BackgroundIn India, acute respiratory infections (ARIs) are a leading cause of mortality in children under 5 years. Mapping the hotspots of ARIs and the associated risk factors can help understand their association at the district level across India.MethodsData on ARIs in children under 5 years and household variables (unclean fuel, improved sanitation, mean maternal BMI, mean household size, mean number of children, median months of breastfeeding the children, percentage of poor households, diarrhea in children, low birth weight, tobacco use, and immunization status of children) were obtained from the National Family Health Survey-4. Surface and ground-monitored PM2.5 and PM10 datasets were collected from the Global Estimates and National Ambient Air Quality Monitoring Programme. Population density and illiteracy data were extracted from the Census of India. The geographic information system was used for mapping, and ARI hotspots were identified using the Getis-Ord Gi* spatial statistic. The quasi-Poisson regression model was used to estimate the association between ARI and household, children, maternal, environmental, and demographic factors.ResultsAcute respiratory infections hotspots were predominantly seen in the north Indian states/UTs of Uttar Pradesh, Bihar, Delhi, Haryana, Punjab, and Chandigarh, and also in the border districts of Uttarakhand, Himachal Pradesh, and Jammu and Kashmir. There is a substantial overlap among PM2.5, PM10, population density, tobacco smoking, and unclean fuel use with hotspots of ARI. The quasi-Poisson regression analysis showed that PM2.5, illiteracy levels, diarrhea in children, and maternal body mass index were associated with ARI.ConclusionTo decrease ARI in children, urgent interventions are required to reduce the levels of PM2.5 and PM10 (major environmental pollutants) in the hotspot districts. Furthermore, improving sanitation, literacy levels, using clean cooking fuel, and curbing indoor smoking may minimize the risk of ARI in children.

Background Dengue and chikungunya (CHIKV) are the two major vector-borne diseases of serious public health concern in India. Studies on socioeconomic and housing determinants of dengue and CHIKV at a pan-India level are lacking. Here, we took advantage of the recently carried out Longitudinal Ageing Study in India (LASI) carried out across all the states and Union Territories of India to study the social indicators of dengue and CHIKV in India. Methods LASI-1 (2017-2018) data on the self-reported period prevalence of dengue and CHIKV from 70,932 respondents aged ≥45 years were used for this analysis. The state-wise distribution of dengue and CHIKV was mapped. Prevalence was estimated for each study variable, and the difference was compared using the χ2 test. The adjusted odds ratios (AOR) of the socioeconomic and housing variables for dengue and CHIKV were estimated using the multiple logistic regression model. Results Urban residence is the major socio-economic indicator of dengue and CHIKV (dengue AOR: 1.57, 95% CI: 1.18-2.11; CHIKV AOR: 1.84, 95% CI: 1.36-2.49). The other notable indicator is wealth; rich respondents have higher odds of dengue and CHIKV. Adults older than 54 years and those with high school education and above are associated with a lower likelihood of dengue and CHIKV. In addition, CHIKV is associated with scheduled and forward castes, households with improper toilet facilities, open defecation, and kutcha house type. Conclusions Despite the limitation that the data is only from adults ≥ 45, this analysis provides important insights into the socioeconomic and housing variables associated with higher odds of dengue and CHIKV in India. Understanding these determinants may assist in the national planning of prevention and control strategies for dengue and CHIKV.

Malaria is endemic in several tribal-dominated districts in India. Partnering and educating the tribal communities are key to malaria elimination efforts. A Knowledge, Attitude, and Practices (KAP) study was undertaken at Kandhamal, a tribal dominated malaria endemic district in the state of Odisha, to assess the gaps in malaria awareness in this community for focused public health interventions. To assess the knowledge, attitudes, and practices on malaria in the tribal-dominated regions of Kandhamal district, Odisha. A descriptive KAP survey was carried out in the Kandhamal district at the household level. Three hundred households/respondents from 6 blocks distributed in 44 villages were selected through convenient sampling. Statistical analysis was carried out using SPSS (version 24), and ArcGIS software was used for GIS mapping. The respondents had good knowledge on the major malaria symptoms. Witchcraft, contaminated food/water, and contact with a malaria case were thought to transmit malaria by 5.3%, 14.3%, and 9.7% of respondents, respectively, and these clusters have been mapped by GIS. Logistic regression identified reduced level of education and open source of water supply to have a strong association with the misconceptions regarding malaria among the respondents. Knowledge and attitude regarding malaria were found to be associated with residence in a hilly area and an open source of water supply, respectively. Overall, the participants in Kandhamal had good KAP on malaria. The clusters with poor knowledge could be the target of focused public health interventions.

BackgroundDengue and chikungunya (CHIKV) are the two major vector-borne diseases of serious public health concern in India. Studies on socio-economic and housing determinants of dengue and CHIKV at a pan-India level are lacking. Here, we took advantage of the recently carried out Longitudinal Ageing Study in India (LASI) carried across all the States and Union Territories of India to study the social determinants of dengue and CHIKV in India.MethodsLASI-1 (2017-2018) data on the self-reported period prevalence of dengue and CHIKV from 70,865 respondents aged ≥45 years were used for this analysis. The State-wise distribution of dengue and CHIKV was mapped. Prevalence was estimated for each study variable, and the difference was compared using the χ2 test. The adjusted odds ratios (AOR) of the socio-economic and housing variables for dengue and CHIKV were calculated using a multiple logistic regression model.ResultsUrban residence is the major socio-economic determinant of dengue and CHIKV (dengue: AOR: 1.57, 95% CI: 1.17-2.10; CHIKV: AOR 1.56, 95% CI: 1.20-2.02). Wealth status (richest) and less than primary schooling are associated with dengue and CHIKV prevalence. In addition to these factors, social group (scheduled and forward castes) is also associated with CHIKV prevalence. Water-source outside the dwelling (AOR: 1.20, 95% CI: 0.96-1.50), pucca or semi- pucca house type are also associated with increased odds of CHIKV. ConclusionsDespite the limitation that the data is only from adults ≥ 45, this analysis provides important insights into the socio-economic and housing variables that increase the odds of dengue and CHIKV in India. Understanding these determinants may assist in the national planning of prevention and control strategies for dengue and CHIKV.

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