Introduction Globally around 47.4% of children and in India, 58% of children aged 6–59 months are anemic. Diagnosis of anemia in children using accurate technologies and providing adequate treatment is essential to reduce the burden of anemia. Point-of-care testing (POCT) devices is a potential option for estimation of hemoglobin in peripheral and field settings were the hematology analyzer and laboratory services are not available. Objectives To access the validity of the POCTs (invasive and non-invasive devices) for estimation of hemoglobin among children aged 6–59 months compared with hematology analyzer. Methods The study participants were enrolled from the pediatric outpatient department in Haryana, India, from November 2019 to January 2020. Hemoglobin levels of the study participants were estimated in Sahli’s hemoglobinometer and invasive digital hemoglobinometers (DHs) using capillary blood samples. Hemoglobin levels in non-invasive DH were assessed from the finger/toe of the children. Hemoglobin levels measured in POCTs were compared against the venous blood hemoglobin estimated in the hematology analyzer. Results A total of 120 children were enrolled. The mean (SD) of hemoglobin (g/dl) estimated in auto-analyzer was 9.4 (1.8), Sahli’s hemoglobinometer was 9.2 (1.9), invasive DH was 9.7 (1.9), and non-invasive DH was 11.9 (1.5). Sahli’s hemoglobinometer (95.5%) and invasive DH (92.2%) had high sensitivity for the diagnosis of anemia compared with non-invasive DH (24.4%). In contrast, non-invasive DH had higher specificity (96.7%) compared with invasive DH (83.3%) and Sahli’s hemoglobinometer (70%). Invasive DH took the least time (2–3 min) for estimation of hemoglobin per participant, followed by Sahli’s (4–5 min) and non-invasive DH (5–7 min). Conclusion All three POCT devices used in this study are reasonable and feasible for estimating hemoglobin in under-5 children. Invasive DHs are potential POCT devices for diagnosis of anemia among under-5 children, while Sahli’s can be considered as a possible option, where trained and skilled technicians are available. Further research and development are required in non-invasive DH to improve accuracy. Lay summary In India, anemia is a serious public health problem, where 58% of the children aged 6–59 months are anemic. Point-of-care testing (POCT) using digital hemoglobinometers (DHs) has been recommended as one of the key interventions by the Anemia Mukt Bharat program since 2018 in India. These POCT devices are easy to use, less invasive, can be carried to field, require minimal training and results are available immediately. Therefore this study assessed the validity of POCT devices—invasive DH, non-invasive DH and Sahli’s hemoglobinometer among 6–59 months children in facility setting compared with the gold standard hematology analyzer. A total of 120 children under 6–59 months of age were enrolled from the pediatric outpatient department in Haryana, India, from November 2019 to January 2020. The (mean hemoglobin in g/dl) invasive (9.7) and non-invasive DH (11.9) overestimated hemoglobin value, while Sahli’s (9.2) underestimated hemoglobin compared with hematology analyzer (9.4). Invasive DH (92.2%) and Sahli’s hemoglobinometer (95.5%) reported high ability to correctly identify those with anemia compared with non-invasive DH (24.4%). In contrast, non-invasive DH (96.73%) had higher ability to correctly identify those without the anemia compared with invasive DH (83.3%) and Sahli’s (70%).

Background: In management of diabetes, self-care plays an important role in prevention of complications. This study aims to find the proportion of diabetic patients following the recommended self-care practices in an urban area of Puducherry. Materials and Methods: Consecutive eligible patients registered in chronic disease clinic were interviewed using Summary of Diabetes Self Care Activities Score (SDSCA) questionnaire. Self-care practices were evaluated in domains of diet, physical activity, foot-care, adherence to medications and blood glucose monitoring. All domains were scored from the range of 0 to 7. Results: Totally 162 diabetic patients were interviewed. The mean (SD) age of participants was 57 (11.1) yrs. Among all domains, adherence to medication was the highest (95.6 %) followed by avoidance of selected food items (99.4%). Almost 78% of patients had their blood sugar checked at least once in the last three months. Only half of them (50.6%) had followed at least 20 minutes of leisure time physical activity. Except washing of foot (83.3%) all other foot care practices were less commonly (35-57%) followed. Conclusion: The study shows that higher level of compliance to self-care practices in terms of taking drugs and diet but self-care in other domains such as foot care is alarmingly low.

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Background As a mitigation measure for COVID-19 pandemic, lockdown was implemented in India for a period of 2 months (24 March–31 May 2020). Disruption in antenatal care (ANC) provisions during lockdown is expected due to diversion of public health facilities on pandemic. Objective To assess the proportion of pregnant women who had not completed the ideal number of antenatal visits, availability of iron–folic acid (IFA) supplements and challenges in availing health services during the period of lockdown. Methods A concurrent mixed-methods study was conducted among pregnant women in Puducherry, India. Information on obstetric characteristics and details regarding antenatal visits were collected through telephonic interviews. In-depth interviews were conducted to understand the perceived challenges in availing health services during the lockdown period. Results Out of 150 pregnant women, 62 [41.3%; 95% confidence interval (CI) 33.6–49.3] did not complete the ideal number of visits and 61 (40.7%, 95% CI 32.7–49.0) developed health problems. Out of 44 women who received medical care for health problems, 11 (25%) used teleconsultation. Of all the women, 13 (8.7%, 95% CI 4.9–14.0) had not taken the IFA supplements as prescribed by the health provider. Economic hardship, restricted mobility, lack of information about the health system changes and psychological stress due to the fear of COVID were the challenges in accessing care. Conclusions Two out of five pregnant women did not complete the ideal number of visits and developed health problems during the lockdown period.

Introduction:Major proportion of the elderly with under nutrition is undetected in the community. One of the feasible ways to detect under nutrition among elderly would be screening in the field settings. in this study, we aimed to identify the utility of alternate anthropometric measures such as mid-upper arm circumference (MUAC), calf circumference, and skin fold thickness in identifying under nutrition among elderly.Materials and Methods:A community-based cross-sectional survey was done among elderly in one of the randomly selected subcenters. Anthropometric measures such as weight, arm span, MUAC, and triceps skinfold thickness were measured as per the standard measurement guidelines by a trained medical graduate. The elderly were identified as undernourished if body mass index (BMI) is <18.5 kg/m2. Utility of alternate anthropometric markers against BMI is represented by area under the curve (AUC) value from receiver operating characteristic curve and correlation coefficient (r).Results:Mean MUAC, calf circumference, and triceps skinfold thickness measured among 271 elderly were 25.6 cm ± 3.7 cm, 27.6 cm ± 3.7 cm, and 3.0 mm ± 1.3 mm, respectively. Among all three proxy anthropometric measures, MUAC had the highest AUC value (AUC = 0.88) Triceps skinfold thickness had the least AUC (AUC = 0.61). The correlation of anthropometric measurements such as MUAC, calf circumference, and triceps skinfold thickness with BMI was 0.74, –0.04, and 0.64, respectively.Conclusion:As MUAC and calf circumference are easy to measure and they are highly correlating with BMI, they can be used routinely by peripheral field workers to assess undernutrition in elderly during their regular house visits.

Background: Fishermen have a high burden of alcohol-related morbidity. The Alcohol Use Disorder Identification Test (AUDIT) is used to classify individual to have harmful use of alcohol and probable alcohol dependence. Hence, this study was conducted among fishermen in a selected fishermen community in Puducherry, South India, to (a) assess the proportion of harmful alcohol use and probable dependence to alcohol among alcohol users using AUDIT tool and (b) find the sociodemographic factors associated with harmful alcohol use and probable dependence among alcohol users. Materials and Methods: A community-based cross-sectional study was carried out among the fishermen above 18 years of age in a selected “fishing hamlet.” A house-to-house survey was conducted to identify the fishermen. A semi-structured questionnaire was used to obtain sociodemographic details. AUDIT tool was administered by interviewer to those fishermen who used alcohol in the past 1 year. Data were entered and analyzed using EpiData software. The proportion of harmful use of alcohol and probable dependence among alcohol users was expressed as percentage. Chi-square test was used to find association between sociodemographic factors with harmful use of alcohol and probable dependence. Results: Of 304 fishermen included in the study, 241 (79%) reported alcohol use in the past 1 year. Of 241 alcohol users, four-fifths (82%) had some formal education and two-thirds (67%) had monthly income <3000 INR. “Harmful use” of alcohol was noted in 76.8% (95% confidence interval [CI]: 71.1%–81.7%) and probable alcohol dependence in 12.4% (95% CI: 8.9%–17.2%). None of the individual characteristics of alcohol users were associated with either harmful use of alcohol or probable dependence. Conclusion: Among fishermen who use alcohol, eight out of ten have harmful use of alcohol. There is a need to screen for alcohol-related disorders among fisherman and adopt brief intervention strategies to counter problems of harmful use of alcohol.