Background COVID-19 is affecting the entire population of India. Understanding district level correlates of the COVID-19’s infection ratio (IR) is essential for formulating policies and interventions. Objective The present study aims to investigate the district level variation in COVID-19 during March-October 2020. The present study also examines the association between India’s socioeconomic and demographic characteristics and the COVID-19 infection ratio at the district level. Data and methods We used publicly available crowdsourced district-level data on COVID-19 from March 14, 2020, to October 31, 2020. We identified hotspot and cold spot districts for COVID-19 cases and infection ratio. We have also carried out two sets of regression analysis to highlight the district level demographic, socioeconomic, household infrastructure facilities, and health-related correlates of the COVID-19 infection ratio. Results The results showed on October 31, 2020, the IR in India was 42.85 per hundred thousand population, with the highest in Kerala (259.63) and the lowest in Bihar (6.58). About 80 percent infected cases and 61 percent deaths were observed in nine states (Delhi, Gujarat, West Bengal, Uttar Pradesh, Andhra Pradesh, Maharashtra, Karnataka, Tamil Nadu, and Telangana). Moran’s- I showed a positive yet poor spatial clustering in the COVID-19 IR over neighboring districts. Our regression analysis demonstrated that percent of 15–59 aged population, district population density, percent of the urban population, district-level testing ratio, and percent of stunted children were significantly and positively associated with the COVID-19 infection ratio. We also found that, with an increasing percentage of literacy, there is a lower infection ratio in Indian districts. Conclusion The COVID-19 infection ratio was found to be more rampant in districts with a higher working-age population, higher population density, a higher urban population, a higher testing ratio, and a higher level of stunted children. The study findings provide crucial information for policy discourse, emphasizing the vulnerability of the highly urbanized and densely populated areas.

Background: Since the COVID-19 pandemic hit Indian states at varying speed, it is crucial to investigate the geographical pattern in COVID-19. We analyzed the geographical pattern of COVID-19 prevalence and mortality by the phase of national lockdown in India. Method: Using publicly available compiled data on COVID-19, we estimated the trends in new cases, period-prevalence rate (PPR), case recovery rate (CRR), and case fatality ratio (CFR) at national, state and district level. Findings: The age and sex are missing for more than 60 percent of the COVID-19 patients. There is an exponential increase in COVID-19 cases both at national and sub-national levels. The COVID-19 infected has jumped about 235 times ( from 567 cases in the pre-lockdown period to 1,33,669 in the fourth lockdown); the average daily new cases have increased from 57 in the first lockdown to 6,482 in the fourth lockdown; the average daily recovered persons from 4 to 3,819; the average daily death from 1 to 163. From first to the third lockdown, PPR (0.04 to 5.94), CRR (7.05 to 30.35) and CFR (1.76 to 1.89) have consistently escalated. At state-level, the maximum number of COVID-19 cases is found in the states of Maharashtra, Tamil Nadu, Delhi, and Gujarat contributing 66.75 percent of total cases. Whereas no cases found in some states, Kerela is the only state flattening the COVID-19 curve. The PPR is found to be highest in Delhi, followed by Maharastra. The highest recovery rate is observed in Kerala, till second lockdown; and in Andhra Pradesh in third lockdown. The highest case fatality ratio in the fourth lockdown is observed in Gujarat and Telangana. A few districts viz. like Mumbai (96.7); Chennai (63.66) and Ahmedabad (62.04) have the highest infection rate per 100 thousand population. Spatial analysis shows that clusters in Konkan coast especially in Maharashtra (Palghar, Mumbai, Thane and Pune); southern part from Tamil Nadu (Chennai, Chengalpattu and Thiruvallur), and the northern part of Jammu & Kashmir (Anantnag, Kulgam) are hot-spots for COVID-19 infection while central, northern and north-eastern regions of India are the cold-spots. Conclusion: India has been experiencing a rapid increase of COVID-19 cases since the second lockdown phase. There is huge geographical variation in COVID-19 pandemic with a concentration in some major cities and states while disaggregated data at local levels allows understanding the geographical disparity of the pandemic, the lack of age-sex information of the COVID-19 patients forbids to investigate the individual pattern of COVID-19 burden. Keyword: COVID-19; India; Case Fatality Rate; Case Recovery Rate; Period Prevalence Rate; Geographical variation

Background The number of patients with coronavirus infection (COVID-19) has amplified in India. Understanding the district level correlates of the COVID-19 infection ratio (IR) is essential for formulating policies and intervention. Objectives The present study examines the association between socioeconomic and demographic characteristics of India's population and the COVID-19 infection ratio at the district level. Data and Methods Using crowdsourced data on the COVID-19 prevalence rate, we analyzed state and district level variation in India from March 14 to July 31, 2020. We identified hotspot and cold spot districts for COVID-19 cases and infection ratio. We have also carried out a regression analysis to highlight the district level demographic, socioeconomic, infrastructure, and health-related correlates of the COVID-19 infection ratio. Results The results showed that the IR is 42.38 per one hundred thousand population in India. The highest IR was observed in Andhra Pradesh (145.0), followed by Maharashtra (123.6), and was the lowest in Chhattisgarh (10.1). About 80 percent of infected cases and 90 percent of deaths were observed in nine Indian states (Tamil Nadu, Andhra Pradesh, Telangana, Karnataka, Maharashtra, Delhi, Uttar Pradesh, West Bengal, and Gujarat). Moreover, we observed COVID-19 cold-spots in central, northern, western, and north-eastern regions of India. Out of 736 districts, six metropolitan cities (Mumbai, Chennai, Thane, Pune, Bengaluru, and Hyderabad) emerged as the major hotspots in India, containing around 30 percent of confirmed total COVID-19 cases in the country. Simultaneously, parts of the Konkan coast in Maharashtra, part of Delhi, the southern part of Tamil Nadu, the northern part of Jammu & Kashmir were identified as hotspots of COVID-19 infection. Moran's- I value of 0.333showed a positive spatial clustering level in the COVID-19 IR case over neighboring districts. Our regression analysis found that district-level population density (β: 0.05, CI:004-0.06), the percent of urban population (β:3.08, CI: 1.05-5.11), percent of Scheduled Caste Population (β: 3.92, CI: 0.12-7.72),and district-level testing ratio (β: 0.03, CI: 0.01-0.04) are positively associated with the prevalence of COVID-19. Conclusion COVID-19 cases were heavily concentrated in 9 states of India. Several demographic, socioeconomic, and health-related variables are correlated with the COVID-19 prevalence rate. However, after adjusting the role of socioeconomic and health-related factors, the COVID-19 infection rate was found to be more rampant in districts with a higher population density, a higher percentage of the urban population, and a higher percentage of deprived castes and with a higher level of testing ratio. The identified hotspots and correlates in this study give crucial information for policy discourse. Keywords COVID-19, socioeconomic, co-morbidity, geographical, hot-cold spot, districts, India.

AbstractsPurposeThe prevalence of substance use among tribal adolescents in north-east India is higher than that of the rest of India.ObjectiveThe study aimed to investigate the association between social network measures and substance use among male tribal adolescents in the West district of Tripura, North-East India.MethodsWe used data on 12-19-year-old tribal adolescents (N=340) from a primary cross-sectional survey in selected schools in the study area. We carried out bivariate and logistic regression analysis to establish the association between substance use and social network.ResultsOut of the total sample 340, about 27.65% reported smoking, 26.18% reported using smokeless tobacco, and 30.59% reported drinking alcohol; 35.29% reported using any of these substances. The substance use status of social network members was highly correlated to the substance use status among adolescents. The odds of substance consumption among adolescents increase with having a friend who smokes (OR = 6.152, 95% CI = 1.80–21.09), having friends who instigate to smoke (OR = 5.41, 95% CI = 1.86–15.74), and having friends who say smoking as a sign of masculinity(OR = 5.19, 95% CI = 1.4–18.22). Adolescents were more likely to smoke when their family member uses a substance (OR = 3.39, 95% CI = 1.5– 7.4,p= 0.002) and who spent time with friends with the same behaviour (OR = 2.66, 95% CI= 1.5–4.5,p≤ 0.000).ConclusionsIntervention is needed to address adolescents’ substance use habits and members belonging to close social networks.

Conventional measurements of aging do not take into account the dynamic nature of aging related characteristics over time. Therefore, in order to refine the estimates of aging, demographers have proposed prospective measures based on remaining life expectancy, Sanderson and Scherbov (2007). We compared these new measures with conventional aging measures using the data from the Census of India 2011 and Sample Registration System life tables 2009 to 2013. In conventional aging measures, we used life expectancy at age 60 and the old age dependency ratio (OADR), whereas for new measures of aging, we applied the threshold of old age based on the remaining life expectancy and prospective old age dependency ratio (POADR). Both measures of aging provided different estimates of the aging population at the national and subnational levels. At national level, application of prospective measures increased the number of older dependents from 66.4 million to 71.8 million (OADR: 8.6% vs. POADR: 10.6%). We observed profound variation at subnational level in India. We also observed that the prospective ageing measures not only provided higher estimates of ageing burden in India, but also altered the gender and rural urban differential in ageing. Considering the heterogeneity of life expectancies across Indian states, prospective measures provide more accurate refined estimates of aging burden in India as they are based on length of life expectancy. Application of these measures has great policy relevance in India.