Trends of Private Drugs' Sales and Costs Incurred by Patients on Anti-tuberculosis Drugs in Selected Districts of Jharkhand (2022): Results From Sub-national TB-Free Certification.

BACKGROUND: The government of India is committed to eliminating tuberculosis (TB) by 2025 under the National Tuberculosis Elimination Programme which provides free investigations and treatment as well as incentives for nutritional support during their treatment course. Many TB patients prefer to seek treatment from the private sector which sometimes leads to financial constraints for the patients. Our study aims to find the burden of TB patients in the private sector and the expenses borne by them for their treatment. METHODOLOGY: Sales data of rifampicin-containing formulation drug consumption in the private sector of six districts of Jharkhand was collected from Clearing and Forwarding agencies. Based on the drug sales data, the total incurring costs of the drugs, total number of patients, and cost per patient seeking treatment from the private sector were calculated for the year 2015-2021. ANOVA and the post hoc test (Tukey honestly significant difference (HSD)) were applied for analysis. RESULTS:  There was a marked difference amongst all the districts in relation to all the variables namely total costs, cost per patient, and total private patients seeking treatment from the private sector which was statistically significant (p < 0.001). East Singhbhum had the highest out-of-pocket expense and private patients as compared to all six districts. Lohardaga showed the sharpest decline in total private patients from 2015 to 2021. The average cost borne by private patients in 2015 was INR 1821 (95% CI 1086 - 2556) which decreased to INR 1033 (95% CI 507 - 1559) in 2021. CONCLUSION: From the study, it was concluded that the purchase of medicines for TB treatment from the private sector is one of the essential elements in out-of-pocket expenditure (OOPE) borne by TB patients. Hence, newer initiatives should be explored to foresee the future OOPE borne by the patients and decrease OOPE-induced poverty.

Immunological survey of COVID-19 among medicos of tribal preponderant state of India.

Background: Immunological Survey or serosurveys have yielded useful information regarding the spread of the COVID-19 pandemic in the general population, but the impact of the continuing pandemic on the medical students in India is yet to be fully recognised. In this study we assessed the students who had received at least two doses of the COVID-19 vaccine for their antibody response. Methodology: A Hospital based, age-stratified, cross-sectional Analytical study design was adopted for the survey, carried out in tribal state of India among medical students. Consecutive sampling method was used where serum samples were tested for antibodies against the SARS-CoV-2 nucleocapsid (N) protein. Result: The vaccinee group comprised of 187 students mostly aged between 18-23 years 68.4% were females, 56.6 % were vaccinated with covishield. The mean IgG (Immunoglobin G) titre was 7343.74 AU/Ml, less than 1000 AU/Ml was found in 8% of participants, while more than 8000 AU/Ml was found in 32.1%. Participants who got the covaxin vaccine had a higher median IgG titre (median 6491.8 AU/mL, interquartile range 8898 AU/mL).The antibody titre of male was 0.328 times lower than that of female. Conclusion: Despite the fact that covishield's mean antibody titre was higher, covaxin's protection lasted longer.

Prevalence of Overweight and Obesity Among Students of Government and Private High Schools in an Indian State With Significant Tribal Population: A Cross-Sectional Analytical Study.

BACKGROUND: Overweight and obesity among school-going children is an emerging public health problem in the country. The information available on the true extent of obesity and overweight among school-aged children is limited. Hence, the present study has been conducted to determine the prevalence of overweight and obesity among high school students in Jharkhand, India. METHODOLOGY: This was a cross-sectional study conducted among 1162 students of government and private schools of Ormanjhi block, Ranchi district, from July 2022 to December 2022. A predesigned, semi-structured, pre-tested questionnaire containing different sections namely sociodemographic characteristics, and health parameters were used for the study subjects. Clinical examination and anthropometric measurements of height, weight, and waist and hip circumferences were taken using standard equipment to calculate body mass index (BMI) and central obesity (waist-hip ratio). RESULTS: The prevalence of overweight and obesity was more at 14 years of age (30.2%), among boys (18.1%), and among students practicing the Islam religion (51.1%). Moreover, the prevalence of overweight and obesity was found to be highest in private schools (66.2%), and that was statistically significant (p<0.001). CONCLUSION: The prevalence of overweight and obesity was found to be significant with respect to age, gender, and religion. The findings from this study would be helpful in raising awareness among students, parents, teachers, and health professionals about the influence of overweight and obesity on a child's physical, social, and psychological well-being, and this, in turn, would facilitate parents, students, and teachers in the adoption of a healthy lifestyle.

Effects of anticonvulsant drug on liver enzymes among children in a tribal state of India: A longitudinal study.

Introduction: Epilepsy is a syndrome of various neurological disorders. Idiosyncratic hepatotoxicity is a rare adverse effect associated with antiepileptic drugs (AED) therapy. Antiepileptic drugs may produce hepatic injury as part of a more widespread hypersensitivity reaction. Laboratory monitoring of asymptomatic effects may allow for the early detection of hepatotoxicity. So the present prospective longitudinal study was carried out to determine the effects of Anticonvulsant drug on liver enzymes among Epileptic Children. Materials Methods: A prospective observational study was conducted among children with seizure disorder attending Paediatric outdoor patient Department of Rajendra Institute of Medical Sciences, Ranchi from February 2014 to October 2015. 50 children with newly diagnosed or untreated seizure disorder were included in case and 50 children of both sexes with same age group as cases were selected as control who did not have seizure. Children with age ranging from 2-10 years were included by consecutive sampling technique. Data was analysed using Statistical Package for Social Sciences (SPSS) software version 25(IBM Corp., Armonk, NY, USA). Paired t test was used to compare the mean values of liver enzymes amongst the children."P-value" was considered to be non - significant if found ≥ 0.05 and significant if P-value was found to be <0.05. Results: In the present study there was no significant alteration of hepatic profile after treatment with valproate except serum alkaline phosphatase which was increased from the initial value than control group and was statistically significantly with P value of less than 0.05. Conclusion: We concluded that these Antiepileptic drugs are safe to use in children up to 1 year.

A Systematic Review and Meta-Analysis Assessing the Role of Oral Health as a Risk Factor in Oral Cancer.

Oral squamous cell carcinoma is the leading type of cancer in Southeast Asian countries and many parts of the world. Many factors increase the risk of oral cancer, like tobacco, betel nuts, alcohol consumption, sharp teeth, infections, and other factors. Oral health-related issues have been reported in many studies of oral cancer, but there is a need to understand the role of the same as a risk factor. The systematic review and meta-analysis were conducted to assess the role of oral health as a risk factor in oral cancer. The population diagnosed with oral cancer (P) of all age groups and both gender, exposure (E) is oral health (includes poor oral hygiene, periodontal disease, and other oral diseases excluding oral potentially malignant disorders (OPMD)), the comparator (C), is patients without oral health issues, outcome (O) is the role of poor oral health as a risk factor for oral cancer. A systematic review and meta-analysis were conducted. The databases used for the search were PubMed, Cochrane Database, Embase, Scopus, and Google Scholar. The unpublished reports, reviews, and grey literature were considered. Case-control studies were included assessing poor oral health as a risk factor with odds ratio as an effective measure. Newcastle Ottawa Scale for risk of bias in the case-control study was considered. The study results showed that tooth loss odds ratio (OR)=1.13, CI (0.99-1.26), I2 value of 71.7%, Oral hygiene OR=1.29, CI (1.04-1.54), I2 value of 19.7% and in periodontal diseases OR=2.14 CI (1.70-2.58), I2 value of 75.3% had a higher risk of developing oral cancer. The risk factors for tooth loss and periodontal disease showed moderate heterogenicity and less heterogenicity for oral hygiene. Poor oral health factors such as periodontal disease, poor oral hygiene, and loss of teeth show higher odds of oral cancer than the control. The periodontal disease shows the highest odds than other factors. These risk factors can be considered for the primordial prevention of oral cancer.

A Cross-Sectional Study on the Epidemiology of Newly Diagnosed Breast Cancer Patients Attending Tertiary Care Hospitals in a Tribal Preponderant State of India: Regression Analysis.

INTRODUCTION: Breast cancer (BC) is globally prevalent and the leading cause of death due to cancer in females. Due to changes in risk factor profiles, improved cancer registration, and cancer detection, its incidence and death rates have risen over the past three decades. Both modifiable and immutable risk factors for BC make up a sizable portion of the total risk factors.  Methodology: This was a hospital-based cross-sectional study carried out in the Department of Surgery, Rajendra Institute of Medical Sciences (RIMS), Ranchi. Consecutive sampling was done with a complete enumeration of all newly diagnosed cases of breast cancer >15 years old. Those who consented to participate and those who were extremely ill, deaf, or dumb were excluded from the study. RESULTS: A total of 88 patients were included. Maximum patients diagnosed with breast cancer belonged to the age group of 40-50 years (37.5%), Hindu by religion (76.1%), non-tribal (80.68%), illiterate (89.8%), married (98.9%), housewives (92%), and of class IV socio-economic status (SES) (65.9%). CONCLUSION: Regular training of Sahiya (the local name of Accredited Social Health Activist (ASHA) in Jharkhand), empowerment of screening clinics for cancer, and upgraded diagnostic facilities for timely referral should be stressed upon.

Bibliometric Analysis of Poor Oral Health as a Risk Factor for Oral Cancer.

Poor oral health is a risk factor for oral cancer, and bibliometrics can tell us important things about publication trends and research. Oral cancer risk factors include smoking, betel nut chewing, alcohol consumption, trauma from sharp teeth, chronic infections, and other factors related to oral health. There is a need to understand the role of poor oral health as a risk factor. Thus, this study aimed to conduct a bibliometric analysis of the literature on poor oral health as a risk factor for oral cancer. A bibliometric analysis was conducted for poor oral health as a risk factor for oral cancer using RStudio 2021.09.0+351 "Ghost Orchid" Release (2021-09-20) for Windows, package "bibliometrix." The literary data for this study were derived from Elsevier's Scopus database, and the data were exported in BibTex format. The results considered the time frame of 1983 to 2022, with journals, books, newspaper articles, and others as sources, accounting for a total of 543 documents. The search yielded a total of 2,882 authors, with a total of 3,306 appearances. The results show that the research on poor oral health and oral cancer is mainly led by the United States (106), India (49), and China (46). The top author is Warnakulasuriya S, followed by Worthington HV. The research shows the countries that are currently working on the topics and helps set up future collaborations to improve the evidence produced and help the scientific community by finding research gaps and experts in this area of research.

Drivers for COVID 19 vaccine hesitancy among breastfeeding women in Eastern tribal state, India.

Background: In the COVID-19 pandemic age, vaccination hesitancy also known as vaccine refusal is a cause for worry since it hinges on the five Cs of confidence, complacency, convenience, calculation, and shared responsibility. The current study was to pinpoint the elements that contribute to breastfeeding women's hesitation to receive the coronavirus disease-19 (COVID-19) vaccine. Materials and Methods: A cross-sectional observational study was carried out at the Department of Obstetrics and Gynaecology, Tertiary Care Hospital, Ranchi, Jharkhand. Result: Out of 365 nursing mothers, 242 (66.3%) were hesitant to get the COVID-19 vaccination. Those who chose not to receive the COVID-19 vaccination mostly belong to those aged 18 to 25 (38.1%), living in rural regions (44.9%), and belonging to non-tribal ethnic groups (41.1%). On application of logistic regression, it was found that rural areas had 3 times higher rate of vaccine hesitancy than urban residents, and that husbands' education levels up to the 12th grade had a 3.55 times higher rate and 5 times agriculture by husband's occupation, which was statistically significant (P value less than 0.05) The most prevalent grounds for rejection were fear of side effects (85.8%) and worry of adverse effects on newborns (83.48%). Conclusion: Both husband and wife, who had completed high school and were aware of the vaccination, were fearful of the COVID-19 vaccine. Concerns about the side effects and undesirable effects of vaccination on their newborns were the main reasons for refusal.

Impact of milk on malnutrition and cognitive skills among school children: Evidence from gift milk initiative from a tribal state of India.

Background: The objective of this study was to assess the impact of fortified milk on various aspects of growth and development among school children in a tribal-predominant district of Jharkhand, India. Materials and Methods: A longitudinal study was planned in 16 schools (eight in intervention group and eight in control group) of Latehar district of Jharkhand in India. Out of the total 962 study participants, only 528 study participants were considered in study analysis, who were present both during baseline and endline study after 1 year of milk introduction. The study participants were assessed for nutrition, intelligence quotient, and hemoglobin levels with the help of study tools and instruments. Results: The decrease in malnutrition was more evident in the intervention group during endline assessment, with 95% confidence interval (95% CI; 7.37, 7.42) and 95% CI (10.63, 10.58) for the difference in proportion in the intervention and control groups for stunting and thinness, respectively. This was statistically significant (P < 0.05). Anemia also improved with better cognition in the intervention group, and the difference was statistically significant (P < 0.05). Conclusion: In our study, beneficial effects of milk on malnourished children were evident, particularly in combating stunting and thinness, and it also had a positive impact on cognitive skills in school children.

An Epidemiological Study of Outbreak Investigation of Chickenpox in Remote Hamlets of a Tribal State in India.

BACKGROUND: Chickenpox is a benign, self-limiting disease caused by the varicella-zoster virus (VZV) that is transmitted from person to person with direct contact or airborne spread, which usually lasts for five to seven days. There was a sudden increase in the number of cases of fever along with rashes at two sites in Jharkhand, India. We aimed to survey and establish the etiology and investigate the extent of the disease. METHODS: We defined the case of chickenpox as a person with acute onset of diffuse maculo-papulovesicular rash. From the clinically suspected cases, blood samples were collected and tested for anti-VZV immunoglobulin M and immunoglobulin G antibodies (depending on the clinical features) with an enzyme-linked immunosorbent assay (ELISA) kit (Novatec Immundiagnostica GmbH, Dietzenbach, Germany). A detailed history was collected from each case including the history of contacts and immunization status. RESULTS: The outbreak investigations were done at two villages of the two different blocks and one school in the Bharno block. According to the case definition, 16 persons were found affected by the varicella-zoster/chickenpox infection who belonged to five different households of Itkhori village in Chatra district. The age group varied from four to 45 years. The mean age was 20.28 years. Out of 16 cases, 10 (62.5%) cases complained of fever, rashes, and itching, two (12.5%) reported rashes and fever, and four (25%) complained of itching along with rashes. While at the Bharno block of Gumla district, out of 62 cases that fulfilled the case definition, 55 (88.7%) cases complained of fever, rashes, and itching, two (3.2%) reported itching and rashes, one (1.6%) reported vomiting along with fever and rashes, one (1.6%) complained about pain and rashes, one (1.6%) complained of cough with rashes, and four (25%) complained of itching along with rashes. There was neither any death nor any serious complication noted due to varicella. CONCLUSION: Chickenpox is still widespread in Northern parts of India like Jharkhand. Most of the cases were self-limiting and recovered at the Itkhori block, while at the Bharno block, there were 20 active cases and the rest were either recovered or were still in the recovery phase.

An epidemiological study on morbidity profile and predictors of health seeking behaviour among elderly population in a tribal dominant state of India: A regression analysis.

Background: Ageing is defined as a process of deterioration in the functional capacity of an individual that results from structural changes, with the advancement of age. Globally the geriatric population has increased from 8% in 2012 to 8.5% in 2015 and expected to rise by 22% in 2050. Hence we planned to study morbidity profiles and predictors of health-seeking behaviour among the elderly population in Ormanjhi, Ranchi. Methodology: A community based cross sectional study was conducted in Ormanjhi, Ranchi, Jharkhand for a period of six months (March-August 2018). The study was done among 206 geriatric populations fulfilling the eligibility criteria, selected by cluster sampling and those not giving their consent were excluded from the study. Data collected were entered in Microsoft Excel and analysis was done on Statistical Package for Social Sciences (SPSS) version 20.0. Results: A total of 206 geriatric populations fulfilling the study criteria, were enrolled during the study. The majority of the age group was found between 60-69 years (71.8%). Around 202 (98.1%) of which resided in rural areas, nearly half 102 (49.5%) depended on pension for livelihood and 108 (52.4%) were illiterate. Two-fifth of the study subjects (40.3%) consulted a government doctor if any health problems occurred followed by 30.5% preferred a private doctor and 20.1% consulted unqualified practitioners. Most of the study participants (64.5%) did not seek medical care due to financial reasons followed by 14.5% considered it a minor illness than 13% complained that health facility far away and 8.1% considered that old age itself as a disease. Non tribal ethnicity, participants who had their own source of income and co-morbidity were significantly associated with health seeking behaviour. Conclusion: Most participants in this study suffered from morbidities which also affect their quality of life. It was also observed that most of them were not dependent on others for their daily activities. Health seeking behaviour was found to be appropriate in nearly two third (70%) of elderly subjects in Ranchi, Jharkhand.

Predictors of quality of life among geriatric population in a tribal dominant state of India: A community based analytical study.

Background: Improving the quality of life of the geriatric population along with maintaining their health and promoting social participation still poses a major public health challenge in the twenty-first century. Hence, we planned to measure the quality of life (QOL) in each domain namely physical, psychological, social, and environmental using the world health organization quality of life brief version (WHO QOL-BREF) questionnaire and to assess the predictors of QOL among the elderly population. Methodology: A community-based cross-sectional study was conducted in Ormanjhi, Ranchi, Jharkhand for a period of 6 months. The study was carried out among 206 geriatric populations fulfilling the eligibility criteria. The data collected were entered in MS Excel and analyzed using SPSS version 20. The QOL scores were expressed in terms of mean and standard deviation, and the difference between mean scores was tested by using student t-test/analysis of variance (ANOVA). The predictor associated with QOL was done by multiple linear regression analysis. P value less than 0.05 was considered statistically significant. Results: A total of 206 geriatric people fulfilling the study criteria were enrolled during the study. The majority of the people were of the age between 60 and69 years (71.8%). Most of them 202 (98.1%) resided in rural areas, 108 (52.4%) of them were illiterate by education, and nearly half 102 (49.5%) depended on pension for livelihood. Nontribal ethnicity, backward category, illiteracy, low socio-economic status, nuclear family, elderly person having no own source of income, currently living alone, person having more co-morbidity, and less activities of daily living (ADL) score were significantly associated with low QOL score. Conclusion: Overall QOL was good to excellent in Ranchi, Jharkhand. We concluded that QOL is affected by many different factors.

Factors associated with development of adverse events after taking COVID-19 vaccine in a tribal state of India: Regression analysis.

Background: Coronavirus disease (COVID-19) vaccination becomes a crucial weapon in the pandemic's control. Two vaccines, Covishield and Covaxin, are approved in India to vaccinate against the virus. Hence, the present study was done to determine the factors associated with the development of adverse events after taking the COVID-19 vaccine in a tribal state of India. Materials and Methods: This was a cross-sectional analytical study. All persons who were willing to participate in our study and had received the first or second dose of the COVID-19 vaccine from January 1 to March 31, 2021, were included. We got 1497 complete responses via (free, web-based Google Docs Editors suite offered by google, Founders- Larry Page Sergey Brin. Menlo Park, California, United States). So our final sample size came out to be 1497 in which analysis was done. The data was compiled in MS excel sheets (Microsoft version 2013, Microsoft Corporation, Redmond, Washington, United States) and a template was generated which was further analyzed in SPSS version 20 (version 25.0; IBM Corp., Armonk, NY, USA). Results: The total number of respondents who participated in the surveillance of adverse events following immunization (AEFI) was 1497. Among them, a majority have taken the Covishield vaccine followed by Covaxin. The majority of participants were female of age group less than 30 years and above 18 years with a mean age of 33.63 ± 51.51. The most common AEFI was pain at the site of injection, after the first and second dose followed by fever after the first and second dose within 24 h following immunization. Conclusion: We conclude that factors like the type of vaccine, gender, and participants who have allergies have a higher risk of presenting the adverse events after the COVID-19 vaccination.

Effect of Ivermectin prophylaxis in prevention of COVID 19: Meta-analysis and systematic review.

Ivermectin was popular drug on trial for preventive and therapeutic role in COVID-19. However, there is disagreement concerning the validity of its clinical efficacy. Hence, we conducted a Meta-analysis and Systematic review for effect of Ivermectin Prophylaxis in prevention of COVID-19. The online databases of PubMed (Central), Medline, and Google scholar for randomized controlled trials, non-randomized trial and prospective cohort study were searched up to March 2021. Nine studies were included for analysis, out of which four were Randomized controlled Trial (RCTs), Two Non-RCTs and three cohort studies. Four randomized trial evaluated prophylactic drug Ivermectin, two combination of topical nasal carrageenan and oral Ivermectin two study used in combination of personal protective equipment (PPE) one with Ivermectin and one with Ivermectin/ Iota-Carrageenan (IVER/IOTACRC). In the pooled analysis we observed non-significant less COVID-19 positivity rate in the prophylaxis group as compared with non-prophylaxis group (Relative Risk (RR) = 0.27 and Confidence Interval (CI) = 0.05, 1.41) with significant heterogeneity (I2 = 97.1%, P < 0.001) The pooled analysis involving the Non-RCTs studies also did not observe significant reduction in the COVID-19 positivity rate in the prophylaxis group as compared with non-prophylaxis group (RR = 0.01 and CI = 0.00, 7.97) with significant heterogeneity between the studies (P < 0.001).Hence,we conclude that Ivermectin is not the 'magical silver weapon' against COVID-19.

Predictors of Breastfeeding Initiation Among Postnatal Mothers at Tertiary Care Center of a Tribal Dominant State in India: A Regression Analysis.

Background Early initiation of breastfeeding (EIBF) is one of the most important predictors for the survival of a child, spacing between two children, and prevention from childhood infections. Breastfeeding plays an important role in reducing child mortality and morbidity but the practice of EIBF globally is way behind the required time for initiation of breastfeeding after delivery. So, we planned to evaluate the early time of initiation of breastfeeding among the postnatal mothers and to determine the predictors of early initiation of breastfeeding in a tertiary hospital setting. Methodology A hospital-based cross-sectional study was conducted in the postnatal ward of Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand for a period of three months (March-May 2017). Our study included 200 postnatal mothers who delivered normal and healthy babies. Mother-infant dyads enrolled in our study were interviewed personally during six hours of the postpartum period. Irrespective of the mode of delivery, all babies born during the study period whose mothers consented to be a part of the study were included. Data collected were entered in MS Excel and analyzed using IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. Results A total of 200 postnatal mothers fulfilling the study criteria were enrolled during the study. Of them, the majority 98 (49%) belonged to the age group 18-25 years. A hundred and twenty-six (63%) of them resided in rural areas, 182 (91%) were housewives, and only 86 (43%) of them had completed secondary education & above. Early initiation of breastfeeding was found to be only 43 (21.5%) among postnatal mothers. Predictors found to be statistically significant with EIBF were mother's residential status [odds ratio (OR): 2.98; 95% confidence interval (CI): 1.25-7.13], educational status of mother (OR: 3.18; 95% CI: 1.12-9.01) mode of delivery of the baby (OR: 8.93; 95% CI: 2.66-30.06) and ante-natal care (ANC) visits (OR: 0.441; 95% CI: 0.311-0.651). Women's age, religion, ethnicity, occupation, type of family, and socioeconomic status displayed no statistically significant relationship with EIBF. Conclusions It is concluded that nearly one-fifth of mothers in the study initiated breastfeeding within one hour of post-delivery. Maternal education, frequent ANC visits, place of residence, and mode of delivery were also associated with EIBF in India. Nursing staff, as well as clinicians, should reinforce the importance of early initiation of breastfeeding by providing proper health education to post-natal beneficiaries.

Effect of milk supplementation on the status of micronutrients among rural school children aged 5-19 years in a tribal predominating district of India.

BACKGROUND: In the tribal state of Jharkhand, there have been very few studies on micronutrient deficiency and how it is addressed among school children. This study was conceived and undertaken to assess the effect of milk supplementation on the micronutrient status of school children. DESIGN: A comparative observational study was conducted among school children of a tribal district in India during 2017-2018. Two groups of schools/clusters were randomly selected, one with milk supplementation and the other without supplementation. A total of 318 children from the two groups of schools were recruited for biochemical analysis of certain micronutrients, such as calcium, vitamin D, vitamin B12 and iron (haemoglobin level), using cluster random sampling. Data were analysed using SPSS V.20.0 software, and multiple logistic regression analysis was done to determine the predictors of serum calcium and vitamin B12 level among school children. RESULTS: Almost all children from both groups had vitamin D deficiency. A higher risk of lower serum vitamin B12 level (OR 2.59, 95% CI 1.61 to 4.16) and calcium level (OR 3.36, 95% CI 1.74 to 6.49) was observed in children of the control group. The difference in the proportion of anaemia in the two study groups was found to be statistically insignificant. Milk consumption was found to be the only significant predictor of normal vitamin B12 and calcium level in the present study. CONCLUSIONS: In this study, it was concluded that milk consumption may help in improving the calcium and vitamin B12 status of school children of a tribal state, whereas it does not have any significant effect on vitamin D level.

Growth Charts for Tribal, School-Going Children in Jharkhand Using Anthropometry and Lambda-Mu-Sigma Methods to Create Growth Charts.

BACKGROUND: This study intends to find the growth patterns of selected school children. Globally accepted statistical methods were used to evaluate the data and prepare a growth chart. METHODS: This cross-sectional study was conducted with school-going children from 16 selected schools of a tribal district in Jharkhand using multistage cluster random sampling. In each selected school, 60 students, 30 boys and 30 girls, were chosen randomly, totaling 960 children (full data was for 935 children only). Growth charts were created using Lambda-Mu-Sigma (LMS) chart maker version 2.5 for height, weight and body mass index (BMI). In the charts, the LMS values with Z scores for each age and respective height and weight for boys and girls were recorded. RESULTS: The 468 boys and 467 girls were in the range of 6-14 years of age. Percentile values obtained for the measured heights in centimetres were evaluated and compared with Indian Academy of Pediatrics reference charts for boys and girls for the same age group, and our values were found to be on the lower side. We were able to plot a growth chart of the data set; as the tribal children's ethnicity is different, this growth chart might be used to assess nutritional status. CONCLUSION: We concluded that growth curves for height, weight, and BMI may be used for evaluating children of age 6-14 years in the tribal population. The measures can be a good indicator of their nourishment status and overall growth patterns, which might be indigenous to their ethnicity. A larger sample size of similar tribal populations may give a clearer picture.

Socio-demographic differentials of cognitive development and nutrition among school children: evidence from the tribal areas of Jharkhand, India.

BACKGROUND: This study attempts to assess the differentials of cognitive development and nutrition of school children in tribal areas of Jharkhand, India. METHODOLOGY: A cross-sectional study was carried out in 16 schools of Jharkhand amongst 962 children during the period of November to December 2017. Anthropometry, hemoglobin and IQ tests were assessed along-with their socio-demographic characteristics using standard procedures after obtaining their guardian's consent. Various tests of significance were used such as an independent sample t-test and Fisher's exact test along with multinomial logistic regression for determination of predictors for low-normal to borderline IQ among school children. RESULTS: Stunting and thinness were noted in 38% and 35% children, respectively, whereas anemia and low IQ were observed in more than 4/5th of the total children assessed. Anemia was more common in children >12 years of age and IQ was lower in tribal ethnic children (p < 0.05) amongst socio-demographic characteristics. Among the predictors, only tribal ethnicity appeared to be associated with low IQ [odds ratio (OR)-1.85; 95% confidence interval (CI) - 1.25, 2.75]. CONCLUSION: Despite various nutrition-related programs being run in government schools, the malnutrition and hemoglobin status of the children presents a poor picture. Cognitive development of children particularly tribal children is unsatisfactory and needs to be worked upon by government agencies.