Background: India is said to be shifting from an undernourished to over nourished population with advances in health, economy and medical care. But there is paucity of information regarding nutritional status of older adults in the country, who are socially and economically insecure. Hence the present study attempts to assess the nutritional status of people above 60 years of age, and to find the factors associated with it.Methods: A cross sectional study was conducted among 129 people aged above 60 years, residing in Pathanamthitta district, Kerala. Mini Nutritional Assessment tool (MNA) was used to classify the respondents as having ‘normal nutrition’ (score 23.5 and above), ‘at risk of malnutrition’ (17-23.5), ‘malnourished’ (<17). A 24-hour dietary recall was done to calculate per day calorie intake and compare with Recommended Daily Allowance (RDA). The results were interpreted as adequate or deficient. Descriptive statistics, chi-square and spearman’s correlation were done to find relationship between various sociodemographic variables, MNA status, BMI and calorie intake.Results: Females constituted 75.2%; 81.4% were unemployed; 62% belonged to rural area. Nutritional assessment showed 41.9% to be having normal nutrition, 46.5% at risk of malnutrition, and 11.6% malnourished. Caloric intake was less than the RDA in 89.1%. There was no association between calorie intake per day and MNA status. Education (p=0.025), place of residence (p=0.021), marital status (p=0.003), and family income (p=0.031) were factors significantly influencing nutritional status in elderly. There was significant correlation between MNA status and BMI (p<0.001, r=0.329).Conclusions: Malnutrition was seen in 11.6% of older adults in this study and another major proportion was at risk of malnutrition. Better nutritional status was significantly associated with good education, urban residence, married state, and higher family income. Dietary intake was inadequate among older adults. 24-hour dietary recall reflected nutritional status of only the malnourished.

Background: Immunization coverage is undisputedly the most effective health status and outcome indicator.  Though India is effectively organizing vaccination campaigns, a large majority of children are often left out. Strong anti-vaccination propaganda is influencing the decision of parents. This study was initiated in the context of vaccine-preventable disease outbreak rising recently in Kerala to assess the knowledge and practices of mothers of children less than five years regarding immunization.Methods: A cross sectional study was conducted among 140 women with children less than 5 years. Sample was drawn from the rural and urban field practice areas of a tertiary care teaching hospital. A pilot tested interviewer administered questionnaire was used to assess the knowledge and practices of immunization among mothers of under-five children. Chi-Square test was used to find the association between dichotomous variables.Results: In the study group 96.4% of the children were fully immunized. Mean score on knowledge regarding immunization among the study population was 6.45 (SD=1.84). Majority (89%) of the mothers agreed on the importance of vaccination. More than half (57.1%) had heard of anti-vaccination campaign and 24.3% were influenced by it at one time or the other. Higher knowledge score was associated with mothers residing in urban area, better occupation of mother and educational status of father. Age of child, sex, religion, type of family did not influence knowledge level. Factors influencing the perceived importance of vaccination are better occupation of father, higher education status of father and mother.Conclusions: Vaccination was perceived significant for child’s health. Immunization coverage in the study population was high. The level of knowledge regarding immunization among the study population was poor. Anti-vaccination campaign has influenced the population at one time or the other.

Background: Control of blood pressure is a global challenge and non-adherence to hypertension medications is a public health concern. Patient, medication and system related factors can contribute to non-adherence. The study was to determine adherence to hypertension medications and to understand the barriers to adherence in an adult group in Pathanamthitta District of Central Kerala.Methods: A cross sectional study was conducted in a community setting in 2016, among 139 adults aged 30 years and above on treatment for hypertension for at least six months. Those with gestational hypertension, those having serious comorbid conditions and those unwilling to participate were excluded. The data sheet included basic demographic information and history related to hypertension. A content validated eight item questionnaire was used to assess reported adherence and scores classified level of adherence as good (8), moderate (6-<8) and poor (<6). The data was analyzed using SPSS. Chi square test of significance and multivariate regression analysis were done. P<0.05 was considered statistically significant.Results: The participants were in the age group 34-91 years, 50.4% belonging to 50-69 years, and 75.5% were females. Adherence to hypertension medications was good in 49.6%, moderate in 31.7% and poor in 18.7%. The most common factors reported to contribute to non-adherence were forgetfulness (70.5%), high cost of medications (51.8%), and symptom-free state (27.3%).Conclusions: Adherence was good in less than half the study participants and poor in almost one-fifth. Forgetfulness and high medication costs were the most commonly reported barriers. These findings highlight the importance of individuals, families and health service, joining hands to tackle the public health problem of non-adherence to hypertension medications.

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