Understanding social problems during lockdown and its relationship to perceived stress - An online survey among adult residents of India.

CONTEXT: Nationwide lock down imposed due to Covid 19 might bring about various social problems, constraints in availing essential services, difficulty in taking care of morbid elderly persons and inaccessibility to health care which can lead to stress. AIMS: To identify social problems among adult Indian residents during lockdown period, to assess perceived stress among them and to identify the factors associated with it. SETTINGS AND DESIGN: The study was conducted through the online platform using a google form among adult residents of India. Perceived stress was assessed by Perceived Stress Scale 10. STATISTICAL ANALYSIS USED: Data were analysed using SPSS version 16.0., using chi square, Odd's Ratio and binary logistic regression. RESULTS: One fourth of the respondents faced economic problem, 11.7% of them had experienced some sort of violence and worsening of familial relationship. The problems encountered in seeking care were chi square test due to non availability of transportation facilities and health services. Overall 80.78% of the respondents were observed to have moderate and high levels of perceived stress. Multivariate analysis revealed single marital status, owing a debt and experiencing violence had 1.62, 1.8 and 9 times higher odds of having moderate to high perceived stress. Violence was identified as its chief correlate. CONCLUSIONS: The present study found negative economic and social consequences on the Indian population and also posed an enormous psychological stress due to sudden lock down in pandemic situation.

Assessment of under nutrition among under 5 tribal children in a rural area in West Bengal.

Tribal population is socio economically disadvantaged group. Knowledge about nutritional status of various tribal populations is important because it impels to identify under nutrition which is a leading cause of morbidity and mortality. This study is conducted to assess under nutrition among under 5 tribal children. In this cross sectional study with a sample of 68 under 5 tribal children selected through complete enumeration fulfilling the inclusion criteria after obtaining ethical clearance from Institutional Ethics Committee. Anthropometric measurements were recorded to determine types of under nutrition prevailing among them using World Health Organization Anthro software. 24 h recall of dietary history of children was taken for 7 days to assess mean energy, protein, and fat intake per day and compared with recommended daily allowances. A total of 30.8% children were stunted, 30.8% were wasted, and 14.7% were both stunted and wasted. The consumption of energy, protein, and fat was much low. Chi square test showed a significant association of under nutrition with gender, education of father, type of family, socio economic status, and birth order but binary logistic regression showed significant association only with socioeconomic status. Under nutrition in form of stunting and wasting and low dietary intake of energy, protein, fat was found among these children. Multi sectoral approach is suggested.

Sexual behavior of transgenders and their vulnerability to HIV/AIDS in an Urban Area of Eastern India.

Transgender (TG) people experience a gender identity that is different from their anatomical sex. For their high-risk sex behavior, they are important group for targeted intervention of HIV/AIDS. The objective of the study was to find the sexual behavior of TG people and to assess few aspects of their vulnerability to HIV/AIDS. This cross-sectional survey was done from June to August 2012, in field practice area of "Kosish," a nongovernmental organization run by TGs in Alipore of Kolkata metropolitan city, India. Information was collected by interviewing 90 TG of 11 selected hotspots using a predesigned questionnaire. Results revealed that 4.5% were illiterate. Drug abuse was reported by 22.2% participants. Inconsistent condom use was found. Venereal disease research laboratory reactivity was found in 11.11%. Nearly 16.7% had experienced sexual violence in the past 3 months. Thus, interventions for overall empowerment of the TGs are recommended.

Taking stocks of antimalarial activities: A study on knowledge and skill of health personnel at primary care setting in the state of West Bengal, India.

BACKGROUND: Early diagnosis and effective treatment are the key areas in malaria control in India. OBJECTIVE: The present study was carried out to assess the knowledge and skill of health personnel at primary care level and the logistic support related to the program at subcenter (SC) level. METHODS: A cross-sectional, descriptive study was conducted among medical and paramedical personnel working at primary health-care institutions in two districts of West Bengal. Knowledge was assessed using a structured questionnaire while diagnostic skill and logistic support were assessed with structured checklists. Clinical skill was assessed with case vignettes. RESULTS: Requisite knowledge on diagnostic procedure was found in two-third to three-fourth of health personnel while only 26.7% and 12.4%, respectively, knew the correct treatment of Plasmodium vivax and Plasmodium falciparum malaria. Median standardized score for knowledge was 50.0 while the scores for skill of preparing blood slide and for rapid diagnostic test were 70.0 and 57.1, respectively. Education and work experience were related to diagnostic skill but had little effect on knowledge. In clinical skill, medical personnel scored 50% or more in investigation and treatment aspects only. In another case vignette, health workers excelled over medical officers and other staff in all axes other than history taking and clinical examination although their performance was also suboptimal. Formal training on malaria did not show any bearing on median knowledge and skill score. Supply of diagnostics and drugs was insufficient in majority of SCs. CONCLUSION: Renewed efforts are needed to create competent workforce and ensure adequate logistic supply.

A study on utilization of Janani Suraksha Yojana and its association with institutional delivery in the state of West Bengal, India.

BACKGROUND: India launched the Janani Suraksha Yojana (JSY) on the principles of conditional cash transfer providing monetary incentive to needy women to improve access to institutional childbirth. OBJECTIVES: This study was conducted among JSY-eligible women who delivered between April 2012 and June 2012 to assess the utilization of cash incentives toward institutional delivery, along with other associated factors influencing institutional delivery. METHODS: It was a cross-sectional, descriptive study conducted between July 2012 and May 2013 on 946 women selected through stratified random sampling of subcentres from better and worse performing districts of West Bengal. RESULTS: 74.7% of the study population was JSY-eligible. 90.2% of those who took three antenatal check-ups (ANCs) and 36.8% JSY-noneligible women received cash. Government institutions were preferred for childbirth among all groups irrespective of JSY eligibility, receipt of cash, and number of antenatal visits. Overall, 78.8% opted for institutional delivery if they had received cash, which was significantly more than those who did not (64.5%). JSY-eligible women were 1.5 times more likely to deliver in government institutions compared to JSY-noneligible women. With no incentive, the likelihood of institutional delivery was halved. The distance of a 24 Χ 7 delivery hub beyond 5 km (74.8% vs. 81.8%), the religion of Islam (62.7% vs. 83.2%), and multiparity (63.9% vs. 83.6%) were significant deterring factors. CONCLUSION: Despite some inclusion and exclusion errors, cash incentive under JSY was associated with increased institutional delivery, especially in government institutions though there were other factors influencing the decision as well.

Domestic violence among ever married women of reproductive age group in a slum area of Kolkata.

BACKGROUND: Domestic violence has serious impact on women's health and well-being. A nationwide survey conducted in India observed that 37.2% of women experienced violence after marriage. OBJECTIVES: To assess the prevalence of domestic violence among the ever married women in reproductive age group and to find out the types of domestic violence and factors associated with it. MATERIALS AND METHODS: The study was a community based cross-sectional study, conducted in a slum area of Kolkata. RESULTS AND CONCLUSION: Overall prevalence of domestic violence was 54%, of which 41.9% suffered from both current and lifetime physical and psychological violence. Presence of property, higher per capita income and social support were protective factors against domestic violence, whereas alcohol addiction and multiple sex partners were the important contributory factors for it. The study recommended more social support, awareness and income generation for women in the slum areas.

Healthcare-seeking behavior of patients with epileptic seizure disorders attending a tertiary care hospital, kolkata.

INTRODUCTION: Neurological diseases are very important causes of prolonged morbidity and disability, leading to profound financial loss. Epilepsy is one of the most important neurological disorders Healthcare seeking by epilepsy patients is quite diverse and unique. AIMS AND OBJECTIVES: The study was conducted among the epilepsy patients, to assess their healthcare-seeking behavior and its determinants. MATERIALS AND METHODS: Three hundred and fifteen epilepsy patients, selected by systematic random sampling, in the neuromedicine outpatient department of a tertiary care hospital were interviewed with a predesigned, pretested, semi-structured proforma. RESULTS AND CONCLUSION: More than 90% sought healthcare just after the onset of a seizure. The majority opted for allopathic medicine and the causes for not seeking initial care from allopaths were ignorance, faith in another system, constraint of money, and so on. A significant association existed between rural residence and low social status of the patients with initial care seeking from someone other than allopaths. No association was found among sex, type of seizure, educational status of the patients, and care seeking. The mean treatment gap was 2.98 ± 10.49 months and the chief motivators were mostly the family members. Patients for anti epileptic drugs preferred neurologists in urban areas and general practitioners in rural areas. District care model of epilepsy was proposed in the recommendation.

A study on self concept and adjustment of auxiliary nursing and midwifery (revised) students in a selected school of nursing, Purulia, West Bengal.

Nursing students are exposed to different types of stress, with which they have to make adjustments. Self concept Influences their capability of adjustment. The study was done to find out the levels of self concept in different dimensions and levels of adjustment in different spheres of the auxiliary nursing and midwifery (revised) [ANM(R)] students, to find out the association between their self concept and adjustment with different sociodemographic factors and to assess the correlation between self concept and adjustment of these students. An observational cross-sectional study was conducted on the ANM(R) students of School of Nursing, Purulia, West Bengal from October 2008 to January 2009 with sample size 50. Chi-square test was done to find out statistical association. Majority of students (64%) had self concept above average category (145-192). Considering levelsof adjustment, majority of the students (56%) fell in the above average category (5572). Mean score of adjustment was highest in the health dimension (9.96) and lowest in the area of education (6.88). No significant association was found between self concept and age, education and family income. The associations of marital status and type of family with self concept are statistically significant. No significant association was found between adjustment and sociodemographic characteristics. Positive correlation was found between self concept and adjustment (correlation co-efficient r = 0.6109). This study has various implications for nursing administration, nursing education, nursing practice and nursing research.

Mass Measles Vaccination Campaign in Aila Cyclone-Affected Areas of West Bengal, India: An In-depth Analysis and Experiences.

Disaster-affected populations are highly vulnerable to outbreaks of measles. Therefore, a mass vaccination against measles was conducted in Aila cyclone-affected blocks of West Bengal, India in July 2009. The objectives of the present report were to conduct an in depth analysis of the campaign, and to discuss the major challenges. A block level micro-plan, which included mapping of the villages, health facilities, temporary settlements of disaster-affected population, communications available, formation of vaccination team, information education communication, vaccine storage, waste disposal, surveillance for adverse events following immunization, supervision and monitoring was developed. The rate of six months to five years old children, who were vaccinated by measles vaccine, was 70.7% and that of those who received one dose of vitamin A was 71.3%. Wastage factor for vaccine doses and auto-disable syringes were 1.09 and 1.07, respectively. Only 13 cases of adverse events following immunization were reported. An average of 0.91 puncture-proof containers per vaccination session was used. Despite the major challenges faced due to difficult to reach areas, inadequate infrastructure, manpower and communication, problems of vaccine storage and transport, the campaign achieved a remarkable success regarding measles vaccine coverage, improvements of cold chain infrastructure, formulating an efficient surveillance and reporting system for adverse events following immunization, building self-confidence of the stakeholders, and developing a biomedical waste disposal system.

Non-cirrhotic portal fibrosis among children admitted in a tertiary care hospital of Kolkata: a search for possible aetiologies.

Non-cirrhotic portal fibrosis (NCPF) is reported to be a very infrequent cause of portal hypertension (PHT) in paediatric population, but a number of cases of NCPF were found in the paediatric ward of NRS Medical College and Hospital, Kolkata which prompted us to do a study with objectives to find out the proportion of NCPF cases among the study population (the total number of PHT cases admitted in the study period) and their sociodemographic profile with special reference to residence in arsenic affected areas. It was a clinic-based retrospective study. All children below 12 years during the study period (August 2005 to July 2008) with clinical features suggestive of PHT were screened for NCPF. Relevant investigations were done and guardians of all the PHT patients were interviewed with a predesigned pretested questionnaire. Among the total 134 cases of PHT, 29 (21.64%) were due to NCPF and the remaining 105 (78.36%) cases were due to other causes of PHT other than NCPF. Among the sociodemographic variables studied significant association was found with residency in arsenic affected areas. The study highlights the need of extensive studies to validate the association in the paediatric population.

A study on the role of parental involvement in control of nutritional anemia among children of free primary schools in a rural area of West Bengal.

An intervention study was conducted among students of three randomly selected free primary schools in rural West Bengal to assess the effect of health-nutrition education for behavior modification of parents on nutritional anemia of children. Clinically anemic students were school-wise randomized into 'groups of two' and intervened with anthelminthic, iron-folic acid (IFA) pediatric tablet and health-nutrition education by reoriented teachers. Parents of study group were involved in behavior change processes. Baseline overall prevalence of anemia was 64.4%. After IFA therapy, prevalence of anemia was not found to differ between two groups (χ² = 2.68, P > 0.05, RR= 0.48, 95% C.I 0.2 < RR < 1.19) while reducing 52.2% of relative risk. Reassessment after six months showed significantly lower prevalence in study group (χ² = 18.14, P < 0.05, RR = 0.20, 95% C.I. 0.08 < RR < 0.49). Parental involvement for life style and dietary modification may curb childhood anemia.

A study on morbidity pattern of child labourers engaged in different occupations in a slum area of Calcutta.

A cross-sectional study of 150 child labourers engaged in different occupations in a slum area of Calcutta was conducted to assess their health and nutritional status. Most (88%) of them had some type of morbidity. Female child workers (95.5%) suffered more than the males (84.7%). Most prevalent morbidities among the child labourers were seen as pallor (49.3%) followed by pediculosis (48%), dental caries (28.6%), malnutrition (22.6%), worm infestation (20.6%) and scabies (16.6%). Garage workers were observed to suffer less from any type of morbidity except pallor which may be attributed to lead exposure. Rag-pickers had significantly (p < 0.05) more risk of developing worm infestation, scabies and pediculosis whereas domestic helpers had significantly (p < 0.05) more risk of developing pediculosis. Occupational hazards were also studied but excepting pallor in garage workers and scabies in rag-pickers, nothing could be documented.

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.