Prevalence of hypertension and associated risk factors in urban slums: A community based cross sectional study in India.

Hypertension is a global public health issue. Being a silent killer, very rarely symptoms are seen in the early stages till a severe medical crisis (heart attack, stroke, or chronic kidney disease) occurs. A community-based cross-sectional study was conducted to estimate the prevalence of hypertension in urban slums and to evaluate the association of hypertension with various modifiable and nonmodifiable risk factors. Data were collected by house-to-house visits in the slums. Pro forma created in the Magpi app was used to collect demographic characteristics and record anthropometric findings. SPSS version 25 was used for statistical analysis. Of the 534 participants, 71.91% were female. The prevalence of hypertension was found to be 15.36%. The risk of hypertension increased with age >50 years, female gender, and habits such as tobacco and alcohol. Awareness programs to reduce modifiable risk factors such as smoking and alcohol, promoting healthy lifestyles, as well as early diagnosis and treatment, will benefit the community.

Prevalence of preconception risk factors for adverse pregnancy outcome among women from tribal and non-tribal blocks in Nashik district, India: a cross-sectional study.

BACKGROUND: Although critical, the preconception phase in women's lives is comparatively ignored. The presence of some risk factors during this phase adversely affects the wellbeing of the woman and the pregnancy outcome. The study objectives were to measure the prevalence of various known risk factors for adverse pregnancy outcome in the preconception period of women and their comparison between blocks. METHODS: This was a community-based cross-sectional study in two tribal and two non-tribal blocks each in Nasik district, Maharashtra, India. The study included married women desiring to conceive within 1 year. Trained Accredited Social Health Activists (field level health worker) collected information from women using a validated interview schedule through house-to-house visits and obtained women's anthropometric measurements in a standard manner. The study assessed the presence of 12 documented risk factors. RESULTS: The study enlisted 7875 women desiring pregnancy soon. The mean age of women was 23.19 (± 3.71) years, and 16% of them were adolescents. Women's illiteracy was higher in tribal areas than non-tribal (p < 0.001). About two-thirds of women have at least one risk factor, and 40.0% have a single risk factor. The most common risk factor observed was no formal education (44.35%). The prevalence of selected risk factors was significantly higher among women from tribal areas. The mean BMI of women was 19.73 (± 3.51), and a higher proportion (40.5%) of women from tribal areas had BMI < 18.5. Despite being of high parity status (≥ 4), about 7.7% of women from the tribal area and 3% from non-tribal desired pregnancy. Tobacco and alcohol consumption was higher among tribal women. The majority of women consumed meals with family members or husbands. Protein and calorie intake of about 1.4% of women was less than 50% of the recommended daily allowance; however, most of them perceived to have abundant food. CONCLUSIONS: Health risks, namely younger age, illiteracy, high parity, consumption of tobacco, low protein, and calorie intake, were quite prevalent, and the risks were significantly more among women from tribal areas. "Continuum of care" must comprise preconception care inclusive of Behavioral Change Communication, particularly for easily modifiable risk factors and specially for tribal women.

Women's health during the preconception phase although important, is an ignored period in her life cycle. Literature has shown that the presence of risk factors in women during the preconception phase is hazardous to the health of women and newborns. The present study is a cross-sectional study conducted in four blocks of Nasik district, Maharashtra, India, to measure risk factors for adverse pregnancy outcome among women and its comparison between blocks.We included married women desiring conception within 1 year. Accredited Social Health Activists asked questions using a validated interview schedule and recorded women's anthropometric measures.Of the 7875 women, 16% were adolescents, and the mean age of women was 23.19 ± 3.71 years. About two-fifth of women had one risk factor, the commonest being no formal education. Overall mean BMI of women was 19.73 (± 3.51). The prevalence of risk factors was significantly higher among women from tribal areas. Despite having ≥ 4 parity a higher proportion of women from tribal areas desired to conceive. About 1.4% of women had protein and calorie intake below 50% recommended consumption.In conclusion, the prevalence of selected risk factors was significantly higher among tribal women. The study identifies the need for preconception care services.

Association between adverse pregnancy outcomes and preceding risk factors: a cross-sectional study from Nashik District, India.

BACKGROUND: The preconception phase of women's life cycle is critical but comparatively ignored. The presence of health risks is judged as hazardous to the wellbeing of women and their offspring. This study aimed to estimate the prevalence of various pregnancy outcomes and assess the association between certain risk factors and adverse outcomes. METHODS: As a part of a preconception care intervention project, a baseline survey was conducted in four blocks of Nashik District, India. In this population-based cross-sectional analytical study, we compared cases in the study group (randomly selected one tribal and one non-tribal block) with those of the control group (one tribal and one non-tribal block). A comparison was also made between the tribal and non-tribal blocks in each group. All women who had a pregnancy outcome in the preceding 12 months (01 April 2017 to 31 March 2018) were interviewed. Trained Accredited Social Health Activists conducted the survey under the direct supervision of Auxiliary Nurse Midwives and Medical Officers. Multivariate analysis was carried out to find the adjusted prevalence ratio of having a particular adverse outcome because of the prespecified potential risk factors. RESULTS: A total of 9307 women participated in the study. The prevalence of adverse pregnancy outcomes was as follows: abortion in 4.1%, stillbirth in 1.7%, preterm birth in 4.1%, low birth weight in 13.2%, and congenital physical defect in 2.8%. Prevalence of parental consanguinity, pre-existing maternal illness at conception, heavy work during the last six months of pregnancy, tobacco consumption, alcohol consumption, direct exposure to pesticides and domestic violence during pregnancy was 18.5, 2.2, 18.7, 5.6, 0.5, 2.3, and 0.8% respectively. Risk factors associated with abortion included pre-existing illness and heavy work in the last six months of the pregnancy. Consanguinity, tobacco consumption during pregnancy and pre-existing illness were identified as risk factors for stillbirth. Significant risk factors of low birth weight were heavy work in the last six months of pregnancy, pre-existing illness and residence in a tribal area. CONCLUSION: There is a need to emphasize on maternal behaviour, including tobacco consumption, and heavy work during pregnancy, as well as on parental consanguinity and pre-existing maternal illnesses, in order to achieve the best possible pregnancy outcomes.

Prevalence and determinants of undernutrition among under-five children residing in urban slums and rural area, Maharashtra, India: a community-based cross-sectional study.

BACKGROUND: Undernutrition among under five children in India is a major public health problem. Despite India's growth in the economy, the child mortality rate due to undernutrition is still high in both urban and rural areas. Studies that focus on urban slums are scarce. Hence the present study was carried out to assess the prevalence and determinants of undernutrition in children under five in Maharashtra, India. METHODS: A community-based cross-sectional study was conducted in 16 randomly selected clusters in two districts of Maharashtra state, India. Data were collected through house to house survey by interviewing mothers of under five children. Total 2929 mothers and their 3671 under five children were covered. Multivariate logistic regression analysis was carried out to identify the determinants of child nutritional status seperately in urban and rural areas. RESULTS: The mean age of the children was 2.38 years (±SD 1.36) and mean age of mothers was 24.25 years (± SD 6.37). Overall prevalence of stunting among children under five was 45.9%, wasting was 17.1 and 35.4% children were underweight. Prevalence of wasting, stunting and underweight were more seen in an urban slum than a rural area. In the rural areas exclusive breast feeding (p < 0.001) and acute diarrhea (p = 0.001) were associated with wasting, children with birth order 2 or less than 2 were associated with stunting and exclusive breast feeding (p < 0.05) and low maternal education were associated with underweight. Whereas in the urban slums exclusive breast feeding (p < 0.05) was associated with wasting, sex of the child (p < 0.05) and type of family (p < 0.05) were associated with stunting,and low income of the family (p < 0.05) was associated with underweight. CONCLUSIONS: Factors like sex of the child, birth order,exclusive breast feeding,economic status of the family, type of family,acute diarrhea and maternal education have influence on nutritional status of the child. Improvement of maternal education will improve the nutritional status of the child. Strategies are needed to improve the economic status of the community. TRIAL REGISTRATION: Trial registration number: CTRI/2017/12/010881 ; Registration date:14/12/2017. Retrospectively registered.

Reported incidence and risk factors of childhood pneumonia in India: a community-based cross-sectional study.

BACKGROUND: Pneumonia is responsible for high morbidity and mortality amongst children under five year of age. India accounts for one-third of the total WHO South East Asia burden of under-five mortality. There is a paucity of epidemiological studies indicating the true burden of pneumonia. Identification of the risk factors associated with pneumonia will help to effectively plan and implement the preventive measures for its reduction. METHODS: It was a descriptive cross-sectional study conducted in 16 randomly selected clusters in two districts of Maharashtra state, India. All mothers of under-five children in the selected clusters were included. A validated pretested interview schedule was filled by trained field supervisors through the house to house visits.WHO definition was used to define and classify clinical pneumonia. Height and weight of children were taken as per standard guidelines. Quality checks for data collection were done by the site investigators and critical and noncritical fields in the questionnaire were monitored during data entry. For continuous variables mean and SD were calculated. Chi-square test was applied to determine the association between the variables. Level of significance was considered at 0.05. RESULTS: There were 3671 under five-year children, 2929 mothers in 10,929 households.Unclean fuel usage was found in 15.1% of households. Mean birth weight was 2.6 kg (SD;0.61). Exclusive breastfeeding till 6 months of age was practiced by 46% of mothers. Reported incidence of ARI was 0.49 per child per month and the reported incidence of pneumonia was 0.075 per child per year. It was not associated with any of the housing environment factors (p > 0.05) but was found to be associated with partial immunization (p < 0.05). Poor practices related to child feeding, hand hygiene and poor knowledge related to signs and symptoms of pneumonia amongst mother were found. CONCLUSIONS: Very low incidence of pneumonia was observed in Pune and Sangli districts of Maharashtra. Partial immunization emerged as a most important risk factor. Reasons for low incidence and lack of association of pneumonia with known risk factors may be a better literacy rate among mothers and better immunization coverage. TRIAL REGISTRATION: Registration number of the trial- CTRI/2017/12/010881 ; date of registration-14/12/2017.

Nomophobia: an emerging issue in medical institutions?

BACKGROUND: Nomophobia is No Mobile Phone Phobia - the fear of being without a mobile device or beyond mobile phone contact. The time and money wastage by medical students is a negative aspect of mobile phone dependence. This time can be utilized for academic and recreational activities. AIM: To assess the prevalence of Nomophobia in the students in 1st year MBBS. METHODS: Study area: A medical college in Pune city. STUDY PERIOD: December 2015 to February 2016. A cross-sectional study was carried out on all the students of 1st year MBBS. A predesigned and pretested questionnaire was used to collect data. Data were analyzed statistically by simple proportions using SPSS v20. RESULTS: A total of 145 students were monitored according to inclusion and exclusion criteria. Amongst all the participants, 45.5% were males (66/145) and 54.5% were females (79/145). Mild Nomophobia was found in 17.9% students whereas 60% had moderate and 22.1% had severe Nomophobia. Amongst the males, 56.06% and 24.24% had moderate and severe Nomophobia, respectively while in females, moderate and severe Nomophobia was found to be 63.25% and 20.25%, respectively. CONCLUSION: Nomophobia is found to be prevalent in students of 1st year MBBS.

Symptomatic survey of COVID-19 in the rural health and demographic surveillance site of Maharashtra, India.

Introduction: The COVID-19 epidemic is fast-evolving and restrictions to contain it changes quickly. The secondary attack rate (SAR) indicates the infectiousness at the household level, and it provides a clue of load of infections in the community. Rapid implementation of a large scale, but brief survey provides a nationally representative view of the pandemic's progression and impact as well as the effect of the measures taken to control the spread. Materials and Methods: This cross-sectional study was done for a period of 2 months July-August 2020, in one of the rural health and demographic surveillance system (HDSS) site in India among 11,507 households having 46,571 individuals with the objective to determine the prevalence of the COVID-19 infection and to estimate the family SAR. The data were collected using the mobile phone by calling the head of the households registered under the HDSS. The research tool was created using questions based on the guidelines provided by the Ministry of Health and Family Welfare, India. The interviewers were first trained in data collection. Results: The households of 33,780 individuals were contacted and 33 patients were diagnosed as COVID positive, prevalence rate of 0.1% was thus documented through telephonic survey. The mean age of COVID patients was found to be 37 ± 16 years, and 63% of the diagnosed patients were males, majority of them belonged to above poverty line households. During the survey, 46 individuals reported to have the symptoms suggestive of COVID, fever and cough were the most commonly reported symptoms. The family SAR of 17.2% was documented. Conclusion: Thus to conclude a low COVID-19 prevalence rate of 0.1%, a higher family SAR of 17.2% was reported in the current study. Timely diagnosis and quarantine of close contacts should be continued to be implemented rigorously to prevent the spread of the COVID-19 virus. These efforts will be useful to contain the epidemic before it reaches an alarming level in the rural areas.

Résumé Introduction: L'épidémie de COVID-19 évolue rapidement et les restrictions pour la contenir changent rapidement. Le taux d'attaque secondaire (SAR) indique l'infectiosité au niveau du ménage et fournit un indice de la charge d'infections dans la communauté. La mise en œuvre rapide d'une enquête à grande échelle mais brève fournit une vue représentative à l'échelle nationale de la progression et de l'impact de la pandémie ainsi que de l'effet des mesures prises pour contrôler la propagation. Matériels et Méthodes: cette étude transversale a été réalisée sur une période de 2 mois de juillet à août 2020, dans l'un des sites du système de surveillance sanitaire et démographique en milieu rural (HDSS) en Inde auprès de 11 507 ménages comptant 46 571 individus dans le but de déterminer prévalence de l'infection au COVID-19 et d'estimer le DAS familial. Les données ont été collectées à l'aide du téléphone mobile en appelant le chef de ménage inscrit au HDSS. L'outil de recherche a été créé à l'aide de questions basées sur les directives fournies par le ministère indien de la Santé et du Bien-être familial. Les enquêteurs ont d'abord été formés à la collecte de données. Résultats: les ménages de 33 780 individus ont été contactés et 33 patients ont été diagnostiqués positifs au COVID, un taux de prévalence de 0,1 % a ainsi été documenté par une enquête téléphonique. L'âge moyen des patients COVID était de 37 ± 16 ans, et 63 % des patients diagnostiqués étaient des hommes, la majorité d'entre eux appartenant à des ménages au-dessus du seuil de pauvreté. Au cours de l'enquête, 46 personnes ont déclaré avoir des symptômes évocateurs de COVID, la fièvre et la toux étaient les symptômes les plus fréquemment signalés. Le SAR familial de 17,2 % a été documenté. Conclusion: Ainsi, pour conclure à un faible taux de prévalence de la COVID-19 de 0,1 %, un DAS familial supérieur de 17,2 % a été rapporté dans la présente étude. Le diagnostic rapide et la mise en quarantaine des contacts étroits doivent être poursuivis et mis en œuvre de manière rigoureuse pour empêcher la propagation du virus COVID-19. Ces efforts seront utiles pour contenir l'épidémie avant qu'elle n'atteigne un niveau alarmant dans les zones rurales. Mots-clés: COVID 19, système de surveillance sanitaire et démographique, téléphone portable, prévalence, milieu rural, taux d'attaque secondaire.

Perceptions of and challenges faced by primary healthcare workers about preconception services in rural India: A qualitative study using focus group discussion.

Background: Providing preconception care through healthcare workers at the primary health care level is a crucial intervention to reduce adverse pregnancy outcomes, consequently reducing neonatal mortality. Despite the availability of evidence, this window of opportunity remains unaddressed in many countries, including India. The public health care system is primarily accessed by rural and tribal Indian population. It is essential to know the frontline healthcare workers perception about preconception care. The study aimed to identify barriers and suggestions for framing appropriate strategies for implementing preconception care through primary health centers. Methods: The authors conducted a qualitative study using focus group discussions (FGDs) with 45 healthcare workers in four FGDs (8-14 participants in each), in four blocks of Nashik district. The transcribed discussions were analyzed in MAXQDA software using the Socio-Ecological Model as an initial coding guide, including four levels of factors (individual, interpersonal, community, and institutional) that influenced an individual's behavior to use preconception care services. Results: Healthcare workers had some knowledge about preconception care, limited to adolescent health and family planning services. The interpersonal factors included heavy workload, stress, lack of support and co-operation, and paucity of appreciation, and motivation. The perceived community factors included poverty, migration, poor knowledge of preconception care, lack of felt need for preconception services, the influence of older women in the household decision, low male involvement, myths and misconceptions regarding preconception services. The identified institutional factors were lack of human resources, specialized services, logistics, and challenges in delivering adolescent health and family planning programs. Healthcare workers suggested the need for program-specific guidelines, training and capacity building of human resources, an un-interrupted supply of logistics, and a unique community awareness drive supporting preconception care services. Conclusion: Multi-level factors of the Socio-Ecological Model influencing the preconception care services should be considered for framing strategies in the implementation of comprehensive preconception care as a part of a continuum of care for life cycle phases of women.

Living and Working Conditions of Female Domestic Workers in Pune City.

CONTEXT: Female domestic workers (FDWs) comprise a significant part of the global workforce in informal sector. Nature of their workplace is such that the work goes unaccounted for in terms of employment policies or legislation. AIMS: The aim of this study was to assess socio-demographic and occupational profile of FDWs. SUBJECTS AND METHODS: A cross-sectional study was conducted in one ward of each of the five geographical zones of Pune city. Domestic workers employed in randomly selected residential societies therein were included in the study. Data collected by interview technique during house visit and general examination done. STATISTICAL ANALYSIS USED: Data were analyzed by using IBM SPSS 25.0 USA statistical software. Percentage, mean, and standard deviation were calculated. RESULTS: Of the 573 FDWs, 62% were between 20 and 40 years, and 35% were educated up to middle school. Three-fourths were currently married. Fifty-one were sole breadwinners. Most FDWs had their own house with electricity and water supply. Almost half had been employed for 5-10 years, working in 3-4 households. Approximately 50% earned between Rs. 4000-8000 per month. Maximum received annual bonus. CONCLUSIONS: Working and living conditions of these FDWs are not as pitiful as depicted in previous studies. However, benefits accorded to the formal sector workers are lacking here like fixed days off, pension, and maternity leave.

Coherence between Existing System of Defining Urban Poor with Kuppuswamy and Hashim's System; Which is More Relevant?

BACKGROUND: Identification of below poverty line (BPL) households is of paramount importance to provide benefits under poverty alleviation and other programs. OBJECTIVES: (1) To assess households in urban slums in terms of housing, assets, and amenities. (2) To compare three different systems of socioeconomic status (SES) - ration card holders, Modified Kuppuswamy Scale, and Hashim's system. MATERIALS AND METHODS: A cross-sectional, community-based study was conducted in urban slums of field practice area of a medical college, Pune. Considering 35% of urban households in India qualify as poor, sample size of 593 households was calculated. A predesigned, validated, pretested questionnaire was used, covering sociodemographic domains including indicators of three systems. Agreement between these scales was calculated by kappa statistics. RESULTS: Total 639 households were surveyed covering 3078 slum population. Percentage of BPL families according to possession of yellow ration card, Modified Kuppuswamy Scale, and Hashim's system were 35.99%, 48.67%, and 48.51%, respectively. The proportion of agreement between Kuppuswamy scale and ration card was 55.71% and for Hashim system and ration card was 51.79%. CONCLUSIONS: The present study revealed no agreement between these three systems. Hashim system gives more accurate and realistic picture of SES of the urban slums households owing to its holistic approach.

Significant treatment gap and co-morbidities identified in an epidemiological survey of pediatric epilepsy in rural suburbs of India.

PURPOSE: A cross-sectional epidemiological survey of children was conducted in two rural clusters to estimate the point prevalence and study various aspects of childhood epilepsy. MATERIAL AND METHODS: In the first stage, a house-to-house survey was conducted by health workers using a screening questionnaire, which was pre-validated in a pilot study. All screen positive houses were visited by pediatric neurologist for detailed evaluation. Children with a clinical diagnosis of epilepsy underwent EEG and were evaluated for type of seizure, epilepsy syndrome, etiology, co-morbidities and treatment gap. Knowledge, attitude and practice regarding epilepsy was assessed amongst caregivers of the affected children. RESULTS: A total population of 75,455 population was screened, 19,181 children aged 2 months to 18 years were identified. Out of 355 screen positive children, 66 were diagnosed with epilepsy. The point prevalence of pediatric epilepsy was 3.44 per 1000 children. 53% had focal epilepsy, 31.8% had an identifiable epilepsy syndrome, 44% had at least one comorbidity. The etiology was identified in 68%, the commonest being perinatal brain insult. The magnitude of treatment gap was 45.45%, with significant deficits in knowledge. CONCLUSION: There are significant deficits in diagnosis and treatment of pediatric epilepsy among the rural population of India. The existing rural health care facilities need to be augmented to facilitate the timely diagnosis and optimum care of these children, including care of associated co-morbidities.

Meager Perception of Preconception Care Among Women Desiring Pregnancy in Rural Areas: A Qualitative Study Using Focus Group Discussions.

Background: India has the second-highest number of under-five deaths in any country in the world. WHO and the Government of India recommended the rollout of preconception care (PCC) to reduce maternal and child mortality. However, very few countries, including India, have started a comprehensive package of PCC services. It implies that women, mainly from rural and tribal areas, are not aware of PCC. PCC has been rolled out through the government health system in two blocks of Nashik district in Maharashtra state, India, among all women who desire to be pregnant within 1 year. This project is the first of its kind in India. To assess basic perceptions, knowledge, and behavior of women on PCC before the implementation of the project, focus group discussions (FGDs) were carried out. The authors think that the finding may help to develop strategies for behavioral change communication. Methods: From each of the four blocks, two villages having subcenter were selected for conducting FGD. A house-to-house survey was conducted by Accredited Social Health Activist (ASHA) to enlist women who desire a baby in 1 year and invite them to subcenter for FGDs, which were conducted in June 2018. Results: A total of 76 women having a mean age of 23.97 years participated in the FGDs. Most of them (46.05%) had completed 10 years of education. About 50% of pregnancies were planned. The decision about the timing of the first pregnancy is influenced by the mother-in-law. Women knew that they should not conceive before 20 years of age, and their suboptimal weight may have an adverse impact on the health of the newborn. There are many myths about food like "hot and cold foods" and "forbidden food" etc. Women had some knowledge about the adverse effects of tobacco and alcohol; very few consumed these. Most of them did not practice behaviors or accessed services related to PCC. Conclusions: Women neither have the knowledge nor adopt behaviors or accessed services related to PCC. Roll out of PCC among them may help in further reduction of maternal and neonatal morbidity and mortality in India.

Prevalence of the Acute Respiratory Infections and Associated Factors in the Rural Areas and Urban Slum Areas of Western Maharashtra, India: A Community-Based Cross-Sectional Study.

Acute respiratory infections (ARIs) continue to be the most important cause of morbidity and mortality among under-five children. Some demographic and environmental factors are associated with ARIs among under-five children. This study was conducted with the objective to estimate the prevalence of ARIs among under-five children in the rural areas and densely populated urban slum areas in Maharashtra, India and to assess the association of the selected sociodemographic and household environmental factors with ARI. This study was conducted in 16 selected clusters from the rural areas and densely populated urban slum areas of the two districts in Maharashtra, India. Structured and validated proforma was used for collecting the data on the sociodemographic and household environmental risk factors. A total of 3,671 under-five children were surveyed. The prevalence of ARIs for the preceding month was 50.4%. It was higher among the children living in the rural areas (54.2%) compared to the children living in the urban areas (46.7%) (p = 0.01). The prevalence of ARIs was reported to be 51.4 and 49.4% in boys and girls, respectively. In the multivariate analysis, the researchers found that living in rural areas (p = 0.01) and parental smoking (p = 0.04) were significantly associated with the ARIs. An intervention such as reducing parental smoking habits at the household level may reduce ARIs.

Effect of Behavior Change Communication on the Incidence of Pneumonia in Under Five Children: A Cluster Randomized Controlled Trial.

BACKGROUND: Improving health education of the mother by providing community-based interventions is known to help control pneumonia. OBJECTIVES: To determine the effect of behavior change communication (BCC) activities for mothers in reducing the incidence of childhood pneumonia. DESIGN: Open-label cluster randomized controlled trial. SETTING: Urban slums and villages in two districs of Maharashtra. PARTICIPANTS/CLUSTER: Under-five children and their mothers from households in the randomly selected 16 clusters out of total 45 clusters, stratified into Pune and Sangli districts and further into rural and urban areas before randomization. INTERVENTION: Three forms of BCC activities were imparted, viz., interactive sessions of education using pictorial mothers' booklet, screening of a audio-visual film, and virtual hand wash demonstration and use of flashcard. Routine care under the National health program was provided by the Accredited Social Health Activists (ASHA) workers in both the arms. OUTCOME: The primary outcome was pneumonia as per the IMNCI criteria assessed during fortnightly visits of the ASHA/anganwadi workers to the houses of under-five children, who received at least one follow-up visit in a period of one year. RESULTS: The incidence of pneumonia in 1993 and 1987 under-five children in the intervention and control arm was 0.80 and 0.48 episodes per child per year, respectively (P=0.03). CONCLUSIONS: BCC for mothers is not sufficient to reduce the incidence of childhood pneumonia.

Assessment of risk of type 2 diabetes using the Indian Diabetes Risk Score in an urban slum of Pune, Maharashtra, India: a cross-sectional study.

BACKGROUND: The urban poor is a group that is known to be vulnerable to adoption of a more urbanized lifestyle that places them at a higher risk for diabetes. Individuals who are unaware of their disease status are more prone to micro- and macrovascular complications. Hence, it is necessary to detect this large pool of undiagnosed participants with diabetes and offer them early therapy. The aim of this study was to use the Indian Diabetes Risk Score, developed by the Madras Diabetes Research Foundation (MDRF-IDRS), to assess the prevalence of people at high risk for developing diabetes, and the correlation with known risk factors. METHODS: A cross-sectional study was conducted in the field practice area of the urban health training centre of a private medical college in Pune, Maharashtra. A total of 425 participants aged 20 years and above were screened for risk factors, including age, waist circumference, family history of diabetes and physical activity. Random testing of the blood glucose level of participants with a high risk score was carried out using a glucometer. Statistical analysis of the data was performed by using the chi-squared test and logistic regression analysis. RESULTS: The prevalence of people at high risk of diabetes was 36.55%. Among high-risk participants on univariate analysis, primary education (P = 0.004), lower socioeconomic class (P = 0.002), less physical activity (P< 0.001) and high waist circumference (P < 0.001) were major contributing factors, while in the moderate-risk group, lower socioeconomic class and high waist circumference were the prominent risk factors for diabetes. Multivariate analysis showed that higher education, moderate to vigorous activity and high waist circumference were significantly associated with risk status. Out of 140 high-risk participants, 68 (49%) had a random capillary blood glucose level of 110 mg/dL or above. CONCLUSION: As the prevalence of people at high risk for diabetes was high, lifestyle changes and awareness regarding risk factors is needed to take control of the diabetes in the study population.

Tuberculosis awareness program and associated changes in knowledge levels of school students.

BACKGROUND: This study aimed to assess the effectiveness of tuberculosis awareness program amongst school students. METHODS: This school-based interventional study was done on 135 secondary school students. They were randomly selected in field practice area of Urban Health Training Center (UHTC) of a private medical college in Pune city. Health awareness session on tuberculosis was conducted by using various visual and audiovisual aids by the medical college undergraduate students. A pre-test and post-proforma was filled before and after the session. Paired t-test was used to assess the effectiveness of awareness program. RESULTS: There was a highly significant (P = 0) increase in the knowledge of school students after the tuberculosis awareness program by medical undergraduate students. The mean pre-test scores were 6.31 (52.58%), and the mean post-test scores were 10.20 (85%). This activity also helped medical undergraduate students to acquire skills related to communication, working in a team, preparation and presentation of various visual aids for health awareness program; they also gained knowledge of research methodology. CONCLUSIONS: Health education program by medical students helped significantly to improve the knowledge of school students regarding tuberculosis. Thus, medical college students can be involved to some extent for conducting health-related behavioral change communication (BCC) activities in schools during their Community Medicine morning posting. Collaboration of private medical colleges, schools, and district tuberculosis units (DTUs) can be ideally achieved under public private partnership (PPP) for health awareness programs.