Estimates of major non-communicable disease risk factors for India, 2010 & 2015: A summary of evidence

Background & objectives: The National Monitoring Framework for the prevention and control of NCDs in India has set targets for reduction of risk factors relative to the measure recorded in 2010. Estimates for 2010 and 2015 were established using meta-analyses in the absence of a national risk factor survey till 2017. Methods: We searched national survey reports and also articles published in English from India between 2008 and 2017 in PubMed, Google Scholar and Cochrane review databases for specific risk factors among 18-69 yr Indians. Quality of studies was evaluated using Joanna-Briggs tool, but all studies were included in analyses. Estimates for each of the eight strata by age, gender and place of residence, respectively, were generated. MetaXL was used to calculate the pooled estimate for 2010 and 2015 using a random effects model. Strata-specific estimates were combined to arrive at national estimate using population weight of each stratum. The credibility of the estimates was determined using four parameters - average Briggs score; representativeness of the contributing studies and precision and stability of the estimates. Results: The estimates [95% confidence interval (CI)] for 2010 for different risk factors were as follows: current alcohol use, 15.7 per cent (13.2-18.2); current tobacco use, 27 per cent (21.4-32.6); household solid fuel use, 61.5 per cent (50.2-72.5); physical inactivity, 44.2 per cent (37.8-50.6); obesity, seven per cent (3.8-10.2) and raised blood pressure, 20.2 per cent (18.4-22.1). In 2015, compared to 2010, tobacco use showed a relative decline of 18 per cent, household solid fuel use of nine per cent and physical inactivity of 15 per cent. The estimates were stable for alcohol use, raised blood pressure and obesity between 2010 and 2015. All estimates varied between moderate and high degrees of credibility. Interpretation & conclusions: The estimates are consistent with other available estimates and with current national-level initiatives focused on tobacco control and improving access to clean fuel. These estimates can be used to monitor progress on non-communicable disease risk factor targets for India

Characterizing the third wave of COVID-19: An analysis from the National Clinical Registry of COVID-19

Background & objectives: Data from the National Clinical Registry for COVID-19 (NCRC) were analyzed with an aim to describe the clinical characteristics, course and outcomes of patients hospitalized with COVID-19 in the third wave of the pandemic and compare them with patients admitted earlier. Methods: The NCRC, launched in September 2020, is a multicentre observational initiative, which provided the platform for the current investigation. Demographic, clinical, treatment and outcome data of hospitalized COVID-19 patients were captured in an electronic data portal from 38 hospitals across India. Patients enrolled during December 16, 2021 to January 17, 2022 were considered representative of the third wave of COVID-19 and compared with those registered during November 15 to December 15, 2021, representative of the tail end of the second wave. Results: Between November 15, 2021 and January 17, 2022, 3230 patients were recruited in NCRC. Patients admitted in the third wave were significantly younger than those admitted earlier (46.7±20.5 vs. 54.6±18 yr). The patients admitted in the third wave had a lower requirement of drugs including steroids, interleukin (IL)-6 inhibitors and remdesivir as well as lower oxygen supplementation and mechanical ventilation. They had improved hospital outcomes with significantly lower in-hospital mortality (11.2 vs. 15.1%). The outcomes were better among the fully vaccinated when compared to the unvaccinated or partially vaccinated.Interpretation & conclusions: The pattern of illness and outcomes were observed to be different in the third wave compared to the last wave. Hospitalized patients were younger with fewer comorbidities, decreased symptoms and improved outcomes, with fully vaccinated patients faring better than the unvaccinated and partially vaccinated ones.

Risk factors for non-communicable disease in urban Haryana: a study using the STEPS approach.

BACKGROUND: India is in the midst of an epidemiological transition with non-communicable diseases increasing in importance. Targeting the risk factors for non-communicable diseases is recognized as an essential preventive strategy. There is lack of good quality data on prevalence of risk factors. The present study addresses this challenge in urban population of Ballabgarh town in Faridabad district of Haryana. METHODS: A total of 1263 male and 1326 female respondents were selected using multistage systematic random sampling, in 5 age groups of 10 years (15-24, 25-34, 35-44, 45-54 and 55-64). The World Health Organization's STEPS approach entails stepwise collection of the risk factor data based on standardized questionnaires (step 1), basic physical measures in step 2 and finally in 3rd step, basic biochemical investigations such as blood sugar and cholesterol. The prevalence was adjusted to the age and sex strata of urban Faridabad as per census 2001. RESULTS: The prevalence of current daily use of smoked tobacco was 22.2% (95% CI7colon; 20.0-24.6) for males and 1.4% (95% CI: 0.9-2.2) for females. In males the prevalence of current alcohol consumption was 28.9% (95% CI: 26.4-31.5). Physical inactivity was reported by 23.2% (95% CI: 20.9-25.6) of males and 52.4% (95% CI: 49.7-55.1) of female respondents. Only 8.6% of males and 4.4% of females were consuming adequate portions of the fruits and vegetables. 23.1% (95% CI: 20.8-25.5) males and 15.7% (95% CI: 13.87ndash;17.8) females were either in Stage 1 and 2 hypertension (JNC VII) or were taking anti-hypertensives. Among males, 25.4% (95% CI: 23.0-27.9) and, among females 34.9% (95% CI: 32.3-37.6) were overweight. CONCLUSION: The prevalence of tobacco and alcohol use among males and physical inactivity among females was high. Low consumption of fruits and vegetables, hypertension and overweight was equally common among both the sexes in the population studied. Thus there is an urgent need for initiating measures at the risk factor level to counter this modern day epidemic of non-communicable disorders, within this urban community.