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Background: The burden of reproductive tract infections (RTI) among urban women in the reproductive age group (15-49 years) is usually a hidden issue. Earlier studies from Kerala mainly focused on reproductive morbidity among commercial sex workers. A cross-sectional study was conducted to estimate the prevalence of RTI and its association with potential socio-demographic risk factors, based on self reported symptoms among females in the age group 15- 49 years in the Urban training Health Centre field practice area of Government Medical College, Kottayam. Methods: The study was conducted among 643 women of the reproductive age group by single stage cluster sampling technique. A pretested semi structured interview schedule was used for collecting data on the socio demographic profile, clinical symptoms and associated factors after obtaining informed consent. Univariate analysis was done to find association of RTI with various factors followed by a bivariate analysis using binary logistic regression model. Results: The prevalence of RTI was 11.8%. RTI was significantly associated with age at marriage (p=0.02), age at first child birth (p=0.01), type of family (p=0.002), female education (p=0.001), socioeconomic status (p=0.007) and previous history of RTI in last one year (p<0.01) of which 84.1% women with symptoms of RTI had consulted a health personnel. Conclusions: A low prevalence of self reported symptoms of RTI with a high treatment seeking behavior was observed; attributed to the high female literacy. A comparable prevalence in younger age group of 15-24 years (10.9%) and 25-39 years (12.9%) suggesting equal susceptibility of adolescents to RTI was a notable finding.

Noncommunicable diseases (NCDs), also known as chronic diseases, are not passed from person to person. They are of long duration and generally slow progression. The four main types of NCDs are cardiovascular diseases (such as heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma), and diabetes. The rapid demographic and epidemiologic transition that India is facing today is paralleled by a massive increase in NCD prevalence, of which diabetes remains the most dominant. Besides genetic and environmental factors, an increase in life expectancy, urbanization, influenced unhealthy lifestyle changes, affluence associated with dietary excess, and reduced physical activity appear to be major drivers for increased burden of diabetes in India. Inappropriate nutrition and physical inactivity lead to obesity, a positive predictor for diabetes. Moreover, early onset of diabetes accompanied by prevailing poverty, low awareness, and poor health consciousness across socioeconomic and demographic strata is reflected in the large burden of undiagnosed cases of diabetes. In addition, reversal of socioeconomic gradient of disease burden observed in India can have serious health and financial implications on individual and healthcare system, which, if left unaddressed, may result in an adverse impact on the nation's economy. Keeping in view, a major shift in India's burden of disease, there is an imperative need for robust, systematic measures for data reporting supported by effective public healthcare interventions to reduce the burden of diabetes. Comprehensive multisectoral actions prioritizing identification of risk factors, early diagnosis, and effective implementation of cost-effective interventions can curb the epidemic of diabetes. A multifaceted approach for implementation of evidence-based policy measures involving various departments of the government and nongovernmental agencies is required to address both preventive and curative aspects of diabetes management. Policies that ensure better surveillance and increase in access to affordable and essential medicines providing universal health coverage should be developed. Policymakers should take lead in the development or strengthening the existing policies and see that they are not only implemented but also evaluated for their effectiveness. A strong commitment from both public and private sectors toward implementation and intensification of population-based prevention strategies through proven programs and policies is required to address the growing burden of diabetes.

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BACKGROUND Acute undifferentiated febrile illness (AUFI / AFI) is one of the most common reasons for people seeking medical care globally. Investigation into the aetiology and trends in AUFI cases are valuable public health data source. Absence of such evidence-based data may result in unintended public health consequences. Present study was undertaken to address the gap in period specific trends in AUFI cases reported from the region. METHODS A record based descriptive study was done in patients treated with AUFI from January 1st, 2015 to December 31st , 2019 in Government Medical College, Ernakulam. Universal sampling technique was adopted, and the data was entered in Microsoft Excel and analysed using Epi-Info software. Line diagram was constructed to obtain the trends in AUFI cases over the five-year period. Chisquare test was applied to find out the association between age group (paediatric and others) and causative agents of AUFI. RESULTS A total of 7998 AUFI cases were included in this study. Highest number of AUFI cases (1986) was reported in the year 2017. Under five age group was the most common, 1564 (19.6 %). Majority of the AUFI were reported among males, 4947 (61.9 %). Undetermined fever was found to be the most common AUFI, 2188 (27.4 %). Dengue fever, 1993 (24.9 %) was the most diagnosed AUFI. Viral aetiology was found to be the most common, 3895 (48.7 %) in both paediatric and other age groups. No statistically significant association was found between (P-value = 0.22) age group and organisms causing AUFI. There were 121 (1.5 %) deaths reported among the AUFI cases during the five-year period. It was seen that the case fatality due to AUFI was highest (2.41 %) in the year 2019. CONCLUSIONS A lack of consistent pattern in the aetiology of AUFI cases reported over the fiveyear study period, calls for persistent vigil by the public health surveillance system in the region, to identify any impending infectious disease outbreak at the earliest. As this study is based on hospital-based surveillance record it can underestimate the disease incidence. KEYWORDS Acute Undifferentiated Febrile Illness (AUFI), Trends, Dengue, Acute Febrile Illness