Poverty, undernutrition and morbidity: The untold story of tea-garden workers of Alipurduar district, West Bengal.

Background: There is a paucity of information on health and nutritional status of tea-garden workers of West Bengal, which is crucial to meet their health needs by formulating appropriate public health interventions. Objectives/Aims: The objective of this study is to assess the morbidity pattern and nutritional status of tea-garden workers of West Bengal, India. Materials and Methods: The present cross-sectional study was conducted among 463 tea-garden workers of randomly selected three tea gardens of Alipurduar district of West Bengal, India, chosen by multi-stage sampling. Pre-designed and pre-tested questionnaire was used to collect information on socio-demographic and other variables by means of interview. Physical examination and anthropometric assessment were performed. The haemoglobin was estimated by the 'filter paper cyanmethemoglobin method'. Morbidities were assessed on the basis of history, clinical examination, evaluation of medical records if any and relevant laboratory investigations and classified and coded as per the 10th revision of the international classification of the diseases. Morbidity profile and nutritional status were assessed through history taking, clinical examination, review of medical records if any, anthropometric assessment and laboratory investigations. Statistical Analysis: Simple proportion was used for interpretation of point prevalence. Chi-square test was applied as the test of significance wherever applicable. Results: Out of total 463 tea-garden workers, majorities (76%) were female and from backward social class (81.2%). More than half (55.9%) were illiterate and three-fourth (67.2%) belonged to lower income quartile. Anaemia was found widespread (87.9%) and more than one-third (36.1%) of the tea-garden workers were found undernourished. Also 43.8% of the workers had airway obstruction as measured by peak expiratory flow rate. Majority (69.8%) of the garden workers had any form of morbidity. Non-communicable diseases (24.2%), musculoskeletal disorders (17.9%), skin disorders (17.7%), respiratory morbidities (16.2%), febrile illness (12.3%), gastro-intestinal disorders (8.6%), ocular problems (8.4%), vitamin and micronutrients deficiencies were found the common morbidities among tea-garden workers. Scheduled tribe caste, undernutrition and anaemia were found independent determinants of any morbidity among the tea-garden workers. Conclusions: Morbidities, anaemia and under-nutrition were found very much prevalent among tea-garden workers of West Bengal, which necessitates urgent public health interventions through multi-disciplinary approach in a focussed manner with an aim to improve the overall quality of life of the tea-garden workers.

Trend, morbidity profile and immunization status of diphtheria admitted cases: A 5-years review from a sentinel centre in Kolkata.

Despite strengthening of the universal immunization program, diphtheria remains endemic in India. Diphtheria is under surveillance for vaccine-preventable diseases of the World Health Organization and also in India. The present record-based retrospective study was conducted on 241 confirmed diphtheria patients admitted in an infectious disease hospital of Kolkata over 5 years (2015-2019) with the objectives of assessing the admission trend, immunization status, and outcome of patients. Among the patients, majority (57.3%) were female; 50.6% were ≥15 years; 49.0% resided in rural areas. Five-year admission rate did not show any declining trend. Major number of cases occurred in 2016; another peak observed in 2019. Only 27.4% fully immunized rest either partiality immunized (44.4%) or nonimmunized (28.2%). Overall, 54% of the patients developed any complications, and case fatality was 9.5%. Gradual age shift toward adults reiterated the widespread use of adult immunization with Td vaccines. Early reporting to the hospital is necessary to reduce complications and case fatality.

Domestic violence against women: A hidden and deeply rooted health issue in India.

BACKGROUND: Domestic violence was identified as a major contributor to the global burden of ill health in terms of female morbidity leading to psychological trauma and depression, injuries, sexually transmitted diseases, suicide, and murder. AIMS: The study was conducted to find out the prevalence of different types of lifetime domestic violence against women, factors associated with it, and care-seeking behavior. SETTINGS AND DESIGN: An observational cross-sectional study conducted at a slum of Burdwan district of West Bengal, India. METHODS AND MATERIAL: Study was done among 320 ever-married women of 15-49 years of age using a predesigned pretested proforma from March 2019 to December 2019 by face-to-face interview. STATISTICAL ANALYSIS USED: Data were compiled and analyzed by EpiInfo 6 and SPSS 20 version. RESULTS AND CONCLUSIONS: The overall prevalence of any form of violence during the lifetime among the study population was 35.63%. Verbal/psychological violence was the most common form of domestic violence (91.23%) followed by physical (82.46%) and sexual violence (64.91%). Slapping and/or beating, kicking, and object throwing were the major forms of physical violence; humiliation (88.46%) was the commonest form of psychological violence and most common form of sexual violence was forced sexual intercourse (51.35%). About 20% of the study population faced violence every day. Older age, lower age at marriage, longer duration of marriage, lower education of husband and wife, lower family income, unemployment of the husband, and alcohol consumption of husband were associated with the occurrence of domestic violence. We have found that the prevalence of domestic violence in this group of population is high. The alarming issue is that approximately one-third of women (32.46%) who faced violence in their lifetime had never sought any help. The findings indicate to develop appropriate and culturally relevant public health interventions to increase awareness.

A study on fertility perception: an experience from west bengal, India.

BACKGROUND: Fertility pattern has some influence on health of mother and child as well as it can resist population growth. METHODS: A cross sectional study on fertility perception among married women of reproductive age group, was carried out in 3 blocks and 2 municipality areas of Howrah District of West Bengal, India, covering 12 villages and 4 wards, selected by stratified multistage random sampling, for a period of 6 months from April to September 2009. Two thousand married women were the respondents. RESULTS: Respondents were mainly belonged to poor and below poverty line groups (86.7%), one third (33.4%) were illiterate and just literate group, 66.8% of the respondents belonged to Hindu by religion and 63.4% had history of teen age pregnancy and more than 50% of the respondents were married early (below 18 years). The study revealed that perception about age of marriage, interval between marriage and 1(st) pregnancy and spacing were incorrect in case of 45.8%, 37.6% and 23% of the respondents, respectively. 22.3% and 13.1% of the respondents had no proper idea regarding desired no of children and Family Planning methods, respectively and their knowledge varied with literacy status, age and religion. Majority (67.5%) of the study population received information about family planning methods from health personnel. CONCLUSIONS: Correct Knowledge regarding different components of fertility among Eligible Couples to be enhanced by intervention through Information, Education and Communication (Interpersonal Communication and Mass Media).

Gender preference and awareness regarding sex determination among antenatal mothers attending a medical college of eastern India.

AIM: There are many women "missing" due to an unfavourable sex ratio in India, which has strong patriarchal norms and a preference for sons. Female gender discrimination has been reported in health care, nutrition, education, and resource allocation due to man-made norms, religious beliefs, and recently by ultrasonography resulting in lowered sex ratio. METHODS: The present study attempts to find out the level of awareness regarding sex determination and to explore preference of gender and factors associated among antenatal mothers attending a medical college in eastern India. Interviews were done by predesigned pretested proforma over 6 months. The data were analysed by SPSS 16.0 software for proportions with chi-squared tests and binary logistic regression analysis. RESULTS: Most women who were multigravida did not know about contraceptives; 1.8% of mothers knew the sex of the fetus in present pregnancy while another 34.7% expressed willingness; 13.6% knew of a place which could tell sex of the fetus beforehand; 55.6% expressed their preference of sex of the baby for present pregnancy while 50.6% of their husbands had gender preference. Gender preference was significantly high in subjects with: lower socioeconomic status (p=0.011); lower level of education of mother (p=0.047) and husband (p=0.0001); multigravida (p=0.002); presence of living children (p=0.0001); and husband having preference of sex of baby (p=0.0001). CONCLUSIONS: Parental education, socioeconomic background, and number of living issues were the main predictors for gender preference. Awareness regarding gender preference and related law and parental counselling to avoid gender preference with adoption of small family norm is recommended.

Reproductive tract infection and health seeking behaviour of eligible couples--an appraisal.

A community-based cross-sectional study was conducted in Paschim Midnapur district of West Bengal during March 2009 to August 2009 to find out the prevalence of reproductive tract infection and the health seeking behaviour. The respondents were 2000 currently married women (15-49 years age group) selected by stratified multistage random sampling. House to house visit and data collection by interview technique was done by faculty members of community medicine of Calcutta National Medical College and other medical colleges through predesigned and pretested schedule. The prevalence of reproductive tract infection was 11.7%, which was higher in 30-35 years age group (19.4%). Reproductive tract infection was indirectly proportional to literacy status. Prevalence of reproductive tract infection was significantly higher among those who did not use sanitary napkin / clean sun-dried domestic clothes. The occurrence of reproductive tract infection was lower who used to practise barrier method of contraception. Majority of symptomatic females complained about vaginal discharge (29.2%). Information, education, communication regarding small family norms, reproductive hygiene and contraceptive practice to be enhanced in the community through intervention (interpersonal communication and mass media) in future to reduce the reproductive tract infection morbidities.

Perceptions of couples about contraception in eastern India.

This community-based, cross-sectional study was conducted in sampled villages and municipal wards of Paschim Medinipur District of West Bengal, India among 2,000 respondents, 3/4 were from rural and 1/4 from urban areas, to determine perceptions of couples about contraception. Decision-making about fertility and contraception was mostly made by the husband. Forty-four point three percent of rural and 77.6% of urban women preferred a birth spacing of > or = 3 years. The ideal interval between marriage and first pregnancy was considered to be > or = 3 years in nearly two thirds of women. With increasing literacy level among women, the ideal birth interval between pregnancies also increased. Eighty-nine point four percent of women had correct knowledge of family planning. Only 49.4% of women knew about the Copper-T contraceptive device.

Critical appraisal of healthcare delivery services by multipurpose workers in rural West Bengal.

This cross-sectional study of 35 multipurpose workers (MPWs) of Goalpokhar--II (Chakulia) block selected by random sampling in the district of Uttar Dinajpur showed that 30 respondents were female mostly in the age group less than 30 years and rest were male in the age group of above 30 years. Majority of respondents (65.7%) were educated up to the level of higher secondary. On an average each MPW used to spend only 5.8 hours per week for home visit. During referral of the patients, the problems faced by the health workers were due to non-availability of vehicles (71.4%), difficulties in the means of communication ie, long distance, road problems, etc (85.7%), and lack of awareness about referral centre (2.8%). Only 5.5% of the MPWs stated absence of difficulty during referral to the higher facility. Regarding difficulties faced during transmission of health related information, 25.7% of MPWs were unaware of the location of the reporting centre; 17.4% of MPWs were unaware of authority to be informed and 14.3% of MPWs complained about social barrier and 22.8% experienced non-availability of manpower. However 42.9% of MPWs did not face any problem while transmitting health related events/information to the higher authority. Most of the respondents (23.5%) opined that their performance may be enhanced by increasing community awareness.

Epidemiological study of measles in slum areas of Kolkata.

OBJECTIVE: An epidemiological study on measles was conducted among the under five children in slum areas of Kolkata to assess the incidence of measles. METHODS: 20 cluster sampling technique was followed and in each cluster 250 under five children were covered. Paramedical workers identified children of the target of age group who had history of measles in past one year and the medical officer confirmed the diagnosis following standard case definition. RESULTS: Incidence of measles was found as 5.76%. Incidence was equal in both the sex groups, but found more among infants. The incidence of measles gradually declined with the increase of age strengthening the view in favor of early immunization. Amongst the measles cases only 19.7% were immunized with measles vaccine. 100% of measles cases gave history of rash, 98.9% had history of fever, 82.8% reported that the rash started from face and progressed downwards to abdomen and leg. Cough, redness of eye and discoloration of skin were reported by 97.5%, 83.8% and 65.2% measles cases respectively. Only 16.9% and 8.6% children received Vitamin A oil before and after the illness respectively. 49% gave history of exposure to measles cases and 46.6% cases had measles within 2 weeks incubation period. CONCLUSION: The study highlighted the necessity of timely measles vaccine coverage, additional dose at a higher age and Vitamin A supplementation through IEC activities.