Community Based Assessment of Unintentional Injuries in a Community Development Block of Purba Bardhaman District, West.

BACKGROUND: Injuries are a focus of public health practice because they pose a serious health threat and are preventable. Currently, injury accounts for 14% of all Disability Adjusted Life Years (DALYs) losses for the world's entire population. In India, unintentional injuries within the home environment have not so far been recognized to the same extent as traffic and work-related injuries among all age groups. With this background, a community based epidemiological study was conducted with the aim to find out the prevalence and epidemiology of unintentional injuries. METHODS: A cross-sectional study was conducted during July 2018 - June 2019 in Bhatar block of Purba Bardhaman District. Cluster random sampling was applied to select required sample of 555 individuals from 24 villages. The study tools used were a predesigned and pretested schedule developed by the researchers with the help of Guidelines for conducting community surveys on injuries by World Health Organization (WHO) and a checklist for assessing household level injury hazard. The study had approval from Institutional Ethics Committee. Chi square test and multivariable logistic regression were performed using SPSS V16. RESULTS: Prevalence of unintentional injury was 8.8 % in the preceding three months. Multivariable logistic regression revealed that those who were below 18 years of age, severely vulnerable to unintentional injuries and belonged to nuclear families had significantly higher odds of developing unintentional injuries at home. CONCLUSION: Unintentional injury is prevalent in West Bengal. Dissemination of injury prevention information with special focus on household modification is an effective strategy to prevent unintentional injuries.

Descriptive Epidemiology of Unintentional Childhood Injuries in India: An ICMR Taskforce Multisite Study.

BACKGROUND: Children 0-14 years constitute about 31.4% of Indian population, among whom the magnitude and risk factors of childhood injuries have not been adequately studied. OBJECTIVE: To study the prevalence of and assess the factors associated with unintentional injuries among children aged 6 month - 18 years in various regions. METHODOLOGY: This multi-centric, cross-sectional, community-based study was conducted at 11 sites across India. States included were Gujarat, Karnataka, Madhya Pradesh, Punjab, Sikkim, Tamil Nadu, Uttarakhand, and West Bengal between March, 2018 and September, 2020. A total of 2341 urban and rural households from each site were selected based on probability proportionate to size. The World Health Organization (WHO) child injury questionnaire adapted to the Indian settings was used after validation. Information on injuries was collected for previous 12 months. Definitions for types (road traffic accidents, falls, burns, poisoning, drowning, animal-related injuries) and severity of injuries was adapted from the WHO study. Information was elicited from parents/primary caregivers. Data were collected electronically, and handled with a management information system. RESULTS: In the 25751 households studied, there were 31020 children aged 6 months-18 years. A total of 1452 children (66.1% males) had 1535 unintentional injuries (excluding minor injuries) had occurred in the preceding one year. The overall prevalence of unintentional injuries excluding minor injuries was 4.7% (95% CI: 4.4-4.9). The commonest type of injury was fall-related (842, 54.8%) and the least common was drowning (3, 0.2%). Injuries in the home environment accounted for more than 50% of cases. CONCLUSIONS: The findings of the study provide inputs for developing a comprehensive child injury prevention policy in the country. Child safe school with age-appropriate measures, a safe home environment, and road safety measures for children should be a three-pronged approach in minimizing the number and the severity of child injuries both in urban and rural areas.

Sleep Quality and its various correlates: A community-based study among geriatric population in a community development block of Purba Bardhaman district, West Bengal.

BACKGROUND: In the elderly population, sleep problems are prevalent and have known to be associated with many factors. There are many adverse consequences of decreased sleep such as heart disease, diabetes, depression, accidents, impaired cognition, and poor quality of life. Correlates of poor sleep quality have not been well explored in Indian research. OBJECTIVES: The present study aimed to measure prevalence of poor sleep quality among elderly and its association with different factors. METHODS: A cross-sectional study was conducted during June-November 2018 in a randomly selected block of Purba Bardhaman district. Cluster random sampling was applied to select required sample of 180 elderly people (≥60 years) from 30 villages. Study tools used were Pittsburgh Sleep Quality Index (PSQI), 5-Item Geriatric Depression Scale (GDS), Generalized Anxiety Disorder 7-item scale (GAD-7), Global Physical Activity Questionnaire (GPAQ), and a pretested schedule for sociodemographic and other variables. The study had approval from Institutional Ethics Committee. Chi-square tests and multivariable logistic regression were performed using SPSS V16. RESULTS: Prevalence of poor sleep quality (GPSQI ≥5) was 68.89%. Median Global PSQI (GPSQI) score was 7.00 (4.00-11.00). Multivariable logistic regression revealed that marital status, vital events in past one month, anxiety status, and depression were significantly associated with sleep quality. Those who were unmarried/widowed, having vital events in past one month in the family, and severe anxiety and depression were having significantly higher odds of developing poor sleep quality. CONCLUSION: Poor sleep quality is high among elderly and measures toward the significant correlates are thus emphasized.

Health-related quality of life of hemophilics and its possible correlates: A perspective in health promotion and disability prevention.

BACKGROUND: Clinical evaluations are not sufficient to adequately characterize the morbidity associated with hemophilia. Quality of life (QoL) of hemophilics and associated factors is not well explored in Indian research. The present study aimed to measure the QoL in hemophilics and its association with socio-demographic characteristics and other characteristics. MATERIALS AND METHODS: A cross-sectional study was conducted during June-November 2018. Two hundred and one hemophilics (age ≥ 4 years) were interviewed with a pre-tested schedule for sociodemographic and other relevant variables. QoL was measured by Haemo-QoL questionnaire for different pediatric age groups and Haem-A-QoL questionnaire for adults and assigned health-related QoL scores. Score achieved in each dimension as well as total scores were transformed on scales ranging from 0 to 100, high values indicate high impairment of QoL. Hemophilic arthropathy was assessed using the World Federation of Hemophilia Joint Scores. One-way ANOVA, independent t-test, Kruskal-Wallis test, and Spearman correlation analyses were performed using SPSS version 16. RESULTS: Mean Haemo-QoL scores for 4-7 years, 8-12 years, 13-16 years, and >16 years were 43.92 ± 8.09, 37.37 ± 8.62, 32.79 ± 6.66, and 45.92 ± 6.30, respectively. Significant difference was noted for QoL scores across different age groups, grades of severity, educational, occupational categories, socioeconomic status classes, marital status, and presence or absence of target joint. Total QoL scores, as well as scores in some of the dimensions, showed a significant positive correlation with the World Federation of Hemophilia joint scores by Spearman correlation analysis. CONCLUSIONS: Improvement of the joint health status by regular physiotherapy is needed to improve the QoL of hemophilics.

Adherence to highly active antiretroviral therapy in a tertiary care hospital in West Bengal, India.

INTRODUCTION: The introduction of highly active antiretroviral therapy (HAART) for the treatment of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) has led to the reduction of mortality and the improvement of the quality of life of people living with HIV/AIDS (PLWHA). The present study was conducted to determine the pattern of adherence to HAART among PLWHA, and to assess the factor(s) affecting nonadherence, if any. METHODS: This study was a hospital-based analytical, cross-sectional epidemiological study conducted between July and October 2011. A total of 370 adult HIV-positive patients registered in the Antiretroviral Therapy Centre of Burdwan Medical College and Hospital, West Bengal, India, were included. Nonadherence was defined as missing at least a single dose of medicine within the last four days. Data was analysed using the Statistical Package for the Social Sciences version 19.0 (IBM Corp, Armonk, NY, USA). RESULTS: A total of 87.6% of patients were found to be adherent to HAART. Principal causes of nonadherence were forgetting to take medicine (70.2%), being away from home (65.2%), and busyness with other things (64.7%). Multivariate logistic regression analysis revealed that nonadherence was significantly associated with a positive family history of HIV/AIDS (odds ratio [OR] 16; 95% confidence interval [CI] 2.2-114.3; p = 0.01), occurrence of side effects with HAART (OR 9.81; 95% CI 1.9-51.7; p = 0.01) and employment (OR 5.93; 95% CI 1.5-23.2; p = 0.01). CONCLUSION: Although overall adherence was high, the factors that affect nonadherence can be addressed with proper counselling and motivation of patients and their family members. Adherence to HAART could delay the progression of this lethal disease and minimise the risk of developing drug resistance.

Nursing personnel planning for rural hospitals in Burdwan District, West Bengal, India, using workload indicators of staffing needs.

Lack of appropriate human resources planning is an important factor in the inefficient use of the public health facilities. Workforce projections can be improved by using objective methods of staffing needs based on the workload and actual work undertaken by workers, a guideline developed by Peter J. Shipp in collaboration with WHO-Workload Indicators of Staffing Need (WISN). A cross-sectional study was carried out to estimate the nursing stuff requirement for the rural hospitals and provide a quantitative description of imbalances, if there is any, in the allocation at the district level during 2011. The average WISN turns out to be 0.35 for entire district, which means only 35% of the required nurses is available or 65% understaffed. So, there is an urgent need for more allocations and deployment of staff so that workload can be tackled and evenly distributed among all nursing personnel.

Coverage and awareness of and compliance with mass drug administration for elimination of lymphatic filariasis in Burdwan District, West Bengal, India.

India adopted WHO's strategy of repeated rounds of mass drug administration (MDA) with diethylcarbamazine to eliminate lymphatic filariasis. The present study attempted to assess the coverage and awareness of and compliance with MDA for elimination of lymphatic filariasis in Burdwan district of India, following MDA round in July 2010. A cross-sectional study was conducted among the four randomly-selected clusters in the district of Burdwan, West Bengal, India, covering 603 individuals from 154 households, using a predesigned pretested schedule. The drug distribution coverage, compliance, and effective coverage were 48.76%, 70.07%, and 34.16% respectively. Only 41.4% of the study population was aware of the MDA activity. This evaluation study noted that MDA is restricted to tablet distribution only. There is an urgent need to improve compliance with drug intake through strengthening of the awareness programme involving both government health workers and community volunteers.

Seropositivity of toxoplasmosis in antenatal women with bad obstetric history in a tertiary-care hospital of Andhra Pradesh, India.

Toxoplasmosis is a well-documented cause of bad obstetric history (BOH) and a major reason of congenitally-acquired infection. The study was conducted to determine the seropositivity of toxoplasmosis in women with BOH, attending the antenatal clinic of the Mamata General Hospital, Khammam, Andhra Pradesh, India. The study subjects included 105 antenatal women with BOH and 105 antenatal women who had previous normal deliveries. A serological evaluation was carried out to determine the presence of Toxoplasma gondii-specific IgG and IgM antibodies, using commercial diagnostic kits, by the enzyme-linked immunosorbent assay method. The seropositivity for Toxoplasma was 49.52% in the study group compared to 12.38% in the control group. The difference in seropositivity was significant (p=0.00). The seroprevalence gradually increased with advancing age. Abortion (51.92%) was the commonest form of pregnancy wastage, followed by stillbirths (36.53%) and premature deliveries (7.69%). The seropositivity of toxoplasmosis was significantly higher in the study group than that in the control group, and the seropositivity played an important role in determining the foetal outcome. Considering the subclinical pattern of infection, routine serological test is recommended for all pregnant women for both IgG and IgM antibodies.

Burden of hospitalized pediatric morbidity and utilization of beds in a tertiary care hospital of kolkata, India.

BACKGROUND: Childhood morbidity consumes a substantial portion of health care resources in terms of hospital bed utilization, and overload in hospital ward remains a major concern in many countries, including India. A possible way to minimize the problem of scarcities of bed is to analyze the pattern of bed utilization by causes and plan services accordingly. OBJECTIVES: To determine the burden of pediatric morbidity and utilization pattern of pediatric beds in a tertiary care hospital. MATERIALS AND METHODS: A retrospective analysis of pediatric inpatient's records was conducted over a period of 1 year from 1 January 2007 to 31 December 2007. RESULTS: Of 3983 total admitted cases, about one-third were infants, of which neonatal and post-neonatal age group constituted 45% and 55% of the cases, respectively. In terms of bed-day utilization, infants, 1-4 years and 5-11 years age group accounted for 35.10%, 32.58% and 32.32% of total days of admission, respectively. Utilization of pediatric beds by major causes of morbidity was respiratory tract infection (22.23%), convulsive disorder (12.68%), accident and poisoning (6.07%), diarrheal disease (4.97%) and chronic hemolytic anemia (4.42%). CONCLUSION: A minor change in admission policy through provision of day care unit for management of certain cases would allow efficient use of hospital beds.

Screening for thalassemia and other hemoglobinopathies in a tertiary care hospital of West Bengal: implications for population screening.

Hemoglobinopathies are common genetic disorders of hemoglobin, which can be prevented by population screening and offering genetic counseling. In absence of population-based screening for hemoglobinopathies, the hospital-based diagnosis register provide idea about the extent of problem in the community. The present study was undertaken to find out the burden of hemoglobinopathies and spectrum of this disorders among the population who were screened in the hospital-based screening program. A record-basedanalysis of subjects who underwent screening for hemoglobinopathies in Burdwan Medical College and Hospital over a period of 3 years and 4 months revealed that overall 29.3% of subjects were positive for hemoglobinopathies. Beta thalassemia heterozygous was the most commonhemoglobinopathy in this region closely followed by hemoglobin E heterozygous. In view of high prevalence of hemoglobinopathies in this region, a routine premarital screening program is needed for identification and prevention of high-risk marriages.

Awareness and perception of mothers about functioning and different services of ICDS in two districts of West Bengal.

Integrated Child Development Services, a national programme of the Government of India has health, nutrition, and pre-school education components of services. To ascertain awareness, perception of mothers about functioning and different services of ICDS a cross-sectional community based study was conducted between June to September 2007 in Howrah and Purulia districts of West Bengal. A total of 1235 mothers were included as study subjects. As per opinion of the mothers 73% AWCs opened regularly, behaviour of the AWWs was friendly (71.6%) and 63% mothers opined that ICDS is beneficial to their children. 84.2% mothers were aware of any ICDS services. Quantity and quality of supplementary food was acceptable to 88% and 72.7% mothers respectively. 79.2% and 87.5% mothers did not receive any advice on child feeding and growth chart. Making beneficiaries aware about services by targeted interventions will ensure better utilization of ICDS.

Assessment of iodine deficiency disorders in Purulia district, West Bengal, India.

Iodine deficiency disorders IDD are major public health problems in India, including West Bengal. Existing programme to control IDD needs to be continuously monitored through recommended methods and indicators. The objective of this study was to assess the prevalence of goitre, status of urinary iodine excretion UIE level and to estimate iodine content of salts at the household level in Purulia district, West Bengal. A school-based, cross-sectional study was conducted during June-September 2005; among 2,400 school children, aged 8-10 years. The "30 cluster" sampling methodology and indicators for assessment of IDD, as recommended by the joint WHO/UNICEF/ICCIDD consultation, were utilized for the study. Goitre was assessed by standard palpation technique, urinary iodine excretion was analyzed by wet digestion method and salt samples were tested by spot iodine testing kit. The total goitre rate TGR was 25.9% (95% Cl=24.1-27.1%) with grade I and grade II (visible goitre) being 19.5% and 6.4% respectively. Goitre prevalence did not differ by sex but significant difference was observed in respect of age. Median urinary iodine excretion level was 9.25 microg/dl and 31.6% children had value less than 5 microg/dl. Only 33.4% of the salt samples tested had adequate iodine content of > or = 15 ppm, High goitre prevalence (25.9%) and median urinary iodine (9.25 microg/dl) below normal range indicate existence of current iodine deficiency in Purulia district. The district is still in the iodine-deficient state. Moreover, salt iodisation level far below the recommended goal highlights IDD as major public health problems in the district. Intensified information, education and communication activities along with sustained monitoring are urgently required.

Availability and use of emergency obstetric care services in four districts of West Bengal, India.

Process indicators have been recommended for monitoring the availability and use of emergency obstetric care (EmOC) services. A health facility-based study was carried out in 2002 in four districts of West Bengal, India, to analyze these process indicators. Relevant records and registers for 2001 of all studied facilities in the districts were reviewed to collect data using a pre-designed schedule. The numbers of basic and comprehensive EmOC facilities were inadequate in all the four districts compared to the minimum acceptable level. Overall, 26.2% of estimated annual births took place in the EmOC facilities (ranged from 16.2% to 45.8% in 4 districts) against the required minimum of 15%. The rate of caesarean section calculated for all expected births in the population varied from 3.5% to 4.4% in the four districts with an overall rate of 4%, which is less than the minimum target of 5%. Only 29.9% of the estimated number of complications (which is 15% of all births) was managed in the EmOC facilities. The combined case-fatality rate in the basic/comprehensive EmOC facilities was 1.7%. Major obstetric complications contributed to 85.7% of maternal deaths, and pre-eclampsia/eclampsia was the most common cause. It can be concluded that all the process indicators, except proportion of deliveries in the EmOC facilities, were below the acceptable level. Certain priority measures, such as making facilities fully functional, effective referral and monitoring system, skill-based training, etc., are to be emphasized to improve the situation.

Soil nitrogen balance assessment and its application for sustainable agriculture and environment.

Soil nitrogen balance assessment (SNBA) serves as an effective tool for estimating the magnitude of nitrogen loss/gain of the agro-eco systems and to appraise their sustainability. SNBA brings forth awareness of soil fertility problems, besides providing information relating to the resultant release of nitrogen into the environment consequent to agricultural practices. Quantitative information relating to nitrogen escape into the environment through such exercises can be gainfully utilized for identification of causative factors, enhancing fertilizer use efficiency and formulating programmes aimed at plugging N leakages. An overview of nitrogen balance approaches and methodologies is presented. A deeper understanding and insight into the agro-eco systems provided by the SNBA exercises can lay the basis for the formulation of effective agronomic interventions and policies aimed at promoting sustainable agriculture and a benign environment.

Soil nitrogen balance assessment and its application for sustainable agriculture and environment.

Soil nitrogen balance assessment (SNBA) serves as an effective tool for estimating the magnitude of nitrogen loss/gain of the agro-eco systems and to appraise their sustainability. SNBA brings forth awareness of soil fertility problems, besides providing information relating to the resultant release of nitrogen into the environment consequent to agricultural practices. Quantitative information relating to nitrogen escape into the environment through such exercises can be gainfully utilized for identification of causative factors, enhancing fertilizer use efficiency and formulating programmes aimed at plugging N leakages. An overview of nitrogen balance approaches and methodologies is presented. A deeper understanding and insight into the agro-eco systems provided by the SNBA exercises can lay the basis for the formulation of effective agronomic interventions and policies aimed at promoting sustainable agriculture and a benign environment.