Association of Oral Health with Multimorbidity among Older Adults:Findings from the Longitudinal Ageing Study in India, Wave-1, 2017–2019

India is witnessing an increase in the prevalence of multimorbidity. Oral health is related to overall health but is seldom included in the assessment of multimorbidity. Hence, this study aimed to estimate the prevalence of oral morbidity and explore its association with physical multimorbidity using data from Longitudinal Ageing Study in India (LASI). LASI is a nationwide survey amongst adults aged ≥ 45 years conducted in 2018. Descriptive analysis was performed on included participants (n = 59,764) to determine the prevalence of oral morbidity. Multivariable logistic regression assessed the association between oral morbidity and physical multimorbidity. Self-rated health was compared between multimorbid participants with and without oral morbidity. Oral morbidity was prevalent in 48.56% of participants and physical multimorbidity in 50.36%. Those with multimorbidity were at a higher risk of having any oral morbidity (AOR: 1.60 (1.48–1.73)) than those without multimorbidity. Participants who had only oral morbidity rated their health to be good more often than those who had physical multimorbidity and oral morbidity (40.84% vs. 32.98%). Oral morbidity is significantly associated with physical multimorbidity. Multimorbid participants perceived their health to be inferior to those with only oral morbidity. The findings suggest multidisciplinary health teams in primary care should include the management of oral morbidity and physical multimorbidity

Prevalence, pattern and determinants of disabilities in India: Insights from NFHS-5 (2019–21)

There is a need to provide an overview of the disability burden in India as there are limited studies. The present study aimed to estimate the prevalence and assess the pattern and determinants of disability in India. We analyzed National Family Health Survey-5 data using the “svyset” command in STATA software. We assessed the correlates by multivariable regression and reported an adjusted prevalence ratio (aPR) with a 95% confidence interval (CI). QGIS 3.2.1 software was used for spatial analysis of distributions of different disabilities. The mean (SD) age of 28,43,917 respondents was 30.82 (20.62) years, with 75.83% (n = 21,56,633) and 44.44% (n = 12,63,086) of them being from a rural area and were not educated, respectively. The overall prevalence of disability was 4.52% [(95% CI: 4.48–4.55), n = 1,28,528]. Locomotor disabilities accounted for 44.70% of all disabilities (n = 51,659), followed by mental disabilities (20.28%, n = 23,436). Age 75 years and above (vs. 0–14 years) [aPR: 2.65 (2.50–2.81)], male (vs. female) [aPR: 1.02 (1.0–1.04)], no education (vs. higher education) [aPR 1.62 (1.56–1.68)], unmarried (vs married) [aPR: 1.76 (1.70–1.82)], seeking the care of non-governmental organization (NGO) (vs. other) [aPR: 1.32 (1.13–1.55)] were significant independent determinants. The highest overall prevalence of locomotor was in Lakshadweep/UTs (8.88%) and Delhi (57.03%), respectively. Out of every hundred individuals in India, four have a disability. More intervention strategies should be planned, considering factors like education, residence, health promotion and caste so that the services provided by the government can be available and accessible to everyone in need

Utilization of modern temporary contraceptive methods and its predictors among reproductive-aged women in India: insights from NFHS-5 (2019–21)

Evidence from various studies on modern contraceptive methods shows that the utilization varies greatly. The present study aimed to estimate the magnitude and determinants for temporary modern contraceptive utilization among reproductive-aged (15-49 years) women in India. We analysed National Family Health Survey-5 data using the “svyset” command in STATA software. Modern contraception utilization was estimated using the weighted prevalence, and its correlates were assessed by multivariable regression by reporting an adjusted prevalence ratio (aPR) with 95% confidence interval (CI). QGIS 3.2.1 software was used for spatial analysis of different temporary modern contraceptives. The mean (SD) age of 359,825 respondents was 31.6 (8.5) years with 75.1% (n = 270,311) and 49.2% (n = 177,165) of them being from rural area and having completed education up to secondary school, respectively. The overall utilization of modern temporary contraception was 66.1% [95%CI: 65.90–66.35, n = 237,953]. Multigravida (vs. nulligravida) [aPR = 2.13 (1.98–2.30)], higher education of husband (vs. not educated) [aPR = 1.20 (1.14–1.27)], urban (vs. rural) [aPR = 1.06 (1.03–1.10)], watching television less than once a week (vs. not at all) [aPR = 1.04 (1.01–1.08)], divorced (vs. married) [aPR = 0.65 (0.45–0.94)], and Scheduled Tribe (ST) (vs. unreserved) [aPR = 0.92 (0.88–0.96)] were significant independent determinants. The highest utilization of male condoms, IUCDs, pills and injections were in Himachal Pradesh (86%), Nagaland (64%), Tripura (85%), and Ladakh (20%), respectively. Out of every ten reproductive-aged (15–49 years) women in India, six are using temporary modern contraceptive methods. More intervention strategies should be planned, considering factors like gravida, education, residence, health promotion and caste to attain replacement fertility level

Factors associated with poor self-rated health among chronic kidney disease patients and their health care utilization: Insights from LASI wave-1, 2017-18

BackgroundChronic kidney disease (CKD), associated with other chronic conditions affects the physical, behavioral, and psychological aspects of an individual, leading to poor self-rated health. Hence, we aimed to assess the factors associated with poor self-rated health (SRH) in CKD patients. Additionally, we assessed their health care utilization.MethodsThis is an observational study consisting of 527 CKD patients from Longitudinal Aging Study in India (LASI), 2017-2018. A descriptive statistic computed prevalence. Regression analysis assessed the association between poor SRH and socio-demographic variables presented as adjusted odds ratio with a confidence interval of 95%. Health care utilization among CKD patients was graphically presented.ResultsAround 64% of CKD patients had poor SRH. Aged 75 years and above (AOR=1.8, 95% CI= 0.5-6.8), rural residents (AOR= AOR 1.8, 95% CI =1.0 -3.1) and those with other chronic conditions (AOR=5.1, 95% CI= 2.3-11.0) were associated with poor SRH. Overall 79% of the CKD patients availed health care facility, most (44.8%) of those visit private facility.ConclusionWe observed older adults, females, rural residents, and having other chronic conditions were associated with poor SRH among CKD patients which highlights the need for equitable and strengthened health care system. There is an urgent need to provide accessible, affordable and quality healthcare services for these individuals so as to maintain continuity of care

Social and biological evaluation of antimicrobial resistance (SOBEAR) in rural India: a study protocol

BackgroundAntimicrobial resistance (AMR) has been one of the biggest global health threats in recent years, mostly in low- and middle-income countries, which requires urgent research using a multidisciplinary research approach. The use of large quantities of antimicrobial drugs inappropriately for humans, poultry and agriculture has been recognized as a leading cause of antibiotic resistance and the predominance of drug-resistance pathogens in the environment. This protocol aims to describe the use/misuse of antibiotics (ABs) in the community and evaluate clinical samples from healthcare settings to detect genes associated with antimicrobial resistance.MethodsWe will conduct a community-level survey in different villages of the Tigiria block to assess knowledge and awareness on ABs and AMR. We will conduct in-depth interviews (IDIs) with doctors, pharmacists, nurses and drug sellers, as well as focus group discussions (FGDs) with ASHA and ANM workers who are involved in antibiotic supplies to the community. Quantitative data from the community survey and qualitative data of IDIs and FGDs will be linked and analyzed using statistical modeling and iterative thematic content analysis. Specimens (stool, urine, blood and wound/pus) will be collected from clinically diagnosed patients of different healthcare centers of Tigiria block. The samples will be cultured for bacterial isolation and antibiotic sensitivity testing. Genomic DNA will be isolated from positive bacterial cultures and sequenced using PCR to evaluate high-threat multi-drug resistance organisms (MDROs), screening of plasmid-mediated quinolone resistance (PMQR) genes, antimicrobial genes responsible for MDR and quinolone resistance-determining regions (QRDRs).ConclusionThis is the community-based protocol to evaluate the knowledge, attitudes, awareness and practices regarding ABs and AMR. The study protocol establishes a foundation for evaluating population-based prevalence and risk factors for AMR and MDROs in rural areas of the Odisha state, India

Association of Oral Health with Multimorbidity among Older Adults: Findings from the Longitudinal Ageing Study in India, Wave-1, 2017–2019

India is witnessing an increase in the prevalence of multimorbidity. Oral health is related to overall health but is seldom included in the assessment of multimorbidity. Hence, this study aimed to estimate the prevalence of oral morbidity and explore its association with physical multimorbidity using data from Longitudinal Ageing Study in India (LASI). LASI is a nationwide survey amongst adults aged ≥ 45 years conducted in 2018. Descriptive analysis was performed on included participants (n = 59,764) to determine the prevalence of oral morbidity. Multivariable logistic regression assessed the association between oral morbidity and physical multimorbidity. Self-rated health was compared between multimorbid participants with and without oral morbidity. Oral morbidity was prevalent in 48.56% of participants and physical multimorbidity in 50.36%. Those with multimorbidity were at a higher risk of having any oral morbidity (AOR: 1.60 (1.48–1.73)) than those without multimorbidity. Participants who had only oral morbidity rated their health to be good more often than those who had physical multimorbidity and oral morbidity (40.84% vs. 32.98%). Oral morbidity is significantly associated with physical multimorbidity. Multimorbid participants perceived their health to be inferior to those with only oral morbidity. The findings suggest multidisciplinary health teams in primary care should include the management of oral morbidity and physical multimorbidity

Hypertension control status and quality of care for hypertension among patients availing treatment from private sector: A cross-sectional study in urban field practice area of JIPMER, Puducherry

Introduction: In low-income countries like India, there is paucity of evidence regarding hypertension control status and the quality of care pertaining to hypertension care among the patients availing treatment from private sector. We wanted to determine the hypertension control status and quality of care pertaining to hypertension received by patients seeking care from private sector. Materials and Methods: This was an community based analytical cross-sectional study carried out in an selected urban area of Puducherry. This study was conducted among 265 adults with hypertension, availing treatment from private sector. Blood pressure was measured according to standard protocol. Data were collected using pre-tested semi-structured questionnaire by doing home visits. Results: The proportion of patients who were optimally controlled for hypertension were 43.9%. More than half (64%) of the participants had not checked their blood pressure in the last 1 year. There were 21.3%, 20%, 18.2%, and 9.5% of the participants who had optimally undergone fundus examination, blood sugar, serum cholesterol and serum creatinine examinations, respectively, as per recommended frequency. More than half (64%) of the study participants had not availed follow-up blood pressure monitoring in the last 1 year. The adherence to medication among the study participants was found to be 76.5%. Conclusion: Around 4 out of 10 patients had their blood pressure status controlled. More than half of the patients did not have any sort of follow-up investigations for the last 1 year. There was a scope for improvement in frequency of follow-up investigations as per recommendations

Correlates of secondhand smoke exposure among nonsmoking youth (15–24 years) in India: Secondary analysis from Global Adult Tobacco Survey, 2009–10

Introduction: Nonsmoking youth form a high-risk group and are at increased risk of ill-effects caused due to secondhand smoke (SHS). The objective is to determine the prevalence and correlates of SHS exposure among the nonsmoking youth in India from global adult tobacco survey (GATS), 2009–10. Methods: Secondary data analysis of GATS, 2009–10 was done to find the correlates of SHS at three different settings – house, workplace - indoor, and public place. All the sociodemographic variables were tested for association with SHS exposure using multivariate analysis. Prevalence ratio with 95% confidence interval [CI] was used to report the risk. Results: The prevalence of SHS was 48.6% (95% CI: 47.7%–49.5%) at house, 25.5% (95% CI: 23.5%–27.6%) at workplace - indoors, and 42.7% (95% CI: 41.7%–43.7%) at public places. SHS exposure among females was found to be higher at house; youth living in rural area were found at increased risk to SHS at both household and public places; and inverse relationship was seen between SHS exposure and education level at both household and workplace - indoors. Overall, the study showed that smokeless tobacco users were at increased risk of SHS exposure at all the three settings. Conclusion: Being female, living in rural area, lower education status, lower socioeconomic status, and use of smokeless tobacco were found to be associated with SHS exposure among nonsmoking youth in India