Prevalence of hypertension and the associated factors among Sabar and Munda tribes of Eastern India.

Background: Hypertension can be attributable to about 10% of all non-communicable diseases (NCDs). There is a steady rise in the prevalence of hypertension among both the urban as well as the rural population and the tribal communities are no exception to this. The present study was done during 2009-10 among two tribes residing in a more developed eastern district of Odisha, but the results can be compared with the studies done in recent times. Objective: 1. To find the prevalence of hypertension among the adult tribal population of Tangi-Choudwar block of Cuttack and to trace the associated risk factors of hypertension among them. 2. To assess their perception regarding hypertension. Materials and Methods: A cross-sectional study was carried out among the tribals of the Tangi-Chowdwar block of Cuttack district during 2009-2010. Total 832 study subjects aged >/=18 years were selected through multistage stratified random sampling. Anthropometric measurements and blood pressure were taken with standard instruments and methodology. Statistical tests, such as Chi-square, Logistic Regression, Odds Ratio, percentage, were used to analyze the data. Result: The overall prevalence of hypertension was 16.7% and 41% were pre-hypertensive. Bivariate analysis showed that the risk of hypertension was significantly associated with the tribe type, age range, tobacco use, marital status, and stress (P < 0.05). Multivariate analysis showed that taking extra salt (OR-1.86; 95%CI-1.03-3.35) was significantly associated with hypertension (P < 0.05). Conclusion: A large number of study participants (16.7%) were found to be hypertensive and in the majority of them, the common risk factors detected were tobacco usage and extra salt intake. Further epidemiological study needs to be conducted among these tribes to know the exact nature and causes of hypertension.

Awareness, perception and practice of stakeholders in India regarding Village Health and Nutrition Day.

BACKGROUND: Village Health and Nutrition Day (VHND) is a community-based health service package delivered on a fixed day approach. Services like early registration of pregnancy, regular antenatal care and postnatal care, growth monitoring and referral of sick children, discussion of health topics to generate awareness, and convergence between health and ICDS, are delivered every month at VHND at the Anganwadi Center. This study explores the awareness, perception and practice of service providers, and beneficiaries, regarding VHND. MATERIALS AND METHODS: It was a cross-sectional study conducted in Odisha during December 2009-November 2010. Personal interviews were conducted at the VHND sessions with 111 beneficiaries and 45 service providers using a semi-structured schedule to know their awareness, perception and practice regarding VHND sessions. Data analysis was done and reported as simple percentages. RESULTS: Most of the health worker females and anganwadi workers considered health awareness as a key component of VHND. 52% of HWFs and 41% of AWWs had misconception about additional roles and responsibilities. 34% of beneficiaries had knowledge regarding fixed day approach of VHND, while 24% did not have knowledge regarding any of its purpose. Only 8% of referral cases had complete knowledge on the reason of referral. There was significant difference in between awareness and practice among the blocks. CONCLUSION: Service providers' orientation should be improved. Behavior change communication activities should also be increased by the state. Referral cases should be properly counseled. The community believed that such a program should continue with better package and quality of services.

Snakebite mortality in India: a nationally representative mortality survey.

BACKGROUND: India has long been thought to have more snakebites than any other country. However, inadequate hospital-based reporting has resulted in estimates of total annual snakebite mortality ranging widely from about 1,300 to 50,000. We calculated direct estimates of snakebite mortality from a national mortality survey. METHODS AND FINDINGS: We conducted a nationally representative study of 123,000 deaths from 6,671 randomly selected areas in 2001-03. Full-time, non-medical field workers interviewed living respondents about all deaths. The underlying causes were independently coded by two of 130 trained physicians. Discrepancies were resolved by anonymous reconciliation or, failing that, by adjudication. A total of 562 deaths (0.47% of total deaths) were assigned to snakebites. Snakebite deaths occurred mostly in rural areas (97%), were more common in males (59%) than females (41%), and peaked at ages 15-29 years (25%) and during the monsoon months of June to September. This proportion represents about 45,900 annual snakebite deaths nationally (99% CI 40,900 to 50,900) or an annual age-standardised rate of 4.1/100,000 (99% CI 3.6-4.5), with higher rates in rural areas (5.4/100,000; 99% CI 4.8-6.0), and with the highest state rate in Andhra Pradesh (6.2). Annual snakebite deaths were greatest in the states of Uttar Pradesh (8,700), Andhra Pradesh (5,200), and Bihar (4,500). CONCLUSIONS: Snakebite remains an underestimated cause of accidental death in modern India. Because a large proportion of global totals of snakebites arise from India, global snakebite totals might also be underestimated. Community education, appropriate training of medical staff and better distribution of antivenom, especially to the 13 states with the highest prevalence, could reduce snakebite deaths in India.

Status of iodized salt coverage in urban slums of cuttack city, orissa.

BACKGROUND: For sustainable elimination of iodine deficiency disorders (IDD), it is necessary to consume adequately iodized salt on a regular basis and optimal iodine nutrition can be achieved through universal salt iodization. OBJECTIVE: To assess the extent of use of adequately iodized salt in the urban slums of Cuttack. MATERIALS AND METHODS: Using a stratified random multi-stage cluster sampling design, a cross-sectional study involving 336 households and 33 retail shops selected randomly from 11 slums of Cuttack was conducted in 2005. A predesigned pretested schedule was used to obtain relevant information and salt iodine was estimated qualitatively by using a spot testing kit and quantitatively using the iodometric titration method. STATISTICAL ANALYSIS: Proportion, Chi-square test. RESULTS: Only 60.1% of the households in urban slums of Cuttack were using adequately iodized salt i.e., the iodine level in the salt was >/=15 ppm. Iodine deficiency was significantly marked in sample salts collected from katcha houses as compared with salts collected from pucca houses. Households with low financial status were using noniodized/inadequately-iodized salt. Both crystalline and refined salts were sold at all retail shops. Crystalline salts collected from all retailers had an iodine content < 15 ppm and refined salts collected from one retailer had iodine content < 15 ppm. About 48.5% of salt samples collected from retail shops were adequately iodized. CONCLUSION: In the urban slums of Cuttack, retailers were selling crystalline salts, which were inadequately iodized- this would be a setback in the progress towards eliminating IDD.