Acute respiratory infections (ARIs) are the leading cause of death among children less than 5 years in India. Emergence of newer pathogenic organisms, reemergence of disease previously controlled, wide spread antibiotic resistance, and suboptimal immunization coverage even after many innovative efforts are major factors responsible for high incidence of ARI. Drastic reduction in the burden of ARI by low-cost interventions such as hand washing, breast feeding, availability of rapid and feasible array of diagnostics, and introduction of pentavalent vaccine under National Immunization Schedule which are ongoing are necessary for reduction of ARI.
1 January 2017 in Journal of Family Medicine and Primary Care
Introduction: Major proportion of the elderly with under nutrition is undetected in the community. One of the feasible ways to detect under nutrition among elderly would be screening in the field settings. in this study, we aimed to identify the utility of alternate anthropometric measures such as mid-upper arm circumference (MUAC), calf circumference, and skin fold thickness in identifying under nutrition among elderly. Materials and Methods: A community-based cross-sectional survey was done among elderly in one of the randomly selected subcenters. Anthropometric measures such as weight, arm span, MUAC, and triceps skinfold thickness were measured as per the standard measurement guidelines by a trained medical graduate. The elderly were identified as undernourished if body mass index (BMI) is <18.5 kg/m2. Utility of alternate anthropometric markers against BMI is represented by area under the curve (AUC) value from receiver operating characteristic curve and correlation coefficient (r). Results: Mean MUAC, calf circumference, and triceps skinfold thickness measured among 271 elderly were 25.6 cm ± 3.7 cm, 27.6 cm ± 3.7 cm, and 3.0 mm ± 1.3 mm, respectively. Among all three proxy anthropometric measures, MUAC had the highest AUC value (AUC = 0.88) Triceps skinfold thickness had the least AUC (AUC = 0.61). The correlation of anthropometric measurements such as MUAC, calf circumference, and triceps skinfold thickness with BMI was 0.74, –0.04, and 0.64, respectively. Conclusion: As MUAC and calf circumference are easy to measure and they are highly correlating with BMI, they can be used routinely by peripheral field workers to assess undernutrition in elderly during their regular house visits.
Setting: Four selected antiretroviral therapy (ART) centres of Gujarat State, India, which accounts for 8% of the human immunodeficiency virus (HIV) burden in India. Objectives: 1) To assess the proportion of people living with HIV (PLHIV) whose partners were not tested for HIV; 2) to assess sociodemographic and clinical characteristics of index cases associated with partner testing; and 3) to understand perceived facilitators and barriers to partner testing and make suggestions on how to improve testing from the perspective of the health-care provider. Design: A mixed-method design with a quantitative phase that involved reviewing the programme records of married PLHIV enrolled during 2011–2015, followed by a qualitative phase of key informant interviews. Results: Of 3884 married PLHIV, 1279 (33%) did not have their partners tested for HIV. Factors including index cases being male, illiterate, aged >25 years, belonging to key populations, substance use and being in advanced clinical stages were more likely to be associated with partner non-testing. Non-disclosure of HIV status (due to fear of marital discord) and lack of awareness and risk perception were the key barriers to testing. Conclusion: One third of PLHIV did not have their partners tested for HIV. Several factors were identified as being associated with the non-testing of partners, and solutions were explored that need to be implemented urgently if we are to achieve the 90–90–90 targets and end HIV.
1 January 2020 in International Journal of Preventive Medicine
Background: Prehypertension increases the likelihood of hypertension, cardiovascular diseases, and renal failure, and it is amenable to control if it is detected early. The burden of prehypertension prevalent in the community is not much explored. This study aimed to estimate the prevalence and to identify the socio-behavioral and dietary factors related to prehypertension in South India. Methods: A community-based cross-sectional study was carried out where data related to socio-demographic status, substance use, dietary patterns, physical activity, and associated comorbidities were assessed using the WHO STEPwise survey tool. Adults aged >=18 years who were not previously diagnosed and treated for hypertension were assessed for prehypertension. Prevalence of prehypertension is reported as percentage with 95% CI. Association was reported as adjusted prevalence ratio obtained through multivariable log binomial regression adjusted for potential confounders. Results: Among 2399 participants, 2213 underwent screening. Among 2213 adults, 810 (36.6%, 95% CI: 34.6–38.6%) were in the prehypertension range. The adjusted prevalence for prehypertension was 36.2% among males and 37.2% among females, respectively. Being in the age group of 45–54 years aPR-1.36, body mass index (BMI) >23 Kg/m2 aPR-1.25, consumption of more than 6 grams of salt per day aPR-1.15 times were more likely to be associated with prehypertension. The comorbid conditions such as diabetes are less likely to be associated with prehypertension aPR-0.54 (0.41–0.72). Conclusions: This community-based surveillance showed 36% of prehypertension among adults which would have been missed if we were to follow the routine cares such as opportunistic and high-risk-based screening. Since prehypertension increases the risk for various end organ failures, there is an impending need to focus on screening and promote healthy lifestyles.
28 May 2023 in Tropical Medicine & International Health
RRH: Rural and Remote Health. Published article number: 5261 - Status of coverage of MR vaccination, after supplementary immunization activities in a rural area of South India: a rapid immunization coverage survey