India is coming to grips with a stage of nutrition transition. According to the Food Safety and Standards Authority of India (FSSAI), preventable micronutrient deficiency is arising public health precedence in India. However, the foremost public health concern is the lack of national prevalence data. The present study was carried out to estimate the pooled age-wise prevalence of six preventable micronutrient deficiencies (vitamin A, vitamin B12, vitamin D, iron, iodine and folic acid) in India. A systematic review was carried out on PubMed and Global Index Medicus databases using the Boolean search strategy. Statistical analyses were done using R software, version 3.6. 2. PRISMA guidelines were strictly adhered to during the review. A preliminary literature search yielded 4302 articles; however, 270 original research articles were found eligible to be included in quantitative synthesis. The estimated overall prevalence was 17 % [95 % confidence interval (CI) 0⋅07, 0⋅26] for iodine deficiency, 37 % (95 % CI 0⋅27, 0⋅46) for folic acid deficiency, 54 % (95 % CI 0⋅49, 0⋅59) for iron deficiency, 53 % (95 % CI 0⋅41, 0⋅64) for vitamin B12 deficiency, 19 % (95 % CI 0⋅09, 0⋅29) for vitamin A deficiency and 61 % (95 % CI 0⋅07, 0⋅26) for vitamin D with high heterogeneity. We classified the population into infants (0–5 years), adolescents (<18 years), adults (>18 years) and pregnant women. Iron deficiency was most prevalent (61 %) in pregnant women. The results of the present study reinforce the data on micronutrient deficiency in India and warrant the immediate need for further active public health interventions to address these deficiencies. The study is registered with PROSPERO (CRD42020205043).
Background: Immunization is the cost-effective public health intervention that prevents and protects against vaccine preventable diseases. The objective was to estimate the timeliness in receiving age appropriate vaccines and to study selected factors influencing the timeliness of age appropriate vaccines as per national immunization schedule among children aged 0 to 23 months in a rural area of Pondicherry.Methods: A retrospective study was done at a Community Health Centre, Karikalampakkam, Pondicherry using data from immunization registers of children aged 0 to 23 months, who were born between July 01, 2013 to July 31, 2015. If the child was vaccinated within 7 days of the scheduled time, it was considered as timely vaccination.Results: Out of 679 children, 52% were males and 48% were females. The median days of delay in vaccination were ranged from 1-171 days. The proportion and the median days of delay were increased progressively as the age of the child increased. The place of delivery was significantly associated with birth doses of OPV, Hepatitis B and BCG vaccination. There was a significant difference in timeliness of vaccination across the birth order of the children for the first, second and third doses of OPV and Pentavalent vaccines (p=0.02). Birth weight of the children was not statistically associated with vaccination delay.Conclusions: Delay in vaccination in varying frequency was observed for the vaccines administered under the national immunisation schedule. Hence, the age-appropriate vaccinations should be given up-to-date as well as on time.
COVID pandemic with repeated outbreaks is associated with newer genomic variants and bound to create professional fatigue, which needs a community-based strategy to control the disease. During March 2021, the Tirunelveli district health authority adopted a Community Sustained Multidisciplinary Approach (CSMA) and was hypothesised to be more productive in managing the 2nd wave. It was a community-centric approach with primary prevention, early diagnosis & referral, early treatment and reduction of morbidity and mortality. The strategy included community-friendly lock-down with social security, community sustained micro-containment, women self-help group sustained hamlet level screening and a time-sensitive patient referral with monitoring of oxygen requirement. This study concludes that resource-constrained public health systems need to adopt a community-based approach to contain the pandemic efficiently, as demonstrated in Tirunelveli district through a Community Sustained Multidisciplinary Approach. This unique public health approach had a vital role in the efficient containment of the pandemic.
Introduction: Globally, breast cancer affects 2.5 million people annually. Younger women with advanced-stage cancers had a lower survival rate, but early detection enhanced survival chances by 27 to 47%. Breast self-examination (BSE) has led to early detection and higher rates of benign biopsies. Studies evaluating the psychosocial impact of BSE are few in India which has been attempted in the present study. Methods: The community-based descriptive cross-sectional study was conducted among rural women aged 30 years and above, who have done BSE at least once without present or prior breast abnormalities in the field practice area of Model Rural Health Research Unit, Tirunelveli. The research questionnaire was developed based on the findings of focus group discussion (FGD) on the same objective in the study area. Results: Among 379 participants, 146 (38.5%) felt confident in their BSE knowledge, 28.2% (n=107) and 5.5% (n=21) of the respondents experienced anxiety and depression while practising BSE, respectively. There is a significant difference between the mean anxiety levels (p-value=0.002) and depression (p-value=0.013) of individuals who have detected anomalies during BSE and those who have not. Conclusion: Regular counselling has to improve knowledge about BSE, like the timing and method of examination, and decreases the anxiety and depression level.
Objective: Neurodevelopmental disorders NDD are neurologic processing problems that interfere with learning in children. Primary and preschool teachers who are essential links in public health reach out to such children do not receive any formal training to identify these disorders. Hence, a primary and preschool level intervention addressing the issue is proposed. Materials and Methods: Primary and preschool teachers of government and government-aided schools and Anganwadi/preschools in the Model Rural Health Research Unit Tirunelveli field practice area will be assigned into two groups. The training module will be developed and validated using neurodevelopmental screening tool (NDST). Before identifying the students using the NDST, the teachers in Group A will get training using the module. Group B is the control group, in which untrained teachers administer the NDST to the children and then will be trained. Neurologists will assess the same children over 1 year. Results: The effectiveness of teacher training for the early detection of children with NDD will be assessed. Thus, the validity of the screening for NDD by the teachers will be estimated. Conclusion: If successful, the module can be incorporated into the Rashtriya Bal Swasthya Karyakram program of India for the early identification of children with NDD.
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