Sociodemographic and environmental factors influencing acute respiratory infections among under-five children of chars (riverine islands) of Tinsukia District, Assam: A community-based cross-sectional study.

Acute respiratory tract infections (ARIs) are a major cause of morbidity and mortality in under-five children worldwide. Assam has around 2500 river islands (locally called Chars/Chaporis) in the Brahmaputra River with socioeconomically deprived inhabitants lacking access to basic health-care facilities. A community-based cross-sectional study was carried out among 380 under-five children living in the Char areas of Tinsukia District to estimate the prevalence of ARI and determine the associated risk factors. The prevalence of ARI among under-five children was found to be 56.32%. Prevalence was significantly higher among children living in Dibru-Saikhowa island, with families having >2 children, belonging to socioeconomic class 5 (modified BG Prasad scale), having a positive history of smoking or ARI in family members, having homes with attached kitchens or using wood for cooking, inadequate ventilation or overcrowding and residences of katcha ghars.

Estimation of tuberculosis incidence at subnational level using three methods to monitor progress towards ending TB in India, 2015-2020.

OBJECTIVES: We verified subnational (state/union territory (UT)/district) claims of achievements in reducing tuberculosis (TB) incidence in 2020 compared with 2015, in India. DESIGN: A community-based survey, analysis of programme data and anti-TB drug sales and utilisation data. SETTING: National TB Elimination Program and private TB treatment settings in 73 districts that had filed a claim to the Central TB Division of India for progress towards TB-free status. PARTICIPANTS: Each district was divided into survey units (SU) and one village/ward was randomly selected from each SU. All household members in the selected village were interviewed. Sputum from participants with a history of anti-TB therapy (ATT), those currently experiencing chest symptoms or on ATT were tested using Xpert/Rif/TrueNat. The survey continued until 30 Mycobacterium tuberculosis cases were identified in a district. OUTCOME MEASURES: We calculated a direct estimate of TB incidence based on incident cases identified in the survey. We calculated an under-reporting factor by matching these cases within the TB notification system. The TB notification adjusted for this factor was the estimate by the indirect method. We also calculated TB incidence from drug sale data in the private sector and drug utilisation data in the public sector. We compared the three estimates of TB incidence in 2020 with TB incidence in 2015. RESULTS: The estimated direct incidence ranged from 19 (Purba Medinipur, West Bengal) to 1457 (Jaintia Hills, Meghalaya) per 100 000 population. Indirect estimates of incidence ranged between 19 (Diu, Dadra and Nagar Haveli) and 788 (Dumka, Jharkhand) per 100 000 population. The incidence using drug sale data ranged from 19 per 100 000 population in Diu, Dadra and Nagar Haveli to 651 per 100 000 population in Centenary, Maharashtra. CONCLUSION: TB incidence in 1 state, 2 UTs and 35 districts had declined by at least 20% since 2015. Two districts in India were declared TB free in 2020.

Sociodemographic and Environmental Factors Influencing Acute Respiratory Infections among Under-five Children of Chars (riverine islands) of Tinsukia District, Assam: A Community-based Cross-Sectional Study

Acute respiratory tract infections (ARIs) are a major cause of morbidity and mortality in under?five children worldwide. Assam has around 2500 river islands (locally called Chars/Chaporis) in the Brahmaputra River with socioeconomically deprived inhabitants lacking access to basic health?care facilities. A community?based cross?sectional study was carried out among 380 under?five children living in the Char areas of Tinsukia District to estimate the prevalence of ARI and determine the associated risk factors. The prevalence of ARI among under?five children was found to be 56.32%. Prevalence was significantly higher among children living in Dibru?Saikhowa island, with families having >2 children, belonging to socioeconomic class 5 (modified BG Prasad scale), having a positive history of smoking or ARI in family members, having homes with attached kitchens or using wood for cooking, inadequate ventilation or overcrowding and residences of katcha ghars.

Morbidity status of low birth weight babies in rural areas of Assam: A prospective longitudinal study.

INTRODUCTION: Low birth weight (LBW) infants suffer more episodes of common childhood diseases and the spells of illness are more prolonged and serious. Longitudinal studies are useful to observe the health and disease pattern of LBW babies over time. AIMS: This study was carried out in rural areas of Assam to assess the morbidity pattern of LBW babies during their first 6 months of life and to compare them with normal birth weight (NBW) counterparts. MATERIALS AND METHODS: Total 30 LBW babies (0-2 months) and equal numbers of NBW babies from three subcenters under Boko Primary Health Centre of Assam were followed up in monthly intervals till 6 months of age in a prospective fashion. RESULTS: More than two thirds of LBW babies (77%) were suffering from moderate or severe under-nutrition during the follow up. Acute respiratory tract infection (ARI) was the predominant morbidity suffered by LBW infants. The other illnesses suffered by the LBW infants during the follow up were diarrhea, skin disorders, fever and ear disorders. LBW infants had more episodes of hospitalization (65%) than the NBW infants (35%). Incidence rate of episodes of morbidity was found to be higher among those LBW infants who remained underweight at 6 months of age (Incidence rate of 49.3 per 100 infant months) and those who were not exclusively breast fed till 6 months of age (Incidence rate of 66.7 per 100 infant months). CONCLUSION: The study revealed that during the follow up, incidence of morbidities were higher among the LBW babies compared to NBW babies. It was also observed that ARI was the predominant morbidity in the LBW infants during first 6 months of age.

Assessment of the nutritional status of the elderly and its correlates.

BACKGROUND: The percentage of elderly is growing rapidly and malnutrition is not uncommon in the elderly. OBJECTIVES: The present study was carried out to assess the nutritional status of the elderly using the Mini Nutritional Assessment (MNA) tool, and to study the various epidemiological factors influencing their nutritional status. MATERIALS AND METHODS: This cross-sectional study was done from July 2012 to August 2013 in Boko-Bongaon Block, Kamrup District, Assam, India. The elderly, those over 60 years of age, who met the inclusion criteria participated in the study. A total of 30 clusters were selected and 12 elderly from each cluster were taken to achieve the desired sample size of 360. Nutritional status was assessed by the MNA tool and a 24-h dietary recall method. RESULTS: Out of the total of 360 elderly persons, 15% were found to be malnourished and 55% were at risk of malnutrition. The association between nutritional status and older age group, female gender, dependent functional status, dependent financial status and inadequate calorie intake was found to be significant. CONCLUSION: The present findings reveal that malnutrition is not an uncommon problem in the elderly, and further studies are needed in this regard.

Assessment of the availability of infrastructure, manpower, materials and knowledge of health care providers regarding child health care services in the sub centers of a block of Dibrugarh district, Assam

Background: The SCs are under constant criticism for their inability to deliver quality services. Every year some 12 million children of developing countries die before they reach their fifth birthday. Around 90% of mortality rate can be prevented by the improvement of health care quality. Methods: Cross-sectional study conducted among health care providers of sub-centers in a randomly selected block of Dibrugarh district of Assam. Results: All SCs had two health worker (female)/ANMs and a multipurpose health worker male (MPW Male). Only 20% SCs adhered to scheduled opening but 100% adhered to scheduled closing time of the health facilities. 100% of SCs were housed in government building. 70% of the SCs had motorable roads. All the SCs had a regular and good supply of BCG, OPV, measles, TT, pentavalent (90% SCs) vaccines. Conclusions: SCs play a crucial role to decrease the morbidity and mortality of under five children in the rural areas. Full-fledged SCs with sufficient manpower, good infrastructure and good knowledge of delivery of child health care among health care providers would definitely improve the level of child health care provided to the community.

Prevalence and factors affecting early initiation of breastfeeding in rural areas of Dibrugarh district, Assam

Background: Early or timely initiation of breastfeeding, specifically within 1 hour of birth has benefits for survival and beyond and it is recommended by the World Health Organization. Breastfeeding initiation after the first hour of birth doubles the risk of neonatal mortality. The present study has been conducted to estimate the prevalence and determine the factors affecting early initiation of breastfeeding in rural areas of Dibrugarh, district, Assam. Methods: Community based cross sectional study from May 2017 to April 2018 among mothers having children in the age group 0 to 23 months in the rural areas of Dibrugarh district. The sample size calculated for the study was 360 children. Results: The results were analyzed for 334 children. Prevalence of early initiation of breastfeeding was found to be 54.8%. On multivariate regression analysis the occupation and education of mothers, number of antenatal checkup visits, type of delivery and religion were found to be independently associated with early initiation of breastfeeding. Conclusions: This study reveals that the early initiation of breast feeding is lower in rural areas of Dibrugarh district. The findings clearly highlight the importance of imparting health education to family members and mothers right from antenatal period on infant and child feeding practices.

Prescribing patterns in primary and secondary level government health facilities in a district of Assam: a cross sectional study

Background: Indian markets are flooded with more than 100,000 formulations, compared to approximately 350 formulations listed in the World Health Organization (WHO) essential drug list. To promote rational drug use in developing countries, assessment of drug use patterns with the WHO drug use indicators is becoming increasingly necessary. This study was conducted to study the prescribing patterns using WHO prescribing indicators in government healthcare facilities in a district of Assam. Methods: This was a cross sectional study carried out from July to September 2017. Out of total 4 blocks in Tinsukia district one (Ketetong) was randomly selected. All the primary and secondary level government health facilities were included and visited one by one. All the prescriptions on that day of visit were digitally photographed at the pharmacy of the health institution after taking written informed consent from the patient. A total of 353 prescriptions were scrutinized and analyzed using appropriate statistical tests. Results: Out of total 353 prescriptions collected, 11 were illegible and excluded from the analysis. The average number of drugs per encounter was 3.8. In 62.3% of encounters antibiotics were prescribed and injections were prescribed in 30.1% encounters. 71.8% drugs were prescribed by generic name and 56.2% drugs were prescribed from the essential drug list (EDL). Conclusions: The average number of drugs, percentage of injections and antibiotics per encounter was higher than recommended whereas prescription by generic name and from EDL or formulary was lower than recommended. Training of healthcare workers on rational drug use is need of the hour.

Health seeking behaviour of elderly in rani block, Kamrup (Rural) district, Assam: a community based cross sectional study.

Background: The current global and demographic structure is shifting towards a higher proportion of elderly. This phenomenon in which older individual come to form a proportionately larger share of total population in the community is known as “Population ageing”. Health seeking behaviour refers to the sequence of remedial actions that individuals undertake to rectify perceived ill health. It is an important determinant of health status of the population and forms an important component in formulating health programmes. The objectives of the study were 1) To assess the health seeking behaviour of elderly residing in Rani block. 2) To study the various factors associated with health seeking behaviour. Methods: Total 390 elderly were included in the study. House to house visit was done and data was collected by interviewer method. Statistical analysis was done using SPSS 17. Results: Out of 390 elderly, 68.5% belonged to the age group of 60-69 years, majority (82.8%) were found to be Hindus, 89% lived in joint family. Most of the elderly were illiterate (69.5%) and majority (48.2%) belonged to Class IV socio economic status. 72% elderly sought treatment for their chronic illness. Majority (51.5%) sought treatment from Government hospital and 98.5% received allopathic treatment. The most common reason cited for not seeking treatment for their chronic illness was financial reasons (63.2%). Conclusions: Education, socio economic status and living status play an important role in health seeking behaviour.