Prashant Kokiwar
@mrims.edu.in/newwebsite
Professor and HOD, Department of Community Medicine
Malla Reddy Institute of Medical Sciences, Hyderabad
EDUCATION
MBBS, MD(Community Medicine)
RESEARCH INTERESTS
Epidemiology
Research Methodology
Biostatistics
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
P. Kokiwar and V. Gaiki
Background: Vaccine hesitancy is hesitancy to take vaccine. Studies are required to identify prevalence of coronavirus disease 2019 (COVID-19) vaccine hesitancy. It is equally important to recognize factors responsible for this hesitancy. This data will help to plan health education measures so that healthcare workers can overcome the barriers for vaccine hesitancy. Objective: The objective of this article is to study prevalence and factors associated with COVID-19 vaccine hesitancy among healthcare workers. Methods: This was a single-center, cross-sectional study carried out over a period of two months among 1063 healthcare workers. Those with missing information, not consenting and absent on the day of survey were excluded. Healthcare workers included doctors including postgraduates, nurses, para-medical staff, admin staff, and housekeeping staff either working in hospital or medical college. Results: Prevalence of vaccine hesitancy was 15.1%. On logistic regression, as age increased odds of vaccine hesitancy decreased significantly (OR = 0.95; 95%CI = 0.92-0.98; P < 0.05). Patient contact of <10/day was associated with the decreased odds of vaccine hesitancy compared to those with patient contact of >40/day. Odds of vaccine hesitancy among those with poor knowledge was 2.84 (95%CI = 1.91-4.21; P < 0.05) times more compared to those with good knowledge. Odds of vaccine hesitancy was 3.22 (95%CI = 1.09-9.48; P < 0.05) times and 3.31 (95%CI = 1.05-10.48; P < 0.05) times more among educated up to primary and illiterate respectively compared to higher educated persons. Conclusion: We conclude that low levels of education, poor knowledge, and young age were independently and significantly associated with vaccine hesitancy among healthcare workers. Prevalence of vaccine hesitancy was still high at 15.1%.
PrashantRamdas Kokiwar, Bhadra Reddy, Preeti Reddy, Siddappa Gowrav, and Chandrakant Shirole
Medknow
Prashant Ramdas Kokiwar
Indian Association of Preventive and Social Medicine
Studies on risk factors of tuberculosis help to focus on risk of tuberculosis and take appropriate policy action which help to eliminate tuberculosis. Hence present study was carried out to study risk factors of pulmonary tuberculosis. Community-based case-control studywas carried out among 78 age and sex matched cases and controls. Cases were incident cases of pulmonary tuberculosis aged 18-45 years of either sex. Data on housing condition was recorded with direct observation. Cases and controls were comparable for age, sex, presence of diabetes, HIV and immuno-compromised status. Mean body mass index was significantly low in cases as compared to controls (18.06 vs. 22.05; p<0.0001). On binomial logistic regression odds of tuberculosis was 5.544 (95%CI=2.513-12.232; P=0.000) among those exposed to indoor air pollution after controlling for other factors. We conclude that exposure to indoor air pollution was significantly associated with risk of pulmonary tuberculosis
P. Kokiwar and P. Nikitha
Context: Learning about menstrual hygiene is vital part of health education for adolescent girls so that they can continue to work and maintain hygienic habits throughout their adult life. Aim: The aim is to study the efficacy of focused group discussion (FGD) in comparison to didactic lecture method (DL) on knowledge and practices related to menstruation among adolescent girls of rural areas. Materials and Methods: Community-based interventional study was carried out among 260 adolescent girls. Knowledge and practice were assessed with the help of questionnaire preintervention. During intervention, 130 girls in DL group were given DL and 130 girls in FGD received FGD. After 2 months, all 260 girls were contacted. Their knowledge and practices were assessed using same questionnaire. Statistical Analysis: Yates corrected Chi-square and Student's t-test was used. Results: Both methods were equally effective in increasing mean knowledge and practices score (P < 0.05). On comparison of mean postintervention scores between the two groups for knowledge, the FGD method was found to be superior (P < 0.05) but not for practices (P > 0.05). Conclusion: FGD was more effective than DL method for knowledge related to menstruation but not for practices.
Adnatesh V. Katta and P. Kokiwar
Context: School-going children are documenting the increasing incidence of high blood pressure (BP). Compared to adults, the prevalence of hypertension (HT) is low among children, but high BP among them can lead to HT in their adult life. Aim: The aim of was to study the risk factors and correlates of high BP among school-going children. Materials and Methods: A cross-sectional study was carried out for 1½ years among 892 randomly selected school children of 6th–10th class. Measurements such as height, weight, and BP were recorded and classified as per the standard guidelines for given age and sex. Statistical Analysis: Correlation and linear regression analysis were done for continuous variables. For dichotomous variables, mean and standard deviation were calculated and t-test was used in this study. Results: Higher age group, being male, and obesity were found to be significantly associated with elevated systolic BP (SBP) and elevated diastolic BP (DBP). Family history of diabetes and HT was significantly associated with elevated DBP. On linear regression analysis, the studied factors explained 30% variation in SBP and only 12% variation in DBP. Weight and body mass index explained the maximum variation in both SBP and DBP. Conclusion: Overweight or obesity, being male, family history of HT, and increasing age were important risk factors of elevated BP.
MS Leena, Mohd. Shafee, PR Kokiwar, and GS Jogdand
Diva Enterprises Private Limited
Context: With a quarter of all cervical cancers occurring in India, the risk for women to contract this condition is high. The burden remains high because cervical screening programs of adequate scale are lacking. Aims: To compare the performance of visual inspection with acetic acid and cervical cytology in south India. Setting and Design: A cross-sectional study was performed in three villages in one of the south Indian district by recruiting 668 healthy women to undergo VIA and conventional Pap smear examination. Method and Material: Women who had a positive result from any of these tests were subjected to colposcopy and biopsies (if necessary), and women with high-grade cervical intraepithelial neoplasia (CIN) were properly treated. Statistical Analysis: Data was analyzed using statistical software from www.OpenEpi.com Results: Overall test positivity was 21.4% for VIA and 2.24% for Pap smear (LSIL threshold), 1.04% for Pap smear (HSIL threshold). VIA was positive in 70% of the women with CIN 1, 75% of those with CIN 2, 66.66% of women with CIN 3 and in two of two (100%) of women with cancer. Approximately 10% of women with no detectable disease had an abnormal VIA. Conclusions: A combined use of VIA with the Pap test allowed specific detection of cervical abnormalities.
PrashantR Kokiwar
Medknow
Sir, Obesity has reached epidemic proportions globally, with more than one billion adults overweight at least 300 million of them clinically obese and is a major contributor to the global burden of chronic disease and disability. The health consequences of obesity are many and varied, ranging from an increased risk of premature death to several non-fatal but debilitating complaints that adversely impact the quality of life. Obesity is a major risk factor for non-communicable diseases (NCDs). Obesity is unique, with its own risk factors on one hand and is itself a risk factor for many other important diseases on the other hand. Surveys on obesity provide an opportunity to educate people regarding hazards of obesity as well as ways to control the same.
PrashantR Kokiwar and Gopal RaoS Jogdand
Medknow
In recent years substance use has increased greatly throughout the world. Adolescence is the critical period when the first initiation of substance use takes place. Interventions at the adolescent age are effective to bring about lifestyle modifications. A community-based, cross-sectional study was carried out among 260 randomly selected adolescents in an urban slum area, with the objective of studying the prevalence and determinants of substance use among adolescents. The adolescent age group was selected as defined by the World Health Organization (WHO) (10 - 19 years). The overall prevalence of substance use was 32.7%. About 31% initiated substance use at 13 - 15 years of age, and the reason was peer pressure in 52.9%. Education of the study subject, education of parents, and substance use by parents and by peers were significantly associated with substance use. Children and parents should be educated to prevent substance use. There was a need to change the social environment.
PrashantR Kokiwar, HemantB Kumar, and Azam Mubashare
Medknow
Maximum number reported to the health facility after 1 year of onset of symptoms. This may be due to rural background, low literacy rates and ignorance among patients. 61.1% women with breast carcinoma were post menopausal. Fine needle aspiration cytology (FNAC) including FNAC + excision (38.9%) and excision biopsy (45.6%) were the principal diagnostic modalities used compared to mammography (1.6%) and other methods like use of core needle biopsy and vacuum assisted biopsy with mammographic or ultrasonographic guidance. Surgery was performed in 343 (61.6%) of the cases and MRM remained the gold standard for maximum of the breast carcinoma. Maximum cases were ductal invasive carcinoma, i.e. 272 (79.3%), compared to only nine (2.6%) cases of ductal carcinoma in situ. This can be attributed to late reporting. Whereas in western countries due to early reporting and detection, ductal carcinoma in situ accounts for more than 20% of breast cancer cases. The important epidemiological risk factors for the development of breast cancer are age, family history, parity, age at menarche and menopause, prior history of breast biopsy, diet, socioeconomic status, and history of exposure to radiation and use of oral contraceptive pills. These risk factors were not recorded in the present hospital records, except a few of these like age, age at menopause, family history and parity. We found that no patient had a positive family history of breast cancer. Similar finding was reported by Sandhu et al. This may be due to the fact that appropriate history taking aspect had been either neglected or the patients were not aware about the breast carcinoma. Information on parity was available in only 32 out of 548 women (5.8%). Sandhu et al., in their study, also found that out of the records of 304 patients studied, the information on parity was available in only 108 records. Other risk factors were not recorded in the present records studied. These records form an important basis of epidemiological information and should have comprehensive format and adequate recording when the patient is seen for the first time. A medical social worker should be appointed to take care of these records and history taking of patients.
Sunil Gupta, PM Durge, and PR Kokiwar
Springer Science and Business Media LLC
Nine hundred twenty-four subjects aged ≥30 years were selected by systematic random sampling of houses. All subjects were interviewed using a standardized pro forma, and all were screened by 75 gm ‚oral glucose tolerance™ test based on WHO criteria. SpeciÞ c prevalence rates for various factors were determined. Chi-square test was used for statistical analysis.