Predictors of Low Birth Weight: A Study in a Health and Demographic Cohort from Assam, India.

Low birth weight is associated with morbidities and mortality in the later life. Prevalence of anemia and under nutrition in Assam were reported to be high which may correlate with low birth weight of infants. The present study assessed prevalence and risk factors for low birth weight in a health and demographic cohort established in Dibrugarh district, Assam. A total of 1437 deliveries (580 from rural and 857 from tea garden) were recorded during March 2019 to February 2020. Prevalence of low birth weight was 30.34%. Tea-garden community [OR: 1.4 (1.06-1.79)], low levels of maternal education [OR: 1.57(1.12-2.13)], low monthly income [OR: 2.1 (1.1-3.9)], pre-term birth [OR: 4.1 (2.2-7.9)] and mother with low BMI [OR: 1.6 (1.3-2.07)] were found to be significantly associated with low birth weight. Intervention strategies to improve socioeconomic condition, promote antenatal checkup and alleviate under nutrition in pregnant mothers are warranted to reduce low birth weight.

Correlates of Breastfeeding in Villages and Tea-Gardens in Assam, India.

OBJECTIVE: To observe and compare breastfeeding practices in villages and tea-gardens. METHODS: Analytical cross-sectional study among mothers of infants in a health and demographic surveillance site in Dibrugarh, Assam. RESULTS: 1435 mothers (855 from tea-gardens, 580 from villages); and 1437 infants (857 from tea-gardens, 580 from villages), were included in study. Mean maternal age was 25.1 (4.4) years in tea-gardens and 25.8 (4.9) years in villages. Timely initiation of breastfeeding was higher in villages (82.6%) than tea-gardens (76.4%). Feeding colostrum was higher in villages (71.2%) than tea-gardens (60.8%). DISCUSSION: Factors affecting breastfeeding were different in villages and tea-gardens. Timely initiation of breastfeeding was associated with nuclear family in villages and joint family in tea-gardens. Hence, interventions promoting breastfeeding practices should be tailored instead of one-size-fits-all approach.

Cohort profile of the largest health & demographic surveillance system (Dibrugarh-HDSS) from North-East India.

Dibrugarh Health and Demographic Surveillance System (Dibrugarh-HDSS), was started in the year 2019 with the objective to create the health and demographic database of a population from a defined geographical area and a surveillance system for providing technical assistance for the implementation of programmes and formulating intervention strategies for reducing disease morbidities and mortalities in the population. Dibrugarh-HDSS adopted a panel design and covered 60 contiguous villages and 20 tea gardens. Line listing of all the households was conducted and a unique identification number detailing State, district, village/tea garden and serial number was provided along with geotagging. Detailed sociodemographic variables, anthropometric measurements (subjects ≥five years) and blood pressure data (subjects ≥18 yr), disease morbidity and mortality were collected. All data were collected in pre-designed and pre-tested questionnaires using a mobile application package developed for this purpose. Dibrugarh-HDSS included a total of 106,769 individuals (rural: 46,762, tea garden: 60,007) with 52,934 males (49.6%) and 53,835 females (50.4%). The number of females per thousand males were significantly higher (1042 in tea garden vs. 985 in rural populations) in the tea-garden community as compared to the village population. More than one-third (35.1%) of tea populations were illiterate compared to the rural population (17.1%). Villagers had significantly higher body mass index than the tea-garden community. The overall prevalence of hypertension (adjusted for age) was 29.4 vs. 28.2 per cent, respectively, for the village and tea-garden population. For both these communities, males (village=30.8%, tea garden=31.1%) showed a higher prevalence of hypertension (adjusted for age) than females (village=28.2%, tea garden=25.8%). The findings of the present study give an insight into the profile of the native rural and tea-garden populations that will help to identify risk factors of different health problems, review the effectiveness of different ongoing programmes, implement intervention strategies for reducing morbidity and mortality and assist the State health authorities in prioritizing their resource allocation and implementation strategies.

Malnutrition and Household Food Insecurity in Children Attending Anganwadi Centres in a District of North East India.

BACKGROUND: Child malnutrition is linked to household food insecurity. Literature reveals mixed results, but most studies were carried out in adults. AIMS: The aim of this study is to assess household food insecurity and nutritional status in children attending Anganwadi centers (AWCs) of Dibrugarh district. MATERIALS AND METHODS: Cross-sectional study among 510 randomly selected children attending AWCs in Dibrugarh was done. Data on nutritional status and food security were collected, and anthropometric measurements were recorded. STATISTICAL ANALYSIS: Data were analyzed using SPSS version 16. Categorical variables presented as percentages and differences between them tested using Chi-square test. Bivariate analysis was performed to find out independent risk factors. RESULTS: The prevalence of stunting, wasting, and underweight was 39.8%, 26.1%, and 39.2%, respectively. Significant associations found between wasting, stunting, or underweight and household food insecurity. Stunting, wasting, and underweight were significantly associated with the literacy status of parents. Underweight and stunting were also associated with socioeconomic class. CONCLUSIONS: Malnutrition in all forms is common in the study population. Rates of stunting, wasting, and underweight were higher than the state average. Along-with access to food, an integrated approach that improves the overall socioeconomic well-being of families and parental education is needed.