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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Original article / research
Full Version
A Cross-sectional Study on Knowledge, Attitude, and Practice Regarding Notification of Tuberculosis Patients by Private Practitioners of Urban Chennai, India
Correspondence Address :
Dr. Kirthana Ganesan,
120/89, AK Swamy Nagar, 8th Street, Kilpauk, Chennai, Tamil Nadu, India.
E-mail: vvmgkiki@gmail.com
Introduction: India accounts for one-fourth of global incidence of Tuberculosis (TB) with 2.79 million estimated cases, annually. To improve and intensify case finding, the Government of India declared TB a notifiable disease in May 2012. It is now mandatory that, all public and private health providers notify TB cases to the designated public health authorities. To facilitate notification, the central government has created a web-based, case-based notification system called Nikshay. Notification also provides support to the private sector in adherence to standards of TB care which helps in the monitoring of the patients, contact screening and adherence to the treatment.
Aim: To assess the knowledge, opinion and barriers regarding TB notification and its processes amongst private practitioners offering TB services.
Materials and Methods: This was a cross-sectional study with both analytical and descriptive components, which was conducted on the private practitioners of urban Chennai for a period of three months from April 2021 to June 2021. Study was done on a convenient sample of 150 private practitioners in urban Chennai. Any registered medical practitioner with a bachelor degree in medicine (MBBS) with private practice in urban Chennai with a minimum of one year practice was included in the study. The knowledge, attitude and practice of notification of TB among private practitioners and other proportions were summarised into percentages and 95% Confidence Intervals (CI) were calculated. The categorical data was analysed by Chi-square (χ2) test. Strength of associations was assessed through odds ratio and 95% CI. Tha analysis of the data was done using Statistical Package for Social Sciences (SPSS) version 28.0.1.1.
Results: Amongst the total sample of 150 study participants, 90% had said that TB notification was mandatory, of whom 80% said that, they had prior sensitisation on the notification procedures. Only 46% were aware of the honorarium given after notification. Attitude of the study participants towards notification, though 100% of the study participants agreed that TB notification was necessary, while 56.7% said that, government should do more towards the sensitisation of the notification procedures. Only 5.3% of the study participants, had initiated treatment on their own and 4% had started treatment based on clinical suspicion Nikshay registration was more among those whose duration of practice was more than or equal to five years (p-value=0.03), those who had prior sensitisation on TB notification procedures (p-value <0.001), those who had TB patients in their Outpatient Department (OPD) (p-value <0.001), and among those who were aware of the honorarium given for notification (p-value <0.001).
Conclusion: Nikshay registration was significantly more among those, who had prior sensitisation and those, who were aware about the honorarium that, they will receive after notifying. This shows that simple awareness creation can significantly increase the Nikshay registration, thereby, increasing the TB notification.
Awareness, Contact tracing, Disease notification, Sensitisation, Treatment
At the start of 2020, the central government has renamed the Revised National TB Control Programme (RNTCP) the National Tuberculosis Elimination Program (NTEP) (1) India with 2.79 million estimated cases annually, accounts for one-fourth of global incidence of TB. In year 2016, out of total 10.4 million, estimated cases 6.67 million TB cases were notified by all countries to the World Health Organisation (WHO). India alone accounts for nearly one million missed cases, among the estimated 3.73 million global missed cases (2). Notification also provides support to the private sector in adherence to standards of TB care which helps in the monitoring of the patients, contact screening and adherence to the treatment (3). It has been reported that, about 46% of TB patients in India are treated ‘outside Directly Observed Therapy (DOT)/RNTCP sources’ in the private health sector (4). A total of 3472 TB patients, were notified under RNTCP in year 2016, out of which only 16 TB cases (<0.5%) were notified by private sector (5). Finding these ‘missing’ cases and treating them successfully is vital to ending TB by 2030, as envisaged by the United Nations Sustainable Development Goals (6).
In May 2012, Government of India issued a gazette notification, which makes it mandatory for private practitioners to notify any case of TB that, they diagnose or treat (7). To increase the notification, the Government of India made non notification a punishable under section 269 and 270 of the Indian Penal Code (IPC) (45 of 1860) in March 2018 (8). To facilitate notification, RNTCP created a web-based, case-based notification system called Nikshay.
Notification also provides an entry-point for engaging private-care providers in delivering higher-quality TB care (9). Thus, the aim of the present study was to assess the knowledge, attitude, and practice of TB notification among private practitioners of Urban Chennai and also, to increase the awareness of TB notification, among the study participants.
A cross-sectional study with both analytical and descriptive components was conducted on the private practitioners of Urban Chennai from April 2021 to June 2021. The descriptive component was used to identify the knowledge and attitude of TB notification of the private practitioners and the analytical component was used to find the association between certain factors hindering the notification of TB and the practice of TB notification. The study was submitted to the Institutional Ethics Committee of ACS Medical College (Registered no: ECR/1182/Inst/TN/2019) and was granted approval vide letter (IEC/ACSMCH Dt. 16.12.2020).
Study was done on a convenient sample of private practitioners in Urban Chennai {As approved via. mail on 6/12/2020 by Indian Council for Medical Research (ICMR) officials}. A total of 150 private practitioners were selected to participate in the study.
Inclusion criteria: Any registered medical practitioner with a bachelor’s degree in medicine (MBBS) with private practice of minimum one year in urban Chennai were included in the study.
Exclusion criteria: Practitioners of alternative systems of medicine such as ayurveda, homeopathy, siddha, unani were not included in the study.
Questionnaire
This was a personalised structured questionnaire-based study to assess the knowledge, attitude, and practice of TB notification among private practitioners of Urban Chennai. The questionnaire was adapted from a previous study on TB notification (10) after some modifications to include Nikshay details. The questionnaire was reviewed by experts and any modifications that were suggested were made. Information was collected from the participants using self-administered structured questionnaire under the guidance of the investigator following which there was a session on creating awareness on the notification procedures. Participants who were found to have poor knowledge and attitude on TB notification were made aware about the various notification procedures and the consequences of non notification. A short talk was also given by the investigator on creating awareness about Nikshay registration and its importance.
Statistical Analysis
The data entry and analysis was done using Statistical Package for Social Sciences (SPSS) version 28.0.1.1. The knowledge, attitude and practice of notification of TB among private practitioners and other proportions were summarised into percentages and 95% confidence intervals were calculated, wherever, appropriate. The associations were analysed by crosstabs and Chi-square (χ2) test were used for statistical significance. Strength of associations was assessed through odds ratio and 95% confidence interval of the odds ratio. The p-value of less than 0.05 was considered as significant.
More than half of the study population (53.3%) was above the age of 45 years and the rest were below the age of 45. Males were more in number (56%). General practitioners were 52 % of the study population (Table/Fig 1).
Among the study participants, 90% had correctly said that, TB notification was mandatory, of whom 80% said that they had prior sensitisation on the notification procedures. Only 46% were aware of the honorarium, given after notification (Table/Fig 2).
When asked about prior sensitisation to the TB notification procedures, 80% were sensitised through some source (Table/Fig 3).
When participants were asked on their practice of TB notification procedures, 69.3% of the study participants said that, they had suspected TB in their patients. Only 5.3% of the study participants had initiated treatment on their own and 4% had started treatment based on clinical suspicion (Table/Fig 4).
When asked about notification of TB, 45.3% of the study participants said they had notified a case of TB and 20% of them had notified through Nikshay. Details can be seen in (Table/Fig 5).
Among the study participants, 36.7% were aware of their Nikshay ID details can be seen in (Table/Fig 6).
Regarding the attitude of the study participants towards notification, though 100% of the study participants agreed that TB notification was necessary, 56.7% said that the Government should do more towards the sensitisation of the notification procedures and only 30.7% practitioners said that, only sure TB cases should be reported, otherwise nil reporting should be done. Details can be seen on (Table/Fig 7).
Nikshay registration was more among those whose duration of practice was more than or equal to five years, those who had prior sensitisation on TB notification procedures, those who had TB patients in their Outpatient Department (OPD) and among those, who were aware of the honorarium given for notification and these associations were statistically significant. However, the other associations were not statistically significant. Details can be seen in (Table/Fig 8).
The present cross-sectional study done amongst private practitioners of urban chennai showed that 69.3% of the participants had suspected TB among their OPD patients, but only 5.3% of them had initiated treatment on their own and a majority of them had referred the patients to other facilities. A study done by Philip S et al., in Azhapuzha district of Kerala also revealed that, practitioners had quoted that they refer their patients to government facilities (3).
According to Arora R et al., cases that were registered to receive drug-resistant TB care had a higher chance of receiving feedback (11). Uplekar M et al., reported out that for TB elimination, all countries should have TB on their national list of notifiable diseases (12). According to another study done on medical practitioners by Satpati M et al., in Mysore district (13), 88% admitted to referring their TB cases to the Government facilities.
The current study showed that 90% of the study participants correctly stated that, TB was a notifiable disease which was similar to the findings of the study done on Mysore (13) which revealed that 83.9% of the participants knew that TB notification was mandatory. A study done by ICMR (13) on TB notification, only 73% participants were aware about the mandatory TB notification and only 33% had ever notified a patient with TB. This is lower than the present study and the reason given the participants for not nofiying the case was, lack of time and fear of offending the patients. The present study showed that the percentage of practitioners registered with Nikshay was 36.7%.
This was more than the rates found on the Mysore study (13) which showed that 15.5% of the study participants were registered with Nikshay. Though the registration rates of the current study were more than that of the other study, the prevalence was still exceptionally low and there is a definite need to improve this. In a recent study by Vinay V et al., the awareness about the Nikshay application (app) was more among public sector physicians (64.7%) compared to the private practitioners (40.8%) and the reason for non notification in the was stigma associated with TB and the technical difficulty of the Nikshay app (14). Unfortunately, more comparison could not be done as the number of quantitative studies done on the topic were very few.
According to the current study, only 46% of the study participants were aware of the honorarium for TB notification and Nikshay registration was more among them, the association was also statistically significant (p<0.001). A study conducted by Nirgude AS et al., in Dakshina, a coastal district of Karnataka concluded that the coverage was low and there were significant delays in receiving the benefit and that the coverage was poorer in urban areas (15). The current study also showed that the there was a statistically significant association between Nikshay registration and prior sensitisation to TB notification procedures (p-value <0.001), this shows that easy interventions can significantly increase the Nikshay registration among practitioners. When asked about, whether punitive action should be given for non notification, 80% of the participants agreed that punitive action was needed, this was more than the number of study participants, who had opined that punitive action should be taken (47.7%) in a study done in Mysore (11), the difference could be because the data was collected from different states. A similar study done in Taiwan by Tan H-F et al., on private practitioners on reporting of communicable diseases said that, most doctors didn’t report the case because they didn’t want to violate the patients privacy and found the reporting procedure troublesome (16).
Limitation(s)
The study was originally planned to be conducted on a simple random sample selected from Thiruvallur district in Tamil Nadu, but unfortunately because of the ongoing pandemic that could not be achieved and so after obtaining permission from ICMR, the study was conducted on a convenient sample of private practitioners from urban Chennai.
The present study has been a valuable eye opener in revealing facts about the low prevalence of Nikshay registration (36.7%) among private practitioners in urban Chennai and that Nikshay registration was significantly more among those, who had prior sensitisation and those, who were aware about the honorarium that, they will receive after notifying. This shows that simple awareness creation in the above mentioned areas can significantly increase the Nikshay registration, thereby, increasing the TB notification.
DOI: 10.7860/JCDR/2022/59563.17364
Date of Submission: Aug 09, 2022
Date of Peer Review: Sep 14, 2022
Date of Acceptance: Nov 30, 2022
Date of Publishing: Dec 01, 2022
AUTHOR DECLARATION:
• Financial or Other Competing Interests: Funded by STS program of ICMR (Researcher ID: 2020 -05281)
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Aug 17, 2022
• Manual Googling: Nov 22, 2022
• iThenticate Software: Nov 29, 2022 (13%)
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