Multi-Sectoral Integrated Health Screening Program Among Food Service Workers: A Revolutionary Community-Based Approach in Kamrup District, Assam, India

Authors

  • Harikumar Pallathadka Vice Chancellor & Professor, Manipur International University, Imphal, Manipur, INDIA
  • Deba Kumar Mishra District Commissioner, Kamrup District, Government of Assam, Guwahati, Assam, INDIA
  • Parag Deb Roy District Surveillance Officer & District TB Officer, Kamrup District, Government of Assam, Guwahati, Assam, INDIA
  • Bipul Chandra Deka District PMDT Coordinator, District TB Cell, Kamrup District, Government of Assam, Guwahati, Assam, INDIA
  • Jayshree Saha Mathematical Expert and Statistical Analysis Specialist, Independent Researcher, Assam, INDIA
  • Shrutika Shrabarna Kataky District Microbiologist, Kamrup District, Government of Assam, Guwahati, Assam, INDIA
  • Monikangkana Lahkar District Epidemiologist, Kamrup District, Government of Assam, Guwahati, Assam, INDIA

DOI:

https://doi.org/10.55544/jrasb.4.3.1

Keywords:

Multi-sectoral health screening, viral hepatitis, community health, food service workers, integrated disease surveillance, SPSS analysis, public health, occupational health, Kamrup

Abstract

Multi-sectoral health screening programs represent an innovative approach to comprehensive community health assessment, aligning with WHO recommendations for integrated health service delivery (World Health Organization, 2016). This study reports the first integrated screening initiative combining National TB Elimination Programme, Sickle Cell Disease Elimination Programme, National Viral Hepatitis Programme, National AIDS Control Programme, and Integrated Disease Surveillance Programme in a single community-based health camp, addressing the critical need for comprehensive occupational health surveillance (International Labour Organization, 2021). A cross-sectional multi-sectoral health screening was conducted among 85 food service workers at Akshaya Patra Foundation, North Guwahati, Kamrup District, Assam, using comprehensive SPSS statistical analysis following established epidemiological protocols (Rothman et al., 2008). Participants underwent screening including viral hepatitis markers, blood glucose, liver function tests, haemoglobin, leptospirosis, TB screening, and adverse drug reaction monitoring according to national guidelines (Ministry of Health and Family Welfare, 2023). Among 85 participants (94.1% male, mean age 33.29±9.81 years), significant health burdens were identified: hepatitis C seroprevalence 1.18% (95% CI: 0.0-3.47%), diabetes prevalence 5.9%, pre-diabetes 10.6%, anemia prevalence 32.9%, liver dysfunction 44.7%, latent TB positivity 2.35%, and one adverse drug reaction case (1.18%). Strong correlation observed between SGPT and SGOT (r=0.787, p<0.001), consistent with established hepatic assessment parameters (Kwo et al., 2017). This multi-sectoral approach demonstrates exceptional feasibility and effectiveness of integrated community health screening programs, providing a gold-standard replicable model for comprehensive health assessment in resource-limited settings, supporting global health system strengthening initiatives (Kruk et al., 2018).

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References

Agresti, A. (2007). An Introduction to Categorical Data Analysis (2nd ed.). Wiley-Interscience.

Altman, D. G. (1991). Practical Statistics for Medical Research. Chapman and Hall.

American Association for the Study of Liver Diseases. (2019). HCV guidance: Recommendations for testing, managing, and treating hepatitis C. Hepatology, 70(2), 632-692.

American Diabetes Association. (2023). Classification and diagnosis of diabetes: Standards of medical care in diabetes—2023. Diabetes Care, 46(Supplement 1), S19-S40.

Andermann, A., Blancquaert, I., Beauchamp, S., & Déry, V. (2008). Revisiting Wilson and Jungner in the genomic age: A review of screening criteria over the past 40 years. Bulletin of the World Health Organization, 86(4), 317-319.

Anjana, R. M., Deepa, M., Pradeepa, R., Mahanta, J., Narain, K., Das, H. K., ... & Mohan, V. (2017). Prevalence of diabetes and prediabetes in 15 states of India: Results from the ICMR–INDIAB population-based cross-sectional study. The Lancet Diabetes & Endocrinology, 5(8), 585-596.

Antunes, L. C., Levandovski, R., Dantas, G., Caumo, W., & Hidalgo, M. P. (2010). Obesity and shift work: Chronobiological aspects. Nutrition Research Reviews, 23(1), 155-168.

Atun, R., de Jongh, T., Secci, F., Ohiri, K., &Adeyi, O. (2010). Integration of targeted health interventions into health systems: A conceptual framework for analysis. Health Policy and Planning, 25(2), 104-111.

Atun, R., Jaffar, S., Nishtar, S., Knaul, F. M., Barreto, M. L., Nyirenda, M., ... & Piot, P. (2013). Improving responsiveness of health systems to non-communicable diseases. The Lancet, 381(9867), 690-697.

Atwood, K., Colditz, G. A., & Kawachi, I. (2011). From public health science to prevention practice: The prevention research centers program. American Journal of Public Health, 101(2), 253-260.

Balgir, R. S. (2007). The burden of hemoglobinopathies in India and the challenges ahead. Current Science, 79(11), 1536-1547.

Barreto, M. L., Miranda, J. J., Figueroa, J. P., Schmidt, M. I., Munoz, S., Kuri-Morales, P. P., & Silva Jr, J. B. (2012). Epidemiology in Latin America and the Caribbean: Current situation and challenges. International Journal of Epidemiology, 41(2), 557-571.

Basu, S., Andrews, J., Kishore, S., Panjwani, R., & Stuckler, D. (2012). Comparative performance of private and public healthcare systems in low-and middle-income countries: A systematic review. PLoS Medicine, 9(6), e1001244.

Beauchamp, T. L., & Childress, J. F. (2012). Principles of Biomedical Ethics (7th ed.). Oxford University Press.

Bharati, S., Pal, M., Bharati, P., & Shome, S. (2019). Prevalence and causes of anemia among community-dwelling elderly people in India: A systematic review and meta-analysis. Public Health Nutrition, 22(11), 2085-2099.

Bharti, A. R., Nally, J. E., Ricaldi, J. N., Matthias, M. A., Diaz, M. M., Lovett, M. A., ... & Vinetz, J. M. (2003). Leptospirosis: A zoonotic disease of global importance. The Lancet Infectious Diseases, 3(12), 757-771.

Bland, J. M., & Altman, D. G. (1995). Multiple significance tests: The Bonferroni method. BMJ, 310(6973), 170.

Brown, L. D., Cai, T. T., & DasGupta, A. (2001). Interval estimation for a binomial proportion. Statistical Science, 16(2), 101-117.

Bureau of Labor Statistics. (2022). Occupational Employment and Wage Statistics: Food Service Workers. U.S. Department of Labor.

Cacoub, P., Poynard, T., Ghillani, P., Charlotte, F., Olivi, M., Piette, J. C., &Opolon, P. (1999). Extrahepatic manifestations of chronic hepatitis C. Arthritis & Rheumatism, 42(10), 2204-2212.

Cattamanchi, A., Smith, R., Steingart, K. R., Metcalfe, J. Z., Date, A., Coleman, C., ... & Pai, M. (2011). Interferon-gamma release assays for the diagnosis of latent tuberculosis infection in HIV-infected individuals: A systematic review and meta-analysis. Journal of Acquired Immune Deficiency Syndromes, 56(3), 230-238.

Centers for Disease Control and Prevention. (2019). Behavioral Risk Factor Surveillance System Questionnaire. U.S. Department of Health and Human Services.

Central Drugs Standard Control Organization. (2015). Pharmacovigilance Programme of India: Guidelines for Spontaneous Adverse Drug Reaction Reporting. Ministry of Health and Family Welfare, Government of India.

Central TB Division. (2020). National Strategic Plan for Tuberculosis Elimination 2017-2025. Ministry of Health and Family Welfare, Government of India.

Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., ... & Sanyal, A. J. (2018). The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology, 67(1), 328-357.

Clinical and Laboratory Standards Institute. (2018). Quality Management System: A Model for Laboratory Services (4th ed.). CLSI.

Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Lawrence Erlbaum Associates.

Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155-159.

Council of Europe. (2018). Convention for the Protection of Individuals with regard to Automatic Processing of Personal Data. Council of Europe Treaty Series.

Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., & Petticrew, M. (2008). Developing and evaluating complex interventions: The new Medical Research Council guidance. BMJ, 337, a1655.

Dean, A. G., Sullivan, K. M., & Soe, M. M. (2013). OpenEpi: Open Source Epidemiologic Statistics for Public Health. Available from: www.OpenEpi.com

Directorate General of Health Services. (2018). National Programme for Prevention and Control of Viral Hepatitis: Operational Guidelines. Ministry of Health and Family Welfare, Government of India.

Drèze, J., & Goyal, A. (2003). Future of mid-day meals. Economic and Political Weekly, 38(44), 4673-4683.

Dudley, L., Garner, P., &Brikci, N. (2011). Defining quality of care within complex health systems. Social Science & Medicine, 73(7), 1022-1030.

Edwards, I. R., & Aronson, J. K. (2000). Adverse drug reactions: Definitions, diagnosis, and management. The Lancet, 356(9237), 1255-1259.

European Association for the Study of the Liver. (2017). EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. Journal of Hepatology, 67(2), 370-398.

European Association for the Study of the Liver. (2018). EASL Clinical Practice Guidelines: Management of cholestatic liver diseases. Journal of Hepatology, 69(2), 486-544.

European Association for the Study of the Liver. (2020). EASL recommendations on treatment of hepatitis C: Final update of the series. Journal of Hepatology, 73(5), 1170-1218.

Faden, R. R., & Beauchamp, T. L. (1986). A History and Theory of Informed Consent. Oxford University Press.

Fiore, A. E., Wasley, A., & Bell, B. P. (2006). Prevention of hepatitis A through active or passive immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recommendations and Reports, 55(RR-7), 1-23.

Gish, R. G., Gadano, A. C., Doss, W., Hiring, J., Lawitz, E. J., Pesacreta, L. C., ... & Sette Jr, H. (2011). Hepatitis A vaccination in patients with hepatitis C: A double-blind, randomized, controlled trial. Hepatology, 54(2), 459-468.

Goris, M. G., &Hartskeerl, R. A. (2014). Leptospirosis serodiagnosis by the microscopic agglutination test. Current Protocols in Microbiology, 32(1), 12E-5.

Hennekens, C. H., & Buring, J. E. (1987). Epidemiology in Medicine. Little, Brown and Company.

Houben, R. M., & Dodd, P. J. (2016). The global burden of latent tuberculosis infection: A re-estimation using mathematical modelling. PLoS Medicine, 13(10), e1002152.

Indian Council of Medical Research. (2017). National Ethical Guidelines for Biomedical and Health Research Involving Human Participants. ICMR.

Indian Council of Medical Research. (2019). India: Health of the Nation's States—The India State-Level Disease Burden Initiative. ICMR.

Institute for Healthcare Improvement. (2020). The Triple Aim: Care, Health, and Cost. IHI.

International Conference on Harmonisation. (2016). Guideline for Good Clinical Practice E6(R2). ICH.

International Council for Standardization in Haematology. (2019). ICSH guidelines for the laboratory diagnosis of nonimmune hereditary red cell membrane disorders. ICSH.

International Labour Organization. (2019). Women and men in the informal economy: A statistical picture (3rd ed.). ILO.

International Labour Organization. (2021). Occupational safety and health in the food and drink industries. ILO.

Jacobsen, K. H., & Koopman, J. S. (2004). Declining hepatitis A seroprevalence: A global review and analysis. Epidemiology and Infection, 132(6), 1005-1022.

Kalaivani, K. (2009). Prevalence & consequences of anaemia in pregnancy. Indian Journal of Medical Research, 130(5), 627-633.

Khera, R. (2013). Mid-day meals in primary schools: Achievements and challenges. Economic and Political Weekly, 48(32), 58-64.

Kirkwood, B. R., & Sterne, J. A. (2003). Essential Medical Statistics (2nd ed.). Blackwell Publishing.

Knowler, W. C., Barrett-Connor, E., Fowler, S. E., Hamman, R. F., Lachin, J. M., Walker, E. A., & Nathan, D. M. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346(6), 393-403.

Kohli, M., Schiller, I., Dendukuri, N., Dheda, K., Denkinger, C. M., Schumacher, S. G., & Steingart, K. R. (2018). Xpert MTB/RIF assay for extrapulmonary tuberculosis and rifampicin resistance. Cochrane Database of Systematic Reviews, (8), CD012768.

Kruk, M. E., Gage, A. D., Arsenault, C., Jordan, K., Leslie, H. H., Roder-DeWan, S., ... & Pate, M. (2018). High-quality health systems in the Sustainable Development Goals era: Time for a revolution. The Lancet Global Health, 6(11), e1196-e1252.

Kwo, P. Y., Cohen, S. M., & Lim, J. K. (2017). ACG clinical guideline: Evaluation of abnormal liver chemistries. American Journal of Gastroenterology, 112(1), 18-35.

Lahariya, C., Subramanya, B. P., & Sosler, S. (2013). An assessment of hepatitis B vaccine introduction in India: Lessons for roll out and scale up of new vaccines in immunization programs. Indian Journal of Public Health, 57(1), 8-14.

Levine, R. J. (1988). Ethics and Regulation of Clinical Research (2nd ed.). Urban & Schwarzenberg.

Lewinsohn, D. M., Leonard, M. K., LoBue, P. A., Cohn, D. L., Daley, C. L., Desmond, E., ... & Mazurek, G. H. (2017). Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention clinical practice guidelines: Diagnosis of tuberculosis in adults and children. Clinical Infectious Diseases, 64(2), 111-115.

Marseille, E., Larson, B., Kazi, D. S., Kahn, J. G., & Rosen, S. (2015). Thresholds for the cost-effectiveness of interventions: Alternative approaches. Bulletin of the World Health Organization, 93(2), 118-124.

McLean, E., Cogswell, M., Egli, I., Wojdyla, D., & De Benoist, B. (2009). Worldwide prevalence of anaemia, WHO vitamin and mineral nutrition information system, 1993–2005. Public Health Nutrition, 12(4), 444-454.

Menzies, D., Pai, M., & Comstock, G. (2007). Meta-analysis: New tests for the diagnosis of latent tuberculosis infection: Areas of uncertainty and recommendations for research. Annals of Internal Medicine, 146(5), 340-354.

Ministry of Health and Family Welfare. (2013). National Health Mission: Framework for Implementation. Government of India.

Ministry of Health and Family Welfare. (2017). National Strategic Plan for Tuberculosis Elimination 2017-2025. Government of India.

Ministry of Health and Family Welfare. (2018). National Action Plan for Viral Hepatitis. Government of India.

Ministry of Health and Family Welfare. (2022). National Sickle Cell Anaemia Elimination Mission. Government of India.

Ministry of Health and Family Welfare. (2023). Clinical Establishment (Central Government) Rules. Government of India.

Mukhopadhyaya, A. (2008). Hepatitis C in India. Journal of Biosciences, 33(4), 465-473.

Naranjo, C. A., Busto, U., Sellers, E. M., Sandor, P., Ruiz, I., Roberts, E. A., ... & Sykora, K. (1981). A method for estimating the probability of adverse drug reactions. Clinical Pharmacology & Therapeutics, 30(2), 239-245.

National AIDS Control Organization. (2021). National AIDS Control Programme Phase-V (2021-26): National Strategic Plan. Ministry of Health and Family Welfare, Government of India.

National Heart, Lung, and Blood Institute. (2014). Evidence-Based Management of Sickle Cell Disease: Expert Panel Report. NIH.

Newbold, K. B., McKeary, M., Hart, R., & Hall, R. (2009). Restaurant workers' occupational health and safety training needs. Safety Science, 47(6), 821-829.

Nugent, R., Bertram, M. Y., Jan, S., Niessen, L. W., Sassi, F., Jamison, D. T., ... & Beaglehole, R. (2018). Investing in non-communicable disease prevention and management to advance the Sustainable Development Goals. The Lancet, 391(10134), 2029-2035.

Occupational Safety and Health Administration. (2021). Guidelines for Employers in the Food Service Industry. U.S. Department of Labor.

Omran, A. R. (2005). The epidemiologic transition: A theory of the epidemiology of population change. The Milbank Quarterly, 83(4), 731-757.

Piel, F. B., Patil, A. P., Howes, R. E., Nyangiri, O. A., Gething, P. W., Dewi, M., ... & Hay, S. I. (2013). Global epidemiology of sickle haemoglobin in neonates: A contemporary geostatistical model-based map and population estimates. The Lancet, 381(9861), 142-151.

Pradeepa, R., & Mohan, V. (2017). Epidemiology of type 2 diabetes in India. Indian Journal of Ophthalmology, 65(6), 524-532.

Puri, P., Anand, A. C., Saraswat, V. A., Acharya, S. K., Dhiman, R. K., Aggarwal, R., ... & Rao, P. N. (2007). Consensus statement of HCV task force of the Indian National Association for Study of the Liver (INASL). Part I: Status report of HCV infection in India. Journal of Clinical and Experimental Hepatology, 4(2), 106-116.

Rahbar, M. H., Zhang, L., Gonzalez, E., Hessabi, M., & Grimes, R. (2004). Efficacy of double data entry and an automated data entry verification process. Proceedings of the Twenty-Ninth Annual SAS Users Group International Conference, 269, 1-7.

Razali, N. M., & Wah, Y. B. (2011). Power comparisons of Shapiro-Wilk, Kolmogorov-Smirnov, Lilliefors and Anderson-Darling tests. Journal of Statistical Modeling and Analytics, 2(1), 21-33.

Reich, M. R., Harris, J., Ikegami, N., Maeda, A., Cashin, C., Araujo, E. C., ... & Evans, T. G. (2016). Moving towards universal health coverage: Lessons from 11 country studies. The Lancet, 387(10020), 811-816.

Rothman, K. J., Greenland, S., & Lash, T. L. (2008). Modern Epidemiology (3rd ed.). Lippincott Williams & Wilkins.

Samb, B., Desai, N., Nishtar, S., Mendis, S., Bekedam, H., Wright, A., ... & Etienne, C. (2010). Prevention and management of chronic disease: A litmus test for health-systems strengthening in low-income and middle-income countries. The Lancet, 376(9754), 1785-1797.

Sharma, R., Garg, R. K., & Gaur, P. K. (2015). Occupational health hazards among food service workers: A review. Indian Journal of Occupational and Environmental Medicine, 19(2), 78-83.

Suwazono, Y., Dochi, M., Sakata, K., Okubo, Y., Oishi, M., Tanaka, K., ... &Nogawa, K. (2008). A longitudinal study on the risk of the development of diabetes mellitus in relation to the periodic health examination. Journal of Occupational Health, 50(4), 337-343.

Todd, E. C., Greig, J. D., Bartleson, C. A., & Michaels, B. S. (2008). Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 4. Infective doses and pathogen carriage. Journal of Food Protection, 71(11), 2339-2373.

Tugwell, P., de Savigny, D., Hawker, G., & Robinson, V. (2006). Applying clinical epidemiological methods to health equity: The equity effectiveness loop. BMJ, 332(7537), 358-361.

von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. The Lancet, 370(9596), 1453-1457.

Wilson, J. M., &Jungner, Y. G. (1968). Principles and practice of screening for disease. World Health Organization.

World Health Organization. (2011). Same-day diagnosis of tuberculosis by microscopy: Policy statement. WHO.

World Health Organization. (2015). The global prevalence of anaemia in 2011. WHO.

World Health Organization. (2016). Framework on integrated, people-centred health services. WHO.

World Health Organization. (2017). Global hepatitis report 2017. WHO.

World Health Organization. (2018). Declaration of Astana: From Alma-Ata towards universal health coverage and the Sustainable Development Goals. WHO.

Zimmermann, M. B., & Hurrell, R. F. (2007). Nutritional iron deficiency. The Lancet, 370(9586), 511-520.

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Published

2025-06-02

How to Cite

Pallathadka, H., Mishra, D. K., Roy, P. D., Deka, B. C., Saha, J., Kataky, S. S., & Lahkar, M. (2025). Multi-Sectoral Integrated Health Screening Program Among Food Service Workers: A Revolutionary Community-Based Approach in Kamrup District, Assam, India. Journal for Research in Applied Sciences and Biotechnology, 4(3), 1–12. https://doi.org/10.55544/jrasb.4.3.1

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