BackgroundSpatial analysis has been vital in mapping the spread of diseases and assisting in policy making. Targeting diarrhea transmission hotspots is one of the potential strategies for reducing diarrhea cases. This study aimed to examine the spatial-temporal variations and to identify the modifiable determinants of diarrhea while controlling for the spatial dependence in the data.MethodsAn ecological study on diarrhea data from DLHS-3 and NFHS- 4 in India. Moran’s I and LISA were used to detect the spatial clustering of diarrhea cases and to test for clustering in the data. Spatial regression was used to identify the modifiable factors associated with the prevalence of diarrhea. The study comprised of the prevalence of diarrhea among the children below the age of five years (U-5 s) across different states in India. The determinants of diarrhea were obtained using spatial lag models. The software used were GeoDa 1.6.6 and QGIS 2.0.ResultsThe presence of spatial autocorrelation in DLHS-3 and NFHS-4 (Moron’s I = 0.577 and 0.369 respectively) enforces the usage of geographical properties while modeling the diarrhea data. The geographic clustering of high-prevalence districts was observed in the state of UP consistently. The spatial pattern of the percentage of children with diarrhea was persistently associated with the household with a sanitation facility (%) (p = 0.023 and p = 0.011). Compared to the diarrhea cases in the period 2007–2008, no much reduction was observed in the period 2015–2016. The prevalence of diarrhea and percentage of household with sanitation were ranging between 0.1–33.8% and 1.3–96.1% in the period 2007–2008 and 0.6–29.1% and 10.4–92.0% in the period 2015–2016 respectively. The least and highest prevalence of diarrhea being consistently from Assam and UP respectively.ConclusionDespite improvements in controlling spread of diarrheal disease, the burden remains high. Focus on widespread diarrheal disease control strategy by addressing the social determinants of health like basic sanitation is crucial to reduce the burden of diarrhea among U-5 s in India. The identification of hotspots will aid in the planning of control strategies for goal setting in the targeted regions.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6213-z) contains supplementary material, which is available to authorized users.

Like several indigenous populations, Sauria Paharias, a vulnerable indigenous tribal group residing in a biodiverse environment of Jharkhand, India, have high levels of undernutrition. We assessed agroforestry and dietary diversity, food consumption especially indigenous food (IF) intake and nutritional status of Sauria Paharia women through a cross‐sectional study conducted in 18 villages of Godda district, Jharkhand. Household level information was elicited through household surveys including a dietary survey and a food frequency questionnaire. Twenty‐four‐hour dietary recalls (24 HDR) and anthropometric assessments were taken on one randomly selected woman per household. An index, Food Accessed Diversity Index (FADI) created to measure agroforestry diversity, showed a low mean score of 0.21 ± 0.15 and range: 0, 0.85. Fifty‐nine percent of women consumed any IF during 24 HDR. Median minimum dietary diversity score for women (MDD‐W) was 3 (acceptable score ≥5). More than 96% of women had intakes below estimated average requirements for all nutrients studied (energy; vitamins A, C, thiamine, riboflavin, niacin, pyridoxine; folate; iron; calcium and zinc) except protein; 41% women were underweight. IF consumption was independently associated with calcium and vitamin A intake. Decision trees developed for micronutrient consumption at different levels of MDD‐W score and IF consumption scenarios revealed 1.3 to 2.9 times higher consumption of micronutrients among women with MDD‐W ≥ 3 or 4. Strategies like agricultural extension programmes promoting indigenous varieties and nutrition education for increasing dietary diversity with IFs have potential to address undernutrition in Sauria Paharia women.

To investigate the psycho-social factors associated with COVID-19 and the nationwide lockdown in India. Study design: An online survey was conducted from April 11 through April 16, 2020 in 28 states and 8 union territories (UT) of India. The potential participants were recruited using snowball sampling procedure. Methods: A cross-sectional online survey was conducted among the people of all states in India. A spatial analysis was performed and Moran's I statistic was applied to investigate the overall clustering of locations. Fisher's exact test was used to investigate associations. GeoDa and R console were used to analyze the data. A total of 1316 responses were received. Results: Those worried for their family's health were likely to follow the lockdown measures < p ( 0.001).Significant association was observed < p ( 0.001) between following the lockdown measures and being satisfied with the government strategy to combat the COVID-19 pandemic. A significant relation was observed between the gender (p = 0.001), job profile < p ( 0.001) and physical activity < p ( 0.001) were observed to be associated with the psycho-social impact. Conclusion:Government and public health officials should consider the sentiments of the community while planning strategies relating to the pandemic. The findings of this study will assist the policymakers in emphasizing the psychological well-being of individuals, along with physical health.

An optical fiber based immunosensing platform formed by two identical chirped long period gratings (CLPGs) for sensitive and label-free detection of Escherichia coli (E. coli) is presented. The proposed immunosensor having two CLPGs with an inter-grating space (IGS) works like a Mach-Zehnder interferometer. The important feature of this sensor is that by changing the refractive index (RI) induced phase at the IGS region, a corresponding shift in resonance wavelength can be realized without affecting the actual grating region. Additionally, the confining bandwidth of the interference fringes promotes greater resolution in the resonance wavelength analysis of the transmission spectrum. The main aim of this study was the specific and rapid detection of the E. coli bacteria in phosphate buffer saline (detection range: 10 cfu/ml to 60 cfu/ml) by using the bio-functionalized IGS region as a sensing probe of the dual CLPG structure. The observed detection limit was 7 cfu/ml. For specificity analysis, Salmonella typhimurium and Staphylococcus aureus were tested and no significant shift in resonance wavelength was observed. In addition, the proposed immunosensor has the ability to selectively detect E. coli in real samples including lake water. The high specificity, good sensitivity to ambient RI, and robustness of the developed sensing platform will open a new avenue in optical immunosensing technology, and cascaded long CLPG sensors can contribute significantly to the detection of pathogenic bacteria in water and food samples.