Background: Vitamin A deficiency is major concern especially for the children living in developing countries. According to UNICEF around one third of the children are not receiving the supplementation of Vitamin A they need. Aim: The present study focuses on Vitamin A deficiency among the children aged 12-59 months in India by analysing the data from the latest nutritional survey. Methods: The Comprehensive National Nutrition Survey (CNNS), conducted during 2016-18, dataset for 0-5 years age has been used in the study. The study has employed bi-variate analysis to assess the prevalence of Vitamin A deficiency (VAD) based on the CRP (C-reactive protein) values (CRP ≤5 mg/L), by the different socioeconomic and demographic characteristics along with dietary diversity, stunting, anaemia and breastfeeding related variables. Log-binomial regression model has been used for the multivariable analysis and based on that predicted probabilities were computed. Results: The overall prevalence of VAD in India is 17.54%. Children who are exposed to longer duration of breastfeeding have lower prevalence of VAD. Children in poorer economic sections are more vitamin A deficient compared to children in richer economic sections. The prevalence of VAD among children having minimum diet diversity is 18.63%. Conclusion:The study suggests in focusing on the targeted groups of children who are at more risk in developing VAD and planning interventions for specific groups. The nutrition programs require a multisectoral approach for addressing the needs of macronutrient and micronutrient deficiencies simultaneously to enhance the current situation of nutrition among children in India.

Background: With the turn of the century, CVDs have become the leading cause of mortality in India. Despite the wide heterogeneous prevalence of risk factors across different regions, CVD is the major cause of death in all parts of India. Therefore, the study aimed to investigate the prevalence of CVDs and its associated risk factors among older adults in India. Methods: The current study used data from the LASI, Wave 1, the world's largest and India's first longitudinal aging study. The total sample for the analysis was 65562 (45 and above individuals). The self-reported prevalence of CVDs was calculated by considering any one of the self-reported diagnosed conditions of hypertension, stroke, and chronic heart diseases. Binary Logistic regression was carried out between CVD and its associated risk factors like age, sex, place of residence, physical activity, family history of CVD, Diabetes/blood sugar, high cholesterol. P < 0.05 from two-sided statistical tests was regarded statistically significant. Results: The study indicated that the overall self-reported prevalence of diagnosed CVDs was 29.4% for older adults age 45 and above in India. Age was associated with increased risk of CVD Female older adults were more likely to have CVDs than male.The place of residence also had a stronger association with CVDs.In addition, high cholesterol, diabetes and physical inactivity were key risk factors for CVDs.The study also indicated that Family history was associated with a greater perceived risk for CVDs. The greater prevalence of CVDs risk factors among older adults manifested alarming public health concerns and a future health demand. It creates a threat if health promotion and awareness programs are not well designed.

Aims: The dust of tobacco enters the respiratory system of beedi workers through inhalation during beedi-making and causes respiratory impairments. The aim of the present study is to evaluate the pulmonary functional status of male beedi workers and to detect the pulmonary function impairments among these workers. Materials and Methods: A standard questionnaire was followed to note the symptoms like cough, breathlessness, morning cough and chest tightness. The tendu leaves contain fungal spores in different phases of its processing, particularly when they were kept in bundles in moist condition before wrapping the beedi. In the present study, pulmonary function status assessment was done by spirometric method using Spirovit-SP-10 and Wright's peak flow meter. Out of the total subjects studied (n=107), 56 were control subjects and 51 were workers exposed to beedi. Statistical Analysis: Paired t-test was done to determine the significant difference between beedi workers and control subjects. Result: A few workers reported symptoms of cough, breathlessness, morning cough and chest tightness. The respiratory symptoms were found higher in exposed beedi workers compared to control subjects. A trend of decrement of lung volumes with the increment of age and duration of work exposure was observed. The pulmonary function abnormalities found among the male beedi workers were obstructive, restrictive and 'combined restrictive and obstructive' type. Conclusion:The respirtory impairments among the beedi workers might be due to their exposure to the work environment.

Background In developing nations like India, fertility and mortality have decreased, and diseases related to lifestyle have become more common. Females in India are more prone to being overweight and obese than their male counterparts, more specifically in affluent families than the poor ones. Understanding the overweight and obesity trend may help develop feasible public health interventions to reduce the burden of obesity and associated adverse health outcomes. Methods The study utilizes the fourth round of the National Family Health Survey (NFHS-4), 2015–16. Descriptive statistics, bivariate and multivariate analysis was used to check the significant relationship between overweight and obesity, and other background characteristics. Income-related inequality in overweight and obesity among women was quantified by the concentration index and the concentration curve. Further, Wagstaff decomposition analysis was done to decompose the concentration index, into the contributions of each factor to the income-related inequalities. Results Overweight & obesity among women had a significant positive association with their age and educational level. The odds of overweight and obesity were 57% more likely among women who ever had any caesarean births than those who did not [AOR: 1.57; CI: 1.53–1.62]. The likelihood of overweight and obesity was 4.31 times more likely among women who belonged to richest [AOR: 5.84; CI: 5.61–6.08] wealth quintile, than those who belonged to poor wealth quintile. Women who ever terminated the pregnancy had 20% higher risk of overweight and obesity than those who did not [AOR: 1.20; CI: 1.17–1.22]. The concentration of overweight and obesity among women was mostly in rich households of all the Indian states and union territories. Among the geographical regions of India, the highest inequality was witnessed in Eastern India (0.41), followed by Central India (0.36). Conclusion The study results also reveal a huge proportion of women belonging to the BMI categories of non-normal, which is a concern and can increase the risks of developing non-communicable diseases. Hence, the study concludes and recommends an urgent need of interventions catering to urban women belonging to higher socio-economic status which can reduce the risks of health consequences due to overweight and obesity. Development nutrition-specific as well as sensitive interventions can be done for mobilization of local resources that addresses the multiple issues under which a woman is overweight or obese.

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Background Studies of the transmission dynamics of COVID-19 have depicted the rate, patterns, and predictions of cases of this pandemic disease. To combat transmission of the disease in India, the government declared a lockdown on March 25, 2020. Even after this strict lockdown was enacted nationwide, the number of COVID-19 cases increased and surpassed 450,000. A positive point to note is that the number of recovered cases began to slowly exceed that of active cases. The survival of patients, taking death as the event that varies by age group and sex, is noteworthy. Objective The aim of this study was to conduct a survival analysis to establish the variability in survivorship of patients with COVID-19 in India by age group and sex at different levels, that is, the national, state, and district levels. Methods The study period was taken from the date of the first reported case of COVID-19 in India, which was January 30, 2020, up to June 30, 2020. Due to the amount of underreported data and removal of missing columns, a total sample of 26,815 patients was considered. Kaplan-Meier survival estimation, the Cox proportional hazard model, and the multilevel survival model were used to perform the survival analysis. Results The Kaplan-Meier survival function showed that the probability of survival of patients with COVID-19 declined during the study period of 5 months, which was supplemented by the log rank test (P<.001) and Wilcoxon test (P<.001) to compare the survival functions. Significant variability was observed in the age groups, as evident from all the survival estimates; with increasing age, the risk of dying of COVID-19 increased. The Cox proportional hazard model reiterated that male patients with COVID-19 had a 1.14 times higher risk of dying than female patients (hazard ratio 1.14; SE 0.11; 95% CI 0.93-1.38). Western and Central India showed decreasing survival rates in the framed time period, while Eastern, North Eastern, and Southern India showed slightly better results in terms of survival. Conclusions This study depicts a grave scenario of decreasing survival rates in various regions of India and shows variability in these rates by age and sex. In essence, we can safely conclude that the critical appraisal of the survival rate and thorough analysis of patient data in this study equipped us to identify risk groups and perform comparative studies of various segments in India. International Registered Report Identifier (IRRID) RR2-10.1101/2020.08.01.20162115

IntroductionIntegrated Child Developmental Services (ICDS) is the most extensive government-run health program for children with its foot spread across the complete Indian Territory. ICDS Scheme, has been provided for 40 years and has been successful in some ways. The program in reducing the undernourishment among children over the past decade has been modest and slow in India than what has been reached in other countries with comparable socio-economic measure. Therefore, this study aims to identify the district level clustering of the non-utilization of ICDS services in India, and the present research also tried to relate it with socio-economic and demographic factors.Materials and MethodsThe data from the fourth round of the National Family Health Survey (NFHS-4) conducted in 2015–16 in India is used to carry out the analysis. We classified the country in 640 districts and employed geospatial techniques like Moran's I, univariate and bivariate local indicators of spatial association (LISA), and spatial error regression.ResultsThe non-utilization under ICDS scheme varied between 93% in West Siang district of Arunachal Pradesh and around 7% in the Kandhamal district of Odisha in 2015–16 in India. The univariate LISA results suggest striking geographic clustering of utilization of ICDS services among children in India (Moran's I: 0.612). On another hand, there were regions with substantially low-low clustering of non-utilization of ICDS services in southeast India, including districts in Andhra Pradesh, Chhattisgarh, Southern Madhya Pradesh, Odisha, Telangana, and West Bengal. The findings also suggest that the proportion of the rural population (−0.190), and poor households (−0.132) in the district were significantly and negatively related while the proportion of uneducated women (0.450) was positively related to the non-utilization of ICDS services within the district.ConclusionThis is the first-ever study that examined the complex interplay of the rural population, female illiteracy, poverty, SC/ST population, and Hindu population with non-utilization of ICDS services among children in the district in India. The study highlights the inter-district geographical disparities in the non-utilization of ICDS services. Further, it confirms that underprivileged districts in terms of the rural population and poor households are also disadvantageous in the utilization of ICDS services.