Patterns of Alcohol Consumption among Male Adults at a Slum in Kolkata, India

Globally, alcohol-abuse is a major cause of mortality and morbidity. Consumption of alcohol has increased in India in the recent decades. It is imperative to know the patterns of alcohol consumption among different types of consumers to launch a well-planned nationwide programme for the prevention and control of this devastating social pathology. This community-based, cross-sectional study was undertaken to identify the patterns of alcohol intake among different types of alcohol consumers and to assess the clinical signs of chronic harmful alcohol-use. A predesigned, pretested, semi-structured alcohol-use disorders identification test (AUDIT) questionnaire was used for interviewing males, aged >18 years, selected by random sampling from an updated household list of a randomly-selected sector of the service area of the Urban Health Centre in Chetla, Kolkata, West Bengal, India. Written informed consents were obtained from all the respondents. Relevant clinical examination for chronic harmful alcohol-use was done according to the AUDIT clinical screening procedures. The results revealed that 65.8% (150/228) were current consumers of alcohol; 14% were alcohol-dependents; 8% were hazardous or harmful consumers, and 78% were non-hazardous non-harmful consumers. The mean age of the respondents at the initiation of drinking alcohol was 20.8+5.9 years. Eighty-six percent of dependents (n=21) took both Indian-made foreign liquor and locally-made alcoholic beverages. The proportions of alcohol consumers who drank alone among alcohol-dependents, hazardous or harmful consumers, and non-hazardous non-harmful consumers were 71.4%, 50%, and 7.7% respectively, and the difference was significant (p<0.01). Forty-one percent of the consumers drank at public places and workplaces, which may be socially harmful. About 38% of the dependents purchased alcohol from unlicensed liquor shops. Only 16% expressed concerns for their drinking habit mainly to the past illness. The proportion of the concerned respondents was higher in the hazardous and harmful drinking patterns than in the non-hazardous non-harmful drinking pattern, and the difference was significant (p<0.05). About 62% of the dependents had clinical signs of chronic alcohol consumption. The presence of a considerable proportion of alcohol-dependents, the low mean age at initiation of drinking alcohol, and the habit of drinking in public places and workplaces are the main areas that need special emphasis by intervention programmes

Patterns of Alcohol Consumption among Male Adults at a Slum in Kolkata, India

Globally, alcohol-abuse is a major cause of mortality and morbidity. Consumption of alcohol has increased in India in the recent decades. It is imperative to know the patterns of alcohol consumption among different types of consumers to launch a well-planned nationwide programme for the prevention and control of this devastating social pathology. This community-based, cross-sectional study was undertaken to identify the patterns of alcohol intake among different types of alcohol consumers and to assess the clinical signs of chronic harmful alcohol-use. A predesigned, pretested, semi-structured alcohol-use disorders identification test (AUDIT) questionnaire was used for interviewing males, aged &gt;18 years, selected by random sampling from an updated household list of a randomly-selected sector of the service area of the Urban Health Centre in Chetla, Kolkata, West Bengal, India. Written informed consents were obtained from all the respondents. Relevant clinical examination for chronic harmful alcohol-use was done according to the AUDIT clinical screening procedures. The results revealed that 65.8% (150/228) were current consumers of alcohol; 14% were alcohol-dependents; 8% were hazardous or harmful consumers, and 78% were nonhazardous non-harmful consumers. The mean age of the respondents at the initiation of drinking alcohol was 20.8+5.9 years. Eighty-six percent of dependents (n=21) took both Indian-made foreign liquor and locally-made alcoholic beverages. The proportions of alcohol consumers who drank alone among alcoholdependents, hazardous or harmful consumers, and non-hazardous non-harmful consumers were 71.4%, 50%, and 7.7% respectively, and the difference was significant (p&lt;0.01). Forty-one percent of the consumers drank at public places and workplaces, which may be socially harmful. About 38% of the dependents purchased alcohol from unlicensed liquor shops. Only 16% expressed concerns for their drinking habit mainly to the past illness. The proportion of the concerned respondents was higher in the hazardous and harmful drinking patterns than in the non-hazardous non-harmful drinking pattern, and the difference was significant (p&lt;0.05). About 62% of the dependents had clinical signs of chronic alcohol consumption. The presence of a considerable proportion of alcohol-dependents, the low mean age at initiation of drinking alcohol, and the habit of drinking in public places and workplaces are the main areas that need special emphasis by intervention programmes

Prevalence and determinants of unmet need for family planning in Kishanganj district, Bihar, India

Background: Unmet need is a valuable indicator for assessing the achievements of national family planning programs. The present study was undertaken with the objectives to determine the magnitude of unmet need for family planning among the married women of reproductive age group (15-49 years), to evaluate the various factors that influence the unmet need and to explore the common reasons for unmet need for family planning. Methods: A community based, cross-sectional study was conducted from February to April 2012 in Laucha village in Kishanganj, Bihar through multistage sampling. Married women aged 15-49 years, who were permanent residents of the village, were selected by complete enumeration (330 in total) and interviewed through house to house survey with the help of a pre-designed, pre-tested and semi-structured questionnaire. Results: The total unmet need for family planning was 23.9%; 9.4% for spacing births and 14.5% for limiting births. The unmet need varied significantly with age (p < 0.05) and was highest in ≤ 19 years age group (33.7%). It was also significantly higher among illiterates, those with low monthly per capita income, among Muslims and among those having more than two living issues (p < 0.05). Husband’s disapproval (34.2%), lack of awareness (27.8%) and fear of side effects (24.1%) were common reasons behind the unmet need. Conclusion: the unmet need for family planning was quite high among the respondents and associated with various bio-social determinants that should be considered while planning for scaling-up the program

PrEP in India’s HIV Prevention Policy in the Era of Social Media and Sex Positivity

Introduction: The global revolution of online social media and connectivity had a tremendous effect on sexual behavior in both developed and developing countries. This global change is influencing the societal structure and existing social principles. Moreover, it has a significant impact on the epidemiology of different infectious diseases, especially HIV.Discussion: India is one of the most diverse democratic countries that has undergone a social-cultural transition in the last decade. However, having the second-highest HIV infection rate in the world, India does not have any other new prevention tools in their national HIV prevention strategy. Pre-Exposure Prophylaxis (PrEP), a boon of HIV prevention widely used in different countries, is still not implemented in India. The concept of “Digital India” by the Government of India is giving wide access of internet to the people of India. Furthermore, people are exposed to social media, and that is impacting their sex seeking behavior. Interestingly, recent legal changes in India promotes sex positivity. It also calls for introspection on existing HIV preventive strategies.Conclusion: Given the current scenario of PrEP and other existing preventive measurements of HIV, further research is needed to determine the acceptance and efficacy of PrEP and improve engagement in care for individuals in India. Various international studies recommend effective implication of PrEP to reduce the rate and economic burden of HIV infection

Attitude of Doctors Towards Homosexuality at a Medical College, West Bengal, India: A Cross-sectional Study

Introduction: Attitude towards homosexuality varies differently in different parts of the world. But, almost everywhere social stigma and marginalisation make them vulnerable to poor health and social outcomes. So, physicians should be made aware and sensitive about this issue in order to provide optimal care without any prejudices and discrimination. Aim: To assess the attitude of the doctors towards the homosexuality at a Medical College, West Bengal, India. Materials and Methods: A cross-sectional study was conducted for three months from August 2021 and October 2021 at Raiganj Government Medical College and Hospital, West Bengal, India. A predesigned, pretested, structured questionnaire was distributed to each of the faculty members of this medical college. The questionnaire was kept anonymous for name, religion, department or academic qualification and began with asking questions on age and sex. It consisted of 18 statements, nine substatements of relevant attitude along with additional specific comments on the subject. The faculty members were requested to put the filled up questionnaires in a drop box placed at a designated area in the Department of Psychiatry. In this way responses were finally obtained from 56 out of total 69 faculty members. All of them were postgraduate degree holders. The attitude scores were compared on the basis of age and sex using Kruskal-Wallis and Mann-Whitney U tests. A p-value was calculated to find the association of attitude score with age and gender groups. Results: Among the study participants 21 (37.5%) were in ≥50 years age group, 18 (32.1%) in 40-49 years age group and 17 (30.4%) in ≤40 years age group. Males were 41 (73.2%) and females were 15 (26.8%). Forty six (82.2%) participants agreed that homosexuality is “constitutionally determined” (an inherent fundamental right as per Indian constitution). However 34 (60.7%) did not believe it to be a “sexual orientation”. Half of the participants are of the opinion that “homosexuals are easily recognizable”. Forty three (76.8%) respondents are of the opinion that “homosexuals should not be employed in school”. Also 41 (73.2%) believed that “homosexuals are danger to children”. Only 23 (41.1%) generally agreed that they “did not feel embarrassed while talking about homosexuality”. Just above half of the participants agreed that they “really did not understand homosexuality. The attitude scores did not however vary according to age (p-value=0.25) or sex (p-value=0.09) groups. Conclusion: Majority of the study participants had inadequate knowledge on the issues of homosexuality with a more or less neutral stance in their attitude

Menopausal status and psychological distress: a cross-sectional survey among middle aged women in an urban slum area of Kolkata, India

Background: Menopausal symptoms and their relationship with the menopause transition vary widely. Although vasomotor symptoms like hot flashes and night sweats cause significant psychological distress, menopausal status could be an independent predictor of psychological distress in middle aged women. A cross sectional survey was thus conducted at the sector clinics of urban health centre of All India Institute of Hygiene and Public Health, Kolkata to determine the magnitude of the problem of psychological distress in relation to menopausal status. Methods: Women aged 40-55 years (n = 189) who visited the sector clinics during the study period (March 2011 to August 2011) were interviewed with the help of a pre-designed and pre-tested questionnaire comprising of questions on socio-demographic factors, menstrual cycle and physical symptoms related to menopause. Questions assessing psychological distress were adopted from 12-item general health questionnaire (GHQ-12) after testing for reliability. Results: Most common menopausal symptoms were body and joint pain (60.3%), followed by hot flush (36.5%). Around 28.6% of the study subjects had evidence of psychological distress, which was more common among peri- menopausal women (47.8%) Psychological distress was found to be significantly associated with menopausal status (p = 0.00002). Conclusion: The association between menopausal status and psychological distress indicated towards the need for organizing specific mental health services for middle aged women particularly in relation to menopause. Simple evaluation tool like GHQ-12 might be useful in initial assessment of such psychological distress by physicians and health workers at field level

Emerging infectious diseases: Epidemiological perspective

Over the past 30 years, at least 30 new infectious diseases have emerged to threaten the health of millions of people across the globe. The major challenge to combat these infections is that for many of them, there is no specific treatment or cure or vaccine. There is limited scope of preventing or controlling them. The contributory factors include urbanization and destruction of natural habitats, climate change and changing ecosystems, changes in population of reservoir hosts or intermediate insect vectors and microbial genetic mutation, international trade and commerce, change in human demographics and behavior, lack of public health services and infrastructure, and antibiotic resistance. It is clear by now that the problem of emerging infectious disease (EID) is not restricted to any single country, and a strong and sustainable international collaboration will be needed in their prevention and control. India along with other countries in the South-East Asian region will continue to bear the brunt of the burden of EIDs in years to come

Prevalence and health-seeking behavior of reproductive tract infection/sexually transmitted infections symptomatics: A cross-sectional study of a rural community in the Hooghly district of West Bengal

A community-based, descriptive, cross-sectional study was conducted in Purushottampur village of the Singur block, Hooghly, using a pre-tested, semi-structured questionnaire, to find out the prevalence of RTI / STI symptomatics among the general population aged 15 to 49 years, and to assess their profiles and health-seeking behaviors. Prevalence of (Reproductive tract infection) RTI / STI (Sexually transmitted infections) symptoms in the last 12 months was found to be 13.9 and 13.6% among males and females, respectively. The most common symptom was dysuria and vaginal discharge among males and females, respectively. Almost half of the STI symptomatics (52% male, 50% female) did nothing for their symptoms. Better health-seeking behavior was observed among females. About 9.4% of the males and 47% of the females sought advice from the clinic / hospital / health workers. Strengthening of activities of the existing national program among the general population is needed to build a positive health-seeking behavior that will ensure success of the syndromic management of RTI / STI

Assessment of validity and reliability of IMNCI algorithm in comparison to provisional diagnosis of senior pediatricians in a tertiary hospital of Kolkata

Background: Integrated management of childhood illness (IMNCI) is already operational in many states of India, but there are only limited studies in Indian scenario comparing its validity and reliability with the decisions of pediatricians. Aims and Objectives: To assess the validity and reliability of the IMNCI algorithm with provisional diagnosis of senior pediatricians for each IMNCI classifications. Materials and Methods: The present study is done with all the young infants between 0-2 months presented during the study period with a fresh episode of illness to test the validity and reliability of the algorithm in comparison to provisional diagnoses of senior pediatricians. The study was done in a tertiary care hospital. Validity characteristics such as sensitivity, specificity, positive predictive value, negative predictive value, and reliability characteristics such as percent agreement and Kappa were assessed for individual IMNCI classifications. Results: The sensitivity of possible serious bacterial infection, local bacterial infection, jaundice, no dehydration and possible serious bacterial infection, not able to feed were 88.89, 14.29, 66.67, 25 and 44.44% respectively. The specificities for the same conditions were 71.72, 99.09, 99.07, 94.50 and 86.87%. Percent agreements for similar conditions were 74, 94, 97, 90 and 80% respectively and the Kappa ratios were 0.38, 0.20, 0.73, 0.19 and 0.29 respectively. Conclusion: It could be concluded that IMNCI is quite a sensitive strategy and could identify severe illnesses of young infants requiring referral to higher facility. Further studies, particularly in primary health care setting, are required