Poverty, undernutrition and morbidity: The untold story of tea-garden workers of Alipurduar district, West Bengal

Background: There is a paucity of information on health and nutritional status of tea-garden workers of West Bengal, which is crucial to meet their health needs by formulating appropriate public health interventions. Objectives/Aims: The objective of this study is to assess the morbidity pattern and nutritional status of tea-garden workers of West Bengal, India. Materials and Methods: The present cross-sectional study was conducted among 463 tea-garden workers of randomly selected three tea gardens of Alipurduar district of West Bengal, India, chosen by multi-stage sampling. Pre-designed and pre-tested questionnaire was used to collect information on socio-demographic and other variables by means of interview. Physical examination and anthropometric assessment were performed. The haemoglobin was estimated by the 'filter paper cyanmethemoglobin method'. Morbidities were assessed on the basis of history, clinical examination, evaluation of medical records if any and relevant laboratory investigations and classified and coded as per the 10th revision of the international classification of the diseases. Morbidity profile and nutritional status were assessed through history taking, clinical examination, review of medical records if any, anthropometric assessment and laboratory investigations. Statistical Analysis: Simple proportion was used for interpretation of point prevalence. Chi-square test was applied as the test of significance wherever applicable. Results: Out of total 463 tea-garden workers, majorities (76%) were female and from backward social class (81.2%). More than half (55.9%) were illiterate and three-fourth (67.2%) belonged to lower income quartile. Anaemia was found widespread (87.9%) and more than one-third (36.1%) of the tea-garden workers were found undernourished. Also 43.8% of the workers had airway obstruction as measured by peak expiratory flow rate. Majority (69.8%) of the garden workers had any form of morbidity. Non-communicable diseases (24.2%), musculoskeletal disorders (17.9%), skin disorders (17.7%), respiratory morbidities (16.2%), febrile illness (12.3%), gastro-intestinal disorders (8.6%), ocular problems (8.4%), vitamin and micronutrients deficiencies were found the common morbidities among tea-garden workers. Scheduled tribe caste, undernutrition and anaemia were found independent determinants of any morbidity among the tea-garden workers. Conclusions: Morbidities, anaemia and under-nutrition were found very much prevalent among tea-garden workers of West Bengal, which necessitates urgent public health interventions through multi-disciplinary approach in a focussed manner with an aim to improve the overall quality of life of the tea-garden workers

Determinants of Household Food Insecurity among Tribal Population: An Experience from Rural West Bengal, India

Background: Knowledge regarding distribution and determinants of household food insecurity focusing on vulnerable groups is utmost important for ensuring food security, which is every nation prime agenda. This study was conducted to determine the prevalence and determinants of household food insecurity among the tribal population of Purulia, West Bengal. Methods: A cross-sectional study was carried out among 134 tribal households covering a total 632 population selected from 3 administrative divisions of Purulia district by two-stage random sampling. Information collected on selected demographic and socio-economic profile of the households including utilization of public distribution system (PDS) by house-to-house interview. A Bengali version of validated household food security scale-short form was used as a tool for data collection. Furthermore, the anthropometry was carried out among the children aged 6-59 months. Results: The results showed that the prevalence of household food insecurity was 35.8% in the study area. Households with lower socio-economic status, kutcha houses, low income related to the family members, holding of below poverty line (BPL), and ration card were significantly associated with the household food insecurity. Prevalence of under-weight and stunting among 6-59 months children were found significantly more among food insecure households. Conclusions: In-spite of several efforts, household food insecurity was quite prevalent especially among vulnerable poor households. Therefore, it shows that food security along with poverty reduction activities are required to be increased at the household leve

An Observational Study on Neonatal Seizures in a Tertiary Care Hospital

Background: Seizures are the most frequent clinical manifestation of central nervous system dysfunction in the newborn with the incidence varying from 1-5%. Neonatal seizures often signal an underlying ominous neurological condition, most commonly hypoxia-ischemia, and others include stroke, intraventricular hemorrhage or intraparenchymal hemorrhage, meningitis, sepsis, and metabolic disorders. Neonatal seizures can permanently disrupt neuronal development, induce synaptic reorganization, alter plasticity and "prime" the brain to increased damage from seizures later in life. The objective of this study was to observe neonatal seizures in a Tertiary Care Hospital. Methods: This study was a hospital-based, prospective, observational study conducted in the sick new born care unit of department of pediatrics in a tertiary care hospital from March 2017 to February 2018. Out of 2654 admitted neonates, 234 notates having symptom of seizures were included in the study after informed consent from the mother of the neonate. The data like history, clinical examination and investigation findings was recorded in the pre-designed, pre-tested, semi structured questionnaire. Template was generated in MS excel sheet and analysis was done on SPSS software. Results : The incidence of neonatal seizures was higher in male neonates. Subtle types of seizures were the commonest type of seizures. out of 234 neonates, 68 (29.06%) were preterm while 166 (70.94%) were term neonates. Out of 68 term neonates, 26 (38.23%) neonates had subtle seizures, 16 (23.52%) neonates had focal clonic seizures. Out of 166 term neonates, 56 (33.73%) neonates had subtle seizures, 42 (25.30%) neonates had focal clonic seizures. Almost 68 (29.05%) developed seizures within 24 hours, 84 (35.91%) neonates had seizures between 25-48 hours, 54 (23.08%) neonates developed seizures between 2-7 days and 28 (11.96%) neonates developed seizures after 7 days. Common causes of neonatal deaths in our center were severe birth asphyxia, intra-ventricular hemorrhage (IVH), septicemia and meningitis. Conclusions: Neonatal seizures are common and may be the first manifestation of neurological dysfunction after a variety of insults. Most of the causes of neonatal seizures are preventable by good perinatal care and early interventions while metabolic seizures need a sharp vigilance and early suspicion

Geriatric Disability and Associated Risk Factors: A Community Based Study in a Rural Area of West Bengal, India

Background: Similar to developed countries, aging is increasedin India. Because of the epidemiology and demographictransition phase, chronic diseases and disabilitiesalong with health costs are increasing day by day. As socialfactors and chronic diseases are the major reasons for geriatricdisability, the present study was done with the following objectives:to assess and compare the socio-demographic characteristicsamong the disabled and non-disabled geriatric population,and to find out the association between sociodemographicand chronic diseases with functional disabilityamong the study population.Methods: A cross-sectional study was done in a rural communityof West Bengal, India. House to house visit, clinicalexamination, observation, and interview were done with a predesigned,pre-tested proforma. Epi Info and SPSS softwarewere used for statistical analysis.Results: A total of 458 people had chronic conditions and theprevalence of disability was 17.47%. Among the sociodemographicvariables, age, female sex, marital status, literacystatus, and family composition and among the chronic diseases,tuberculosis, chronic obstructive pulmonary diseases, ischemicheart disease, osteoarthritis, neuropathy, acid peptic disorder,prostatic hypertrophy, and osteoporosis were found as risk factorsof disability in binary logistic regression analysis. 71.2% ofthe disabilities were explained by these risk factors.Conclusion: The data highlighted the different risk factorsassociated with disability. No single measure rather multidimensionalapproach should be the model for the preventionof disability