BACKGROUND: The World Health Organization recommends indoor residual spray (IRS) including dichlorodiphenyltrichloroethane (DDT), as a malaria vector control measure. OBJECTIVE: The objective was to ...assess the knowledge and practice of IRS with DDT in rural area of the West Tripura district. METHODOLOGY: A community based cross-sectional study was conducted in rural area of West Tripura District during the period of June to July 2019. Two hundred adult participants were interviewed from randomly selected families using multistage simple random sampling technique using a predesigned, pretested interview schedule. Data were analyzed using Microsoft excel 2007 and the Epi-info version 6.0 (CDC, Atlanta, Georgia, USA). RESULTS: More than 43% of the families knew that DDT spray was for malaria prevention and control measures. Reasons for not allowing DDT spray were due to stains of houses (35.13%), bad odors (3.5%), unpreparedness (3.5%), uninformed (3%), and 7% other reasons. CONCLUSIONS: Practice on indoor residual spray (DDT) was below the level of coverage required for mass effect recommended by the World Health Organization. However, the population had a good knowledge of the diseases spread by the mosquitoes.
Introduction: Prehypertension is defined as an independent category of blood pressure (BP) by the seventh joint national committee on prevention, detection, evaluation, and treatments of BP. Systolic ...BP (SBP) between 120 and 139 mm Hg or diastolic BP between 80 and 89 mm Hg are considered to have prehypertension. BP ≥140/90 mm Hg is considered hypertension. It is to assess the prevalence of prehypertension and hypertension among urban school-going children. Materials and Methods: A cross-sectional study was conducted among 1011 school-going children of both sexes within 12–17 years of age group and each participant was selected using a simple random sampling technique. Pretested predesigned questionnaire was used for data collection. Results: Prevalence of normotensive, prehypertensive, and hypertensive were 73.6%, 19.4%, and 7%, respectively, when both systolic and diastolic components have been taken into account. Conclusion: This study has showed that more than 19% prehypertensive and 7% hypertensive among the school-going children aged between 12 and 17 years when both systolic and diastolic components have been taken into account.
Introduction: Anemia is a public health problem worldwide, and in pregnancy, the main cause of anemia is nutritional. Non-compliance to iron and folic acid supplement plays a role in the high ...prevalence of anemia in pregnant women. Objectives: The objectives were to find out the proportion of compliance to iron and folic acid tablets (IFA) among pregnant women and to determine factors associated with it. Methods: A cross-sectional study was conducted among 240 pregnant women attending antenatal clinic in Agartala Govt. Medical College, from 15th June to 14th September 2019. Subjects were recruited through consecutive sampling. A pretested, predesigned, semi-structured interview schedule was used to collect information. Data were analyzed using SPSS 15.0. Chi-square and Fisher's exact tests were used to find out the association of compliance with independent variables. P value of < 0.05 was considered as significant. Results: Majority (56.3%) of the participants were in the age group of 20-29 years and were housewives (92.1%), Hindu (93.8%), and completed secondary education (34.6%). The proportion of compliance to IFA among pregnant women was 52.5% (n = 126), and the reason for non-compliance (n = 114) in the majority was side effects of IFA (35.09%), followed by forgetfulness (28.07%). Factors like age, religion, education, socio-economic status, birth order, number of antenatal visits, or number of IFA consumed daily have not shown any significant association with this compliance. Conclusion: This study highlighted that only around half of the pregnant women are compliant with IFA, and this situation demands for information education and communication activities to generate awareness.
Background: Excess fat in the upper part of human body correlates with increased mortality and risk for diabetes, dyslipidemia, and hypertension. In India, there are very limited data available on ...the association of excess body visceral fat with hypertension and dyslipidemia independent of obesity and diabetes. Objective: The objective of this study is to assess the role of body visceral fat percentage in hypertension and dyslipidemia among diabetic and nondiabetic indigenous ethnic population of Tripura. Methods: Random blood sugar test was done for each of the study subjects with the help of a standard and validated glucometer. Then, blood samples were obtained after an 8-12-h overnight fast using vacutainer. Later on, all the blood samples were transported to the MRU laboratory at Agartala Government Medical College maintaining cold chain for following investigations: (1) FBS, PP by GOD-POD method; (2) HbA1c by immunoturbidimetric method; (3) cholesterol estimation by CHOD-PAP method; and (4) triglyceride estimation by glycerol phosphate oxidase method. Results: In this study, it has been found that 62.5% diabetic subjects having high body visceral fat are suffering from Dyslipidemia, whereas only 42.9% nondiabetic subjects with high body visceral fat percentage are having dyslipidemia. Fisher's exact test showed association between diabetes status and body visceral fat (P = 0.048). It has been also observed that there was significant (P < 0.05) association between hypertension and body visceral fat among local indigenous ethnic population of Tripura. Conclusion: Body visceral fat percentage is significantly associated with hypertension, dyslipidemia, and type-2 diabetes among indigenous ethnic population of Tripura.
Aim
To report on glycated haemoglobin (HbA1c) values among individuals with normal glucose tolerance (NGT) at different age groups, using data acquired from a large national survey in India.
...Materials and methods
Data on glycaemic parameters at different age groups were obtained from the Indian Council of Medical Research–INdia DIABetes (ICMR–INDIAB) study, in adults aged ≥ 20 years representing all parts of India. Age-wise distribution of HbA1c was assessed among individuals with NGT (n = 14,222) confirmed by an oral glucose tolerance test using the World Health Organization (WHO) criteria. Results were validated in another large epidemiological study (n = 1077) conducted in Chennai, India.
Results
Among NGT individuals, HbA1c increased gradually with age from 5.16 ± 0.71% (33 mmol/mol) in the age group of 20–29 years to 5.49 ± 0.69% (37 mmol/mol) in those aged 70 + years. In the validation study, conducted in another study population, HbA1c was 5.35 ± 0.43% (35 mmol/mol) in age group of 20–29 years and 5.74 ± 0.50% (39 mmol/mol) in those aged 70 and above. In the INDIAB study, for every decadal increase in age, there is a 0.08% increase in HbA1c and this increase was more significant in females (females: 0.10% vs. males: 0.06%) and in urban (urban: 0.10% vs. rural: 0.08%) population.
Conclusions
HbA1c levels increase steadily with age. This suggests that age-specific cutoffs be used while utilizing HbA1c to diagnose diabetes and prediabetes, so as to minimize the risk of overdiagnosis and unnecessary initiation of treatment in elderly people who could have physiological increase in HbA1c levels.
Background: Stress is very common psychological phenomena where medical students faced in day to day activities. Epidemiological studies have asserted that about 70-80% of the diseases may be related ...to stress. Research related to this stress especially among medical students is essential, considering their learning, role and responsibilities as a future physician and health intervention programs. Objectives: To estimate the prevalence of stress and identify stressors among medical students. Materials and Methods: A Cross-sectional study was carried out among undergraduate medical students and self administered GHQ-12 and stressor questionnaire were used to collect information regarding stress. Binary logistic regression analysis was performed to calculate odds ratio (OR). Results: Prevalence of stress was 94.52% and more common among females. 33.56% students felt constantly under strain and 25.34% had loss of sleep over worry. Majority of the students of all semesters had stress (P > 0.05) and stressors viz. ′competition for marks′ (P = 0.005), ′frequent examination′ (P = 0.001), ′difficulty in finding time for recreation′ (P = 0.014) and ′being away from home′ (P = 0.027) were predominantly experienced by the 1 st year medical students. Multiple logistic regression analysis revealed the causal effect of main parameter on the GHQ caseness and students who found difficulties in following teaching language among the caseness had 81.59% higher chance of developing stress (OR = 8.159, CI = 1.228-54.213). Conclusion: The stress experience was more common due to academics and seen among all year of medical students. Strategy development for eliminating stressors is necessary for promoting healthy life.
BACKGROUND Globally, tuberculosis (TB) is one of the top 10 causes of death due to infectious diseases. TB continues to rank among world’s most serious health problems despite effective diagnostic & ...treatment measures. The objectives of the study were to asses and compare the knowledge of tuberculosis among rural and urban slum population and identify the factors associated with their knowledge of tuberculosis. METHODS A cross sectional study was conducted and multistage random sampling technique was applied for selection of the individual study subjects. Data was collected using a semi-structured and pre-tested interview schedule. RESULTS 200 individuals were included in the study with an overall mean age (SD) of the individuals of 36.66 (± 13.091) years. 189 (94.5) participants had heard of tuberculosis. 36 (37.9 %) urban slum and 20 (21.3 %) rural participants said that cough is the most common symptom of pulmonary tuberculosis. 42 (52.5 % among rural population was having good knowledge (rural vs. urban; 52.5 % vs. 47.5 %) compared to urban slum population. Literacy (P = 0.049) and family type (P = 0.044) have played a significant role in acquiring good knowledge of tuberculosis among the participants irrespective of their place of residence. CONCLUSIONS There was no significant difference in the knowledge of TB among rural and urban slum population. Literate persons were more aware compared to illiterate population irrespective of their place of living. In spite of having good awareness regarding TB, in general the knowledge level on risk factors was not satisfactory and needs further improvement. Therefore, a special drive has to be started for imparting knowledge to the community regarding risk factors as this could prevent further occurrence or progress of TB. KEYWORDS Tuberculosis, Knowledge of TB, Urban Rural Difference
Previous studies have not adequately captured the heterogeneous nature of the diabetes epidemic in India. The aim of the ongoing national Indian Council of Medical Research-INdia DIABetes study is to ...estimate the national prevalence of diabetes and prediabetes in India by estimating the prevalence by state.
We used a stratified multistage design to obtain a community-based sample of 57 117 individuals aged 20 years or older. The sample population represented 14 of India's 28 states (eight from the mainland and six from the northeast of the country) and one union territory. States were sampled in a phased manner: phase I included Tamil Nadu, Chandigarh, Jharkhand, and Maharashtra, sampled between Nov 17, 2008, and April 16, 2010; phase II included Andhra Pradesh, Bihar, Gujarat, Karnataka, and Punjab, sampled between Sept 24, 2012, and July 26, 2013; and the northeastern phase included Assam, Mizoram, Arunachal Pradesh, Tripura, Manipur, and Meghalaya, with sampling done between Jan 5, 2012, and July 3, 2015. Capillary oral glucose tolerance tests were used to diagnose diabetes and prediabetes in accordance with WHO criteria. Our methods did not allow us to differentiate between type 1 and type 2 diabetes. The prevalence of diabetes in different states was assessed in relation to socioeconomic status (SES) of individuals and the per-capita gross domestic product (GDP) of each state. We used multiple logistic regression analysis to examine the association of various factors with the prevalence of diabetes and prediabetes.
The overall prevalence of diabetes in all 15 states of India was 7·3% (95% CI 7·0-7·5). The prevalence of diabetes varied from 4·3% in Bihar (95% CI 3·7-5·0) to 10·0% (8·7-11·2) in Punjab and was higher in urban areas (11·2%, 10·6-11·8) than in rural areas (5·2%, 4·9-5·4; p<0·0001) and higher in mainland states (8·3%, 7·9-8·7) than in the northeast (5·9%, 5·5-6·2; p<0·0001). Overall, 1862 (47·3%) of 3938 individuals identified as having diabetes had not been diagnosed previously. States with higher per-capita GDP seemed to have a higher prevalence of diabetes (eg, Chandigarh, which had the highest GDP of US$ 3433, had the highest prevalence of 13·6%, 12.8-15·2). In rural areas of all states, diabetes was more prevalent in individuals of higher SES. However, in urban areas of some of the more affluent states (Chandigarh, Maharashtra, and Tamil Nadu), diabetes prevalence was higher in people with lower SES. The overall prevalence of prediabetes in all 15 states was 10·3% (10·0-10·6). The prevalence of prediabetes varied from 6·0% (5·1-6·8) in Mizoram to 14·7% (13·6-15·9) in Tripura, and the prevalence of impaired fasting glucose was generally higher than the prevalence of impaired glucose tolerance. Age, male sex, obesity, hypertension, and family history of diabetes were independent risk factors for diabetes in both urban and rural areas.
There are large differences in diabetes prevalence between states in India. Our results show evidence of an epidemiological transition, with a higher prevalence of diabetes in low SES groups in the urban areas of the more economically developed states. The spread of diabetes to economically disadvantaged sections of society is a matter of great concern, warranting urgent preventive measures.
Indian Council of Medical Research and Department of Health Research, Ministry of Health and Family Welfare, Government of India.
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