Prevalence of Non - Communicable Diseases and their Risk Factors in Tribal South India: A Community Based Cross Sectional study

BACKGROUND : Non communicable diseases are the leading cause of morbidity and mortality in India. Cardio vascular disease accounts for majority of non communicable diseases related deaths. This cross-sectional study was conducted among the residents of Jawadhu hills which is situated in Vellore and Tiruvannamalai districts of Tamil Nadu. The main objective of this study was to estimate the prevalence of diabetes mellitus, hypertension, dyslipidaemia and metabolic syndrome and their risk factors among the residents of Jawadhu hills aged between 30-60 years. METHODS : This study was conducted in 14 villages of Jawadhu hills in Tiruvannamalai district. Two stage cluster sampling method was used. Villages were selected by probability proportionate to size sampling. Consecutive Households were selected from village starting point in clockwise direction as per the algorithm until the required sample size was obtained. Totally 480 people (males-225 & females-255) were surveyed from February 2016 to July 2016 using modified WHO-STEPS questionnaire. Socio demographic factors, behavioural and metabolic risk factors and anthrometric measures were collected. Fasting and post prandial (2 hour) blood glucose were collected for 480 people by using glucometer. Among the subset of 138 people (one participant from alternate household) fasting lipid samples were collected. RESULTS: Of the subjects (480) studied, 3.3% had diabetes mellitus,7.6% had prediabetes, 17.7% had hypertension. Among the sub group of 138 people, 51.5% had abnormalities in any one of the lipid parameters. 16.7% of the study population had hypercholestremia, 24.6% had hyper triglyceridemia, 26.8% had low HDL, 18.1% had high LDL, 10.8% had high total cholesterol/HDL ratio (>4.5) and 12.3% had metabolic syndrome. Out of 480 people, 11.7% had low physical activity (less than the WHO recommended). Using Asian cutoff, prevalence of obesity, overweight and central obesity were 20%, 4.8% and 9.8% respectively. Most of the participants were from low socio economic status. Alcohol use and smoking is common among men (72.9%and 64% respectively). In the multivariate analysis, overweight was significantly associated with hypertension and dyslipidaemia. Low levels of physical activity and obesity were associated with and metabolic syndrome. CONCLUSION : Prevalence of diabetes in this tribal population is low (3.3%). However, 51.5% had dyslipidaemia and 17.7% had hypertension. High prevalence of behavioural and metabolic risk factors calls for urgent intervention

Factors associated with unexplained sudden deaths among adults aged 18-45 years in India – A multicentric matched case–control study

Background & objectives: In view of anecdotal reports of sudden unexplained deaths in India's apparently healthy young adults, linking to coronavirus disease 2019 (COVID-19) infection or vaccination, we determined the factors associated with such deaths in individuals aged 18-45 years through a multicentric matched case–control study. Methods: This study was conducted through participation of 47 tertiary care hospitals across India. Cases were apparently healthy individuals aged 18-45 years without any known co-morbidity, who suddenly (<24 h of hospitalization or seen apparently healthy 24 h before death) died of unexplained causes during 1st October 2021-31st March 2023. Four controls were included per case matched for age, gender and neighborhood. We interviewed/perused records to collect data on COVID-19 vaccination/infection and post-COVID-19 conditions, family history of sudden death, smoking, recreational drug use, alcohol frequency and binge drinking and vigorous-intensity physical activity two days before death/interviews. We developed regression models considering COVID-19 vaccination ≤42 days before outcome, any vaccine received anytime and vaccine doses to compute an adjusted matched odds ratio (aOR) with 95 per cent confidence interval (CI). Results: Seven hundred twenty nine cases and 2916 controls were included in the analysis. Receipt of at least one dose of COVID-19 vaccine lowered the odds [aOR (95% CI)] for unexplained sudden death [0.58 (0.37, 0.92)], whereas past COVID-19 hospitalization [3.8 (1.36, 10.61)], family history of sudden death [2.53 (1.52, 4.21)], binge drinking 48 h before death/interview [5.29 (2.57, 10.89)], use of recreational drug/substance [2.92 (1.1, 7.71)] and performing vigorous-intensity physical activity 48 h before death/interview [3.7 (1.36, 10.05)] were positively associated. Two doses lowered the odds of unexplained sudden death [0.51 (0.28, 0.91)], whereas single dose did not. Interpretation & conclusions: COVID-19 vaccination did not increase the risk of unexplained sudden death among young adults in India. Past COVID-19 hospitalization, family history of sudden death and certain lifestyle behaviors increased the likelihood of unexplained sudden death