BackgroundOmran's theory explains changing disease patterns over time predominantly from infectious to chronic noncommunicable diseases (NCDs). India's epidemiological transition is characterized by dual burden of diseases. Kumar addressed low mortality and high morbidity in Kerala, which seems also to be true for India as a country in the current demographic scenario.MethodsNSS data (1986–1987, 1995–1996, 2004) and aggregated data on causes of death provided by Registrar General India (RGI) were used to examine the structural changes in morbidity and causes of death. A zero-inflated poisson (ZIP) regression model and a beta-binomial model were used to corroborate the mounting age pattern of morbidity. Measures, namely the 25th and 75th percentiles of age-at-death and modal age-at-death, were used to examine the advances in mortality transition.ObjectiveThis study addressed the advances in epidemiological transition via exploring the structural changes in pattern of diseases and progress in mortality transition.ResultsThe burden of NCDs has been increasing in old age without replacing the burden of communicable diseases. The manifold rise of chronic diseases in recent decades justifies the death toll and is responsible for transformation in the age pattern of morbidity. Over time, deaths have been concentrated near the modal age-at-death. Modal age-at-death increased linearly by 5 years for females (r2=0.9515) and males (r2=0.9020). Significant increase in modal age-at-death ascertained the dominance of old age mortality over the childhood/adult age mortality.ConclusionsIndia experiences a dual burden of diseases associated with a remarkable transformation in the age pattern of morbidity and mortality, contemporaneous with structural changes in disease patterns. Continued progress in the pattern of diseases and mortality transition, accompanied by a linear rise in ex, unravels a compelling variation in advances found so far in epidemiological transition witnessed by the developed nations, with similar matrices for India.
Background Health at older ages is a key public health challenge especially among the developing countries. Older adults are at greater risk of vulnerability due to their physical and functional health risks. With rapidly rising ageing population and increasing burden of non-communicable diseases older adults in India are at a greater risk for multimorbidities. Therefore, to understand this multimorbidity transition and its determinants we used a sample of older Indian adults to examine multimorbidity and its associated risk factors among the Indian older-adults aged 45 and above. Methods Using the sample of 72,250 older adults, this study employed the multiple regression analysis to study the risk factors of multimorbidity. Multimorbidity was computed based on the assumption of older-adults having one or more than one disease risks. Results Our results confirm the emerging diseases burden among the older adults in India. One of the significant findings of the study was the contrasting prevalence of multimorbidity among the wealthiest groups (AOR = 1.932; 95% CI = 1.824- 2.032). Similarly women were more likely to have a multimorbidity (AOR = 1.34; 95% CI = 1.282—1.401) as compared to men among the older adults in India. Conclusion Our results confirm an immediate need for proper policy measures and health system strengthening to ensure the better health of older adults in India.
HighlightsFor decades, India’s HCES has collected individual household member data on meals.Underreported food away from home had been a growing source of measurement error.Household level food questions linked to members’ meals questions were introduced.The changes markedly reduced discrepancies between FAFH and meals away from home.More countries should introduce similar changes to improve food security measures.
1. The robust estimate of Basic Reproduction Rate (R0) of COVID-19 based on a meta-analysis performed on the pieces of evidence available across countries is 3.11 (2.49-3.71) persons for a generalised population in the absence of any control measures 2. The robust estimate of Case Fatality Rate (CFR) based on a meta-analysis performed on the pieces of evidence available across countries equals to 2.56 (2.06-3.05) per cent for a generalised population in approximately one-and-a-half months from the onset of the disease COVID-19. A significant regional variation is evident for the Basic Reproduction Rate (R0)but not for the Case Fatality Rate (CFR) 4. The peer-reviewed articles with a small sample size do not suffer from publication bias in a meta-analysis of COVID-19. Added Value of this StudyOut study combine available evidence of the parameter values, such as reproduction rate and case fatality rate, of the generalised epidemiological models for coronavirus disease of 2019 . In this way, we have reduced the dependency on data from a particular region or time or a homogeneous population. By applying meta-analysis, we estimated the robust estimate of reproduction rate and case fatality rate, which is applicable across heterogeneous populations. We proclaim that the reproduction rate of COVID-19 varies across subgroups of populations and regions and periods, but the case fatality rate remained the same. These estimates of reproduction rate and case fatality rate are worthwhile for developing countries like India and at a lower level of geography, in ambivalence. AbstractBackground: The outbreak of novel coronavirus disease of 2019 (COVID-19) has a wider geographical spread than other previous viruses such as Ebola and H1N1. The onset of disease and its transmission and severity has become a global concern. The policymakers have a serious concern for containing the spread and minimising the risk of death.Aim: This study aims to provide the estimates of basic reproduction rate (R0) and case fatality rate (CFR) which applies to a generalised population.Methods: A systematic review was carried out to retrieve the published estimates of reproduction rate and case fatality rate in peer-reviewed articles from PubMed MEDLINE database with defined inclusion and exclusion criteria in the period 15 December 2019 to 3 May 2020. The systematic review led to the selection of 24 articles for R0 and 17 articles for CFR. These studies used data from China and its provinces, other Asian countries such as Japan, Korea, the Philippines, and countries from other parts of the world such as Nigeria, Iran, Italy, Europe as a whole, France, Latin America, Turkey, the United Kingdom (UK), and the United States of America (USA). These selected articles gave an output of 30 counts of R0 and 29 counts of CFR which were used in a meta-analysis. A meta-analysis, with the inverse variance method, fixed-and random-effects model and the Forest plot, was performed to estimate the mean effect size or mean value of basic reproduction rate and case fat...
The combined effects of decreased fertility and mortality coupled with increasing survivorship across most ages have been upsetting the levels and age patterns of morbidity and mortality in India. This study examined data from the National Sample Survey (NSS) and Sample Registration System (SRS) of India. The results reveal marked structural changes in the age patterns of morbidity and mortality. The analysis also tested whether morbidity contours are being compressed or expanded, connecting it with the ongoing processes of demographic and epidemiological transition. The Sullivan (1971) method was used to estimate the health ratio over three time periods to ascertain the expansion of morbidity. The results reveal an exceptional rise in the prevalence rate of chronic non-communicable diseases in ages 60 and above. The proportion of unhealthy years of the total life expectancy has increased more than before for all older age groups. Overall, the results confirm that an expansion of morbidity is in progress, with a heavier and cumulated concentration of morbidity in older ages. The expansion of morbidity hypothesis is validated for major categories of population: rural, urban, male and female. Older females bear a much heavier burden of chronic non-communicable diseases and are vulnerable to a higher proportion of unhealthy years. The age-structural shifts in morbidity and mortality signal the steady progress of epidemiological transition in India.
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