Sexual practices of People Living with HIV/AIDS attending School of Tropical Medicine, Kolkata.

A hospital-based, cross-sectional, observational study of People Living with HIV/AIDS (PLWHAs) attending the School of Tropical Medicine (STM), Kolkata was carried out for a period of 6 months from May 2006 to October 2006, to assess the sexual practices of PLWHAs. Past sexual practice of PLWHAs revealed that 93.4% males were polygamous, compared to 16.4% females. Of them, 45.7% males and 92.8% females reported sex with a nonregular sex partner (NRSP) in 1 year. Consistent condom use was low in both sexes. Current sexual practice showed that more than four-fifth (87.9%) of the new patients and two-thirds (68.9%) of the indoor patients were currently sexually active in 1 month recall period (P=3.79, Z=0.0000). However, consistent condom use was found only in 35.5% indoor patients and 15.5% of new patients and the difference was statistically significant.

Tobacco abuse among school going adolescents in a rural area of West Bengal, India.

Adolescents are vulnerable targets of tobacco industry with all consequences of usage. Studies reveal that tobacco abuse is rising in this age group in India. A cross sectional survey was carried out in two coeducational high schools of Anandanagar village of Singur block, Hooghly district, West Bengal among 276 students of VIII-IX standard to study the knowledge and abuse of tobacco and to find out influencing socio-demographic factors. Knowledge score was higher in females, students from nuclear families, and those with literate parents. Low prevalence of tobacco intake was obtained among the students, with 9.8% reported having ever used smokeless tobacco and 4.3% ever smoked. Tobacco intake was higher among those with a history of parental tobacco intake. Continued information education and communication (IEC) activities should be conducted by the school authorities, with involvement of nongovernment organizations (NGOs) and parents for primary prevention.

Assessment of nutritional status by composite index for anthropometric failure: a study among slum children in Bankura, West Bengal.

A community-based cross-sectional study was conducted to find out the prevalence of composite index of anthropometric failure (CIAF) among 117 slum dwelling under-five children in Bankura town, West Bengal and its relation with some common socio-economic factors. Among study population, the prevalence of underweight was 41.6%, whereas CIAF was 80.3%. CIAF gave a near complete estimation of undernutrition unlike underweight. Children who were unimmunized, with more number of siblings, living in a nuclear family, or with illiterate mothers were more likely to be undernourished.

Understanding health care seeking behavior in a tribal setting in West Bengal.

Background: The health-related problems of the tribal population depend on their ecology and culture. Often the tribal people do not utilize the medical and preventive health services available to them. Health problems in tribal groups need special attention because many tribal communities are backward. The current study was planned to determine the healthcare-seeking behavior of the tribal population in India. Method: A descriptive, cross-sectional study, conducted by interviewing key respondents of each participating family. Result: Two-thirds of the key respondents were literate and half (53.8%) of the total households in the three villages had a per capita monthly income between Rupees 500-1499. More than half (57%) of all respondents preferred government institutions for moderate illness, and the rest equally opted for private practitioners and quacks. However, for emergencies, dog bites, and snake bites, all key respondents in the three study villages unanimously preferred government institutions. A significant population (38.5%) got their children delivered at home. The majority of illiterate respondents (86.1%) preferred government institutions for health care of under-five children, while 60% of literates expressed a similar view. The choice of government institutions as a source of health care was increasingly favored with decreasing per capita monthly household income. Conclusion: Traditional healers are no longer preferred among the tribal population but they are reluctant to avail them because of the loss of valuable time. Home delivery is still prevalent. With improving socioeconomic status, people are going further away from government services as private practitioners, and quacks take less time.

A study on care seeking behavior of chest symptomatics in a slum of Bankura, West Bengal.

A cross-sectional, community based study was undertaken in Patpur slum of Bankura to determine the prevalence of chest symptomatics, their health care seeking Behavior and its correlates. Prevalence of chest symptomatics (cough for 3 weeks or more) was found to be 5.5%, three fourths of whom sought relief from a health care provider. Among them, 70.8% did so within 2 weeks, median being 7 days. No preference for either government or private health care provider was seen in first visit, where the major reason for choosing facilities was advice by family & friends (43.8%). Most of the chest symptomatics (75%) were retained in the same facility. Shift from private to government facility for subsequent visits (33.3%) was higher than from government to private facility (16.7%). The main reason (50%) for changing health facility was expectation for better service.

Perceived Discrimination among Tuberculosis Patients in an Urban Area of Kolkata City, India.

CONTEXT AND AIMS: Tuberculosis (TB) in India is a leading public health problem plagued by social determinants such as stigma and discrimination, which may affect treatment seeking, adherence, and possibly treatment outcome. This study was conducted to elicit the perceived discrimination, its determinants, as well as to determine whether perceived discrimination is predicting treatment outcome among TB patients registered in an Urban Health District, Kolkata City, India. SETTINGS AND DESIGN: An institutionbased follow-up study was conducted where all the TB patients registered within the 1st 4 months of data collection were followed up for their current course of treatment. SUBJECTS AND METHODS: Perceived discrimination was assessed at treatment initiation, after intensive period and after continuation phase using a predesigned and pretested questionnaire. STATISTICAL ANALYSIS USED: Multivariable logistic regression analyses were performed to identify the determinants of perceived discrimination as well as the treatment outcome. RESULTS: Perceived discrimination by family members, neighbors, and colleagues was reported by 9.4%, 36.5%, and 34.2% participants, respectively, overall discrimination being 37.9%. Multivariable analysis revealed that discrimination was significantly more among patients with older age group, females, and from joint families. Perceived discriminated was found to be significantly predicting unfavorable treatment outcome even after adjustment with background and treatment-related variables. CONCLUSIONS: Sensitization programs should incorporate measures to address stigma and discrimination and more emphasis needs to be placed on women and elderly patients.

Quantification of health-related quality of life among patients with rheumatoid arthritis: An institution-based study in Kolkata, West Bengal.

CONTEXT: Rheumatoid arthritis (RA) is a known chronic debilitating disease accounting for a large percentage of disability globally. Pain and stiffness, decreased work function, depression and emotional state alteration, fatigue, disability, and social handicaps are some patient reported outcomes, which if considered with priority the health-related quality of life (HRQOL) of patients with RA could improve. AIMS: This study was conducted with the aim to assess the HRQOL of the patients with RA and the determinants related to it. SETTINGS AND DESIGN: This was a cross-sectional study conducted at Rheumatology Department of a tertiary care hospital, Kolkata. SUBJECTS AND METHODS: A total of 252 patients with RA were selected in this study through systematic random sampling. STATISTICAL ANALYSIS USED: Data were analyzed using appropriate statistical measures with Statistical Package for the Social Sciences(SPSS) version 16.0 (Armonk, NY: IBM Corporation) software program, version 16.0. Univariate and multivariable logistic regression were carried out. RESULTS: In the study, the mean age of the patients was 43.1 years (mean age ±SD: 43.05±10.63 years). The proportion of female subjects was 84.5%. Unsatisfactory QOL was found in 59.9% study participants. In multivariable logistic regression unsatisfactory quality of life was significantly associated to moderate to high functional disability [AOR: 6.04, CI: 2.86, 12.78], disease activity moderate to high [AOR: 5.41, CI: 1.87, 15.69], presence of comorbidity [AOR: 2.90, CI: 1.39, 6.04], extra-articular manifestations [AOR: 3.14, CI: 1.41, 6.96] and delay in starting Disease-Modifying Anti-Rheumatoid Drugs (DMARDs) [AOR: 1.24, CI: 1.08, 1.42]. CONCLUSION: Findings of this study clearly indicate the presence of high proportion of unsatisfactory QOL among the patients with RA. Early identification and prompt referral are the key strategies to prevent any permanent damage. Regular follow-up of the patients should be carried out to prevent or delay the disability progression and provide high-quality physical and mental health.

Effect of DOTS on quality of life among tuberculosis patients: A follow-up study in a health district of Kolkata.

CONTEXT AND AIMS: This study was carried out to assess quality of life (QoL) of tuberculosis patients receiving treatment from DOTS centres, to find out its change with treatment, and to ascertain its determinants. MATERIALS AND METHODS: An institution based follow-up study was conducted in Bagbazar Urban Health District (UHD), Kolkata where all the tuberculosis patients registered within 1st 4 months of data collection were followed up for their current course of treatment. Quality of Life (QoL) was assessed using SF36v2 questionnaire at the start of treatment and after continuation phase (CP) (within 14 days). STATISTICAL ANALYSIS USED: General Linear Model was used to assess the predictors of change of QoL with treatment. RESULTS: 61.4% and 16.4% patients were at the risk of depression at the start and end of their TB treatment respectively. Patient's per-capita monthly Income (PCI) and current smoking status interacted with time to predict trends in the Physical component scores. Similarly, PCI and educational status interacted with time to predict trends in the mental component scores. PCI and unemployment were found to be predictor of differences of Physical and mental component scores (between subject effects) respectively. CONCLUSIONS: QoL assessment in different stages of treatment should be incorporated in the ongoing RNTCP to make the programme more client-oriented and comprehensive, and to provide social support to those who need it most. Directly observed treatment should be supplemented with economic support, de-addiction campaign and Inter-personal counselling by the DOTS providers.

The silent burden of anemia in school age children: a community based study in West Bengal.

BACKGROUND: Under nutrition and anemia are common co-morbidities in school age children. Due to transition in dietary habits in developing countries, a paradoxical finding of coexistence of anemia and normal/over nutrition is also a cause of concern. OBJECTIVE: > T o assess the nutritional status and prevalence of anemia among school age children (6 - 16 years) residing in rural and urban areas of a district of West Bengal and also to find out the association between weight status, measured as Body Mass Index(BMI) and anemia. MATERIALS AND METHODS: Age, height & weight were measured in 86 rural and 86 urban school age (6 -16 years) children in rural and urban field practice areas of Midnapore Medical College. Their blood was estimated for haemoglobin concentration. RESULTS: Overall prevalence of anemia was 80.2%, and not significantly different between the rural (83.7%) and urban (76.7%) participants and across the genders both in rural (86.4% versus 80.9%) and urban (85.7% versus 72.4%) areas. Thinness was observed to be higher in urban area (48.8% versus 41.9%). However, severe thinness was higher in rural area (18.5% versus 13.9%). Significantly, higher proportion of boys revealed severely low BMI compared to girls in both rural (33.3% versus 4.5%) and urban (17.2% versus 7.1%) areas with no significant differences between the prevalence of anemia across the grades of underweight and normal nutritional status. CONCLUSIONS: Poor nutritional status and anemia are still, taking heavy toll and new program strategies are needed, particularly those that improve the overall nutrition status of children.

Study of serum electrolytes in pregnancy induced hypertension.

Hypertension complicating pregnancy is an important cause of foetal and maternal mortality and morbidity. Serum sodium, potassium, calcium and magnesium were evaluated in cases with gestational hypertension and pre-eclampsia and compared with normotensive pregnant women of corresponding period of gestation. Taking urinary micro-albumin creatinine ratio as standard to predict pregnancy induced hypertension, the role of serum electrolytes to predict the same was studied. A total of 200 patients were evaluated. There were no change in serum sodium and potassium in gestational hypertensive cases as well as in pre-eclamptic cases when compared with control group. Similar results were obtained when serum calcium level was evaluated. Mean serum magnesium level (1.53 +/- 0.29 mg/dl) was significantly low in cases of pre-eclampsia, while it was 1.79 +/- 0.25 mg/dl in patients with gestational hypertension and 2.19 +/- 0.2 mg/dl in control group. Patients having gestational hypertension along with increased micro-albumin creatinine ratio had significantly low mean magnesium level (1.68 +/- 0.1 mg/dl) when compared with gestational hypertensive patients with normal microalbumin creatinine ratio (serum magnesium level 1.87 +/- 0.1 mg/dl).

Perceptions of people living with HIV/AIDS.

BACKGROUND: HIV/AIDS being a behavioral disease, appropriate knowledge is important for those who are infected. OBJECTIVES: To elicit and compare knowledge and attitude about HIV/AIDS among newly diagnosed and previously diagnosed HIV/AIDS patients attending or admitted in Calcutta School of Tropical Medicine, (CSTM), Kolkata. MATERIALS AND METHODS: A cross-sectional descriptive study was undertaken among previously diagnosed HIV/AIDS Patients admitted in indoor wards and newly diagnosed HIV/AIDS patients attending Integrated Counseling and Testing Centre (ICTC) of the School of Tropical Medicine, Kolkata. Data were gathered by interviewing patients using a predesigned, pretested, semi-structured questionnaire. RESULTS: More in-patients had heard about AIDS than ICTC patients. Television was the most popular source of information in both groups, followed by health personnel and friends. Correct knowledge about transmission, symptoms, prevention of AIDS, and lifestyles desirable for affected patients was significantly higher among in-patients who had already been counseled, than the newly diagnosed ICTC patients yet to receive. Within each group of patients, the knowledge score was significantly higher among females, Christians, urban residents, patients educated beyond middle school, and non- migrants. In-patients had a significantly higher attitudinal score toward HIV/AIDS. CONCLUSION: Repeated counseling is required to keep up high level of knowledge and positive attitude pertaining to HIV/AIDS to reduce risk behavior, prevent disease transmission, and improve quality of life.