Tobacco Use and Cessation among a Nationally Representative Sample of Men in India, 2019-2021.

Tobacco users are exposed to a higher risk of noncommunicable diseases, leading to premature mortality and disability-adjusted life years (DALYs). The future prediction indicates that tobacco-related mortality and morbidity rates will substantially increase in coming years. The study is aimed at assessing the prevalence of tobacco consumption and cessation attempts for different tobacco products among adult men in India. The study utilized information from India's latest National Family Health Survey-5 (NFHS-5) data which was conducted during 2019-21, including 988,713 adult men aged 15 years and above and 93,144 men aged 15-49. Results suggest that 38 percent of men consume tobacco, including 29% in urban and 43% in rural areas. Among the men aged 35-49 years, the odds were significantly higher for consuming any form of tobacco (AOR: 7.36, CI: 6.72-8.05), smoking cigarettes (AOR: 2.56, CI: 2.23-2.94), and smoking bidi (AOR: 7.12, CI: 4.75-8.82) as compared to those aged 15-19. The application of multilevel model indicates that tobacco usages are not evenly distributed. In addition, there is maximum clustering of tobacco usages found around household level factors. Further, 30% of men aged 35-49 years attempted to stop consuming tobacco. Though 27% of men tried to quit tobacco in the last 12 months and 69% of men are exposed to secondhand smoke, 51% of men who received advice for quitting tobacco and visited the hospital in the last 12 months belong to the lowest wealth quintile. These findings prioritize promoting awareness about adverse effects of tobacco use, especially in rural areas, and capacitate them to adopt cessation efforts so that those who want to quit may be successful in their efforts. In addition, the health system's response to the tobacco epidemic in the country should be strengthened by training of service providers to promote cessation efforts through appropriate counselling of all the patients visiting them in the context of tobacco use in any form as key drivers of the increasing burden of noncommunicable diseases (NCDs) in the country.

Impact of Spirulina Chikki Supplementation on Nutritional Status of Children: An Intervention Study in Tumkur District of Karnataka, India.

Objective: To assess the impact of Spirulina Chikki supplementation on the nutritional status of children (6 months-6 years). Design: A cross-sectional study design was adopted to assess the changes in nutritional status among the children (after 12 months of intervention period). The bassline and endline assessment were carried out from September 2020 to August 2021, respectively. Setting: Total 106 villages (108 Anganwadi Centers in nine circles) from Tumkur District were covered. Methods: Children aged 6 months-6 years were the study subjects. Anthropometric measurements viz., height, weight, and mid-arm circumference were collected from total 971 and 838 children during baseline and endline assessments correspondingly. The information on children's health and nutrition status was gathered from the mothers of sampled children. WHO's Anthro and AnthroPlus software were utilized to estimate the anthropometric measurements (Stunting, wasting, and underweight) of study participants. Results: The study found apparent disparities in the prevalence of stunting, wasting and underweight among the male and female children. There was a significant decline viz., 4% (28.6%-baseline to 24.5%-end line) in the prevalence of severe wasting. Also, severe stunting dropped by 6% at end line (30%-end-line to 24%-baseline). Improvement in nutritional status was evident among both female male children in all three indicators stunting, wasting, and underweight. Mid-upper arm circumference (MUAC) measurement shows substantial improvements from baseline to end line: SAM (5.3-0.6%), MAM (23-9%), and normal (72-91%). The study discloses significant improvements in the nutritional status among those children who consumed spirulina chikkis/granules for a longer duration viz., 9-10 months as compared to those who consumed for lesser duration. Conclusions: Findings reveal improvement in nutritional status among the beneficiaries who consumed spirulina chikki/granules as per the recommended quantity (amount) during the intervention period. Post intervention, spirulina chikki supplementation for nutritional intervention is implied to address large scale malnutrition among young children.

Age heaping among individuals in selected South Asian countries: evidence from Demographic and Health Surveys.

Age misreporting is a common phenomenon in Demographic and Health Surveys, and there are numerous reasons for this. The trend and pattern of disparity in age heaping vary between countries. The present study assesses age heaping in the selected South Asian countries of Afghanistan, India, Nepal, Bangladesh and Pakistan using data from the most recent round of the Demographic and Health Survey. The respondent sample sizes were 203,703 for Afghanistan, 2,869,043 for India, 49,064 for Nepal, 81,618 for Bangladesh and 100,868 for Pakistan. Age heaping was assessed by respondent's age, education level, sex and level of education. Whipple's index was calculated to assess systematic heaping on certain ages as a result of digit preference. Bangladesh, Afghanistan and India showed stronger preference for ages ending with the digits '0' and '5' compared with Pakistan and Nepal among uneducated respondents. On the other hand, strong avoidance of ages ending in the digits '1', '4' and '9' was observed in Bangladesh, Afghanistan and India. However, urban-rural place of residence was not found to be associated with digit preference in the study countries. Among males, age misreporting with the final digits '0' and '5' was highest in Bangladesh, followed by Afghanistan and India, and Nepal showed the least displacement. Strong digit preference and avoidance, and upper age displacement, were witnessed in the surveys conducted in Bangladesh, Afghanistan and India on the parameters of sex and education level. Innovative methods of data collection with the measurement and minimization of errors using statistical techniques should be used to ensure accuracy of age data.

Prevalence and Risk Factor of Occupational Skin Complaints among Male Tannery Workers of Kanpur, India.

BACKGROUND: Occupational skin illnesses are the second most common occupational health hazard following musculoskeletal disorders. Tannery workers have frequent and prolonged exposure to skin irritants and allergens and may have a higher risk of developing occupational dermatitis. AIMS AND OBJECTIVES: The aim of this study is to examine the extent of skin problems and their determinants among male tannery workers. MATERIALS AND METHODS: The data for the present research was drawn from a cross-sectional household study of tannery and nontannery workers in the Jajmau area of Kanpur, Uttar Pradesh. A total of 284 tannery and 289 nontannery workers were interviewed using purposive sampling technique. Descriptive statistics and multivariate techniques have been used. RESULTS: Tannery workers experienced itching hands or fingers with fissures (21%), scaling of hands or fingers with fissures (18%), red and swollen hands or fingers (11%), and vesicles on the hands or between the fingers (11%). The workers who had moderate/high dermal exposure to chemicals were 35(P < 0.001), and they were 31 (P < 0.001) times more likely to experience vesicles on scaling hands or fingers with fissures, and itching hands or fingers with fissures. The tannery workers engaged in wet finishing work were significantly 3.9 (P < 0.1) times more likely to experienced scaling on hands or fingers with fissures. CONCLUSION: The study acclaims the mechanization of tannery activities at workplaces, so that risk of skin complaints can be minimized among tannery workers. As the risk of skin complaints is very high with the dermal exposure to chemicals, personal protective equipment must be provided and their use should be included in the curriculum of the ternary workers.

A true face of Indian married couples: Effect of age and education on control over own sexuality and sexual violence.

INTRODUCTION: Though there are several interventions evaluated over the past 25 years, significant knowledge gaps continue to exist regarding the effective prevention of sexual violence. This study explored the socio-economic and context-specific distinctive characteristics of husbands and wives on sexual autonomy and unwanted sexual experiences of currently married women in India. METHODOLOGY: We have utilized the recent round of National Family Health Survey (NFHS-4, 2015-16) data for this exploration. The NFHS-4 survey had adopted a stratified two-stage sample design to reach out to the survey households. A total of 63,696 couples are included in the analysis comprising of women of 15-49 years age and men of 15-54 years age. Multivariate techniques have been applied to understand the adjusted effects of socio-economic and demographic variables on control over their sexuality and sexual violence. RESULTS: Uneducated women married to uneducated men experienced more sexual violence and had less control over their sexuality than the other categories. The adjusted multivariate logistic model shows that educated husbands were significantly more likely to exercise control over their educated wives' sexuality (AOR = 0.88; CI:0.78-0.99). Women having older husbands were significantly less likely to be having no-control over own sexuality (AOR = 0.89; CI:0.83-0.95) and experienced sexual violence (AOR = 0.81; CI:0.70-0.95). Women having comparatively more-educated husbands were significantly less likely to experience sexual violence (AOR = 0.62; CI:0.47-0.81). Muslim women were significantly more likely to have no control overown sexuality. SC/ST women were significantly more likely to experience sexual violence (28%). CONCLUSIONS: This study highlights the factors associated with control over one's sexuality and preponderance to sexual violence: age, education, spouse working status, wealth status, husband's alcohol consumption, women autonomy, decision-making, and freedom for mobility. This study suggests that empowering women with education, creating awareness regarding reproductive health, and addressing their socio-economic needs to help them achieve autonomy and derive decision-making power.

Potential effect of household environment on prevalence of tuberculosis in India: evidence from the recent round of a cross-sectional survey.

BACKGROUND: Tuberculosis (TB) has been a major health problem globally since ages, and even today, it is a major cause of morbidity in millions of people each year. In 2015 alone, TB accounted for about 1.4 million deaths globally, with India carrying the biggest burden of the disease. The physical environment of the household, an individual living in, has a significant influence on the incidence of TB. Thus, an understanding of the socio-economic, demographic and environmental factors that individuals are exposed to is of importance. The objective of present study is to examine the association of household environment with the prevalence of Tuberculosis in India. METHODS: The study utilizes data from the fourth round of National Family Health Survey (NFHS-4), 2015-16, which was collected from self-reported information pertaining to Tuberculosis in the household questionnaire. The specific question was, "Does any usual resident of your household suffer from tuberculosis?" the response to which helped in the detection of Tuberculosis. Binary Logistic regression was performed from which appropriate inferences are drawn on the association of household environment with Tuberculosis. RESULTS: Prevalence of TB was found to be the highest among elderly people (0.9%), no education (0.4%) and people belonging to the poorest wealth quintile (0.53%). Family members who were regularly (daily) exposed to smoke (second-hand smoke) inside the house were more prone to getting tuberculosis (OR = 1.49; CI = 1.39-1.61) as compared with households where people do not smoke inside the house. Further, households having a finished wall (OR = 0.7; CI = 0.6-0.8) are less likely to get TB than the households with mud walls. Households that shared their toilets with other households are more likely to get hold of Tuberculosis (OR = 1.2; CI = 1.1-1.4). CONCLUSIONS: Results strongly suggest that a contaminated household environment increases the risk of tuberculosis in India. There are multiple risk factors that are strongly associated with Tuberculosis: smoke inside house, type of cooking fuel, separate kitchen, floor, roofing and wall material, number of persons sleeping in a room, sharing toilet and potable water with other households; and individual characteristics such as age, sex, educational attainment, marital status, place of residence and wealth index.

Prevalence, predictors and economic burden of morbidities among waste-pickers of Mumbai, India: a cross-sectional study.

BACKGROUND: The occupation of waste-picking characterised as 3Ds - dangerous, drudgery and demanding. In this context, the study aimed to assess occupational morbidities among the waste-pickers and attempts to identify potential individual level risk factors enhancing health risks. Additionally, economic burden of morbidities has been assessed. METHODS: The burden of the morbidities was assessed and compared with a comparison group through a cross-sectional survey. Waste-pickers (n = 200) and a comparison group (n = 103) working for at least a year were randomly selected from the communities living on the edge of the Deonar dumping site. The difference in the prevalence of morbidities was tested using the chi-square test. The effect of waste picking resulting the development of morbidities was assessed using the propensity score matching (PSM) method. A multivariate logistic regression model was employed to identify the individual risk factors. T-test has been employed in order to analyse the difference in health care expenditure between waste pickers and non-waste pickers. RESULTS: The prevalence of morbidities was significantly higher among the waste-pickers, particularly for injuries (75%), respiratory illness (28%), eye infection (29%), and stomach problems (32%), compared to the comparison group (17%, 15%, 18%, and 19% respectively). The results of the PSM method highlighted that waste-picking raised the risk of morbidity for injuries (62%) and respiratory illness (13%). Results of logistic regression suggest that low level of hygiene practices [household cleanliness (OR = 3.23, p < 0.00), non-use of soap before meals (OR = 2.65, p < 0.05)] and use of recyclable items as a cooking fuel (OR = 2.12, p < 0.03) enhanced health risks among the waste pickers when adjusted for the age, duration of work, duration of stay in community and substance use. Additionally, the high prevalence of morbidities among waste pickers resulted into higher healthcare expenditure. Findings of the study suggest that not only healthcare expenditure but persistence of illness and work days lost due to injury/illness is significantly higher among waste pickers compared to non-waste pickers. CONCLUSIONS: The study concluded that waste-picking raised the risk of morbidities as also expenditure on healthcare. Results from the study recommend several measures to lessen the morbidities and thereby incurred healthcare expenditure.

Reliability and validity of general health questionnaire (GHQ-12) for male tannery workers: a study carried out in Kanpur, India.

BACKGROUND: The purpose of this study was to test the reliability, validity and factor structure of GHQ-12 questionnaire on male tannery workers of India. We have tested three different factor models of the GHQ-12. METHODS: This paper used primary data obtained from a cross-sectional household study of tannery workers from Jajmau area of the city of Kanpur in northern India, which was conducted during January-June, 2015, as part of a doctoral program. The study covered 286 tannery workers from the study area. An interview schedule containing GHQ-12 was used for tannery workers who had completed at least 1 year at their present occupation preceding the survey. To test reliability, Cronbach's alpha test was used. The convergent test was used for validity. Confirmatory factor analysis was used to compare three factor structures for the GHQ-12. RESULTS: A total of 286 samples were analyzed in this study. The mean age of the tannery workers in this study was 38 years (SD = 1.42). We found the alpha coefficient to be 0.93 for the complete sample. The value of alpha represents the acceptable internal consistency for all the groups. Each item of scale showed almost the same internal consistency of 0.93 for the male tannery workers. The correlation between factor 1 (Anxiety and Depression) and factor 2 (Social Dysfunction) was 0.92. The correlation between factor 1 (Anxiety and Depression) and factor 3 (Loss of confidence) was the highest 0.98. Comparative fit index (CFI) estimate best-fitted for model-III that gave the CFI value 0.97. The SRMR indicator gave the lowest value 0.031 for the model-III. CONCLUSIONS: The findings suggest that the Hindi version of GHQ-12 is a reliable and valid tool for measuring psychological distress in male tannery workers of Kanpur city, India. Study found that the model proposed by the Graetz was the best fitted model for the data.