Health status of tribes of Uttar Pradesh with special reference to health-seeking behaviour of uncharted Tharu tribe: A mappingreview

Background & objectives: The tribal population in India is considered as one of the vulnerable groups with respect to their achievements in health and other developmental issues. In this context, this mapping review attempted to understand the health profile of the Tharu tribal community residing in the northern State of Uttar Pradesh, India through literature mining. Tharu tribe is one of the indigenous groups living in the Terai plain on the Indo-Nepal border. In 1967, this tribe was documented as a Scheduled Tribe by the Government of India. The present review aimed to map the health-seeking behaviour of the Tharu population and review other factors pertaining to their health such as socioeconomic, developmental, employment, education, etc. Methods: Online data search was carried out on PubMed and Google Scholar using search terms ‘Tharu’ AND ‘India’. In addition, official reports avaibale in public domain and grey literature was also searched. Results: Twenty seven studies including reviews, articles, books/book chapters were evaluated along with 13 reports (including reports from government organizations and grey literature) were retrieved and analyzed. Of the 27 published reports, 16 were found relevant to Tharu tribe in India. A total of 29 (16 articles + 13 reports ) were included in this review. Interpretation & Conclusions: This mapping review highights the health seeking behaviour of the Tharu tribe in India that can help inform future interventions to improve the health status of the Tharu tribe as well as other aspects of their development.

Development & validation of scales to assess stigma related to COVID-19 in India

Background & objectives: COVID-19 pandemic has triggered social stigma towards individuals affected and their families. This study describes the process undertaken for the development and validation of scales to assess stigmatizing attitudes and experiences among COVID-19 and non-COVID-19 participants from the community. Methods: COVID-19 Stigma Scale and Community COVID-19 Stigma Scale constituting 13 and six items, respectively, were developed based on review of literature and news reports, expert committee evaluation and participants’ interviews through telephone for a multicentric study in India. For content validity, 61 (30 COVID-19-recovered and 31 non-COVID-19 participants from the community) were recruited. Test–retest reliability of the scales was assessed among 99 participants (41 COVID-19 recovered and 58 non-COVID-19). Participants were administered the scale at two-time points after a gap of 7-12 days. Cronbach’s alpha, overall percentage agreement and kappa statistics were used to assess internal consistency and test–retest reliability. Results: Items in the scales were relevant and comprehensible. Both the scales had Cronbach’s ? above 0.6 indicating moderate-to-good internal consistency. Test–retest reliability assessed using kappa statistics indicated that for the COVID-19 Stigma Scale, seven items had a moderate agreement (0.4-0.6). For the Community COVID-19 Stigma Scale, four items had a moderate agreement. Interpretation & conclusions: Validity and reliability of the two stigma scales indicated that the scales were comprehensible and had moderate internal consistency. These scales could be used to assess COVID-19 stigma and help in the development of appropriate stigma reduction interventions for COVID-19 infected, and mitigation of stigmatizing attitudes in the community.

Community Knowledge, Attitude, Awareness and Protective Practices Regarding Malaria in Mewat and Rohtak Districts of Haryana, India.

Aim: Mosquito borne diseases especially malaria is a serious public health problem in the tropical and sub-tropical regions of the world especially the developing countries including India. Besides available key interventions to control the spread of vectors and vector borne diseases, there is a felt need for involving a suitable community approach based on knowledge, attitude, awareness, behaviour and protective practices to get the best results. Hence, the present study is an attempt to provide some inputs in this direction. Methodology: A community based cross-sectional survey was carried out in a highly malaria endemic cluster of six selected villages of Rohtak and Mewat region of Haryana to know the respondent knowledge about malaria and other mosquito-borne diseases, as much as their attitude, awareness and practices regarding the malaria and its control. The results obtained were processed and analyzed statistically by using STATA version 10 software. Results: The study revealed that about 52% of the respondents in Rohtak region and 42.68% in Mewat region committed that malaria is transmitted by mosquito bite which was directly correlated with the level of education. It was observed that high fever, chills and body pain were considered as the major signs/symptoms of malaria. Television followed by friends and relatives and health care provider’s acts as the major source of information about malaria and other mosquito borne diseases. Overall (76.2%) individuals from both study areas mentioned that malaria is a serious problem in their area but only 46.3% knew about various Government measures for the protection and treatment of malaria. Mosquito nets, mosquito coil and repellents were commonly used as protective practices by the respondents but the difference was not found significant except for mosquito net (P <0.05) in both the study areas. Conclusion: Promoting active community participation by improving current intervention strategies through information, education and communication regarding malaria and other mosquito-borne diseases may yield better results.

Estimating the Economic Burden of Malaria and Assessing Its Relationship with Socio-Economic Condition in Rohtak and Mewat Districts of Haryana, India.

Aim: Malaria continues to remain a serious public health problem and causes significant economic burden especially among the poor tribal and marginalised communities in the tropical and subtropical countries of the World. In view of the lack of information in respect of malaria and economic losses in Haryana, an attempt was made to assess the relationship between the occurrence of malaria and socio-economic conditions as well as to estimate the direct and indirect costs incurred due to malaria in Rohtak and Mewat districts of Haryana. Methodology: A community based cross-sectional survey was carried out in a highly malaria endemic cluster of six selected villages of Rohtak and Mewat region of Haryana, to estimate the economic burden in terms of direct and indirect costs of malaria. Results: The study revealed that on an average a household incurred a total cost of Rs.1835 (29.77 US$) in Rohtak district and Rs 2027 (32.91 US$) in Mewat district as direct and indirect cost per patient. It was estimated that direct costs due to malaria consumed 36-40% of annual income of poor households and 3-4% of high income households suggesting that the burden of malaria is significantly higher among poor households. Conclusion: The study revealed that malaria posses a significant economic burden on poor households both through out-of-pocket expenditure and man-days lost. To reduce the economic burden of malaria implementation of suitable intervention measures with focus on poor and marginalised along with better allocation of resources and health care facilities at the Government hospitals must be taken into consideration. It is also needed the intensification of IEC (Information, Education and Communication) campaigns regarding malaria to enhance awareness and solicit community participation.

Relationship between malaria and sociocultural aspects in villages along the river Mahi in central Gujarat.

The sociocultural practices of the people differ between communities and play an important role in malaria control operations. The present study was carried out with the aim to understand the association of malaria with sociocultural determinants in malaria prone riverine villages of Kheda district in central Gujarat. Blood smears of persons with fever or having history of fever were collected and examined under microscope for malarial parasite. A structured questionnaire was used to record age, sex, social groups, education, sleeping habits and other sociocultural aspects of each patient. Data obtained was pooled and analysed statistically by applying Chi-square test. A total of 1781 patients with fever were screened for malaria (slide positivity rate -14.8% and Plasmodium falciparum -53.9%). Sociocultural practices of 1650 cases among which 259 had malaria were analysed. There was variable degree of malaria in different groups. A significant relation was noticed between malaria and social groups, profession, economic status and personal protection of the respondents. Malaria incidence was relatively high in scheduled castes, dependents (mainly kids and old aged people), farmers and in low-income group. The treatment seeking behaviour of the people did not show significant association with malaria although 63.4% patients took treatment after three days of the onset of fever. These observations indicate significant relationship between malaria morbidity and sociocultural practices. The findings would be helpful in better planning and implementation of malaria control strategies in the study area.

Observations on anopheline breeding in relation to aquatic plants in different breeding habitats of Kheda (Gujarat).

Water bodies infested with aquatic vegetations may pose problems in mosquito control through bio-environmental methods. Paucity of information pertaining to association of mosquito breeding with aquatic vegetation was the basis for present investigation. The mosquito breeding sites infested with solitary/dominating plant community viz., Eichhornia crassipes, Ipomoea aquatica, Hydrilla verticillata, Nymphea neuchali, Trapa bispinosa, Lemna paucicostata, Trachelomonas spp., Azolla pinnata, Algae spp. and Cynodon dactylon were selected for the study. The investigation revealed that breeding of eleven anopheline species was associated with Eichhornia in different habitats followed by Hydrilla, algae and Cynodon (8 each), Ipomoea and Trapa (6), Lemna. and Nymphea (5), Azolla and Trachelomonas (4). An. subpictus was associated with all types of vegetation. An. annularis, An. nigerrimus and An. barbirostris were associated with nine plant species. An. culicifacies, the principal malaria vector was found breeding in association with seven aquatic plants and showed strong association with Cynodon, Hydrilla and algae. The species diversity in habitats infested with Hydrilla, algae and Cynodon seems to be most favourable for the breeding of An. culicifacies. It is suggested that thinning or removal of such vegetations at regular interval may help to reduce vector population and enhance the efficacy of biological control agents particularly the larvivorous fishes in such habitats.