To identify literature on health literacy levels and examine its association with tuberculosis treatment adherence and treatment outcomes. Two authors independently searched Pubmed®, Embase, CINAHL, PsycINFO, Scopus, LILACS, Global Health Medicus and ScienceDirect for articles reporting on health literacy levels and tuberculosis that were published between January 2000 and September 2023. We defined limited health literacy as a person's inability to understand, process, and make decisions from information obtained concerning their own health. Methodological quality and the risk of bias was assessed using the JBI critical appraisal tools. We used a random effects model to assess the pooled proportion of limited health literacy, the association between health literacy and treatment adherence, and the relationship between health literacy and tuberculosis-related knowledge. Among 5813 records reviewed, 22 studies met the inclusion criteria. The meta-analysis revealed that 51.2% (95% confidence interval, CI: 48.0–54.3) of tuberculosis patients exhibit limited health literacy. Based on four studies, patients with lower health literacy levels were less likely to adhere to tuberculosis treatment regimens (pooled odds ratio: 1.95; 95% CI: 1.37–2.78). Three studies showed a significant relationship between low health literacy and inadequate knowledge about tuberculosis (pooled correlation coefficient: 0.79; 95% CI: 0.32–0.94). Health literacy is associated with tuberculosis treatment adherence and care quality. Lower health literacy might hamper patients' ability to follow treatment protocols. Improving health literacy is crucial for enhancing treatment outcomes and is a key strategy in the fight against tuberculosis.

The study aims to estimate and compare the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence, the fraction of asymptomatic or subclinical infections in the population, determine the demographic risk factors and analyse the antibody development at different time points among adults in Bhubaneswar city, India. This was a serial three-round cross-sectional, community-based study where participants were selected from the residents of Bhubaneswar city using multi-stage random sampling. Blood samples were collected during household visits along with demographic and clinical data from every participant. Total anti-SARS-CoV-2 antibody present in serum was assessed using the electro-chemiluminescence immunoassay platform. Temporal comparisons of the community seroprevalence were performed against the detected number of cumulative cases, active cases, recoveries and deaths. A total of 3693 participants were enrolled in this study with a cumulative non-response rate of 18.33% in all the three rounds. The gender-weighted seroprevalence for the city in the first round was 1.55% (95% confidence interval (CI) 0.84–2.58), second round was 5.27% (95% CI 4.13–6.59) and in the third round was 49.04% (95% CI 46.39–51.68). In the first round, the seroprevalence was found to be highest in the elderly population, whereas the seroprevalence for the second and third phases was highest in the age group of 30–39 years. Seroprevalence showed an increasing trend over the three time periods, with the highest seropositivity rates among individuals sampled between 16 and 18 September 2020. By the third round, 93.93% of those who had previously been tested positive by real-time reverse transcription polymerase chain reaction had seroconversion and 46.57% of those who had been tested negative also showed seroconversion. Infection to case ratio during first round was 27.05, for second round and third round it was 5.62 and 17.91, respectively.

Inadequate water, sanitation, and hygiene (WASH) among urban poor women is a major urban policy concern in low- and middle-income countries (LMICs). There was a paucity of systematic information on WASH among the urban poor during the pandemic. We reviewed the opportunities and challenges faced by the urban poor in LMICs during the COVID-19 pandemic. We used the PRISMA guidelines to conduct a comprehensive search of 11 databases, including MEDLINE, Embase, Web of Science, and CINAHL, between November 2019 and August 2021. We used thematic analysis to synthesize the qualitative data and meta-analyses to estimate the pooled prevalence. We screened 5008 records, conducted a full-text review of 153 studies, and included 38 studies. The pooled prevalence of shared water points was 0.71 (95% CI 0.37–0.97), non-adherence to hygiene practices was 0.15 (95% CI 0.08–0.24), non-adherence to face masks was 0.27 (95% CI 0.0–0.81), and access to shared community toilets was 0.59 (95% CI 0.11–1.00). Insufficient facilities caused crowding and long waiting times at shared facilities, making physical distancing challenging. Women reported difficulty in maintaining privacy for sanitation, as men were present due to the stay-at-home rule. Due to unaffordability, women reported using cloth instead of sanitary pads and scarves instead of masks.

Objective To examine existing literature regarding health literacy levels and their association with multimorbidity and the potential underlying mechanisms behind the said association. Design Systematic review and meta-analysis. Data sources The databases MEDLINE, EMBASE, CINAHL and Science Direct were searched for articles published between 1 January 2000 and 31 October 2023 using a systematic search strategy. Eligibility criteria Included were all primary studies conducted in people over 18 years old with data on health literacy levels and the presence of multimorbidity. No language restrictions were used. Data extraction and synthesis Two authors independently extracted data and assessed the bias using the Joanna Briggs Institute critical appraisal tools. Results We included a total of 39 studies (36 quantitative, two qualitative and one mixed-method), representing 154 337 participants. We found a 32% proportion of limited health literacy among individuals with multimorbidity. Analysis of three articles using the Health Literacy Questionnaire tool (n=31 228) (Pooled OR 2.88 (95% CI 1.92 to 4.31)) and three articles using the Health Literacy Survey Questionnaire–European Union tool (n=35 358) (OR 1.16 (95% CI 1.07 to 1.25)) indicated that people with limited health literacy were likely to have multiple conditions. One of three articles studying underlying mechanisms reported that self-efficacy mediates the association between health literacy and multimorbidity. Additionally, substantial literature identified education and income as the most consistent determinants of health literacy among individuals with multimorbidity. Of the only two articles studying the effectiveness of health literacy-related interventions, both reported an improvement in clinical outcomes after the intervention. Conclusions Our review demonstrated a consistent association between health literacy and multimorbidity, indicating that people with lower health literacy levels are more likely to have multimorbidity. More evidence is needed regarding the effect of health literacy interventions on multimorbidity. PROSPERO registration number CRD42022301369.

Dengue continues to remain a public health problem in many regions of the world. This study focuses on addressing the community level barriers and opportunities using a health education intervention model to aid in dengue control. In-depth interviews of frontline workers were conducted to understand potential barriers during surveillance. A house-to-house cross-sectional survey was conducted in November 2018 among the crowded urban Pratapnagar area followed by intervention in the form of health education using pamphlets and counselling. The entomological indices were found to be above the critical levels in the hotspot area. 90% of the population had heard about dengue but only 51.4% had knowledge about fever as one of the symptoms of dengue. Overall knowledge among the community was good. But attitudes and practices were low and probably required more sustained health education intervention over prolonged period. The potential barriers for surveillance which were recognised during In-depth interviews were safety issues, lack of manpower and availability of dedicated vehicles, dearth of community participation and lack of inter and intra departmental coordination. The health administration needs to adopt robust surveillance and monitoring activities with inter-departmental coordination ensuring greater community participation focusing on behaviour change.