Study of socio-demographic factors affecting prevalence of hypertension among bank employees of Surat City.

Cardiovascular diseases including hypertension are increasing in developing countries especially among high-risk group people like bank employees. A cross-sectional study of 1493 bank employees of Surat city was conducted during August, 2004 to September, 2005 to study the prevalence of hypertension among bank employees and the effects of socio-demographic factors on prevalence of hypertension. Data were analyzed using epi 6 software. The χ[2] -test was applied as a nonparametric test of statistical significance. Prevalence of hypertension was 30.4% and prehypertension was 34.5%. Out of 455 found as hypertensive, 258 (56.70%) were not having any symptoms at the time of examination. Prevalence was high among persons with age 50 years and above (48.5%); among male (32.5%) as compared to female (23.1%); among employees having small family size; among separated/divorcee person (40.0%). Prevalence of hypertension increased with seniority of the official position of bank employee with highest prevalence among managers (45.9%). Prevalence of hypertension was noted highest among the higher socioeconomic group; SEC I (35.0%) followed by class II (20.4%). Effects of different risk factors of hypertension were observed here. This study may help in identifying the common profile of hypertensive or persons at risk, which may further help in identifying the risk group and planning the group specific IEC interventions.

A case control study to explore the risk factors for acquisition of leptospirosis in Surat city, after flood.

BACKGROUND: Between August and November 2006, a population-based case control study was conducted to identify the probable risk factors for leptospirosis during flooding in Surat city. MATERIALS AND METHODS: Sixty-two laboratory confirmed cases out of 129 suspected cases, and 253 age and sex matched fever and healthy controls were interviewed with the help of predesigned questionnaire. The association of risk factors with acquiring leptospirosis was assessed by adjusted OR with the help of logistic regression model to control confounders. RESULTS: By univariate analysis, factors identified were, walking barefoot (OR = 10.34, 95% CI 5.09-21.31, P <0.05). CONCLUSIONS: Prompt and vigilant fever surveillance activities in pre-monsoon preparedness plan, intensive IEC messages, rodent control programs and improvement of environmental sanitary conditions may help to greatly reduce the incidence of leptospirosis.

Prevalence of Trichomonas vaginalis infection in and around Surat.

Trichomonas culture method was used for the diagnosis of trichomoniasis along with gram staining and wet mount preparation. We selected 51 urban women and 51 rural women in this study. Samples were taken from both symptomatic and asymptomatic individuals. Out of 102 samples 35 samples were positive for Trichomonas vaginalis by culture method. 20 women were positive for Trichomonas vaginalis by wet mount and 15 by gram staining technique. So it is a fact that culture of Trichomonas vaginalis is a "gold standard" in the diagnosis of trichomoniasis. As we had the opportunity to compare both urban and rural women in our study we were able to come to the conclusion that incidence of Trichomonas vaginalis is more in urban women than in rural women.

Effect of physical and mental activity on blood pressure.

OBJECTIVES: The authors measured and recorded the physical (outdoor playing) and mental (home study) activity behavior and blood pressure amongst school going children and observed their association with the blood pressure levels. METHOD: It was a cross sectional school-based study from 12 primary schools; selected by stratified random sampling. Participants included 2250 children aged 10 years and above. Explanatory variables were age, sex, outdoor playing (hours/ day) and home-study (hours/ day). Outcome variables were mean and standard deviation (SD) of systolic and diastolic blood pressures in various activity groups. Statistical tools used were proportions, correlation co-efficient (r), coefficient of determination (r2) and Regression analysis. RESULTS: 47.8% boys and 2.5 % girls were engaged in outdoor playing for more than two hours. No trend was observed for systolic blood pressure (SBP) in both the sexes in various activity groups of outdoor playing. Both mean diagnostic blood pressure (DBP) and mean BMI showed decreasing trend in boys. Mean BMI had an inverse relationship with outdoor playing in girls. Correlation of age and weight with both SBP and DBP was highly significant in both the sexes and in all the age groups except that of the 15-year age. Both SBP and DBP were not associated with home study in all sex and age groups except the age group of 10 and 12 years. Both SBP and DBP were significantly associated with the outdoor playing taking the whole sample as one group, but not in different sex or age groups; except that the SBP was significantly correlated with outdoor playing in 10 to 13 years age groups in boys. CONCLUSION: Boys spent twice the time in outdoor playing than girls. They were spending more time on outdoor playing than on home study. Conversely girls spent more time in home study. A weak negative correlation was observed between outdoor playing and blood pressures. Less time spent in physical activities by the girls may have contributed to their higher BMI. They need behavior change communication for involvement in physical activities.

Impact assessment of mass measles vaccination.

OBJECTIVE: The mass measles vaccination campaign was conducted in the slums of Surat City, in Gujarat State, as a part of urban measles control initiative in India. One dose each of the vaccine was administered to children in the age range of 9-59 months residing in these slums, regardless of their previous vaccination status. METHODS: One year later, (October 2000), the present study was carried out in order to assess the impact of the mass vaccination campaign on the vaccination coverage and on the incidence of measles by comparing the findings with those of the baseline survey carried out in May 98. This was a retrospective study with a recall period of the preceding year. 3,147 children under five were studied in thirty slum clusters selected by the cluster sampling method. The parents/caretakers of these children were interviewed for information on any episode of fever with rash conforming to the case definition. RESULT: The incidence rate for measles declined from 7.7 percent reported in the baseline (May 1998) to 3.5 percent in the impact assessment study. The incidence was 8 times higher in unvaccinated children. The mean and median age at contracting the illness increased from 26 +/- 14.2 months and 26 months in the baseline to 30.9 +/- 14.7 months and 30 months respectively in the impact assessment. The vaccination coverage had improved from 48.3 percent to 73.7 percent following the campaign. CONCLUSION: The compaign increased vaccination coverage decreased disease incidence and caused a shift towards higher age-groups in vaccinated children.

Infant Deaths - Data Disparity and Use of Ante, Intra and Post-natal Services Utilization: An Experience from Tribal Areas of Gujarat.

BACKGROUND: Infant death depends upon the care during the infancy and also upon the service utilization during antenatal and intra-natal periods and with its decline, it is necessary to find the under-reporting if any and identify the most appropriate agency for its reporting. OBJECTIVES: (1) To document disparities between different reporting systems about infant deaths and find out the under-reporting if any and identify the most appropriate agency and (2) To identify utilization of health services during ante, intra and post-natal period for all infant deaths. MATERIALS AND METHODS: Study was conducted in 51 villages of 3 Primary Health Centers (PHCs) from a tribal dominated Taluka (block) of South Gujarat during September - November 2005. Information was gathered for 1 year (1 September 2004 to 31 August 2005) from 4 sources namely health care system, Integrated Child development services (ICDS) scheme, Civil Registration System (CRS) and Investigator himself (Gold standard). Data was collected in a designed verbal autopsy questionnaire by house to house survey and analyzed in Epi Info. RESULTS: A total of 48 infant deaths were recorded by investigator against reported 2, 10 and 8 infant deaths by CRS, Health System and ICDS respectively. While profiling these 48 infant deaths it was found that only 29.2% mothers received full antenatal care (ANC) and 60.4% delivered at home (by untrained personnel). Not a single delivery was done at PHCs or its sub centers (SC). In 25% cases there was poor cord care. 39.6% mothers did not breastfeed and 35.4% gave pre-lacteal feeding. CONCLUSIONS: There was gross underreporting of infant mortality in all 3 agencies. The utilization of ANC and post natal care (PNC) services was poor in these death cases. Health system and ICDS need to be sensitized to work in coordination to provide quality ANC, INC and PNC to prevent such avoidable infant deaths.

HIV and STI prevalence and determinants among male migrant workers in India.

BACKGROUND: Our objective was to estimate for the first time the prevalence and determinants of human immunodeficiency virus type 1 (HIV-1) and sexually transmitted infections (STIs) among male migrants in India. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a multi-stage stratified probability sample survey of migrant (defined as not born in Surat city) men aged 18 to 49 years working in the diamond and textile industries in Surat city. Behavioural and biological data were collected. Biological data included laboratory diagnosed herpes simplex virus type 2 (HSV-2), syphilis, chlamydia, gonorrhoea, Trichomonas vaginalis (together defined as 'any STI') and HIV-1. Likely recently acquired STIs included chlamydia, gonorrhoea, T. vaginalis and syphilis with rapid plasma reagin ≥1:8. The response rate was 77% (845/1099). Among 841 participants, HIV-1 prevalence was 1.0%, 'any STI' prevalence was 9.5% and 38.9% of these STIs were likely to have been recently acquired. Being a diamond worker, Surat resident for 10+ years and recent antibiotic use were each associated with higher odds of 'any STI' (aORs 1.83 (95% CI 1.09-3.09), 1.98 (95% CI 1.22-3.22) and 2.57 (95% CI 1 .17-5.64), respectively) after adjusting for the other two factors and age. The main study limitation was social desirability bias for self-reported sexual behaviour; STIs were diagnosed in some self-reported virgins. CONCLUSIONS/SIGNIFICANCE: HIV and STI prevalence were lower than expected, but prevention interventions remain necessary in Surat since almost 40% of STIs among participants were probably recently acquired and sentinel surveillance HIV prevalence remains high. The participants had a similar HIV prevalence to Surat antenatal clinic attendees, a proxy for the general population. This suggests migrants are not always at higher risk of HIV compared to the general population in their migration destination. Our findings highlight the need to contextualise research findings from a specific setting with other local information to guide HIV/STI prevention interventions.

Spectrum of visual impairment among urban female school students of Surat.

AIM: Eye morbidities with or without symptoms delineate a significant morbidity among adolescent schoolgirls in India. The study was undertaken to assess the extent of visual impairment and ocular morbidity to identify influencing factors and the impact on scholastic performance. MATERIALS AND METHODS: A population-based cross-sectional study was undertaken among 3002 urban girl students of Surat in Gujarat, India. Overall prevalence of refractive error was found to be 15.22%; myopia affected 91.47%, hyperopia 4.60%, and astigmatism 0.04%. The prevalence of myopia and astigmatism was more in higher age groups, while hyperopia was more in lower age groups; even students with good vision reported ophthalmic symptoms. Of all spectacle users, in 29.73% cases the eyesight was not found to be with the best possible corrections. Refractive error was observed to be higher among the general caste (50.98%) and among Muslims (54.05%). Still, among those with problems of eyesight, 75.93% students had good academic performance. Associated ocular morbidity was noted in 20.35% participants along with the refractive error. CONCLUSION: This study highlighted the load of eye morbidities of adolescent Indian urban girls.

Knowledge and practices related to sexually transmitted infections and HIV among sex workers in an urban area of Gujarat, India.

This study is a part of STD prevalence study done in Gujarat amongst sex workers (SWs) of urban red light area during the year 2000. In the clinic specially set up in their area, after an informed consent from the participants, knowledge, attitude and practices (KAP) questionnaire schedule was administered to 125 SWs; 2/3rds of them were below the age of 30 years, 81.5% had never gone to school and 76.6% of them had their first sexual intercourse before the age of 20 years. Majority of SWs. (83.1%) has joined the profession before the age of 25 years; 60.5% were having 3-5 sexual partners on an average; 94.4% reported using condom all the time during a sexual encounter; 91.9% of them had suggested the use of condom to their client themselves, and 79.8% of them made it sure by helping the client to put on the condom. Out of 29 SWs who had regular partners, 44.8% use condom all the times with their regular partner, 92% had never seen female condom; 85 to 90% were aware about various symptoms/diseases transmitted by unsafe sexual practice in male and female; 23.4% took treatment from the health workers for such problems; 87.9% SWs were aware that HIV is transmitted by unprotected sex with an infected partner and 88.7% were aware that consistent use of condom could protect her from HIV infection. However, they did not know other measures, 65.3% don't perceive the risk of getting HIV infection. Out of those 39 who perceived this risk, 48.7% attributed it to having many clients, 30.8% to irregular use of condom and only 2.6% to non-treatment of STD. Fifty-eight per cent are not aware about any behavioural change needed to reduce the risk.

Assessment of immunization status in the slums of surat by 15 clusters multi indicators cluster survey technique.

RESEARCH QUESTION: What is the immunization status of children in the slums of Surat and what changes has it undergone in recent times? OBJECTIVE: To assess the immunization status of children between the ages of 12 and 23 months in the slums of Surat and to compare it with the MICS from previous years. STUDY DESIGN: This was a community-based cross-sectional study conducted in 15 clusters. SETTINGS: 15 urban slums selected out of a total of 299 slums using the cluster sampling method. STUDY TOOL: The Multi Indicator Cluster Sampling (MICS) method was used for sample selection and the proforma designed by UNICEF was used as a study tool. STATISTICAL ANALYSIS: Simple proportions and a Chi-square test. RESULTS: Only 25% of the children between the ages of 12 and 23 months were fully immunized; coverage was highest for BCG (75%) and lowest for measles (29.9%). As far as the dropout rate is concerned, it was 60.2%, 31.9%, and 31.5% for BCG to measles, DPT(1) to DPT(3), and OPV(1) to OPV(3), respectively. Vitamin A was taken by only 28.9% of the subjects. Between the two, female children were more disadvantaged in terms of vaccination. When compared with the coverage of 1997 and 1998, the current coverage is poor, more so in relation to DPT and OPV.

Sexually transmitted infections and reproductive tract infections in female sex workers.

The present study was conducted in 300 female sex workers (FSWs) from Surat city in 2005-2006. Vaginal swabs, endocervical swabs and serum samples were collected from each of these FSWs. Vaginal samples were screened for bacterial vaginosis (BV), candidiasis and Trichomonas vaginalis . Endocervical swabs were screened for gonococcal infection. Serological tests for human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg) and syphilis were performed. From a total of 300 FSWs, BV was detected in 40 (13.33%), trichomoniasis in six (2%), candidiasis in 31 (10.33%), HIV seropositivity in 35 (11.66%), HBsAg reactivity in 10 (3.33%) and rapid plasma regain (RPR) reactivity in 20 (6.66%) cases. RPR-positive serum samples were confirmed by the treponema pallidum hemaglutination test. Gonococcal infection was not found in any of the FSWs. Of the total of 35 HIV-positive patients, 20 patients had associated coinfection. Of the 35 HIV-seropositive FSWs, BV was detected in six (17.14%), candidiasis in six (17.14%), syphilis in five (14.28%) and HBsAg in two (5.71%). One (2.85%) HIV-positive FSW was positive for both candidiasis and syphilis.

RTI/STI prevalence among urban and rural women of Surat: A community-based study.

OBJECTIVES: To estimate the prevalence of RTI/STI among women in urban and rural areas of Surat and analyze the influence of socioeconomic, socio-demographic and other determinants possibly related to RTI/STI. METHOD: A community-based cross-sectional study. Women aged 15-49 years (n = 102) were interviewed and underwent a gynecological examination. Specimens were collected for laboratory diagnosis of chlamydia, gonorrhea, trichomonas, bacterial vaginosis (BV), candidiasis, hepatitis B, HIV, and syphilis. RESULTS: Out of 51 women in rural areas, 27 (53%) and among 51 women in urban areas, 35 (69%) were identified having RTI/STI. In total, the prevalence of trichomoniasis was found to be 41% by culture, 22% by wet mount, and 16% by Gram staining among urban women, while trichomoniasis among rural women was found to be 27% by culture, 18% by wet mount, and 14% by Gram staining. The prevalence of candidiasis was found to be 14% among urban women and 12% among rural women. By using Gram staining Nugent's criteria, the prevalence of bacterial vaginosis was found to be 24% among urban women and 25% among rural women. The prevalence of syphilis was found to be 2% by VDRL both among urban as well rural women.

Domestic environment and morbidity of under five children.

Healthy environment for children initiating an alliance for action (WHO) has reported that over 40% of the global burden of disease attributed to environmental risk factors fall on children below 5 years of age, who account for about 10% of the world's population. That is why to look into the new area of concern, this cross sectional study was carried out to explore the influence of domestic environment over the illness of under five children.

Evaluation of Desensol As a Standard Patch Test Kit.

In a study undertaken to find out the usefulness of 'Desensol' patch test kit to detect contact allergens, in 200 cases revealed 24 cases with negative patch test with all the antigens and 55 cases reacted to even the Vaseline control. -Excluding these 79 cases, the common contact allergens were potassium bichr6ma,te, (40.49%), TMTD(28.92%), PPD(24.79%), epoxy resin (23.14%), colophony (19.0%), nickel sulfate (19.0%), Framycetin (19.0%) and nitrofurazone (19.0%). Desensol patch test kit is lacking in certain antigens while in our country due to varied environmental factors and social customs, a person is exposed to a large number of natural and man-made contact allergens. So usefulness of such a kit like. Desensol is limited.