality, the country accounts for 8.3% of global mortality. India faces a high burden of cancer with the late-stage presentation being a common feature. Early...

MPOX is a zoonotic disease caused by orthopoxvirus. The disease is endemic in African countries, but major outbreak was reported in the early 2022 outside the endemic countries and subsequently spreading in the whole world following which it was declared as a Public Health Emergency of International Concern on July 23, 2022. MPOX is a self-limiting...

Problem considered: The initial foods that children have are critical not only for their immediate survival but also for their long-term potential. This study was done to describe the complementary feeding practices in children aged 6–23 months in rural Lucknow, Uttar Pradesh and to identify the factors associated with appropriate feeding practices...

Background: Gestational diabetes mellitus (GDM) is an emerging public health concern in India, which has detrimental effects on both the mother and the baby. The data on prevalence of GDM was unavailable at secondary urban health facilities, from where a majority of pregnant women seek antenatal services, and the following study identifies this bu...

Introduction: Community acquired pneumonia (CAP) is a leading cause of under-five mortality in India and Streptococcus pneumoniae is the main bacterial pathogen for it. Pneumococcal Conjugate Vaccine 13 (PCV13) has been introduced in a phased manner, in the national immunization program of India since 2017/2018. The primary objective of this study...

Health Insurance has come to the forefront of Public Health Policy with the launch of Ayushman Bharat. Government spending on health is dismal compared to other countries, even within the same income bracket, and health insurance is being proposed as the way out. Although health insurance is not a new concept, people are still unfamiliar with it. H...

Background Disparities in healthcare access to internal migrants exist, and the gaps may widen further if appropriate steps are not taken. Innovative approaches are needed to better align the healthcare services with the migrants’ needs. Aim The aim was to develop and test a supportive strategy of healthcare, which would achieve the desired level...

Background: The cross-sectional study was conducted in rural area of Lucknow, UP to assess the developmental status and its determinants among children aged 3 to 6 years registered in AWCs.Methods: A visit was made to the households of all the registered children (3-6 years) and parents were interviewed to obtain the sample size of 314.Results: Typ...

Background India rolled out the world's largest vaccination program on January 16, 2021, marking the beginning of an effort to vaccinate a population of 1.3 billion against coronavirus disease 2019 (COVID-19) infection. However, the hesitancy toward safe and effective vaccine against severe infection is a major global health threat. Hence, public a...

Background: Community-acquired pneumonia (CAP) is the leading cause of under-five mortality in India. An increased risk of mortality has been reported in cases of hypoxic pneumonia. Methods: The primary objective of this study was to assess the proportion of children aged 2-59 months, hospitalized with hypoxic CAP, as well as socio-demographic,...

Objective: This study examined the pattern of care-seeking behavior for childhood pneumonia and factors influencing it, in Madhya Pradesh (MP), Uttar Pradesh (UP) and Tamil Nadu (TN). Methods: Using a mixed-methods design, consenting mothers of children less than 5 years with probable pneumonia participated in a household survey to assess their...

During this pandemic 'Covid-19' a web based online study was conducted in the month of April 2020, during amidst lockdown period in India. The study was designed for students, pursuing higher education (graduation and above) as well as for the teachers, undergoing online classes. In that the online classes were found useful for science students (90...

Introduction: Home-based newborn care (HBNC) is a strategy adopted by government of India to overcome the burden of newborn deaths in the first week of life, it provides continuum of care for newborn and post-natal mothers. HBNC introduced since 2011 is centred around Accredited Social Health Activist (ASHA) and it is the main community-based appr...

Introduction: The postnatal period is the most critical period for mothers and her newborn especially during the hours and days after birth. Proper utilization of postnatal care services plays a vital role in dropping the maternal mortality ratio and infant mortality rate. Methods: The community based, cross-sectional study was carried out in th...

Background: The burden of community acquired pneumonia (CAP) in infants is high in India and Streptococcus pneumoniae is stated to be an common etiological agent for it. Hence Pneumococcal Conjugate Vaccination (PCV) has been introduced in India since 2017 in a phased manner. The objective of this study was the effect of PCV on radiological finding...

Context: Cardiovascular diseases (CVDs) are the number one cause of death globally, with low- and middle-income countries being affected disproportionately. By 2020, it is projected that there will be 25 million deaths from CVD worldwide, 19 million of which would be from middle- and low-income countries. Aims: The aim of this study was to estim...

An amendment to this paper has been published and can be accessed via the original article.

Background: NFHS-4 stated high unmet need for family planning (FP) among married women in Uttar Pradesh. Unmet need is highest among age groups: 15-19 and 20-24 years. Currently few data is available about unmet need for FP among vulnerable section of the community, i.e.15-24 year's age group living in the urban slums. Therefore this study was con...

Background: India is facing the surging trend of non-communicable diseases (NCD). Forecasting the burden for NCDs, the Government of India (GOI) initiated a program in 2010 across the country, i.e., National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke. The GOI has envisaged the female health workers...

Background: Postgraduate medical students face many issues regarding clinical ethics. Inadequate management of ethical issues in patient care can lead to multiple conflicts. This study was conducted to explore the perceptions and practices regarding standard clinical ethics and the challenges faced by postgraduate residents. Methods: A Cross-sectio...

Children have milder clinical course and better prognosis from SARS-Co-V-2 infection. But the after-effects of this pandemic can have severe repercussions on nutrition of children, especially those who are already malnourished. Poor nutrition in the first 1,000 days of a child’s life can lead to stunted growth, which is associated with impaired cog...

Background Based on World Health Organization guidelines, Government of India recommended management of possible serious bacterial infection (PSBI) in young infants up to two months of age on an outpatient basis where referral is not feasible. We implemented the guideline in program setting to increase access to treatment with high treatment succes...

Objectives The current study was a hospital-based surveillance of cases hospitalised with WHO-defined community-acquired pneumonia in children aged 2–59 months, to assess the radiological abnormalities in chest X-rays and to identify the demographic and clinical correlates of specific radiological abnormalities, in residents of prespecified distric...

Background and objectives Iodine plays a critical role in fetal brain development and hence has immense importance during pregnancy. Even mild to moderate iodine deficiency in pregnancy has adverse effects on obstetric and neonatal outcome. So, the aim of this study was to assess the trimester-wise urinary iodine status of pregnant women in rural a...

Background: Community acquired pneumonia is responsible for 16% of under 5 mortality in India, probably due to delayed recognition and qualified care seeking. Therefore these deaths could possibly be averted by creating community awareness and promoting care seeking from qualified physicians in the government system. The objective of study was to...

Objective: To report various components of health system responsiveness among poor internal migrants who availed the government health facilities in 13 Indian cities. Materials and methods: Cluster random sampling was used to select 50,806 migrant households, of which 14,263 households avail the government health facility in last six months. In...

Background: India bears highest burden of childhood morbidity and mortality due to childhood pneumonia. The study was conducted with aim to assess caregivers’ knowledge about signs/symptoms of childhood pneumonia and their perception about its risk factors and preventive measures. Methodology: This community based cross sectional study was carried...

Background: Cervical cancer is one of the most prevalent cancers among Indian women. Cervical cancer incidence reduces dramatically when effective screening programs linked with access to treatment are in place and are readily accessible. Peripheral health workers (PHWs) being frontline workers have a major influence on raising awareness among comm...

Abstract Background Community Acquired Pneumonia (CAP) is the leading cause of childhood morbidity and mortality worldwide including India. Many of these deaths can be averted by creating awareness in community about early symptoms of CAP and by ensuring availability of round the clock, quality health care. The objective was to assess the effective...

Background: Several socio-cultural risk factors have been cited as risk factor for maternal death. Birth preparedness prepares the mother and her family for place of delivery, transport for delivery and save money for delivery. Methods: This was a community based case-control study done in rural areas of Lucknow, UP (India) in a period of one year....

High maternal mortality ratio is not just an indicator of poor development but also an indicator of lack of human rights and gender inequity. Our study aimed to assess the distribution of biosocial characteristics amongst the different known causes of maternal deaths. Data was collected from the family members of the deceased for socio-demographic...

Background: The WHO estimates that of the 529 000 maternal deaths occurring every year 136 000 take place in India. Methods: This was a community based case-control study done in rural areas of Lucknow, UP (India) in a period of one year. 90 maternal deaths were identified and were matched with two controls. Data were analysed using SPSS version 1...

Background: The WHO estimates that, of the 529 000 maternal deaths occurring every year 136 000 take place in India amongst which postpartum haemorrhage (PPH) being the most (29.6%) commonly reported complication. However deaths from PPH can be prevented.The purpose of this study was to identify the risk factors contributing to maternal deaths amon...

Background: The WHO estimates that of the 529 000 maternal deaths occurring every year 136 000 take place in India. Methods: This was a community based case-control study done in rural areas of Lucknow, UP (India) in a period of one year. 90 maternal deaths were identified and were matched with two controls. Data were analysed using SPSS version 17...

Background: Health has been declared a fundamental human right. Governments all over the world are striving to expand and improve their health care services. Though there is scarcity of health care resources in India, yet utilization of the Govt. Health care facilities reveal that their outreach was not only poor but even where they are within the...

Japanese encephalitis (JE) virus and dengue virus are closely related flaviviruses but interaction between them is scarcely studied in humans. The objective of this study was to compare the outcome of JE patients who are positive and negative for dengue IgG antibodies. Patients of acute encephalitis syndrome (AES) fulfilling predecided inclusion an...

The role of frontline health workers is crucial in strengthening primary health care in India. This paper reports on the extent of services provided by frontline health workers in migrants' experiences and perceptions of these services in 13 Indian cities. Cluster random sampling was used to sample 51 055 households for a quantitative survey throug...

ABSTRACT Integrated Child Development Services, a flagship programme of the Government of India provides health, nutrition, and pre-school education to children aged three years to six years. Even after 35 years of implementation, the success of ICDS in tackling childhood and maternal problems remains a matter of concern. As per NFHS-3, in Uttar Pr...

Context: Globally, around 16% of under-five children die due to pneumonia. Childhood pneumonia, if identified early is a readily treatable through low-cost antibiotics. Access to timely and appropriate care is a key action to control pneumonia. Aims: The aim of the study was to understand the caregiver's care-seeking behavior for the management of...

Background: Total fertility rate of Uttar Pradesh is 2.7 with annual growth rate of 16.5. Age specific marital fertility rate (ASMFR) in Uttar Pradesh is highest in the age group of 20-24 years (383.9) followed by 15-19 years (271.0) age group. Use of contraceptives is also very low in this most productive age group. Among the Young married women i...

Community acquired pneumonia (CAP) is the leading cause of childhood deaths globally. Poor recognition of the danger signs of CAP, inappropriate care seeking, and community distrust in the primary health system are factors largely responsible for CAP related deaths in rural India. Our objective was to develop and pilot test culturally sensitive com...

Introduction: HIV/AIDS is one of the most devastating illnesses that humanity has ever faced. Depression in HIV/AIDS patients is very common but the factors affecting it are not well studied. Therefore, the present study aims to assess the prevalence and the predictors of depression among people living with HIV/AIDS (PLHA). Methods: A cross-section...

Pneumonia is responsible for about 1.2 million deaths in children under five years of age, mostly in developing countries, including India. In India. _Streptococcus pneumoniae_ (SP) and _Hemophilus influenzae_ (HI) are the common bacterial etiologic agents of pneumonia, and often cause abnormal chest radiology. Vaccine against HI has already been i...

Introduction: Hand washing with soap has been viewed as one of the most cost-effective modes of diminishing the overall burden of infectious diseases predominantly diarrhoea and respiratory infections. Objective: The present study aimed at determining the knowledge and practice of hand washing among the mothers with children aged 0-23months attendi...

Introduction: Adherence to antiretroviral therapy is a principal predictor for the success of human immunodeficiency virus (HIV) treatment. It remains as a challenge to acquired immunodeficiency syndrome (AIDS) treatment and care with the widespread of the associated risks. Therefore, study aims to assess nonadherence level and factors associated...

Background: Adequate infant and young child feeding (IYCF) practices are essential to ensure optimal survival, health, growth, development and overall nutritional status of children. Objective: The objective of the present study was to assess the IYCF practices among mothers with children aged 0-23 months attending immunisation clinic at a tertiary...

Context: Prevention with a positive approach has been advocated as one of the main strategies to diminish the new instances of HIV and the target are those who are engaged in high-risk sexual behavior. Therefore, understanding the risky behaviors of the HIV-infected individual is important. Aims: This study aimed to assess the prevalence and the...

Background: One of the major health challenges faced by India is the rapid growth of HIV/AIDS and its impact upon human life. Co-morbidities like anxiety are often overlooked while providing ART services to HIV/AIDS patients. Therefore the present study was conducted to assess the anxiety and associated factors among PLHA (People Living with HIV/AI...

INTRODUCTION: Understanding of family planning scenario among different societies and communities, which by and large reside in urban slum areas, might prove useful in increasing family planning acceptance by them and decreasing population growth. Unmet need is a valuable indicator for assessing the achievements of national family planning programs...

Introduction: Promotion of reproductive health through institutional delivery has been adopted by government as a strategy for reducing maternal mortality rate but still about half of the deliveries have been conducted at home. Cost barrier is one of the major cause for preferring home delivery instead of institutional delivery. Not only the direct...

Background: Worldwide pneumonia and diarrhoeal diseases are two major killers of children younger than five years. India tops the list across the world with high burden of pneumonia in under five children. To reduce the deaths due to pneumonia the most essential step is that caregivers must recognize the signs and symptoms and then seek appropriate...

Community-acquired pneumonia (CAP) is the leading cause of under-five mortality globally with almost one-quarter of deaths occurring in India.To identify predisposing, enabling and service-related factors influencing treatment delay for CAP in rural communities of two states in India. Factors investigated included recognition of danger signs of CAP...

Background: Slums have been part of the history of most cities, particularly in the early years of industrialization. Rapid urbanization and the mismatch in the provision and maintenance of proper housing conditions result in environmental decay, which further leads to origin and spread of health problems and diseases. Objective: To study the housi...

Background: Nutritional deficiency during pregnancy in rural India is common. The nutritional requirements during pregnancy are increased and on the other hand the dietary intake decreases because of symptoms related to pregnancy. This adversely affects the weight of newborn. In developing countries low birth weight is major problem. So this study...

Background: Lack of awareness about the risk factors is an important reason for delay in seeking medical care among patients with acute chest pain of cardiac origin. Objectives: To study the prevalence and awareness of cardiovascular risk factors and its sociodemo graphic determinants in patients attending cardiac emergency with acute chest pain of...

Majority of the death during neonatal period occur due to the low birth weight. So reduction of the neonatal mortality, availability of neonatal care service especially for low birth weight babies were required at the primary and secondary health care level. For this first assessment of actual condition of health services of essential newborn care...

Introduction To assess the magnitude, distribution, and determinants of catastrophic health expenditures (CHE) of households in urban Lucknow, North India. Methods A cohort of 400 households was selected by 2-step cluster sampling and baseline demographic survey was done followed by two six-monthly health surveys. CHE was defined as health expendi...

Background Health insurance in India is almost non-existent. Therefore all expenses incurred during illnesses are borne directly by the family and accurate estimates are not available. The primary objective of the study was to assess the proportion of households who incur out of pocket medical expenditure due to sickness of family members in an urb...

The upper extremity motor deficit is one of the functional challenges in post stroke patients. The objective of the present study was to evaluate the effectiveness of the meaningful task-specific training (MTST) on the upper extremity motor recovery during the subacute phase after a stroke. This was a randomized, controlled, double-blinded trial in...

The outcome of any disease is influenced by the decisions to seek care, timely arrival at appropriate diagnostic and treatment services and the receipt of adequate care from service providers. Satisfaction in service provision is increasingly being used as a measure of health system performance. Satisfaction manifests itself in the distribution, ac...

To assess household practices that can affect neonatal health, from the perspective of caregivers and health workers; to identify signs in neonates leading either to recognition of illness or health-care seeking; and to ascertain the proportion of caregivers who recognize the individual items of the integrated management of neonatal and childhood i...

OBJECTIVE: To assess household practices that can affect neonatal health, from the perspective of caregivers and health workers; to identify signs in neonates leading either to recognition of illness or health-care seeking; and to ascertain the proportion of caregivers who recognize the individual items of the integrated management of neonatal and...