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.

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.

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.

Introduction: Menstrual problems like menorrhagia, dysmenorrhea and premenstrual syndrome (PMS) are common in adolescent girls. However literature regarding association between menstrual and mental health problems is limited; hence the current study was planned. Methods: It is a cross-sectional study conducted in Sangli district (Maharashtra), India among the female students from three randomly selected graduation colleges. Calculated sample size was 605 and cluster random sampling technique was applied. The study duration was June 2013 - May 2014. Study instrument was self-administered questionnaire with inventories like PSST-A, DASS-21 and SPIN. Statistical analysis was done using chi-square test and binary logistic regression. Results: Of the 707 participants; 413 (58.4%) had menstrual problems with dysmenorrhoea being the commonest. Embarrassment due to menstruation was felt by 14.9%. Menstrual problems were associated with perceived body type, body image, stress and anxiety. Embarrassment due to menstruation was associated with social phobia, stress, anxiety and depression. On binary logistic regression; body image and embarrassment due to menstruation were significant predictors for menstrual problems. Conclusions: Menstrual problems contribute to the development of various Mental Health disturbances. Hence, girls should be encouraged to seek health advice for the menstrual problems. A full time Health counsellor in schools and colleges can justify addressing adolescent health problems.

Background:Cancer is a leading cause of death globally. Every year, millions of cancer patients could be saved from premature death and and suffering if they had timely access to early detection and treatment. There are two main components of early detection: early diagnosis and screening. In India, cancers of cervix, breast, mouth/oropharynx are the most frequent cancers in women. These cancers are amenable to early detection. More than two third of the cancer patients are already in an advanced and incurable stage at the time of diagnosis.Objectives:This study was designed with the aim to know the reasons for non availment of cancer screening procedures and early diagnostic facilities.Materials and Methods:This cross-sectional study was planned in Sangli, Miraj and Kupwad Corporation area during October 2013 - March 2014 by a pretested questionnaire. Women of 25 years and above were study subjects selected randomly from a cluster sample of ward with estimated sample size of 559 women. Statistical analysis was done with the help of IBM SPSS 22.Results:Nearly 74% of women said that cancer is curable. For awareness about signs and symptoms, risk factors and screening test 82.3% women scored less than 50% of total score. Only 17.7% women had awareness score more than 50%. But their attitude score was > 50% in 85.2% of women. For practice score, 24.4% women scored > 50%. Significant association was found between awareness, attitude and practice scores and education, occupation and history of cancer in family, friends and neighborhood of respondents.Conclusions:Low awareness is the main barrier for undergoing cancer screening and early detection. There is a need of effective health education programme.

Background: In developing countries, the leading cause of disability in women aged 15-44 years is pregnancy and childbirth related complications. Many women do not die of causes related to pregnancy but suffer severe morbidities due to pregnancy related physiological stress.Methods: It is a Community based cross sectional study, conducted at randomly selected villages, towns and households in Sangli, Maharashtra, India. Sampling was done by simple random sampling, with a computed sample size of 3200. Study tool was a pre-tested questionnaire. Statistical analysis was done using percentages and Chi-square test. Microsoft Excel and SPSS 22 were used for analysis.Results: The study revealed a high prevalence of maternal morbidity in Sangli, Maharashtra, India. 52.65% women in urban area and 96.53% in rural area suffered from at least one morbidity. In rural area of Sangli, Maharashtra, India maximum of the women surveyed i.e., 30% have primary school education as compared to urban area of Sangli, Maharashtra, India which constitute 34%. A majority of the women in both the districts were suffering from mild complications but the percentage of serious complications is very high in the rural area (15%) than in the urban area (6%).Conclusions: In spite of low levels of perception about maternal morbidities, relatively higher utilization of health services during antepartum period should be taken as an advantage for initiating complete antenatal services, i.e. beyond the coverage of women by TT injection and supply of IFA tablets. The governmental initiation of supplying protein-rich food to pregnant and lactating mothers through ICDS programme has significantly lowered the morbidity levels probably by lessening the levels of anaemia.