PREVALENCE OF ANAEMIA AMONG RURAL PRE-SCHOOL CHILDREN OF MAHARASHTRA, INDIA

Background: Anaemia continues to be a severe public health nutritional problem in India affecting all physiological groups, even after the National Nutritional Anaemia Prophylaxis Programme has been in operation for more than three decades. Objective: To assess the prevalence of anaemia among rural pre-school (1-5-years) children of Maharashtra. Methods: A community based cross-sectional study was carried by National Nutrition Monitoring Bureau (NNMB) covering a total of 404 (Boys-243; Girls-161) pre-school children. Information of socio-demographic particulars was obtained and the finger prick blood samples were collected for the estimation of haemoglobin levels by cyanmethmoglobin method. Results: The result shows that 59.2 % (CI: 54.4-64.0) of the rural pre-school children of Maharashtra were anaemic, and the prevalence was significantly (p<0.001) higher (76.5% with CI: 68.1-84.9) among 1-3-year children as compared to 53.6% in 4-5-year- children. Stepwise Logistic regression analysis also revealed that the risk of anaemia in 1-3-year-age group was three times higher (OR= 2.8; 95% CI: 1.6-4.7). Conclusion: Anaemia was severe public health nutritional problem (>40%) among rural pre-school children of Maharashtra. Therefore, appropriate intervention measures such as supplementary iron & folic acid, periodic deworming and health & nutrition education should be strengthened. The community needs to be encouraged to diversify their diets by consuming iron rich foods

Condom use and prevalence of syphilis and HIV among female sex workers in Andhra Pradesh, India – following a large-scale HIV prevention intervention

<p>Abstract</p> <p>Background</p> <p>Avahan, the India AIDS initiative began HIV prevention interventions in 2003 in Andhra Pradesh (AP) among high-risk groups including female sex workers (FSWs), to help contain the HIV epidemic. This manuscript describes an assessment of this intervention using the published Avahan evaluation framework and assesses the coverage, outcomes and changes in STI and HIV prevalence among FSWs.</p> <p>Methodology</p> <p>Multiple data sources were utilized including Avahan routine program monitoring data, two rounds of cross-sectional survey data (in 2006 and 2009) and STI clinical quality monitoring assessments. Bi-variate and multivariate analyses, Wald Chi-square tests and multivariate logistic regressions were used to measure changes in behavioural and biological outcomes over time and their association.</p> <p>Results</p> <p>Avahan scaled up in conjunction with the Government program to operate in all districts in AP by March 2009. By March 2009, 80% of the FSWs were being contacted monthly and 21% were coming to STI services monthly. Survey data confirmed an increase in peer educator contacts with the mean number increasing from 2.9 in 2006 to 5.3 in 2009. By 2008 free and Avahan-supported socially marketed condoms were adequate to cover the estimated number of commercial sex acts, at 45 condoms/FSW/month. Consistent condom use was reported to increase with regular (63.6% to 83.4%; AOR=2.98; p<0.001) and occasional clients (70.8% to 83.7%; AOR=2.20; p<0.001). The prevalence of lifetime syphilis decreased (10.8% to 6.1%; AOR=0.39; p<0.001) and HIV prevalence decreased in all districts combined (17.7% to 13.2%; AOR 0.68; p<0.01). Prevalence of HIV among younger FSWs (aged 18 to 20 years) decreased (17.7% to 8.2%, p=0.008). A significant increase in condom use at last sex with occasional and regular clients and consistent condom use with occasional clients was observed among FSWs exposed to the Avahan program. There was no association between exposure and HIV or STIs, although numbers were small.</p> <p>Conclusions</p> <p>The absence of control groups is a limitation of this study and does not allow attribution of changes in outcomes and declines in HIV and STI to the Avahan program. However, the large scale implementation, high coverage, intermediate outcomes and association of these outcomes to the Avahan program provide plausible evidence that the declines were likely associated with Avahan. Declining HIV prevalence among the general population in Andhra Pradesh points towards a combined impact of Avahan and government interventions.</p

Impact of Chronic Drought on Nutritional Status of the Community in Drought affected areas in India

Background:&nbsp;Communities affected by chronic drought conditions face a wide variety of challenges including an adverse effect on their nutritional status. The Government of India, during the year 2002-03, declared nine States viz., Andhra Pradesh, Karnataka, Tamil Nadu, Madhya Pradesh, Maharashtra, Rajasthan, Gujarat, Chhattisgarh and Orissa as drought affected.&nbsp;Material and Methods:&nbsp;At the request of Department of Agriculture, Government of India, a rapid community based cross-sectional study was carried out adopting multistage random sampling procedure with the objective to assess the nutritional status of community in these nine chronic drought affected states in India.&nbsp;Results: In general, the intakes of all the nutrients were grossly deficit as against their RDAs. The nutrition intervention programmes initiated by the Government of India, in general, contributed to meet the daily requirement of staples like cereals &amp; millets in most of the States.&nbsp;Conclusion:&nbsp;In drought-affected areas, where the level of famine impact is unknown, an early rapid assessment of the nutritional status and the health needs of the population are critical to estimate the degree of impact to plan timely and appropriate interventions

Screening Acute HIV Infections among Chinese Men Who Have Sex with Men from Voluntary Counseling & Testing Centers

Recent studies have shown the public health importance of identifying acute HIV infection (AHI) in the men who have sex with men (MSM) of China, which has a much higher risk of HIV transmission. However, cost-utility analyses to guide policy around AHI screening are lacking.An open prospective cohort was recruited among MSM living in Liaoning Province, Northeast China. Blood samples and epidemiological information were collected every 10 weeks. Third-generation ELISA and rapid test were used for HIV antibody screening, western blot assay (WB) served for assay validation. Antibody negative specimens were tested with 24 mini-pool nucleic acid amplification testing (NAAT). Specimens with positive ELISA but negative or indeterminate WB results were tested with NAAT individually without mixing. A cost-utility analysis of NAAT screening was assessed. Among the 5,344 follow-up visits of 1,765 MSM in 22 months, HIV antibody tests detected 114 HIV chronic infections, 24 seroconverters and 21 antibody indeterminate cases. 29 acute HIV infections were detected with NAAT from 21 antibody indeterminate and 1,606 antibody negative cases. The HIV-1 prevalence and incidence density were 6.6% (95% CI: 5.5–7.9) and 7.1 (95% CI: 5.4–9.2)/100 person-years, respectively. With pooled NAAT and individual NAAT strategy, the cost of an HIV transmission averted was $1,480. The addition of NAAT after HIV antibody tests had a cost-utility ratio of$3,366 per gained quality-adjusted life year (QALY). The input-output ratio of NAAT was about 1∶16.9.The HIV infections among MSM continue to rise at alarming rates. Despite the rising cost, adding pooled NAAT to the HIV antibody screening significantly increases the identification of acute HIV infections in MSM. Early treatment and target-oriented publicity and education programs can be strengthened to decrease the risk of HIV transmission and to save medical resources in the long run

Prevalence of hypertension, its correlates and awareness among adult tribal population of Kerala state, India

Background: Increasing prevalence of hypertension is a public health problem in India. Aims: To study prevalence, correlates, and awareness of hypertension among tribal adult population in Kerala. Setting and Design: A community-based, cross-sectional study was carried out in tribal areas of Kerala by adopting multistage random sampling procedure. Materials and Methods: Data was collected on socio-demographic and behavioral factors, and anthropometric measurements were carried out. Body mass index (BMI) was categorized using the classification recommended for Asians. Waist circumference ≥90 cm for men and ≥80 cm for women was used cut off for defining an abdominal obesity. Bivariate and multivariate analysis was carried out to study association of hypertension with socio-demographic variables, personal habits, and obesity. Results: A total of 4,193 adults (men 1,891, women: 2,302) of ≥20 years of age were covered. The overall prevalence of hypertension was 40% (n=1671). The prevalence of hypertension increases with increase in age among both the genders. Regression analysis showed that the risk of hypertension was significantly (P<0.001) lower among educated and among higher socio-economic status group. Sedentary activity had 1.3 times (CI=1.09-1.60) and alcohol consumption had 1.4 (CI=1.17-1.73) times higher risk of hypertension. The risk of hypertension was 1.7 times higher among overweight/obese subjects. Overall, only 10% (n=164) of the adult population was aware of hypertension status, and about 8% (n=129) were on regular treatment. Conclusion: It was observed that the prevalence of hypertension was higher among tribal adult population of Kerala and was associated with age, gender, education, HHs wealth index, physical inactivity, alcohol consumption, and overweight/obesity