Inadequate awareness of cervical cancer and its prevention among young women of Delhi, India: public health policy implications.

BACKGROUND: The increasing burden of cancer is a cause of concern worldwide including in India. Cervical cancer is amongst the most common cancers among women associated with high morbidity and mortality. Younger women are at risk of acquiring human papilloma virus (HPV) infection that can lead to cervical cancer later in life. The present study is an attempt to assess awareness about cervical cancer, its prevention and HPV among young women so that future policies can be designed accordingly. METHODOLOGY: This was a cross-sectional study conducted among college-going women students of Delhi. Data was collected using a pre-designed, pretested semi-structured tool followed by descriptive statistical analysis. RESULTS: Although 83% women students had heard of cervical cancer, the signs and symptoms were known to less than half (41.9%) of the students. HPV vaccine availability was known to 56.0% of the students, but very few students were vaccinated (15.0%). Similar disparity was also found in screening knowledge and practices. CONCLUSION: With poor knowledge about risk factors, and preventive strategies among young women, this study highlights the need for health education programmes related to cervical cancer targeting young women. As most of the risk factors of cervical cancer are modifiable, awareness generation at a young age could bring about a paradigm shift in incidence and the mortality associated with it.

Epidemiological profile of tuberculosis patients in Delhi, India: A retrospective data analysis from the directly observed treatment short-course (DOTS) center.

BACKGROUND: Tuberculosis (TB) has been a public health menace for decades. India harbors its highest burden globally. The present study was conducted to study the epidemiological profile of patients taking treatment from a directly observed treatment short-course (DOTS) center in Delhi, India. METHOD: Retrospective analysis of past 1-year treatment records of a total of 227 patients undergoing treatment in DOTS since June 2014-2015 was undertaken. Socio-demographic information, data related to disease status, and HIV testing were collected and analyzed. RESULTS: The majority of cases were new (77.1%) and pulmonary TB (69.2%). The highest disease burden was found in the 20-60 year age group (72.2%) and males (58.6%). Genitourinary TB was present only among females. None of the patients was HIV positive. A significant association was found between the age group of 20-60 years and relapse and loss to follow-up cases (P < 0.05). CONCLUSIONS: A higher proportion of adult males aged 20-60 years constituted the majority of patients treated in the DOTS center. Focussed interventions can be designed for this age group in future public health policies to reduce disease burden in the total population. Further research is required to be undertaken in exploring reasons for higher prevalence among males and productive age group and role of age, gender in disease causation.

Use of information on pre-packaged foods among residents of an urban village of South Delhi, India.

Background: With rapid urbanization and hectic lifestyle, there is a growing demand of pre-packaged food items. 'Food label', present on most packaged food items provides information about the contents, their nutritive value and other information that can help the consumer to make an informed choice. Few studies in India have assessed the consumer's knowledge and practices related to information on a food label. Methods: We assessed the awareness, perceptions and practices related to the use of information on food labels among residents of an urbanized village of south Delhi. House-to-house visits were made and information gathered using a pre-designed, pre-tested, semi-structured questionnaire. Descriptive analysis was done and logistic regression performed to document the determinants of 'reading food label' by the study participants. Results: A total of 368 individuals were interviewed. The mean (SD) age of the participants was 29.1 (9.7) years. Around one-fourth (97/368; 26.4%) of all participants reported buying pre-packaged foods daily. A majority (222/ 368; 60%) of participants bought pre-packaged foods because they liked the taste, and also because they were easily available (153/368; 41.7%). A total of 64.1% (236/368) reported that they read food labels, but a majority checked only for the manufacture and expiry dates (203/236; 86%). Educational status, socioeconomic status and body mass index of the study participants were found to be significantly associated with reading of labels. Conclusions: The intention of promoting healthy food choices through the use of food labels is met inadequately at present. Awareness generation activities would be required to improve this behaviour.

Knowledge assessment regarding poliomyelitis among the caregivers of children who received oral polio vaccine reveals lack of awareness of the vaccine vial monitor (VVM): Implications extending beyond polio eradication.

Vaccine vial monitor (VVM) is now commonly used for vaccines that are included in the National Immunization Schedule in India. It helps to indicate the viability of the vaccine and of the proper functioning of the cold chain. This is useful as it prevents health personnel from administering damaged vaccine. Studies have shown a lack of awareness of health workers regarding the use and interpretation of a VVM. The current study, undertaken among the caregivers of children who were immunized, showed that this lack of information about the VVM also exists among the caregivers. This deficiency in knowledge, both in the health workers and the caregivers, can affect the health of the child and needs urgent attention.

Prevalence of induced abortions and contraceptive use among married women in an urban slum of Delhi, India.

OBJECTIVE: To document abortion practices and contraceptive use among women of reproductive age in an urban slum of Delhi. METHODS: Data were collected as part of a cross-sectional study conducted in an urban resettlement colony in the North East District of Delhi between November 2010 and December 2011. Systematic random sampling was used to enroll 200 married women aged 15-49 years from each of the four blocks of the colony. Participants were interviewed and data were entered into a pretested semi-structured questionnaire. RESULTS: Among 802 participants, 284 (35.4%) reported at least one spontaneous or induced abortion, and 196 (24.4%) reported induced abortions. Unsupervised medical termination was reported by 78 (27.5%) of the 284 women. Overall, only 207 (25.8%) women practiced any type of contraception. The predominant decision maker regarding contraception was the husband for 95 (45.9%) women and the mother-in-law for 78 (37.7%). CONCLUSION: There is a need for focused community-based education to address specific issues, particularly regarding the dangers of unsafe abortion and choosing a method of contraception in consultation with a healthcare practitioner.

Estimating the burden of 'weighing less': A systematic review and meta-analysis of low birth-weight in India.

BACKGROUND: The National Family Health Survey-3 (NFHS- 3; 2005-06) reports that the prevalence of low birth-weight babies is 22% in India. This old figure is probably an underestimate as this nationwide survey acquired information on birth-weight of only 34% of babies. We aimed to make a fresh estimate of the proportion of low birth-weight babies. METHODS: A systematic search was done through PubMed, Google Scholar, Cochrane Library, Medline, IndMed, Embase, WHO and Biomed Central databases. Studies published from 2004 to 2014 were included. Study quality was assessed using the adapted Mirza and Jenkins checklist. An 'adjustment' of 24% was applied to the published estimates where data were collected through records or through a combination of records and anthropometry. The adjustment was done to account for the heaping of birth-weight data at 2500 g. Metaanalysis using both random and fixed effects model was done to derive an estimate. RESULTS: Nineteen studies with 44 133 subjects were included in the review. The pooled estimate for the prevalence of low birth-weight was 27% (95% CI 24%-30%) and the 'adjusted' pooled prevalence was 31% (95% CI 28%-33%). The prevalence in urban and rural areas was 30% (95% CI 23%- 38%) and 26% (95% CI 22%-30%), respectively. Regionwise estimates revealed that the prevalence at 33% was comparatively higher in eastern regions (95% CI 29%-37%). CONCLUSION: The pooled prevalence of low birth-weight is higher than that reported by NFHS-3. Updated estimates should be used to guide future interventions and policies.

Prevalence of reproductive tract infections and their determinants in married women residing in an urban slum of North-East Delhi, India.

BACKGROUND: Reproductive tract infections (RTIs) have adverse implications on the health of the women. Community-based studies in India have shown a high prevalence of RTIs but here is a lack of sizeable literature from urban slums and resettlement areas. AIMS AND OBJECTIVES: The objective was to document the prevalence and determinants of RTIs in married women (15-49 years) residing in an urban slum in Delhi, India. MATERIALS AND METHODS: The study was conducted in an urban resettlement colony of Gokulpuri in the North-East district of Delhi. Systematic random sampling method was adopted to choose the study subjects, that is, married and non-pregnant women in the reproductive age group (15-49 years) residing in the study area. Data were collected using a pretested semi-structured questionnaire, through the house to house visits. The diagnosis of RTIs was made as per the World Health Organization syndromic approach. Data were analyzed in SPSS version 16 (Chicago, IL, USA). RESULTS: A total of 802 women were interviewed. The mean age of study subjects was 30.79 ± 7 years. A total of 352 (43.9%) women currently had symptoms of RTIs. The most frequently reported symptoms included abdominal pain (68.2%), back pain (69.6%), and vaginal discharge (59.3%). Older women (≥25 years) (odds ratio [OR] 2.2, 95% confidence interval [CI]; 1.4-3.5), those belonging to the lower socioeconomic status (OR 2.1, 95% CI; 1.5-2.9), those using cloth during menses (OR 2.6, 95% CI; 1.6-4.3), those having more than three pregnancies (OR 1.8, 95% CI; 1.2-2.6) and those using an intrauterine contraceptive device (OR 11.8, 95% CI; 4.3-32.0) had higher odds of having RTIs. CONCLUSIONS: A high case load was found based on the syndromic approach. Generating community awareness, ensuring proper menstrual hygiene, and improving the socioeconomic status would help in reducing the cases of RTI.

Childhood Experiences of Physical, Emotional and Sexual Abuse among College Students in South India.

OBJECTIVES: To document the prevalence of physical, emotional and sexual abuse during childhood among college students. METHODS: The study was conducted among college students of Puducherry, South India. Stratified random sampling was done to select colleges. Data were gathered using the adapted 'Ministry of Women and Child Development Questionnaire on Child Abuse for Young adults'. RESULTS: A total of 936 college students completed the questionnaire. Mean ± SD age of the participants was 19.2 ± 1.1 years. Half (48%) of the participants reported being mocked because of their physical appearance. In all, 56% (524/936) of the participants reported that they were beaten during their childhood, of which 13.4% (70/524) required medical treatment. Around 10% reported someone exposing his/her private parts to them, while in 6.4% of the cases, the perpetrator forced the study participants to expose their private parts. CONCLUSIONS: Emotional, physical and sexual abuse is common in childhood and demands prompt interventions at the familial, community and political levels.

An assessment of facilities and services at Anganwadi centers under the Integrated Child Development Service scheme in Northeast District of Delhi, India.

OBJECTIVE: The current study was aimed to assess the facilities and services being provided at the Anganwadi Centres (AWCs) by the Anganwadi workers with regards to the norms laid down by Integrated Child development Service (ICDS) scheme, with special emphasis on the children of 0-6 years of age. DESIGN: Cross-sectional study. SETTING: A resettlement colony of North-West District of Delhi, having a population of hundred thousand. PARTICIPANTS: A total of 41 AWCs were present in the study area and were included in our study. The Anganwadi workers at these AWCs were interviewed. MAIN OUTCOME MEASURES: The outcome measures were the facilities present at the AWCs and knowledge of Anganwadi workers regarding the services to be provided and revised supplementary nutrition norms laid down by ICDS. RESULTS: The AWCs in the area were covered under three projects namely Project A, B and C consisting of 18, 9 and 14 AWCs, respectively. The mean room size for all the AWCs was 108.97 ± 62.18 square feet. A weighing machine was present in 29 (70.7%) of the AWCs. Growth charts for growth monitoring of children were present in 28 (68.3%) of AWCs. A drug kit was not present in 14 (34.1%) of the 41 AWCs. The mean number of children of 0-3 years enrolled per AWC was 45.78 ± 14.07. However, the mean number of children present at the time of the visit at the AWCs was 6.24 ± 5.39. Knowledge of Anganwadi workers regarding revised norms for calorie and protein for beneficiaries was found to be poor. CONCLUSION: This study showed a lack of facilities at the AWCs and poor knowledge of Anganwadi workers. Thus a regular training and supportive supervision of the Anganwadi workers is recommended along with the availability of adequate facilities and infrastructures.

The role of maternal diet and iron-folic acid supplements in influencing birth weight: evidence from India's National Family Health Survey.

AIM: To examine the role of maternal diet in determining low birth weight (LBW) in Indian infants. METHODS: Data from the National Family Health Survey (2005-06) were used. Multivariate regression analysis was used to analyse the effect of maternal diet on infant birth weight. RESULTS: Infants whose mothers consumed milk and curd daily [odds ratio (OR), 1.17; 95% confidence interval (CI), 1.06-1.29]; fruits daily (OR, 1.20; 95% CI, 1.07-1.36) or weekly (OR, 1.13; 95% CI, 1.02-1.24) had higher odds of not having a low birth weight baby. The daily consumption of pulses and beans (OR, 1.18; 95% CI, 1.02-1.36) increased the odds while weekly consumption of fish (OR, 0.79; 95% CI, 0.70-0.89) decreased the odds of not having a LBW infant. Intake of iron-folic acid supplements during pregnancy increased birth weight by 6.46 g per month. CONCLUSION: Improved intake of micronutrient-rich foods can increase birth weight.