Objectives: To map the alcohol hot spots and understand the Sociodemographic Indices (SDI) affecting alcohol consumption in Indian men and women.Methods: Data from National Family Health Survey-4 carried out from 2015 to 2016 with a sample size of 103,411 men and 699,686 women were used for Geographic Information System mapping, and hot spot identification by spatial statistics (Getis-Ord Gi*). Bivariate analyses and multiple logistic regressions were used to analyze SDI.Results: India has three major alcohol hot spots: (1) North-East (NE) states, (2) Eastern Peninsular states formed by Chhattisgarh, Odisha, Jharkhand, and Telangana, and (3) Southern states of Tamil Nadu and Kerala. Hot spot analysis strongly correlated with region-wise analysis of SDI. Respondents who consumed tobacco have higher odds (men adjusted odds ratio [aOR]: 5.42; women aOR: 4.30) of consuming alcohol. Except for religion and social category, other socioeconomic factors have a low to moderate effect on alcohol consumption.Conclusions: Hot spots and high-risk districts of alcohol consumption identified in this study can guide public health policies for targeted intervention. Alcohol use is at the discretion of individual states and union territories, and stringent anti-alcohol policies strictly enforced across India are the keys to control alcohol use.
Worldwide and in India, malaria elimination efforts are being ramped up to eradicate the disease by 2030. Malaria elimination efforts in North-East (NE) India will have a great bearing on the overall efforts to eradicate malaria in the rest of India. The first cases of chloroquine and sulfadoxine-pyrimethamine resistance were reported in NE India, and the source of these drug resistant parasites are most likely from South East Asia (SEA). NE India is the only land route through which the parasites from SEA can enter the Indian mainland. India’s malaria drug policy had to be constantly updated due to the emergence of drug resistant parasites in NE India. Malaria is highly endemic in many parts of NE India, and Plasmodium falciparum is responsible for the majority of the cases. Highly efficient primary vectors and emerging secondary vectors complicate malaria elimination efforts in NE India. Many of the high transmission zones in NE India are tribal belts, and are difficult to access. The review details the malaria epidemiology in seven NE Indian states from 2008 to 2018. In addition, the origin and evolution of resistance to major anti-malarials are discussed. Furthermore, the bionomics of primary vectors and emergence of secondary malaria vectors, and possible strategies to prevent and control malaria in NE are outlined.
Background: Even though malaria cases have drastically come down in the last decade, malaria remains a serious public health concern in many parts of India. National Framework for Malaria Elimination in India (2016–2030) has been launched with the goal to eliminate malaria by 2030. Understanding the socio-economic and household determinants of malaria at the national level will greatly aid India’s malaria elimination efforts. Methods: The data from Longitudinal Ageing Survey of India (LASI) Wave 1 (2017–2018) survey comprising 70,671 respondents ≥ 45 years across all the States and Union Territories were used for the analysis. Simple and multiple logistic regressions were used to obtain the unadjusted and adjusted odds ratio respectively of the socio-economic and household variables. Results: The major socio-economic variables that increase the likelihood of malaria are caste (‘scheduled tribes’), low education levels and rural residence. The scheduled tribes have 1.8 times higher odds of malaria than the scheduled castes (AOR: 1.8; 95% CI: 1.5–2.1). Respondents with high school education (6–12 grade) (AOR: 0.7; 95% CI: 0.6–0.8) and college education (AOR: 0.5; 95% CI: 0.4–0.6) had a very low risk of malaria than those with no school years. Rural residence and occupation (agriculture and allied jobs) also increases the odds of malaria. The major housing determinants are household size (≥ 6), housing type (kutcha), use of unclean fuel, outside water source, improper sanitation (toilet facilities) and damp wall/ceiling. Conclusions: The study has identified the major socio-economic and housing factors associated with malaria in adults aged 45 and above. In addition to vector and parasite control strategies in the tribal dominated regions of India, improving literacy and housing conditions may help India’s malaria elimination efforts.
1 January 2021 in Geomatics, Natural Hazards and Risk
Tamil Nadu (TN)’s South-Eastern coastal plain comprises of 5235 villages/wards, is densely populated (∼2000/km2), and is highly vulnerable to multi-hazard events. Earlier vulnerability case studies carried out in TN utilized district as a unit of analysis, considering mostly the physical parameters. For the first time, the socio-economic vulnerability at the level of micro administrative units was analyzed for the entire stretch of the coastal plains of TN using ten census and household data-based indicators. All the indicators were used to determine the degree of vulnerability and summed up to determine the hot spots of socio-economic vulnerability. Public perception surveys carried out with 406 respondents from 363 villages were used to derive the likelihood-impact risk matrix. Results show that ∼60% of the villages between the coastal stretch of Nagapattinam and Puducherry, including major parts of Cuddalore district are highly vulnerable (hot spots) to multi-hazard risks. The information retrieved at micro administrative units can be used by policymakers and coastal managers to develop effective plans for improving the resilience and preparedness of the community.
India has made tremendous progress in reducing malaria mortality and morbidity in the last decade. Mizoram State in North-East India is one of the few malaria-endemic regions where malaria transmission has continued to remain high. As Mizoram shares international borders with Bangladesh and Myanmar, malaria control in this region is critical for malaria elimination efforts in all the three countries. For identifying hotspots for targeted intervention, malaria data from 385 public health sub-centers across Mizoram were analyzed in the Geographic Information System. Almost all the sub-centers reporting high Annual Parasite Index (> 10) are located in Mizoram’s districts that border Bangladesh. Getis-Ord Gi* statistic shows most of the sub-centers located along the Bangladesh border in the Lawngtlai and Lunglei districts to be the malaria hotspots. The hotspots also extended into the Mamit and Siaha districts, especially along the borders of Lawngtlai and Lunglei. Analysis of terrain, climatic, and land use/land cover datasets obtained from the Global Modelling and Assimilation Office and satellite images show Mizoram’s western part (Lawngtlai, Lunglei, and Mamit districts) to experience similar topographic and climatic conditions as the bordering Rangamati district in the Chittagong division of Bangladesh. Climatic trends in this region from 1981 to 2021, estimated by the Mann–Kendall test and Sen's slope estimates, show an increasing trend in minimum temperature, relative humidity, rainfall, and the associated shift of climatic pattern (temperate to tropical monsoon) could facilitate malaria transmission. The quasi-Poisson regression model estimates a strong association (p < 0.001) between total malaria cases, temperature range, and elevation. The Kruskal–Wallis H test shows a statistically significant association between malaria cases and forest classes (p < 0.001). A regional coordination and strategic plan are required to eliminate malaria from this hyper-endemic malaria region of North-East India.
Background: Dengue and chikungunya (CHIKV) are the two major vector-borne diseases of serious public health concern in India. Studies on socioeconomic and housing determinants of dengue and CHIKV at a pan-India level are lacking. Here, we took advantage of the recently carried out Longitudinal Ageing Study in India (LASI) carried out across all the states and Union Territories of India to study the social indicators of dengue and CHIKV in India. Methods: LASI-1 (2017-2018) data on the self-reported period prevalence of dengue and CHIKV from 70,932 respondents aged ≥45 years were used for this analysis. The state-wise distribution of dengue and CHIKV was mapped. Prevalence was estimated for each study variable, and the difference was compared using the χ2 test. The adjusted odds ratios (AOR) of the socioeconomic and housing variables for dengue and CHIKV were estimated using the multiple logistic regression model. Results: Urban residence is the major socio-economic indicator of dengue and CHIKV (dengue AOR: 1.57, 95% CI: 1.18-2.11; CHIKV AOR: 1.84, 95% CI: 1.36-2.49). The other notable indicator is wealth; rich respondents have higher odds of dengue and CHIKV. Adults older than 54 years and those with high school education and above are associated with a lower likelihood of dengue and CHIKV. In addition, CHIKV is associated with scheduled and forward castes, households with improper toilet facilities, open defecation, and kutcha house type. Conclusions: Despite the limitation that the data is only from adults ≥ 45, this analysis provides important insights into the socioeconomic and housing variables associated with higher odds of dengue and CHIKV in India. Understanding these determinants may assist in the national planning of prevention and control strategies for dengue and CHIKV.