Indian Journal of Community Medicine最新文献

{"title":"Determinants of Antiretroviral Therapy Nonadherence among People Living with HIV: A Cross-sectional Study from a Tertiary Care Hospital in Jabalpur, Madhya Pradesh, India.","authors":"Aprajita, Sunita Patel, Arvind Sharma, Prince K Lodhi","doi":"10.4103/ijcm.ijcm_21_26","DOIUrl":"10.4103/ijcm.ijcm_21_26","url":null,"abstract":"<p><strong>Background: </strong>Nonadherence to antiretroviral therapy (ART) remains a critical barrier to achieving optimal treatment outcomes among people living with HIV (PLHIV). Understanding multidimensional factors influencing adherence is essential for targeted interventions.</p><p><strong>Aim and objective: </strong>This study aimed to assess determinants of nonadherence to ART among PLHIV attending a tertiary care hospital in Jabalpur, Madhya Pradesh, India.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted among 1,067 PLHIV aged ≥18 years receiving ART for ≥6 months at a tertiary care hospital in Jabalpur, Madhya Pradesh. Adherence was assessed using the pill count method, with <95% defined as nonadherence. Data on sociodemographic, patient-related, condition-related, therapy-related, and health system-related factors were collected through structured interviews and medical records review. Chi-square tests and odds ratios were calculated to identify significant associations.</p><p><strong>Results: </strong>Nonadherence prevalence was 17.5%. Significant predictors included dissatisfaction with family support (aOR = 38.61), NGO linkage (aOR = 3.82), non-heterosexual transmission routes (aOR = 3.09), current CD4 count <200 cells/mm³ (aOR = 2.90), and age ≤35 years (aOR = 1.51).</p><p><strong>Conclusion: </strong>This study found a 17.5% nonadherence rate among PLHIV on ART in Jabalpur. Younger age, non-heterosexual transmission, poor family support, and low CD4 counts were key predictors. Strengthening social support, addressing stigma, and focusing on vulnerable groups may help improve ART adherence and contribute to progress toward the 95-95-95 targets.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 5","pages":"902-910"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Successful Breastfeeding: A Skill-based Education Intervention for First-Time Mothers.","authors":"D Diksha, Meenakshi Khapre, Latika Chawla, Smita Sinha, Nishit Jain","doi":"10.4103/ijcm.ijcm_697_25","DOIUrl":"10.4103/ijcm.ijcm_697_25","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding provides optimal nutrition and immune protection for newborns; however, in India and other low- and middleincome countries, only about half of infants are breastfed within the first hour of birth, making initiation and continuation challenging. This study assessed the effectiveness of a skill-based group education module on breastfeeding among primiparous women in the third trimester in establishing successful breastfeeding.</p><p><strong>Materials and methods: </strong>A quasirandomized controlled trial was conducted from December 2023 to May 2024 in the inpatient and outpatient departments of AIIMS Rishikesh and SPS Hospital. Primiparous women in the third trimester were allocated day-wise to either the intervention or control group. The intervention group received a validated skill-based breastfeeding education session supplemented with WhatsApp support and routine antenatal care (ANC), while the control group received routine ANC alone. Data on breastfeeding knowledge, attitude, early initiation of breastfeeding (EIBF), breastfeeding self-efficacy (BFSEF), and challenges were collected before and after the intervention.</p><p><strong>Results: </strong>The intervention group demonstrated a significant improvement in knowledge scores, increasing from a prepartum mean of 3.12 (SD (standard deviation) =0.87) to 7.93 (SD = 0.25) postdelivery, with a mean difference of 4.81 (SD = 0.90). Although the proportion of EIBF was higher in the intervention group, the difference was not statistically significant after adjustment for baseline knowledge. The overall mean breastfeeding success score was higher in the intervention group (16.13, SD = 1.15) compared with the control group (15.35, SD = 1.15). BFSEF was also significantly higher in the intervention group (45.36, SD = 3.98) than in the control group (40.71, SD = 4.05).</p><p><strong>Conclusions: </strong>Skill-based breastfeeding education significantly improved maternal knowledge, components of successful breastfeeding, and selfefficacy. Although EIBF rates did not differ significantly, the intervention enhanced preparedness and confidence among firsttime mothers.</p><p><strong>Trail registration: </strong>CTRI/2024/02/063346 (Clinical trial registry of India registered on February 29, 2024. First patient recruited on March 29, 2024).</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 5","pages":"792-800"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Challenges in Special Education: A Qualitative Analysis from the Perspectives of Special Educators in Tamil Nadu, India.","authors":"Harishma Ramesh, Pavan Kumar Gollapalli, Rajeshkannan Sivakumar, Vedapriya Dande Rajasekar","doi":"10.4103/ijcm.ijcm_50_26","DOIUrl":"https://doi.org/10.4103/ijcm.ijcm_50_26","url":null,"abstract":"<p><strong>Introduction: </strong>Special educators play a crucial role in supporting children with disabilities, yet social, institutional, and policy-related challenges shape their professional experiences. This study explored the lived experiences and perceived challenges of special educators in Tamil Nadu, India.</p><p><strong>Methods: </strong>A qualitative descriptive phenomenological study was conducted between April and June 2024 among 32 special educators working in government, private, and non-governmental organization settings in Tamil Nadu. Participants were recruited using purposive snowball sampling. Data were collected through semi-structured interviews conducted in English or Tamil. Interviews were audio-recorded, transcribed verbatim, translated where required, and analyzed using inductive thematic analysis with Atlas.ti. Trustworthiness was enhanced through member checking, peer debriefing, reflexive note-taking, and maintenance of an audit trail.</p><p><strong>Results: </strong>Five major themes emerged: community and parental involvement, societal knowledge and acceptance, professional development needs, policy and administrative support, and lack of resources and support. Educators reported delayed parental recognition of disability, inconsistent parental cooperation, societal stigma, gaps in practical training, uneven administrative support, and limited teaching resources. The themes were interconnected, indicating that challenges in special education arise from the interaction of family, societal, institutional, and policy-level factors.</p><p><strong>Conclusion: </strong>Special educators in Tamil Nadu face multidimensional challenges that extend beyond classroom teaching. Strengthening special education requires improved parental engagement, disability-sensitive community awareness, regular professional development, adequate resource allocation, and stronger implementation of supportive policies.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 5","pages":"863-870"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"STI Care Beyond Biomedical Models: Addressing Stigma, Gender, and Psychosocial Dimensions.","authors":"Akhil Dhanesh Goel, Manoj Kumar Gupta, Sumit Aggarwal","doi":"10.4103/ijcm.ijcm_808_26","DOIUrl":"10.4103/ijcm.ijcm_808_26","url":null,"abstract":"","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 5","pages":"763-764"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Determinants of Post-Coronavirus Disease Syndrome by Disease Severity: An Ambispective Cohort Study from a Tertiary Care Hospital in Puducherry.","authors":"S R Renjana, Mahadevan Duraiswamy, Venkatachalam Jayaseelan, Arulprasad Radjasegarane, Mukta Wyawahare, Sitanshu Sekhar Kar, Ravivarman Lakshmanasamy, Vanessa Ravel","doi":"10.4103/ijcm.ijcm_612_25","DOIUrl":"10.4103/ijcm.ijcm_612_25","url":null,"abstract":"<p><strong>Background: </strong>Post-coronavirus disease 2019 (COVID-19) condition, or long COVID, persists beyond the acute phase, impacting quality of life. This study estimated the incidence and determinants of post-COVID syndrome (PCS) in Puducherry, India.</p><p><strong>Methods: </strong>This ambispective cohort study from May to December 2022 included 1162 adults with COVID-19. Participants were stratified by disease severity (moderate/severe and mild) based on clinical parameters during acute illness. We conducted follow-ups at 1, 3, 6, and 12 months. PCS was defined as having ≥two of five common symptoms (fatigue, joint/muscle pain, breathing difficulty, loss of smell/taste, or sleep problems). Relative risks (RR) and 95% confidence intervals (CI) were estimated using binomial regression with a Poisson link, adjusting for socio-demographic and clinical factors.</p><p><strong>Results: </strong>Incidence of PCS was consistently higher in the moderate/severe group. At 1, 3, 6, and 12 months, incidence was 65.6%, 37.7%, 24.4%, and 34.4% for moderate/severe cases, and 24.3%, 11.0%, 7.1%, and 16.9% for mild cases, respectively. Moderate/severe cases had significantly higher RR of 2.70 at 1 month (95% CI: 2.31-3.15), 3.42 at 3 months (95% CI: 2.65-4.40), 3.46 at 6 months (95% CI: 2.49-4.80), and 2.04 at 12 months (95% CI: 1.65-2.52), all <i>P</i> < 0.001. Independent risk factors for PCS included rural residence, comorbidities, complications during hospitalization, and age over 30 years.</p><p><strong>Conclusion: </strong>Moderate/severe COVID-19 severity and specific socio-demographic and clinical factors were associated with an elevated risk of PCS. Early identification and targeted follow-up are recommended to mitigate long-term impacts.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 5","pages":"842-849"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging Digital Health for Effective Public Health Program Implementation in India.","authors":"Parasuraman Ganeshkumar, Murali Krishnan Nambirajan, Mathan Karuppiah","doi":"10.4103/ijcm.ijcm_108_25","DOIUrl":"10.4103/ijcm.ijcm_108_25","url":null,"abstract":"<p><p>The World Health Organization (WHO) underscores the critical role of information in health systems, highlighting its pivotal impact on healthcare outcomes. Digital health represents a transformative shift in healthcare delivery by leveraging Information and Communication Technologies (ICTs) such as mobile applications, electronic health records, telemedicine platforms, and data management systems to improve access to care, efficiency and decision-making in health services. Initiatives like India's Ayushman Bharat Digital Mission (ABDM) and national digital health roadmap underscore a commitment to digital solutions. However, there are hurdles to the implementation of digital health, including design complexity and aversion to change. To ensure easy integration into national health programs, WHO promotes a digital health enterprise model that places a strong emphasis on aligning digital technologies with health system processes, governance, and infrastructure to enable coordinated and scalable digital health implementation. Digital health plays a crucial role in planning, operationalization, and monitoring of healthcare interventions. Therefore, identifying these key factors that contribute to successful implementation is essential. A systematic implementation approach is essential, including situational analysis, interdisciplinary collaboration, clear intervention goals, appropriate technology selection, realistic planning, cost considerations, and robust monitoring. Embracing digital development principles in a digital health enterprise approach holds promise for overcoming health system challenges and enhancing program outcomes, thereby advancing healthcare objectives.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 5","pages":"765-769"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Pre-hospital Delay in Myocardial Infarction: A Cross-sectional Study at a Tertiary Care Center of Ahmedabad, India.","authors":"Parthvi Shah, Amal R Nair, Venu Shah, Viral Dave","doi":"10.4103/ijcm.ijcm_817_25","DOIUrl":"10.4103/ijcm.ijcm_817_25","url":null,"abstract":"<p><strong>Background: </strong>Myocardial infarction (MI) is a leading cause of death globally, with early treatment being critical in reducing mortality. Understanding determinants contributing to pre-hospital delay is essential to improve the outcome.</p><p><strong>Objective: </strong>The present study evaluated the time distribution between symptom onsets to hospital arrival and associated factors among patients with MI.</p><p><strong>Materials and methods: </strong>A cross-sectional study included 105 MI patients admitted to a tertiary care teaching hospital in Ahmedabad city during March to August 2024. Patients fulfilling the inclusion criteria were interviewed using a pre-tested, semi-structured questionnaire. Pre-hospital delay was considered as the time elapsed from symptom onset to arrival at a tertiary care hospital among MI patients. Delay was categorized into two groups: ≤2 hours and >2 hours. Appropriate statistical tests were used to assess the association between factors influencing the time from symptom onset to hospital arrival.</p><p><strong>Results: </strong>The median time from symptom onset to tertiary hospital arrival was 90 minutes (Interquartile range: 45-210 minutes). Out of a total of 105 participants, 37 (35.2%) experienced delays of >2 hours. Younger age (odds ratio [OR]: 2.16; <i>P</i> = 0.171), female gender (OR: 3.2; <i>P</i> = 0.03), and nuclear family structure (OR: 1.56; <i>P</i> = 0.39) were predictors of pre-hospital delay. Patients having previous similar episodes of symptoms or who misinterpreted them as non-heart-related also reported longer delays.</p><p><strong>Conclusion: </strong>Approximately one-third of patients reported a delay of >2 hours. Younger age, female gender, nuclear family structure, previous episodes of symptoms, and misinterpretation of symptoms were significant determinants of pre-hospital delay in MI patients.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 5","pages":"919-923"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of Deaths and Disability-adjusted Life Years Attributable to Suboptimal High Temperature in India: Analysis of the Global Burden of Disease Estimates (1990-2021).","authors":"Sonia Kochhar, Deepak Chaudhary, Ashwani Ummat, Kenisha Ummat, Moonis Mirza, Madhur Verma","doi":"10.4103/ijcm.ijcm_706_25","DOIUrl":"10.4103/ijcm.ijcm_706_25","url":null,"abstract":"<p><strong>Background: </strong>Rising ambient temperatures are an escalating health risk in India, yet long-term, disease-specific burdens are poorly quantified. The present study assessed national and subnational trends in mortality and disability-adjusted life years (DALYs) attributable to suboptimal high temperatures in India and quantify 1990-2021 trends in heat-attributable deaths and DALYs.</p><p><strong>Methods: </strong>We conducted a secondary descriptive analysis of Global Burden of Disease 2021 estimates for India and all states/union territories (UTs) from 1990 to 2021. Outcomes were absolute deaths/DALYs and age-standardized rates per 100,000, stratified by sex and cause groups. Estimates with 95% uncertainty intervals were extracted from Global burden of disease (GBD) Compare; no additional modeling beyond GBD methods was performed.</p><p><strong>Results: </strong>India's heat-attributable burden more than tripled in absolute terms between 1990 and 2021, while age-standardized death rates increased modestly (7.78 to 9.89 per 100,000). Males consistently had higher mortality and DALY rates than females. A marked shift from communicable, maternal, neonatal, and nutritional (CMNN) diseases to non-communicable diseases (NCDs) was observed. Among selected NCDs, ischemic heart disease and stroke showed increasing age-standardized DALY rates, whereas chronic kidney disease and chronic respiratory diseases showed slight declines. State-level heterogeneity was substantial, with Kerala, Tamil Nadu, and Delhi showing stable/declining rates, whereas Maharashtra, Chhattisgarh, Bihar, West Bengal, and several northeastern states recorded pronounced increases.</p><p><strong>Conclusions: </strong>Heat-attributable deaths and DALYs in India have risen sharply with an epidemiological shift toward NCD-related vulnerability and subnational disparities. Findings underscore the urgent need to implement state-tailored heat action plans with health-system preparedness that integrate NCD risk management and prioritize high-risk populations and geographies.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 5","pages":"801-809"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Determinants of Diabetic Peripheral Neuropathy among Participants with Type 2 Diabetes Mellitus in Rural South India: A Community-Based Cross-Sectional Study.","authors":"Ravikrishnan Ravi, Vinothkumar Gunasekaran, Murugan Venkatesan","doi":"10.4103/ijcm.ijcm_825_25","DOIUrl":"10.4103/ijcm.ijcm_825_25","url":null,"abstract":"<p><strong>Background: </strong>Diabetic peripheral neuropathy (DPN) is one of the most common microvascular complications of type 2 diabetes mellitus (T2DM) and contributes substantially to morbidity and disability. Early detection and identification of associated factors are essential for preventing complications and improving diabetes care.</p><p><strong>Objectives: </strong>To estimate the prevalence of diabetic peripheral neuropathy and identify its independent predictors among participants with T2DM in rural South India.</p><p><strong>Methods: </strong>A community-based cross-sectional study was conducted among 390 participants with T2DM in the field practice area of a Rural Health and Training Centre, Chengalpattu district, Tamil Nadu, from October 2022 to August 2024. Participants were selected using a two-stage cluster sampling technique. DPN was assessed using the 10-g monofilament test, 128-Hz tuning fork test, and ankle reflex assessment. Data were analyzed using descriptive statistics, Chi-square test, and multivariable logistic regression. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were reported.</p><p><strong>Results: </strong>The prevalence of diabetic peripheral neuropathy was 35.6% (95% CI: 30.8%-40.3%). Poor glycemic control and low medication adherence were observed in 47.2% and 34.1% of participants, respectively. Multivariable logistic regression showed that age ≥60 years, insulin-based treatment, alcohol consumption, the presence of comorbidities, poor glycemic control, and low medication adherence were independent predictors of diabetic peripheral neuropathy. Participants aged <60 years had significantly lower odds of diabetic peripheral neuropathy than those aged ≥60 years.</p><p><strong>Conclusion: </strong>More than one-third of participants with T2DM had diabetic peripheral neuropathy. Early screening, routine foot examination, improved glycemic control, and strengthening primary healthcare services are essential to reduce the burden of DPN in rural communities.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 5","pages":"850-856"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycemic Status and its Determinants among People Living with Type 2 Diabetes Attending NCD clinics of Health and Wellness Centre-Urban Primary Health Centres of Kalyani, Nadia, West Bengal.","authors":"Jeevanmuktha Somashekara, Farhad Ahamed, Debkumar Pal, Sarika Palepu, Nimisha Biswas, Ayan Roy, Jitendra Majhi","doi":"10.4103/ijcm.ijcm_1_26","DOIUrl":"10.4103/ijcm.ijcm_1_26","url":null,"abstract":"<p><strong>Background: </strong>Prevalence of diabetes is on a rising trend worldwide as well as in India. Diabetes control remains suboptimal in India's noncommunicable diseases (NCD) clinics despite the implementation of the National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD). This study assessed glycemic status and determinants among diabetics attending health and wellness center (HWCs)-urban primary health centers (UPHCs).</p><p><strong>Materials and methods: </strong>Cross-sectional study of 164 type 2 diabetics (≥6 months duration) consecutively recruited from NCD clinics of two UPHCs in the months of October and November 2025. Glycemic status was determined using hemoglobin A1c (HbA1c) where available, or fasting and postprandial blood glucose values according to the American Diabetes Association criteria. Medication adherence was measured using the Hill-Bone Medication Adherence Scale and blood investigation compliance was measured objectively. Multivariable logistic regression identified determinants of uncontrolled glycemic status, and a sensitivity analysis restricted to participants with HbA1c measurements was performed.</p><p><strong>Results: </strong>The proportion of diabetics with uncontrolled glycemic status was 59.8% (95% confidence interval [CI]: 51.8-67.3). Significant predictors included male gender (adjusted odds ratio [aOR]: 2.59; 95% CI: 1.11-6.05; <i>P</i> = 0.027), obesity (aOR: 0.31; 95% CI: 0.13-0.74; <i>P</i> = 0.008), diabetes duration >5 years (aOR: 4.55; 95% CI: 2.02-10.21; <i>P</i> < 0.001), and blood investigation non-compliance (aOR: 8.47; 95% CI: 3.54-20.28; <i>P</i> < 0.001). Sensitivity analysis yielded findings consistent with the primary analysis. Major barriers to blood investigation non-compliance were inconvenience, waiting time, and forgetfulness.</p><p><strong>Conclusion: </strong>High uncontrolled glycemia (59.8%) among NCD clinic attendees underscores implementation gaps. Male gender, long duration, and investigation non-compliance drive poor outcomes. Point-of-care testing and targeted interventions can optimize primary care diabetes management under the NP-NCD.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"51 5","pages":"879-884"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}