India is one of the countries where hydrofluorosis is a major public health problem, affecting 18 of the 33 constituent States of the Country. Tamil Nadu is one of the Southern states having 10 of the 29 districts affected with fluorosis. Fluorosis is caused by ingestion of excess fluoride mainly through drinking water contamination. A cross sectional study was undertaken in 13 selected villages of five contiguous North western districts of Tamil Nadu viz: Vellore, Dharmapuri, Krishnagiri, Salem and Erode to assess the prevalence of fluorosis, adopting stratified random sampling procedure. A total of 8700 individuals, including 1745 children in the age group of 5-14 years were examined from 2800 Households for dental mottling. The study revealed that community bore wells formed the major source of drinking water among the villages. One hundred and twenty six drinking water samples were collected and the mean fluoride content was found to be more than WHO cut off level of 1.5 ppm in seven of the 13 villages surveyed. The prevalence of dental mottling (DM) was high among the total population in the districts of Dharmapuri (36%), Krishnagiri (24%) and Salem (33%), where the mean fluoride levels were 2.7, 2.2, and 1.2ppm respectively, however, the prevalence of skeletal deformities was low. The prevalence of DM was still high among the children (5-14 years) in the above three districts (53%, 43% and 42% respectively). Evaluation by Community Index for Dental fluorosis (CIDF) (>42% is considered as public health) suggested that the fluorosis is of public health importance in most of the villages. Such high prevalence of fluorosis requires community based interventions through supply of fluoride free surface water from a river, which is the most effective long-term strategy to control and prevent fluorosis.
The objective of the paper is to assess the diet and nutritional status of the tribal elderly (> or = 60 years) using data from a cross-sectional study carried out by National Nutrition Monitoring Bureau (NNMB) exclusively in Integrated Tribal Development Project (ITDP) villages of 9 provincial States in India during 1998-1999. A total of 1,239 elderly completed the diet survey (24-hour recall) and 3,932 elderly completed anthropometric measurements. In general, the mean consumption of all the foods and the median intakes of all the nutrients were below the Recommended Dietary Intakes (RDI) in both men and women. The mean heights and weights significantly decreased with increase in age in both males and females (p < 0.001). The prevalence of Chronic Energy Deficiency (CED = BMI < 18.5) was relatively higher (65.4%) in females compared with their male counterparts (61.8%). The prevalence of CED was significantly higher (p < 0.001) among the elderly living in kutchaand landless households. The tribal elderly are subsisting on inadequate diets, which are reflected in the poor intakes of all the nutrients and higher prevalence of undernutrition. Significantly higher proportion of tribal elderly are undernourished compared with their rural counterparts (p < 0.001).
Food Frequency Questionnaire (FFQ) is a commonly used tool for the measurement of food intake of a large population. However, FFQ could be influenced by the cultures, seasons and food habits. Thus FFQ should be validated against a known or standard tool like a multiple 24-hour dietary recalls (24h) and also needs to be tested for its reproducibility. Hence, in this study, the reproducibility of a Raw food based quantitative FFQ (RFFQ) was assessed and validated against the standard multiple 24h method. A community-based longitudinal study was conducted among 106 urban adult subjects in Hyderabad Metropolitan city of South India. The reproducibility of RFFQ was assessed at two reference periods of a year and seasonal variation was investigated across three seasons. Further, RFFQ was validated against 24h across three seasons of the year. The median and Inter Quartile Range (IQR) of food and nutrient intakes have shown that the RFFQ was comparable to 24h of four months duration and also between baseline and final RFFQs. No significant seasonal difference in food and nutrient intake was observed by the RFFQs (p>0.05). Bland-Altman analysis showed an agreement between the RFFQ and 24h indicating relative validity of the RFFQ in the study population. The reproducibility of the RFFQs was found to be good as observed by Intra class Correlation Coefficients (ICC). The RFFQ of one year duration is thus a valid tool to elicit long-term habitual dietary intake pattern of urban adult subjects in South India. As the RFFQ used in this study is raw food based it could be adopted to other parts of the country.
Objective: In four states in southern India we explored the determinants of HIV prevalence among female sex workers (FSW), as well as factors associated with district-level variations in HIV prevalence among FSW. Methods: Data from cross-sectional surveys in 23 districts were analysed, with HIV prevalence as the outcome variable, and sociodemographic and sex work characteristics as predictor variables. Multilevel logistic regression was applied to identify factors that could explain variations in HIV prevalence among districts. Results: HIV prevalence among the 10 096 FSW surveyed was 14.5% (95% confidence interval 14.0–15.4), with a large interdistrict variation, ranging from 2% to 38%. Current marital status and the usual place of solicitation emerged as important factors that determine individual probability of being HIV positive, as well as the HIV prevalence within districts. In multivariate analysis, compared with home-based FSW, the odds of being HIV positive was greater for brothel-based FSW [adjusted odds ratio (AOR) 2.17, P ≤ 0.001] and for public place-based FSW (AOR 1.32, P = 0.005). Unmarried FSW and those who were widowed/divorced/separated, or from the devadasi tradition, had higher odds of being HIV positive (AOR 1.79, P ≤ 0.001 and 1.98, P < 0.001, respectively), than those currently married. The estimated district level variance in HIV prevalence was lowest (0.152) for brothel-based unmarried FSW, followed by brothel-based widowed/divorced/separated or devadasi FSW (0.192). Conclusion: Heterogeneity in the organization and structure of sex work is an important determinant of variations in HIV prevalence among FSW across districts in India, much more so than the districts themselves. This understanding should help to improve the design of HIV preventive interventions.
The health of women is linked to their status in the society. The demographic consequence of the women has formed expression in various forms, such as female infanticide, higher death rate, lower sex ratio, low literacy level and lower level of employment of women in the non-agricultural sector as compared to men. Generally, at household level, cultural norms and practices and socio-economic factors determine the extent of nutritional status among women. National Nutrition Monitoring Bureau has been carrying out regular surveys on diet and nutritional status of different population groups since 1972. For the purpose of present investigation, the data collected during 1998-99 and 2005-06 on diet and nutritional status of tribal and rural population respectively in nine States of India was utilized. The intake of all the foods except for other vegetables and roots and tubers was lower than the suggested level among rural as well as tribal women. The study revealed inadequate dietary intake, especially micronutrient deficiency (hidden hunger) during pregnancy and lactation. The prevalence of goiter was relatively higher (4.9%) among tribal women compared to their rural counterparts (0.8%). Tribal women were particularly vulnerable to undernutrition compared to women in rural areas. The prevalence of chronic energy deficiency was higher (56%) among tribal NPNL women compared to rural women (36%).
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 (p40%) 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.
Tribal population constitutes about 8% of the total population in India. They are particularly vulnerable to undernutrition, because of their geographical isolation, socio-economic disadvantage and inadequate health facilities. Recognizing the problem, Government of India launched different programmes for their welfare. Adolescence is a significant period of growth and maturation. The nutritional status of adolescent girls, the future mothers, contributes significantly to the nutritional status of the community. Therefore an attempt was made to assess the diet and nutritional status of adolescent population from the different tribal areas of India. The available database collected by National Nutrition Monitoring Bureau (1998-99) was utilized for this purpose. Data on a total of 12,789 adolescents (10-17 yrs) was included for the analysis. Four percent of the adolescent girls were married and less than 1% were either pregnant (0.4%) or lactating (0.7%) at the time of the survey. The mean intake of all the foodstuffs, especially the income elastic foods such as Pulses, Milk & Milk products, Oils & fats and Sugar & Jaggery were lower than the recommended levels of ICMR. The intake of all the foodstuffs except green leafy vegetables was lower than that of their rural counterparts. The intake of all the nutrients were below the recommended level, while that of micronutrients such as iron, vitamin A and riboflavin were grossly inadequate in all the age and sex groups. About 63% of adolescent boys and 42% of girls were undernourished (< 5th BMI age percentiles of NHANES). A significant association between undernutrition and socio-economic parameters like type of family, size of land holding and occupation of head of household was observed. Therefore, there is a need to evolve comprehensive programmes for the overall development of tribal population with special focus on adolescents.
Vitamin A deficiency (VAD) continues to be a major public health nutritional problem in India, even though the National Vitamin A Prophylaxis Programme has been in operation for more than three decades.To assess the prevalence of vitamin A deficiency among rural pre-school children.A community-based cross-sectional study was carried out in rural Madhya Pradesh. A total of 8777 pre-school children were clinically examined for VAD and blood vitamin A levels were estimated in a sub-sample by dried blood spot method.Prevalence of night blindness and Bitot's spot, an objective sign of VAD, was 0.8% and 1.4%, respectively, and prevalence increased significantly (p < 0.001) with age. The proportion of children with blood vitamin A deficiency ( < 20 μg/dL) was 88% (95% CI: 84.8-91.2).The prevalence of Bitot's spot was significantly (p < 0.001) higher among children of lower socio-economic communities, 3-5-year age group and those of illiterate mothers.VAD is a major public health problem among rural children of Madhya Pradesh. Children of 3-5 years and those belonging to lower socio-economic communities are at high risk of VAD. Therefore, appropriate intervention measures are to be initiated to improve the vitamin A status of children.
Rajasthan had experienced drought conditions in the beginning of the millennium resulting drop in agricultural production, acute shortage of drinking water and fodder for cattle. Large number of cattle deaths was also reported. About 63% of the households stated that they were benefited by special ration supplied through PDS, 45% of the households had drinking water supply through tankers, while about 23% of the households participated in drought relief works. Coping strategies adopted during food scarcity were, borrowing cash/kind from neighbours (51.4%) managing with available food stocks (39.4%), reduced food consumption (35.6%), opting low cost foods (31%). The intake of all the foods except cereals & millets, roots & tubers and milk & milk products were lower than the recommended level. The intake of nutrients revealed that the diet was deficient in energy, vitamin A, and vitamin C and was also marginally lower than those observed during non-drought period The prevalence of undernutrition (<75% of weight for age) among preschool children was higher (50.7%) during drought compared to non-drought period (43%). Similarly about 49% of adult males and 40% of adult females had chronic energy deficiency (BMI<18.5). The factors, which deserve immediate attention, are strengthen the ongoing rehabilitation measures, ensure the supply of food, fodder and drinking water. Health and veterinary care have to be improved to minimize the untoward effects of consequences of severe drought.
To quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian countries.We used the 2010 Global Burden of Disease national surveys to characterize risk factor levels by age and sex. We derived etiological effects of risk factors-disease endpoints, by age, from meta-analyses. We defined optimal levels. We combined these inputs with cause-specific mortality rates to compute population-attributable fractions as a percentage of total cardiometabolic deaths.Suboptimal diet was the leading cause of cardiometabolic mortality in 4 of 5 countries, with population-attributable fractions from 40.7% (95% uncertainty interval = 37.4, 44.1) in Bangladesh to 56.9% (95% uncertainty interval = 52.4, 61.5) in Pakistan. High systolic blood pressure was the second leading cause, except in Bangladesh, where it superseded suboptimal diet. This was followed in all nations by high fasting plasma glucose, low fruit intake, and low whole grain intake. Other prominent burdens were more variable, such as low intake of vegetables, low omega-3 fats, and high sodium intake in India, Nepal, and Pakistan.Important similarities and differences are evident in cardiometabolic mortality burdens of modifiable dietary and metabolic risks across these countries, informing health policy and program priorities.
'%3e%3ccircle r='20' fill='%23008'/%3e%3ccircle r='17.5' fill='%23fff'/%3e%3ccircle r='3.5' fill='%23008'/%3e%3cg id='d'%3e%3cg id='c'%3e%3cg id='b'%3e%3cg id='a' fill='%23008'%3e%3ccircle r='.875' transform='rotate(7.5 -8.75 133.5)'/%3e%3cpath d='M0 17.5.6 7 0 2l-.6 5L0 17.5z'/%3e%3c/g%3e%3cuse xlink:href='%23a' transform='rotate(15)'/%3e%3c/g%3e%3cuse xlink:href='%23b' transform='rotate(30)'/%3e%3c/g%3e%3cuse xlink:href='%23c' transform='rotate(60)'/%3e%3c/g%3e%3cuse xlink:href='%23d' transform='rotate(120)'/%3e%3cuse xlink:href='%23d' transform='rotate(-120)'/%3e%3c/g%3e%3c/svg%3e)
