Prevalence of Noncommunicable Disease (NCDs) risk factors in Tamil Nadu: Tamil Nadu STEPS Survey (TN STEPS), 2020.

BACKGROUND: Noncommunicable diseases (NCDs) account for nearly 75% of all deaths in Tamil Nadu. The government of Tamil Nadu has initiated several strategies to control NCDs under the Tamil Nadu Health Systems Reform Program (TNHSRP). We aimed to estimate the prevalence of NCD risk factors and determine the predictors of diabetes and hypertension, which will be helpful for planning and serve as a baseline for evaluating the impact of interventions. METHODS: A state-wide representative cross-sectional study was conducted among 18-69-year-old adults in Tamil Nadu in 2020. The study used a multi-stage sampling method to select the calculated sample size of 5780. We adapted the study tools based on WHO's STEPS surveillance methodology. We collected information about sociodemographic factors, NCD risk factors and measured blood pressure and fasting capillary blood glucose. The predictors of diabetes and hypertension were calculated using generalised linear models with 95% confidence intervals (95% CI). RESULTS: Due to the COVID-19 pandemic lockdown, we could cover 68% (n = 3800) of the intended sample size. Among the eligible individuals surveyed (n = 4128), we had a response rate of 92%. The mean age of the study participants was 42.8 years, and 51% were women. Current tobacco use was prevalent in 40% (95% CI: 33.7-40.0) of men and 7.9% (95% CI: 6.4-9.8) of women. Current consumption of alcohol was prevalent among 39.1% (95% CI: 36.4-42.0) of men. Nearly 28.5% (95% CI: 26.7-30.4) of the study participants were overweight, and 11.4% (95% CI: 10.1-12.7) were obese. The prevalence of hypertension was 33.9% (95% CI: 32.0-35.8), and that of diabetes was 17.6% (95% CI: 16.1-19.2). Older age, men, and obesity were independently associated with diabetes and hypertension. CONCLUSION: The burden of NCD risk factors like tobacco use, and alcohol use were high among men in the state of Tamil Nadu. The prevalence of other risk factors like physical inactivity, raised blood pressure and raised blood glucose were also high in the state. The state should further emphasise measures that reduce the burden of NCD risk factors. Policy-based and health system-based interventions to control NCDs must be a high priority for the state.

Effectiveness of the ChAdOx1 nCoV-19 Coronavirus Vaccine (CovishieldTM) in Preventing SARS-CoV2 Infection, Chennai, Tamil Nadu, India, 2021.

We estimated the effectiveness of two doses of the ChAdOx1 nCoV-19 (Covishield) vaccine against any COVID-19 infection among individuals ≥45 years in Chennai, Tamil Nadu, India. A community-based cohort study was conducted from May to September 2021 in a selected geographic area in Chennai. The estimated sample size was 10,232. We enrolled 69,435 individuals, of which 21,793 were above 45 years. Two-dose coverage of Covishield in the 18+ and 45+ age group was 18% and 31%, respectively. Genomic analysis of 74 out of the 90 aliquots collected from the 303 COVID-19-positive individuals in the 45+ age group showed delta variants and their sub-lineages. The vaccine's effectiveness against COVID-19 disease in the ≥45 age group was 61.3% (95% CI: 43.6-73.4) at least 2 weeks after receiving the second dose of Covishield. We demonstrated the effectiveness of two doses of the ChAdOx1 vaccine against the delta variant in the general population of Chennai. We recommend similar future studies considering emerging variants and newer vaccines. Two-dose vaccine coverage could be ensured to protect against COVID-19 infection.

Determining pulmonary function and the associated risk factors among stone quarry workers in a suburban area of Chennai, Tamil Nadu, India.

BACKGROUND: Stone quarrying activities generate dust and fine particulate matters of silica and heavy metals. The prolonged exposure to suspended particulates leads to fatal respiratory complications. Occupational pulmonary complications are poorly characterized among quarry workers in Tamil Nadu. OBJECTIVES: This study aims to assess pulmonary function and determine the associated risk factors among quarry workers. MATERIALS AND METHODS: A comparative, cross-sectional study was conducted from April 2014 to January 2015 among workers at seven stone quarries in Chennai and residents within a 5 Km radius. Pulmonary function tests (PFT) and sputum analysis were done. RESULTS: Overall, 670 participants were enrolled in the study, with a median age of 37 years. Comparatively, the mean PFT measures were significantly lower in quarry workers with a higher proportion of airflow obstruction and tuberculosis infection. CONCLUSION: The risk of airflow obstruction among quarry workers increased with smoking and longer duration of work years in quarry.

Monitoring smoke-free laws in restaurants and educational institutions in Chennai, India.

BACKGROUND: Smoking tobacco affects the health of smokers as well as non-smokers who are exposed to secondhand smoke. The Government of India enacted the Cigarettes and Other Tobacco Products Act in 2003, which included a ban on smoking in public places and on sale of tobacco around educational institutions. We assessed the extent of compliance with these laws in restaurants and educational institutions in Chennai, Tamil Nadu, India. METHODS: We conducted a cross-sectional survey using an observation checklist in restaurants and educational institutions in Chennai. We used cluster sampling for restaurants and random sampling for schools and colleges. We collected data regarding the signage displaying prohibition of smoking as per the law and sale of tobacco products around educational institutions. We estimated the proportions for various indicators. RESULTS: Among the 400 restaurants surveyed, 371 (92.8%) did not have any signage displaying prohibition of smoking and of the 29 restaurants with signage, only 4 were as per the specifications. There were 62 (15.5%) smoking events in restaurants at the time of visit for survey. Among the 287 schools surveyed, only 8 (2.8%) had the signage displaying prohibition of smoking and 2 (0.7%) had the signage for ban on sale of tobacco products. Of the 54 colleges surveyed, 8 (14.8%) had the signage displaying prohibition of smoking and 7 (13%) had the signage for ban on sale of tobacco products. CONCLUSION: There was low compliance of smoke-free laws in restaurants and educational institutions in Chennai. We recommend a robust monitoring mechanism to ensure the enforcement of smoke-free laws in public places.