Estimating the burden of 'weighing less': A systematic review and meta-analysis of low birth-weight in India.

Background. The National Family Health Survey-3 (NFHS- 3; 2005–06) reports that the prevalence of low birth-weight babies is 22% in India. This old figure is probably an underestimate as this nationwide survey acquired information on birth-weight of only 34% of babies. We aimed to make a fresh estimate of the proportion of low birth-weight babies. Methods. A systematic search was done through PubMed, Google Scholar, Cochrane Library, Medline, IndMed, Embase, WHO and Biomed Central databases. Studies published from 2004 to 2014 were included. Study quality was assessed using the adapted Mirza and Jenkins checklist. An ‘adjustment’ of 24% was applied to the published estimates where data were collected through records or through a combination of records and anthropometry. The adjustment was done to account for the heaping of birth-weight data at 2500 g. Metaanalysis using both random and fixed effects model was done to derive an estimate. Results. Nineteen studies with 44 133 subjects were included in the review. The pooled estimate for the prevalence of low birth-weight was 27% (95% CI 24%–30%) and the ‘adjusted’ pooled prevalence was 31% (95% CI 28%–33%). The prevalence in urban and rural areas was 30% (95% CI 23%– 38%) and 26% (95% CI 22%–30%), respectively. Regionwise estimates revealed that the prevalence at 33% was comparatively higher in eastern regions (95% CI 29%–37%). Conclusion. The pooled prevalence of low birth-weight is higher than that reported by NFHS-3. Updated estimates should be used to guide future interventions and policies. Natl Med J India 2016;29:73–81

Challenges in scaling up successful public health interventions: Lessons learnt from resistance to a nationwide roll-out of the weekly iron–folic acid supplementation programme for adolescents in India.

Anaemia, a major public health problem globally, affects an estimated 1.6 billion people.1 It has effects on the physical and mental health, as well as the productivity of people, particularly those in the vulnerable groups.2,3 The National Family Health Survey (NFHS)-3, 2005–06 estimated that 56% of women and 30% of men in India in the age group of 15–19 years were anaemic.4 Anaemia among people in the age group of 15–24 years was reported to be more common in the rural than urban areas, and among families belonging to the lower socioeconomic strata (Table I). Iron deficiency anaemia is one of the most prevalent micronutrient deficiencies globally and in India.5 About 60% of adolescents in the age group of 10–17 years have been reported to consume less than 50% of the recommended dietary allowance of iron, according to the 2012 National Nutrition Monitoring Bureau (NNMB) multistate survey.6 The low iron content of a typical Indian diet, along with the high prevalence of worm infestation, is the cause of the high prevalence of anaemia in India.7 The various strategies for the

Suicide an Emerging Public Health Problem: Evidence from Rural Haryana, India.

Analysis of annual mortality data for year 2002-2009 of twenty eight villages in Ballabgarh block of rural Haryana was carried out to calculate suicide rates per 100,000 population. In addition, informal discussions were carried out amongst health providers to understand their perceptions regarding suicides. In a period of 8 years, out of total 4552 deaths, 163 (3.5%) deaths were attributed to suicides giving a suicide rate of 24.4/100,000 population (95% CI 24.1- 24.7). Mean years of productive life lost for males and females were estimated to be 44.4 (SD 1.1) years and 39.9 (SD 1.4) years respectively. Poisoning (41.1%) was the most common mode of suicide followed by hanging (36.8%) and burns (14.7%). Health workers also perceived suicide as major problem in the community and marital confl ict was identifi ed as major cause for suicides. There is need to address the complex issue of suicide by public- health approach at the community level.

Evaluation of hysterosalpingoscintigraphy (HSSG) as a tool for tubal patency test.

Aim: To evaluate the role of hysterosalpingoscintigraphy (HSSG) as a tubal patency test and compare it with hysterosalpingography (HSG) in infertile patients. Objectives: To determine tubal patency with hysterosalpingoscintigraphy and test its accuracy as compared to hysterosalpingography; compare pain scale between hysterosalpingoscintigraphy and hysterosalpingography; determine time taken for the radiopharmaceutical to ascend up the genital tract during hysterosalpingoscintigraphy. Design: Prospective study Place: The study was conducted in the University Hospital setting. Patients and methods: HSSG was performed on 30 patients with 1 mCi technetium 99m labelled sulphur colloid. Sequential static images were obtained at 0, 15 minutes and 30 minutes. The results were compared to findings of hysterosalpingography. Results: Out of the 30 cases evaluated, 50% had bilateral patent tubes, 33.33% had unilateral patent tube, and 16.67% had bilateral blocked tubes. Time taken for sulphur colloid to reach uterus was 3 minutes 45 seconds; tubes 10 minutes 32 seconds; ovaries 25 minutes 48 seconds. All patients marked 0 on pain scale after HSSG while after HSG, 16 patients marked 3 and 14 patients marked 4 on pain scale. The sensitivity of HSSG was calculated to be 69.64%, specificity 75%, positive predictive value 97.5% and negative predictive value 15%. Conclusion: HSSG is easy to perform, with no premedication requirement and no pain in procedure with high positive predictive value (97.5%), but a poor negative predictive value (15%). This test can be used as compliment to other tubal patency test in the work up of infertility.