Diarrhea is the third leading cause of childhood mortality in India, and is responsible for 13% of all deaths/year in children under 5 years of age. Information on diarrheal diseases, its determinants and preventive and control strategies need to be reviewed for better planning and organization of health services. This study reviewed literature on diarrheal disease control among under-five children in India from literature published in PubMed, Google search engine and other databases on the internet. Data were described in terms of disease burden in India, determinants, management and intervention strategies, preventive strategies, and role of public health and scope for future action. This review calls for a comprehensive diarrheal disease control strategy, through improved case management, addressing social determinants of health and research in the field of cost-effective interventions to reduce the burden of diarrhea among children in India. With < almost one year left to reach the 2015 Millennium Development Goal on reducing child mortality, progress on control of diarrheal diseases must be accelerated.

a b s t r a c tBackground: Diabetes mellitus and hypertension (HT) are common diseases in adulthood, pre-disposing to many cardiovascular complications, posing a major public health challenge. Few studies have reported increased prevalence of cardiovascular disease risk factors and type 2 diabetes in policemen. Hence, this study aims to assess the prevalence of cardiovascular risk factors such as diabetes, HT, smoking, alcohol intake, and obesity among policemen. Materials and methods: A cross-sectional study was carried out in 2008e2009 among 256 policemen in Puducherry, South India. Policemen were selected by simple random sampling. Socio-demographic details and some of the risk factors such as alcohol intake and smoking history were obtained using a pretested, structured questionnaire. Presence of stress was measured using the professional life stress score questionnaire. Blood pressure, waist circumference, and hip circumference were measured by standard methods. Fasting blood sugar was estimated using a glucometer. Serum cholesterol was also measured. Lipid profile was measured for a randomly chosen subgroup of 50 participants. Results: Mean age of study participants was 40.9 years (SD AE 10.9). Out of the study subjects, 23% (n ¼ 60) were known diabetic and 16.8% (n ¼ 43) were known hypertensive. Prevalence of diabetes among study participants was 33.6% (CI: 27.8%e39.6%). Prevalence of HT among study participants was 30.5% (CI: 24.9%e36.5%). Seventy percent (n ¼ 178) had at least moderate range of stress in their life related to their profession and 4% (n ¼ 11) had stress as a "problem" in their life. Conclusions: Burden of cardiovascular risk factors such as diabetes and HT was high among police personnel of Puducherry.

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The new agenda for Public Health in India includes the epidemiological transition, demographical transition, environmental changes and social determinants of health. Based on the principles outlined at Alma-Ata in 1978, there is an urgent call for revitalizing primary health care in order to meet these challenges. The role of the government in influencing population health is not limited within the health sector but also by various sectors outside the health systems. This article is a literature review of the existing government machinery for public health needs in India, its success, limitations and future scope. Health system strengthening, human resource development and capacity building and regulation in public health are important areas within the health sector. Contribution to health of a population also derives from social determinants of health like living conditions, nutrition, safe drinking water, sanitation, education, early child development and social security measures. Population stabilization, gender mainstreaming and empowerment, reducing the impact of climate change and disasters on health, improving community participation and governance issues are other important areas for action. Making public health a shared value across the various sectors is a politically challenging strategy, but such collective action is crucial.

BackgroundReducing delay to accessing care is necessary to reduce the Tuberculosis (TB) burden in high incidence countries such as India. This study aimed to identify factors associated with delays in seeking care for TB in Southern India.MethodsWe analyzed data from newly diagnosed, smear-positive, culture-confirmed, pulmonary TB patients in the Regional Prospective Observational Research for TB (RePORT) cohort in Puducherry and Tamil Nadu, India. Data were collected on demographic characteristics, symptom duration, and TB knowledge, among other factors. Delay was defined as cough ≥4 weeks before treatment initiation. Risky alcohol use was defined by the AUDIT-C score which incorporates information about regular alcohol use and binge drinking. TB knowledge was assessed by knowing transmission mode or potential curability.ResultsOf 501 TB patients, 369 (73.7%) subjects delayed seeking care. In multivariable analysis, risky alcohol use was significantly associated with delay (aOR 2.20, 95% CI: 1.31, 3.68). Delay was less likely in lower versus higher income groups (<3000 versus >10,000 rupees/month, aOR 0.31, 95% CI: 0.12, 0.78). TB knowledge was not significantly associated with delay.ConclusionsLocal TB programs should consider that risky alcohol users may delay seeking care for TB. Further studies will be needed to determine why patients with higher income delay in seeking care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2629-9) contains supplementary material, which is available to authorized users.

BackgroundWe aimed to define characteristics of TB patients in Puducherry and two districts of Tamil Nadu, India and calculate the population attributable fractions (PAF) of TB from malnutrition and alcohol.MethodsNew smear-positive TB cases were enrolled into the Regional Prospective Observational Research for Tuberculosis (RePORT India) cohort. Census and National Family Health Survey data were used for comparisons.ResultsData were analyzed for 409 participants enrolled between May 2014-June 2016; 307 (75.1%) were male, 60.2% were malnourished (body mass index [BMI] <18.5 kg/m2), and 29.1% severely malnourished (BMI <16). “Hazardous” alcohol use (based on AUDIT-C score) was reported by 155/305 (50.8%) of males. Tuberculosis cases were more likely than the Puducherry population to be malnourished (62.6% v 10.2% males and 71.7% v 11.3% of females; both p<0.001), and male cases were more likely to use alcohol than male non-cases (84.4% v 41%; p < .001). The PAF of malnutrition was 57.4% in males and 61.5% in females; the PAF for alcohol use was 73.8% in males and 1.7% in females.ConclusionsAlcohol use in men and malnutrition are helping drive the TB epidemic in Southern India. Reducing the TB burden in this population will require efforts to mitigate these risk factors.

A cross-sectional study was conducted among 164 students in a medical school in Pondicherry, India, by administering a questionnaire consisting of anthropometric data, menstrual history and psychosocial stress. Psychosocial stress was assessed using Perceived Stress Scale (PSS10). We observed that out of the 164 students who answered the questionnaire, students who reported premenstrual symptoms, irregular cycles and dysmenorrhoea severe enough to take medication had significantly higher mean PSS scores (p = 0.000, 0.025, 0.035, respectively). High stress (fourth quartile PSS score) was significantly associated with occurrence of premenstrual symptoms and dysmenorrhoea severe enough to take medication. Stress in medical students is associated with severe dysmenorrhoea, irregular cycles and premenstrual syndrome. This implies that interventions to reduce the stress can improve the menstrual health of medical students, thereby reducing future health risks and improving the quality of life.