Background Undernutrition among under five children in India is a major public health problem. Despite India’s growth in the economy, the child mortality rate due to undernutrition is still high in both urban and rural areas. Studies that focus on urban slums are scarce. Hence the present study was carried out to assess the prevalence and determinants of undernutrition in children under five in Maharashtra, India. Methods A community-based cross-sectional study was conducted in 16 randomly selected clusters in two districts of Maharashtra state, India. Data were collected through house to house survey by interviewing mothers of under five children. Total 2929 mothers and their 3671 under five children were covered. Multivariate logistic regression analysis was carried out to identify the determinants of child nutritional status seperately in urban and rural areas. Results The mean age of the children was 2.38 years (±SD 1.36) and mean age of mothers was 24.25 years (± SD 6.37). Overall prevalence of stunting among children under five was 45.9%, wasting was 17.1 and 35.4% children were underweight. Prevalence of wasting, stunting and underweight were more seen in an urban slum than a rural area. In the rural areas exclusive breast feeding (p < 0.001) and acute diarrhea (p = 0.001) were associated with wasting, children with birth order 2 or less than 2 were associated with stunting and exclusive breast feeding (p < 0.05) and low maternal education were associated with underweight. Whereas in the urban slums exclusive breast feeding (p < 0.05) was associated with wasting, sex of the child (p < 0.05) and type of family (p < 0.05) were associated with stunting,and low income of the family (p < 0.05) was associated with underweight. Conclusions Factors like sex of the child, birth order,exclusive breast feeding,economic status of the family, type of family,acute diarrhea and maternal education have influence on nutritional status of the child. Improvement of maternal education will improve the nutritional status of the child. Strategies are needed to improve the economic status of the community. Trial registration Trial registration number: CTRI/2017/12/010881; Registration date:14/12/2017. Retrospectively registered.

Context:Breast and cervical cancer are the most common causes of cancer mortality among women worldwide, but actually they are largely preventable diseases. Healthcare providers in developing countries regularly see women with advanced, incurable cancers. Health of a rural Indian women and her access to health facility is compromised due to sociocultural, economical, and environmental factors.Aims:To know the problems associated with early detection of cancers in rural women.Settings and Design:Rural area and cross-sectional.Subjects and Methods:Study subject: Women of 35 years and above. Exclusion criteria: Not willing to participate. Sample size: All eligible women of selected villages.Sampling Technique:Random selection of villages. Study duration: 2 months. Study tools: Pretested questionnaire.Statistical Analysis Used:Percentages, χ2 test, analysis of variance (ANOVA), multivariate analysis.Results:Awareness about symptoms, possibility of early detection, available tests, possibility of cure of disease was low. Main barrier for screening was cognitive, that is, ‘don’t know’ answer by 83.99% women for cancer cervix, 84.93%, for cancer breast, and 67.26% for oral cancer. Awareness score was significantly associated with age (χ2 = 17.77, P = 0.001), education (χ2 = 34.62, P = 0.000), and income (χ2 = 16.72, P = 0.002); while attitude score with age (χ2 = 16.27, P = 0.012) and education (χ2 = 25.16, P = 0.003). Practice score was significantly associated with age (χ2 = 11.28, P = 0.023), education (χ2 = 32.27, P = 0.003), and occupation (χ2 = 10.69, P = 0.03). Awareness, attitude, and practice score of women having history of cancer in family or relative was significantly high than women without history.Conclusions:Cognitive barrier was the important barrier which has to be taken care of.

BackgroundPneumonia is responsible for high morbidity and mortality amongst children under five year of age. India accounts for one-third of the total WHO South East Asia burden of under-five mortality. There is a paucity of epidemiological studies indicating the true burden of pneumonia. Identification of the risk factors associated with pneumonia will help to effectively plan and implement the preventive measures for its reduction.MethodsIt was a descriptive cross-sectional study conducted in 16 randomly selected clusters in two districts of Maharashtra state, India. All mothers of under-five children in the selected clusters were included. A validated pretested interview schedule was filled by trained field supervisors through the house to house visits.WHO definition was used to define and classify clinical pneumonia. Height and weight of children were taken as per standard guidelines. Quality checks for data collection were done by the site investigators and critical and noncritical fields in the questionnaire were monitored during data entry. For continuous variables mean and SD were calculated. Chi-square test was applied to determine the association between the variables. Level of significance was considered at 0.05.ResultsThere were 3671 under five-year children, 2929 mothers in 10,929 households.Unclean fuel usage was found in 15.1% of households. Mean birth weight was 2.6 kg (SD;0.61). Exclusive breastfeeding till 6 months of age was practiced by 46% of mothers. Reported incidence of ARI was 0.49 per child per month and the reported incidence of pneumonia was 0.075 per child per year. It was not associated with any of the housing environment factors (p > 0.05) but was found to be associated with partial immunization (p < 0.05). Poor practices related to child feeding, hand hygiene and poor knowledge related to signs and symptoms of pneumonia amongst mother were found.ConclusionsVery low incidence of pneumonia was observed in Pune and Sangli districts of Maharashtra. Partial immunization emerged as a most important risk factor. Reasons for low incidence and lack of association of pneumonia with known risk factors may be a better literacy rate among mothers and better immunization coverage.Trial registrationRegistration number of the trial- CTRI/2017/12/010881; date of registration-14/12/2017.

Background Undernutrition among under five children in India is a major public health problem.Despite India’s growth in the economy, the child mortality rate due to undernutrition is still high in both urban and rural areas.Studies that focus on urban slums are scarce. Hence the present study was carried out to assess the prevalence and determinants of undernutrition in children under five in Maharashtra, India.Methods A community-based cross-sectional study was conducted in 16 randomly selected clusters in two districts of Maharashtra state, India. Data were collected through house to house survey by interviewing mothers of under five children. Total 2929 mothers and their 3,671 under five children were covered. Multivariate logistic regression analysis was carried out to identify the determinants of child nutritional status seperately in urban and rural areas. Results The mean age of the children was 2.38 years (±SD 1.36) and mean age of mothers was 24.25 years (± SD 6.37).Overall prevalence of stunting among children under five was 45.9 %, wasting was 17.1% and 35.4% children were underweight.Prevalence of wasting, stunting and underweight were more seen in an urban slum than a rural area.In the rural areas exclusive breast feeding(p<0.001) and acute diarrhea (p=0.001) were associated with wasting, children with birth order 2 or less than 2 were associated with stunting and exclusive breast feeding (p<0.05) and low maternal education were associated with underweight. Whereas in the urban slums exclusive breast feeding(p<0.05) was associated with wasting, sex of the child (p<0.05) and type of family(p<0.05)were associated with stunting,and low income of the family(p<0.05) was associated with underweight.Conclusions Factors like sex of the child, birth order,exclusive breast feeding ,economic status of the family, type of family,acute diarrhea and maternal education have influence on nutritional status of the child. Improvement of maternal education will improve the nutritional status of the child. Strategies are needed to improve the economic status of the community.Trial registration-This article is part of baseline data of the project, hence not related to trial registration. After baseline data principal investigator had done trial registration retrospectively.

Introduction:Diabetes is an important public health problem of India. Studies have shown that increase in patients’ knowledge regarding the disease results in better compliance to treatment and decrease in complications. This study was planned to assess the knowledge about diabetes and its correlation with pharmacological and non-pharmacological compliance, among the diabetic patients attending rural health center from Sangli District, Maharashtra (India).Materials and Methods:The study was conducted during September to November 2014. The study subjects were all willing adult patients with type II diabetes mellitus attending a selected rural hospital. The study tool was pretested and self-administered questionnaire. Analysis was done using Microsoft Excel and SPSS-22.Results:Total study participants were 307 in number, with the mean age of 55.6 years. The mean morbidity with diabetes was 10.7 years. Only 23.8% had good knowledge regarding diabetes, while 19.2% participants had poor knowledge. Knowledge was significantly associated with the compliance to the pharmacological and non-pharmacological management.Conclusion:Although most of the patients were suffering with diabetes for many years there is lack of knowledge regarding the disease and self care. The compliance to the management of diabetes was better in patients with good knowledge. Seminars, counseling sessions and workshop should be arranged periodically for diabetic patients to increase their awareness.

Acute respiratory infections (ARIs) continue to be the most important cause of morbidity and mortality among under-five children. Some demographic and environmental factors are associated with ARIs among under-five children. This study was conducted with the objective to estimate the prevalence of ARIs among under-five children in the rural areas and densely populated urban slum areas in Maharashtra, India and to assess the association of the selected sociodemographic and household environmental factors with ARI. This study was conducted in 16 selected clusters from the rural areas and densely populated urban slum areas of the two districts in Maharashtra, India. Structured and validated proforma was used for collecting the data on the sociodemographic and household environmental risk factors. A total of 3,671 under-five children were surveyed. The prevalence of ARIs for the preceding month was 50.4%. It was higher among the children living in the rural areas (54.2%) compared to the children living in the urban areas (46.7%) (p = 0.01). The prevalence of ARIs was reported to be 51.4 and 49.4% in boys and girls, respectively. In the multivariate analysis, the researchers found that living in rural areas (p = 0.01) and parental smoking (p = 0.04) were significantly associated with the ARIs. An intervention such as reducing parental smoking habits at the household level may reduce ARIs.

Background Undernutrition among under five children in India is a major public health problem. In India almost 60 million children are underweight. Despite India’s growth in economy, child mortality rate due to undernutrition is still high in both urban and rural area. Studies that focuses on undernutrition in urban slums are scarce. Hence present study was carried out to measure all forms of undernutrition like underweight, stunting and wasting. Methods A community based cross sectional study was conducted in 16 randomly selected clusters in two districts of Maharashtra state,India. All 2,929 mothers of under five children from these clusters were included in the study. Data was collected by house to house survey by interviewing mothers of underfive children.Odds ratio was calculated to determine association between the variables. Results Total 3,671 under five children were covered. Mean age of the children was 2.38 years (± SD 1.365).Stunting (45.9%) was found to be the commonest form of undernutrition among under five children, followed by underweight (35.4%), and wasting (17.1%). Sex of the child (urban slum; OR=1.32, rural area OR=1.63) birth order (rural area; OR= 0.47), immunization status (urban slum; OR=0.23) exclusive breast feeding (urban slum; OR=0.51), childhood infections like diarrhea(rural area OR= 1.69) acute respiratory tract infection (ARI) (rural area OR= 0.82), economic status of the family, (urban slum OR= 1.32), maternal age (P = 0.001)and maternal education(P <0.001) had either positive or negative influence on nutritional status of the children from urban slums and rural area. Conclusion Undernutrition in the form of underweight and stunting is more prevalent than wasting in the urban slum and rural area. It was related to sex of the child, economic status of the family, partial immunization of the child, ARI (Past 1 month) and maternal education. Improvement of immunization of under five children and maternal education will improve the nutritional status of the child. Trial registration-This article is part of baseline data of the project, hence not related to trial registration. After baseline data principal investigator had done trial registration retrospectively.

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