Assessment of Isoniazid Preventive Therapy and Incidence of Tuberculosis among People Living with Human Immunodeficiency Virus Seeking Care in an Anti-retroviral Therapy Center, Puducherry.

BACKGROUND: One in three deaths among people living with human immunodeficiency virus (PLHIV) is due to Tuberculosis. Isoniazid preventive therapy (IPT) was implemented in antiretroviral therapy (ART) center Puducherry in July 2017. OBJECTIVES: We have determined the proportion of PLHIV who were eligible, initiated, completed IPT and also the incidence of tuberculosis before and after implementation of IPT. MATERIALS AND METHODS: It was a facility based longitudinal descriptive study. All PLHIV, aged 10 years and above, seeking care in ART Centers was included. The number of PLHIV eligible, initiated and completed IPT was summarized as proportion with 95% CI. RESULTS: Among the registered PLHIV (999), the proportion of PLHIV those were found eligible for IPT was 93% [95% CI (91.24%-94.67%)] and initiated on IPT was 92% [95% CI (90.20%-93.95%)]. Completion rate of IPT was 96.3% [95% CI (94.59%-97.63%)]. CONCLUSION: Initiation of IPT was relatively less among newly registered PLHIV as compared to older cohort of PLHIV.

Implementation Status of Airborne Infection Control Measures in Primary and Secondary Public Health Facilities, Puducherry: A Mixed-Methods Study.

Background: Poor ventilation in healthcare settings is a concern for airborne infections, particularly in light of the potential for coronavirus disease 2019 (COVID-19) transmission. This study aimed to assess the implementation status of airborne infection control (AIC) measures in primary and secondary public healthcare facilities (HCFs) and to explore the facilitating factors and barriers in the implementation of AIC measures. Methods: A mixed-methods approach was adopted, which includes a cross-sectional descriptive study using a checklist to collect data on the implementation of AIC measures in 22 primary and two secondary public HCFs in Puducherry, South India, between October 2020 and February 2021. Further, key informant interviews (KIIs) were conducted among medical officers (MOs). The qualitative data were manually analyzed, and transcripts created from handwritten notes and audio recordings were deductively evaluated. Results: Of the twenty-four health facilities visited, 54.2% had infection control (IC) committees. Annual IC training was held for housekeeping staff, MOs, nurses, and laboratory technicians in 23 (95.8%), 21 (87.5%), 20 (83.4%), and 14 (58.4%) facilities, respectively. Respiratory symptomatic patients were counseled on cough etiquettes in 22 (91.6%) facilities. Adequate cross-ventilation was present in outpatient departments in 16 (66.6%) institutions. N95 masks and face shields were provided in 21 (87.5%) facilities. Training through the KAYAKALP program and the presence of a separate sputum collection area were facilitators of IC, while lack of patient adherence and delays in fund release were found as barriers. Conclusion: Overall, the AIC measures were well-implemented, but improvements are needed in infrastructure development for patient segregation in outpatient departments and dedicated AIC training for all healthcare personnel.

Status of Substance use among Undergraduate Medical Students in a Selected Government Medical College in Puducherry - An Explanatory Mixed Method Study.

Background: Studies have shown increase in health-risking behavior and a decline in health-promoting behavior among medical students during their stay in medical school. This study aims to determine the prevalence and reason for substance abuse among the undergraduate medical students in a selected medical college in Puducherry. Material and Methods: This was a facility-based explanatory mixed method study conducted from May 2019 to July 2019. Assessment of their substance abuse was done using ASSIST questionnaire. Substance use was summarized as proportions with 95% CI. Results: A total of 379 participants were included in the study. The mean age of the study participants was 20 years (± 1.34). The most prevalent substance use was alcohol (10.8%). About 1.9% and 1.6% of students surveyed consume tobacco and cannabis, respectively. Conclusion: Facilitating factors for substance use as perceived by the participants were stress, peer pressure, easy availability of substances, socialization, curiosity, and awareness knowledge about safe limits of alcohol and tobacco.

Effects of web-based training for carers in old age homes using WHO-iSupport for dementia, as a training tool - A mixed-method study.

WHO recognized Dementia as public health priority and developed iSupport, a knowledge and skills training program for carers of people living with Dementia. This Mixed-Method study assessed the effectiveness of web-based training sessions among carers at old age homes in and around Puducherry, India, using WHO-iSupport for dementia hardcopy manual as a training tool. We registered the clinical trial protocol with Clinical Trial Registry-India (CTRI), CTRI/2020/11/029154. We determined the change in 35 carer's knowledge and attitude following the training sessions using pre and post-test questionnaires quantitatively. Further, we explored their learning experience by conducting eight descriptive one-to-one telephonic interviews. Due to the COVID-19 pandemic, we conducted this study online. i.e., obtained virtual consents, pre and post-test using Google forms, and training sessions through a webbased platform. We divided carers into groups where each carer attended two training sessions, and each session lasted for 2 h. Training sessions improved the carer's knowledge from a pre-test score of Median (IQR) 12 (9, 15) to a post-test score of 17 (16, 20) and attitude score from 30 (27.3, 34.8) to 33.5 (30.3, 39) in post-test. They perceived that the training sessions were helpful as they gained knowledge on dementia care, and their attitude has changed optimistically towards people living with Dementia. These findings suggest that web-based training has an effect and indicates the need for training among carers in various old age homes for betterment in providing care.

Prevalence of Oral Lesions and Its Associated Risk Factors Among PLHIV Availing Anti-Retroviral Therapy from a Selected Tertiary Care Hospital, Puducherry - A Cross Sectional Analytical Study.

Background and Objectives: Oral lesions are among the earliest and most important indicators of infection with human immunodeficiency virus (HIV). The presence of oral lesions has a significant impact on the physical and mental health of the PLHIV. Hence, a novel attempt is made to assess the prevalence of various types of oral lesions among the adult people living with human immunodeficiency virus (PLHIV) undergoing antiretroviral therapy. Methodology: In this facility-based cross-sectional study, a total of 239 out of 300 eligible PLHIV were assessed between September and October 2018. All consecutive eligible patients encountered during the data collection period were included. Oral examination was carried out using disposable mouth mirrors, sterile piece of cotton, and bright illuminated torch. Results: The prevalence of oral mucosal abnormalities was found to be 25% (95% confidence interval: 20.03-30.97). The most prevalent oral lesions were acute necrotizing ulcerative gingivitis, acute necrotizing ulcerative periodontitis, and candidiasis. CD4 count <200 cells/mm3, current tobacco use, and alcohol usage were significantly associated with the prevalence of oral lesions. Conclusion and Recommendations: The study revealed that one-fourth of the study participants had oral lesions. Strategies for early detection and prompt treatment of oral lesions need to be planned and incorporated in the program to reduce the morbidity due to oral lesions.

Epidemio-toxicological profile and reasons for fatal suicidal poisoning: A record-based study in South India.

Introduction: Poisoning is the second frequent cause of suicide in India. To plan an effective intervention and awareness program, it is essential to know the sociodemographic profile, pattern, and reasons for suicide. Objective: We conducted this study to find the sociodemographic profile, pattern, and reasons for fatal suicidal poisoning. Methods: We conducted a record-based study in a tertiary hospital in Puducherry. We reviewed autopsies conducted between January 2010 and December 2014 for fatal suicidal poisoning. We extracted data using a data collection sheet for age, gender, marital status, occupation, residence, the reason for suicide, time of injury, time of death. We entered data in Microsoft Excel, and we did a descriptive analysis by using R software version. Results: We reviewed 3996 medicolegal autopsies, out of which 595 cases were of fatal suicidal poisoning. The mean age of the cases was 35.8 years (SD-14.6). The majority of the cases were married (74.8%) for 20-30 years (31.8%). Most of the victims were agriculture workers (22.2%), lived in a rural setting (84.4%), died during the daytime (61.2%), and in the summer season (54.5%). The most common poison used was organophosphates (48.7%), and the most common reason was family problems (30.2%). The median survival time (h) for the cases (n = 564) was 45.8 h (IQR: 16.4 to 110.6). Conclusion: We found fatal suicidal poisoning was common among males, young adults, married, agriculture workers/laborers, and in a rural setting. The findings help plan an effective intervention for suicide prevention in India.

Contribution of community health care volunteers in facilitating mobilization for diabetes and hypertension screening among the general population residing in urban puducherry - An operational research study.

Introduction: Non-communicable diseases (NCDs) have contributed to almost half of the global disease burden. Many countries have experimented with Community Health Volunteers (CHVs) to provide necessary care for NCDs. We aimed at evaluating the contribution of CHVs in mobilizing adults for the Diabetes and Hypertension screening in a selected Primary Health Centre (PHC) of Puducherry, India. Methodology: A community-based operational research study was conducted, where five volunteers from each of the 13 anganwadis functioning under the PHC were chosen as study participants. They were interviewed before enrolment for willingness. Four batches of sensitization and training sessions were conducted to provide the necessary training. CHVs were then given 3 months to mobilize the individuals for NCD screening. This model was evaluated using the Theoretical underpinning technique. Results: Of the total 85 CHVs suggested, around 65 (76.5%) showed willingness for rendering services. Approximately 32 (49.2%) discontinued during the initial weeks of the intervention due to various reasons. The remaining CHVs could reach 363/1470 (24.7%), eligible individuals, among them, 303 (83.5) were convinced to visit the health centre for screening. From the total members who were screened, approximately 52 (17%) and 31 (10%) were diagnosed to have diabetes and hypertension respectively and were initiated on treatment as per national guidelines. Conclusion: About half of the CHVs who volunteered, remained till the end and effectively contributed to a screening of NCDs. The involved volunteers aided in improvising the NCD coverage under the PHC.

Prevalence of malnutrition and its associated sociodemographic and clinical factors among adolescents in selected schools of Urban Puducherry, India.

BACKGROUND: In India, adolescents constitute 21% of the total population. Majority of boys and girls in developing countries enter adolescence as undernourished, making them more vulnerable to several diseases. OBJECTIVE: Among adolescents in selected schools of urban Puducherry, we determined the prevalence of malnutrition and also assessed the sociodemographic and clinical factors associated with undernutrition. MATERIALS AND METHODS: A cross-sectional analytical study was conducted among adolescents (10-18 years) in selected public schools of Urban Puducherry. Data were collected using semi-structured and pre-tested questionnaires. The data collection period was between September and October 2019. Malnutrition was assessed by the World Health Organisation recommended Height-for-age and body mass index-for-age cut-offs using AnthroPlus software. RESULTS: A total of 144 (28.9%) boys and 355 (71.1%) girls were included in the study (N = 499). The prevalence of malnutrition was 46.8% (95% confidence interval [CI]: 42.5-51.3). The prevalence of undernutrition was 33.3% (Stunting [21.6%] and Thinness [15%]). The prevalence of overweight and obesity were 10.2% and 5.8%, respectively. Male gender was found to be an independent risk factor of undernutrition (annual percentage rate = 1.4; 95% CI: 1.0-1.9); and known risk factors such as socio-economic status, parental education were not significantly associated with undernutrition. CONCLUSIONS: One in every two school-going adolescents was malnourished. Despite the high prevalence of undernourishment, over nourishment was also commonly observed. Educating parents and students about growth monitoring and dietary habits might help in bringing down the burden of malnutrition.

Treatment Seeking Behavior, Treatment Cost and Quality of Life of Head and Neck Cancer Patients: A Cross-Sectional Analytical Study from South India.

BACKGROUND: Head and neck cancer constitute one-third of all cancers. Due to the complex nature of Head and Neck Cancer treatment, expenditure on cancer treatment are higher and the Quality of Life of patients is also compromised. The objectives of the study were to determine the time taken by patients for seeking care from registered medical practitioners, time to definitive diagnosis and treatment initiation, expenditure incurred, and Quality of Life. METHODS: The present study was a cross-sectional descriptive involving outpatient with head and neck cancer reported to the department of radiotherapy, regional cancer center, JIPMER. The quality of life was assessed using validated FACT-Hand N scales. RESULTS: The preferred first contact for seeking care for most was the private sector (52%). The median (IQR) presentation interval, diagnostic interval, and treatment initiation interval were 36.5 (16 - 65.7), 14 (7 - 31.5), and 65.5 (45 - 104) days respectively. The average indirect cost incurred was INR 8424 (4095-16570) in JIPMER, which was spent over an average duration of 240 days. The median (IQR) wage loss by the patients and/or caregivers was INR18000 (5250-61575). The source of expenditure was mainly from their family savings (56%). Functional well-being was severely impaired. The patients with occupation, head of the family, and early stage of cancer had a statistically significant quality of life. CONCLUSION: The majority of the patients were diagnosed in the regional cancer center, JIPMER although their preferred first point of contact was private practitioners. The average time interval from diagnosis to treatment initiation was more than two months. The expenditure during the treatment was mainly because of indirect cost and wage loss. The functional quality of life was severely impaired for the majority of the cases.

Severe undernutrition in children affects tuberculin skin test performance in Southern India.

BACKGROUND: Undernutrition impairs immunity to Mycobacterium tuberculosis and is a risk factor for tuberculosis disease (TB). We aim to investigate if severe undernutrition affects the tuberculin skin test (TST) response among household contacts (HHCs) of pulmonary TB cases. METHODS: We analyzed data from HHCs (> five years) of pulmonary TB cases in Southern India. Undernutrition was defined as per World Health Organization based on body mass index (BMI) for adults (undernutrition 16-18.4 and severe undernutrition <16 kg/m2) and BMI relative to the mean for children (undernutrition 2SD-3SD and severe undernutrition < 3SDs below mean). Univariate and multivariate models of TST positivity (> five mm) were calculated using logistic regression with generalized estimating equations. RESULTS: Among 1189 HHCs, 342 were children (age 5-17 years) and 847 were adults. Prevalence of TST positivity in well-nourished, undernourished and severely undernourished children was 135/251 (53.8%), 32/68 (47.1%), and 7/23 (30.4%) respectively; among adults, prevalence of TST positivity was 304/708 (42.9%), 43/112 (38.4%) and 12/26 (46.2%), respectively. Severe undernutrition in children was associated with decreased odds of TST positivity (adjusted odds ratio 0.3; 95%CI 0.1-0.9). CONCLUSION: Severe undernutrition in children was associated with decreased odds of TST positivity. False-negative TSTs may result from undernutrition; caution is warranted when interpreting negative results in undernourished populations.

Community-based assessment of postnatal care in Puducherry-A cross-sectional study.

INTRODUCTION: Postnatal period is a neglected period compared to the antenatal period. Providing adequate care to infant and mother during this vital period is essential. OBJECTIVES: To assess the postnatal care (PNC) received by the mothers and newborn children in Puducherry. MATERIALS AND METHODS: Community-based cross-sectional study done among the postnatal mothers under the care of two urban Primary Health Centers (PHC A and PHC B) in Puducherry in 2015-2016. Eligible mothers were contacted at their houses within 4 weeks of completion of their postnatal period to assess the postnatal care. RESULTS: Out of 227 postnatal mothers in the study, only 37.4% (85) (95%CI 31.3-43.9) of the mothers had received adequate counselling services on topics of nutrition, hygiene, contraception, essential newborn care, breastfeeding, and immunization. Cord care was given for 99.1% of the babies and breastfeeding position was checked for 88.5% of the babies. Among the mothers who had normal deliveries, 48.1% (76) (95% CI 40.4-55.9) of the mothers had initiated breastfeeding within 1 h of normal delivery and within 4 h of delivery for 72.4% (50) (95% CI 61.1-82.0) among the mothers who had a cesarean section. Only 20.7% (47) (95%CI 15.8-26.3) of the mothers and newborns had received at least one postnatal home visit and none of the mothers had received adequate postnatal home visits as per Indian Public Health Standards guidelines. Out of the 126 eligible mothers for JSY benefits, only 46% (58) (95% CI 37.5-54.8) of them had registered. Among those who were not registered, 20.6% had reported that they were unaware of the scheme. Out of 227 births, 14.1% (32) of them were of low birth weight (<2.5 kg) and 1.3% (3) were of very low birth weight (<1.5 kg) category. CONCLUSION: Although the antenatal care is satisfactory in the study setting, implementation of PNC needed further attention and active guidance via health system strengthening.

Risk factors for death during treatment in pulmonary tuberculosis patients in South India: A cohort study.

OBJECTIVE: Identifying the risk factors for deaths during tuberculosis (TB) treatment is important for achieving the vision of India's National Strategic Plan of 'Zero Deaths' by 2025. We aimed to determine the proportion of deaths during TB treatment and its risk factors among smear positive pulmonary TB patients aged more than 15 years. STUDY DESIGN: We performed a cohort study using data collected for RePORT India Consortium (Regional Prospective Observational Research in Tuberculosis). SETTING: Revised TB Control Program (RNTCP) in three districts of South India. PARTICIPANTS: The cohort consisted of newly diagnosed drug sensitive patients enrolled under the Revised National TB Control Program during 2014-2018 in three districts of southern India. Information on death was collected at homes by trained project staff. PRIMARY OUTCOME MEASURES: We calculated 'all-cause mortality' during TB treatment and expressed this as a proportion with 95% confidence interval (CI). Risk factors for death were assessed by calculating unadjusted and adjusted relative risks with 95% CI. RESULTS: The mean (SD) age was of the 1167 participants was 45 (14.5) years and 79% of them were males. Five participants (0.4%) were HIV infected. Among the males, 560 (61%) were tobacco users and 688 (75%) reported consuming alcohol. There were 47 deaths (4%; 95% CI 3.0-5.3) of which 28 deaths (60%) occurred during first two months of treatment. In a bi-variable analysis, age of more than 60 years (RR 2.27; 95%CI: 1.24-4.15), male gender (RR 3.98; 95% CI: 1.25-12.70), alcohol use in last 12 months (RR 2.03; 95%CI: 1.07-3.87), tobacco use (RR 1.87; 95%CI: 1.05-3.36) and severe anaemia (RR 3.53: 95%CI: 1.34-9.30) were associated with a higher risk of death. In adjusted analysis, participants with severe anaemia (<7gm/dl) had 2.4 times higher risk of death compared to their counterparts. CONCLUSION: Though deaths during TB treatment was not very high, early recognition of risk groups and targeted interventions are required to achieve zero TB deaths.

Prevalence of anaemia and compliance to weekly iron-folic acid supplementation programme amongst adolescents in selected schools of urban Puducherry, India.

CONTEXT: Adolescents constitutes 21% of total Indian population. Iron deficiency anaemia has remained as a major nutritional problem amongst adolescents. To overcome this problem, Government of India started weekly iron-folic acid supplementation (WIFS) in 2012. AIMS: Amongst adolescents in selected schools of urban Puducherry, to determine the prevalence of anaemia, proportion of those compliant to WIFS and to assess the sociodemographic and clinical factors associated with anaemia and compliance to WIFS. SUBJECTS AND METHODS: A cross-sectional analytical study was conducted amongst school-going adolescents (10-18 years) in selected schools of Urban Puducherry. Data were collected using semi-structured, self-administered and pretested questionnaire. Haemoglobin estimation was done using a digital haemoglobinometer. Details regarding intake of iron and albendazole tablets were recorded. The anaemia status was evaluated as per World Health Organization guidelines. RESULTS: The prevalence of anaemia was found to be 62.7% (95% confidence interval [CI]: 58.2-67.0). Proportion having mild, moderate and severe anaemia were 27.3%, 32.5% and 2.8% respectively. The proportion of adolescents compliant to WIFS was 67.7%. Late adolescents were significantly more associated with anaemia (adjusted prevalence ratio [aPR]: 1.7 95% CI: 1.0-3.0) as compared to early adolescents. Males were more compliant to iron-folic acid (IFA) tablets (aPR 1.4 95% CI: 1.0-1.8). CONCLUSIONS: More than half of adolescents were anaemic. This study emphasises on the fact that stricter supervision by teachers will result in better compliance to WIFS program. Strategies to improve WIFS compliance, imparting knowledge regarding IFA intake and involvement of school teachers will help to tackle anaemia amongst adolescents.

Assessing the Status of Mandatory Tuberculosis Case Notification among Private Practitioners in Urban Puducherry.

BACKGROUND: In India, tuberculosis (TB) was made a notifiable disease in 2012 and nonnotification was made a punishable offense in March 2018. In 2018, 25% of TB cases notified were from private sector. OBJECTIVES: The objective of the study is to assess the proportion of private practitioners (PPs) who notified TB cases to the Revised National Tuberculosis Control Programme (RNTCP) and to identify the facilitating factors and barriers to TB case notification, including channels most preferred for notification. METHODOLOGY: This descriptive cross-sectional study was conducted among PPs in urban Puducherry. PPs were included consecutively, and data were collected using a pretested structured questionnaire. RESULTS: Almost 60% (75 of 125) of PPs had dealt with presumptive TB cases in the last 1 year. Only one of 16 PPs who diagnosed and two of four PPs who treated had notified. PPs preferred electronic modes of notification such as e-mail and short messaging service (SMS). Concerns regarding patient confidentiality and delay in collection of notification forms from PPs by RNTCP were the barriers to notification. CONCLUSIONS: Notification for TB diagnosis was poor as PPs preferred to refer cases to RNTCP rather than notifying. Only four PPs had initiated TB treatment, of whom two PPs (50%) had notified.

Alcohol use and tuberculosis clinical presentation at the time of diagnosis in Puducherry and Tamil Nadu, India.

SETTING: Alcohol use increases the risk of tuberculosis (TB) disease and is associated with worse outcomes. OBJECTIVE: To determine whether alcohol use affects TB severity at diagnosis in a high-burden setting. DESIGN: Participants were smear-positive people living with TB (PLWTB) in India. Disease severity was assessed as 1) high versus low smear grade, 2) time to positivity (TTP) on liquid culture, 3) chest radiograph cavitation, and 4) percent lung affected. Alcohol use and being at-risk for alcohol use disorders (AUD) were assessed using the AUDIT-C. Univariable and multivariable analyses were conducted. RESULTS: Of 1166 PLWTB, 691 (59.3%) were drinkers; of those, 518/691 (75.0%) were at-risk for AUD. Drinkers had more lung affected than non-drinkers (adjusted mean difference 10.8%, p<0.0001); this was not significant for those at-risk for AUD (adjusted mean difference 3.7%, p = 0.11). High smear grade (aOR 1.0, 95%CI: 0.7-1.4), cavitation (aOR 0.8, 95%CI 0.4-1.8), and TTP (mean difference 5.2 hours, p = 0.51) did not differ between drinkers and non-drinkers, nor between those at-risk and not at-risk for AUD. CONCLUSIONS: A large proportion of PLWTB were drinkers and were at-risk for AUD. Alcohol drinkers had more lung affected than non-drinkers. Studies are needed to explore mechanisms of this association.

Injury and its associated factors among residents of an urban slum during the festival month in South India: A community-based survey.

INTRODUCTION: Injury morbidity and mortality have been steadily increasing in both developed and developing countries including India. The current study tried to assess the incidence of injury and identify the risk factors associated with injuries during the festival month in a selected urban area in Puducherry. METHODS: It is a community-based cross-sectional survey conducted among the residents in the urban field practice area of a medical college in Puducherry. Participants were interviewed using a pretested questionnaire. Information on the incidence of injury and its associated factors were collected. Data were entered in EpiData and analyzed using Stata. Generalized linear models with Poisson distribution were used to identify the risk factors associated with the injuries. RESULTS: Overall, 1380 participants from two selected clusters were interviewed. The incidence rate of injuries was 5.2% (95% CI: 4.0-6.4). In adjusted analysis male (RR 1.96, 95% CI: 1.15-3.37) and student (RR 2.91, 95% CI: 1.13-7.54) were independently associated with having an injury. Most of the injuries were unintentional and accidental. CONCLUSION: The reported incidence of at least one injury was 52 per 1000 population per month and the majority were accidental in nature. It was higher during the festival week. Public health strategies at the primary healthcare level targeting adult males and school children will be effective in the reduction and prevention of injury.

A community-based cross-sectional study on hypertension screening in Puducherry, India.

Background & objectives: Hypertension is a health problem of global priority. Screening and early diagnosis is important to plan appropriate interventions. The present study objectives were to screen the urban population aged 30 yr and above and diagnose for hypertension and to identify the factors associated with poor screening for hypertension, if any. Methods: A community-based descriptive cross-sectional study was conducted in urban field practice area of a tertiary care hospital in Puducherry, India, among individuals aged 30 yr and above. Individuals were asked if they have tested themselves for hypertension in the past two years. Pretested questionnaire was used for data collection. Data collection was done during regular working time of the health centre. All eligible participants from consecutive households were included till the required sample size of 394 was achieved. Results: Of the 394 individuals interviewed, 252 (64%) had undergone screening for hypertension. The prevalence of self-reported hypertension among those screened was 26.2 per cent with no significant gender-wise differences. Screening for hypertension was better among females (71.6%) as compared to males (55.2%). Population who were at a higher risk of not getting screened for hypertension were relatively younger (30-44 yr) individuals and males. Interpretation & conclusions: The prevalence of self-reported hypertension among those screened was 26.2 per cent [95% confidence interval (21.1-31.9)]. Screening needs to be targeted more towards males and younger population.

High prevalence of anemia among postnatal mothers in Urban Puducherry: A community-based study.

BACKGROUND: Anemia is a common problem across all life stages and ages with a higher burden among women. The postnatal period is an often-neglected period for the provision of effective care to the mothers. Anemia burden is also high during this period, which leads to many morbidities and poor quality of life. METHODS: A community-based cross-sectional study was done in the field practice area of two Urban Primary Health Centres (PHCs) in Puducherry between March 2015 and February 2016. A total of 227 postnatal mothers were selected by simple random sampling from the list of mothers delivered from the field practice area. House visit was done within 4 weeks of completion of their postnatal period. Socio-demographic details and third-trimester hemoglobin levels were collected using a pretested questionnaire. Hemoglobin level during post-partum was measured using Sahli's Hemoglobinometer. Paired t-test is done to assess the difference in hemoglobin antepartum and post-partum. Multiple Logistic Regression is done to identify factors associated with postpartum anemia. RESULTS: The mean (SD) hemoglobin during postpartum was 10.95 (1.1) gm% ranging from 7.4 gm% to 13.8 gm%. The prevalence of anemia among postnatal mothers is 76.2% (n = 173, 95% CI: 70.4%-81.4%). Around 26% (59) had mild anemia, 49.8% (113) had moderate anemia and 0.4% (1) had severe anemia. One-fourth of the mothers who had a normal hemoglobin level in their third trimester had developed anemia in the postnatal period. There was a significant difference in mean hemoglobin during postpartum and that of third trimester (10.95 vs 10.69 gm%, t = 3.4, df 226, P = 0.001). Birth order of two or more is significantly associated with postpartum anemia (aOR 2.2, 95% CI: 1.07-4.39). CONCLUSIONS: The prevalence of anemia among postnatal mothers is high. Routine hemoglobin estimation, advice on consumption of iron-rich foods and Iron and Folic Acid (IFA) supplementation have to be provided to postnatal mothers to improve this situation.