No abstract

Greater involvement of the private sector to assist the government would help augment nutrition in children and indirectly impact school performance, attendance and literacy.

Background: India's Garment Industry has been rapidly growing in last few years. The Garment Industry is of major importance to the Indian economy as it contributes substantially to India's export earnings. Thus employees working in the above sociological context of working life are expected to be affected by the general acceleration of the pace of life, contributing to work intensification and constant time pressure. Managers play a key role in reducing the significant sources of stress and shaping the future of employees. Thus the above study was undertaken among managers and supervisory level staff. The objectives of the study were to estimate the magnitude and level of work-related stress and to find the association of socio-demographic factors with work-related stress in garment manufacturing factory. Methods: A cross-sectional study was undertaken for 4 months, from October 2015 to January 2016, in a selected garment factory, located in the periphery of Bangalore city. A total of 167 supervisors and 41 managers, were included in the study. Stress was assessed by using ‘Tool to assess and classify work stress and associated symptoms’, developed by Centre for public health, NIMHANS. Results: Prevalence of work-related stress was 26% (95% CI; 18.04-26.36). Managers had higher prevalence of stress (29.3%) when compared to supervisors (25.1%). Majority of managers were perceived to have moderate stress level (58.4%) when compared to supervisors (26.10%). Among all the socio-demographic factors; age, total monthly income, travel time and mode of transport were significantly associated with work-related stress (p<0.05). Conclusions: Organization changes viz., effort-reward imbalances, needs to be corrected and appropriate transport facilities meeting the employee requirements have to be provided, to cope up stress associated with travelling.

Background Health benefits of physical activity measured in terms of metabolic equivalent minutes (MET-minutes per week) have been established. However, factors affecting physical activity, like age, gender, body mass index, waist-hip ratio, particularly in rural communities have not been documented on a large sample. Methods Baseline physical activity data of more than 4000 subjects over 30 years of age, who were enrolled in a randomised community-based study on non-communicable diseases, were analysed. Global Physical Activity Questionnaire was used and anthropometric measurements were classified according to the MONICA study manual. Three domains of physical activity were measured as MET-minutes per week - activity at work, travel to and from places and recreational activities. Association of MET-minutes with sociodemographic variables and risk factors for cardiovascular diseases was studied. Results Mean MET-minutes per week of females were found to be significantly lower than that of males and decreased with advancing age and higher BMI in both genders. Married persons, normal BMI, normal waist-hip ratio, lower leisure time activity had demonstrated higher MET values (P = 0.000). In our study, the prevalence of inactivity (<600 MET-minutes) was 3.2% which was similar in both males and females. As high as 96.2% of the subjects had MET-minutes of > 1200. Nearly 50% of the subjects had leisure time ranging from 121 to 240 minutes per day. Conclusion A large majority of adults over 30 years of age in a rural community in Karnataka (96.2%) had very high MET-minutes per week of >1200 per day. Abnormal BMI, higher waist-hip ratio and more leisure time were associated with lower MET-minutes which are modifiable. About 50% had more than 2 hours of leisure time per day. It is recommended that health promotion for active lifestyle should be encouraged.

Background: MDRTB is a global health concern with its current prevalence in India being 2.3% and 17.2% respectively among newly diagnosed and previously treated cases. Besides its clinical impact, the disease affects the QOL of patients suffering from MDR-TB. The objective of the study was to assess the quality of life among MDR-TB cases in comparison with non-MDR TB cases and TB cured subjects (Category I, RNTCP).Methods: A cross sectional study was conducted in all the 14 TUs under District Tuberculosis Centre of Municipal Corporation of Bengaluru (BBMP). Study subjects comprised of 52 MDR-TB Cases, 53 Non-MDR-TB cases and 54 Category I TB cured subjects. WHOQOL BREF questionnaire was used to assess the QOL among study subjects. Median [IQR] scores of QOL in each of the domains among various groups were compared using Kruskal Wallis test. P<0.05 was considered as statistically significant.Results: Median age among MDRTB cases was 35 years [IQR: 26-50] whereas it was 37 years [IQR: 28-47] among Non MDRTB cases and 30.5 years [IQR: 22-45] among TB cured subjects. Out of 52 MDRTB cases, 26(50%) were females compared to 14 (26.4%) among Non MDRTB cases and 26(48.1%) among TB cured subjects (p=0.0024). As compared to non MDRTB cases, physical and environmental domains’ scores of MDRTB cases were significantly low (p=0.01 and p=0.001 respectively).Whereas, as compared to TB cured subjects, physical and psychological domains’ scores of MDRTB cases were significantly low (p<0.001 and p<0.001 respectively).Conclusions: The QOL of patients suffering from TB is affected and the impact is even worse in MDRTB. Hence prompt treatment of TB and early diagnosis of MDRTB will reduce the disease severity and improve the QOL.

Background: Food insecurity exists when people are undernourished due to the physical unavailability of food, lack of social or economic access to adequate food, and inadequate food utilization. As per FAO, India is home to 25% of world’s hungry population and 194.6 million undernourished people for the period of 2014-2016. The objectives were to assess the food insecurity and determine its correlates in a rural community of Karnataka.Methods: A cross sectional study was undertaken to assess food insecurity and its correlates in households of a rural community of Karnataka using the “Household Food Insecurity Access Scale (HFIAS) for measurement of food access: Version 3” questionnaire during December 2014. The data collected was analyzed using SPSS version 20.0 and mean, proportion and chi-square were calculated as appropriate.Results: The average HFIAS score was as low as 4.15. 80.8% of the 52 households were food insecure, of which 17.3% were mildly insecure, 48.1% were moderately insecure and 15.4% were severely food insecure.Conclusions: With 80.8% food insecurity in the rural agriculture-based community, there is a need for improvements in stability, accessibility and utilization of available food through use of fair price shops and garden kitchen promotion.

Background: Tobacco is known as a major cause of various preventable non-communicable diseases and kills half of all its users. With a greater prevalence in the rural community compared to the urban, this global health burden is substantially malignant. This study aimed to bridge the gap in the lack of adequate statistical information pertaining to prevalence and determinants of smoking and smokeless tobacco use in the rural population of Karnataka. Subjects and Method: This randomized community interventional study was conducted in primary health center areas of Karnataka, India. A total of 4,576 persons were interviewed (2,087 males and 2,489 females). Subjects ≥30 years of age and residents for a minimum of six months were included. Mentally challenged, bedridden or differently abled subjects were excluded. The study employed a validated questionnaire adapted from the WHO STEPS questionnaire concerning demographical information, behavioral, physical, and biochemical measurements. Besides tobacco, information on use of beedis, cigarettes, and smokeless tobacco products (snuff, chewing tobacco) were also elicited. Data analysis of socio-demographic characteristics (age, educational/ marital/ occupational status) was carried out only for the participants with a current smoking habit. Data were analyzed using SPSS Version 18.0. Results:The overall prevalence rate of current smoking and smokeless tobacco habit in the study population was 54.8% (95%CI= 53.40 to 56.20) and the prevalence rate of ever/past users was 39.7% (95%CI= 38.26 to 41.10). Gender-wise analysis predicted a higher prevalence of males currently smoking, and among them, most were 50 to 59 years of age (43.3%), illiterate (42.7%), widowed/ separated (39.8%), unskilled (44%), and semi-skilled workers (30%). Conclusion: Both genders participate in tobacco use, prevalence of smoking was higher among men and consumption of smokeless tobacco was higher among women. Subjects aged 50-59 years, illiterate, divorced/widowed/separated and, involved in unskilled or semi-skilled labor exhibited greater prevalence of tobacco habit compared to other determinants.

Background: Multidrug resistant tuberculosis (MDR-TB) is of growing health concern globally and in India. MDR-TB is defined as Mycobacterium tuberculosis resistant to Isoniazid and Rifampicin. The current prevalence of MDR-TB in India is 2.3% (ranging from1.8%-2.8%)and 17.2% (ranging from 14.9%-19.5%) among newly diagnosed and previously treated cases respectively. Increased cost, more side effects and longer duration of treatment makes MDR-TB management a great challenge.Methods & Materials: The present study was conducted as an Unmatched Case Control study to identify the determinants of MDR-TB. The study was conducted in all the 14 Tuberculosis units (TU) of Revised National Tuberculosis Control Programme (RNTCP) under the Municipal Corporation of Bengaluru. The source of the study subjects were patients registered under 14 TUs during the period of January 2013 to June 2014, with 52 MDR-TB patients as Cases and 53 non MDR-TB patients as Controls. Cases and controls were confirmed by culture and drug susceptibility test done at the Intermediate Reference Laboratory (IRL), Bengaluru. Both cases and controls were interviewed at their residence using a pretested semi structured questionnaire.Results: Univariate analysis including descriptive statistics along with Chi-square test and multivariate logistic regression were used to analyse the data. The mean age of the cases was 38.5 ± 15.8 years which was almost similar to that of the controls (38.5 ± 13.0 years). Univariate analysis revealed -the number of previous episodes of TB, type of health setup approached during the first episode of TB, treatment outcome of the first episode of TB, Gender, employment status, religion, education and socioeconomic status as statistically significant determinants of MDR-TB. After adjusting for potential confounders with multivariate logistic regression -the number of previous episodes of TB (OR = 4.08, 95%CI: 1.53-10.86), the treatment outcome of the first episode of TB(OR = 2.15, 95%CI: 1.42-3.25) and gender (OR = 3.14, 95%CI: 1.18-8.29) were found to be independent determinants of MDR-TB. Conclusion:Hence prompt treatment of newly diagnosed cases of tuberculosis in the first instance is critical in prevention of MDR-TB. Adequate counselling regarding treatment adherence to the patients at the first episode of TB will ensure compliance and reduce the chances of drug resistance.